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Showing 551 - 600Patient Assistance Programs Provide Psychosocial but Not Practical Help
“Patients with breast cancer who connect to relevant patient assistance programs receive useful informational and psychosocial but not practical help,” concluded Nina A. Bickell, MD, MPH, of Mount Sinai School of Medicine in New York, and colleagues who conducted a randomized trial among 374 women...
Impact of Hormone Replacement Therapy on Breast Cancer Risk Varies by Race, Weight, and Breast Density
The impact of hormone replacement therapy on breast cancer risk varies according to the patient’s to race/ethnicity, body mass index, and breast density. An analysis of 1,642,824 screening mammograms with 9,300 breast cancer cases in postmenopausal women aged 45 years or older found that hormone...
Variations in Risk Factors Suggest Distinct Etiology for Inflammatory Breast Cancer
“Varying risk factor associations between inflammatory and noninflammatory breast cancer suggest a distinct etiology for [inflammatory] breast cancer,” according to a study in the Journal of the National Cancer Institute. High body mass index was shown to increase risk of inflammatory breast cancer ...
SIDEBAR: Expect Questions About Support Systems for Unmarried Patients
The study finding that unmarried patients with cancer “are at significantly higher risk of presentation with metastatic cancer, undertreatment, and death resulting from their cancer,” generated a lot of comments from colleagues, family members, and patients, the study’s lead author Ayal A. Aizer,...
'Clear and Consistent Protective Effect of Marriage' Found in Patients With 10 Most Clinically Significant Cancers
A clear and consistent protective effect of marriage among patients harboring one of the 10 most clinically significant malignancies affecting Americans” was found in a study analyzing Surveillance, Epidemiology, and End Results (SEE) data for 734,889 patients diagnosed with lung, colorectal,...
Impact of Pelvic Radiotherapy and Lymphadenectomy on Endometrial Cancer Mortality
Analysis of data from 58,172 patients identified from Surveillance, Epidemiology, and End Results (SEER) registries as having stage I or II endometrial adenocarcinoma found that pelvic radiotherapy and lymphadenectomy were associated with statistically significantly reduced noncancer mortality,...
Nodal Status and Tumor Size Predicted Late Recurrences of ER-Positive Breast Cancer in Postmenopausal Women
Only nodal status and tumor size provided statistically significant prognostic information for predicting recurrences 5 to 10 years after diagnosis for postmenopausal women with early estrogen receptor–positive breast cancer enrolled in the monotherapy arms of the ATAC (Arimidex, Tamoxifen, Alone...
One in Three American Adults Do Not Comply With Screening Guidelines for Colorectal Cancer
The percentage of American adults aged 50 to 75 who are up-to-date with recommended screening for colorectal cancer “increased from 54% in 2002 to 65% in 2010, primarily driven by increased use of colonoscopy,” according to data from the 2012 Behavioral Risk Factor Surveillance System survey....
SIDEBAR: Expect Questions From Your Patients
Risk-reducing salpingo-oophorectomy “is an important strategy for reducing both breast and gynecologic cancer risk for women with BRCA1 or BRCA2 mutations and is proven to improve life expectancy,” Noah D. Kauff, MD, told The ASCO Post. Questions persist, however, about whether women undergoing...
'Reasonable but Not Required' for Women With BRCA Mutations to Have Hysterectomy Concurrent With Salpingo-Oophorectomy
For women with BRCA1 or BRCA2 mutations who choose to have salpingo-oophorectomy to reduce their risks of ovarian and breast cancer, also choosing to have a hysterectomy is “reasonable but not required,” noted Noah D. Kauff, MD, Director of the Ovarian Cancer Screening and Prevention Program and...
Spanning a Spectrum of Issues Related to Head and Neck Cancers
Five recent articles in JAMA Otolaryngology–Head & Neck Surgery1-5 span a spectrum of issues related to head and neck cancers. These include risk factors, concentration of care to teaching hospitals, avoiding venous thromboembolism, and encouraging patients to eat and do swallowing exercises to ...
Young Tobacco Consumers Frequently Use Products Other Than Cigarettes
“A substantial proportion of youth tobacco use occurs with products other than cigarettes, so monitoring and prevention of youth tobacco use needs to incorporate other products, including new and emerging products,” according to the Morbidity and Mortality Weekly Report, published by the Centers...
