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issues in oncology

Why Patients’ Understanding of Their Prognosis Often Differs From Their Oncologists’

A recent study1 published in the Journal of Clinical Oncology (see “Breaking the ‘Conspiracy of Silence’” in this issue of The ASCO Post) found that just 1 in 20 patients with advanced, incurable cancer has sufficient understanding of his or her prognosis or life expectancy. Now, another new study ...

skin cancer

Management of Merkel Cell Carcinoma

A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the...

hematologic malignancies

Autologous Stem Cell Transplant May Age Immune Cells as Much as 30 Years

University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers, by tracking p16INK4a, a molecular marker that has been shown to increase in white blood cells as people age, have uncovered clues suggesting that stem cell transplant is linked to a marked increase in the...

health-care policy
issues in oncology

Researchers Question Process for Reviewing Coverage of 'Off-Label' Cancer Drug Use

A group of University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers is calling for an overhaul of the process that determines which cancer drugs used off-label—or beyond their approved use—are reimbursed by federally funded health insurance in the United...

hematologic malignancies

Bone Marrow–Derived Stem Cells May Offer Blood Transplant Recipients Better Quality of Life

A large, nationwide study published by Lee et al in the journal JAMA Oncology found that patients who received transplants of cells collected from a donor's bone marrow had better self-reported psychological well-being, experienced fewer symptoms of graft-vs-host disease (GVHD), and were more...

gynecologic cancers
lymphoma

I’m the Luckiest Person in the World

July 2009 was the start of the worst 5-year period of my life, and I’m just grateful I am still here to tell you about it. I was preparing for brain surgery to remove an acoustic neuroma on the right side of my brain when I noticed a lump on my left thigh. Thinking I had pulled a muscle while...

colorectal cancer

Multiple Means to Realize the Benefits of Colorectal Cancer Screening

In an updated recommendation statement, the U.S. Preventive Services Task Force (USPSTF) continues to strongly recommend screening for colorectal cancer for asymptomatic adults aged 50 through 75; but rather than emphasize specific screening strategies, it notes there are multiple screening...

geriatric oncology
survivorship

The Complexities of Care for Older Cancer Survivors

Integrated care, a focus on prevention and screening, and acknowledgment of comorbidities on the impact of treatment all play a critical role in the cancer survivorship of older patients, according to Martine Extermann, MD, PhD, a medical oncologist at Moffitt Cancer Center in Tampa, Florida....

supportive care
symptom management

Dealing With GI Toxicities After Chemoradiation

Chemotherapy- and radiotherapy-induced gastrointestinal (GI) toxicities have risen alongside improved survival rates for many cancers, according to Jervoise Andreyev, MA, PhD, Consultant Gastroenterologist in GI Consequences of Cancer Treatment at the Royal Marsden Hospital in London. “For every...

breast cancer
issues in oncology
genomics/genetics

Using Social Media to Accelerate Genomic Research

The success of using social media to push forward causes for social good was a driving factor in the launch this past October of the Metastatic Breast Cancer Project (MBC project), which aims to accelerate the understanding of what makes patients with metastatic breast cancer genetically unique....

breast cancer

Stress and Adverse Life Events Unlikely to Cause Breast Cancer

Day-to-day psychological stress and adverse life events are unlikely to increase a woman’s risk of developing breast cancer, according to a new prospective study published by Schoemaker et al in Breast Cancer Research. Women with breast cancer often consider stress as a likely cause of their ...

colorectal cancer

Thriving With Cancer

Seven years ago, at age 44, I was the picture of health. I played tennis every day, went bike riding and lifted weights several times a week, and made sure I ate a healthy diet. The closest I had ever come to cancer was caring for my mother during her 2-year illness with esophageal cancer. As it...

