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Showing 4201 - 4250Recognizing Physical Signs Associated With Impending Death Can Assist Clinicians, Patients, and Caregivers With Complex Decisions
In a recently published study of patients with advanced cancer whose status was systematically documented twice a day, from the time of admission to a palliative care unit until death or discharge, investigators identified eight physical signs associated with death within 3 days. Taken together...
The Center of Who We Are
The following essay by Eric M. Genden, 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. There’s...
Mobile Patient-Centered App Tracks Breast Cancer Survivors’ Experiences
Patricia Ganz, MD, Director of Cancer Prevention and Control Research at the Jonsson Cancer Center of UCLA, and collaborators Apple and Sage Bionetworks, recently announced the launch of “Share the Journey: Mind, Body and Wellness after Breast Cancer,” a patient-centered mobile application (app)...
Wrestling With the Challenges of Breast Cancer
Bookmark Title: Then Came Life: Living With Courage, Spirit, and Gratitude After Breast CancerAuthor: Geralyn LucasPublisher: Gotham BooksPublication date: October 2, 2014Price: $19.89; hardcover, 240 pages Over the past decade or so, the oncology community has increased its understanding and...
Medicine Turned Upside Down
BookmarkTitle: The Patient Will See You Now: The Future of Medicine Is in Your HandsAuthor: Eric Topol, MDPublisher: Basic BooksPublication date: January 2015Price: $28.99; hardcover, 384 pagesMost books about health care center on fixing broken parts of the massive $3 trillion system, as seen with ...
Five Questions Can Guide the Treatment of Relapsed Myeloma
Joseph Mikhael, MD, MEd, myeloma expert at the Mayo Clinic in Arizona, Scottsdale, and Associate Dean of the Mayo School of Graduate Medical Education, considers five questions when selecting treatment for patients with multiple myeloma who relapse. “With prolonged survival, which approaches 10...
Avoiding Burnout and Maintaining Well-Being While Caring for Seriously Ill Patients
A variety of studies, including one published this past year in the Journal of Clinical Oncology,1 have showed that clinicians who care for seriously ill patients are at high risk for diminished personal well-being, including high rates of burnout; moral distress, defined as the inability to act in ...
Ongoing Controversies in Allocating Our Health‑Care Resources
Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care...
Adjuvant Ovarian Suppression May Benefit Women With Premenopausal Breast Cancer Who Received Prior Chemotherapy
In a phase III trial (SOFT) reported in The New England Journal of Medicine, Prudence A. Francis, MD, of Peter MacCallum Cancer Centre, Melbourne, Australia, Meredith M. Regan, ScD, of IBCSG Statistical Centre at Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of...
Hypofractionated Whole-Breast Irradiation After Breast-Conserving Surgery Used in Up to One-Third of Eligible Patients
In a study reported in JAMA, Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues found that approximately two-thirds of patients with early-stage breast cancer for whom hypofractionated whole-breast irradiation (for 3–5 weeks) was endorsed received...
Many Cancer Patients at Risk for Hepatitis B Virus Reactivation
In 2015, no cancer patients should be cured of their malignancy only to die of reactivation of hepatitis B virus (HBV),” according to Anna S. Lok, MD, the Alice Lohrman Andrews Research Professor in Hepatology and Director of Clinical Hepatology at the University of Michigan, Ann Arbor. “I...
Expert Point of View: Andrew Loblaw, MD
Commenting on this study, formal discussant D. Andrew Loblaw, MD, a radiation oncologist at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada, said: “The trial showed that after a median follow-up of 7.0 years, there were no differences in overall survival between the two ...
High-Dose Radiotherapy Provides Meaningful Improvements in Localized Prostate Cancer—But Not Increased Survival Yet
High-dose radiotherapy failed to improve overall survival at 7 years compared with standard-dose radiotherapy in men with stage II localized prostate cancer. However, the high-dose schedule had several advantages, including improved rates of local tumor control and distant metastasis, according to...
