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issues in oncology

We Can Conduct Clinical Trials of Protons

A great deal has been written about proton therapy, with a good deal of heat and only a modest amount of light. I would like to comment on an aspect of the proton vs photon controversy that I believe has not been adequately addressed: Should we run clinical trials that would allow us to prove that...

breast cancer
legislation

Giving Women a Fighting Chance When They Have Breast Cancer

I knew there was a chance I could get breast cancer, I just never thought it would really happen to me. I am one of 2.5 million breast cancer survivors living in our country today. Just weeks after getting a clean mammogram and my 41st birthday, I felt a lump in my breast. As a young and otherwise...

issues in oncology

LETTER TO THE EDITOR: ‘Unrealistic Optimism’ or Losing Sight of the Forest for the Trees?

The article: “Unrealistic Optimism Poses Ethical Challenges, May Affect Informed Consent Process” (The ASCO Post, September 1, 2011, page 35) seems to be delving into a subject with an intent that is unclear. I agree fully with Dr. Jimmie Holland that discrimination between “optimism” and...

breast cancer

LETTER TO THE EDITOR: Treating Cancer or Fear?

I read the article by Deb Stewart, “Acting on Fear” (The ASCO Post, August 15, 2011, page 1) with interest, disappointment, and empathy. “Acting on fear” in cancer treatment generally, and particularly in breast cancer, is not uncommon. Hence, I was most interested in the article’s major thrust, as ...

colorectal cancer

‘Hot Chemotherapy’ Generates Heated Debate about Its Use with Cytoreductive Surgery to Manage Peritoneal Metastases

"Hot chemotherapy” has become the common term for hyperthermic intraperitoneal chemotherapy (HIPEC), which together with cytoreductive surgery is being used by some surgeons to treat patients with carcinomatosis from colorectal cancer. While HIPEC is not considered the most important component of...

health-care policy

ASCO Issues Policy Statement to Reduce Cancer Care Disparities

Last August, ASCO issued the policy statement, “Opportunities in the Patient Protection and Affordable Care Act to Reduce Cancer Care Disparities” in the Journal of Clinical Oncology.1 The statement builds on ASCO’s policy on disparities in cancer care released in 2009. It calls on both the...

survivorship
supportive care
geriatric oncology

Yoga, Geriatric Assessment, and Nausea/Vomiting Addressed in Session on Supportive Care and Survivorship Issues

Marie E. Wood, MD, of the Familial Cancer Program at the University of Vermont, Burlington, addressed clinically relevant issues in supportive care and survivorship at the Best of ASCO® Annual Meeting ‘11 in Miami. Delayed Nausea and Vomiting Two studies addressed the problem of...

leukemia

Improvements Highlighted in Treatment of Leukemias and Preleukemias

Certain preleukemic conditions and leukemia in high-risk patients have remained challenging to treat despite advances in hematology, according to Wendy Stock, MD, of the University of Chicago. But studies reported at the Best of ASCO® Annual Meeting ‘11 in Seattle show progress even in these ...

New Features Added to Cancer.Net’s Popular ‘Find an Oncologist’ Database

When patients need to find an oncologist, Cancer.Net is there to help with the Find an Oncologist database, at www.cancer.net/findanoncologist. This database is made up of ASCO members who have made their contact information public. In addition to location and specialty, patients can now search by...

ASCO Study Shows Integrating Nonphysician Providers into Oncology Practices Is a Win for Patients and Providers

Is the expanded use of nonphysician providers (NPPs) a viable way to help ease the challenges oncology practices could feel if the number of oncologists entering the field does not keep pace with potential growth in the demand for their services? The ASCO Workforce Advisory Group thought the...

prostate cancer

Short-term Androgen Deprivation plus Radiotherapy Improves Outcomes in Intermediate-risk Prostate Cancer

The addition of short-term androgen-deprivation therapy to external-beam radiation therapy improved overall and disease-specific survival in men with nonbulky localized prostate cancer and prostate-specific antigen (PSA) levels up to 20 ng/mL, as reported recently in The New England Journal of...

