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health-care policy

Highlights of ACCC Annual Meeting Include Discussion of Trends Shaping the Future of Health Care 

The 39th Annual National Meeting of the Association of Community Cancer Centers (ACCC) was held in Washington, DC, in March. With a focus on business, economics, and policy, the program included the inauguration of a new ACCC President (see page 102), a keynote speech on the future of health care,...

health-care policy

Implementing a National Cancer Clinical Trials System for the 21st Century 

In March 2011, the National Cancer Policy Forum of the Institute of Medicine (IOM), in conjunction with ASCO, held a workshop to discuss a collaborative approach to making the National Cancer Institute (NCI)-funded clinical trials system more viable and productive. That workshop included...

C. Everett Koop, MD, Surgeon General Under Ronald Reagan, Dies at 96 

Appointed by the President and called “America’s Doctor,” the Surgeon General’s chief task is to protect and advance the health of the nation. Most of our Surgeon Generals have tiptoed around hot-button public health issues that might bruise political sensibilities and their own careers. C....

issues in oncology

ASCO-SEP®, 3rd Edition, Features Digital Formats and Complementary Study Tools

ASCO has released the latest edition of ASCO-SEP®, a comprehensive resource designed to help medical providers assess and improve their level of knowledge in the various areas of oncology, enabling them to provide care that will optimize the quality of life for people with cancer. ASCO-SEP, 3rd...

leukemia

Gene Transfer Therapy Is Producing Prolonged Remissions in Patients with Advanced Leukemia 

In August 2011, researchers from the University of Pennsylvania published their breakthrough findings of a pilot study showing sustained remissions of up to 1 year in a small number of patients with advanced chronic lymphocytic leukemia (CLL) who had been treated with genetically engineered...

Expert Point of View: Anthony V. D’Amico, MD, PhD

“Thirty-six months of hormone therapy is the standard of care for the treatment of high-risk prostate cancer treated with radiotherapy,” said formal discussant Anthony V. D’Amico, MD, PhD, Professor in the Department of Radiation Oncology at Harvard Medical School and Chief of Genitourinary...

lung cancer

Genomic Analysis of Squamous Cell Lung Cancer Tumors May Lead to More Targeted Therapies 

Last fall, a consortium of more than 300 researchers from The Cancer Genome Atlas (TCGA) Research Network published the results of their large-scale genetic analysis of squamous cell lung cancer in the journal Nature.1 The study, the first of its kind, compared the tumor cells from 178 untreated...

breast cancer

Does All DCIS Need Treatment? Debaters Take Sides at Surgical Oncology Meeting 

There are a few things about ductal carcinoma in situ (DCIS) on which everyone agrees: Incidence increased dramatically with the advent of mammography screening, not all cases detected will go on to cause symptoms in the patient’s lifetime, and there’s no proven way to tell which cases will...

colorectal cancer

BRAF Mutations in Colorectal Cancer: The Next Frontier 

Some 5% to 10% of patients with colorectal cancer harbor the BRAF mutation, placing them at risk for poor treatment response and worse outcomes. The ASCO Post interviewed S. Gail Eckhardt, MD, an expert in this area who is Professor and Head of the Division of Medical Oncology at the University of...

hepatobiliary cancer
pancreatic cancer
gastrointestinal cancer

Important Data and Treatment Advances Reported in GIST and in Pancreatic and Liver Cancers 

The 10th annual Gastrointestinal Cancers Symposium, held recently in San Francisco, was jointly sponsored by ASCO, the AGA (American Gastroenterological Association), ASTRO (American Society for Radiation Oncology), and the SSO (Society of Surgical Oncology). “We seek to present the newest...

survivorship

Sexual Health after Cancer: Communicating with Your Patients 

Studies show virtually all cancer survivors will experience some form of sexual dysfunction following a cancer diagnosis and treatment. Yet few cancer survivors seek help for physical problems they may be experiencing, such as vaginal dryness, dyspareunia, chemically induced menopause, reduced...

colorectal cancer

Is Aspirin Protective against Colorectal Cancer? 

