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hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions

Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Questions

Hematology Expert Review is an occasional feature that includes a case report followed by questions, answers, and expert commentary. In the July 25 issue of The ASCO Post, part 1 of a case report was published and focused on diagnosis (see summary below). Here, in part 2, the management of this...

issues in oncology

Strengthening the Doctor-Patient Relationship: An Interview With Lidia Schapira, MD, FASCO

Earlier this summer, Lidia ­Schapira, MD, FASCO, a medical oncologist at Massachusetts General Hospital Cancer Center and Associate Professor of Medicine at Harvard Medical School, was named Editor-in-Chief of Cancer.Net, ASCO’s patient information website. Prior to taking on this role, Dr....

Conquer Cancer Foundation Donor Spotlight: Ludwig Cancer Research

Among the Conquer Cancer Foundation’s newest supporters, Ludwig Cancer Research is an international community of distinguished scientists dedicated to preventing and controlling cancer. Its emphasis on collaboration and long-term support has fostered its role as a leader in immunotherapy and other...

issues in oncology

Johnson & Johnson Creates Independent Bioethics Panel to Evaluate Compassionate Drug Use Requests

In May 2015, Johnson & Johnson announced its partnership with New York University (NYU) School of Medicine in New York to create a first-of-its kind independent bioethics panel to review requests made to the company for compassionate use of an investigational drug and determine how the company...

15th Annual Conference of the International Society of Geriatric Oncology (SIOG)

Join the best minds in Geriatric Oncology during the 15th SIOG Annual Conference taking place in Prague, Czech Republic, on November 12–14, 2015. The 3-day scientific program of SIOG 2015 will have the theme: “Geriatric Oncology and Supportive Care: A Global Approach to Advance the Science.”   ...

cns cancers

Improved Understanding of Glioma Tumor Biology

The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....

breast cancer

Adding Everolimus to First-Line Trastuzumab/Paclitaxel Does Not Increase Progression-Free Survival in HER2-Positive Metastatic Breast Cancer

In the phase III BOLERO-1 trial, reported in The Lancet Oncology, Sara A. Hurvitz, MD, of the University of California, Los Angeles, and colleagues found that the addition of the mTOR inhibitor everolimus (Afinitor) to trastuzumab (Herceptin)/paclitaxel did not significantly increase...

cost of care

Calculating the Value of Cancer Drugs

For nearly a decade, Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York, has been a leading voice in sounding the alarm over the escalating cost of cancer drugs and in seeking a solution to the problem. In 2012, Dr....

colorectal cancer

Learning to Refine the Use of Regorafenib to Best Advantage in Advanced Colorectal Cancer

In patients with advanced colorectal cancer who have been heavily treated with a sequence of chemotherapy regimens and/or targeted therapies, the goals of treatment on or off a clinical trial are readily definable. These patients and their managing teams are striving to extend the length of lives,...

supportive care
pain management
palliative care
symptom management

Managing Cancer Pain at the End of Life

Cancer-related pain does not exist in a vacuum. To effectively treat it, clinicians should understand the contributing factors. Proper assessment and management of cancer pain at the end of life can significantly alleviate patient suffering, according to Eduardo Bruera, MD, FAAHPM, Department Chair ...

health-care policy

‘Right to Try’ Laws: Helpful or Harmful?

Since 2014, “Right to Try” legislation has been sweeping the nation. Created to enable terminally ill patients to gain access to experimental drugs, biologics, and devices by sidestepping the approval process of the U.S. Food and Drug Administration (FDA), at press time, 22 states have enacted...

lymphoma

Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma

Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular diseases throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be aware...

Expect Questions or Ask About Postmastectomy Pain

Since postmastectomy pain occurs in an estimated 20% to 40% of patients undergoing the procedure, physicians who treat these women can expect questions about the pain and how to deal with it. However, some patients may be reluctant to ask about it. “Sometimes, women don’t want to complain to their ...

From Small-Town Mexico to Big Pharma, a Look at Opiates for Good and Bad

Bookmark Title: Dreamland: The True Tale of America’s Opiate Epidemic Author: Sam Quinones Publisher: Bloomsbury Press Publication date:  April 21, 2015 Price: $28.00; hardcover, 384 pages Despite growing awareness within the oncology community and the emergence of the palliative care...

To the One of the Many

(Using Shakespeare’s words to confront the plight of a Physician)   Give me that man That is not passion’s slave Give me that blanket that comforts and soothes For in my heart There was a fighting that would not let me sleep, Our indiscretion Sometimes serves us well. In those wakeful...

breast cancer
survivorship

‘Share the Journey’ Mobile App Aims to Understand the Different Experiences of Breast Cancer Survivors

In March 2015, Sage Bionetworks and Apple released “Share the Journey: Mind, Body, and Wellness After Breast Cancer,” a patient-centered iPhone app that tracks five common consequences of breast cancer treatment, including fatigue, cognitive function, sleep disturbances, mood changes, and a...

breast cancer

I’m Living a Full and Happy Life With Stage IV Breast Cancer

After coping with breast cancer for more than a decade, it is difficult for me to put into words exactly how grateful I am to all the doctors, nurses, and researchers whose efforts have kept me alive for all these years. And not just alive, but thriving. A routine mammogram had discovered two...

