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solid tumors

Stereotactic Ablative Radiotherapy May Improve Outcomes in Some Patients With Oligometastatic Tumors

IN PATIENTS with a controlled primary tumor and up to 5 oligometastatic lesions, delivering stereotactic ablative radiotherapy was associated with a 13-month improvement in overall survival when compared with palliative standard-of-care treatments alone (41 months vs 28 months; P = .09).1...

Denial’s Many Faces

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

supportive care
palliative care

Study Finds Poor Adherence to Guidelines in Preventing Chemotherapy-Induced Nausea and Vomiting

Adherence to antiemetic guidelines for the prevention of chemotherapy-induced nausea and vomiting has been shown to improve patient outcomes. However, a new study suggests that physicians are still struggling to reach attainable adherence targets in antiemetic prophylaxis.1 According to data...

supportive care
palliative care

Artificial Intelligence–Based Smartphone App Decreases Pain and Reduces Inpatient Hospitalizations in Patients With Cancer

A smartphone application utilizing elements of artificial intelligence was associated with improved cancer pain outcomes and a significant reduction in pain-related hospital admissions, according to data presented at the 2018 Palliative and Supportive Care in Oncology Symposium.1 Results of the...

Palliative Care Trailblazer, Charles von Gunten, MD, PhD, Shares Insights With Advanced Practitioners

“The data are in, and they are clear and convincing. Palliative care leads to better outcomes for patients. The major challenge now is to make it part of standard cancer care everywhere in the United States and then everywhere else in the world, said Charles von Gunten, MD, PhD, a medical...

supportive care
palliative care

Palliative Care in the Pediatric Oncology Setting

Cancer is the leading cause of disease-related childhood death. To better serve the special needs of this highly vulnerable patient population, pediatric palliative care teams use a personalized, holistic, and interdisciplinary approach tailored to relieve the physical, psychosocial, and spiritual ...

supportive care
palliative care
issues in oncology
global cancer care

Unequal Burden of Cancer-Related Suffering and Need for Palliative Care

The global burden of cancer-related suffering is tremendously unbalanced, according to Eric L. Krakauer, MD, PhD, Director of the Global Palliative Care Program at Massachusetts General Hospital and Harvard Medical School, Boston and a lead coauthor of the Report of the Lancet Commission on Global...

issues in oncology
global cancer care

Global Burden of Cancer on the Rise: Implications for Cancer Prevention and Control

As the global burden of cancer grows, cancer control measures must be tailored to regional and national priorities, underscoring the need for high-quality cancer registries, according to Christopher P. Wild, PhD, Director of the International Agency for Research on Cancer in Lyon, France. Earlier...

palliative care
issues in oncology

Factors Affecting Use of Outpatient Specialty Palliative Care Clinics Among Patients With Advanced Cancer

In a study reported in the Journal of Oncology Practice, Yu et al identified factors affecting use of outpatient specialty palliative care (OSPC) among patients with advanced cancer in the University of Pittsburgh Medical Center Hillman Cancer Center Network (UPMC-HCCN). Study Details The...

A Pediatric Oncologist Recounts 7 Years at a Hospital in Jerusalem

Elisha Waldman, MD, is a pediatric oncologist and Associate Chief in the Division of Palliative Care at the Ann and Robert H. Lurie Children’s Hospital in Chicago. He grew up in a Connecticut suburb, the son of a conservative rabbi. Early on, Dr. Waldman majored in religious studies and felt...

issues in oncology

Focus on the Rocky Mountain Oncology Society

Formed in 1991, the Rocky Mountain Oncology Society (RMOS), a Chapter Member of the Association of Community Cancer Centers (ACCC) and State Affiliate of ASCO, serves as the voice for Colorado’s multidisciplinary cancer care teams and the patients they serve. Representing the common interests of...

pain management
supportive care

Parenteral Opioid Shortage Threatens Appropriate Pain Care for Patients With Cancer

In response to the opioid-overdose epidemic, several measures have been put in place, such as the reclassification of hydrocodone as a Schedule II opioid and new requirements for physician review of prescription drug–monitoring program databases in most states. Moreover, the Surgeon General and...

