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gynecologic cancers

Gynecologic Cancer Treatment at High-Volume Centers May Be Lifesaving

Women with gynecologic cancers who are treated at hospitals that frequently manage these conditions appear to live significantly longer than those who receive their care at lower-volume centers, according to a large study presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on...

Case Studies: Collaborative Practice in Action

The panel presented two case studies—one on high-dose methotrexate toxicity and one on 5-FU toxicity—as a platform for discussion of considerations, challenges, and interconnected roles of oncologists, nurse practitioners, physician assistants, and clinical pharmacists in safely managing patients...

Collaborative Exchange: Timing of Uridine Triacetate

The challenge of deciding when to administer uridine triacetate was explored by the panel. Dr. Schwartzberg: I assume uridine triacetate would work more effectively if given very early; otherwise we would see the same kind of downstream toxicity we see with methotrexate. Dr. Campen: Exactly, but...

prostate cancer

Genitourinary Toxicity More Likely With Stereotactic Body Radiotherapy Than With Intensity-Modulated Radiotherapy

A retrospective analysis of patients with prostate cancer receiving primary treatment with either stereotactic body radiation therapy or intensity-modulated radiation therapy found that those receiving stereotactic body radiotherapy had greater rates of genitourinary toxicity during 2-year...

issues in oncology

Breaking Bad News Badly Can Add to Upset

When the prognosis is poor, breaking the bad news badly can exacerbate the distress experienced by cancer patients and their families. A lack of sensitivity to patient and family emotions and not being attuned to how individual patients would prefer to be informed about their prognoses can result...

issues in oncology

An Oncologic Surgeon Discusses the Pros and Cons of Pursuing a Business Degree

Is pursuing a Master of Business Administration (MBA) degree a good idea for ambitious surgical oncologists who want to advance their careers? The ASCO Post recently spoke with Martin J. Heslin, MD, MSHA, Chief, Section of Surgical Oncology, University of Alabama at Birmingham (UAB) Medical Center, ...

survivorship
global cancer care

Improving Quality of Life in Cancer Survivors

The number of cancer survivors has been steadily increasing in recent years. According to the Ministry of Health National Cancer Registry, in 2010 there were 254,000 cancer survivors in Israel (3.3% of the population) compared with 15,700 (0.4% of the population, P < .005) in 1975.1 Forty years...

thyroid cancer

Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?

In a study reported in JAMA Otolaryngology Head & Neck Surgery,1 Davies and Welch found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis of papillary...

supportive care
survivorship

Maximizing the Benefits of Exercise in Patients With Cancer

Many nonpharmacologic therapies increase both physical and emotional strength during cancer treatment as well as throughout survivorship. These therapies include the mind-body practices of meditation, self-hypnosis, guided imagery, and breath awareness, touch therapies including massage and...

Setting a ‘Moon Shots’ Goal to Drastically Reduce Cancer Mortality Over the Next Decade

In 2012, just 1 year after taking the reins as President of The University of Texas MD Anderson Cancer Center, Ronald A. DePinho, MD, announced his plans to launch the Moon Shots Program, the most ambitious endeavor undertaken by the cancer center to dramatically accelerate the pace of reducing...

prostate cancer

Continued Survival Benefits Seen With Radical Prostatectomy vs Watchful Waiting in Long-Term Follow-up of the SPCG-4 Trial

The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the...

supportive care
survivorship

ASCO Releases Adapted Guideline on Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer

A majority of cancer patients experience some level of fatigue during the course of their treatment, and approximately 30% contend with persistent fatigue for years after treatment. Fatigue is among the most common and distressing long-term effects of cancer treatment and significantly affects...

breast cancer

Postmastectomy Radiotherapy Benefits Women With Breast Cancer That Has Spread to One to Three Lymph Nodes

In women with breast cancer who had between one and three positive lymph nodes, radiotherapy reduced the recurrence rate by 32% and the breast cancer death rate by 20%. Giving radiotherapy to these women led to nearly 12 fewer recurrences of breast cancer per 100 women after 10 years, and eight...

issues in oncology

Challenges in Creating and Promoting Clinical Practice Guidelines

With regard to clinical practice guidelines, clinicians want an authoritative resource that will clearly and concisely instruct them in most clinical scenarios. Guideline developers want to give them this, “but producing guidelines is not as straightforward as it might seem,” according to David...

issues in oncology
cost of care

ASCO Develops New Strategy to Increase Value in Cancer Care

Last January, ASCO held a leadership summit in Washington, DC, with representatives from the pharmaceutical industry, insurance payers, patient advocates, and physicians to address the skyrocketing costs of new drugs and technologies used in the diagnosis and treatment of cancer. Although costs are ...