A Cancer Handbook for Inquisitive Laypersons and Health-Care Professionals

Bookmark Title: The Cancer Solution: Taking Charge of Your Life With CancerAuthor: Jack C. Westman, MD, MSPublisher: Archway PublishingPublication date:  January 15, 2015Price: $20.00; paperback, 310 pages I was at a meeting in San Francisco in 1978 and received a call from my wife, Nancy:...

Never Say Never

The following essay by Grace Wang, 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. D.K. came to me ...

gynecologic cancers

How Carolyn D. Runowicz, MD, FASCO, Is Shaping the Future of Gynecologic Cancers

Carolyn D. Runowicz, MD, ­FASCO, has worn just about every hat in the field of oncology—clinician, professor, researcher, administrator, and even cancer survivor.  Currently the Executive Associate Dean for Academic Affairs and Professor in the Department of Obstetrics and Gynecology at the Herbert ...

The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version

Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...

Getting There From Here: What You Need to Know About Traveling to Cuba

In January 2015, the U.S. Department of the Treasury and the U.S. Department of Commerce announced changes related to the easing of sanctions on Cuba, which loosened some restrictions on travel for Americans, although some rules still apply. There are 12 legal categories of travel to Cuba,...

lung cancer

Roswell Park Cancer Institute Partners With Cuban Scientists to Develop Lung Cancer Vaccine

Just 4 months after President Barack Obama’s announcement in December 2014 that there would be an easing of the trade embargo between the United States and Cuba, a deal was struck between Roswell Park Cancer Institute in Buffalo, New York, and the Center for Molecular Immunology (CIM) in Havana,...

solid tumors

State-of-the-Art Management of Germ Cell Tumors Produces High Cure Rates

Pasquale W. Benedetto, MD, the Leonard M. Miller Professor of Medicine at the University of Miami/Sylvester Comprehensive Cancer Center, recently spoke at the 2015 New Orleans Summer Cancer Meeting about his approach to diagnosing and treating germ cell tumors in men.1 The ASCO Post was there to...

issues in oncology

Emerging Technology Will Help Tackle Tumor Complexity

Emerging laboratory technology will be “moving the bar forward” in terms of molecular markers, genomics, and gene-expression profiling, with the potential for huge payoffs to oncologists and patients, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Medicine at Stanford School of...

breast cancer

Genetic Testing in Breast Cancer Offers Much Information but Poses Challenges in Interpretation

For breast cancer patients with robust family histories, medical oncologists should be testing not only for BRCA1/2 mutations, but also for large duplications and deletions as well as for PALB2 mutations. “These [findings] have proven utility in testing breast cancer patients,” said Louise E....

NCI and Sage Bionetworks Present: Up for A Challenge?

The National Cancer Institute (NCI) Division of Cancer Control and Population Sciences is partnering with Sage Bionetworks for “Up for a Challenge (U4C): Stimulating Innovation in Breast Cancer Genetic Epidemiology.” This prize competition aims to explore the genomic basis of breast cancer in...

issues in oncology

New Techniques in Oncologic Surgery and Radiology: Some Worth the Expense, Some Not So Much

In recent years, patients with cancer have had the benefit of much high technology: proton-beam radiotherapy, intensity-modulated radiation therapy, various minimally invasive surgery techniques, and robots in the operating room. They all receive hype in the professional and public press, and...

geriatric oncology

Coping With Aging and Cancer: Psychosocial Factors and Geriatric-Specific Interventions

You can’t control the wind, but you can adjust your sails,” said Mindy Greenstein, PhD, consulting psychologist and author, to begin her talk at the 2015 World Congress of Psycho-Oncology, held in July in Washington, DC. The sense of this proverb pervaded the entire session on cancer and aging....

supportive care

Suicide After Cancer: Understanding the Challenges Across the Treatment Trajectory

Suicidal thoughts and impulses are among the most challenging symptoms in patients with cancer, and they may occur both during and after treatment. It has long been known that a cancer diagnosis carries an increased risk for suicide, but the problem is not widely addressed. Suicide is one of the...

International Psycho-Oncology Society and American Psychosocial Oncology Society Meet to Foster Psychosocial Oncology Worldwide

The International Psycho-Oncology Society (IPOS) has partnered with the American Psychosocial Oncology Society (APOS) for the 17th World Congress of Psycho-Oncology, held in late July 2015 in Washington, DC. Its theme, “From National to Global: Implementing the Standard of Psychosocial Care in...

