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integrative oncology

‘New Science, New Solutions’ Explored at Society for Integrative Oncology Conference

“Innovating Integrative Oncology: New Science, New Solutions” was the title of the Society for Integrative Oncology (SIO) Eighth International Conference. Topics ranged from molecular biology to mitigation of treatment toxicity to mind-body medicine. A total of 505 people attended the conference,...

colorectal cancer

Further Individualizing Staging Offers Benefits in Patients with Colon Cancer

Supplementing the American Joint Committee on Cancer (AJCC) TNM classification system with additional information available from tumor registries can assist in personalizing treatment and follow-up care for patients with colon cancer, according to a collaborative study by investigators at Memorial...

thyroid cancer

Vandetanib Demonstrates Therapeutic Efficacy in Patients with Advanced Medullary Thyroid Cancer

A phase III trial among patients with locally advanced or metastatic medullary thyroid cancer met its primary objective of progression-free survival prolongation among patients receiving vandetanib compared to placebo. The secondary efficacy endpoints of objective response rate, disease control...

lung cancer

High EGFR Expression Can Predict Survival Benefit from Cetuximab plus First-line Chemotherapy in NSCLC

High expression of epidermal growth factor receptor (EGFR) can predict survival benefit from cetuximab (Erbitux) added to first-line chemotherapy in patients with advanced non–small cell lung cancer (NSCLC). The identification of high EGFR expression as a tumor biomarker follows findings from the...

prostate cancer

Risk of Sexual and Continence Problems No Lower with Robotic than with Open Surgery

Although robotic-assisted laparoscopic radical prostatectomy “is eclipsing open radical prostatectomy among men with clinically localized prostate cancer,” the risks of problems with sexual functioning and continence are no lower with robotic than open surgery, according to a study in the Journal...

SIDEBAR: Expect Questions from Your Patients

When patients and family members have concerns about depression, they often bring them up with the staff, not with the treating oncologist. “I think that people with cancer don’t want to distract their medical oncologist or their surgeon by talking about their mood,” Dr. Massie noted. “Some people ...

supportive care

Depression Is Dangerous among Patients with Cancer, but Talking and Pharmacologic Treatments Can Be Effective

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. “Depression is a very dangerous...

breast cancer

Partial Breast Irradiation with Brachytherapy in Early Breast Cancer: Retrospective Analysis Looks at Trends and Guidelines

Accelerated partial breast irradiation using brachytherapy (APBIb) as an alternative to whole-breast irradiation (WBI) after breast-conserving surgery has been rapidly adopted in the United States, but the majority of patients receiving APBIb may not be considered suitable for it. A retrospective...

hepatobiliary cancer

Laparoscopic Liver Resections Can Be Safe and Oncologically Efficient

Laparoscopic resection of primary and metastatic liver cancers can be safe and oncologically efficient and reduce postoperative length of stay, a single-center study from the United Kingdom found.1 The investigators cautioned, however, that “adequate patient selection and extensive experience in...

skin cancer

Cancer Survivors at Greater Risk for Cutaneous Melanoma

Patients with a previously diagnosed cancer have an increased risk of developing cutaneous melanoma, with the highest risk among patients who have had a prior diagnosis of melanoma, according to a report published in the Archives of Dermatology.1 Key Findings Using Surveillance, Epidemiology, and...

SIDEBAR: Expect Questions from Your Patients

The possibility of reexcision after breast-conservation surgery should be discussed with patients before the initial surgery, advised Laurence E. McCahill, MD, lead investigator of the JAMA study on reexcision following breast-conservation surgery, which showed wide variability in reexcision...

breast cancer

Reexcision Rates Following Breast-conservation Surgery Vary Widely

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. Reexcision rates for women with...

SIDEBAR: Should ‘AYA’ Be an Oncology Subspecialty?

The lag in improvement in survival rates for adolescents and young adults (AYAs) with cancer and a greater awareness of the unique issues they face has prompted discussion about whether “AYA” should become a new oncology subspecialty.1 “Yes and no,” according to Archie Bleyer, MD. “I am going to...

