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Many Type A personalities deal with problems by controlling all aspects of the problem. Sometimes this works. Sometimes it works for a while. Sometimes it doesn’t work at all. The health-care system—hospitals, clinics, and doctors’ offices—have policies (specific office hours and strict...
To the Last Drop
It was 2:15 PM, and my afternoon clinic had not yet begun. The morning had been particularly trying as a result of disastrous clinical developments for two of my long-standing patients. Jessica had metastatic breast cancer, and I had been taking care of her for 7 years. Multiple lines of...
The X-Ray Era 1901–1915
The text and photograph on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photo below is from the volume titled “The X-Ray Era: 1901–1915.” The photograph appears...
The Art of Networking: Advice for the Oncologist-in-Training
It was Friday night of the 2016 ASCO Annual Meeting in Chicago. I planned to meet a friend, another 2nd-year heme-onc fellow, at a “free drink thing,” as she called it. I sheepishly entered the hotel bar, made a nametag at the insistence of the greeter, and started edging my way through the crowd. ...
A Frank Memoir About Doctors, Patients, and the Health-Care System
“In 1981, 2 days after my older brother Matthew was born, my father sawed off the tip of his index finger.” So begins No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine, a memoir by Rachel Pearson, MD, who is currently a resident at Seattle Children’s Hospital. ...
Will the UK’s Departure From the EU Impact Oncology in Europe?
“No man is an island entire of itself; any man’s death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee.” —John Donne (1624) This statement is almost certainly true—and sadly in a negative way not just for the UK but for...
Expect Questions About Shift in Prostate Cancer Screening Recommendation
A draft recommendation from the U.S. Preventive Services Task Force (USPSTF) advises that for men aged 55 to 69, the decision to be screened for prostate cancer should be an individual one, based on the man’s own values and priorities and discussions with a clinician about the potential benefits...
USPSTF Emphasizes Importance of Informed Discussions About PSA Screening for Men Aged 55 to 69 Years
For a man aged 55 to 69 years, the decision to be screened for prostate cancer should be an individual one, based on the man’s own values and priorities and discussions with a clinician about the potential benefits and harms of screening, the U.S. Preventive Services Task Force (USPSTF) advised in ...
A Remembrance of H. Jean Khoury, MD
Winship Cancer Institute of Emory University (Winship) is mourning the loss of an esteemed colleague: H. Jean Khoury, MD, died on May 22 at the age of 50, after a year spent battling cancer. His many colleagues and friends remember him as an outstanding physician, researcher, and educator and a...
The Serendipitous Road to Drug Development
BOOKMARK Title: The Drug Hunters: The Improbable Quest to Discover New MedicinesAuthors: Donald R. Kirsch, PhD, and Ogi Ogas, PhDPublisher: Arcade PublishingPublication date: January 2017Price: $24.99, hardcover, 328 pages Only about 1 in 100 drug discovery projects initiated by the pharmaceutical ...
Special Awards and Lectures Presented During 2017 ASCO Annual Meeting
Recipients of ASCO’s Notable Awards and Lectures are individuals who have made extraordinary contributions to the research and treatment of patients with cancer. These individuals were honored during several special sessions held during ASCO’s 53rd Annual Meeting, where more than 30,000 physicians, ...
Pioneer in Geriatric Oncology, Hyman Muss, MD, Continues to Improve Care for Older Patients
Hyman Muss, MD, a pioneer in geriatric oncology, considers himself “a real Brooklyn boy.” His father was a dentist, and his uncle was a general practitioner. “They both practiced out of a small brownstone house in Brownsville-Crown Heights. It was sort of reminiscent of the famous movie The Last...
Distinguished Pediatric Oncologist Anna T. Meadows, MD, Led the Way for Studies in Childhood Cancer Survivors
Anna T. Meadows, MD, an internationally distinguished pediatric oncologist who led paradigm-changing survivorship research and clinical care of children with cancer, had an unusual introduction to the United States. “My mother was traveling abroad on vacation and got married in Poland. Although...
Nobel Laureate David Baltimore, PhD, Plays Integral Role in Linking Cell Biology and Cancer Genetics
David Baltimore, PhD, whose work profoundly influenced international science, was born on March 7, 1938, in Queens, New York, to Gertrude and Richard Baltimore. While he was in second grade, the family moved to Great Neck, New York, a middle-class suburb with top-notch public schools. “My father...
Renowned Hematologist Mojtaba Akhtari, MD, Reflects on a New Era in Treating Blood Cancers
The nationally recognized hematologist-oncologist Mojtaba Akhtari, MD, was born and reared in Tehran, Iran. “In my early years, I had a couple of cousins who were medical students. When I visited them in their homes, I was fascinated with the images in their medical text books. I would flip the...
Impact of Proposed Cuts to NIH Budget: More Than Just About Cancer
If enacted, the proposed budget reduction of $5.8 billion to the National Institutes of Health (NIH) will slow research, deprive patients afflicted with cancer of hope, and deliver a devastating blow to our science workforce and the Commonwealth of Pennsylvania. This proposed reduction directly...
