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integrative oncology

Ginseng in the Spotlight 

I read the study by Barton and colleagues in Journal of the National Cancer Institute with great interest. Ginseng seems potentially to be one treatment for cancer-related fatigue, a poorly understood but debilitating symptom that patients experience during and after treatment.1 I am impressed that ...

prostate cancer

Study Suggests Low-Grade Prostate Cancers May Not Progress Over Time 

Data analyzed from a large cohort study of men diagnosed with prostate cancer found that prostate cancer aggressiveness may be established when the tumor is formed and not changed over time. The researchers of the study, Kathryn L. Penney, ScD, Instructor in the Department of Medicine at Harvard...

survivorship

Fertility Rates in Childhood Cancer Survivors Suggest Strategies for Follow-up Care 

Childhood cancer survivors with clinical infertility have a good chance of achieving pregnancy, according to new findings from the Childhood Cancer Survivor Study (CCSS). Study Background As a group, women who survive childhood cancer are known to have lower fertility rates. This study, however,...

lymphoma

Molecular Profiling Improves Classification of Nodal Peripheral T-Cell Lymphomas 

One of the primary obstacles we face in caring for patients with peripheral T-cell lymphomas is a too often inadequate response to chemotherapy with low rates of progression-free and overall survival.1 And while more intensive treatment programs and the availability of novel agents give a greater...

gynecologic cancers

Olaparib Shows Robust Progression-Free Survival Benefit in Patients With BRCA Mutations 

Maintenance therapy with olaparib extended progression-free survival and the time to disease progression after a second subsequent therapy in patients with platinum-sensitive relapsed serous ovarian cancer and a BRCA mutation, according to an updated analysis of Study 19 presented at the 2013 ASCO...

head and neck cancer

Many Patients With Head and Neck Cancer Report Being Depressed, but Few Use Mental Health Services  

Despite a relatively high rate of depression among patients with head and neck cancer following radiation therapy, mental health services were severely underutilized in this group, concluded researchers who analyzed questionnaire results from 211 patients. The patients had been previously treated...

thyroid cancer

More Prudent Interpretation of Thyroid Ultrasound Could Reduce Unnecessary Biopsies 

Thyroid ultrasound imaging could be used to identify patients who have a low risk of thyroid cancer for whom biopsy could be deferred, according to a retrospective case-control study reported in JAMA Internal Medicine. Reviewing 11,618 thyroid ultrasound imaging examinations from 8,806 patients...

skin cancer

Indoor Tanning Common Among Young White Females Despite Skin Cancer Risk 

Indoor tanning, defined as using a tanning booth, sun bed, or sunlamp, is common among non-Hispanic white female high school students and young adults, despite risks of melanoma and nonmelanoma skin cancer, according to a study published online by JAMA Internal Medicine.  Using data from the 2011...

skin cancer

Low Risk of Transformation to Melanoma for Biopsy-Diagnosed Mildly or Moderately Dysplastic Nevi 

The risk of transformation to melanoma appears very low for biopsy-diagnosed mildly or moderately dysplastic nevi, and routine surgical excision of nevi with a positive biopsy margin may not be indicated. Patients with biopsy-diagnosed moderately-to-severely and severely atypical nevi, however,...

SIDEBAR: Expect Questions From Your Patients 

Physicians and patients should engage in open discussion” about the complex issues of cancer screening, overdiagnosis, and overtreatment, according to a report from the chairs of a National Cancer Institute working group tasked with developing a strategy to improve the current approach to cancer...

issues in oncology

Tackling Overdiagnosis and Overtreatment, by Words and by Deeds  

The complexity of the pathologic condition called cancer,” according to a Viewpoint article in the Journal of the American Medical Association,1 “complicates the goal of early diagnosis.” Failure to recognize that cancers are heterogeneous, and that not all progress to metastases and death, can...

