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breast cancer
issues in oncology

Should Oncologists Be Ordering Breast Cancer Gene Panels?

Two oncologic surgeons squared off at the 32nd Miami Breast Cancer Conference to debate whether breast cancer genetic susceptibility panel testing is ready for routine use in the clinic. J. Michael Dixon, MD, Professor of Surgery and Consultant Surgeon at the Edinburgh Breast Unit in the United...

issues in oncology

Clinical Trial Participation: ‘Is It All Worth It?’

Clinical trials have become increasingly complex over the past several years, and unfortunately, this has resulted in the typical scenario described below. We are fortunate that there are so many promising agents available for patients, and we want to encourage their participation in clinical...

breast cancer
pain management

Opioid-Reduction Strategy for Postoperative Pain After Breast Cancer Surgery

One persistent and potentially debilitating problem breast cancer patients suffer with is postoperative pain. Studies show that proper pain management is an essential component in the healing process, but undertreatment of pain symptoms remains an ongoing issue in the oncology community. Opioids,...

issues in oncology

20 Years of NCCN: The Best Is Yet to Come

As the National Comprehensive Cancer Network (NCCN) celebrates its 20th year, The ASCO Post asked its Chief Executive Officer, Robert W. Carlson, MD, to reflect on the organization’s accomplishments, mission, and future and on the role he may have played in its success.  The Early Years You became...

pancreatic cancer

Heal Thy Patient … Reflections on the Human Side of Medicine

Dr. Are extended to me the opportunity to make additional comments about his article. I am the husband of the most wonderful Mrs. X he discusses. As always, Dr. Are’s comments are very kind and generous. Three Roles Based on my experience and observations, I would like to mention three roles a...

supportive care

A Cautionary Note on Psilocybin Therapy

The controversial nature of [psilocybin] is garnering attention before [the NYU investigators’] work has been peer-reviewed, which is concerning. Could psilocybin therapy be a helpful anxiolytic in any patient? Yes, I suppose, but I’d like to see the data. Is psilocybin an anxiolytic in cancer...

Courage Under Fire

The following essay by Kishore K. Dass, 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. Born in...

health-care policy

ASCO, ACCC Respond to Repeal of Medicare Sustainable Growth Rate Formula

The American Society of Clinical Oncology (ASCO) and the Association of Community Cancer Centers (ACCC) responded to the approval of H.R.2, a Medicare-reform bill to end the program’s sustainable growth rate  (SGR) formula. ASCO’s Statement ASCO President Peter Paul Yu, MD, FACP, FASCO, praised the ...

thyroid cancer

Welcome to Multikinase Inhibitors in Radioiodine-Refractory Thyroid Cancer

In the past 2 decades, the incidence of thyroid cancer has risen steeply, with rates now growing by 5.5% annually.1 In 2014, 62,980 new cases of thyroid cancer were diagnosed in the United States. The good news is that, overall, the prognosis of thyroid cancer remains excellent; 97.8% of patients...

cns cancers

Will the PVS-RIPO Poliovirus Be a Game Changer in the Treatment of Recurrent Glioblastoma?

Although the idea of using viruses to target cancer cells dates back more than 100 years, technologic advances in the genetic engineering of viruses are now making it possible to safely test oncolytic virotherapy as a valid strategy against cancer cells. One type of genetically engineered virus...

skin cancer

The Promise of Immune Checkpoint Inhibition: Changing the Therapeutic Landscape for Melanoma and Other Malignancies

The past 3 years have witnessed transformative changes in the way that solid tumors and hematologic malignancies are approached, in almost every instance now including consideration of some form of immunomodulation in the first- or later-line therapeutic setting. The greatest success has occurred...

issues in oncology

Agreement on High-Value Screening for Five Common Cancers

Finding agreement on high-value cancer screening among organizations publishing screening guidelines, the American College of Physicians (ACP) issued advice listing the least-intensive screening strategies that all the organizations recommend—as well as strategies not recommended—for five common...

