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Showing 2901 - 2950Delivering Affordable Cancer Care: Is It Possible and What Will It Entail?
Many experts agree that at 18% of gross domestic product, health care (to paraphrase Shakespeare) is eating the country out of house and home. “The average cost of treating the most common cancers has increased, and as more expensive targeted therapies and other new technologies become the...
Options Shifting for First-line Treatment of Renal Cell Carcinoma
Trials with pazopanib (Votrient) have “provided significant efficacy, toxicity, and tolerability data for pazopanib to be established as a first-line standard of care” for renal cell carcinoma,” Tim Eisen, PhD, of the University of Cambridge, United Kingdom, stated at the 11th International Kidney...
SIDEBAR: Mammography Study Stokes Overdiagnosis Debate
Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...
Defining and Recognizing the Causes of Imatinib Resistance and the Importance of Adherence
Imatinib (Gleevec) is a highly effective therapy for the majority of patients with chronic myeloid leukemia (CML). In the IRIS study, only 30% of patients could be considered to have failed imatinib treatment after 6 years.1 However, these 30% of patients are a substantial minority. John Goldman,...
Promoting a More Balanced Approach to Cancer Prevention and Treatment
Margaret I. Cuomo, MD, is a board-certified radiologist who served for many years as an attending physician in diagnostic radiology at North Shore University Hospital, Manhasset, New York. Dr. Cuomo is the daughter of former New York Governor Mario Cuomo and sister to Governor Andrew Cuomo. She is...
Dr. Jimmie C. Holland’s Research Has Long Underscored the Importance of Caring for the Whole Patient
Although internationally recognized today as the founder of the subspeciality of psycho-oncology, the field of psychiatry held no interest for Jimmie C. Holland, MD, when she entered Baylor College of Medicine in Houston, Texas, in the mid-1940s. Born in 1928 at the dawn of the Great Depression,...
The Language of Cancer
I am a member of ASCO and read with interest your piece entitled “The Language of Cancer” in the October 15, 2012, issue of The ASCO Post. By way of introduction, I am an attending physician specializing in urologic oncology at Loyola University Medical Center. My group recently published an...
Health-care Crisis Reconsidered
As an oncologist in private practice, I usually read with great interest the many articles in The ASCO Post on issues regarding the politics of oncology practice. These articles deal with the major topics of the day, ranging from the high cost of oncologic care to shortages of generic drugs, to...
Ambitious Call to Arms Seeks a Shift in Priorities to Eradicate Cancer
It has been more than 4 decades since our nation loaded its medical cannons and declared war on cancer, self-assured that money and American scientific resolve would lead to victory. But cancer has proved to be a humbling enemy. The war is now fought in targeted skirmishes; the weaponry is a...
The Ethics of Rationing Cancer Care
Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...
Oral Rinse Doxepin Relieves Painful Mucositis in Head and Neck Cancer
Doxepin oral rinse significantly improved oral mucositis in patients treated with radiation therapy for head and neck cancer according to results of a phase III trial presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Boston. However, the improvement was...
What Combinations Should Be Tested?
If the therapy combinations tested in the BeST trial don’t deserve to move on to phase III trials, what other combinations do show enough promise against renal cell carcinoma to merit being tested in phase III trials? “None at the present time,” maintained Bernard Escudier, MD, of the Institut...
Combination Therapy Not Better than Single-agent Bevacizumab for Advanced Renal Cell Carcinoma in BeST Trial
None of three combination therapies tested among patients with advanced renal cell carcinoma in the BeST trial came close to achieving the primary objective of a 67% improvement in median progression-free survival compared to single-agent bevacizumab (Avastin), Keith T. Flaherty, MD, reported at...
ASTRO Names Neurosurgeon Mark P. Carol, MD, 2012 Honorary Member
The American Society for Radiation Oncology (ASTRO) has named Mark P. Carol, MD, a distinguished leader in the fields of intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT), as its 2012 Honorary Member. The title of Honorary Member is the highest honor ASTRO...
I’m Not the Same Person I Was before Cancer
It’s not clear to me—and my doctors can’t say with any certainty—whether taking birth control pills for many years had anything to do with my getting breast cancer 3 years ago, at age 44. But the cancer growing in my left breast was diagnosed as stage I, estrogen receptor–positive. Although I never ...
The Rise of the Vintage Readers Book Club
Providing care beyond medical treatment, the multidisciplinary field of psychosocial oncology addresses the psychological, social, and emotional health of the patient with cancer. On an occasional basis, The ASCO Post will explore the realm of psychosocial oncology with a column guest edited by...
Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven
That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman,...