The Role of Meditation in Cancer Care
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, present the case...
Cranberry
Scientific Name: Vaccinium macrocarpon Common Names: Mossberry, sassamanash, bounceberry Case Study M.C. is a 55-year-old woman with a history of stage I endometrial cancer, diagnosed and curatively treated 5 years ago. Since then, she has been having urinary tract infections from time to time....
An Oncology Care Model: One Institute’s Experience
At this year’s ASCO Quality Care Symposium, Blase N. Polite, MD, MPP, Associate Professor of Medicine at The University of Chicago Medical Center, examined his practice’s experience with the Oncology Care Model, a Centers for Medicare & Medicaid Services test payment and delivery program...
Conquer Cancer Foundation Honors 65 Young Oncology Professionals With Merit Awards
The Conquer Cancer Foundation of ASCO (CCF) is pleased to announce the recipients of its 2017 CCF Merit Awards in Gastrointestinal Cancers, Cancer Survivorship, Genitourinary Cancers, Immuno-Oncology, and Quality Care. The following 65 young researchers, recognized for the scientific merit of their ...
The Mystery of Grace
The day after I told Nell she had seven metastases to her brain, she sent me flowers. She was my patient; I was her oncologist. I had met her 1 year prior, when she was well into her cancer journey, stage IV breast cancer at diagnosis. I took over from her current oncologist, who was moving. At...
Soy
Scientific Name: Glycine max Common Names: Soybean, soya, tofu, miso, tempeh Overview An annual herb indigenous to East Asia, soy was domesticated more than 3,000 years ago for its pods and edible seeds. It is now the world’s most important legume crop and is grown in diverse climates. Foods...
Bright Future for Osimertinib in EGFR T790M–Positive Lung Cancer
The AURA3 study—reported by Mok and colleagues and reviewed in this issue of The ASCO Post—confirms the dramatic activity of osimertinib (Tagrisso) in patients with advanced epidermal growth factor receptor (EGFR)-mutant non–small cell lung cancer (NSCLC) and acquired resistance to prior EGFR...
On the Horizon: New Tools for Prostate Cancer
The field of prostate cancer is being energized by discoveries in genetics, novel imaging techniques, and the potential of checkpoint inhibitors in the treatment of prostate cancer. Not all of these advances are currently clinically actionable, but all have the potential to change clinical...
What Have We Got to Lose?
Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...
An Insider’s Account of the AIDS Epidemic
On June 5, 1981, the Centers for Disease Control and Prevention published a Morbidity and Mortality Weekly Report (MMWR) describing cases of a rare lung infection in five young gay men in Los Angeles. The men had other unusual infections as well, indicating their immune systems were compromised....
Addressing Discrimination and Bias in Medical Education
“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat) and been asked questions like, ‘Where are you really from?’ or ‘How old...
A Lesson From David
The following essay by Jeremy K. Hon, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. As physicians, ...
Women in Oncology: Breaking Down Barriers and Looking to the Future
There has been no better time than the present for women in the field of oncology: Women at all stages of their careers are finding more opportunities and avenues to excel. At the time of the last ASCO workforce survey, women made up 28.4% of the oncologist workforce, and that proportion is rising...
A Gleason 6 Tumor: Is It Cancer, and Should It Be Treated?
The diagnosis and treatment of prostate cancer have long been a source of controversy among the oncology community, the political sector, and patient advocacy groups. Most notably, the decision to biopsy a man’s prostate gland rests largely on his prostate-specific antigen (PSA) test numbers, the...
Pioneer in Cancer Immunology, Richmond T. Prehn, MD, Dies
Until 1957, the prevailing thought was that since cancers develop in normal patients, they are not recognized as foreign by the immune system. That changed when Richmond T. Prehn, MD, and his laboratory assistant, Joan Main, showed that tumors induced by chemical carcinogens in mice could...
NCCN Launches Campaign to Eradicate Fatal Vincristine Errors
It is uniformly fatal and impossible to undo. When the chemotherapy drug vincristine is placed in a syringe and injected intrathecally—into the spinal fluid—the patient always dies. And despite safety guidelines and labels, deaths continue to occur. Now the National Comprehensive Cancer Network®...
Dave, Dave, Dave
It was 1983, and I was in my third year as an attending physician at a major East Coast university medical center and just 5 years out of fellowship. As was common at the time, I saw and treated all malignancies except leukemia and gynecologic cancers. In the middle of a typically busy day at the ...
Fulminant, Fatal Myocarditis Reported in Two Patients After Starting Combined Immune Checkpoint Blockade Treatment
In an article in The New England Journal of Medicine, Johnson et al reported the occurrence of fulminant, fatal immune-related myocarditis in two patients who received combined ipilimumab (Yervoy) and nivolumab (Opdivo) for metastatic melanoma. Patient Courses One patient was a 65-year-old woman...