A growing body of evidence provides biologic and clinical evidence that nonsteroidal anti-inflammatory agents are protective against colorectal cancer. “It is fascinating for me as a medical oncologist and epidemiologist to see how the worlds of colorectal cancer treatment and epidemiology are...

Acts of Kindness Were Key to My Survival 

Just 1 month after undergoing a mammogram that was deemed normal with some dense tissue in my left breast, my gynecologist felt a mass in that breast about the size of a cherry tomato during a routine well visit. After watching the lump for a month to see if it was cyclical, she sent me for another ...

Expect Questions from Younger Women about Breast Cancer  

“SEER data showed a small but statistically significant increase in the incidence of breast cancer with distant involvement for women aged 25 to 39 years,” concluded a study published in the Journal of the American Medical Association.1 “The trajectory of the incidence trend predicts that an...

breast cancer

Increase in Advanced Breast Cancer among Younger Women Is Small but Significant, and Trend Is Likely to Continue 

The incidence of advanced breast cancer among women aged 25 to 39 years increased by an average of 2.07% per year from 1976 to 2009 and the trend seems likely to continue, according to an analysis of data for 936,497 women diagnosed with malignant breast cancer. The small but statistically...

global cancer care

From One to Many, Here and Around the World

The Conquer Cancer Foundation Grants and Awards Program has grown tremendously in 30 years, from supporting just one researcher in the United States to thousands working around the world. These investigators are performing breakthrough research in all aspects of cancer and making discoveries that...

hematologic malignancies
leukemia

A Promising New Agent's Road to Approval in CLL Raises Questions, Stirs Controversy 

Early trial results in single-agent therapy with the oral Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib have produced excellent responses in patients with chronic lymphocytic leukemia (CLL). Moreover, ibrutinib is extremely well tolerated, allowing patients to remain on trial and receive the...

issues in oncology

Access to Care: Who Gets Referred to a Medical Oncologist and/or Another Cancer Specialist and Who Receives Treatment for Advanced Cancer? 

What factors determine who is referred to a medical oncologist and receives treatment for advanced cancers? Several articles in the Journal of Oncology Practice suggest that factors influencing referral and treatment go beyond the patient’s medical condition and preference and include such details...

issues in oncology

CancerLinQ Prototype Demonstrates Use of Big Data in Clinical Care 

ASCO has unveiled the prototype of a computer system that will allow oncologists, from their desks, to leverage “big data” to measure the quality of care that their practices provide. The prototype is a major step in the development of CancerLinQ, a system that will eventually allow millions of...

SIDEBAR: The Ethical Imperative of Clinical Equipoise 

In her editorial about the RESONATE trial (page 1), Dr. O’Brien raises the issue of equipoise in this phase III clinical trial that compares the efficacy of ibrutinib and ofatumumab (Arzerra) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who are not appropriate...

leukemia

Ibrutinib CLL Trial: Where Is the Equipoise?

The RESONATE trial is randomly assigning patients with refractory or relapsed CLL to either ofatumumab (Arzerra) or the investigational oral agent ibrutinib. Ofatumumab is an anti-CD20 monoclonal antibody like rituximab (Rituxan), but is more potent as a single agent. It was approved for refractory ...

skin cancer

Does Every Melanoma Patient with a Positive Sentinel Node Need More Lymph Nodes Removed? 

When sentinel node biopsy was shown to predict whether early melanoma had spread to regional lymph nodes, it revolutionized care. Before that, dissection of all regional lymph nodes was the norm for most patients. After that, the standard of care became a sentinel node biopsy and then—only if the...

Emil 'Tom' Frei III, MD, Trailblazer in the Development of Combination Chemotherapy, Dies at 89 

The pages of medical history are dog-eared with breakthroughs that have transformed medicine and saved lives. One of those dog-eared pages belongs to Emil Frei III, MD, known to his colleagues and friends as Tom. In the dawn of oncology, Dr. Frei, along with his associate, Emil Freireich, MD, did...

SIDEBAR: Going Public with Ovarian Cancer Outcomes  

Commenting on the study finding that most women with ovarian cancer are not being treated with the recommended standard of care, a New York Times editorial noted, “One of the surest ways to improve performance would be to analyze and make public how well individual doctors and hospitals do in...

