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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...

A Chemist Exposes Dangerous Chemicals

Bookmark Title: Pick Your Poison: How Our Mad Dash to Chemical Utopia Is Making Lab Rats of Us All Author:  Monona Rossol Publisher: John Wiley & Sons Publication date: October 2015 Price: E-book, 210 pages Monona Rossol is a chemist and “industrial hygienist” who is a frequent contributor to...

A Pandemic’s Story of Tragedy and Success

Bookmark Title: AIDS Between Science and Politics Author:  Peter Piot Publisher: Columbia University Press Publication date: May 2015 Price: $29.95; hardcover, 216 pages AIDS is a global phenomenon that recognizes neither national boundaries nor social strata. The AIDS pandemic was one of the...

The Future of ASCO: President-Elect Candidates Share Their Vision

S. Gail Eckhardt, MD, FASCO, is a tenured Professor at the University of Colorado School of Medicine, where she also holds the Stapp Harlow Chair in Cancer Research. She has been a faculty member at the institution since 1999 and was Division Head of Medical Oncology from 2006–2014. Currently, she...

symptom management

Management of Aromatase Inhibitor–Induced Musculoskeletal Symptoms: A Physiatric Approach

Aromatase inhibitors have demonstrated efficacy in reducing the risk of breast cancer recurrence in hormone receptor–positive patients, but medication compliance can be limited by uncomfortable side effects, including musculoskeletal pain and dysfunction. Musculoskeletal symptoms have been reported ...

neuroendocrine tumors

Telotristat Etiprate Added to Standard Therapy for Carcinoid Syndrome Shows Clinical Benefit in Patients With Metastatic Neuroendocrine Tumors

The investigational drug telotristat etiprate was shown to have clinical benefit when added to somatostatin analog therapy for carcinoid syndrome not adequately controlled by long-acting somatostatin analog therapy, the current standard of care, in patients with metastatic neuroendocrine tumors....

skin cancer

Why Melanoma Rates Are Increasing in Adolescents and Young Adults, Especially Among Females

The incidence of melanoma among children, adolescents, and young adults has reached epidemic proportions, increasing more than 250% over the past 4 decades, with young females at highest risk for the deadly cancer, according to a study1 by researchers at Roswell Park Cancer Institute in Buffalo,...

solid tumors
lymphoma

ASCO Recommendations for Use of White Blood Cell Growth Factors: What Remains the Same and What Has Been Modified

Neutropenic complications remain the main dose-limiting toxicity of cancer chemotherapy treatment and are associated with considerable morbidity, mortality, and costs.1 Although patients who have experienced a prior neutropenic event are at increased risk of subsequent events, several studies have...

palliative care

End-of-Life Clinical Decisions Still Need Conversations About Improving Care

In 2014, the Institute of Medicine report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life called for more conversations about improving care for those who are dying. Improving the care of the imminently dying is an important issue in the oncology...

NCCN Unveils Graphic Evidence Blocks to Guide Decision-Making

Treatment decision-making for oncologists and their patients may become simpler through the use of graphic NCCN Evidence Blocks™, which were unveiled at the NCCN 10th Annual Congress: Hematologic Malignancies™ sponsored by the National Comprehensive Cancer Network® (NCCN¨). The first of the NCCN...

gynecologic cancers

Ovarian Cancer Trialists Forming Work Group to Standardize Definition of Pathologic Complete Response

Ovarian cancer clinical trialists are forming a working group to develop a standard definition of pathologic complete response in ovarian cancer treated with neoadjuvant chemotherapy. Such agreement within the field potentially would enable the U.S. Food and Drug Administration (FDA) to consider...

Expert Point of View: William J. Gradishar, MD, FASCO

Discussant of the Neoadjuvant Breast Symphony Trial data, William J. Gradishar, MD, FASCO, Betsy Bramsen Professor of Breast Oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, underscored the importance of identifying patients in a more precise and...

lung cancer

Combined EGFR and VEGF Inhibition Ameliorates the Impact of  the EGFR T790M Mutation in NSCLC

Treatment with erlotinib and bevacizumab (Avastin) may help overcome the poor prognosis associated with T790M mutations present at diagnosis in advanced non–small cell lung cancer (NSCLC), according to the results of the phase II BELIEF trial.1 At the 2015 European Cancer Congress, Rolf A. Stahel,...

