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head and neck cancer

HPV-Positive Head and Neck Cancer: When Can Chemotherapy Be Omitted?

Are there patients with locally advanced squamous cell carcinoma of the head and neck associated with human papillomavirus (HPV) for whom chemotherapy can be omitted? Experts debated this question at the 2015 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia,...

lymphoma

Mantle Cell Lymphoma: Is Transplantation Still Necessary?

Autologous stem cell transplantation has played a critical role in the treatment of mantle cell lymphoma, but in the age of novel treatments, is it always warranted? Two experts in the field explored the question at the 2015 Debates and Didactics in Hematology and Oncology Conference sponsored by...

lymphoma

Double-Hit Lymphoma: Many Treatment Strategies, No Standard of Care

"Double-hit lymphoma” represents a challenging malignancy without a standard-of-care treatment, although outcomes for some patients are better than was once believed, according to Jonathon B. ­Cohen, MD, Assistant Professor of Hematology and Medical Oncology at Emory University, Atlanta. Dr. Cohen...

cost of care

Making Their Voices Heard: 118 Oncologists Speak Out About Stemming the High Cost of Cancer Drugs

In a bold move to shed light on the ramifications of the ever-increasing cost of cancer drugs for patients with cancer and for the health-care system, 118 prominent oncologists came together to write a commentary in Mayo Clinic Proceedings detailing their concerns.1 To learn more about these...

lung cancer

First-Line Nivolumab/Ipilimumab Combination in Non–Small Cell Lung Cancer Shown to Be Tolerable

For advanced non–small cell lung cancer (NSCLC), first-line treatment with combined immune checkpoint blockade—in novel doses and schedules—was associated with deep and durable responses, encouraging progression-free survival, and much better tolerability than has been previously observed with...

Thomas A. Stamey, MD, Noted Urologist and Prostate Cancer Expert, Dies at 87

Thomas A. Stamey, MD, Professor Emeritus of Urology at the Stanford University School of Medicine and a leader in the study and treatment of prostate cancer, died of Alzheimer’s disease September 4. He was 87. A True Pioneer in the Field Dr. Stamey helped lay the groundwork for the...

Scotty’s Gift

The following essay by Emil J. Freireich, 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 learned...

solid tumors

Extraordinary Medical Advances and the Conundrum They Pose

BOOKMARK Title: Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the LineAuthor: Sharon R. KaufmanPublisher: Duke University PressPublication date: May 29, 2015Price: $26.95 paperback, 336 pages Medicine has changed radically over the past 15 years. Who doesn’t welcome...

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...

breast cancer

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer

Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...

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...

pain management

The Need for a Multidisciplinary Approach to Combating Cancer-Related Pain

The statistics are staggering. Despite the development of novel analgesics and the increasing awareness of the importance of adequately controlling pain from cancer or its treatment, up to 50% of patients undergoing treatment and between 70% and 90% of patients with advanced disease experience some ...

issues in oncology

Focus on Geriatric Oncology: ASCO Prepares for an Aging Nation

The United States—and much of the world—is experiencing unprecedented demographic shifts in the population of older people, defined as people age 65 and over. In 2012, the population of older people in the United States reached a never-before seen height of 43.1 million, a number that will more...

breast cancer

Male Breast Cancer: An Understudied Disease and Clinical Challenge

Male breast cancer is an uncommon disease, although the incidence has increased over the past couple of decades. As with many other “orphan” diseases, male breast cancer is understudied, especially in randomized controlled trials. Although it shares similarities with female breast cancer, some...

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...

issues in oncology

Better Definitions and Biomarkers Needed to Reduce Cancer Overdiagnosis

At the third annual Preventing Overdiagnosis Conference, speakers described the prevalence and consequences of overdiagnosis in several medical specialties, including cancer. The Conference, which had the theme “Winding Back the Harms of Too Much Medicine,” was co-sponsored by the National Cancer...

supportive care
survivorship

Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life

Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif ­Kamal,...