Promoting Timely Referral to Reproductive Specialists for Patients Concerned About Fertility
Updated clinical guidelines published this year by ASCO “give oncology care providers an opportunity to partner with their reproductive specialist colleagues to ensure that the clinical and psychosocial needs of patients with cancer are addressed as close to the time of diagnosis as possible,”...
Oncologists Need to Inform Primary Care Physicians About Late and Long-Term Effects of Chemotherapy
A nationally representative survey of 1,130 oncologists and 1,072 primary care physicians found that primary care physicians had limited awareness of late or long-term effects of chemotherapy agents. This was attributed to primary care physicians not typically encountering chemotherapy agents...
Using Life Expectancy, Not Age, to Make Cancer Screening Decisions Can Maximize Potential Benefits
Using life expectancy, rather than chronologic age, to inform decisions about whether to continue cancer screening for older persons can maximize the potential benefits of screening, while minimizing the harms, according to results of a population-based cohort study of 407,749 people over 66...
Three-Drug Regimen Produces High Response Rate in Relapsed/Refractory Myeloma
A phase II trial to evaluate the combination of bendamustine (Treanda) with bortezomib (Velcade) and dexamethasone in patients with relapsed/refractory multiple myeloma “showed a remarkable response rate of 60.9%,” and when minor responses were included, 75.9%,” researchers reported in Blood. “The...
Disease-Free Survival Is Acceptable Surrogate for Overall Survival in Trials of Adjuvant Chemotherapy
Disease-free survival is an acceptable surrogate for overall survival in trials of cytotoxic agents for gastric cancer in the adjuvant setting, the GASTRIC group concluded after conducting a meta-analysis of data from 3,288 individual patients enrolled in 14 randomized clinical trials. The trials...
SIDEBAR: Expect Questions From Patients
Not discussing the costs of medical interventions could result in “financial toxicity” for patients who have trouble paying out-of-pocket costs, as well as problems adhering to expensive treatment regimens. “The problem is perhaps starkest in cancer care, but it applies to all complex illness,”...
Disclosing Medical Costs Can Help Avoid 'Financial Toxicity'
High costs of cancer treatments can be an “undisclosed toxicity” that can harm a patient’s overall health and well-being, according to an article in The New England Journal of Medicine.1 High medical bills can not only cause stress and anxiety but may also compel patients to cut back on spending...
African Americans Report Receiving Few Positive Recommendations by Physicians About Joining Clinical Trial
A study among African American patients with cancer who had declined to participate in a therapeutic clinical trial found that few patients reported receiving a positive recommendation from their physician to participate in the trial. “Patients gave multiple refusal reasons,” researchers led by...
Increased Ultraviolet Radiation Exposure May Protect Against HL, Particularly in Those With EBV-Positive Disease
Increased exposure to ultraviolet radiation may offer protection against Hodgkin lymphoma (HL), particularly against Epstein-Barr virus (EBV)-positive HL, according to a pooled analysis of studies involving 1,320 HL patients and 6.381 controls. “Our pooled analysis of 7,701 participants from 4...
Effects of Oral Contraceptives on Breast/Ovarian Cancer Risks Are Similar Regardless of BRCA Mutation Status
The effects of oral contraceptives on breast and ovarian risks are similar for women with BRCA1 or BRCA2 mutations and for women in the general population, according to analyses of observational studies. Oral contraceptive use “is inversely associated with ovarian cancer risk, whereas a modest but...
No Significant Improvement With Decongestive Therapy vs More Conservative Approach to Treating Arm Lymphedema
Daily manual lymphatic drainage and bandaging followed by compression garments did not result in significant improvement in lymphedema compared to a more conservative approach with compression garments only, according to a study evaluating 95 women previously treated for breast cancer with...
SIDEBAR: Expect Questions From Your Patients About Hyperthermia
Most but not all cancer treatment with hyperthermia is still being done in clinical trials. The exception is using hyperthermia for superficial cancers, most commonly chest wall recurrences in the breast. Using hyperthermia for superficial cancer “is approved and reimbursable by Medicare,” Mark W....
Using Hyperthermia for Cancer Treatment: Proofs, Promises, and Uncertainties
With the headline, “Rare Cancer Treatments, Cleared by F.D.A. but Not Subject to Scrutiny,” a recent article in The New York Times reported that several medical centers were treating patients with cancer using a hyperthermia system that had received a Humanitarian Use Device approval from the U.S....
