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gynecologic cancers

Olaparib Maintenance Prolongs Progression-Free Survival in Ovarian Cancer

Maintenance therapy with the tablet formulation of olaparib (Lynparza) significantly prolonged progression-free survival in patients with platinum-sensitive relapsed ovarian cancer and mutations in BRCA1/2 in the phase III SOLO2 trial, presented at the 2017 Society of Gynecologic Oncology (SGO)...

Discrimination in Medical Education—Another Perspective

I read with great interest Dr. ­Robert E. Montenegro’s comments in the The ASCO Post, January 25, 2017, where he felt “marginalized” when questioned about his country of origin or the quality of his English. As physicians, we constantly deal in a world of uncertainties and are required to address...

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...

pancreatic cancer

Update on Overall Survival for Newly Diagnosed Patients With Metastatic Pancreatic Cancer

Although “treatment advances” and “precision medicine” are today’s buzz words in oncology, they don’t apply equally to all malignancies. For instance, median overall survival for newly diagnosed patients with metastatic pancreatic cancer has not improved much over the past 20 years, according to...

survivorship

How Stupid Cancer Is Building a Support Community for AYA Survivors

In 1995, Matthew Zachary, an aspiring concert pianist and composer, was en route to graduate school to study film composition when he lost all fine-motor coordination in his left hand, was diagnosed with pediatric brain cancer (medulloblastoma), told he would never play again, and was given 6...

breast cancer

Cancer Has Made Me the Person I Am

My breast cancer diagnosis in 1993, at age 34, came at the happiest moment in my life. I had gotten married just 10 months earlier and was looking forward to the future and children. But instead of celebrating my first wedding anniversary with my husband over a romantic dinner, we were at a cancer ...

An Introduction to Recognizing and Managing Professional Burnout

There’s no getting around it: the practice of oncology can be inherently stressful. First, there’s the workload: compared to other medical specialists, oncologists see a larger number of patients and spend more time with them in face-to-face interactions. It’s not unusual for oncologists to work 60 ...

survivorship
health-care policy

Timing Is Everything

In 1959, my 5-year-old cousin, Kim, was diagnosed with acute lymphocytic leukemia (ALL). As an 8-year-old, I didn’t really understand what was happening to him, except that he had to go to the Riley Hospital for Children in Indianapolis, Indiana, for treatment. The haunting vision of his looking...

skin cancer

Disease Symptoms Are the Most Frequent Indicators of Recurrence in Patients With Stage II Melanoma

Recurrences of early-stage (stage II) melanoma are more often detected by patients and their physicians than by routine imaging tests, according to study results published by Berger et al in the Journal of the American College of Surgeons. “We are most concerned about patients who have stage ...

multiple myeloma

I Plan to Live Long Enough to Be Cured of Multiple Myeloma

Like many other patients diagnosed with multiple myeloma, I didn’t know I had the cancer until I broke a bone. I had felt a twinge of pain on my left side when I hoisted a bucket of baseballs over my left shoulder after participating in a baseball tournament in the spring of 2011, but there was...

issues in oncology

NCCN Working Group on Value Tools Presents Preliminary Findings and Recommendations

Over the past several years, the introduction of decision-making tools for patients from major cancer organizations, including ASCO and the National Comprehensive Cancer Network® (NCCN®), has been news, applauded as a step toward more patient-centered care and featured at many meetings. Next steps, ...

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...

What Cancer?

If they are honest, most oncologists who’ve practiced medicine for more than 15 years will tell you they’ve learned much more from their patients than their patients have learned from them. The life lessons I’ve learned from treating this complicated, resilient, and often cruel disease are many....

palliative care

Canadian Study Looks at an Integrated Palliative Care Model

Although initiation of palliative care from the time of cancer diagnosis produces optimal outcomes for patients, this strategy is often not practiced. A recent Canadian study conducted in patients with advanced cancer and their caregivers examined the opinions of patients with advanced cancer and...

Jennifer Lycette, MD, Takes Pride in Delivering Cancer Care to Those Most in Need in Northwest Oregon

Born and reared in Anchorage, a city located in Southcentral Alaska, farther north than St. Petersburg, Russia, Jennifer Lycette, MD, grew up during the 1970s and 1980s. “We were fairly isolated from the lower 48. We didn’t have cable TV in Anchorage, and I remember my father would turn off the TV ...

issues in oncology

Addressing Discrimination and Bias in Medical Education

“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat) and been asked questions like, ‘Where are you really from?’ or ‘How old...

leukemia

Treating the Whole Person

Twenty-five years ago, I was a physically fit woman of 45 in training to run a marathon, which had been a lifelong goal. I was feeling fine and had no hint of the illness that would nearly take my life and has forever changed it. While ramping up to go the 26.2-mile distance, I decided to have a...

