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Expert Point of View: John L. Marshall, MD

The pendulum continues to swing in the treatment of stage II and III colon cancer. Not 5 years ago, our party line was that essentially all patients should receive 6 months of adjuvant FOLFOX (leucovorin, fluorouracil [5-FU], oxaliplatin): patients with stage II or III disease, whether rectal or...

SIDEBAR: Mammography Study Stokes Overdiagnosis Debate

Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...

Seeking Solutions to the Dilemmas of Overdiagnosis and Overtreatment

Widespread use of screening technologies has markedly increased early detection rates of cancer, saving countless lives. However, while screening technologies have remarkable sensitivity, their  inability to identify which tumors will progress and which will not has created the phenomenon of...

Defining a Cure for Chronic Myeloid Leukemia and Strategies to Achieve this Goal

In chronic myeloid leukemia (CML), continued long-term therapy that prevents both progression to accelerated-phase disease and the emergence of resistance may be thought of as an “operational” or “functional” cure. However, long-term disease control without the requirement for continuous treatment...

Managing Treatment Failure in Chronic Myeloid Leukemia

As John Goldman, DM, FRCP, FRCPath, FMedSci, discussed earlier, a substantial minority of patients with chronic myeloid leukemia (CML) experience treatment failure. Jorge Cortes, MD, of The University of Texas MD Anderson Cancer Center, introduced this session with two patient cases to illustrate...

SIDEBAR: Expect Questions and Respond with Reasoned Explanations

“Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver,” three physicians from Memorial Sloan-Kettering Cancer Center (MSKCC) in New York...

solid tumors

I Am Not a Victim

Six years ago, at age 62, I was feeling in great shape. The year before, I had taken over custody of my 2- and 3-year-old great-grandchildren and decided to change the course of my career from motivational speaker to motivational coach to be home more often with the kids. It was during one of our...

Dr. Jimmie C. Holland’s Research Has Long Underscored the Importance of Caring for the Whole Patient

Although internationally recognized today as the founder of the subspeciality of psycho-oncology, the field of psychiatry held no interest for Jimmie C. Holland, MD, when she entered Baylor College of Medicine in Houston, Texas, in the mid-1940s. Born in 1928 at the dawn of the Great Depression,...

The ‘True’ History of the Discovery of Prostate-specific Antigen

I am frequently asked about the “true” history of prostate-specific antigen (PSA). As PSA has become more important, a controversy about its discovery has increased. I lived through much of this history and have known many of the “players.” Here are the relevant facts, as I believe them to be ...

sarcoma

No Survival Advantage for Combination Chemotherapy in Advanced Soft-tissue Sarcoma  

The addition of aggressively dosed ifosfamide to doxorubicin in the treatment of advanced soft-tissue sarcomas significantly delayed disease progression but did not improve survival in the randomized phase III EORTC 62012 trial conducted by the Soft Tissue and Bone Sarcoma Group of the European...

solid tumors
prostate cancer

Stereotactic Body Radiation Therapy Produces Impressive Results in Organ-confined Prostate Cancer

Stereotactic body radiation therapy (SBRT) delivered via the CyberKnife can achieve excellent outcomes with minimal toxicity in patients with prostate cancer. Importantly, this technique delivers therapeutic doses of radiation in four to five fractions, which reduces the number of clinic visits...

issues in oncology
cost of care
health-care policy

The Ethics of Rationing Cancer Care

Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...

Research of Three Conquer Cancer Foundation Grantees Featured among Top Cancer Advances of the Year

Every year, the Conquer Cancer Foundation of the American Society of Clinical Oncology funds research grants that provide critical start-up funding for young physician-scientists, with the goal of enabling them to develop successful careers in cancer research so that they can bring new treatments...

Genetic Variation in Vitamin D Pathway Is Tied to Colorectal Cancer Risk among African Americans

African Americans’ risk of colorectal cancer varies according to whether they have certain genetic variants that affect vitamin D metabolism, according to a study presented at the Fifth American Association for Cancer Research (AACR) Conference on The Science of Cancer Health Disparities, held...

head and neck cancer

Oral Rinse Doxepin Relieves Painful Mucositis in Head and Neck Cancer

Doxepin oral rinse significantly improved oral mucositis in patients treated with radiation therapy for head and neck cancer according to results of a phase III trial presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Boston. However, the improvement was...

breast cancer

Fox Chase Researchers Find Most Medicare Patients Wait Weeks before Breast Cancer Surgery

Although patients may feel anxious waiting weeks from the time of their first doctor visit to evaluate their breast until they have breast cancer surgery, new findings from Fox Chase Cancer Center in Philadelphia show that these waits are typical in the United States. Results were published...

breast cancer

Plenary Session Included Findings on Partial- vs Whole-breast Techniques and Patient Beliefs about Radiotherapy

When the dates were picked for the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), no one could have anticipated that the meeting would coincide with Hurricane Sandy’s devastation of parts of the northeast. As the storm approached on Monday and Boston shut down its...

Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?

Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center,...

Gene-expression Profiles of Triple-negative Breast Cancers Differ between African American and Native African Women

Triple-negative breast cancers in African-American women and native African women have differing gene-expression profiles that may have implications for treatment, according to the first study to directly compare tumor gene expression between these populations. Results were reported at the Fifth...

Current Perspectives on Triple-negative Breast Cancers

Triple-negative breast cancer—which lacks expression of the estrogen receptor, progesterone receptor, and HER2 oncogene—is a challenge for oncologists. The emergence of data showing strong heterogeneity for this subtype of breast cancer creates even more confusion regarding prognosis and...

Recognizing and Managing Physician Burnout in Oncology

Although job burnout occurs in all professions, it is more common among physicians, according to a study published recently in Archives of Internal Medicine.1 Physicians on the front line of care, such as those working in emergency rooms or in family medicine, experience the highest rates of...

lung cancer

Volume-doubling Time May Help Distinguish Aggressive Cancer from Slow-growing Tumors

Changes in the size of lung tumors over time, as measured by volume-doubling times on low-dose computed tomography, can be used to distinguish aggressive lung cancer from slow-growing or indolent tumors and reduce overdiagnosis that could result in overtreatment and unnecessary morbidity. Results...

breast cancer

Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality

An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...

SIDEBAR: Expect Questions from Patients

A study finding that a diet high in total carbohydrates can increase the risk of cancer recurrence and mortality doesn’t mean that patients need to totally avoid carbohydrates, any more than previous findings about increased risk from a Western pattern diet means patients can’t eat any red meat....

colorectal cancer

Patients Treated for Colon Cancer Can Reduce Risk of Recurrence with Balanced Diet and Lower Carbohydrate Intake 

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. Patients who have received standard...

integrative oncology

Green Tea

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

ASCO CEO Discusses the Society’s Initiatives

Created in 1964,a the American Society of Clinical Oncology (ASCO) has become the world’s preeminent professional cancer organization, with more than 30,000 members in the United States and abroad, unified by its founders’ “common concern for the patient with cancer.” The ASCO Post recently spoke...

breast cancer

I’m Not the Same Person I Was before Cancer

It’s not clear to me—and my doctors can’t say with any certainty—whether taking birth control pills for many years had anything to do with my getting breast cancer 3 years ago, at age 44. But the cancer growing in my left breast was diagnosed as stage I, estrogen receptor–positive. Although I never ...

Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven

That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman,...

issues in oncology

Teens and Young Adults with Cancer Want a Voice in End-of-life Care

A top the list of concerns of adolescents and young adults with a life-threatening cancer are these two considerations: being able to choose the kind of medical treatment they want (or do not want) and expressing their wishes to family and friends about how they want to be remembered, according to...

prostate cancer

Online Prostate Cancer Information Is Written at Reading Levels above Many Americans’ Literacy Skills

Although 61% of Americans are going online to access health information,1 many of them may not understand what they find there, including information about prostate cancer treatment options. According to a new study published in The Journal of Urology,2 as many as 90 million Americans have literacy ...

issues in oncology

Community Research Forum Addresses Conundrums Common to Community Practices that Conduct Research 

It is every research site’s biggest concern. The National Cancer Institute (NCI), the FDA, or drug company sponsors could arrive at any time to comb through a site’s documents related to a specific trial. It’s called an audit, and it’s common. And yet, not all sites that conduct research have...

cost of care

ASCO Top Five List Highlighted in IOM Workshop

As part of the Institute of Medicine’s (IOM) National Cancer Policy Forum workshop on delivering affordable cancer care in the 21st century, ASCO’s Top Five list was highlighted as an example of a way to improve quality of care for patients while reducing unnecessary costs. Lowell Schnipper, MD,...

issues in oncology

Developing Cancer Care Pathways for the New Environment

As community practices and the insurance industry seek cost-effective ways to adapt to the Patient Protection and Affordable Care Act, the evolving concept of cancer care pathways is emerging as a strategy that may help control oncology costs and add value to care. At ASCO’s recent Quality Care...

issues in oncology

ASCO’s Approach to Health Information Technology and the Rapid-learning System

The slow, but inevitable evolution of electronic oncology health-care systems has already, at least conceptually, moved to the next generation of machines that not only store and process data, but also have the ability to provide real-time clinical decision support. At ASCO’s first Quality Care...

