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What Cancer?

If they are honest, most oncologists who’ve practiced medicine for more than 15 years will tell you they’ve learned much more from their patients than their patients have learned from them. The life lessons I’ve learned from treating this complicated, resilient, and often cruel disease are many....

issues in oncology

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....

leukemia

Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?

Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...

breast cancer

Expert Point of View: Howard A. “Skip” Burris, MD

Howard A. “Skip” Burris, MD, President of Clinical Operations and Chief Medical Officer at Sarah Cannon Research Institute, Nashville, commented on the poster presentation for The ASCO Post. He said the results “fit the whole paradigm” that is desired for triple-negative breast cancer, which is to ...

cns cancers

Accelerating Progress in the Treatment of Glioblastoma Multiforme

W.K. Alfred Yung, MD, has wanted a career in medicine since he was a high-school student and has spent nearly 4 decades fulfilling that dream, specifically in the research and treatment of one of the deadliest cancers, malignant brain tumor, especially glioblastoma multiforme, the most common...

lymphoma

Expert Point of View: Brad S. Kahl, MD

Speaking about the GALLIUM study in the ASH News Daily, Brad S. Kahl, MD, of Washington University School of Medicine, St. Louis, commented, “It is a potentially practice-changing study that clearly shows an 8% absolute improvement in progression-free survival at 2 years for the patients getting...

supportive care

Cardiac Complications in Patients Receiving Combination Checkpoint Inhibitors Are Rare but Can Be Fatal

Cardiovascular toxicities associated with cancer treatments are not new. What is new, and what has prompted recent articles in The New England Journal of Medicine,1,2 is the explosion of cancer therapies, which has dramatically changed the natural course of many cancers but can lead to cardiac,...

issues in oncology

Using Art to Humanize Medicine

Among the most widely attended sessions at the 2016 Palliative Care in Oncology Symposium in September was the keynote lecture, “Wit, Hex, Vin, Life, Death: Using Wit as a Teaching Tool,” given by Margaret Edson, author of the Pulitzer Prize–winning play Wit. Wit tells the story of an accomplished ...

Randi Kaplan, LMSW, Named Schwartz Center’s 2016 National Compassionate Caregiver of the Year

The Schwartz Center for Compassionate Healthcare, a national leader in providing compassionate care to patients and caregivers, has named Randi Kaplan, LMSW, Director of the Arthur D. Emil Caregiver Support Center at Montefiore, the National Compassionate Caregiver of the Year. The prestigious...

health-care policy
issues in oncology

Having a Child With Cancer May Adversely Affect Parents’ Income and Employment

Having a child with cancer led to income reductions for parents and job discontinuation among mothers in a recent study, even after adjusting for prediagnosis sociodemographic factors. Published by Norberg et al in Cancer, the findings indicate that childhood cancer affects parents' income and...

breast cancer

Expect and Encourage Questions About Breast Reconstruction

An article in The New York Times about women who had chosen not to have reconstruction following breast cancer surgery might prompt questions from newly diagnosed patients considering their options.1 Deanna J. Attai, MD, FACS, told The ASCO Post that whenever an article on breast cancer appears in...

breast cancer

Helping Patients With Breast Cancer Decide Whether to Have Reconstruction

A “nascent movement to ‘go flat’” is how an article in The New York Times characterized the decisions by some women to opt out of reconstruction following surgery for breast cancer.1 The article examined the reasons several patients made that decision, which included avoiding multiple surgeries and ...

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 ...

palliative care

How When Breath Becomes Air Is Helping the Public—and Physicians—Confront Their Mortality

It should not come as a surprise to anyone who has read Dr. Paul Kalanithi’s brilliant—and unforgettable—memoir, When Breath Becomes Air (Random House, 2016), that nearly a year after publication, it remains on The New York Times best-seller list, its popularity only increasing with time. Written...

lymphoma
skin cancer

High-Throughput Sequencing of T-Cell Receptors May Transform Diagnosis and Treatment of Cutaneous T-Cell Lymphomas

High-throughput sequencing of T-cell receptors may be a solution to some of the challenges confronting oncologists who treat cutaneous T-cell lymphomas. According to experts who presented talks on high-throughput sequencing of T-cell receptors at the 3rd World Congress of Cutaneous Lymphoma...