skin cancer

Adjuvant Ipilimumab Increases Recurrence-Free Survival After Complete Resection of High-Risk Stage III Melanoma

In the phase III European Organisation for Research and Treatment of Cancer (EORTC) 18071 trial reported in The Lancet Oncology, Alexander M.M. Eggermont, MD, PhD, Director General of the Gustave Roussy Cancer Center in Villejuif, France, and colleagues found that adjuvant therapy with the immune...

issues in oncology

FDA’s Pregnancy Category Labeling

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA supervisory toxicologist Todd Palmby, PhD, and pharmacologist Eias Zahalka, PhD, MBA, discuss the approach taken in the Office of ...

palliative care

The Importance of Including Adolescents and Young Adults With Cancer in Their Advance Care Planning

Three years ago, a study of adolescents and young adults aged 16 to 28 with metastatic or recurrent cancer or HIV/AIDS compared the usefulness of two previously developed advance care planning guides—one prepared specifically for adolescents and young adults and one specifically for adults. The...

leukemia

A Lasting Legacy

When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...

colorectal cancer

Regorafenib Improves Overall Survival in Asian Patients  With Previously Treated Metastatic Colorectal Cancer

In a phase III trial (CONCUR) reported in The Lancet Oncology, Jin Li, MD, and colleagues found that the multikinase inhibitor regorafenib (Stivarga) improved overall survival vs placebo in Asian patients with previously treated metastatic colorectal cancer.1 Regorafenib is approved in the United...

colorectal cancer

Secondary Prevention in Metastatic Colorectal Cancer: Benefits of Vitamin D and Aspirin Explored

Two low-cost, low-tech options may lead to a survival benefit in metastatic colorectal cancer, according to separate retrospective studies selected for the Best of ASCO® 2015. The first study suggested that vitamin D supplementation is worthy of investigation in this regard,1 and the second study...

Let It Be Hard

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,...

palliative care

One Doctor’s Road to Palliative Care Services in the Inner City

St. Barnabas Hospital is located in the heart of Bronx, New York, and as such, it has a culturally diverse, largely poor, patient population. The backbone of successful palliative care services is the doctor-patient communication bonding process. However, many of the patients with late-stage cancer ...

A Practical Guide to Surviving Breast Cancer and Its Treatments

BOOKMARK Title: Bald Is Better With Earrings: A Survivor’s Guide to Getting Through Breast CancerAuthor: Andrea HuttonPublisher: Harper CollinsPublication date: July 7, 2015Price: $17.99; paperback, 224 pages There are a plethora of books written by breast cancer survivors, and there are sure to...

global cancer care

Measuring Global Health Issues, Seven Billion Times

BOOKMARK Title: Epic Measures: One Doctor. Seven Billion PatientsAuthor: Jeremy N. SmithPublisher: Harper WavePublication date: April 7, 2015Price: $26.99; hardcover, 352 pages Health measures are essential tools in assessing public health and safety. Collecting large amounts of data is a laborious ...

Expect Questions About Treatment for Ductal Carcinoma in Situ

The recent study findings that women diagnosed with ductal carcinoma in situ had a low breast cancer–specific mortality and that preventing ipsilateral recurrences did not prevent breast cancer mortality1 might lead some women diagnosed with ductal carcinoma in situ to question the need for...

issues in oncology

A Cancer Care Model for Rural Areas

Rural cancer patients have long had to adjust to difficult geographic and financial barriers to access high-quality cancer care. These problems are exacerbated by today’s fiscal challenges, which have disrupted many of the small community practices that once served rural communities. In 2006, the...

issues in oncology

Bridging the Gap Between Pediatric and Adult Oncology Care

According to the National Cancer Institute (NCI), about 70,000 adolescents and young adults—defined by the NCI as those in the 15- to 39-year-old range—are diagnosed with cancer each year in the United States, about six times the number of cases diagnosed in children aged 0 to 14.1 And, although...

lung cancer

EGFR Gene Copy Number as Biomarker for Antibody Treatment in Squamous Cell NSCLC

Two studies presented at the 16th World Conference on Lung Cancer suggest that high expression of the epidermal growth factor receptor (EGFR), or gene copy number, may indicate potential benefit from EGFR antibodies in squamous cell non–small cell lung cancer (NSCLC). The studies were presented by...