Expect Questions about Experience and Outcomes  

“Patients are becoming more sophisticated in their ability and willingness to interrogate the health-care system about their care,” according to Robert E. Bristow, MD, MBA, lead author of the study finding that many women with ovarian cancer are not receiving care consistent with National...

gynecologic cancers

Most Women with Ovarian Cancer Do Not Get Guideline-specified Treatment Linked to Survival Benefits 

Most women with ovarian cancer are not receiving adequate treatment, as specified in National Comprehensive Cancer Network (NCCN) Guidelines,1 and as a result are being deprived of the survival benefits correlated with guideline-recommended treatment, according to a study presented at the Society...

solid tumors
prostate cancer

Obese Men with Benign Biopsy at High Risk for Prostate Cancer

Obese men were more likely to have precancerous lesions detected in their benign prostate biopsies compared with nonobese men and were at a greater risk for subsequently developing prostate cancer, according to data published recently in Cancer Epidemiology, Biomarkers & Prevention.1 “Our study ...

solid tumors
breast cancer
survivorship

Dr. Bernard Fisher's Breast Cancer Research Left a Lasting Legacy of Improved Therapeutic Efficacy and Survival 

Bernard Fisher, MD, is recognized today for his groundbreaking research in breast cancer, which ultimately ended the standard practice of performing the Halsted radical mastectomy, a treatment that had been in place for more than 75 years. His laboratory and clinical investigations led to more...

Focus on Alaska's Denali Oncology Group

Located in Anchorage, Alaska, the Denali Oncology Group faces the dual challenge of serving a diverse and large population of more than 731,000 spread across a vast state of 586,000 square miles, with just 20 medical oncologists and 5 radiation oncologists located mainly in Alaska’s two biggest...

gynecologic cancers

Lynch Syndrome: A Multitude of Predispositions 

The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is...

NCCN Patient Guidelines for Adolescents and Young Adults 

The National Comprehensive Cancer Network (NCCN) has issued new NCCN Guidelines for Patients, titled “Caring for Adolescents and Young Adults [AYA].” These guidelines fill an unmet need in oncology, as Peter F. Coccia, MD, Chair of the NCCN Guidelines Panel for Young Adult Oncology and a member of...

lung cancer

Lessons of 2 Decades' Experience with CHESS

Our work on an Internet-based intervention for lung cancer confirmed what many other studies have shown about technologic interventions for health-care consumers—that such interventions can improve quality of life for caregivers and patients.1 We expected this result in part because of the...

issues in oncology

Debt and the Oncology Fellow 

Despite today’s challenging economy, health care is one field that offers vast career opportunities. Oncology, with the impending workforce shortage, is especially eager for bright young doctors to join its ranks. But the rising costs of medical school can be a deterrent, leading the best and...

Cancer Treatment Pioneers to Share Prize in Medicine and Biomedical Research

Peter C. Nowell, MD, Janet D. Rowley, MD, and Brian J. Druker, MD, have been named as the recipients of the 2013 Albany Medical Center Prize in Medicine and Biomedical Research, to be officially awarded May 17. The $500,000 award, given to those who have altered the course of medical research, is...

ASCO President’s Personal Philanthropy Honors Founder Jane C. Wright, MD

During her term as ASCO President, Sandra M. Swain, MD, FACP, of the Washington Cancer Institute has kept a solid focus on her presidential and 2013 ASCO Annual Meeting theme of “Building Bridges to Conquer Cancer.” These bridges take many forms, spanning challenges to be overcome in oncology...

issues in oncology
health-care policy

Disparities in Cancer Care: How A Deep South Community Overcame Them 

Racial inequities were a daily observation for Edward E. Partridge, MD, growing up in Alabama during the civil rights era. When he became a physician, he saw that these disparities extended into his own field, gynecologic oncology. He decided to do something about it. Dr. Partridge recently...