St. Jude Children's Research Hospital Recognizes Childhood Cancer Awareness Month

Childhood cancer remains the leading cause of death by disease among young Americans. September marks Childhood Cancer Awareness Month, a time to highlight efforts to reduce the disease’s toll on children. At St. Jude, the past year has brought advances in understanding and treating childhood...

lymphoma
survivorship

Celebrating 2 Decades as a Cancer Survivor 

This past June, I celebrated 20 years of being a cancer survivor by throwing myself a party. It was an interesting experience because I learned that many of the 100 guests I invited were also cancer survivors or were family members of cancer survivors, and so we celebrated their lives as well. Our...

lymphoma

Potential Prognostic Significance Shown for Interaction of Follicular Lymphoma Cells with Immune Microenvironment 

It has been shown that CD4 and CD8 tumor-infiltrating lymphocytes in follicular lymphoma have impaired function and suppressed recruitment of critical signaling proteins to the immunologic synapse, and a number of studies have indicated the prognostic importance of the immune microenvironment in...

cns cancers

Sitimagene Ceradenovec/IV Ganciclovir in Glioblastoma: Legitimizing the Gene Therapy Approach for Brain Tumors 

The ASPECT study,1 a randomized, open-label, phase III trial examining adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir for patients with operable high-grade glioma, is an important achievement for both neuro-oncology and gene therapy. As vector engineering...

gynecologic cancers

Progesterone and Estrogen Receptor Expression Are Prognostic Markers for Endometrioid and High-Grade Serous Ovarian Cancer 

Few markers of ovarian cancer prognosis have been established, perhaps because potential subtype associations are missed in studies including patients with all histopathologic subtypes. In a study reported in The Lancet Oncology, Weiva Sieh, MD, PhD, Assistant Professor of Health Research and...

thyroid cancer

High-Tech Imaging Contributes to Overdiagnosis, Overtreatment of Low-Risk Thyroid Cancers  

A study from the Mayo Clinic Center for the Science of Health Care Delivery finds that advances in imaging technologies, including ultrasound, computed tomography, and magnetic resonance imaging, are fueling an epidemic in the diagnosis and treatment of thyroid cancers that are unlikely to ever...

issues in oncology

Prescribing of Off-Label Chemotherapy Is Common, and Most Off-Label Drug Use Meets NCCN Compendium Criteria  

Off-label prescribing of drugs remains common in oncology, but about two-thirds of off-label prescribing is consistent with the National Comprehensive Care Network (NCCN) compendium, according to a study1 reviewed at the Best of ASCO® ’13 meeting in Chicago by Monika K. Krzyzanowska, MD, MPH,...

breast cancer

Platinum Agents in Triple-Negative Breast Cancer: Encouraging New Data 

For the treatment of triple-negative breast cancer, there is renewed interest in investigating the role of platinum chemotherapy, according to Melinda L. Telli, MD, Assistant Professor of Medicine at Stanford University, Palo Alto. At the Best of ASCO meeting in Los Angeles, Dr. Telli reviewed the...

prostate cancer

Shiftworkers Likely to Have Increased Risk  

A strong positive association with shiftwork and elevated prostate-specific antigen (PSA) level was found in an analysis of three National Health and Nutrition Examination Survey (NHANES) studies. “Our data support the notion that sleep or circadian disruption is associated with elevated PSA,...

skin cancer

Sunscreen Use Infrequently Discussed With Patients  

Although the incidence of skin cancer in increasing, “the rate at which physicians are mentioning sunscreen at patient visits is quite low, even for patients with a history of skin cancer,” according to an analysis of data from more than 18.30 billion patient visits. “Sun-protection counseling...

multiple myeloma

Pomalidomide In Patients With Disease Progression Who Are Refractory to Bortezomib and Lenalidomide  

The second-generation immunomodulatory drug pomalidomide (Pomalyst) “has shown impressive results in patients with multiple myeloma who are refractory to lenalidomide [Revlimid] and bortezomib [Velcade],” according to a review of clinical data leading to the drug’s approval by the FDA. In February, ...

integrative oncology

Herb-Drug Interactions in Oncology  

Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...

lymphoma

Cancer Does Not Discriminate 

Looking back, my son Max’s fall as he was running after another little boy while playing baseball was such a blessing. Although he landed on his right arm, the fall didn’t seem severe enough to cause him to cry out in such excruciating pain. But after several hours of icing the bruise failed to...