issues in oncology

Nosayaba Osazuwa-Peters, MPH, PhD, on Suicide Among Male Patients With Cancer: Study Findings

Nosayaba Osazuwa-Peters, MPH, PhD, of St. Louis University, discusses study findings on married cancer survivors with advanced stage disease who were less likely to die by suicide, highlighting the value of supportive care in cancer survivorship (Abstract 181).

issues in oncology
immunotherapy
symptom management

Allison S. Betof Warner, MD, PhD, on Managing Immune-Related Adverse Events: Incorporating Guidelines

Allison S. Betof Warner, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses the rationale for immunotherapy and combination treatments, identifying the agents that lead to toxicities, and ways to manage them.

issues in oncology
pain management

Charles von Gunten, MD, PhD, on Protecting Opioid Access for Patients in Need

Charles von Gunten, MD, PhD, of OhioHealth, discusses the critical need for opioids to manage cancer pain as well as the myth of addiction, which may impede best care.

supportive care
symptom management

Eric Roeland, MD, on Preventing Chemotherapy-Induced Vomiting

Eric Roeland, MD, of Massachusetts General Hospital, discusses the wide variation among physicians in preventing vomiting from highly emetogenic chemotherapy (Abstract 74).

geriatric oncology
palliative care

Katherine C. Lee, MD, on Emergency Surgery and End-of-Life Care

Katherine C. Lee, MD, of Massachusetts General Hospital, discusses her study findings that showed older patients with metastatic cancer who survived emergency general surgery experienced higher intensity end-of-life care than similar patients who did not undergo surgery (Abstract 56).

supportive care
pain management

Mihir M. Kamdar, MD, on Managing Cancer-Related Pain With Artificial Intelligence

Mihir M. Kamdar, MD, of Massachusetts General Hospital, discusses study findings on a smartphone app called ePAL, which significantly reduces pain and pain-related hospital admissions by combining patient-reported outcome data and artificial intelligence via a telemedicine platform (Abstract 76).

issues in oncology
palliative care

Mary E. Johnson on Holding Vigil With Dying Loved Ones

Mary E. Johnson, author of Stay With Me Awhile, discusses her play, a compilation of vigil stories from across cultures and religions, and the profound impact the performances have had on audience members.

issues in oncology
immunotherapy

Betty R. Ferrell, PhD, on Quality of Life in the Era of Immunotherapy

Betty R. Ferrell, PhD, of City of Hope, discusses the many advances in immunotherapy and the drugs’ effect on patients’ quality of life, including psychological well-being.

immunotherapy
symptom management

Elizabeth Jane Cathcart-Rake, MD, on Immunotherapy-Related Toxicities: More Common Than Originally Reported?

Elizabeth Jane Cathcart-Rake, MD, of the Mayo Clinic, discusses the frequency of side effects from immunotherapy, the need to closely monitor those receiving this treatment, and the role of clinicians in educating their patients on toxicities (Abstract 184).

cost of care

Mary K. Buss, MD, MPH, and Candice A. Johnstone, MD, MPH, on Financial Toxicity During Treatment and Beyond

Mary K. Buss, MD, MPH, of Beth Israel Deaconess Medical Center, and Candice A. Johnstone, MD, MPH, of the Medical College of Wisconsin, discuss a session they co-chaired on the perspective of stakeholders on the cost of cancer care, what drives patients’ preferences when faced with mounting medical ...

palliative care
survivorship
myelodysplastic syndromes
leukemia

Suleika Jaouad on Making the Most of a Life Interrupted: A Young Adult Perspective on Cancer

Suleika Jaouad, an Emmy Award–winning writer, advocate, and cancer survivor who was diagnosed at age 22 with myelodysplastic syndrome and acute myeloid leukemia, discusses what she has learned about coping with cancer, learning from it, and growing beyond it.

palliative care
pain management

Leslie J. Blackhall, MD, on Unregulated Opioid Access: Consequences and Outcomes

Leslie J. Blackhall, MD, of the University of Virginia, discusses abuse of opioids, prescribing responsibly, and reducing cancer pain while also decreasing the risk of misusing these agents.

