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issues in oncology
lymphoma

The Power of Laughter

The following essay by Julie Vose, MD, MBA, FASCO, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories (May 2014), coedited by Stan Winokur, MD, and Vincent Coppola. The book is available on Amazon.com and thebigcasino.org.   When I met Cindy, she was...

cns cancers

A Candidly Humorous Approach to the Cancer Journey

BOOKMARK Title: Shrinkage: Manhood, Marriage, and the Tumor That Tried to Kill MeAuthor: Bryan BishopPublisher: Thomas Dunne BooksPublication date: April 29, 2014Price: $25.99; hardcover, 336 pages   At 30 years old, Bryan Bishop was having the time of his life. Known to millions of radio fans as...

issues in oncology

A Father and Son’s Journey Through Medicine

BOOKMARK Title: The Good Doctor: A Father, a Son, and the Evolution of Medical EthicsAuthor: Barron H. Lerner, MDPublisher: Beacon PressPublication date: May 13, 2014Price: $25.95; hardcover, 240 pages   One morning in 1996, an infectious disease specialist was making rounds when he and his team...

lung cancer

ASCO Endorses CAP/IASLC/AMP Guidelines for Molecular Testing of Patients With Non–Small Cell Lung Cancer

Personalized medicine is an established treatment concept for patients with advanced non–small cell lung cancer (NSCLC), and molecular characterization of tumors is crucial for choice of (first-line) therapy. As of right now, we have U.S. Food and Drug Administration (FDA)-approved drugs for two...

lung cancer

ASCO Endorses Guideline for Molecular Testing for Selecting Lung Cancer Patients for EGFR and ALK Inhibitor Treatment

ASCO has endorsed the recently developed joint College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) guideline on molecular testing for selection of patients with lung cancer for EGFR and ALK inhibitor...

issues in oncology

Expert Panels Offer Five Proposals to Address Challenges in Regulating, Implementing Next-Generation Sequencing

At the third annual Blueprint for Drug/Diagnostic Co-Development forum, cohosted by Friends of Cancer Research in Washington, DC, and the Alexandria Center for Life Science in New York, two panels tackled considerations in simultaneous development of drugs and companion diagnostics. Friends of...

palliative care

Dying in America: Ensuring High-Quality Care at the End of Life

In September, the Institute of Medicine (IOM) released its report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The report argues that the U.S. health-care system subjects patients to too many—and often futile—interventions near the end of life, often ...

survivorship

Addressing Patients’ Sexual Dysfunction Throughout Survivorship

Studies show that all cancers and related treatments have the potential to affect sexuality and sexual function. Surgery, chemotherapy, hormonal therapy, bone marrow transplantation, and radiation therapy can physically impact sexual health in myriad ways, including vaginal dryness, dyspareunia,...

pancreatic cancer

Pancreatic Cancer in 2014

Adenocarcinoma of the pancreas is the fourth leading cause of cancer death in men and women in the United States. This year, about 46,000 people in this country will be diagnosed with pancreatic cancer, and more than 39,000 will die of the disease. The ASCO Post recently spoke with Margaret A....

breast cancer

Complexity of the Contralateral Prophylactic Mastectomy Decision

The powerful and important study by Kurian et al,1 reviewed in this issue of The ASCO Post, adds vital information to the discussion regarding use of contralateral prophylactic mastectomy among patients with unilateral breast cancer in the United States.2,3 Based upon data from the California...

Commentary: Screening Young Adults for Nonhereditary Colorectal Cancer

In a related commentary, ­Kiran K. Turaga, MD, MPH, of the Medical College of Wisconsin, Milwaukee, writes: “In the setting of these congratulatory reports of a successful public health screening program, this report from Bailey et al is rather unsettling.” “Nevertheless, assuming that this...

Interviews With Candidates for 2015-2016 ASCO President-Elect

The ASCO Nominating Committee has selected Daniel F. Hayes, MD, FASCO, and Patrick J. Loehrer, Sr, MD, FASCO, as candidates for the position of 2015-2016 President-Elect (2016-2017 President). In the abridged interviews below, the candidates discuss their vision for the Society and their leadership ...

Expert Point of View: Hope S. Rugo, MD

Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the results of the RESILIENCE trial presented at the European Society for Medical Oncology ...

Expert Point of View: Hope S. Rugo, MD

Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education for the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the two studies on maintenance bevacizumab (Avastin) for metastatic breast cancer...

Expert Point of View: Stefan Sleijfer, MD, PhD

Formal discussant of the PAZOGIST trial at the European Society for Medical Oncology (ESMO) 2014 Congress, Stefan Sleijfer, MD, PhD, of Erasmus MC Cancer Institute, Rotterdam, the Netherlands, said “The title of my talk is ‘Small Molecules: Greater Success,’ and we are not yet there.” He agreed...