Donald L. Morton, MD: September 12, 1934–January 10, 2014

Donald L. Morton, MD, transformed the management of melanoma and breast cancer by introducing the sentinel node biopsy, giving surgeons an accurate roadmap for treatment, and sparing generations of cancer patients from the morbidity associated with unnecessary surgery. Throughout his distinguished...

Enthusiasm and Vision Guide the Head of FDA’s Oncology Office

In  2005, Richard Pazdur, MD, was named the FDA’s Director of the Office of Hematology and Oncology Products. By any measure, being arbiter of the nation’s oncology drug pipeline is a daunting prospect, but Dr. Pazdur sees it as an opportunity to encourage his talented staff to work for the greater ...

Nationally Renowned Surgeon and Researcher, John E. Niederhuber, MD, Relishes the Challenges That Lie Ahead

John E. Niederhuber, MD, was born and grew up in Steubenville, Ohio, a steel mill town located along the Ohio River. Dr. Niederhuber had a childhood interest in engineering and chemistry, but it was the town’s general practitioner who made a lasting impact on his career path. “He was an old-style...

cost of care

Speaking Up Against High Cancer Drug Prices

Physicians have a duty to speak up against high cancer drug prices,” Hagop M. Kantarjian, MD, resolutely stated in an interview with The ASCO Post. “We should speak up because high drug prices are harming patients.” A leader in the effort to drive down the cost of drugs needed to treat patients...

breast cancer

Cancer Has Robbed Me of My Physical Beauty but Not My Inner Strength

I’ve been plagued with various ailments all my life. Physically and emotionally abused by my stepfather as a child, over the years I’ve developed severe psychological issues including depression and anxiety disorder. I am also in constant physical pain from cervical degenerative disc disease,...

breast cancer

Margin Reassessment in Breast-Conservation Therapy

Significant progress has been made in local-regional and systemic treatments of breast cancer. Most patients currently diagnosed with breast cancer in the United States are diagnosed with early-stage disease and achieve excellent outcomes with breast-conservation therapy. Indeed, outcomes have...

lung cancer

Ceritinib in ALK-Positive Metastatic NSCLC Patients With Progression on or Intolerance to Crizotinib

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On April 29, 2014, ceritinib (Zykadia) was granted accelerated...

survivorship
supportive care
bladder cancer

NCCN Scientific Posters Include New Findings in Bladder Cancer, Survivorship Care, and Antiemetic Therapy

The 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), recently held in Hollywood, Florida, featured a number of scientific posters by member organizations and meeting sponsors. The ASCO Post captured some of the most interesting findings for our readers, including these...

survivorship

Study Calls for Revisiting Guidelines for Screening Childhood Cancer Survivors at Risk of Congestive Heart Failure

One of the first studies to analyze the effectiveness of screening survivors of childhood cancer for early signs of impending congestive heart failure found improved health outcomes but suggests that less frequent screening than currently recommended may yield similar clinical benefit. The...

colorectal cancer

Surveillance After Colon Cancer Surgery: Too Much of a Good Thing?