Expert Point of View: Christian Blank, MD

Christian Blank, MD, Group Leader of Immunology at the Netherlands Cancer Institute, Amsterdam, formally discussed the COMBI-v findings. He first credited targeted therapy and immunotherapy for almost tripling the chance of patients with metastatic melanoma living beyond 1 year; however, he noted...

prostate cancer

Meta-analysis Evaluates Benefit of Docetaxel and Bisphosphonates in Hormone-Sensitive Prostate Cancer

The results of a meta-analysis conducted in the United Kingdom may guide clinicians in the use of docetaxel and bisphosphonates in patients with hormone-sensitive prostate cancer.1 Claire L. Vale, PhD, Senior Research Scientist at the Medical Research Council Clinical Trials Unit at University...

issues in oncology
legislation

Debate Over Physician-Assisted Suicide Continues, State by State

In 1997, after surviving a storm of high-court legal challenges, Oregon’s Death With Dignity Act went into effect, making Oregon the first American state to legalize physician-assisted suicide. The Supreme Court ruled that there was no right to assisted suicide in the Constitution but implied that...

Expect Questions About Updated Breast Cancer Screening Guidelines

As Chair of the American Cancer Society (ACS) panel that issued an updated guideline for breast cancer screening, Kevin C. Oeffinger, MD, has answered questions and offered perspective on the updated guideline and its development for The New York Times, USA Today, and other major media outlets. As...

breast cancer
issues in oncology

Updated ACS Breast Cancer Screening Guideline Recognizes Greater Role for Individual’s Values and Preferences

The reactions to the updated breast cancer screening guideline from the American Cancer Society (ACS) have been many, varied, and not consistently favorable but not surprising to Kevin C. Oeffinger, MD, who chaired the ACS panel that issued the guideline. Breast cancer screening “is an area that...

Stepping Back in Medical History: A Groundbreaking Surgeon’s Battle With the Establishment

Bookmark Title: Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern MedicineAuthor:  Cristin O’Keefe AptowiczPublisher: Gotham BooksPublication date: September 8, 2015Price: $17.00, paperback; 384 pages In the late 1740s, John Wesley—a British evangelist and...

Cancer Cured My Life

The following essay by Richard M. Levine, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which is coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and the bigcasino.org. I’m a...

solid tumors

Engaging Clinicians in the Collection of Cancer Registry Data to Improve Clinical Research

In June, the Commission on Cancer of the American College of Surgeons published a revision of its Facility Oncology Registry Data Standards (FORDS) manual, which contains all the data items, codes, and rules to abstract data into cancer registries at the more than 1,500 Commission on...

issues in oncology

ASCO Launches TAPUR to Assess the Off-Label Use of Targeted Therapies for Patients With Advanced Cancers

Two years ago, Richard L. ­Schilsky, MD, FACP, FASCO, Chief Medical Officer of ASCO, proposed a unique clinical trial concept during an educational session on the challenges of delivering precision medicine services in a community setting at ASCO’s Annual Meeting. The idea was to design a clinical...

A Shrink Tells the Inside Story of Psychiatry

Bookmark Title: Shrinks: The Untold Story of PsychiatryAuthor:   Jeffrey A. Lieberman, MD, with Ogi OgasPublisher: Little, Brown and CompanyPublication date: March 10, 2015Price: $28.00, hardcover; 352 pages Jeffrey A. Lieberman, MD, is the Lawrence C. Kolb Professor and Chairman of Psychiatry at...

breast cancer
issues in oncology

Getting the Content and the Message Right in Breast Cancer Screening Guidelines

According to recent national headlines, the American Cancer Society (ACS) now recommends that women at average risk of breast cancer should “screen later and less often.”1 While the new ACS recommendations (summarized in this issue of The ASCO Post) might initially be taken as casting doubt on the...

How QOPI® Is Improving Oncology Care

Launched in 2002 as a pilot program to promote excellence in oncology care, the origins of ASCO’s Quality Oncology Practice Initiative (QOPI®) date as far back as 1997, when the Institute of Medicine (IOM) created a National Cancer Policy Board to assess the state of cancer care in the United...

issues in oncology

TAPUR: ASCO’s First Clinical Trial Addresses Critical Gaps in Understanding of and Access to Targeted Therapies

ASCO is preparing to expand the boundaries of precision medicine with the launch of its first clinical trial. At a press briefing during the 2015 ASCO Annual Meeting, the Society formally announced its plans for the Targeted Agent and Profiling Utilization Registry (TAPUR) study. At a time when...

hematologic malignancies

The State of Progress in Hematologic Malignancies

The number of targeted therapies approved by the U.S. Food and Drug Administration (FDA) in the treatment of a variety of cancers, especially hematologic malignancies, continues to rise. In 2014 alone, 4 of the 10 new agents directed at discrete molecular targets approved by the FDA were for blood...

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