A Cancer Diagnosis Brings Two Sisters Back Together

Elizabeth Lesser is an award-winning writer and co-founder of the Omega Institute, the largest adult education center in the United States focusing on health, wellness, spirituality, and creativity. She is the author of several acclaimed books including Broken Open: How Difficult Times Can Help...

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 ...

head and neck cancer

ESMO 2016: Nivolumab Maintains Function and Reduces Symptoms in Relapsed Metastatic Head and Neck Cancer

Nivolumab (Opdivo) maintains function and reduces symptoms in treatment of relapsed metastatic head and neck cancer, according to results from the CheckMate 141 trial presented by Harrington et al at the 2016 European Society for Medical Oncology (ESMO) Congress in Copenhagen, Denmark (Abstract...

gynecologic cancers

Expect Questions About the FDA Discouraging Use of Ovarian Cancer Screening Tests

The release of a U.S. Food and Drug Administration (FDA) Safety Communication “alerting women about the risks associated with the use of tests being marketed as ovarian cancer screening tests”1 and recommending against using these tests comes not as a result of startling new studies, but from an...

Jacques Galipeau, MD, FRCP(C), Brings Personalized Stem Cell Treatment to UW Carbone

An international leader in harnessing a patient’s own stem cells to fight cancer and autoimmune diseases joined the faculty of the University of Wisconsin (UW) Carbone Cancer Center on September 1. Jacques Galipeau, MD, FRCP(C), came from the Winship Cancer Center at Emory University, where he...

issues in oncology
supportive care
palliative care

Why Care About the Caregivers?

Caregivers of patients with cancer provide invaluable health-care services, but they are an underserved and undervalued group, with many unmet needs. Early palliative care may provide important benefits to these often tireless individuals, according to J. Nicholas Dionne-Odom, PhD, RN, ACHPN, of...

palliative care

Benefits of Early Palliative Care Interventions Extend Beyond the Patient

A session at the 2016 Palliative Care in Oncology Symposium focused on the special needs of cancer caregivers. In a large survey, caregivers of persons with cancer reported higher levels of stress and significantly more duties than caregivers of other patients. But, according to research from...

global cancer care

Baylor and Texas Children’s Hospital Partner to Bring Fellowship Training in Oncology and Hematology to East Africa

Medical students and practicing pediatricians in Uganda and other East African countries lack access to specialty pediatric training and education in oncology and hematology in their region, despite the need for doctors to provide care for patients with cancer and blood disorders. A new program of...

Researcher Spotlight: Conquering Cancer With Dr. Effinger

When it comes to pediatric cancer, there are so many signs of hope, starting with the fact that the childhood cancer 5-year survival rate has climbed all the way up to 83%. But while we celebrate the victories of all these children over cancer, little is known about the long-term health effects,...

issues in oncology

Breaking the ‘Conspiracy of Silence’

A new study1 showing that just 1 in 20 terminally ill patients with cancer has sufficient understanding about the prognosis or purpose of treatment is highlighting the need for improvements in both the way oncologists communicate prognosis with their patients and in the development of educational...

integrative oncology

The Role of Music Therapy in Cancer Care

Music therapy, an established adjuvant to standard cancer care, is offered in a growing number of cancer centers throughout the United States and internationally. Defined by the American Music Therapy Association (AMTA) as “the evidence-based use of music interventions to accomplish individual...

lymphoma
thyroid cancer

I’ve Survived Two Cancers

In 2012, my husband, Robert, and I were looking forward to starting the next phase of our lives and were feeling excited about the future. Although only in our 50s, we had decided to retire early from our full-time careers, move to our cabin in Hayward, Wisconsin, and find less stressful part-time ...

issues in oncology

Mastery Learning: A New Paradigm for Oncology Medical Education?