Expert Point of View: Solange Peters, MD, PhD

Solange Peters, MD, PhD, of the Lausanne University Hospital, Switzerland, put these updates in context of what is known about programmed cell death protein 1 (PD-1) antibodies in non–small cell lung cancer (NSCLC), concluding that nivolumab (Opdivo) is “one of the best options” for...

lung cancer

Lung Cancer Rates Doubling Among Nonsmokers

Lung cancer is becoming an equal-opportunity malignancy—with rates rising among never-smokers, especially females, according to studies presented at the 16th World Conference on Lung Cancer in Denver. British investigators reported that in one large tertiary medical center, the proportion of...

breast cancer

Ductal Carcinoma in Situ: Where We Have Been and Where We Can Be

Ductal carcinoma in situ has been a recent topic of debate in the news because of a recent article by Narod et al1 and an accompanying editorial2 about the study in JAMA Oncology. This study, summarized in this issue of The ASCO Post, chronicled the long-term outcomes for women diagnosed with...

Noted Integrative Oncology Specialist Mitchell L. Gaynor, MD, Dies at 59

Integrative oncology had a long road to acceptance by the mainstream medical community; the field is now widely accepted for its healthful benefits, especially in assuaging the more troublesome side effects of cancer treatments. Many well-known oncologists have adapted integrative oncology into...

breast cancer

Mayo Clinic Receives Federal Grant to Fund Clinical Test of Triple-Negative Breast Cancer Vaccine

Researchers on Mayo Clinic’s Florida campus have been awarded a $13.3 million, 5-year federal grant to test a vaccine designed to prevent the recurrence of triple-negative breast cancer. This Breakthrough Award from the U.S. Department of Defense’s Breast Cancer Research Program will fund a...

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,...

colorectal cancer
issues in oncology

Important Caveats to Consider Concerning Low-Dose Daily Aspirin for the Primary Prevention of Colorectal Cancer

The use of low-dose aspirin by most adults aged 50 to 59 for the primary prevention of colorectal cancer is now included in the U.S. Preventive Services Task Force (USPSTF) updated draft recommendation statement, “Aspirin to Prevent Cardiovascular Disease and Cancer.”1 The release of the statement...

breast cancer

The Race of My Life

I've lived my adult life by three guiding principles I learned as an adventure racer: to set goals, to determine how to achieve them, and to persevere in the face of adversity. Those standards helped me complete more than 70 marathons and 7 Ironman competitions, and they helped me conquer breast...

American Cancer Society Awards 2015 Medals of Honor

The American Cancer Society has bestowed its highest honor on four individuals and one foundation during the Society’s 2015 Medal of Honor ceremony and celebration dinner in Washington, DC. The Medal of Honor is awarded to those who have made the most valuable contributions and impact in the fight...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is the most likely diagnosis for this patient? Correct Answer: B. Primary central nervous system lymphoma. Expert Perspective In an immunocompetent host, the differential diagnosis of isolated or multiple brain lesion(s) includes autoimmune etiologies such as neurosarcoidosis,...

lymphoma

Questions: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Hematology Expert Review is an occasional feature that includes a case report followed by questions,answers, and expert commentary. In this issue of The ASCO Post, Drs. Abutalib and Lukas present part 1 of a case report on primary diffuse large B-cell lymphoma. Part 2 will be published in an...

hematologic malignancies

Early Research of David G. Nathan, MD, Ushered in the Field of Pediatric Hematology

When David G. Nathan, MD, was admitted to Harvard University in 1947, he had every intention of becoming an English professor. It was only his lack of writing talent that dissuaded him from a life in the classroom and propelled him into a medical career that has spanned more than 5 decades and has...

Confessions of a Neurosurgeon

BookmarkTitle: Do No Harm: Stories of Life, Death, and Brain SurgeryAuthor:  Henry Marsh, CBE, FRCSPublisher: Thomas Dunne BooksPublication date: May 26, 2015Price: $25.99, hardcover; 288 pages “I often have to cut into the brain and it is something I hate doing. With a pair of diathermy forceps I ...

A Neurologist’s Life: Oliver Sacks, MD

BookmarkTitle: On the Move: A LifeAuthor: Oliver Sacks, MDPublisher: Alfred A. KnopfPublication date: April 28, 2015Price: $27.95, hardcover; 416 pages Our ability to detect cancer has grown markedly over the past several decades, with the advent of more sensitive screening methods, new...

pain management

Pain, Still Undertreated and Misunderstood

Bookmark Title: A Nation in Pain: Healing Our Biggest Health ProblemAuthor:  Judy ForemanPublisher: Oxford University PressPublication date: May 1, 2015Price: $19.95, paperback; 464 pages The subject of pain has been written about extensively, from the intriguing sociopolitical history of opium to...