The Age of the Atomic Hematologists/Oncologists

Every longstanding culture has ages: The Minoans were followed by the Mycenaeans and, later, the Hellenistic peoples. And so it is with hematology/oncology. A descriptive age dominated predominately by histopathologists was followed by an age of experimentalists. Development of the atomic bombs...

geriatric oncology
global cancer care

Geriatric Oncology in Asia: The Dawn of a New Era in Cancer Care

Asia is currently experiencing an unprecedented rate of growth in its aging population. This “silver tsunami” has translated into a burgeoning number of older patients with cancer, as cancer is a disease of aging. However, unlike their Western counterparts, elderly patients with cancer in Asia are ...

sarcoma

A Conquer Cancer Foundation Award Helps to Launch a Pioneering Study in Liposarcoma

Mark A. Dickson, MD, has been fascinated by science and medicine since he was in high school. After graduating magna cum laude from Harvard University in 1999, Dr. Dickson pursued a medical degree from the College of Physicians and Surgeons at Columbia University in New York. Once he decided on a...

issues in oncology
global cancer care

European Demand for Radiotherapy Expected to Rise Approximately 16% Over Next Decade

The demand for radiotherapy across all European countries will increase by an average of 16% between 2012 and 2025, with the highest expected increase being for prostate cancer cases (24%), according to a new study published by ­Borras et al in Radiotherapy and Oncology.1 These projections came...

gastrointestinal cancer
pancreatic cancer
colorectal cancer

Treatment Update in Gastric, Pancreatic, and Colorectal Cancers

Although new gastrointestinal cancers are on the rise, advancements in their treatment, as well as the upcoming results of perioperative trials, could prove to be “clinical practice game-changers,” declared Thomas J. George, Jr, MD, FACP, at the 2016 Community Oncology Conference in Orlando,...

multiple myeloma

The ENDEAVOR Trial: A Case Study in the Interpretation of Modern Cancer Trials

It can be easy to miss the forest for the trees in the interpretation of clinical trials. In particular, trials for the treatment of cancer are exceedingly complex, with long lists of inclusion and exclusion criteria, designs with hidden biases, drugs with unpronounceable names (if not cumbersome...

colorectal cancer

DDW 2016: Low-Residue Diet Prior to Colonoscopy Shows Improved Tolerance and Bowel Preparation vs Clear Liquid Diet

A new study finds that patients who ate certain solid foods, considered “low residue,” were better prepared for their colonoscopies than individuals who followed the conventional liquid diet. Additionally, researchers saw that these patients who ate foods such as eggs, white bread,...

issues in oncology
global cancer care

A Perilous Time for Refugees With Cancer

The numbers are difficult to fathom. According to a report by the United Nations High Commissioner for Refugees (UNHCR), in 2015, over 60 million people worldwide were forcibly displaced as a result of conflict, persecution, generalized violence, or human rights violations.1 Over 9 million of those ...

Expect Questions About the New Rule on E-Cigarettes

“There are a lot of myths around new and emerging tobacco products, including e-cigarettes, and unfortunately, the biggest misconception is that these products are fairly or entirely harmless and risk-free,” Alexander V. Prokhorov, MD, PhD, said in an interview with The ASCO Post about a new...

issues in oncology

New FDA Rule Prohibits Sale of E-Cigarettes to Anyone Under Age 18 and Requires Warning Labels

A new rule extending U.S. Food and Drug Administration (FDA) oversight to all tobacco products, including electronic cigarettes (e-cigarettes), and banning the sale of these products to anyone under the age of 181 was hailed as a major advanced by many leaders of medical and health organizations....

White Knuckling

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

issues in oncology
solid tumors
hematologic malignancies

How Immunotherapy Is Revolutionizing Cancer Care

More than 100 years after ­William B. Coley, MD, used bacterial toxins to goad the immune system into recognizing cancer cells as foreign to the body and mount an immune response to go after and kill them, the recognition of immunotherapy as a powerful anticancer therapy is finally being...