According to William C. McGaghie, PhD, Professor of Medical Education and Professor of Preventive Medicine at Northwestern University Feinberg School of Medicine in Chicago, the principles of today’s clinical medical education are rooted in a 19th century model that is no longer useful in a...

issues in oncology

Addressing the Significant Disparities and Barriers to Health Care Experienced by LGBT Cancer Survivors

In 2011, the Institute of Medicine (IOM) published its landmark report “The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding,” which recognized the scarcity of research in lesbian, gay, bisexual, and transgender (LGBT) individuals and the...

palliative care

Palliative Care 2016: Cancer Caregivers Experience Unique Burdens Compared With Those Caring for Patients With Other Conditions

An analysis of data from more than 1,200 caregivers in the United States finds that cancer caregivers report a higher burden and spend significantly more hours per week caregiving, as opposed to individuals who care for people with other conditions. The analysis was based on survey data from the...

Surgical Oncologist Quan P. Ly, MD, FACS, Flees From Vietnam and Finds a Home at the University of Nebraska

After the Vietnam War, close to a million refugees, known as “boat people,” fled Vietnam, hazarding the open ocean on dangerously overloaded vessels. The term “boat people” is often used generically to refer to all the Vietnamese (about 2 million) who left their country by any means between 1975...

issues in oncology

Metabolic Imaging as a Method to Assess Treatment Response to Cytotoxic and Cytostatic Agents

Tumor shrinkage is not the only measure of a successful anticancer therapy. A University of Colorado Cancer Center article published by Serkova et al in Frontiers in Oncology describes a promising alternative: metabolic imaging. Tumors rush their metabolism to grow and proliferate. By recognizing a ...

palliative care

Integrating Early Palliative Medicine Into Oncology Care to Improve Patients’ Quality of Life

At the 2015 Palliative Care in Oncology Symposium in Boston, Vicki Jackson, MD, MPH, Chief in the Division of Palliative Care and Geriatrics at Massachusetts General Hospital, Co-Director of the Harvard Center for Palliative Care, and Associate Professor of Medicine at Harvard Medical School,...

supportive care
symptom management

Dealing With GI Toxicities After Chemoradiation

Chemotherapy- and radiotherapy-induced gastrointestinal (GI) toxicities have risen alongside improved survival rates for many cancers, according to Jervoise Andreyev, MA, PhD, Consultant Gastroenterologist in GI Consequences of Cancer Treatment at the Royal Marsden Hospital in London. “For every...

breast cancer

Sampling Method Used for New Breast Cancer Tests May Lead to Underestimation of Risk

Not only is breast cancer more than one disease, but a single breast cancer tumor can vary within itself, a finding that University of Pittsburgh Cancer Institute (UPCI) researchers discovered has the potential to lead to very different patient treatment plans depending on the tumor sample and...

An Epic Medical Story by an Old-Style Doctor on the Front Lines of Care

The U.S. health-care system is a $3 trillion behemoth of dizzying complexity. Government oversight, ever-changing regulations, mountains of paperwork, electronic health records, initiative after initiative, and so forth, all of which has reshaped the delivery of care, for the good and bad. But...

health-care policy

FDA Advances Precision Medicine Initiative by Issuing Draft Guidances on Next-Generation Sequencing–Based Tests

In support of the President’s Precision Medicine Initiative, on July 6, the U.S. Food and Drug Administration (FDA) issued two draft guidances that, when finalized, will provide a flexible and streamlined approach to the oversight of tests that detect medically important differences in a...

colorectal cancer

Thriving With Cancer

Seven years ago, at age 44, I was the picture of health. I played tennis every day, went bike riding and lifted weights several times a week, and made sure I ate a healthy diet. The closest I had ever come to cancer was caring for my mother during her 2-year illness with esophageal cancer. As it...

colorectal cancer
issues in oncology

What’s Driving the Rising Rates of Colorectal Cancer in Young Adults?