No Survival Benefit Reported With Docetaxel Added to Hormone Therapy in Metastatic Prostate Cancer
Docetaxel added to androgen-deprivation therapy did not improve overall survival over androgen-deprivation therapy alone in hormone-naive metastatic prostate cancer, according to an updated analysis of the GETUG-AFU 15 trial presented at the 2015 Genitourinary Cancers Symposium.1 In a retrospective ...
Our Aging Population: Challenges in Caring for Older Patients With Cancer
Managing older-aged cancer patients represents one of the major challenges to our health-care system. Caring for older cancer patients, with their frequent multiple morbidities and a variable health status, requires special integration of an oncologic and geriatric approach. Moreover, our aging...
I Refuse to Capitulate to Cancer
Editor’s note: We regret to announce that Paul Kalanithi, MD, passed away on March 9, 2015. Dr. Kalanithi was Chief Resident in Neurological Surgery at Stanford University when he shared his story, reprinted here, with The ASCO Post just over 1 year ago, in March 2014. We extend our deepest...
Shining a Spotlight on Epithelioid Hemangioendothelioma
In the winter of 2013, my son, Dmitriy, now 26, had a cough that wouldn’t go away. After several rounds of antibiotics failed to halt the persistent problem, a pulmonologist we consulted ordered a chest x-ray, which showed a large tumor lodged between Dmitriy’s lungs. Although the doctor said the...
A Surgeon Cuts to the Chase
BookmarkTitle: The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar IndustryAuthor: Paul A. Ruggieri, MDPublisher: Berkley BooksPublication date: September 2014Price: $16.00; paperback, 320 pages The woman seated on the exam table was lean and fit and seemed perfectly at...
Adding Cetuximab to First-Line FOLFIRI Does Not Benefit Metastatic Colorectal Cancer Patients With RAS Mutations
The phase III CRYSTAL trial showed that the addition of cetuximab (Erbitux) to first-line FOLFIRI (fluorouracil, leucovorin, and irinotecan) significantly improved overall survival, progression-free survival, and objective response rates in patients with KRAS codon 12/13 (exon 2) wild-type...
The ASPIRE Trial of Carfilzomib in Relapsed Myeloma: A Major Step Forward
Currently in myeloma, there are at least five new agents that are either approved or in the late-stage of development with impending approval. Major questions in the field relate to how we, as clinicians, will use these new agents and where they will fit in the overall treatment schema. The phase...
Increased Progression-Free Survival With Addition of Carfilzomib to Lenalidomide/Dexamethasone in Relapsed Multiple Myeloma
In a planned interim analysis of the phase III ASPIRE trial reported in The New England Journal of Medicine, A. Keith Stewart, MB, ChB, of the Mayo Clinic, Scottsdale, Arizona, and colleagues found that the addition of the proteasome inhibitor carfilzomib (Kyprolis) to lenalidomide...
The Emerging Role of Radiation Therapy in Gastrointestinal Cancers
The use of radiation therapy in the treatment of gastrointestinal cancer has evolved over the past several decades, in a gradual, stepwise fashion. Since most gastrointestinal cancers are diagnosed at a locally advanced stage, coupled with the inherent sensitivity of most parts of the...
Current Progress Against Cancer and What Lies Ahead in the Next Decade
In January, ASCO released its report, Clinical Cancer Advances 2015: An Annual Report on Progress Against Cancer,1 which details research advances over the past decade that have led to longer survival and better quality of life for the more than half-a-million people diagnosed with cancer each...
No Overall Survival Difference for Immediate vs Deferred Chemotherapy After Radical Cystectomy in Muscle-Invasive Bladder Cancer
In the European Organisation for Research and Treatment of Cancer (EORTC) 30994 trial, a phase III intergroup study reported in The Lancet Oncology,1 Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo and Forlanini Hospitals, Rome, and colleagues found no overall survival...
Breast Cancer Management in Review
Anyone who has attended the major oncology meetings knows that research from clinical trials in breast cancer often dominates the stage, with countless abstracts featuring new and updated results. To help the readers of The ASCO Post stay up to date with the latest discoveries and findings...