SIDEBAR: Expert Q and A

D. Neil Hayes, MD, MPH, of the University of North Carolina, Chapel Hill, discusses the role of HPV status in head and neck cancer. Are you convinced human papillomavirus (HPV) positivity is associated with better prognosis? Dr. D. Neil Hayes: The HPV story influences almost everything we do in...

head and neck cancer

New Therapies and Prognostic Techniques Highlighted in Head and Neck Cancer

D. Neil Hayes, MD, MPH, of the University of North Carolina at Chapel Hill, described efforts to position the epidermal growth factor receptor (EGFR) inhibitor cetuximab (Erbitux) in head and neck cancer treatment. Surprisingly negative results came from the phase III Radiation Therapy Oncology...

sarcoma

Novel Approaches and Agents Making Headway against Sarcoma

Novel approaches and agents reported at the ASCO 2011 Annual Meeting are improving outcomes in sarcoma, a heterogeneous disease with historically poor outcomes, according to William D. Tap, MD, Section Chief of Sarcoma Oncology at Memorial Sloan-Kettering Cancer Center in New York. Dr. Tap...

SIDEBAR: Using Axitinib in Advanced Renal Cell Carcinoma

With a new tyrosine kinase inhibitor joining the armamentarium, the question is how to optimize targeted agents for advanced renal cell carcinoma. The AXIS trial demonstrated strong clinical activity for axitinib, which was superior to second-line sorafenib (Nexavar) and generally appears most...

SIDEBAR: Will East-West Differences Limit Transferability of Clinical Trial Results?

Differences in patients’ tumor characteristics and in surgical practices between eastern and western countries may limit the transferability of clinical trial results in early gastric cancer, according to Dr. Lockhart. One major difference is tumor location. For example, in the Asian CLASSIC...

gastrointestinal cancer

Practice-changing Evidence in Treatment of Noncolorectal GI Cancers

Studies presented at the ASCO Annual Meeting in the field of noncolorectal gastrointestinal cancer both reaffirmed certain standards of care and introduced some practice-changing data, according to A. Craig Lockhart, MD, of Washington University in St. Louis. Perioperative Therapy for Gastric...

SIDEBAR: Risk-based Approach Needed for Stage II Colorectal Cancer

Management of stage II colorectal cancer remains a considerable gray area where an individualized risk-based approach and more molecular research are needed, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. “Stage II is a little bit more complicated than stage III,” he...

SIDEBAR: Is G13D KRAS Mutational Status Ready for Prime Time?

Individual oncologists will have to decide for themselves whether the results from the pooled analysis of cetuximab trials regarding G13D KRAS mutational status are ready for clinical application, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. “We still need...

colorectal cancer

Standards of Care Confirmed in Latest Group of Colorectal Cancer Trials

Colorectal cancer studies reported at this year’s ASCO meeting offered little in the way of practice-changing information, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. But they did confirm existing standards of care, he noted at the Best of ASCO® meeting in Seattle....

SIDEBAR: Stay Tuned for More Information on Neuropathy-related Genes

According to Daniel F. Hayes, MD, of the University of Michigan, Ann Arbor, who moderated the Best of ASCO® Miami conference, taxane-induced neuropathy is a more complicated story than the study by Schneider and colleagues may suggest. “There are now three observations regarding inherited germline ...

SIDEBAR: Studies Sparked Questions to Breast Cancer Specialists

Based on the MAP.3 findings, should we be using exemestane to prevent breast cancer in high-risk patients? Dr. Harold Burstein: The risk of developing breast cancer was 2.5% in the placebo arm, vs 1% to 1.5% risk with exemestane. Also, the cancers that were avoided were probably ones with good...

lung cancer

Research Increasingly Points to the Role of Molecular Diversity in Metastatic Lung Cancer

Molecular diversity—its existence, extent, and implications for therapy—was a central theme of key metastatic lung cancer studies presented at this year’s ASCO meeting, according to D. Ross Camidge, MD, PhD, of the University of Colorado, Denver, who addressed major findings in advanced lung cancer ...

colorectal cancer

Fear of the Unknown: Cancer Treatment Can Be Scarier than the Disease Itself

Two years ago, I was feeling fine except for a nagging problem with severe constipation. I believed this was caused by some loperamide I had taken to quell the episodes of diarrhea I experienced following dinner at a local barbecue restaurant. When the symptoms persisted for a couple of months, I...