Expert Point of View: Axel Grothey, MD

In his discussion of the QUASAR2 presentation at the European Society for Medical Oncology (ESMO) 2014 Congress, Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, said the results “confirm what we know” and have no implications for clinical practice or for future...

issues in oncology
cost of care

Tackling the Complexity of Cancer: Finding Common Ground on Value and Progress

To kick off the second national Turning the Tide Against Cancer conference, sponsored by the American Association for Cancer Research, Personalized Medicine Coalition (PMC), and Feinstein Kean Healthcare, Edward Abrahams, PhD, President of PMC, noted that U.S. health-care costs are unsustainable...

issues in oncology

Young Adults With Cancer: Unique Issues Highlight Importance of Patient-Centered Care

Suleika Jaouad, a journalist, was 22 and had just gotten her first chance to cover a major news story—the revolution underway in Tunisia—when she was diagnosed with myelodysplastic syndrome that had evolved into acute myeloid leukemia (AML). Months into her treatment, she began to write again, but...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

colorectal cancer

For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated

Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...

sarcoma

Advances in Sarcoma Owe Much to Children’s Oncology Group

Improvements over the past 3 decades in 5-year survival rates for patients with osteosarcoma and Ewing’s sarcoma owe a lot to chemotherapy clinical trials conducted by the Children’s Oncology Group (COG), Mark Agulnik, MD, acknowledged at the Best of ASCO meeting in Chicago. Dr. Agulnik is...

cost of care

Financial Toxicity Potentially Harmful Treatment‑Related Effect

It turns out that in addition to treatment-related toxicity, cancer patients commonly experience “financial toxicity,” a phrase that is increasingly coming into parlance in the cancer community. Patients should be assessed for financial toxicity as early as possible following diagnosis so that they ...

issues in oncology

Choosing Wildly: A Patient’s Perspective on Overtreatment and Quality Care

Over the past decade, there has been growing concern in the oncology community about overdiagnosis and overtreatment of cancers that prove to be indolent and nonlethal, resulting in unnecessary and sometimes harmful procedures.  At this year’s ASCO Quality Care Symposium in Boston, this important...

cost of care

Overutilization a Key Target in Efforts to Control Health-Care Costs

Overutilization of health-care interventions has become a prime target of efforts to rein in health-care costs. Overtreatment of cancer patients is associated with a number of common harms to the patient—not just financial harm to the health-care system. At the recent ASCO Quality Care Symposium in ...

issues in oncology

Why I Think Dr. Ezekiel Emanuel Is Wrong About Aging

The image of aging that Ezekiel Emanuel, MD, PhD, expresses in his essay, “Why I Hope to Die at 75,” in the October issue of The Atlantic,1 is bleak indeed and one that has contributed mightily to the negative views of aging imbedded in our society. But I refute his description of growing older as...

issues in oncology

Striving for Quality, Not Quantity, of Life

Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...

Expert Point of View: Solange Peters, MD, PhD

The IMPRESS trial asks a simple question: Should you continue an [epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor] while you switch to chemotherapy,” said Solange Peters, MD, PhD, Head of the Thoracic Malignancies Program at the University of Lausanne, Switzerland, at the European ...

Raising Consciousness About Drug Costs: A Call to Action

As medical oncologists working in chemotherapy utilization management (Oncology Analytics, Inc), my colleagues and I find ourselves daily in the center of the drug-cost maelstrom. While it is encouraging to see that more attention is being paid in the popular and medical press to this...

gastroesophageal cancer

Customizing Surveillance Strategy in Patients With Esophageal Adenocarcinoma

A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...

Expect Questions From Patients

Screening for thyroid cancer should be discouraged to prevent an “epidemic of diagnosis”—like the one occurring in South Korea—from happening in the United States and other countries, according to the authors of an analysis of the South Korean screening program. That study was published in The New...

lung cancer

Beating the Odds

I know it sounds odd, but the past 10 years spent living with non–small cell lung cancer (NSCLC) have been very productive, wonderful years. It is not the life I had before my diagnosis, but it is the life I remember most clearly, and knowing how deadly this cancer is, I’m grateful for every day of ...

O Physician, MY Physician

Where Art thou O Physician With comforting smiles Soft touching hands Your words that soothe And eyes that sympathize What happened O Physician With transforming skills A frown is affixed The hands barely touch Your words are hurried And eyes barely size Like a peach O Physician Once with intricate ...

A Good Life, All the Way to the Very End

BOOKMARKTitle: Being MortalAuthor: Atul Gawande, MDPublisher: Metropolitan BooksPublication date: October 7, 2014Price: $26.00; hardcover, 304 pages   Mortality is the invisible observer in the oncology exam room. When people hear the three words, “You have cancer,” they see their world as they...

When Life Couldn’t Be Better

The following essay by Carolyn D. Runowicz, 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. Just...

skin cancer

Memorial Sloan Kettering Team Discovery Advances Understanding of Immunotherapy’s Successes—and Its Failures

A collaborative team of leaders in the field of cancer immunology from Memorial Sloan Kettering Cancer Center has made a key discovery that advances the understanding of why some patients respond to the CTLA-4 blocking antibody ipilimumab ­(Yervoy), an immunotherapy drug, while others do not. A...

