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issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

symptom management

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

Family Archivist Holds Joyful Memories Amid Grief of Losing Loved Ones

BOOKMARK Title: The Trail to Tincup: Love Stories at Life’s EndEditors: Joyce Lynnette HockerPublisher: She Writes PressPublication date: May 2018Price: $23.95, hardcover, 288 pages Human mortality is embedded in the day-to-day challenges of clinical oncology; a cancer diagnosis is a reality...

supportive care
integrative oncology

Acupuncture for Joint Symptoms Caused by Aromatase Inhibitors

Arthralgia is a common and debilitating adverse effect experienced by patients with breast cancer who are being treated with aromatase inhibitors, often resulting in poor adherence. And premature treatment discontinuation can negatively impact disease-free and overall breast cancer survival....

Never a Doubt About a Career in Medicine for Anne S. Tsao, MD

There was no epiphany or family influences, as long as she can remember; Anne S. Tsao, MD, always wanted to be a doctor or, because of her love for caring for sick animals, a veterinarian. Dr. Tsao was born in Fountain Creek, Pennsylvania, but her parents moved to a suburb just outside of Chicago...

issues in oncology

Cancer Care in the U.S. Prison System

A health-care system is evaluated by various metrics: one is how it cares for its most vulnerable patients. The United States spends far more on health care than any nation in the world, yet access to high-quality oncology services remains elusive to certain minority populations—none more so than...

issues in oncology
cost of care

Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More

Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...

ASH Honors John E. Dick, PhD, and Reed E. Drews, MD, With 2018 Mentor Award

The American Society of Hematology (ASH) will recognize John E. Dick, PhD, of the University of Toronto, Princess Margaret Cancer Center, and Ontario Institute for Cancer Research in Toronto, and Reed E. Drews, MD, of Beth Israel Deaconess Medical Center in Boston, with the 2018 Mentor Award for...

solid tumors
breast cancer

The Persephone Trial Reconsidered

Persephone is a 4,088-patient trial that Helena Margaret Earl, MBBS, PhD, reported at the 2018 ASCO Annual Meeting as establishing that 6 months of trastuzumab (Herceptin) is not inferior to 12 months in 4-year survival without invasive or local regional recurrence or distant metastases. Dr. Earl...

solid tumors
breast cancer

The Persephone Trial Reconsidered

The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...

issues in oncology
health-care policy

Health-Policy Forum Focuses on New Care-Delivery Paradigms

What was an MBA doing at the podium of a clinical oncology meeting? Ten years ago or so, that might have been surprising. But in an era of rapid change—in therapies, costs, payment models, and practice—it only makes sense. Amy Porter-Tacoronte, MBA, Health System Chief Administrative Officer at the ...

issues in oncology

The COLORS Training: Online LGBT Cultural Competency for Oncologists

An interactive online LGBT cultural competency training program for oncologists may be acceptable and feasible—and may improve LGBT-related knowledge and clinical practices, according to preliminary results of a pilot study of oncologists in Florida presented by Schlumbrecht et al at...

solid tumors

2018 ASTRO: SABR-COMET: Stereotactic Ablative Radiation Therapy for Oligometastatic Tumors

In the first randomized, phase II clinical trial of its kind, researchers have shown that an aggressive form of high-precision radiation therapy can increase survival in patients with oligometastatic tumors. These findings were presented by Palma et al in the plenary session at the 60th Annual ...

head and neck cancer

2018 ASTRO: Liquid Biopsy in HPV-Associated Oral Cancer Surveillance

A highly sensitive blood test that detects minute traces of cancer-specific DNA has been shown to accurately determine whether patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) are free from cancer following radiation therapy. Findings were presented by...

Many Patients With Early-Stage Follicular Lymphoma May Not Receive Guideline-Recommended Radiation Therapy

Radiation therapy for early-stage follicular lymphoma “is underused,” Joanna C. Yang, MD, MPH, and Joachim Yahalom, MD, declared in a recent editorial in the Journal of Clinical Oncology.1 This underuse of radiation therapy can result in overtreatment with systemic therapies or overconfidence in...

Exercise Therapy for Symptom Management and Treatment in Patients With Cancer

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Although physical activity is associated with many positive outcomes in the general population,...

Humbled by Challenges, Renowned Hematologist Kanti R. Rai, MD, Recalls a Rich Career

For this installment of the Living a Full Life series, guest editor, Jame Abraham, MD, interviewed Kanti R. Rai, MD, Professor of Medicine at the Karches Center for Oncology Research, Feinstein Institute for Medical Research, Manhasset; Professor of Medicine at Zucker School of Medicine at...

Has the Promise of Precision Medicine Been Oversold?

Recently, the term “personalized medicine” in oncology care has been overtaken by the more contemporary concept of “precision medicine.” According to the National Research Council of the National Academies of Science, Engineering, and Medicine, the newer terminology shifts the focus to improving...

