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issues in oncology

Overcoming Sexism in Academic Medicine

The troubling results from a survey1 investigating the sexual harassment and discrimination experiences of academic medical faculty show that such incidents continue to happen with unexpected frequency despite increasing awareness of the problem. The study by Reshma Jagsi, MD, DPhil, and...

palliative care
supportive care

Understanding the Cultural Differences Among Ethnic Minorities in Palliative and End-of-Life Care

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development.   Because cultural origins...

leukemia

Newer Approaches With CAR T Cells Explored in CLL

Chimeric antigen receptor (CAR) T-cell therapy is a hot area of research and development in hematologic malignancies and, more recently, some solid tumors. Results have been particularly good in acute lymphocytic leukemia, and one or more CAR T-cell products may be getting close to approval by the ...

genomics/genetics
issues in oncology

How Watson for Oncology Is Advancing Personalized Patient Care

After undergoing nearly 5 years of intensive medical training, IBM’s Watson for Oncology cognitive computing system is starting to make good on its promise to accelerate personalized care for patients with cancer. The system has been trained by oncologists at Memorial Sloan Kettering Cancer Center ...

prostate cancer

Androgen Blockade and Salvage ­Radiation Therapy in Prostate Cancer: Cautious Optimism Amid Unanswered Questions

The recent report of results of RTOG 9601 by Shipley et al in The New England Journal of Medicine1—reviewed in this issue of The ASCO Post—strongly supports the variably used practice of adding “androgen blockade” to salvage radiation therapy in men with a rising prostate-specific antigen (PSA)...

lung cancer

ASCO President, Bruce E. Johnson, MD, FASCO, Participates in Key Research With EGFR Mutation in Lung Cancer

Bruce E. Johnson, MD, FASCO, 2017–2018 ASCO President, was born in St. Peter, Minnesota, and grew up on a rural dairy farm. “Neither of my parents had college degrees, but working on a dairy farm with them gave me a solid work ethic. I was working outside on the farm before I was 10 years old. In...

survivorship
lung cancer

Precision Medicine and My Own Activism Are Keeping Me Alive

In 2009, I was living my dream. My work as a business development manager for a technology company was thriving; I had a satisfying social life; I was active in sports, especially hiking and biking; and I was involved in social justice causes as a volunteer at San Quentin State Prison, helping...

genomics/genetics

Recognizing Major Role of Random Mutations in Causing Cancer Does Not Diminish Importance of Primary Prevention

Random mistakes made during DNA replication are responsible for about two-thirds of the mutations that cause human cancers, according to a study reported in Science.1 Recognizing the role of these replication errors “does not diminish the importance of primary prevention but emphasizes that not all ...

genomics/genetics

‘It Is What It Is’

Mark looked at me shyly through his oversized Elvis Costello–style glasses. Was he feeling embarrassed by his own reply or just waiting for my reaction? He was sitting between his mom and dad, wearing a t-shirt with a huge Minion print. His braces showed when he smiled, something he does often in...

issues in oncology
pain management

New Canadian Guideline Provides Advice to Physicians to Avoid Overprescribing of Opioids

Opioid overdoses are claiming the lives of thousands of Canadians. The impact of the opioid crisis continues to be devastating to individuals, families, and communities. Inappropriate prescribing of opioids has led to long-term dependence on this class of drugs. To help address problematic...

cns cancers

One Physician’s Experience

In a separate interview, George Ansstas, MD, a medical neuro-oncologist at Siteman Cancer Center, Washington University, St. Louis, discussed his experience in treating patients with tumor-treating fields. He has treated about 35 patients with glioblastoma in the first-line setting and 20 with...

skin cancer

Novel Imaging Method for Predicting Immunotherapy Response

Although cancer immunotherapy can produce dramatic responses, only a minority of patients benefit from such therapy. Being able to differentiate treated responders from nonresponders early in the course of therapy would help to triage nonresponding patients away from ineffective therapies, reducing ...