ASTRO Offers Five Recommendations as Part of Choosing Wisely Campaign

The American Society for Radiation Oncology (ASTRO) released its list of five radiation oncology-specific treatments that are commonly ordered but may not always be appropriate as part of the national Choosing Wisely® campaign, an initiative of the American Board of Internal Medicine Foundation....

gynecologic cancers

Cisplatin Plus Radiation Therapy for Advanced Cervical Cancer Improves Disease-Free Survival vs Radiotherapy Alone

Adding the chemotherapy drug cisplatin to a treatment plan of radiation therapy and high–dose rate brachytherapy for patients with stage IIIB cervical cancer is beneficial, according to research presented recently at the American Society for Radiation Oncology’s 55th Annual Meeting.1 Study Details...

global cancer care

Aftermath of the AIDS Pandemic: Cancer Care in Botswana  

The Republic of Botswana is slightly smaller than the state of Texas and with a population of just over 2 million people it is one of the world’s most sparsely populated countries. Botswana was among Africa’s poorest countries at the time it gained independence from the United Kingdom in 1966....

breast cancer

Alcohol Consumption Between Menarche and Pregnancy and Breast Cancer Risk: Factors in Risk Accumulation   

In a study recently published in the Journal of the National Cancer Institute and summarized in this issue of The ASCO Post, we found a relationship between alcohol intake between menarche and first pregnancy and risk for breast cancer. Placing this study in context can help us interpret the data...

A Great IDEA: Supporting the Next Generation of Oncology Leaders in Low- and Middle-Income Countries 

Leadership has been cited as a critical success factor for improving access to cancer care in low- and middle-income countries.1 Effective clinical leaders in these countries can be transformative by supporting the development of cancer treatments to meet the needs of their patients, by advocating...

gynecologic cancers

Challenging and Changing the Standard of Care for Cervical and Ovarian Cancers 

“It was a very exciting session this year, particularly for cervical cancers,” said Paul Haluska MD, PhD, of the Mayo Clinic, Rochester, Minnesota, in speaking of the 2013 ASCO Annual Meeting’s gynecologic oncology session and the abstracts highlighted recently at Best of ASCO in Chicago. In one...

Expert Point of View: Monica Morrow, MD

Monica Morrow, MD, the Anne Burnett Windfohr Chair of Clinical Oncology and Chief of the Breast Service, Department of Surgery, at Memorial Sloan-Kettering Cancer Center, New York, congratulated Christiane K. Kuhl, MD, and colleagues for “an innovative approach to making screening magnetic...

breast cancer

Radiation Therapy Is Safe in the Management of Ductal Carcinoma In Situ: No Increase in Risk of Cardiovascular Disease 

Radiation therapy as part of the management of ductal carcinoma in situ (DCIS) did not increase the risk of cardiovascular disease 10 years after treatment, according to a large retrospective study presented at a press conference held just prior to the 2013 Breast Cancer Symposium.1 Longer...

Expert Point of View on ductal carcinoma in situ

In an e-mail interview, E. Shelley Hwang, MD, an expert who has coauthored several papers on ductal carcinoma in situ (DCIS), weighed in on the two abstracts about management of DCIS featured in this issue of The ASCO Post—one presented by Melissa L. Pilewskie, MD (perioperative MRI in DCIS, page...

breast cancer

What Is on the Horizon in the Management of Breast Cancer? 

In Keynote Lectures during the 2013 ASCO Breast Cancer Symposium, experts George Sledge, MD, and Monica Morrow, MD, offered their opinions and outlook on how the medical and surgical management of breast cancer may continue to evolve over the next 5 to 10 years.1 Dr. Sledge is Chief of Oncology at...

issues in oncology

Contemporary Studies Dispute Findings of Radiation-Induced Cardiotoxicity  

At the 2013 Breast Cancer Symposium, studies suggested that with current radiotherapy techniques the mean radiation doses to the heart are much lower—and thus radiotherapy is presumably much safer—than findings suggested by an article published in The New England Journal of Medicine last spring.1...

breast cancer

Breast Cancer Radiotherapy and Cardiotoxicity: What Is the True Risk?  