Results of RTOG 0617 Reconsidered
Radiation Therapy Oncology Group (RTOG) 0617 was a study initially designed to address an important issue in radiation oncology regarding the treatment of stage III non–small cell lung cancer (NSCLC): Are outcomes improved with high-dose as opposed to standard-dose thoracic radiation therapy? The...
No Benefit of High- vs Standard-Dose Radiotherapy or Addition of Cetuximab to Chemoradiation in Stage IIIA/IIIB NSCLC
As reported in The Lancet Oncology by Jeffrey D. Bradley, MD, of Washington University, and colleagues, the phase III Radiation Therapy Oncology Group 0617 trial showed no survival benefit of high- vs standard-dose radiotherapy or addition of cetuximab (Erbitux) to concurrent...
Expert Point of View: D. Andrew Loblaw, MD
"I believe the study by Nabid and colleagues will help inform practice,” said formal discussant D. Andrew Loblaw, MD, radiation oncologist at Odette Cancer Institute, Sunnybrook Health Sciences Centre, Toronto, Canada. “At a median follow up of 6.3 years, short-term androgen-deprivation therapy...
Immune Gene Profile Strongly Associated With Benefit of Adjuvant Trastuzumab in HER2-Positive Breast Cancer
In a study reported in the Journal of Clinical Oncology, Edith A. Perez, MD, of the Mayo Clinic, Jacksonville, and colleagues found that an immune function gene profile was associated with significantly improved relapse-free survival among patients with early-stage HER2-positive breast cancer who...
No Survival Benefit From Adjuvant Sorafenib or Sunitinib in Kidney Cancer
Adjuvant therapy with sorafenib (Nexavar) or sunitinib (Sutent) failed to make any inroads in improving disease-free survival in patients with locally advanced kidney cancer in the randomized, placebo-controlled, multicenter, phase III Adjuvant Sorafenib and Sunitinib for Unfavorable Renal...
Too Young to Have Cancer
The first inkling I had that something could be seriously wrong occurred just over a year ago, when I was suddenly inflicted with such severe heartburn it kept me awake at night. Prescriptions from my doctor for ranitidine (Zantac) and meloxicam (Mobic) not only failed to tamp down the fiery pain,...
Researcher Spotlight on Conquer Cancer Foundation International Innovation Grant Recipient Mya Thida, MBBS
In 2014, Mya Thida, MBBS, of Myanmar, was awarded one of the first-ever Conquer Cancer Foundation of ASCO International Innovation Grants. This grant was created to fund novel research projects that may significantly improve cancer control in low- and middle-income countries. One year later, Dr....
Preparing for the ‘Silver Tsunami’ and the Impact of an Aging Population on Cancer Care
“Older adults constitute the only increasing natural resource in the entire world.” —Linda Fried, PhD, Columbia School of Public Health The good and bad news about our changing demographic world is that the population of older adults is increasing in the United States and worldwide. While it is...
In Search of ‘Just’ Prices: Questioning the High Cost of New Cancer Drugs
As the oncology community begins the slow and often difficult-to-define transition from volume to value in the delivery of cancer care, the relationship between the price and value of certain high-priced cancer drugs is getting more scrutiny. We generally correlate the efficacy of a new drug and...
Breast Cancer Management in Review
With the field of breast oncology as complex as ever, a brief update of the latest findings impacting breast cancer treatment seems timely. To that end, I have assembled highlights from a collection of newsworthy studies featured over the past year and into early 2015. Part 1 of this review, which...
Opioid-Reduction Strategy for Postoperative Pain After Breast Cancer Surgery
One persistent and potentially debilitating problem breast cancer patients suffer with is postoperative pain. Studies show that proper pain management is an essential component in the healing process, but undertreatment of pain symptoms remains an ongoing issue in the oncology community. Opioids,...
Should We Be Worried If Patients Tolerate Endocrine Therapy Well?
When meeting with patients to discuss adjuvant endocrine therapy for breast cancer, the question often arises, “How will I know that the treatment is working?” While the efficacy of these treatments has been demonstrated for the majority of patients in multiple large randomized clinical trials,...