The study statistics are alarming—and perplexing. According to an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) colorectal cancer registry, colon cancer incidence among young adults aged 20 to 34 is expected to increase 90% by 2030, and the incidence of rectosigmoid...

Inside Knowledge From a Cancer Survivor

Curtis Pesmen is a well-regarded writer who has authored six books of nonfiction as well as numerous articles for publications such as Esquire and The New York Times. He also has served as founding editor of LIVESTRONG Quarterly and often speaks and writes on patient advocacy. Shortly after...

A Journalist’s Cancer Saga

Readers of the recently published memoir A Series of Catastrophes & Miracles: A True Story of Love, Science, and Cancer find out that the book has a happy ending on the cover page of chapter 1. Spoiler: I lived, writes the author, Mary Elizabeth Williams, an acclaimed journalist with a list...

An Exotic Journey Into Immunotherapy

In his new book, Sharks Get Cancer, Mole Rats Don’t: How Animals Could Hold the Key to Unlocking Cancer Immunity in Humans, James S. Welsh, MD, examines a wide array of animal and human biologic phenomena, searching for clues that might help us unlock the full power of the human immune system....

Vanguard Practices Support Sharing Big Data With CancerLinQ™

CancerLinQ LLC, recently announced that it has completed agreements with 36 vanguard oncology practices from around the country to begin implementing the tool. According to physicians at the vanguard practices, gaining access to the experience of oncology practices across the country motivated...

health-care policy
issues in oncology

Supporting Policy to Reduce Tobacco-Related Deaths

One billion lives. That is the estimated human death toll of tobacco use in the 21st century.1 Tobacco use is the leading cause of preventable death worldwide—20% of all deaths and 30% of cancer deaths in the United States are linked to tobacco use.2,3 Impacting this preventable public health...

Breast Density Legislation: An Opportunity for Better Risk Assessment

Dense breasts are not an automatic indication for additional imaging. Instead, breast density generally provides an opportunity for improved risk assessment, according to Kevin Hughes, MD, of Massachusetts General Hospital, Boston. “More than 20 states have mandated that women be informed of...

The Importance of Listening to Patients

My experience with cancer, or more accurately, cancers, is complicated. In 2002, after returning from a medical mission to Honduras, I noticed a bean-sized lymph node above my left clavicle. As an oncology-certified nurse, I knew not to ignore any unusual nodules that pop up on the body and asked...

Rising

There were once two patients with leukemia. Other than their diagnoses and their ages, these two men had nothing in common. Meet Michael Michael was an artist—a sculptor. He had large, sensitive, blue eyes and a quiet, pensive manner. His acute observational power led him to ponder deep questions...

issues in oncology

How Will Value Framework Tools Be Used in Everyday Practice?

Value framework tools made a splash in 2015, with five different groups unveiling methods to help physicians and patients compare therapies based on efficacy, toxicity, and/or cost. Now these potential users are beginning to examine and debate the tools, including how and whether they will work in...

palliative care
issues in oncology

ASCO 2016: Many Younger Cancer Patients Receive Aggressive End-of-Life Care Despite ASCO’s Choosing Wisely Campaign

An analysis of health claims data from 2007­–2014 on more than 28,000 patients under the age of 65 found that a large proportion of patients with advanced solid tumors received at least one form of aggressive care within the last 30 days of life. The study was presented by Chen et al at...

Noted Gastrointestinal Oncologist Leonard Saltz, MD, Tempers Optimism With Reality and Factors Cost Into the Equation of Value in Cancer Care

Leonard Saltz, MD, was born in New York, New York, and reared in Westchester County, in the suburbs of the City. Terrance Archer, his high-school biology teacher, whom Dr. Saltz described as a “force of nature,” a wonderful human being, and a major role model, influenced his nascent curiosity in...

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