Bosutinib Shows 'Acceptable Safety' in Philadelphia Chromosome–Positive Leukemia
Bosutinib (Bosulif) demonstrated “acceptable safety with manageable toxicities” in a phase I/II study among patients with chronic-phase chronic myeloid leukemia (CML) or advanced Philadelphia chromosome–positive leukemia (accelerated-phase/blast-phase CML or acute lymphoblastic leukemia). Patients...
Some Lung Cancers Detected by Low-Dose CT in National Lung Screening Trial May Be Indolent
More than 18% of all lung cancers detected by low-dose computed tomography in the National Lung Screening Trial (NLST) may be clinically insignificant. Overdiagnosis should be considered when describing the risks of [low-dose computed tomography] screening for lung cancer, according to a review of...
Final Overall Survival Data Show Better Results With Higher Dose of Fulvestrant
Among patients with locally advanced or metastatic estrogen receptor–positive breast cancer, fulvestrant (Faslodex) given at 500 mg “is associated with a 19% reduction in risk of death and a 4.1-month difference in median overall survival compared with fulvestrant 250 mg,” according to final...
Expect Questions, and Some Reluctance, About Getting a Flu Shot
People with weakened immune systems due to diseases like cancer are at increased risk of severe complications from the flu virus and should get flu shots annually. The Centers for Disease Control and Prevention (CDC) strongly encourages this practice, and most oncologists would recommend that for...
Cancer Patients Are at Increased Risk of Complications From the Flu and Should Receive Flu Shots, but Not the Nasal Spray
Widespread influenza activity continues to be reported by the Centers for Disease Control and Prevention (CDC), with a recent increase in flu-related hospitalizations.1,2 Patients with cancer are at increased risk from flu complications and should receive the flu shot, but not the flu nasal spray...
Role for Reduced-Intensity Conditioning Regimen in AML After Allogeneic Transplantation
Reduced-intensity conditioning and myeloablative-conditioning regimens following allogeneic hematopoietic cell transplantation in children with acute myeloid leukemia (AML) resulted in comparable survival, according to a study published in Blood. The study evaluated 181 patients, 39 treated with...
Anticipated Shortage of Oncologists Will Strain Ability to Provide Quality Cancer Care
An update of the ASCO 2007 oncology workforce study found that the Patient Protection and Affordable Care Act, when fully implemented, may “modestly exacerbate” anticipated workforce shortages, increasing the demand for oncologists and radiation oncologists by 500,000 visits per year. “Unless...
Pomalidomide Plus Low-Dose Dexamethasone: Important New Option in Relapsed/Refractory Multiple Myeloma
Pomalidomide (Pomalyst) plus low-dose dexamethasone significantly improved progression-free survival compared to pomalidomide alone in patients with relapsed and refractory multiple myeloma enrolled in a multicenter, open-label study, the phase II part of the MM-002 trial. The study confirmed the...
In CLL With Coexisting Conditions, Chlorambucil Produces Better Outcomes With Obinutuzumab Than With Rituximab
A randomized phase III trial conducted in 26 countries found that combining chlorambucil (Leukeran) with an anti-CD20 antibody—either obinutuzumab (Gazya) or rituximab (Rituxan)—produced better outcomes among patients with previously untreated chronic lymphocytic leukemia (CLL) and coexisting...
High Expression of hENT1 Can Predict Better Survival Among Patients on Postsurgical Gemcitabine
High levels of expression of the human equilibrative nucleoside transporter 1 (hENT1) were associated with longer median survival of patients with pancreatic adenocarcinoma receiving gemcitabine, according to an analysis of clinical data and cancer tissue collected from the European Study Group for ...
Expect Questions from Patients
Like all early detection strategies, screening mammography involves trade-offs,” H. Gilbert Welch, MD, MPH, and Honor J. Passow, PhD, of the Dartmouth Institute for Health Policy & Clinical Practice, Hanover, New Hampshire, wrote in a Special Communication in JAMA Internal Medicine.1 They...
Confronting Uncertainty About the Harms and Benefits of Screening Mammography
“If women are to truly participate in the decision of whether or not to be screened [for breast cancer using mammography], they need some quantification of its benefits and harms,” asserted H. Gilbert Welch, MD, MPH, Professor of Medicine, and Honor J. Passow, PhD, Instructor, at The Dartmouth...
R-GCVP Regimen for Patients With Diffuse Large B-Cell Lymphoma and Cardiac Comorbidity
For patients with diffuse large B-cell lymphoma (DLBCL) who are unable to receive anthracycline-containing chemoimmunotherapy because of cardiac comorbidity, a regimen of rituximab (Rituxan), gemcitabine, cyclophosphamide, vincristine, and prednisolone (R-GCVP) “is an active, reasonably...