Managing Female Reproductive Complications after Cancer Treatment in Children and Young Adults 

Follow-up care for female patients treated for cancer as children, adolescents, or young adults should include assessment and management of the late effects that therapy may have on reproductive health, as detailed in updated guidelines from the Children’s Oncology Group. “It is important for...

issues in oncology

Women in Oncology: Trending in the Right Direction 

According to ASCO President ­Sandra M. Swain, MD, FACP, an important part of her Presidential theme, “Building Bridges to Conquer Cancer,” is finding creative ways to ensure that we have enough oncologists to care for our burgeoning cancer patient population. Adding more women to the oncology...

breast cancer
issues in oncology
survivorship

Breakthroughs in Targeted Therapies for Breast Cancer Are Improving Patient Survival Rates 

For more than 20 years, José Baselga, MD, PhD, has devoted his medical and scientific career to caring for breast cancer patients and the development of novel molecular targeted agents to treat the disease. From 1996 to 2010, he was Head of the Oncology Department of Vall d’Hebron University...

SIDEBAR: Left-sided Adjuvant Breast Radiotherapy: A Change of Heart? 

Darby and colleagues are to be congratulated for an ambitious population-based case-control study that demonstrates the impact of postoperative adjuvant ionizing radiation for early-stage breast cancer on ischemic heart disease.1 The study examined roughly 1,000 cases and 1,000 controls in Sweden...

issues in oncology

Tobacco Use in Cancer Patients: Often Overlooked but Critical to Address 

One would hope that the importance of treatment for tobacco dependence would be well recognized as a cornerstone of standard care for cancer patients. However, a policy statement released by the American Association for Cancer Research (AACR) at its recent Annual Meeting revealed some surprising...

lung cancer

The Tissue Is the Issue: Choosing Therapy for Lung Cancer 

The new guidelines from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology (CAP/IASLC/AMP) are a significant step toward personalized therapy of patients with lung cancer. More than 226,000 new patients per year are...

lung cancer

New Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitor Treatment 

A new guideline for molecular testing to select lung cancer patients for treatment with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors has been jointly developed by the College of American Pathologists, International Association for the Study ...

NCCN Clinical Practice Guidelines in Oncology: 2013 Updates 

At the 18th Annual Conference of the National Comprehensive Cancer Network (NCCN), representatives of NCCN Guidelines panels presented two new sets of guidelines along with updates for several tumor types, summarized in this issue of The ASCO Post. New NCCN Guidelines for Survivorship “The...

On the Potential for Conflicts of Interest

In a recent issue of The ASCO Post, I counted 14 expert commentaries where the authority who wrote or was interviewed for the piece reported “no potential conflicts of interest.” I wondered how likely that was. We need to be clearer on the meaning of potential conflicts of interest. How often have...

health-care policy
legislation

Sequestration's Impact on Cancer Care  

On March 1, the deficit-budget mechanism known as sequestration took effect, triggering $85 billion in across-the-board cuts to most federal agencies over the remaining 7 months in fiscal year 2013. The total federal deficit reduction budget under the Budget Control Act of 2011 calls for $1.2...

Proof of Principle for Adoptive T-cell Therapy in Cancer 

In a recently published study, Memorial Sloan-Kettering Cancer Center investigators demonstrated the considerable antitumor efficacy of 19-28z chimeric antigen receptor (CAR)-modified T cells in patients with relapsed/refractory B-cell acute lymphoblastic leukemia (ALL). The ASCO Post asked lead...

More Recollections on Emil 'Tom' Frei III, MD

I have read with interest the recent tributes to Emil “Tom” Frei III, MD, who passed away in April. I was backstage at the ASCO Annual Meeting in 1981, when Dr. Frei was giving his Karnofsky acceptance address. I had a slide presentation at the combined ASCO/American Association for Cancer Research ...

breast cancer

Study Clarifies Appropriate Timing of Follow-up Imaging after Benign Breast Biopsies 

Follow-up imaging for patients with benign breast biopsies can be safely done at 12 months rather than 6 months, when radiologic and pathologic findings are concordant, according to a study reported at the American Society of Breast Surgeons Annual Meeting in Chicago.1 Current guidelines from the...

Expect Questions from Your Patients 

Patients reading or hearing about the updated draft recommendation statement from the U.S. Preventive Services Task Force (USPSTF) on the use of medications to reduce risk for primary breast cancer1 may ask if and how it applies to them. To help answer those questions, the information presented...

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