Overcoming Long-Term Health and Economic Impact of Cancer on Young Adult Survivors

A pair of studies showcased the potentially devastating long-term health and financial consequences cancer has on adult survivors of childhood cancer compared with other adults, as well as survival disparities based on health insurance status.1,2 Despite increasing survival rates among the more...

solid tumors
head and neck cancer

The Sontag Foundation: Turning a Difficult Diagnosis Into Action to Benefit Patients With Brain Cancer

When Frederick B. Sontag’s wife, Susan, was diagnosed in 1994 with grade III astrocytoma, the couple was understandably overwhelmed to hear that her expected survival was 3 years. At that time, there were few organizations providing resources to patients with brain tumors and their families. While...

issues in oncology

Cancer Policy Priorities Highlighted During 2018 ASCO Advocacy Summit

More than 100 ASCO volunteers from across the country came to Capitol Hill on September 25–26 for the 2018 ASCO Advocacy Summit, where they urged Congress to act on major policy priorities to support cancer research and ensure access to high-quality care for the millions of people in the United...

issues in oncology

Quality Improvement: Worth the Effort but Not Always Easy to Execute

According to Kaveh Shojania, MD, the keynote speaker at the 2018 ASCO Quality Care Symposium, dedicated quality improvement work can help repair a fragmented health-care delivery system, but it’s challenging, and there are multiple things that can go wrong during the process.1 “I’ve developed this ...

supportive care
pain management

The Opioid Crisis From the Oncology Perspective

As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...

immunotherapy

Assay Uses Big Data to Predict Responses to Immunotherapy

In the age of big data, cancer researchers are discovering new ways to monitor the effectiveness of immunotherapy treatments. Researchers at the Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy developed a new way to use bioinformatics as a gathering tool to determine how a...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

issues in oncology
genomics/genetics

Next-Generation Sequencing: New Technology That Requires Further Thought

Next-generation sequencing is used with increasing frequency to provide essential information about a patient’s diagnosis and treatment. In recent months, the U.S. Food and Drug Administration (FDA) has approved several new next-generation sequencing diagnostic tools, and the Centers for Medicare...

lung cancer

NELSON Trial: ‘Call to Action’ for Lung Cancer CT Screening of High-Risk Individuals

Results of the very large, randomized, population-based NELSON trial confirm the value of low-dose computed tomography (CT) screening in people at high risk for developing lung cancer. The protective value of screening was more pronounced in women than in men. These study findings were presented at ...

Expert Point of View: Everett Vokes, MD

“PACIFIC is a positive trial, with a 32% improvement in survival, and maintenance durvalumab is a new standard of care,” stated formal discussant Everett Vokes, MD, Chair of the Department of Medicine at the University of Chicago and a pioneer in the concurrent use of chemotherapy and radiotherapy ...

issues in oncology
global cancer care

Cancer Care in the Palestinian Territories

The global burden of cancer is huge and growing. In 2018, there will be > 18 million new cancer cases and 9.6 million deaths.1,2 Although several recent articles have reviewed cancer in developing countries, few have focused on the Palestinian territories. There are several reasons for that,...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

lung cancer

Atezolizumab Plus Standard Chemotherapy Improves Progression-Free Survival in Stage IV NSCLC

The combination of atezolizumab (Tecentriq), a programmed cell death ligand 1 (PD-L1) inhibitor, plus carboplatin or cisplatin and pemetrexed (Alimta) as first-line therapy followed by pemetrexed plus atezolizumab maintenance therapy improved progression-free survival in patients with stage IV...

issues in oncology
gastroesophageal cancer
symptom management

ESMO 2018: Pooled Analysis of Influence of Sex on Chemotherapy Efficacy and Toxicity in Esophagogastric Cancer

In an analysis presented by Davidson et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract 619PD_PR), data were pooled from four UK randomized controlled clinical trials of first-line chemotherapy in esophagogastric cancer, finding significant differences in a...

breast cancer

ESMO 2018: About 1 in 6 Premenopausal Patients With Early Breast Cancer Do Not Adhere to Adjuvant Endocrine Therapy

Nearly 1 in 6 premenopausal women being treated for early-stage breast cancer do not adhere adequately to tamoxifen therapy after 1 year of treatment, potentially putting themselves at increased risk of recurrence and reduced survival, reported a French prospective study at the European Society for ...

breast cancer

ESMO 2018: Patients With Breast Cancer Use Twitter as a Nonmedical Forum to Share Experiences

Twitter is a place where many patients with cancer go to share and discuss their experiences of the disease, according to a recent exploratory study to be presented by Sánchez-Bayona et al at the European Society for Medical Oncology (ESMO) 2018 Congress (360P_PR). The...

A Pathologic Fascination With Humanity

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

breast cancer

Living a Purposeful Life Is My Revenge on Cancer

There is a lot of breast cancer in my family history. My mother was diagnosed with the disease at 44, and my paternal grandmother died of breast cancer when she was just 33, so I’ve always been diligent about performing breast self-exams— often weekly—to ensure that if I did get breast cancer, it...