Glimpses of the Human Condition Through Lively, Medically Themed Short Stories

BookmarkTitle: A View From the Inside: A Collection of Medically Oriented Short StoriesAuthor: Augustine L. Perrotta, DOPublisher: Keith Publications, LLCPublication date: March 31, 2015Price: $14.95, paperback; 246 pages The field of medicine, ripe with dramatic tension, offers an endless array...

lung cancer

Anti-EGFR Therapy in Squamous Cell Lung Carcinoma: Swimming With or Against the Tide?

Lung cancer is the most common, lethal, and costly cancer worldwide, accounting for at least 1.8 million new cases per year (12.9% of the total).1 Over the past decade, there has been a major shift in the treatment of non–small cell lung cancer (NSCLC), especially in adenocarcinoma, accompanied by...

Three Young Investigators Named Winners of 2015 Paul Marks Prize for Cancer Research

Memorial Sloan Kettering Cancer Center (MSKCC) has named three investigators as recipients of this year’s Paul Marks Prize for Cancer Research. The award recognizes promising investigators aged 45 or younger for their efforts in advancing cancer research. The winners are Bradley E. ­Bernstein, MD,...

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...

colorectal cancer

Many Patients Do Not Accurately Recall Important Colonoscopy Details as Time Lapses

As time lapses, many patients who have undergone a colonoscopy become less and less likely to recall when and where they last had the procedure performed, who the doctor was who performed it, whether polyps were found, and, if so, the number and size of those polyps, according to new study results...

Alternative Therapies: Knowledge Is Power, but Consider the Source

The use of dietary supplements and other complementary and “alternative” therapies by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about complementary therapies can be...

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,...

breast cancer

MRI Improves Breast Cancer Detection in Women at Average Risk

Magnetic resonance imaging (MRI) screening of women at average risk for breast cancer achieved a mean additional cancer yield of 15.8 cases per 1,000 women, greatly surpassing yields for supplemental digital breast tomosynthesis (1.25 per 1,000) or supplemental ultrasound (4.1 per 1,000). The...

Expert Point of View: Clifford Hudis, MD

Clifford Hudis, MD, Chief of the Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York, said the findings suggest there is essentially no meaningful benefit from chemotherapy in the recurrence score low-risk subset. “It is clinically appropriate to offer endocrine therapy...

issues in oncology

Chemotherapy/Radiotherapy Safe in Second and Third Trimesters of Pregnancy

Children with in utero exposure to chemotherapy and/or radiation therapy during maternal treatment for cancer had no impairment in cognition, cardiac function, and general early childhood development, according to a study reported at the European Cancer Congress in Vienna, Austria, and published...

cost of care

Discussing Financial Toxicity With Patients Who Have Cancer

Patient: “Doc, how much are these drugs going to cost me?” Physician: “They are expensive, and you can see our financial counselor to help you understand the costs.”   Cancer care is not a black-and-white endeavor, and costs are considered a distasteful subject to be passed over in tactful silence. ...

Expert Point of View: Cora N. Sternberg, MD, FACP

Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo Forlanini Hospital in Rome, Italy, formally discussed CheckMate 025 at the Presidential Session of the 2015 European Cancer Congress as well as findings from the METEOR trial of cabozantinib (Cometriq) in metastatic renal cell...

breast cancer
leukemia

Shadowed by Cancer

Although genetic testing has not turned up any inherited mutations that might explain the number of cancers that have plagued my immediate family, over the past 15 years, I have lost my father, aunt, and sister to the disease. In 2001, my husband, Wayne, died of acute promyelocytic leukemia, and...

Equanimity

The following essay by S. Vincent Rajkumar, 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. It was...

issues in oncology

A Cancer Diagnosis Can Lead to Significant Loss of Working Hours, Income

A new analysis indicates that when American adults are diagnosed with cancer, they experience significant decreases in the probability of working, in the number of hours they work, and correspondingly, in their incomes. Such negative impacts of a cancer diagnosis are particularly pronounced among...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...

lymphoma

Questions: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear here with expert ­commentary. In the October 25 issue of The ASCO Post, part 1 of a...

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