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Has the Promise of Precision Medicine Been Oversold?

Recently, the term “personalized medicine” in oncology care has been overtaken by the more contemporary concept of “precision medicine.” According to the National Research Council of the National Academies of Science, Engineering, and Medicine, the newer terminology shifts the focus to improving...

On the Frontier of Breast Cancer Research With Joyce A. O’Shaughnessy, MD

Nationally regarded breast cancer researcher and clinician Joyce A. O’Shaughnessy, MD, was born in upstate New York, just outside of Albany, where she attended grade school before her family moved to Beverly, Massachusetts, a suburban town 26 miles from Boston, where her family’s roots were....

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

hepatobiliary cancer

Regular Aspirin Use and Reduction in Risk for Hepatocellular Carcinoma

A pooled analysis of two large U.S. prospective cohort studies reported in JAMA Oncology by Simon et al indicates that regular use of aspirin is associated with a significant reduction in risk for hepatocellular carcinoma (HCC), with an apparent dose- and duration-dependent effect. Study Details...

breast cancer

Living a Purposeful Life Is My Revenge on Cancer

There is a lot of breast cancer in my family history. My mother was diagnosed with the disease at 44, and my paternal grandmother died of breast cancer when she was just 33, so I’ve always been diligent about performing breast self-exams— often weekly—to ensure that if I did get breast cancer, it...

Learning to Listen and Returning to the Art of Medicine

Bernard Lown, MD, was born in Lithuania, the son of a rabbi. He immigrated to the United States at the age of 14, where his scientific precocity bloomed. After attaining his medical degree from John Hopkins University School of Medicine, he pursued his passion of raising international awareness of...

On Aging and the Wellness Industry

Only a few centuries ago, the major source of moral and scientific authority in Western culture was religion, which requires trusting one of numerous supernatural deities. However, the presumption that medicine is based on evidence-based and peer-reviewed science is what gives it authority in...

survivorship

Getting Their Lives Back: Helping Survivors of Cancer to Move Forward

Thirteen years ago, Stephanie Koraleski, PhD, an oncology psychologist, and Kay Ryan, PhD, RN, a cardiac nurse and breast cancer survivor, in Omaha, brought together colleagues in the fields of clinical research, nursing, nutrition, mental health, physical therapy, pharmacy, and spirituality to...

issues in oncology
palliative care

Closing the Gender Divide in Preference for Palliative Care

Eight years ago, a survey of the preferences of Dutch patients with cancer for health care found that while gender was one aspect influencing how men and women approach cancer care, it was the most important, with men, generally, regarding most care aspects as less important than women. The study...

lung cancer

WCLC 2018: Oncogene-Driven Patient-Caregiver Communities Creating New Paradigm for NSCLC Research

A recent review of patient-caregiver communities focused on non–small cell lung cancer (NSCLC) with genomic alterations showed that these groups are improving outcomes by supporting patients and caregivers, increasing awareness and education, and accelerating research. Patient advocate Janet...

lung cancer

Cancer Doesn’t Frighten Me

In the fall of 2009, I suddenly went from being a healthy, physically active 47-year-old to a patient with stage IV non–small lung cancer (NSCLC), with a 5-year survival rate of less than 5%. A never-smoker, I had attributed a persistent cough I’d been having to the change in the season. And why...

Brave Journey Home

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Meet Your ASCO President-Elect, Dr. Howard A. ‘Skip’ Burris

Howard A. “Skip” Burris III, MD, FACP, FASCO, a long-time ASCO member and volunteer, began his role as ASCO President-Elect in June 2018. An ASCO member for nearly 30 years, Dr. Burris’ service to the Society is extensive. His volunteer roles include member of the ASCO Board of Directors and...

breast cancer

Somatic Mutations in ER-Positive Breast Cancer and Prognosis

Recent research and genomic studies have revealed a number of genes that accumulate somatic mutations and alterations in estrogen receptor (ER)–positive breast cancer. However, while a few alterations are quite common and relatively well-understood, many genes are mutated in less than 5% of...

lung cancer

Lung Cancer Expert Leora Horn, MD, Recalls Her Journey to a Career in Oncology and a Home in Nashville

The tumultuous history of modern South Africa has numerous stories that lie beneath the surface of the sociopolitical headlines, such as the story of lung cancer expert Leora Horn, MD. “I was born and reared in Johannesburg, South Africa, a second-generation African family. In 1987, because of the...

solid tumors
head and neck cancer

Every Day Is a Bonus

I have always been plagued with nagging headaches, so when they intensified in late 2010, I wasn’t too concerned. But when my eyes began involuntarily moving rapidly back and forth as I was writing Christmas cards, I knew the symptoms were a sign of something serious. A magnetic resonance imaging...

prostate cancer

Treating Nonmetastatic Castration-Resistant Prostate Cancer: Implications of the PROSPER Trial

A MAN in his early 70s sits in our office. His general health is good, and he is feeling well. Yet he is deeply worried. Four years ago, when his prostate-specific antigen (PSA) level rapidly increased after radical prostatectomy and subsequent radiation therapy, he was started on...

gynecologic cancers
head and neck cancer
issues in oncology

HPV Vaccine Completion Up 5% From 2016 to 2017

The number of adolescents who are up to date on human papillomavirus (HPV) vaccination—meaning they started and completed the HPV vaccine series—increased 5 percentage points from 2016 to 2017, according to results from a national survey published by Walker et al in Morbidity and...