issues in oncology

Dealing With the Challenges Presented by the Parenteral Opioid Shortage

The opioid drug problem in the United States is a crisis, with unprecedented numbers of overdose deaths. The reaction to this has resulted in new federal laws and regulations aimed at restricting overuse and overprescribing of opioids. However, these well-intentioned actions, along with other...

palliative care
issues in oncology
symptom management

2018 Palliative Care: Can an AI-Based App Help Manage Cancer-Related Pain?

A study of 112 patients with metastatic solid tumors found that the use of an artificial intelligence (AI)-based smartphone app reduced both the severity of patients’ reported pain and hospital admissions. After an 8-week period, patients who used the AI-powered app to monitor and address...

issues in oncology
symptom management

2018 Palliative Care: Immunotherapy-Related Adverse Events May Be More Common Than Initially Reported

An analysis of nearly 2,800 patients with non­–small cell lung cancer (NSCLC) who received the immune checkpoint inhibitors nivolumab (Opdivo), pembrolizumab (Keytruda), or atezolizumab (Tecentriq) found that adverse events may be more common than reported in the initial trials that led...

issues in oncology

Novel Physician-Driven Practice Model Offers Alternative to Community Oncologists

Three leading oncology practices have united with partners in technology and finance to launch OneOncology, a physician-driven company that aims to unite more than 225 community oncology providers from 60-plus locations. Altogether, OneOncology will treat nearly 158,000 cancer patients a year. The...

palliative care

Developing Patient-Centered Palliative Care From Diagnosis to End of Life

In December, The University of Texas at Austin Dell Medical School will launch an innovative cancer care model called the CaLM (cancer life re-imagined) Clinic as part of its new cancer center, the Livestrong Cancer Institutes. The goal of the Livestrong Cancer Institutes and the CaLM Clinic is to...

issues in oncology

Challenges and Successes of Adopting an Oncology Care Model

IN ORDER TO rein in the untenable rise in costs while delivering high-value cancer care, the Centers for Medicare & Medicaid Innovation developed a new payment system—the Oncology Care Model. At the 2018 ASCO Quality Care Symposium, Cardinale B. Smith, MD, PhD, shed light on the system’s...

issues in oncology
palliative care

End-of-Life Dashboard Drives Transformation With Actionable Personalized Data

A NUMBER OF STUDIES from the palliative care literature have shown that nonbeneficial health-care interventions actually may harm patients’ quality of life, increase patient and caregiver distress, and drive costs. Yet, according to the National Cancer Institute, about 30% of all cancer spending...

issues in oncology

Cancer Care in the U.S. Prison System

A health-care system is evaluated by various metrics: one is how it cares for its most vulnerable patients. The United States spends far more on health care than any nation in the world, yet access to high-quality oncology services remains elusive to certain minority populations—none more so than...

solid tumors

2018 ASTRO: SABR-COMET: Stereotactic Ablative Radiation Therapy for Oligometastatic Tumors

In the first randomized, phase II clinical trial of its kind, researchers have shown that an aggressive form of high-precision radiation therapy can increase survival in patients with oligometastatic tumors. These findings were presented by Palma et al in the plenary session at the 60th Annual ...

supportive care
pain management

The Opioid Crisis From the Oncology Perspective

As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...

issues in oncology

Matti S. Aapro, MD, on Advanced Disease: Reducing Use of Futile Treatments

Matti S. Aapro, MD, of the Genolier Cancer Centre, discusses the challenges of avoiding futile treatments and the need to work with patients, integrate palliative care, and monitor toxicities.

issues in oncology
global cancer care

Cancer Care in the Palestinian Territories

The global burden of cancer is huge and growing. In 2018, there will be > 18 million new cancer cases and 9.6 million deaths.1,2 Although several recent articles have reviewed cancer in developing countries, few have focused on the Palestinian territories. There are several reasons for that,...

palliative care
lung cancer
issues in oncology
cost of care

ICU Admissions During Terminal Hospitalizations in Patients With Stage IV Lung Cancer

In a study reported in the Journal of Oncology Practice, Mrad et al found an increase in the proportion of patients with stage IV lung cancer admitted to the intensive care unit (ICU) during terminal hospitalization between 1998 and 2014. A large increase in palliative care contacts also occurred,...