A Lesson From David

The following essay by Jeremy K. Hon, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. As physicians, ...

Women in Oncology: Breaking Down Barriers and Looking to the Future

There has been no better time than the present for women in the field of oncology: Women at all stages of their careers are finding more opportunities and avenues to excel. At the time of the last ASCO workforce survey, women made up 28.4% of the oncologist workforce, and that proportion is rising...

Overcoming the Physical, Emotional, and Financial Effects of Cancer

Although my diagnosis of stage IIIB melanoma 5 years ago came as a shock, in hindsight, it shouldn’t have been so surprising. I had noticed a small freckle-like lesion on my upper left thigh that had become itchy and occasionally bled, but it didn’t fit the ABCDE (Asymmetry, Border irregularity,...

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

Using Art to Humanize Medicine

Among the most widely attended sessions at the 2016 Palliative Care in Oncology Symposium in September was the keynote lecture, “Wit, Hex, Vin, Life, Death: Using Wit as a Teaching Tool,” given by Margaret Edson, author of the Pulitzer Prize–winning play Wit. Wit tells the story of an accomplished ...

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...

Dave, Dave, Dave

It was 1983, and I was in my third year as an attending physician at a major East Coast university medical center and just 5 years out of fellowship. As was common at the time, I saw and treated all malignancies except leukemia and gynecologic cancers. In the middle of a typically busy day at the ...

palliative care

How Video Support Tools Help Patients Make Informed Decisions About End-of-Life Care

A relatively recent study by Areej El-Jawahri, MD, and her colleagues is showing how the use of visual media can empower patients with advanced cancer, as well as other life-threatening illnesses, to make more informed decisions about their end-of-life care.1 The aim of Dr. El-Jawahri’s study was ...

palliative care

Research Highlights From the 2016 Palliative Care in Oncology Symposium

More than 650 attendees gathered in San Francisco on September 9 and 10 for the 2016 Palliative Care in Oncology Symposium, focusing on the theme of “Patient-Centered Care Across the Cancer Continuum.” Research presented during the Symposium demonstrated how integrating palliative care into cancer...

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...

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...

health-care policy

How ASCO Is Preparing Members for MACRA

On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) announced its final policy on what physicians need to do to begin implementing the Quality Payment Program outlined in the Medicare Access and CHIP Reauthorization Act of 2015 ­(MACRA). The Quality Payment Program is a...

multiple myeloma

My Catch-22 Predicament

In the spring of 2011, I was feeling so fatigued I needed to rest after walking just a few steps to the kitchen and not doing anything more strenuous than making a cup of coffee. Fortunately, I have a wonderful primary care physician who takes me seriously when I have a complaint about my health,...

When Breath Becomes Air: Dr. Lucy Kalanithi Reflects on Dr. Paul Kalanithi’s Life and Writing

Perhaps more than any other book in recent memory, When Breath Becomes Air has struck a chord among readers, both inside the medical community and among the public, desiring an honest and philosophical consideration of death. The autobiographical account of Paul Kalanithi, MD, a physician diagnosed ...

breast cancer
issues in oncology

The Medical Profession Has to Become Culturally Sensitive to the Needs of LGBT Cancer Survivors

Despite my breast cancer diagnosis 4 years ago, I feel really lucky. My cancer was detected relatively early, stage IIB, during a routine mammogram screening—a test that many of my lesbian friends skip because they don’t want to deal with a medical system steeped in a heterosexual culture that is...

palliative care

Bridging the Gap in Oncology Care

The third annual Palliative Care in Oncology Symposium, held on September 9–10, 2016, in San Francisco, California, brought together more than 650 attendees from multiple countries, including the United States, Canada, the United Kingdom, France, Italy, and China. It featured over 250 study...

lymphoma
thyroid cancer

I’ve Survived Two Cancers

In 2012, my husband, Robert, and I were looking forward to starting the next phase of our lives and were feeling excited about the future. Although only in our 50s, we had decided to retire early from our full-time careers, move to our cabin in Hayward, Wisconsin, and find less stressful part-time ...