NCI Director Assesses Barriers to Faster Progress in Cancer Research
At a National Press Club media event in Washington, DC, on September 25, 2012, National Cancer Institute (NCI) Director Harold E. Varmus, MD, addressed a group of 75 reporters and officials. His discussion focused on impediments—biologic, economic, institutional, and cultural—to faster cancer...
Never a Dull Moment: A Day in the Life of an Oncology Fellow
Oncology fellows represent the future of cancer care, bringing the best and brightest young doctors into a rigorous training environment that molds their future career paths. Due to an impending workforce shortage in cancer care, the public health-care demands placed on today’s oncology fellows...
Teens and Young Adults with Cancer Want a Voice in End-of-life Care
A top the list of concerns of adolescents and young adults with a life-threatening cancer are these two considerations: being able to choose the kind of medical treatment they want (or do not want) and expressing their wishes to family and friends about how they want to be remembered, according to...
Lumpectomy Rates Inconsistent with Response Rates in Early Breast Cancer
Achieving a pathologic complete response to neoadjuvant chemotherapy does not always reduce the aggressiveness of breast cancer surgery, according to an analysis of the NeoALLTO trial presented at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna.1 Carmen Criscitiello, MD, of ...
Online Prostate Cancer Information Is Written at Reading Levels above Many Americans’ Literacy Skills
Although 61% of Americans are going online to access health information,1 many of them may not understand what they find there, including information about prostate cancer treatment options. According to a new study published in The Journal of Urology,2 as many as 90 million Americans have literacy ...
ASCO Top Five List Highlighted in IOM Workshop
As part of the Institute of Medicine’s (IOM) National Cancer Policy Forum workshop on delivering affordable cancer care in the 21st century, ASCO’s Top Five list was highlighted as an example of a way to improve quality of care for patients while reducing unnecessary costs. Lowell Schnipper, MD,...
Elekta Receives FDA 510(k) Clearance for Clarity 4D Monitoring
Elekta has received 510(k) clearance from the FDA for its Clarity 4D Monitoring software, enabling U.S. medical centers to implement a new way of reducing the uncertainty caused by prostate motion during radiation treatment. Physicians will be able to monitor the motion of the prostate and...
Developing Cancer Care Pathways for the New Environment
As community practices and the insurance industry seek cost-effective ways to adapt to the Patient Protection and Affordable Care Act, the evolving concept of cancer care pathways is emerging as a strategy that may help control oncology costs and add value to care. At ASCO’s recent Quality Care...
ASCO’s Approach to Health Information Technology and the Rapid-learning System
The slow, but inevitable evolution of electronic oncology health-care systems has already, at least conceptually, moved to the next generation of machines that not only store and process data, but also have the ability to provide real-time clinical decision support. At ASCO’s first Quality Care...
National Comprehensive Cancer Network Appoints New CEO
The National Comprehensive Cancer Network (NCCN) recently appointed nationally regarded breast cancer expert Robert W. Carlson, MD, as its new CEO. Previously, Dr. Carlson was Professor of Medicine in the Division of Oncology and Medical Informatics, Stanford University Medical Center; he first...
Does Health-care Quality Translate to Value?
On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first...
E-mail Reminders to Providers May Improve Documentation of Code Status in Patients with Advanced Disease
E-mail reminders to providers at the start of each new chemotherapy regimen may improve the rate and timing of code status documentation for patients with advanced lung cancer, according to a study in the Journal of Clinical Oncology. Jennifer S. Temel, MD, and colleagues from Massachusetts General ...
Social Media Is Helping My Brother Fight Kidney Cancer
My brother, Rick Thomas, is a great guy. I’m not just saying that because he’s my brother. He’s funny, warm, and kind to everyone he meets. He became a commercial airline pilot for American Airlines after flying C-5s in the Air Force for 12 years and has always been a responsible person and a...
Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer
Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients...
Cost of Cancer Drugs: What Price for What Benefit?
In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...
Important Messages about Palliative Care and Hospice at the Heart of New End-of-life Memoir
The illness memoir’s appeal proves enduring in a very crowded genre, perhaps because illness is a tie that binds us all. As Susan Sontag wrote in her classic work, Illness as a Metaphor, “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in...
A Look at the Patient Navigator Program in Breast Cancer
In 1990, Harold P. Freeman, MD, established the nation’s first patient navigation program at Harlem Hospital Center in New York (see accompanying article here). Since then, Dr. Freeman’s vision has gained national attention and is currently being looked at in a demonstration project across multiple ...
The Doctor Who Championed Patient Navigation in Harlem
After completing his residency at Memorial Sloan-Kettering Cancer Center, Harold P. Freeman, MD, arrived at Harlem Hospital Center in 1967, where the overwhelming majority of his patients presented with late-stage disease. That early experience with underserved patients would shape his career as...