Association of Community Cancer Centers Grants 2018 Innovator Awards

THE ASSOCIATION OF COMMUNITY CANCER CENTERS (ACCC) has chosen seven cancer centers nationwide to receive 2018 ACCC Innovator Awards. Now in its 8th year, the Innovator Awards recognize ACCC member programs that have created solutions to challenges commonly faced by cancer programs and practices as...

issues in oncology
palliative care

Closing the Gender Divide in Preference for Palliative Care

Eight years ago, a survey of the preferences of Dutch patients with cancer for health care found that while gender was one aspect influencing how men and women approach cancer care, it was the most important, with men, generally, regarding most care aspects as less important than women. The study...

Cancer.Net: Trusted Information for Patients and Caregivers, Useful Tools for Providers

Cancer.Net is ASCO’s patient information website, hosting a wealth of information and resources for people diagnosed with cancer and their families and caregivers. With information on over 120 types of cancer, visitors to the site can find medical information, tips for treatment management,...

lung cancer
issues in oncology

Health Resource Utilization and CNS Metastases in EGFR-Mutant Advanced NSCLC

In a single-center study reported in the Journal of Oncology Practice, Chooback et al found that central nervous system (CNS)  metastases are frequent in patients with EGFR-mutant advanced non­–small cell lung cancer (NSCLC) and are associated with increased health resource...

Brave Journey Home

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

integrative oncology

Care for the Cancer Caregiver

Providing care to patients with cancer can be overwhelming, and caregivers are at risk for physical and psychological distress, which can negatively impact their own health. Over the past decade, supporting caregiver well-being has gained prominence as a national health-care issue. In this...

ASCO Answers Palliative Care: A Resource for Your Patients

THE ASCO ANSWERS Palliative Care booklet shares how palliative care or supportive care is used to manage symptoms and side effects; help with practical concerns; address spiritual questions; and support caregivers, family, and friends. Your patients will find: Practical advice on how to access...

issues in oncology
palliative care

Expanding the Use of Provider Orders for Life-Sustaining Treatment for Patients With Advanced Cancer

Patients with advanced cancer often get more aggressive treatment than they want because too few oncologists elicit their end-of-life treatment preferences.1,2 In response to this problem, leading associations, including ASCO3,4 and the Institute of Medicine,5 have called for more advance care...

lymphoma
geriatric oncology

Challenges of Managing Older Patients With Diffuse Large B-Cell Lymphoma

As the population continues to age, the interplay between aging and cancer increasingly shows cancer to be a disease of older people. By the year 2030, there will be an increased incidence of non-Hodgkin lymphoma (NHL) in older individuals.1 The median age of patients diagnosed with diffuse large...

palliative care

Quality Improvement Initiative for Documenting Goals of Care for Patients With Advanced Cancer

In a study reported in the Journal of Oncology Practice, Karim et al found that a quality improvement initiative at a single cancer center improved documentation of goals-of-care discussions and referral to palliative care for patients with advanced cancer. Study Details In the study,...

issues in oncology

Psycho-oncology: After Decades of Acceptance, Still an Emerging Field

As the field of psycho-oncology continues to mature, new studies are being conducted to evaluate ways to better address the needs of patients with cancer and their families. The ASCO Post recently spoke with Michael Hoerger, PhD, MSCR, Assistant Professor of Psychology, Psychiatry, and Oncology at ...

SMARTIE Initiative for Advanced Practitioners in Oncology Recognized by Alliance for Continuing Education

AN ONGOING educational initiative, the Study to Measure Advanced Practitioner Retention of Targeted Information and Education (SMARTIE), measures oncology learning and how it is used with advanced practitioners and their patients with cancer. The initiative, conducted by Harborside Medical...

issues in oncology

Stakeholders Agree: ‘Value’ in Cancer Care Depends on Perspective

In a roundtable discussion moderated by Clifford Goodman, PhD, of The Lewin Group, Falls Church, Virginia, representatives of the patient advocacy community, public and private payers, large and small clinics, and the pharmaceutical industry did not always see eye to eye on what “value” means nor ...

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