SIDEBAR: Expect More Answers in the Future

“We are still following patients from the initial cohort,” reported Martin G. Sanda, MD, principal investigator of the study published in JAMA, “Prediction of Erectile Function Following Treatment for Prostate Cancer.” At a median follow-up now of about 6 years, “there is evidence that there might...

prostate cancer

Physicians Can Help Patients Set Realistic Expectations for Sexual Functioning after Treatment for Prostate Cancer

Models that can be personalized to predict erectile function of individual patients following treatment for early-stage prostate cancer have been developed and validated in a study involving a total of 2,940 men, and are ready for use in clinical practice, according to Martin G. Sanda, MD, the...

integrative oncology

Integrative Medicine Offers Added Value for Patients with Cancer

Addressing a patient’s physical, emotional, and spiritual needs during the cancer journey, integrative medicine combines such time-honored therapies as nutrition, exercise, and meditation alongside allopathic approaches to cancer care, with the ultimate goal of improving survival rates and reducing ...

Expert Point of View: Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions

Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, found the findings presented by Marc Peeters, MD, PhD,1 at the 2011 European Multidisciplinary Cancer Congress to be of great interest, from both clinical and research perspectives. “We have two discrepant analyses now for G13D. When we...

cost of care

New Technologies Are Driving Up Costs: Are They Worth the Price?

Expensive new cancer therapies and technologies are alluring for both physicians and their patients. Prostate cancer, because of the sheer volume of cases and the variability of treatment options, serves as a dynamic disease model in the ongoing debate over how to curb spending and maintain...

issues in oncology
cost of care

A Conversation with Richard J. Gilbertson, MD, PhD

St. Jude Children’s Research Hospital, Memphis, the country’s first and only NCI-designated Comprehensive Cancer Center devoted solely to children, recently appointed internationally regarded pediatric brain tumor researcher, Richard J. Gilbertson, MD, PhD, as its new Cancer Center Director. In a...

health-care policy

AACR Issues Landmark Report on Cancer Progress

At a recent press conference in Washington, DC, the American Association for Cancer Research (AACR) assembled luminaries from the cancer research and care communities to discuss the salient points of the association’s newly released progress report on the current and future state of cancer research ...

Expert Point of View: European Perspective

Martine Piccart, MD, of the Institut Jules Bordet, Brussels, Belgium, and President-Elect of the European Society for Medical Oncology, was highly enthusiastic about the findings of the phase II T-DM1 study, but said, “We have to remember this is an open-label trial, and in a study like this,...

issues in oncology

Do We Need the USPSTF?

Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...

breast cancer

FDA Commissioner Announces Decision on Bevacizumab

On November 18, FDA Commissioner Margaret A. Hamburg, MD, said she is revoking the agency’s approval of the breast cancer indication for bevacizumab (Avastin) after concluding that the drug has not been shown to be safe and effective for that use. Bevacizumab will still remain on the market as an...

health-care policy

ASCO Supports the United Nations Political Declaration on Noncommunicable Diseases

In September, government leaders from around the world as well as representatives from civil society, the private sector and academia gathered at the United Nations in New York for the first-ever summit on the growing economic and human crisis posed by noncommunicable diseases (NCDs), especially in ...

cost of care
issues in oncology

A Conversation with Craig B. Thompson, MD

In November 2010, Craig B. Thompson, MD, was named President and CEO of Memorial Sloan-Kettering Cancer Center (MSK) in New York, succeeding Harold Varmus, MD, who is now Director of the NCI. A cancer clinician and researcher, before coming to Memorial Sloan-Kettering Dr. Thompson was Director of...

breast cancer

Researchers Explore Reasons for Higher Risk of Triple-negative Breast Cancer in Underserved African-American Women

Triple-negative breast cancer, one of the most aggressive forms of the disease, has a bad reputation, and among socioeconomically disadvantaged black women, that reputation is especially well deserved. In fact, according to Lisa A. Newman, MD, Director of the Breast Care Center, University of...

gynecologic cancers

Fighting to Get Back Control

I’ve had raging hormones since I was 18, when I was diagnosed with a benign pituitary adenoma. The tumor caused unpredictable menstrual cycles that remained constant throughout my life, even after it had been successfully treated. So 2 years ago, when I turned 40 and started having sudden bouts of...