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...

colorectal cancer
hepatobiliary cancer

Colorectal Liver Metastases: Thumbs Up for Radiofrequency Ablation, Jury Still Out for Selective Internal Radiotherapy

Two “firsts” in studies of colorectal liver metastases were highlighted at the 2015 ASCO Annual Meeting: the first prospective randomized trial to evaluate radiofrequency ablation plus chemotherapy1 and the first large randomized phase III trial to study liver-directed selective internal radiation...

lymphoma

Indolent Lymphoma: A More Complex Malignancy Than Once Thought

With a growing number of options for follicular lymphoma, clinicians may wonder whether there is one best regimen. James O. Armitage, MD, FACP, FRCP, Professor of Medicine at the University of Nebraska, Omaha—and Editor-in-Chief of The ASCO Post—tackled this question and offered recommendations at...

Charting a New Course: From Clinical Investigator to University President

What first intrigued Fadlo R. Khuri, MD, FACP, about the prospect of becoming the 16th President of the American University of Beirut (AUB) in Lebanon was the chance to give back to an institution and a country that had given him so much. Born in Boston, Massachusetts, in 1963, Dr. Khuri was raised ...

multiple myeloma

Elotuzumab Ushers in a New Era in Myeloma Therapy

The long wait for monoclonal antibodies for the treatment of multiple myeloma is over. In the landmark ELOQUENT-2 study, reviewed in this issue of The ASCO Post, Lonial and colleagues convincingly demonstrate the effectiveness of elotuzumab, a monoclonal antibody directed against SLAMF7, in the...

kidney cancer

My Positive Attitude Is Keeping Me Alive

Until I was diagnosed with stage III renal cell carcinoma in early 2008, I had no firsthand experience with cancer. To my knowledge, there is no history of cancer in my immediate family, and despite a smoking habit I picked up when I was young, I had been in relatively good health in the 56 years...

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,...

Internationally Acclaimed Cancer Researcher, Gianni Bonadonna, MD, Dies at 81

Gianni Bonadonna, MD, was considered the “Father of Italian Oncology,” but his scientific contributions to the field and his generous collegial spirit extended far beyond the shores of his native land. Dr. Bonadonna was at the forefront in the battle to convince the surgical establishment that...

In Search of a Good Ending for a Life Well Lived

BOOKMARK Title: The Conversation: A Revolutionary Plan for End-of-life CareAuthor: Angelo E. Volandes, MDPublisher: BloomsburyPublication date: January 13, 2015Price: $26.00; hardcover, 240 pages A quick Google search on books about end-of-life care will yield pages of hits on the subject. The...

An Unvarnished, Behind-the-Scenes Look at the Hospital Nurse

BOOKMARK Title: The Nurses: A Year of Secrets, Drama, and Miracles With the Heroes of the HospitalAuthor: Alexandra RobbinsPublisher: Workman Publishing CompanyPublication date: April 14, 20155Price: $17.53; hardcover, 368 pages Florence Nightingale, the most famous and influential figure in...

Microbes by the Trillions

BOOKMARK Title: 10% Human: How Your Body’s Microbes Hold the Key to Health and HappinessAuthor: Alanna CollenPublisher: Harper CollinsPublication date: April 27, 2015Price: $39.99; hardcover, 400 pages "As I walked back through the forest that night in the summer of 2005, with twenty bats in...

integrative oncology

Why It Is Important to Have a Physiatrist on a Cancer Care Team

Physical medicine and rehabilitation in oncology care explores the benefits of cancer rehabilitation in oncology clinical practice to screen survivors for physical and cognitive impairments along the care continuum to minimize survivors’ disability and maximize their quality of life. According to a ...

geriatric oncology

ASCO 2015: Geriatric Oncology Highlights

The theme of the 2015 ASCO Annual Meeting, Illumination and Innovation, is especially appropriate as we consider the field of geriatric oncology. For too long, the elderly cancer patient has remained in the dark regarding treatment planning, clinical trial enrollment, and shared decision-making....

NCI Awards Huntsman Cancer Institute, University of New Mexico Cancer Center Comprehensive Cancer Center Designations

The National Cancer Institute (NCI) recently awarded Huntsman Cancer Institute (HCI) at the University of Utah and The UNM Cancer Center (UNMCC) at the University of New Mexico Comprehensive Cancer Center status. An NCI-Designated Comprehensive Cancer Center must demonstrate depth and breadth of...

Conquer Cancer Foundation Donor Spotlight: Fibrolamellar Cancer Foundation

When Tucker Davis was diagnosed with fibrolamellar hepatocellular carcinoma (FL-HCC) in 2008, there was very little information about this very rare cancer and, as Tucker would soon discover, even fewer treatment options available. An annoying cough and sharp pain radiating down his back leg...

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 ...

issues in oncology

For Big Data Projects, Bigger Is Better

In an interview with The ASCO Post, Robert S. Miller, MD, FACP, Senior Director, Quality and Guidelines, ASCO, and Medical Director, CancerLinQ™, described how the system could work with data specific to radiation oncology. “The system is in the rapid build phase now, what we are calling the...

symptom management

Managing High-Risk Patients With Febrile Neutropenia

Febrile neutropenia is of particular concern in high-risk patients who have undergone stem cell transplant, according to William J. Hogan, MB, BCh, Assistant Professor of Medicine at the Mayo Clinic in Rochester, Minnesota. Dr. Hogan delivered an update on febrile neutropenia management in this...

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