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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...

pancreatic cancer

Let’s Win: Innovative Online Community Offers Guidance to Patients With Pancreatic Cancer and Their Families

Let’s Win is an online community for persons with pancreatic cancer (www.letswinpc.org), but it is far more than a typical support group. Let’s Win propels interested users toward cutting-edge research, based on its founders’ commitment that no patient with pancreatic cancer should settle on the...

issues in oncology
supportive care

Talking to Children With Cancer: Sometimes Less Is More

I still remember the day I met Kensie. It was Valentine’s Day. I had sneaked out of the hospital to get my wife a Valentine’s Day card, taking my place among scores of other husbands and boyfriends in front of the rapidly emptying rack of cards. As I started browsing, my beeper sounded. It was the ...

breast cancer

Is Observation Without Surgery a Viable Strategy for Managing Ductal Carcinoma in Situ?

In a spirited debate, abounding with citations of clinical trials and other evidence, but not without humor and mutual respect, E. Shelley Hwang, MD, MPH, and Armando E. Giuliano, MD, reviewed the data and their clinical experience managing ductal carcinoma in situ and reached opposite...

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...

skin cancer

Personalized Vaccines May Protect Patients With High-Risk Melanoma

The field of cancer vaccines may be reinvigorated by a new understanding, and the therapeutic leveraging, of neoantigens. Researchers from Dana-Farber Cancer Institute in Boston are exploring this novel approach as a means of protecting patients with high-risk melanoma from recurrence. Early...

Arti Hurria, MD: From Leadership Development Program to Board of Directors

Arti Hurria, MD, a geriatric oncologist at City of Hope in Duarte, California, is the first graduate of ASCO’s Leadership Development Program to be elected to ASCO’s Board of Directors. Within 5 years of completing the program, Dr. Hurria went from learning leadership skills to applying them to...

breast cancer
supportive care

Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression

“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...

skin cancer

ESMO 2016: Ipilimumab as Adjuvant Therapy Improves Overall Survival in High-Risk Stage III Melanoma

Ipilimumab (Yervoy) as adjuvant therapy significantly improves overall survival in patients with high-risk stage III melanoma, according to the European Organisation for Research and Treatment of Cancer (EORTC) 18071 phase III trial results presented by Eggermont et al at the European Society for...

leukemia

Susan M. O’Brien, MD, Embraces the Challenge of Balancing Patient Care With Clinical Trial Investigation

Susan M. O’Brien, MD, one of the nation’s foremost leukemia experts, told The ASCO Post that she wanted to become a doctor since her earliest memories. “The idea of being able to help sick people always appealed to me,” said Dr. O’Brien, who was born in Manhattan but spent her formative years in...

head and neck cancer

Particular HPV Strain Linked to Improved Prognosis for Oropharyngeal Cancer

When it comes to cancer-causing viruses like human papillomavirus (HPV), researchers are continuing to find that infection with one strain may be better than another. In an analysis of survival data for patients with oropharyngeal cancer, researchers from the University of North Carolina (UNC)...

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...

prostate cancer

Surgery and Radiation ProtecT Against Progression/Metastasis vs Active Monitoring in Prostate Cancer, but at What Cost?

The ProtecT trial showing similar 10-year survival with active monitoring, surgery, or radiotherapy for prostate-specific antigen (PSA)-detected localized prostate cancer but a greater risk of disease progression/metastasis with monitoring was recently reported by Hamdy and colleagues and is...

survivorship
issues in oncology

Improving Management of Sexual Problems for Cancer Survivors

What do up to 60% of cancer survivors have in common? Answer: some type of long-term sexual dysfunction. How many cancer survivors seek professional help for sexual problems? Answer: less than 20%. Even when they do seek help, they may not be successful in finding professionals with expertise in...

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