NCCN Challenges Medical Community to ‘Just Bag It’ to Eradicate Deadly Medical Error
As part of its mission to improve the quality, effectiveness, and efficiency of cancer care so that patients can live better lives, the National Comprehensive Cancer Network® (NCCN®) has announced the launch of Just Bag It: The NCCN Campaign for Safe Vincristine...
When Breath Becomes Air: Dr. Lucy Kalanithi Reflects on Dr. Paul Kalanithi’s Life and Writing
Perhaps more than any other book in recent memory, When Breath Becomes Air has struck a chord among readers, both inside the medical community and among the public, desiring an honest and philosophical consideration of death. The autobiographical account of Paul Kalanithi, MD, a physician diagnosed ...
A Space to Heal
We pass them every day on our way to the hospital, the street dwellers of our town in India. Their home consists of a plastic sheet suspended between four poles on the pavement. One day, two women sat under the plastic sheet in happy conversation. It had rained heavily the previous night, and I...
Friendship
Mr. C is almost 90 now, but every summer the boxes of squash, pumpkins, tomatoes, and other vegetables from his truck farm still arrive like clockwork at our door. The cancer that required treatment 17 years ago has never recurred. He’s now struggling with a new problem, recovering from a broken...
Susan G. Komen Announces $27 Million Initiative to Reduce Breast Cancer Deaths in African American Community
The Susan G. Komen breast cancer organization gathered philanthropic, civic, medical, and business leaders in Washington, DC, September 14 to formally launch a $27 million, 10-city initiative to reduce breast cancer death rates among African American women. “African American women are almost 40%...
Surgery and Radiation ProtecT Against Progression/Metastasis vs Active Monitoring in Prostate Cancer, but at What Cost?
The ProtecT trial showing similar 10-year survival with active monitoring, surgery, or radiotherapy for prostate-specific antigen (PSA)-detected localized prostate cancer but a greater risk of disease progression/metastasis with monitoring was recently reported by Hamdy and colleagues and is...
Risk of Metastasis With Active Monitoring in PSA-Detected Localized Prostate Cancer: The ProtectT Trial
The ProtecT study findings1 are provocative. Despite having a control arm of active monitoring with serial prostate-specific antigen (PSA) testing, as compared with watchful waiting in the prior randomized trials (ie, SPCG-42 and PIVOT3), and also enrolling men with more favorable-risk disease...
Saul J. Sharkis, PhD, Stem Cell Researcher, Dies
Saul J. Sharkis, PhD, a scientist who studied the biology of blood stem cells and how they could be used to treat cancer through bone marrow transplantation, died on September 4. He was 72. Dr. Sharkis was Professor of Oncology at the Johns Hopkins University School of Medicine and a faculty...
Nobel Laureate Roger Y. Tsien, PhD, Dies
In 2008, Roger Y. Tsien, PhD, shared the Nobel Prize in chemistry with Drs. Osamu Shimomura and Martin Chalfie for helping turn green fluorescent protein from a jellyfish into a research tool that could tag cancer cells or track the advance of Alzheimer’s disease. “Our work is often described as...
Oncologist’s Guilt
The best part of my day is hearing that little voice yell, “It’s Momma!” as my son rushes to greet me with a hug. It is humbling, and sometimes terrifying, to realize that I brought a little person into the world who is completely dependent on my husband and me for survival. Few would argue...
The Best Oncology Lesson
I was 2 months into my first-year fellowship at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, when I learned the best oncology lesson of my career. I owned a copy of DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology and had read Cancer Treatment...
Is Human Life Worth No More Than a Text Message?
The words “cost control,” “value-based health care,” and similar iterations are floating around freely these days to make us aware of the unsustainable upward trajectory of health-care costs. We are reminded constantly about how health care in America currently costs more than $3.4 trillion...
Chamomile
Scientific Name: Matricaria recutita, Chamomilla recutita, Matricaria chamomilla Common Names: Hungarian chamomile, wild chamomile Overview An aromatic annual herb prevalent in Europe, North Africa, and Northwest Asia, chamomile has been used as a medicinal plant for several centuries. It has been ...
Internationally Renowned Geneticist, Alfred George Knudson, MD, PhD, Dies
Considered a visionary in cancer research, Alfred George Knudson, MD, PhD, was internationally recognized for his “two-hit theory” of cancer causation, which explained the relationship between hereditary and nonhereditary cancer types, predicting the existence of tumor suppressor genes. Dr. Knudson ...
Measures of Success
I was raised to be an engineer. I grew up in an industrial community, worked summer jobs in a U.S. Steel chemical plant, and was good at science and math. My career choice was straightforward: I went to an engineering university. My first semester freshman year included a mandatory introduction...
Moonshots and ‘Onco-nauts’
Where were you on July 20, 1969? I certainly remember where I was—sitting in a mess hall at summer camp watching a grainy black-and-white TV as Neil Armstrong took “one small step for man, one giant leap for mankind.” I recall the sense of jubilation and accomplishment that all American citizens...