SIDEBAR: Expect and Ask Questions about Sex and Fertility Preservation

What most concerns the adolescent and young adult population? “If they are worried about anything, it is sex and having families,” according to Archie Bleyer, MD. Years ago, he said, “oncologists were so worried about just getting them in remission, treating their cancers, and getting them to...

issues in oncology

Adolescents and Young Adults with Cancer: A Distinct Population of Patients Who Need to Be Treated Differently

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. Cancer among adolescents and young...

integrative oncology

Some Patients Using Complementary and Alternative Therapies May Be Receiving ‘Parallel’ Rather Than Integrative Care

Most patients with cancer receiving complementary and alternative medicine do so not as part of integrative care, but rather as “parallel care,” according to Lynda Balneaves, RN, PhD, Associate Professor, University of British Columbia, School of Nursing in Vancouver. Dr. Balneaves is lead...

colorectal cancer

Adjuvant Therapy for Stage III Colon Cancer: Survival Advantage of Oxaliplatin Reported in Clinical Trials Extends to Diverse Group of Patients

The survival advantage conferred by adding oxaliplatin to adjuvant chemotherapy with fluorouracil (5-FU) in stage III colon cancer, as previously shown in patients in randomized controlled trials, extends to patients in the general population, including older and minority group patients and those...

Expect and Encourage Questions from Your Patients

The oncologist has an important role in advising patients about infertility as a potential risk of cancer treatment and answering basic questions about fertility preservation options, according to the ASCO Recommendations on Fertility Preservation in People Treated for Cancer. An ASCO slide set...

issues in oncology

Options for Preserving Fertility Should Be Considered Early to Maximize the Likelihood of Success

Most cancer survivors prefer to have biologic offspring despite concerns about the possible effects of cancer treatment on the child, the child’s lifetime cancer risk, or their own longevity, according to an ASCO panel that developed guidelines on fertility preservation in patients with cancer.1...

SIDEBAR: Expect Questions from Your Patients: Cervical Cancer Screening Guidelines

Changes in the cervical cancer screening guidelines, as recommended by the U.S. Preventive Services Task Force (USPSTF), mainly concern longer intervals between screening tests and recommended ages when women should start and stop being screened. USPSTF Co-Vice Chair Michael L. LeFevre, MD, MSPH,...

SIDEBAR: Women Who Received HPV Vaccine Still Need Cervical Cancer Screening

The updated cervical cancer screening guidelines from the the U.S. Preventive Services Task Force (USPSTF) note that women who receive the HPV vaccine still need to be screened for cervical cancer because the vaccine does not protect against all strains of HPV that can cause cervical cancer. “The...

SIDEBAR: Could HPV Testing Be Used Alone?

“In the United States, there are no recommendations currently for HPV screening alone as a primary screening test for cervical cancer,” Michael L. LeFevre, MD, MSPH, Co-Vice Chair of the U.S. Preventive Services Task Force (USPSTF) told The ASCO Post. “Cytology picks up very few cases of...

gynecologic cancers
issues in oncology

New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important

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. In March 2012, the U.S. Preventive...

kidney cancer

Partial Nephrectomy Can Optimize Survival in Patients with Early-stage Disease

Following recent clinical trial data from the European Organisation for Research and Treatment (EORTC) showing a survival benefit for patients with small kidney cancers treated with radical vs partial nephrectomy, an analysis using linked Surveillance, Epidemiology and End Results (SEER) and...

leukemia

Integrated Genetic Profiling Can Identify Predictors of Outcome and Improve Risk Stratification in AML Patients

A mutational analysis of 18 genes in 398 patients with acute myeloid leukemia (AML) found at least one somatic alteration in 97.3% of the patients and identified genetic predictors of outcome that improved risk stratification among patients with AML, independent of age, white-cell count, induction...

head and neck cancer

Younger Patients Treated with Systemic Carboplatin at Higher Risk of Ototoxicity

Patients younger than 6 months at the start of systemic carboplatin treatment for retinoblastoma have a significant risk of developing hearing loss, according to a study in the Journal of Clinical Oncology. A review of audiologic test results of 60 patients with retinoblastoma who received...