As Computers Learn to 'Talk' to Each Other, Patient Care Will Improve
Last fall, Edward P. Ambinder, MD, Clinical Professor of Medicine, Hematology, and Medical Oncology at the Icahn School of Medicine at Mount Sinai in New York, and a member of ASCO’s Health Information Technology Work Group, spoke about “The Information Age: Cyberspace and Cancer,” at the...
International Members Cite Networking, Enhanced Patient Care Among Benefits of ASCO Membership
Thanks to the membership category ASCO designed for physicians in developing countries, Brazilian oncologist Milena Mak, MD, can greatly enhance the care she delivers in the very busy 580-bed Instituto do Cancer do Estado de Sao Paulo. And radiation oncologist Pooja Nandwani Patel, MD, can use the...
Expert Point of View: Michel Ducreux, MD, PhD
Michel Ducreux, MD, PhD, of the Institut Gustave Roussy in Villejuif, France, discussed the findings at the ESMO meeting. He said that TH-302 represents a “new drug and new concept, the microenvironment.” He noted, “Pancreatic cancers are frequently hypovascularized, at least the primary tumor, and ...
Integration across the Spectrum: Community Perspective on the Medical Oncology Home Model
The term “patient-centered cancer care” has become ingrained in today’s health-care vernacular. However, no matter what modifications occur in clinical oncology practice, the terms value and cost-effectiveness are now a solid part of the equation. At ASCO’s Quality Care Symposium, Linda D....
Expert Point of View: Philip Agop Philip, MD and Alan P. Venook, MD
Philip Agop Philip, MD, Head of the Multidisciplinary Team for Gastrointestinal and Neuroendocrine Oncology and Neuroendocrine at Karmanos Cancer Institute at Wayne State University, Detroit, was the formal discussant of the paper at the Gastrointestinal Cancers Symposium. He said the positive...
Make a Lasting Difference: Choose the Giving Option that Works for You
If you are like the many supporters of the Conquer Cancer Foundation, you may have reached a point where you would welcome the opportunity to influence not only the future ownership of your possessions, but the meaning that others assign to your life. One way to accomplish this is by considering...
Oncology Career Fair at ASCO Annual Meeting
The 13th Annual Oncology Career Fair at the 2013 ASCO Annual Meeting offers a convenient way for attendees to learn more about employment opportunities available in the rapidly developing oncology profession. In addition, the Career Opportunities and Other Medical Meetings posting boards, located...
Expert Point of View: Axel Grothey, MD and Eric Van Cutsem, MD, PhD
Two gastrointestinal cancer experts commented on the findings in interviews with The ASCO Post. Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, noted, “The PEAK and SPIRITT trial were decently designed, decently powered randomized phase II trials, and the results...
Study Finds Young Cancer Survivors Often Skip Checkups
Athough the majority of the more than 69,000 adolescents and young adults (AYAs) diagnosed with cancer each year will survive their disease, many of them will experience interruptions in their education and a derailment in their career tract, curtailing their lifetime earning potential and reducing ...
Patients with Cancer Need to Know That It Is Never Too Late to Quit Smoking
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Patients with head and neck or lung...
My Life Will Never Be Normal
After being diagnosed with stage II invasive ductal carcinoma in my right breast in 2004, I did an Internet search to learn more about my treatment options so I could be prepared when I met with my oncologist to discuss my treatment plan. I was especially interested in therapies that would be...
Focus on the Medical Oncology Association of Southern California
For more than 2 decades, the guiding principle of the Medical Oncology Association of Southern California (MOASC) has been to ensure the continuation of the private practice of medical oncology and to provide the highest quality care to cancer patients. Founded in 1990, MOASC is the largest...
Enhanced Electronic Module Aims to Prevent Errors in Oral Chemotherapy Prescribing
An oral chemotherapy prescription-writing module grafted to a shared electronic medical record is part of a series of quality improvement efforts undertaken at Dana-Farber Cancer Institute in Boston to prevent errors in prescribing oral chemotherapy agents. While oncologists have readily accepted...
Preparing for the Next Superstorm: Protecting Patients during Natural Disasters
When Hurricane Sandy slammed into the East Coast last October, the magnitude of devastation it left in its wake exceeded even the most dire predictions. Eighty mile per hour winds and record storm surges destroyed antiquated electrical grids and flooded subway stations, leaving much of New York...
SIDEBAR: Value-based Effective Care
The study by Chen and colleagues addresses the extremely important topic of the use and delivery schedule for radiotherapy in palliation for patients with metastatic lung cancer. The number of patients who will be considered candidates for such therapy in the United States and around the world each ...