multiple myeloma

Oral Proteasome Inhibitor May Be a Game-changer in Myeloma

An investigational oral proteasome inhibitor currently known as MLN9708 could make the treatment of multiple myeloma much more convenient and possibly less neurotoxic, according to the results of a phase I/II study of treatment-naive multiple myeloma patients presented at the 54th Annual Meeting of ...

issues in oncology

National Comprehensive Cancer Network Appoints New CEO

The National Comprehensive Cancer Network (NCCN) recently appointed nationally regarded breast cancer expert Robert W. Carlson, MD, as its new CEO. Previously, Dr. Carlson was Professor of Medicine in the Division of Oncology and Medical Informatics, Stanford University Medical Center; he first...

health-care policy

Does Health-care Quality Translate to Value?

On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first...

Expert Point of View: Peter Ravdin, MD and Sandra M. Swain, MD, FACP

Putting these results in perspective, Peter Ravdin, MD, moderator of a San Antonio Breast Cancer Symposium press conference where ATLAS findings were discussed, said that in the United States, there is currently a different strategy for pre- and postmenopausal women. Tamoxifen is used as primary...

kidney cancer

Social Media Is Helping My Brother Fight Kidney Cancer 

My brother, Rick Thomas, is a great guy. I’m not just saying that because he’s my brother. He’s funny, warm, and kind to everyone he meets. He became a commercial airline pilot for American Airlines after flying C-5s in the Air Force for 12 years and has always been a responsible person and a...

leukemia
breast cancer

Oncology Trailblazer James F. Holland, MD, Recalls a Time of Unbridled Scientific Excitement 

James F. Holland, MD, began his journey into oncology when it was still a nascent discipline, working alongside groundbreaking pioneers in the field such as Drs. Emil “Tom” Frei and C. Gordon Zubrod. Dr. Holland recently shared a glimpse of his role in oncology’s formative years with The ASCO Post. ...

issues in oncology

Helping Patients Prepare for Cancer Treatment Decisions

Under the stress of a cancer diagnosis and overwhelmed with the influx of information, patients often report that they feel unprepared to engage fully in the discussion with their health-care provider around a critical treatment decision. Consequently, the Cancer Support Community—an international...

issues in oncology

Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer  

Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients...

health-care policy

Health Insurance Issues for Young Cancer Survivors

The latest addition to Cancer.Net’s video series for young adults, Moving Forward: Perspectives from Survivors and Doctors, deals with the health insurance issues young adult cancer survivors may face. This video series is a collaboration between Cancer.Net and LIVESTRONG. Each set of videos in the ...

breast cancer
lung cancer

ASCO Decision Aids Intersect Evidence-based Guidelines, Productive Patient Communication

Imagine this common clinical scenario: A 64-year-old woman presents with a new abnormality on a mammogram. A core needle biopsy and subsequent partial mastectomy reveal a 1.8-cm invasive ductal carcinoma. Sentinel lymph nodes are negative for cancer. The tumor is moderately differentiated and is...

Pediatric Cancer Foundation Names Four Recipients of 2012 Award, Each to Receive Grant for Research 

Alex’s Lemonade Stand Foundation, a nonprofit group dedicated to finding cures for all children with cancer, has named four researchers 2012 recipients of the “A” Award. Christopher Vakoc, MD, PhD, of Cold Spring Harbor Laboratory; Roland Walter, MD, PhD, of the Fred Hutchinson Cancer Research...

lymphoma

PET-negative Scan after Short-course Chemotherapy Identifies Early Hodgkin Lymphoma Patients Who Can Forgo Radiation

Positron-emission tomography (PET)-directed therapy is promising for early-stage Hodgkin lymphoma, according to results of the UK NCRI RAPID trial presented at the 54th Annual Meeting of the American Society of Hematology (ASH).1 The use of PET scan enabled the identification of a population of...

issues in oncology

Expert Point of View: Kevin P. Weinfurt, PhD

Our work suggests three specific recommendations for researchers and care providers who are discussing with patients the possibility of enrolling in a phase I clinical trial. First, we should always communicate the likelihood of benefit in terms of the number of participants expected to derive...

SIDEBAR: Expect Questions from Patients with Diabetes and Cancer

Patients with diabetes and cancer need to know that some chemotherapy drugs and adjuvant agents may require modifications in how they manage their diabetes. For example, patients who are receiving steroids might have to further restrict their diet to keep blood sugar levels under control. “You...

issues in oncology

Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have Cancer 

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 and diabetes can be comorbid...

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