ASCO Releases Position Statement on Access to Investigational Drugs

ASCO strongly supports increasing access to investigational new treatment options for patients with cancer, while raising serious concerns about recently proposed federal “right-to-try” legislation as well as state-enacted right-to-try laws. In a position statement released April 4, 2017, ASCO said ...

head and neck cancer

Deintensifiying Treatment of HPV-Positive Oropharyngeal Cancer Could Reduce Toxicity While Maintaining Function and Survival

“The status quo for HPV [human papillomavirus]-associated oropharyngeal squamous cell carcinoma is not sufficient.… Our treatment is effective, but the toxicity associated with it is not tolerable.” And HPV-associated oropharyngeal cancer “is a cancer of relatively younger patients,” said Nishant...

palliative care

Practice-Changing Research: Making Palliative Care a Routine Part of Cancer Care in the United States and Abroad

With its recently issued clinical practice guideline update, reviewed in this issue of The ASCO Post, ASCO has spoken: Interdisciplinary palliative care teams improve the outcomes of cancer care; patients live longer and feel better.1 There is no doubt. Multiple well-designed studies show the...

issues in oncology

The Mystery of Grace

The day after I told Nell she had seven metastases to her brain, she sent me flowers. She was my patient; I was her oncologist. I had met her 1 year prior, when she was well into her cancer journey, stage IV breast cancer at diagnosis. I took over from her current oncologist, who was moving. At...

health-care policy
issues in oncology

ASCO’s State of Cancer Care in America: 2017 Report Acknowledges Both the Progress Made in Oncology Care and the Challenges Ahead

Despite advances in cancer risk assessment, prevention, disease detection, drug development, and health-care delivery, which have led to unparalleled reductions in cancer incidence and mortality, access to affordable health care and increased administrative burdens placed on oncology practices...

An Evening for Cancer Survivors and Caregivers: Bringing Together a Community of Support

On January 26, 2017—prior to the official opening of the 2nd Annual Cancer Survivorship Symposium—cancer survivors, caregivers, patient advocates, family physicians, oncology providers, and others gathered in San Diego, California, to make connections, discuss survivorship issues, and get expert...

solid tumors

Coping With an Uncommon Cancer

In April 2014, I was so sick with uncontrollable vomiting and diarrhea and severe abdominal and chest pain that I had to be hospitalized for 5 days. As I was in my late 20s and in otherwise good health, there was no easy explanation for my symptoms. After I was released from the hospital, my...

supportive care
integrative oncology
symptom management
breast cancer

Acupuncture for the Management of Hot Flashes

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, present a case study...

Close to Home: Dr. Rick Boulay’s Experience With Cancer Survivorship and Caregiving

Richard ‘Rick’ Boulay, MDChief of Gynecologic Oncology Institution: Lehigh Valley Health Network Member since: 2016 Three years ago, Richard ‘Rick’ ­Boulay, MD, Chief of Gynecologic Oncology at Lehigh Valley Health Network, walked onto the stage at ­TEDx Lehigh River and confronted his audience...

gynecologic cancers

Cervical Cancer Mortality Is Higher and Racial Disparity Wider Than Previously Reported

Cervical cancer mortality rates were significantly higher, particularly among black women, when national data were corrected to exclude women who have had hysterectomies. For black women, the cervical cancer mortality rate rose from 5.7 to 10.1 per 100,000 when corrected for hysterectomy, an...

breast cancer

Cancer Has Aged Me

The news that I had breast cancer came at an especially difficult time in my life and was quite shocking to hear. My father had died of lung cancer just 1 month before my diagnosis, and I was still grieving his death when I suddenly had to confront my own mortality. In retrospect, the diagnosis...

prostate cancer

No Benefit From Older Standard-of-Care Drug in Adjuvant Chemotherapy for High-Risk Prostate Cancer, but Newer Trials Feasible

An older trial designed to evaluate the benefits of adjuvant therapy following radical prostatectomy in patients with high-risk prostate cancer showed no difference in overall or disease-free survival between 2 years of androgen-deprivation therapy and 2 years of androgen-deprivation therapy plus...