Finding salvageable colon cancer recurrence is akin to finding a needle in a haystack, rendering routine patient surveillance of little value. But finding that needle offers an opportunity for treating recurrent disease early, which makes surveillance worthwhile. These were the opposing views...

health-care policy
geriatric oncology

AACR Calls on Congress to Support Cancer Research Funding to Meet the Challenges of Our Aging Population

Great progress is being made in the battle against cancer, but a renewed commitment of federal support for medical research is needed to speed its eradication, according to leaders of the American Association for Cancer Research (AACR), commenting in connection with a recent Senate hearing on “The...

lung cancer
issues in oncology

Medicare Advisory Panel Cast Doubts on Lung Cancer Screening, Leaving Advocates Dismayed but Undaunted

On April 30, 2014, the Centers for Medicare & Medicaid Services (CMS) convened the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) to assess the value of low-dose computed tomography (CT) lung cancer screening in the Medicare population. After a decades-long battle,...

colorectal cancer

Colonoscopy Adenoma Detection Rate Inversely Proportional to Risk of Interval Colorectal Cancer and Colorectal Cancer Mortality

In a study of health-care organization data reported in The New England Journal of Medicine, Douglas A. Corley, MD, PhD, of Kaiser Permanente, and colleagues assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent ...

colorectal cancer

Colorectal Cancer Screening Poised for Change

New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...

breast cancer

Preoperative Breast MRI: Does Higher Sensitivity Equal Better Outcomes?

Breast magnetic resonance imaging (MRI) is superior to more commonly used imaging modalities in preoperative breast cancer staging and should be a key element in routine workup. But despite its high sensitivity for catching cancers, breast MRI still does not deliver maximum value for the patient....

lung cancer

Lung-MAP Launches: First Precision Medicine Trial From National Clinical Trials Network

A public-private collaboration among the National Cancer Institute (NCI), SWOG Cancer Research, Friends of Cancer Research, the Foundation for the National Institutes of Health (FNIH), five pharmaceutical companies (Amgen, Genentech, Pfizer, AstraZeneca, and AstraZeneca’s global biologics R&D...

lung cancer

Pieces of the Puzzle in Treating Early Non–Small Cell Lung Cancer

Separate studies in early-stage non–small cell lung cancer (NSCLC) found that the addition of consolidation chemotherapy to concurrent chemoradiotherapy did not improve survival and that adjuvant erlotinib (Tarceva) did not improve survival. There was a suggestion of benefit for adjuvant erlotinib...

lung cancer
issues in oncology

Time to Move Forward With Lung Screening

Start with the most lethal cancer globally—lung cancer—for which standard approaches result in a modest 5-year survival. Then consider the results from the National Lung Screening Trial (NLST), suggesting in a well done randomized study that significant mortality reduction does occur with low-dose...

head and neck cancer
issues in oncology

Limited Public Awareness of Head and Neck Cancers Raises Concerns About Prevention and Detection

Public awareness of head and neck cancer is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV), according to results of a cross-sectional online survey reported in JAMA...

palliative care

Discontinuing Statins Near the End of Life Is Safe, Can Reduce Symptom Burden, and Is Generally Acceptable to Patients

Discontinuing statins for patients near the end of life is safe, saves money, spares patients from swallowing yet another pill and from the symptoms associated with statins, and is generally welcomed by patients. That last bit might come as a surprise to some physicians who worry that discontinuing ...

lung cancer

Stronger Nicotine Dependency Associated With Higher Lung Cancer Risk

A study by investigators at the National Cancer Institute (NCI) has indicated that people who are highly addicted to nicotine, ie, those who smoke their first cigarette within 5 minutes after awakening, are at higher risk of developing lung cancer than those who wait for 1 hour or more to smoke....

breast cancer

Ado-Trastuzumab Emtansine as a Late Treatment for HER2-Positive Metastatic Breast Cancer—Better and Less Toxic Than Physician’s Choice

TH3RESA is a randomized phase III open-label study, reported in The Lancet Oncology and summarized in this issue of The ASCO Post, which examined the activity of ado-trastuzumab emtansine (Kadcyla) in heavily pretreated HER2-positive metastatic breast cancer.1 Formerly known as T-DM1,...

skin cancer

Long-Term Follow-up of Phase I Nivolumab Trial

In the longest follow-up to date of any programmed death (PD)-1 receptor inhibitor in previously treated advanced melanoma, one-third of patients are demonstrating durable responses to the investigational agent nivolumab, and in some cases, these persist following discontinuation of the drug,...