In Celebration of a Remarkable Career at ASCO

In March, ASCO announced that Allen S. Lichter, MD, FASCO, was stepping down as Chief Executive Officer (CEO) at the end of June, ending his 10-year tenure as head of the Society and the Conquer Cancer Foundation of ASCO. Clifford A. Hudis, MD, FACP, Chief of Breast Medicine Service and Vice...

gynecologic cancers

Combining Two FDA-Approved Diagnostic Tests Increased Detection of High-Grade Cervicovaginal Lesions

Cytopathology researchers at Houston Methodist Hospital recently found that combining two diagnostic tests—the Papanicolau (Pap) and high-risk human papillomavirus (hrHPV)—dramatically decreased the chance of missing tumors and high-grade lesions by sevenfold. Zhou et al published...

‘So How Long Do I Have?’

Imagine accidentally falling off an abyss. One simply cannot fully understand the gravity of the situation! You might skip a beat thinking about it while sitting in a chair in your living room, if you have tons of empathy, as you try to get into the shoes that are flailing for survival. But there...

Expect Questions About Potential Trade-Offs of Contralateral Prophylactic Mastectomy

Women who were diagnosed with breast cancer and had contralateral prophylactic mastectomy had only marginal improvement in psychosocial well-being, such as feeling confident and emotionally healthy, according to a study published in the Journal of Clinical Oncology.1 Those who also had breast...

Compartmentalizing Cancer

I was the last one on the oncology team to meet Mel. He was 36 years old, and by then Mel had been living with metastatic colon cancer for several years. During that time, his clinicians had never referred him to our psycho-oncology team because of his strong attitude and outlook. Mel’s outward...

A Political Activist Challenges the Drug Approval Process and the U.S. Government

The U.S. Food and Drug Administration’s (FDA’s) primary concern in the drug approval process is to ensure that the drug is safe and effective. For the past several decades, the advocacy groups have vociferously painted the agency as a stodgy bureaucracy that prevents desperate patients access to...

pancreatic cancer

Phase Ib/II Study Reports High Response Rates Seen With Addition of Cisplatin to Regimen for Advanced Pancreatic Cancer

The oncology research team at HonorHealth Research Institute in Scottsdale, Arizona, is spearheading a phase Ib/II trial that is demonstrating promising results with a novel regimen in patients with advanced pancreatic cancer. “The patients we are treating have advanced adenocarcinoma of the...

health-care policy

Providing Perspective on Pressing Economic Issues Facing Cancer Care—Now and in the Future

CANCERSCAPE, the 2016 Annual Meeting of the Association of Community Cancer Centers (ACCC), provided a forum for about 300 attendees to gain insight into the complexities of oncology treatment, where “clinical advances, policy mandates, and value-based payment reform intersect.” Of particular...

issues in oncology

Outcome Measures in Quality and Identifying High-Quality Practice

At this year’s ASCO Quality Care Symposium, Craig Earle, MD, MSc, of the Ontario Institute for Cancer Research, used Donabedian’s Triad—structure, process, and outcome—to set the stage for his presentation on the science of quality. “The theory behind Donabedian’s Triad is that structure...

breast cancer

ENDO 2016: BPA Changes Fetal Development of the Mammary Gland, Can Raise Breast Cancer Risk

A new culture system that tests the role of chemical exposure on the developing mammary gland has found that bisphenol A (BPA) directly affects the mammary gland of mouse embryos. The study results, presented by Speroni et al Friday, April 1, at the Endocrine Society's Annual Meeting in Boston...

breast cancer

I Never Forget I Have Cancer

I have a history of fibrocystic breasts, which required biopsies to make certain the cysts were benign, and for years they were. But in 2009, my mammogram screening picked up a suspicious lump in my right breast, which turned out to be stage III estrogen receptor–positive/progesterone...

integrative oncology

Benefiting From Mind-Body Therapy

My diagnosis of early-stage breast cancer at age 35 was a shock, also because I come from a family with no history of cancer. In disbelief, I was literally speechless—I lost my voice completely for several days. I grew up in the former Soviet Union and then in the newly independent Kyrgyzstan. My...