colorectal cancer

Study Finds Sharp Rise in Colon and Rectal Cancers in Young Adults

Although the overall incidence rate of colorectal cancer in the United States has been declining rapidly since the mid-1980s, the decrease has been in older adults. During this same period, incidence rates have been increasing sharply for adults younger than age 50, finds a study by the American...

lung cancer

New Lung Cancer Staging Manual Set to Modify Clinical Practice

A revised tumor classification based on 70,967 evaluable patients with non–small cell lung cancer (NSCLC) and 6,189 patients with small cell lung cancer is now available to lung cancer specialists around the world in the form of the 8th edition of the tumor, node, and metastasis (TNM)...

lung cancer

Expert Point of View: Paul Mitchell, MD

“The progression-free and overall survival curves of CheckMate 057 suggest the presence of two patient populations with respect to nivolumab (Opdivo): a relatively sensitive one and a less sensitive, possibly even resistant, one, according to invited discussant Paul Mitchell, MD, Associate...

lung cancer

Expert Point of View: Edward B. Garon, MD

“There are several possible ways to move first-line immunotherapy for non–small cell lung cancer (NSCLC) forward, according to invited discussant Edward B. Garon, MD, Director of Thoracic Oncology at the David Geffen School of Medicine at the University of California, Los Angeles. “We could expand...

pain management

Combating Untreated Cancer-Related Pain

The problem of pain management facing clinicians today is twofold: how to ensure safe and effective treatment for patients with cancer in chronic pain, while avoiding the overuse of opioid medications and the potential for substance use disorder and diversion. According to the American Cancer...

kidney cancer

2017 GU Cancers Symposium: In Advanced Kidney Cancer, Antibiotic Use Lowers Efficacy of Immunotherapy

A new retrospective analysis suggests that immunotherapy may be less effective in patients who receive antibiotics less than a month before starting treatment. In the study, cancer worsened more quickly in such patients than in those who did not receive antibiotics (with median progression-free...

Oliver Smithies, PhD, Nobel Laureate Who Discovered Gene Targeting, Dies

The ability to artificially alter DNA opens the door to new scientific understanding and treatments for various diseases. Oliver Smithies, PhD, made the crucial discovery that a disease-causing gene could be modified. For that and other groundbreaking work, he, along with two other scientists, was ...

prostate cancer

On the Horizon: New Tools for Prostate Cancer

The field of prostate cancer is being energized by discoveries in genetics, novel imaging techniques, and the potential of checkpoint inhibitors in the treatment of prostate cancer. Not all of these advances are currently clinically actionable, but all have the potential to change clinical...

gynecologic cancers

Women of Indigenous Communities Prefer Self-Screening for Cervical Cancer

Cervical cancer is a preventable disease if detected on time, but it remains one of the leading causes of cancer deaths among women in Latin America, particularly women of poor and indigenous communities. A new study by the University of Michigan published by Gottschlich et al in the Journal of...

breast cancer

ECCO 2017: Low Cause-Specific Mortality in Women Over 50 Treated for Ductal Carcinoma in Situ

Women over 50 who have been treated for ductal carcinoma in situ (DCIS) are more likely to be alive 10 years later than women in the general population, according to new research presented by Elshof et al at the 2017 European Cancer Congress (ECCO) (Abstract 173). DCIS differs from breast cancer...

What Have We Got to Lose?

Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...

issues in oncology

Preclinical Study Potentially Explains Vulnerability of Young Patients With Cancer to Treatment Toxicities

Despite many successes in treating pediatric cancer, young children remain at high risk for developing severe, long-lasting impairments in their brain, heart, and other vital organs from chemotherapy and radiation treatments. In adults, however, these tissues are relatively spared. This disparity, ...

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,...