health-care policy

IOM Workshop Explores Growing Problems in Patient Access to Cancer Drugs

Cancer patients’ out-of-pocket costs are rising dramatically, and insurance premiums, cost sharing, and ancillary expenses can be devastating. Many people go bankrupt as a result of the high costs of health care. Drugs are among the most serious economic culprits. They grow more expensive every...

lung cancer

Lung-MAP Trial Debuts—Other Personalized Studies Will Follow

Oncologists now have a means of bringing personalized medicine to advanced squamous cell carcinoma, and it involves a biomarker-driven clinical trial that maximizes the chance of successful treatment and new drug approvals. Lung-MAP (Lung Cancer Master Protocol) is a unique concept in which the...

breast cancer

Swiss Medical Board Recommendation to End Mammography Screening: A Disturbing Proposal

Despite evidence from a number of prospective, randomized controlled trials showing that screening mammography reduces breast cancer mortality, screening mammography has been the subject of continual debate, controversy, and conflicting guidelines. Recently, the Swiss Medical Board, tasked with...

solid tumors
hematologic malignancies

ASPHO Abstracts Cover Broad Range of Topics

More than 400 abstracts—a record—were submitted for the 27th Annual Meeting of the American Society of Pediatric Hematology/Oncology in Chicago. Here is a small sampling of those studies, with comments from the abstract authors. Token Economy to Improve Compliance BMT Bucks form the basis of a...

cost of care

Federally Funded Trials Praised—and Underfunded

All four studies presented at the 2014 ASCO Annual Meeting Plenary Session were at least partially funded by federal dollars, bringing long overdue attention to the value of federally supported cancer research. Perhaps because of this high visibility, ASCO leaders took to the soapbox to sound the...

breast cancer

Breast Cancer–Related Benefits of Weight Loss

Obesity and physical inactivity are associated with an increased risk of developing and dying of breast cancer via several proposed mechanisms. Two studies presented at the 2014 ASCO Annual Meeting explored the relationships among exercise, weight loss, and breast cancer risk. One study was...

skin cancer

Intralesional Injections Trigger Immune Responses in Melanoma

The emerging approach to treating metastatic melanoma is a full-throttle effort to stimulate an immune response. One of the components of this strategy could be intralesional injections, according to studies presented at the 2014 ASCO Annual Meeting. T-VEC Oncolytic Immunotherapy Talimogene...

prostate cancer

Mutations in IGF Pathway Genes Associated With Prostate Cancer Mortality

In a study reported in the Journal of the National Cancer Institute, Cao and colleagues identified mutations in insulin-like growth factor (IGF) pathway genes that were significantly associated with mortality in prostate cancer. Analysis of 530 single nucleotide polymorphisms (SNPs) in 26 IGF...

integrative oncology

Getting Results: How Oncologists and Pathologists Can Work Together to Facilitate Molecular Testing

Advances in molecular testing mean that highly specific information can be detailed about the molecular characteristics of a patient’s tumor, as well as indications of potential responsiveness to targeted therapy. But getting those detailed results from the pathologists can be a challenge to many...

prostate cancer

PREVAIL Trial: Enzalutamide Before Chemotherapy Prolongs Survival in Metastatic Prostate Cancer

The androgen-receptor inhibitor enzalutamide (Xtandi) has been shown to prolong survival in men with metastatic castration-resistant prostate cancer with progressive disease after chemotherapy. In the phase III PREVAIL trial reported in The New England Journal of Medicine, Tomasz M. Beer, MD, of...

supportive care

Supportive Care in Pediatric Patients With Cancer: Recent Developments in Treating Febrile Neutropenia

Recent developments in supportive care for children with cancer can be broken down into three categories: doing the simple things well, applying evidence-based medicine to daily practice, and extending the benefits to everyone, according to Scott C. Howard, MD, of St. Jude Children’s Research...

supportive care

NEPA for Chemotherapy-Induced Nausea and Vomiting: Key Endpoints and Additional Analyses Show Strong Efficacy

For the prevention of chemotherapy-induced nausea and vomiting, NEPA, a novel combination of a neurokinin-1 (NK1) receptor antagonist and the 5-HT3 receptor antagonist palonosetron (Aloxi), has been studied in three pivotal trials that were recently published in the Annals of Oncology.1-3 Further...

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