What Do You Say When She Is No Longer Living With Cancer?

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,...

health-care policy

Inconsistent Federal Regulations Undercut U.S. Research Productivity, National Academies’ Report Finds

Ask any U.S. academic investigator whether research is hindered by duplicative or confusing federal regulations, and the answer is usually a resounding “Yes.” Now comes a report written by representatives of research administrators, former federal government officials, and principal...

palliative care

Important Research in the Palliative Care of Patients With Cancer

The emphasis at this year’s Palliative Care in Oncology Symposium, held earlier this month in Boston, was on patient-centered care throughout the cancer continuum. The meeting attracted more than 650 attendees and included six general sessions featuring best practices in communication,...

issues in oncology
legislation

Debate Over Physician-Assisted Suicide Continues, State by State

In 1997, after surviving a storm of high-court legal challenges, Oregon’s Death With Dignity Act went into effect, making Oregon the first American state to legalize physician-assisted suicide. The Supreme Court ruled that there was no right to assisted suicide in the Constitution but implied that...

issues in oncology

ASCO Launches TAPUR to Assess the Off-Label Use of Targeted Therapies for Patients With Advanced Cancers

Two years ago, Richard L. ­Schilsky, MD, FACP, FASCO, Chief Medical Officer of ASCO, proposed a unique clinical trial concept during an educational session on the challenges of delivering precision medicine services in a community setting at ASCO’s Annual Meeting. The idea was to design a clinical...

Expert Point of View: David Beyer, MD

In an interview with The ASCO Post, incoming ASTRO President David Beyer, MD, provided his perspective on the use of hypofractionation in prostate cancer. Dr. Beyer is Medical Director of the Cancer Centers of Northern Arizona in Sedona. “Fractionation has been an important topic over the past few...

breast cancer
supportive care

APF530 Superior to Ondansetron in Preventing Chemotherapy-Induced Nausea or Vomiting

As part of a three-drug regimen, APF530 (extended-release formulation of granisetron) has become the first 5-HT3 (5-hydroxytryptamine) receptor antagonist to demonstrate superiority over the standard of care for delayed nausea and vomiting after highly emetogenic chemotherapy. According to the...

Expert Point of View: Clifford Hudis, MD, Shanu Modi, MD, and Richard Gelber, PhD

Discussant Clifford Hudis, MD, Chief of Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York, highlighted neratinib’s benefits while also advocating caution in interpreting the results due to incomplete data, the serious side effect of diarrhea, and the potentially...

breast cancer

The Sixth Edition of the Essential Breast Cancer Book

Bookmark Title: Dr. Susan Love’s Breast Book Author: Susan M. Love, MD Publisher: Da Capo Lifelong Books Publication date: September 8, 2015 Price: $24.00; paperback, 704 pages For more than 25 years, Dr. Susan Love’s Breast Book has been the best source of information for women with breast...

integrative oncology
palliative care

Integrating Spirituality Into Palliative Care Services

Over the past couple of decades, the oncology community has made great strides in mediating the psychosocial needs of our patients. However, a patient’s spirituality is a subjective and uncomfortable issue for many oncologists, which leaves a gap in the continuum of care. To reach a better...

The Highs and Lows of a Transplant Surgeon

Bookmark Title: Last Night in the OR: A Transplant Surgeon’s OdysseyAuthor: Bud Shaw, MDPublisher: Plume, division of Penguin GroupPublication date: September 15, 2015Price: $16.00; paperback, 304 pages Surgery has a distinct place in medicine. Surgeons cut deep into our bodies amid clusters of...