Nintedanib Combined With Docetaxel Is Effective Second-Line Option for Advanced NSCLC
The combination of nintedanib and docetaxel “is an effective second-line option” for patients with advanced non–small cell lung cancer (NSCLC) who have received previous treatment with one line of platinum-based therapy, according to results from the phase III LUME-Lung 1 study published in The...
Task Force Recommends Against Beta-Carotene or Vitamin E Supplements for Primary Cancer Prevention
The U.S. Preventive Services Task Force (USPSTF) recommends against the use of beta-carotene or vitamin E supplementation for the primary prevention of cancer or cardiovascular disease, according to an updated recommendation statement published in the Annals of Internal Medicine. “The USPSTF found...
‘Epidemic of Diagnosis’ of Thyroid Cancer Is Most Acute for Women
The epidemiology of the increased incidence of thyroid cancer, which has nearly tripled since 1975, “suggests that it is not an epidemic of disease but rather an epidemic of diagnosis,” Louise Davies, MD, MS, and H. Gilbert Welch, MD, MPH, concluded after analyzing trends in patients diagnosed with ...
Dietary Lycopene Linked to Reduced Risk of Lethal Prostate Cancer, Less Tumor Angiogenesis
“Dietary intake of lycopene was associated with reduced risk of lethal prostate cancer and with a lesser degree of angiogenesis in the tumor,” Ke Zu, MD, of Harvard School of Public Health, Boston, and colleagues concluded after reviewing dietary information and total and lethal prostate cancer...
Aspirin Associated With Reduced Risk of Ovarian Cancer, Especially in Low Daily Doses
“Aspirin use was associated with a reduced risk of ovarian cancer, especially among daily users of low-dose aspirin,” according to an analysis of pooled individual data from the Ovarian Cancer Association Consortium. Analyzing data from 12 population-based case-control studies of ovarian cancer,...
For Metastatic Colorectal Cancer, Bevacizumab Is More Commonly Included Than Anti-EGFR Antibody Therapies
Analysis of a large cohort of patients with metastatic colorectal cancer who received chemotherapy at academic, private, and community-based oncology practices using the same chemotherapy order entry system showed that “bevacizumab has been more consistently integrated into treatment regimens than...
Expect Questions About the Appropriate Use of Mohs Surgery
Mohs surgery can be an effective treatment option for nonmelanoma skin cancer, as well as for more rare but aggressive skin cancers. In addition, Mohs can be particularly helpful to treat patients with skin cancers that have recurred,” Brett M. Coldiron, MD, Clinical Associate Professor of...
Dermatologists Defend Mohs Surgery as Effective and Cost-Efficient With Low Rate of Recurrence
The headline, “Patients’ Costs Skyrocket, Specialists’ Incomes Soar,” aptly encapsulates the theme of a recent article in The New York Times,1 part of a series entitled, “Paying Till It Hurts.” “Oncologists benefit from the ability to mark up (and profit from) each dose of chemotherapy they...
National Program to Screen Ashkenazi Women in Israel for BRCA Mutations Is Being Explored
Citing a World Health Organization report that lists Israel as having one of the highest rates of breast cancer in the world, The New York Times reported on a proposed screening program to identify women with BRCA1 and BRCA2 mutations.1 “A number of influential geneticists and cancer doctors from...
Bendamustine/Rituximab May Be Important Alternative for Indolent NHL or MCL
Results from the BRIGHT study combined with long-term safety data from other studies suggest that bendamustine (Treanda) plus rituximab (Rituxan) “may be an important alternative treatment option” for the initial treatment of patients with low-grade non-Hodgkin lymphoma (NHL) and mantle cell...
Adding Idelalisib to Rituximab Improved Survival in Patients With Relapsed CLL
Receiving rituximab (Rituxan) with idelalisib, rather than rituximab with placebo, “significantly improved progression-free survival, response rate, and overall survival” among patients with relapsed chronic lymphocytic leukemia (CLL) who were less able to undergo chemotherapy because of clinically ...
Long-Term Benefit With Dasatinib After Imatinib Failure in Chronic-Phase Chronic Myeloid Leukemia
Patients with chronic myeloid leukemia (CML) in the chronic phase who are resistant or intolerant to imatinib (Gleevec) can experience long-term benefit with dasatinib (Sprycel), according to long-term results of a randomized phase III study. The CA180-034 study also found that early molecular and...