Expert Point of View: David Raben, MD

“As radiation oncologists, we have pushed some important envelopes to try to mitigate long-term toxicity,” said David Raben, MD, Professor of Radiation Oncology at the University of Colorado Cancer Center, Aurora, Colorado. “We’ve been able to utilize intensity-modulated radiation techniques to...

symptom management

Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management

Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most...

gastrointestinal cancer

‘Red-Flag’ Symptoms That Could Signal Colorectal Cancer in Patients Under 50 Years Old Should Be Taken Seriously

In clinical practice, Samantha Hendren, MD, MPH, has been “shocked by what a large proportion of patients we are seeing who are under 50 and presenting with colorectal cancer,” often with advanced disease due to delayed diagnosis. “And that is because patients and physicians don’t even think of...

colorectal cancer
issues in oncology

Half of Elderly Patients With Colorectal Cancer Receive Expensive Therapy With Little Survival Benefit

A study published by Bradley et al in Medical Care showed that over a recent 10-year period, the rate of metastatic colorectal cancer patients older than age 75 receiving three or more treatments increased from 2% to 53%. During this period, 1-year treatment costs increased 32% to reach an...

issues in oncology

ASCO Provides Support and Guidance for the White House Cancer Moonshot Initiative

Although President Richard Nixon signed the National Cancer Act in 1971, essentially declaring a war on cancer, the genesis of the idea had actually been born 2 years earlier, after the first landing on the moon set off a new era of scientific exploration and sparked a belief that any scientific...

cns cancers

A Brain Tumor Diagnosis Has Taken My Life in New Directions

The first sign that I could have a life-threatening illness was a bout of severe dizziness, which sent me first to a general practitioner for a physical examination and then to an ear specialist for more tests. At just 24 and in excellent health, the sudden onset of dizziness didn’t initially set...

Certainty

The following essay by William N. Harwin, 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.   My wife...

issues in oncology

Pieces of Grief

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

Saving Children Orphaned by AIDS in South Africa

Bookmark Title: Empty Hands, A Memoir: One Woman’s Journey to Save Children Orphaned by AIDS in South Africa Author:  Sister Abegail Ntleko Publisher: North Atlantic Books Publication date: September 1, 2015 Price: $12.95; paperback, 176 pages With the development of the multidrug highly active...

breast cancer
issues in oncology

The New Frontiers of Breast Cancer

A seismic shift is underway in screening and treatment approaches for breast cancer. These changes are being fueled by studies showing that mammography in younger women may do more harm than good and that advances in genomic testing and a better understanding of the biology of breast cancers may...

palliative care

How Effective Communication Can Improve Patient Care—and Reduce Physician Burnout

Surveys conducted between 1950 and 1970 show that most physicians considered it inhumane to give patients with a poor cancer prognosis the bad news.1,2 Since then, it has been well established that open communication between physician and patient is an essential part of effective cancer care and...

Breast Cancer Symposium to Offer Uniquely Interdisciplinary Approach for Attendees

Many breast cancer–focused meetings and conferences are held each year, but the Breast Cancer Symposium, which takes place this year in San Francisco, September 8–11, is one of the few that takes an interdisciplinary approach to delivering practical, how-to clinical information for attendees from...

survivorship

A Conversation with Patricia A. Ganz, MD

Researching the effects of cancer on patients’ quality of life and championing the development and implementation of survivorship care plans have been at the forefront of the 20-year-long career of Patricia A. Ganz, MD, Director of the Division of Prevention and Control Research at UCLA’s Jonsson...

global cancer care

A Prominent Oncologist Retraces Her Steps from Baghdad

Maha Hussain, MD, FACP, Professor of Medicine and Urology, is the Associate Director for Clinical Research at the University of Michigan Comprehensive Cancer Center (UMCCC) and Co-leader of its Prostate Cancer/GU Oncology program. Dr. Hussain recently spoke with The ASCO Post about becoming a...

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