Oncologist’s Guilt

The best part of my day is hearing that little voice yell, “It’s ­Momma!” as my son rushes to greet me with a hug. It is humbling, and sometimes terrifying, to realize that I brought a little person into the world who is completely dependent on my husband and me for survival. Few would argue...

The Best Oncology Lesson

I was 2 months into my first-year fellowship at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, when I learned the best oncology lesson of my career. I owned a copy of DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology and had read Cancer Treatment...

issues in oncology
cost of care

ESMO Publishes Results of European Consortium Study on the Availability of Antineoplastic Medicines

A major new study has found substantial differences in the formulary availability, out-of-pocket costs, and actual availability of anticancer medicines across Europe. The European Society for Medical Oncology (ESMO) European Consortium Study on the Availability of Antineoplastic Medicines was...

lymphoma

For High-Grade and Aggressive Non-Hodgkin Lymphomas, Treat Adults Like Children

Outcomes for adults with high-grade and aggressive non-Hodgkin lymphomas (NHLs) appear to be better when these patients are treated with pediatric-inspired protocols, according to Mitchell S. Cairo, MD, Chief of the Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Maria...

head and neck cancer

Use of Lugol’s Iodine Stain May Reduce the Need for Repeat Resection of Oral and Oropharyngeal Cancers

By identifying residual dysplasia in the tumor bed, Lugol’s iodine staining may improve pathologic outcomes with resection of oral and oropharyngeal cancers, according to interim findings of a UK randomized controlled trial reported at the 9th International Conference on Head and Neck Cancer.1...

Surgical Oncologist Quan P. Ly, MD, FACS, Flees From Vietnam and Finds a Home at the University of Nebraska

After the Vietnam War, close to a million refugees, known as “boat people,” fled Vietnam, hazarding the open ocean on dangerously overloaded vessels. The term “boat people” is often used generically to refer to all the Vietnamese (about 2 million) who left their country by any means between 1975...

issues in oncology
health-care policy

Six Perspectives on the Cancer Moonshot Goal of Making 10 Years of Progress in 5 Years

The Cancer Moonshot initiative is bringing together scientists, oncologists, patient advocates, and representatives of the biopharmaceutical industry with renewed collaborative focus and the ambitious objective of consolidating 10 years of cancer research in 5 years. Achieving this outcome will...

lymphoma

Outcomes With Rituximab in DLBCL: Does Gender Matter?

For diffuse large B-cell lymphoma, does the dose of rituximab (Rituxan) matter? Are there patient characteristics that determine outcomes as well as the optimal dose? These questions were explored at the 2016 Pan Pacific Lymphoma Conference by Matthew A. Lunning, DO, Assistant Professor of...

issues in oncology

Parents May be More Likely to Support HPV Vaccine Requirements for School Entry If States Include Opt-Out Provisions

Parents are more likely to support laws that would make the human papillomavirus (HPV) vaccine mandatory for school entry if their state offers opt-out provisions, according to a study published by Calo et al in Cancer Epidemiology, Biomarkers & Prevention. However, opt-out provisions may...

A Ruby Anniversary

On July 16, 1975, at 26 years of age, after almost 6 months of observing a left epididymal mass slowly enlarge, with workup for epididymal tuberculosis, I finally underwent a left inguinal orchiectomy and resection of what proved to be a pure seminoma. A subsequent lymphangiogram was reported to...

issues in oncology
global cancer care

Making a Difference in the Lives of Others

Quyen D. Chu, MD, MBA, FACS, this year’s recipient of ASCO’s Humanitarian Award, lives by the axiom that “One person can make a positive difference in the lives of others.” Although the term has become cliché, the experiences in Dr. Chu’s life and oncology career prove just how profound and...

issues in oncology
geriatric oncology

Safety Concerns Weigh Heavily in Elderly Patients With Cancer

Active pharmacovigilance in detecting and assessing the safety signals related to drugs and devices, and disseminating those findings to relevant stakeholders, is an important component in delivering safe, high-quality care in the cancer setting. To reach a better understanding of this issue,...

Daniel F. Hayes, MD, FASCO, Leader in Translational Research, Begins Term as ASCO President

In 1995, Daniel F. Hayes, MD, FASCO, gathered with several other oncologists at a conference center in San Francisco to begin writing the first-ever ASCO guidelines on cancer treatment. He and his colleagues felt like pioneers scouting uncharted frontier. “I’ll never forget, that first hour or so, ...

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