Learning to Listen and Returning to the Art of Medicine

Bernard Lown, MD, was born in Lithuania, the son of a rabbi. He immigrated to the United States at the age of 14, where his scientific precocity bloomed. After attaining his medical degree from John Hopkins University School of Medicine, he pursued his passion of raising international awareness of...

On Aging and the Wellness Industry

Only a few centuries ago, the major source of moral and scientific authority in Western culture was religion, which requires trusting one of numerous supernatural deities. However, the presumption that medicine is based on evidence-based and peer-reviewed science is what gives it authority in...

survivorship

Getting Their Lives Back: Helping Survivors of Cancer to Move Forward

Thirteen years ago, Stephanie Koraleski, PhD, an oncology psychologist, and Kay Ryan, PhD, RN, a cardiac nurse and breast cancer survivor, in Omaha, brought together colleagues in the fields of clinical research, nursing, nutrition, mental health, physical therapy, pharmacy, and spirituality to...

issues in oncology
palliative care

Closing the Gender Divide in Preference for Palliative Care

Eight years ago, a survey of the preferences of Dutch patients with cancer for health care found that while gender was one aspect influencing how men and women approach cancer care, it was the most important, with men, generally, regarding most care aspects as less important than women. The study...

solid tumors
issues in oncology

New Techniques in Intraoperative-Guided Imagery May Enhance Outcomes in Patients With Cancer

Primary treatment of most solid tumors includes surgical excision or radiation therapy, both of which require precise anatomic localization of the tumor as well as surrounding tissue and organs. If the targeting is too broad, unnecessary morbidity may occur to nearby structures, along with the...

prostate cancer
issues in oncology

PCF Releases First National Report on Public Perception of Prostate Cancer in the United States

The Prostate Cancer Foundation (PCF) recently released the results of its first national public awareness report about risks, actions, and attitudes toward prostate cancer in the PCF 3P Report 2018: Public Perception of Prostate Cancer. Each year, even though more than three million men in...

head and neck cancer
immunotherapy

DNA Vaccine Leads to Immune Responses in HPV-Related Head and Neck Cancer in Small Study

A therapeutic vaccine may boost antibodies and T cells, helping them infiltrate human papillomavirus (HPV)-related head and neck cancer tumors. Researchers from the Abramson Cancer Center of the University of Pennsylvania tested the immunotherapy approach in two groups of patients with...

Updated ASCO Answers Fact Sheets for Your Practice

Be sure to check out these newly updated ASCO Answers fact sheets: Chronic Lymphocytic Leukemia Lung Cancer Melanoma Multiple Myeloma Pancreatic Cancer Prostate Cancer Thrombocytopenia When Cancer Spreads to the Bone These one-page (front and back) introductions include a topic overview; an...

Cancer.Net: Trusted Information for Patients and Caregivers, Useful Tools for Providers

Cancer.Net is ASCO’s patient information website, hosting a wealth of information and resources for people diagnosed with cancer and their families and caregivers. With information on over 120 types of cancer, visitors to the site can find medical information, tips for treatment management,...

hematologic malignancies
multiple myeloma

Emerging Options and Sequencing Therapy in Relapsed Multiple Myeloma

Advances in the treatment of multiple myeloma have led to longer progression-free survival, but the majority of patients will still relapse despite newer treatments. A number of new drugs and combinations are under study in the hope of improving outcomes. “Multiple myeloma is a complex disease...

lung cancer
pain management

Study Shows Invasive Lung Cancer Surgery Can Lead to Long-Term Opioid Use

Patients treated with more invasive surgical techniques for early-stage non–small cell lung cancer (NSCLC) are more likely to become chronic opioid users than patients treated with minimally invasive surgery, highlighting the need for additional research into how pain management after surgery ...

breast cancer

More to Learn About Using PARP Inhibitors for Advanced Breast Cancer With Germline BRCA Mutation

Germline mutations in the breast cancer–susceptibility genes 1 and 2 (BRCA1/2) increase the risk for cancer due to an inability to repair DNA double-strand breaks, and about 5% of patients with unselected breast cancer carry a germline BRCA mutation.1 These DNA repair–deficient tumors are...

hematologic malignancies
leukemia

Beat AML Trial Seeking to Change Treatment Paradigm

The Beat AML Master Clinical Trial seeks to change the treatment paradigm and outcomes in acute myeloid leukemia (AML) by personalizing therapy and ultimately facilitating the approval of novel targeted agents. Co-investigator William Blum, MD, of the Winship Cancer Institute at the Emory...

issues in oncology

Wear That White Coat—With Pride

These days it can be hard for physicians. Many in the physician workforce wonder whatever happened to the ideals and expectations that drew them to this noble profession. The genuine passion to heal the sick and infirm and in turn improve the health of the entire society The ability to touch human ...

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