breast cancer

Women Treated with Breast-conserving Surgery More Likely to Have Diagnostic and Invasive Procedures over Time

Women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery “continue to have diagnostic and invasive breast procedures in the conserved breast over an extended period,” according to a study reported in the Journal of the National Cancer Institute. “The estimated 10-year...

breast cancer

Concepts about Effects of Menopausal Hormone Therapy on Breast Cancer Continue to Change

In 2002, it was thought that menopausal hormone therapy using estrogen alone increases breast cancer risk, although not as quickly as combined estrogen plus progestin. Current thinking about estrogen alone is that it reduces breast cancer risk. This is just one example of changing concepts about...

lymphoma

Two Cycles of Chemotherapy plus Involved-field Radiation Improves Tumor Control in Early Unfavorable Disease

Final analysis of the German Hodgkin Study Group (GHSG) HD14 trial concluded that intensified chemotherapy with two cycles of escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine [Matulane], and prednisone) followed by two cycles of ABVD (doxorubicin,...

SIDEBAR: Expect Questions from Your Patients

While the process of finding permanent solutions to the shortage of oncology drugs continues, physicians and patients may still face difficult situations when certain drugs, possibly part of curative regimens, are not available. “The key thing is that we urge patients to have discussions with...

SIDEBAR: Drug Development in the Era of Personalized Medicine

Advances in understanding cancer on a molecular level and the identification of subgroups of cancer patients with rare diseases are expected to have an effect on drug development and supply. “The vision of what cancer care will be like in the future is this very precise personalized care, where...

issues in oncology
health-care policy

Update on Oncology Drug Shortage: Better for Now, But Permanent Solutions Must Address Underlying Issues

Over the past few years, drug shortages in the United States have been on the rise, involving hundreds of agents, many of which are lifesaving medications for patients with cancer. In recent months, the FDA has taken steps to alleviate some of the most critical oncology drug shortages. “We should...

SIDEBAR: Social Media: A Generational Thing?

Overheard Monday morning conversations about concerns expressed by patients and family members over the weekend triggered the idea for the article about the challenges of using social media to communicate with patients in the oncology setting, according to the article’s lead author, Lori Wiener,...

issues in oncology

Before Accepting a ‘Friend’ Request on Social Media, Carefully Consider the Potential Pitfalls and Perils

To friend or not to friend? That is the question many social networkers ponder daily. Oncologists and other health professionals considering “friend” requests from patients would be wise to first consider the potential pitfalls and perils of accepting such requests, according to an article written...

lung cancer
issues in oncology

Analysis Suggests CT Screening Could Save Lives at Relatively Low Cost

Results of an actuarial analysis suggest that offering lung cancer screening with low-dose spiral computed tomography (CT) as a commercial insurance benefit to individuals who are 50 to 64 years old and have a smoking history of 30 pack-years or more could save lives at relatively low cost....

SIDEBAR: Learning from Advanced Disease

Current testing of immunotherapy approaches against cancer involves patients in whom standard therapies have failed. “That really puts us at a great disadvantage because a lot of the standard therapies are immunosuppressive, as is the tumor itself as it grows,” Olivera Finn, PhD, said at a press...

Immunotherapy Clinical Trials Show Benefits for Patients with Advanced Cancers

Immunotherapeutic approaches, including vaccines, a monoclonal antibody, and a combination of low-dose interleukin (IL)-2 (Proleukin) and retinoic acid, are showing some success in clinical trials investigating the prevention of breast cancer recurrence in women at high risk, the treatment of...

gynecologic cancers

Scoring System Based on DNA Repair Pathways Predicts Outcomes and Response to Platinum Therapy

A potentially important tool to identify patients with advanced-stage ovarian cancer likely to benefit from platinum-based chemotherapy and redirect those with poor predicted outcomes to alternative treatments was developed using gene-expression data and validated in two independent datasets. While ...