Profound Answers to Simple Questions

A few years ago, I had the good fortune to join a research team that intended to create a device to help dying children express their wants and needs despite communication challenges. The brain tumor team at SickKids [also known as The Hospital for Sick Children] had cared for several children...

issues in oncology

Faculty Development in Oncology: Advancing the Field by Optimizing Opportunities for Educators to Learn and Grow

In 2015, Janet Riddle, MD, and her colleagues published an article1 outlining 12 key themes for delineating how fellowship programs in medical education should be developed (See “12 Tips for Developing Successful Fellowship Programs for Medical Educators,” below.) The ASCO Post talked with Dr....

breast cancer

SABCS 2016: Adding Everolimus to Fulvestrant Improved Outcomes for Postmenopausal Patients With Hormone Receptor–Positive Breast Cancer

Progression-free survival was more than doubled for patients with metastatic hormone receptor–positive, HER2-negative breast cancer resistant to aromatase inhibitor therapy by adding everolimus (Afinitor) to treatment with the endocrine therapeutic fulvestrant (Faslodex), according to data...

solid tumors

Mutanome-Directed Immunotherapy: Finding the Best Treatment Match

Oncologists may be accustomed to looking for commonalities in patients, but highly personalized therapies are now being developed based on mutational analysis of tumors. According to data presented at the Cedars-Sinai annual symposium on New Therapeutics in Oncology: The Road to Personalized...

leukemia

ASH 2016: Children With Down Syndrome and ALL Fare as Well as Other Children Treated on ALL Consortium Protocols

Despite an elevated risk of toxicity from chemotherapy, children with Down syndrome and acute lymphoblastic leukemia (ALL) did not experience higher rates of relapse or treatment-related mortality compared with other children treated on Dana-Farber Cancer Institute ALL Consortium Protocols,...

leukemia

ASH 2016: Patients With CML and Stable Molecular Responses May Be Able to Safely Decrease the Dose of Their Tyrosine Kinase Inhibitor

A study led by researchers at the University of Liverpool presented by Clark et al at the 58th American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 938) suggests many patients with chronic myeloid leukemia (CML) may be able to safely reduce tyrosine kinase inhibitor side...

leukemia

Gleevec Is Saving My Life but at a Cost

Like many patients in the chronic phase of chronic myeloid leukemia (CML), my cancer was discovered during a routine physical, when an off-the-chart white blood cell count signaled a serious problem that my primary care physician attributed to unspecified internal bleeding. Fortunately for me, my...

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...

lung cancer
cost of care

A Lung Cancer Specialist Talks About Value in Cancer Care

Over the past few years, the term value-based cancer care has become integrated into the vernacular of the oncology community. Value is a subjective term, which is defined largely by its clinical setting. However, value in cancer care is evaluated by the multiple stakeholders involved in the...

breast cancer

Clinical Strategies for Improving Endocrine Therapy in Metastatic Breast Cancer

Most women with hormone receptor–positive breast cancer receive endocrine therapy as part of their treatment, but “the reality is that patients who receive antihormone therapy in the metastatic disease setting ultimately develop disease progression, ” William J. Gradishar, MD, stated at the 18th...

issues in oncology

The Emergence of Philanthropy to Fund High-Risk, High-Reward Cancer Research

Earlier this year, Sean Parker, the cofounder of the music streaming service Napster and an early president of Facebook, joined a growing list of entrepreneurs who are committing large portions of their wealth to funding cancer research. In April, Mr. Parker announced he was donating $250 million...

breast cancer

Living With Metastatic Breast Cancer Is Like Walking a Tightrope

I’ve always had fibrocystic breasts and was steadfast in performing monthly breast self-exams, so I could become familiar with the terrain of my breasts and spot any subtle changes. So, in November 2002, when I felt something in my left breast that seemed different from my usual lumps, I made a...

supportive care
pain management
issues in oncology
symptom management

Medical Marijuana: The Topic You Can’t Escape

With reports about new marijuana dispensaries sprouting up as more states approve the legal use of medical marijuana, and patients and family members questioning how to get it, medical marijuana is a “topic you can’t escape,” noted Judith A. Paice, PhD, RN.1 Dr. Paice is Director of the Cancer...

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