Evidence has long been accumulating that radiotherapy involving the heart can result in premature ischemic heart disease, but interest peaked last spring when a case control study published in The New England Journal of Medicine1 found an increased risk for cardiac-related deaths in breast cancer...

skin cancer

Intralesional Cytokine Therapy in Cutaneous Melanoma: A Call for Clinical Trials

Cutaneous melanomas are mostly an immunogenic group of tumors, but they are also heterogeneous. Therefore, therapeutic specificity and autogenetic approaches are essential to secure beneficial results. The objective of sentinel lymph node biopsy, at the time of diagnosis, is to identify patients...

breast cancer

Better Risk Communication Strategies Needed to Ensure Decision to Have Contralateral Prophylactic Mastectomy Is Evidence-Based 

Overestimating the risk that cancer in one breast will affect the other breast may cause many young women with breast cancer to choose contralateral prophylactic mastectomy even though most know it does not clearly improve survival. In a survey of 123 women who were diagnosed with cancer in one...

lung cancer

Claudia I. Henschke, PhD, MD, Took a Circuitous Route to Her Groundbreaking Work in Lung Cancer Screening 

“Once you have tasted flight, you will forever walk the earth with your eyes turned skyward, for there you have been, and there you will always long to return.”  —Leonardo da Vinci Lung cancer CT screening may have had no greater advocate than Claudia I. Henschke, PhD, MD. In the face of...

lung cancer

Lung Cancer Screening: Actionable Evidence 

This recent paper in The New England Journal of Medicine outlines the details of the clinical outcomes with two incidence screens that were conducted as part of the National Lung Screening Trial (NLST).1 In the wake of the positive review of the U.S. Preventive Services Task Force (USPSTF) draft...

lung cancer

Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography  

Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and...

leukemia

FDA Grants Volasertib Breakthrough Therapy Designation in AML

Boehringer Ingelheim Pharmaceuticals, Inc, has announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to volasertib, an investigational inhibitor of polo-like kinase (Plk), which being evaluated for the treatment of patients aged 65 or older with...

breast cancer
global cancer care

Zhe-Bin Liu, MD, PhD, of China Receives 2013 Long-Term International Fellowship in Breast Cancer

Zhe-Bin Liu, MD, PhD, of Shanghai Cancer Center, Fudan University, China, is the recipient of the 2013 Conquer Cancer Foundation of ASCO Long-Term International Fellowship (LIFe) in Breast Cancer, generously supported by The Breast Cancer Research Foundation. The LIFe provides early-career...

global cancer care

International Cancer Corps Provides Valuable First-Time Volunteer Experience 

Even as oncologists try to tackle the changing landscape of health care in the United States, many realize that both physicians and patients in this country are still in a better position than those fighting cancer abroad in low- and middle-income countries. In 2009, ASCO joined with Health...

multiple myeloma

New Strategies for Relapsed/Refractory Multiple Myeloma Explored 

Although upfront therapy can achieve remission in multiple myeloma, most patients will ultimately relapse. Newer targeted therapies and genomic analysis are moving the management of relapsed/refractory multiple myeloma forward, according to Kenneth C. Anderson, MD, Director, Jerome Lipper Multiple...

colorectal cancer

The AVEX Trial

As reported in The Lancet Oncology by Cunningham and colleagues and reviewed in this issue of The ASCO Post, the AVEX trial was an open-label randomized phase III trial limited to patients over the age of 70 years with previously untreated, unresectable metastatic colorectal cancer who were not...

colorectal cancer

Aspirin Protects Against Colorectal Cancer Recurrence in PIK3CA-Mutant Tumors 

At the 2013 European Cancer Congress, two investigative teams attempted to explain how aspirin may protect against colorectal cancer recurrences, with one study showing PIK3CA mutations associated with protection from aspirin, but not a COX-2 inhibitor, and the other study implicating HLA class I...

breast cancer

Women Undergoing Mammography Fail to Understand Breast Cancer Risk 

More than 90% of women undergoing mammography screening could not give an accurate estimate of their personal risk of developing breast cancer, according to results of a large survey reported at the 2013 ASCO Breast Cancer Symposium and featured in a premeeting presscast. The survey showed that a...

issues in oncology

ASCO's 2013 Top Five List in Oncology for Choosing Wisely Campaign

ASCO recognizes the importance of evidence-based cancer care and making wise choices in the diagnosis and management of patients with cancer. After careful consideration by experienced oncologists, ASCO annually highlights five categories of tests, procedures and/or treatments annually whose common ...

breast cancer

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...

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