leukemia

Pediatric ALL with Induction Failure Is Highly Heterogeneous with Varying Outcomes

While failure of remission-induction therapy is rare in children and adolescents with acute lymphoblastic leukemia (ALL), when it does occur it is highly adverse and heterogeneous, according to a study in The New England Journal of Medicine. “Patients who have T-cell leukemia appear to have a...

lymphoma

Panobinostat Produces Objective Responses in Patients Refractory to Autologous Transplant

Panobinostat produced objective responses in 27% and tumor reductions in 74% of 129 patients enrolled in “the largest, prospective, multicenter, international trial conducted in heavily pretreated patients” with Hodgkin lymphoma who relapsed or were refractory to autologous stem cell...

thyroid cancer

Low-dose Radioiodine as Effective as High-dose in Thyroid Ablation

Two studies in The New England Journal of Medicine found that low-dose radioiodine is as effective as a high-dose strategy in treating patients with thyroid cancer and that recombinant human thyrotropin (thyrotropin alfa [Thyrogen]) and thyroid hormone withdrawal had similar efficacy in preparing...

pain management

Screening for Distress and Unmet Needs in Patients with Cancer

In the past decade, “screening for distress has been positioned as the sixth vital sign in cancer care, in addition to the first five, which are measurements of pulse, respiration, blood pressure, temperature, and pain,” according to a review article in the Journal of Clinical Oncology. Although...

pain management
palliative care

Pain Remains Prevalent and Often Inadequately Treated among Cancer Outpatients

“Pain is as prevalent in ambulatory oncology patients with common solid tumors as it was more than 20 years ago, despite the fact that opioid prescribing in the United States has increased more than 10-fold since 1990,” according to results of a study among 3,023 ambulatory patients with cancer...

SIDEBAR: Difference between Efficacy and Effectiveness

One of the reasons large population-based studies are important is based on the “difference between efficacy—does a treatment work in a highly controlled setting of a phase III randomized clinical trial—and effectiveness—does a treatment work in general practice,” according to Benjamin D. Smith,...

SIDEBAR: Expect Questions from Your Patients

“Our study provides critical interim companion data to awaited randomized trials and may help clinicians and patients quantify the risk-benefit ratio of brachytherapy compared with standard therapy,” Benjamin D. Smith, MD, said of a study comparing lumpectomy and either whole-breast irradiation or...

breast cancer

Will Study Showing Increased Complications Compared to Whole-breast Irradiation Put the Brakes on Brachytherapy?

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. Older women treated for invasive...

prostate cancer

Denosumab Delays Time to First Bone Metastasis in Men with Castration-resistant Prostate Cancer

Denosumab (Xgeva) significantly delayed time to first bone metastases among men with nonmetastatic castration-resistant prostate cancer enrolled in a phase III randomized, placebo-controlled trial. The time to first bone metastasis was 33.2 months among the 716 patients randomly assigned to receive ...

gastrointestinal cancer

Strong Biomarker Candidates for Predicting Clinical Response to Bevacizumab

Plasma vascular endothelial growth factor A (VEGF-A) and tumor neuropilin-1 “are strong biomarker candidates for predicting clinical outcome in patients with advanced gastric cancer” after treatment with bevacizumab (Avastin). This was the conclusion of a mandatory biomarker program following up on ...

issues in oncology
survivorship

Cancer Survivors Stand Up, Give Thanks, and Give Back

“I have me back,” is how breast cancer survivor Jeanette Daniel of Memphis described her life after being treated on a clinical trial at Vanderbilt-Ingram Cancer Center in Nashville. Being conducted by the Stand Up To Cancer P13K Dream Team, whose leader discovered the PI3K pathway, the trial...

survivorship

Risk Stratification and Targeted Therapy, Abetted by Collaboration, Improve Outcomes for Children with Cancer

Outcomes for children with cancer have “improved over the course of the years incrementally, mostly not from the development of new drugs, because virtually all the drugs that we use now in leukemia were available in the 1970s. It is really through better understanding of the heterogeneity of the...

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