skin cancer

Investigators Unlocking the Mysteries of Merkel Cell Carcinoma

Researchers at the University of Pittsburgh Cancer Institute have documented the molecular activity through which the Merkel cell polyomavirus contributes to 80% of cases of Merkel cell carcinoma—a finding that holds promise for future therapies. The researchers are now working on testing more than ...

breast cancer

Tamoxifen vs Surgery Study Shows Older Patients with Breast Cancer Can Achieve a ‘Personal Cure’

A truly final review—when all the patients in the trial have died and the cause of death is known for each—of a randomized trial comparing tamoxifen to surgery in patients over the age of 70 with operable breast cancer found no differences in the survival rates or deaths attributable to breast...

ASCO in Action Online: Your Source for Policy News and Information

The recently enhanced ASCO in Action site ascoaction.asco.org is a one-stop source for the latest policy news related to quality cancer care and research. Whether it is information about legislation that affects cancer patients or oncology practices, easy links to ASCO’s recent policy positions,...

ASCO Journal Apps Now Available for iPad and iPhone

Users of the market-leading mobile devices have been able to access optimized versions of the Journal of Clinical Oncology (JCO) and Journal of Oncology Practice (JOP) websites since the spring of 2011. Now, iPad and iPhone users can download free JCO and JOP apps from the iTunes store. Smooth and...

Oncology’s Only Benchmark Report, National Practice Benchmark, Is Now a Yearly JOP Supplement

Would it surprise you to learn that 40% of your peers in oncology who responded to a survey last year have a certified electronic medical record system in place? Or that 86% of them are in physician-owned practices? Or that the average number of full-time equivalent hematology/oncology physicians...

Global Trials: Do Benefits Outweigh Pitfalls?

Global clinical trials have many advantages and are essential in many disease settings, but there are also challenges that confront global industry-sponsored research, said Sandra Horning, MD, Senior Vice President and Global Head of Clinical Development in Hematology/Oncology for Genentech (Table...

lung cancer

NCCN Guidelines® for Lung Cancer Screening Now Available

The new NCCN Guidelines for Lung Cancer Screening primarily refer to non–small cell lung cancer, the most common type of lung cancer, and recommend helical low-dose computed tomography (LDCT) screening for select patients at high risk for the disease. In addition to outlining the appropriate use of ...

issues in oncology

Important Lessons for Oncology from the Front Lines of the AIDS Pandemic

On June 5, 1981, the CDC issued a warning about a rare type of pneumonia discovered among a small group of young gay men in Los Angeles, later determined to be AIDS-related, ushering in the HIV/AIDS epidemic. Early on, AIDS-related malignancies brought the oncology community into this formidable...

health-care policy

Medicare Reimbursement to Physicians: Déjà Vu All Over Again

In February 2011, The ASCO Post published an opinion piece (“Congress and the ‘Doctor Fix’: Looking Back, Looking Ahead”) about the ping-pong of legislative continuing resolutions to avert a 21.3% cut in physician reimbursement. These continuing resolutions were necessary because the Affordable...

leukemia
head and neck cancer

My Cancer Is Incurable, but My Future Is Limitless

Cancer has nearly always been part of my life. When I was 6 years old, I was diagnosed with acute lymphoblastic leukemia. The doctors told my parents that unless I was treated immediately, I wouldn’t live longer than a month. Over the next 3 years, I underwent intensive courses of chemotherapy and...

Expert Point of View: Researchers Find Remarkable Heterogeneity in Sarcomas

Historically, studying sarcoma has been problematic for several reasons. Sarcomas represent only about 1% of all adult cancers, and there are many subtypes, so getting a group of patients with one type of sarcoma together for a clinical trial in a single institution can be challenging. In the past, ...

Reflections from The ASCO Post

The editors gratefully acknowledge all contributors to The ASCO Post and thank the columnists who contributed to Volume 2, January–December 2011: Al B. Benson III, MD, FACP Richard Boxer, MD, FACS Carlton G. Brown, RN, PhD, AOCN Barrie R. Cassileth, PhD E. David Crawford, MD Emil J. Freireich, MD, ...

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