Discussing Cessation of Medications Near the End of Life

Discussions with patients and families about stopping non–cancer-related medications near the end of life are thorny but necessary, according to Arif H. Kamal, MD, of Duke Cancer Institute, at the Best of ASCO meeting in Seattle. “What’s happening now is that a lot of hospices are having a...

survivorship

Major Strides Seen This Year in Survivorship Care

"This year was actually a boon for the patient and survivor care section,” Arif H. Kamal, MD, said at the Best of ASCO meeting in Seattle, where he reviewed the leading abstracts and gave some of his own perspective. “What you see is a lot of the limitations of research in the palliative care and...

palliative care

How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer

A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants...

Helping Adolescents and Young Adults Cope With Cancer

Each year, about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States, almost six times the number of cases diagnosed in children up to 14 years of age. While overall cancer survival rates continue to rise—according to the American Cancer Society, there are...

cns cancers

Treating Brain Cancer in 2014

While primary malignant brain tumors account for only 2% of all adult cancers, these deadly neoplasms cause severe cancer-related disability; the 5-year survival rates for brain tumors rank third lowest among all cancers, with those for pancreas and lung cancers being first and second lowest,...

Study Finds Wide Variation in Quality, Content of Clinical Cancer Guidelines

What’s the best way to treat rectal cancer? Consult any of five top clinical guidelines for rectal cancer and you will get a different answer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center. Their findings were published online in the journal...

multiple myeloma

HDAC Inhibitors and Triple Therapy in Relapsed Myeloma

The use of histone deacetylase (HDAC) inhibitors as human cancer therapy has focused on the impact of these agents on epigenetic regulation and gene transcription. However, the use of HDAC inhibitors in myeloma may be working through a different mechanism. Specifically, HDAC6 is known to regulate...

issues in oncology

Advancing ASCO’s Commitment to Quality to Ensure That Every Patient Receives the Highest Level of Cancer Care

On December 3, 2014, Robert S. Miller, MD, FACP, FASCO, will start his new position as Medical Director of ASCO’s Institute for Quality (iQ). Established in 2012 to oversee the development of clinical practice guidelines, the Quality Oncology Practice Initiative (QOPI), the QOPI Certification...

issues in oncology

Top 5 Features of ASCO’s Newly Redesigned Patient Education Website Highlighted

ASCO recently launched a new and redesigned version of Cancer.Net, its patient-facing website that includes timely, comprehensive, and oncologist-approved information. With support from the Conquer Cancer Foundation, Cancer.Net is able to bring the expertise and resources of ASCO to your patients...

issues in oncology

ASCO Announces Top 5 Advances in Modern Oncology

To mark ASCO’s 50th anniversary, the Society called on the oncology community to select the five most pivotal advances in cancer research and patient care over the past 50 years. Now, with more than 2,000 votes cast, ASCO has announced the results on CancerProgress.Net, its interactive website on...

gynecologic cancers

With New Innovator Award, Biomedical Engineer to Study How Ovarian Cancer Spreads

With approximately 22,000 diagnoses annually in the United States, ovarian cancer isn’t among the most commonly occurring cancers. Yet, the mortality rate for women who have ovarian cancer hovers above 60%. For Pamela Kreeger, PhD, a University of Wisconsin–Madison Assistant Professor of Biomedical ...

prostate cancer

From ‘Clinical Judgment’ to Evidence-Based Medicine: Thoughts on the  ASCO/CCO Guideline in Metastatic Castration-Resistant Prostate Cancer

We are witnessing unprecedented progress in the development of therapy for patients with metastatic castration-resistant prostate cancer. The U.S. Food and Drug Administration (FDA) has issued 13 approvals since 1996 for agents that have demonstrated an impact on overall survival, pain, or...

colorectal cancer

Sigmoidoscopy or Colonoscopy for Colorectal Cancer Screening: Is It Still the Question?

Mortality from colorectal cancer remains a public-health concern, being the second leading cause of cancer-related death for men and women combined. The major preventive measure for colorectal cancer is to screen for and remove adenomatous polyps. Average-risk individuals (ie, those who do not have ...

leukemia
issues in oncology

Childhood Obesity and Leukemia: Is It Time to Intervene?

"Obesity is associated with cancer mortality,” said Steven D. Mittelman, MD, PhD, at the recent American Association for Cancer Research (AACR) International Conference on Frontiers in Cancer Prevention Research.1 Dr. Mittelman presented a wealth of data to explain the link between obesity and...

Expert Point of View: Deborah Schrag, MD, MPH

Formal discussant of the Quality Care Symposium presentation on the impact of tumor boards, Deborah Schrag, MD, MPH, Dana-Farber Cancer Institute, Boston, commended the authors for the collaborative use of data to improve quality of care. “For this study, Dr. Kehl and coauthors leveraged the...

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