Lung Cancer: Hope From Science

The following essay by Paul A. Bunn, Jr, 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. I grew up...

palliative care

Practicing the Humanistic and Holistic Approach to End-of-Life Care

In 1990, when Bruce (B.J.) ­Miller, MD, was an undergraduate at Princeton University, the practice of medicine was far from his mind. Then a student in Chinese and Asian studies and later an art history major, Dr. Miller would come to pursue a career specializing in palliative medicine after an...

cost of care

The Complex Interactions of Treatment Costs, Clinical Outcomes, and Patient Expectations

A clinical dilemma that is receiving a great deal of attention in the oncology community is the undue financial burden some patients face during their treatment and into survivorship. While much emphasis is put on methods to reduce and help patients navigate the complex payment system, little is...

issues in oncology
health-care policy

Cancer Care in Low-Resource Areas: Some Improvements Over the Years, but Serious Problems Remain

Low- and middle-income countries bear a larger share of the global cancer burden than does the developed world,” said Greta ­Massetti, PhD, Associate Director for Science, Centers for Disease Control and Prevention (CDC) Division of Cancer Prevention and Control and Co-Chair of the National Cancer...

skin cancer

Gut Bacteria May Facilitate Efficacy of Anti–PD-L1 Agents

Could the manipulation of bacteria in the gut pack the same punch in melanoma as antibodies targeting the programmed cell death protein and its ligand (PD-1/PD-L1)? It’s possible, at least in mice, according to research from the University of Chicago, recently published in Science.1 The researchers ...

issues in oncology

Filial Gaze at Our Noble Profession

As we stood outside patient X’s room going over the vitals, from a distance, I saw the father of the patient by the side of her bed. I saw him standing there and looking down at his child conveying what I guess were words of reassurance and reinforcing the pillars of strength needed for her...

multiple myeloma

Hoping for a Cure

Unless you have a type of cancer that can be surgically removed or blasted into oblivion with chemotherapy or radiation therapy rendering a cure, having a chronic cancer like multiple myeloma robs you of a normal life. Learning to accept that fact is an adjustment. I was diagnosed with multiple...

hematologic malignancies
leukemia
myelodysplastic syndromes

Selected Abstracts From 2015 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For full details of these study abstracts, visit...

health-care policy
issues in oncology

Clinical Trial System Badly in Need of Overhaul, Say Panelists at Friends-Brookings Conference

Cancer clinical trials in three distinct phases, as they have been conducted for decades, are probably no longer the best way to bring a drug or biologic agent to market. This was the consensus of three panels at the 8th Annual Conference on Clinical Cancer Research convened by Friends of Cancer...

gynecologic cancers

Moore Scoring System Helps Identify Women With Advanced Cervical Cancer Who May Not Benefit From Bevacizumab

Previously published reports from the randomized phase III Gynecologic Oncology Group (GOG) protocol 240 clinical trial showed that adding bevacizumab (Avastin) to a chemotherapy regimen of paclitaxel plus cisplatin or topotecan significantly increased overall survival and progression-free survival ...

supportive care
palliative care

Palliative Care 2015: Study Finds the Answer to One Question Can Help Identify Patients Nearing the End of Life

Determining the answer to a simple question, “Would you be surprised if this patient died within the next year?” can be an important tool to help predict which patients with cancer may be in their final year of life, according to the findings from a study by Vick et al. The tool, known...

issues in oncology
cns cancers

Early Study Suggests Which Glioblastoma Patients May Benefit From Dasatinib

Clinicians testing the drug dasatinib (Sprycel), approved for several blood cancers, had hoped it would slow the aggressive growth of the deadly brain cancer glioblastoma; however, clinical trials to date have not found any benefit. Researchers at Mayo Clinic, who conducted one of those clinical...

health-care policy
issues in oncology

ASCO Issues Statement Praising the Senate Repeal of SGR

In a statement, the American Society of Clinical Oncology praised the U.S. Senate’s 92-to-8 approval of legislation to repeal the Sustainable Growth Rate formula. ASCO President Peter Paul Yu, MD, FACP, FASCO, said, “Today's courageous vote by the U.S. Senate to finally end the...

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