20 Years of NCCN: The Best Is Yet to Come
As the National Comprehensive Cancer Network (NCCN) celebrates its 20th year, The ASCO Post asked its Chief Executive Officer, Robert W. Carlson, MD, to reflect on the organization’s accomplishments, mission, and future and on the role he may have played in its success. The Early Years You became...
How the International Innovation Grant Is Improving Cancer Care for Women in Myanmar
In 2014, the Conquer Cancer Foundation awarded four inaugural International Innovation Grants to aid novel research projects in Colombia, Myanmar, Nigeria, and Tanzania. The program, which supports a 1-year research grant of up to $20,000 to a nonprofit organization or governmental agency in a low- ...
Noncommunicable Diseases Are the Leading Cause of Death in Low- and Middle-Income Countries
The greatest health threat to people living in low- and middle-income countries is no longer infectious diseases like HIV/AIDS, which has seen a 33% decline in the global rate of new infections since 2001.1 It is the rise of noncommunicable diseases (including cancer, cardiovascular disease, and...
PRIME II and the Omission of Radiation Therapy in Low-Risk, Elderly Patients Undergoing Breast Conservation: The Time Has Come
Despite the high prevalence of breast cancer worldwide, it is important to recognize that > 40% of all cases occur in women aged 65 years or older in both the United States and the United Kingdom.1,2 Breast cancers in older patients are more often associated with indolent features and with...
Clinical Trials Actively Recruiting Patients With Neuroblastoma
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with newly diagnosed or relapsed or refractory neuroblastoma. The studies include pilot, observational, phase I, phase II, and phase III trials investigating single-agent and...
Cancer Has Left an Indelible Mark on Me
Even though today I’m cancer-free, the experience of getting a cancer diagnosis and going through treatment leaves an indelible mark on your psyche—as well as your body—that time doesn’t erase. Once you have cancer, you become a cancer survivor, and that status doesn’t change. I’ve known many...
A Cautionary Note on Psilocybin Therapy
The controversial nature of [psilocybin] is garnering attention before [the NYU investigators’] work has been peer-reviewed, which is concerning. Could psilocybin therapy be a helpful anxiolytic in any patient? Yes, I suppose, but I’d like to see the data. Is psilocybin an anxiolytic in cancer...
Researchers Discuss Pilot Study on Hallucinogenic Therapies for Cancer Anxiety
Although varying levels of existential distress are near-ubiquitous among patients with cancer, evidence-based interventions in this clinical area remain somewhat elusive. Seeking to explore novel approaches in the palliative care environment, New York University (NYU) School of Medicine principal...
Combination Immunotherapy Better Than Monotherapy in Advanced Melanoma
As clinical research struggles to keep up with the pace of new immunotherapies, one of the burning questions is how best to combine the new drugs. A new study found that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) is superior to ipilimumab alone as front-line therapy for untreated ...
Experts Debate: Can We Cure Metastatic Breast Cancer?
Can metastatic breast cancer ever be cured? This issue was debated at the 32nd Annual Miami Breast Cancer Conference by two experts in the field: George W. Sledge, Jr, MD, Professor of Medicine at Stanford University Medical Center, Palo Alto, California, and Clifford A. Hudis, MD, Chief of the...
ASCO Releases 2015 Report on The State of Cancer Care in America
In March, ASCO published its second annual report, The State of Cancer Care in America: 2015.1 Its findings show a mixed landscape, on the one hand, spotlighting advances in therapy and improving survival rates, but on the other, describing a cancer care system under stress from increasing demand...
Creating a Collective Path Forward to Optimize Value in Cancer Care
The Centers for Medicare and Medicaid Services projects that U.S. health-care spending will reach $4.3 trillion and account for 19.3% of the nation’s gross domestic product by 2019.1 Although cancer care represents a small fraction of overall health-care costs, the cost of cancer care is rapidly...
Profile: Julie M. Vose, MD, MBA, FASCO, Making a Difference in Both Clinical Medicine and Research
At this year’s ASCO Annual Meeting, Julie M. Vose, MD, MBA, FASCO, will begin her term as the Society’s 51st President. It is fitting that the meeting will be held in Chicago, the city where the first seven visionaries met over lunch in 1964 to formulate a medical organization centered on cancer...