On Not Being Ready

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

breast cancer

I Am Too Young for Breast Cancer

Two years ago, when I began having pain and bloody discharge in my left breast, I thought it was the return of a solitary intraductal papilloma I had had in that breast when I was a college student 6 years earlier, so the symptoms didn’t initially alarm me. It wasn’t until I noticed that the mass...

Breast Cancer Surgeon Hannah Hazard-Jenkins, MD, Deftly Balances Career and Family

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with breast cancer surgeon...

issues in oncology

Obesity and Cancer: Complex Interplay of Multiple Factors

The evolving concept that dietary fat plays an important role in the etiology of human cancer emerged more than 50 years ago. Ernst Wynder, MD, whose seminal epidemiologic work led to identifying smoking as a contributory cause of lung cancer, presented a paper in 1967 showing a decided correlation ...

supportive care

Therapeutic Applications for Cannabinoids in Oncology: The Debate Continues

In the early part of the 20th century, the U.S. government classified cannabis as a Schedule 1 drug: a dangerous substance with no medical value. For many years, that classification prevented systematic research in cannabinoid use in medicine. As a result of societal changes and an intense and...

issues in oncology

Medical Marijuana: Research Not Anecdotes

For patients with cancer, marijuana may be valuable in controlling pain and chemotherapy-induced nausea and vomiting. Furthermore, it may have efficacy as an appetite stimulant. No randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate these symptoms in ...

issues in oncology

Ensuring Quality With Patient-Reported Outcomes and Electronic Health Records

Accurately assessing the quality of cancer care over the continuum of treatment requires a special set of metrics and data-gathering methods. Moreover, with a growing number of cancer survivors, the post-treatment care involves primary care providers who are adept at managing the comorbidities...

issues in oncology

The Story of a Notorious Cluster of Childhood Cancers

BOOKMARK Title: Toms River: A Story of Science and SalvationAuthor: Dan FaginPublisher: Random HouseOriginal publication date: March 2013Price: $28.00, hardcover, 560 pages The Toms River emerges in the Pine Barrens of northern Ocean County, New Jersey, and zigzags through wetlands, emptying into...

prostate cancer

SPOP-Mutant Prostate Cancer Subtype, High PSA, and Prognosis

Conventional wisdom suggests that a high level of the protein prostate-specific antigen (PSA) in men with prostate cancer means a poor prognosis. However, this may not always be the case in men with a particular subtype of prostate cancer, according to a new study from Weill Cornell Medicine and...

Pseudosophisticated Language and Needless Confusion?

I’ve been a loyal ASCO member since the early 1970s (aka “back in the day”) and wanted to share a growing pet peeve. I thought of attacking an individual author, but my sense tells me the source of my annoyance is really now a cultural problem and one that can only be fixed at the editor level....

solid tumors
breast cancer

Oral Taxane Shows Strong Activity and Good Tolerability in Metastatic Breast Cancer

As first-line treatment for metastatic breast cancer, the oral taxane tesetaxel produced a 45% confirmed response rate and was well tolerated, producing little alopecia or neuropathy, according to Andrew D. Seidman, MD, and colleagues from several cancer centers. Dr. Seidman, of Memorial Sloan...

Expert Point of View: David Graham, MD, FASCO and Richard Schilsky, MD, FACP, FASCO, FSCT

ASCO expert David Graham, MD, FASCO, of the Levine Cancer Institute in Charlotte, North Carolina, was encouraged by the IMpower131 findings. “This is one more example of how immunotherapy is making steady gains against a number of cancers. Immunotherapy has been shown to be effective in other...

breast cancer

8-Year Update of SOFT and TEXT Trials: Positive but Not Definitive

At the 2017 San Antonio Breast Cancer Symposium (SABCS), the International Breast Cancer Study Group (IBCSG) and its collaborators presented the 8-year updates of the key modern trials of ovarian function suppression after local treatment for young women with resected breast cancer.1 These updates...

skin cancer
immunotherapy

Immunotherapy in Merkel Cell Carcinoma: ‘Field Has Been Thrown on Its Head’

At the 2018 ASCO Annual Meeting, investigators presented long-term follow-up data for immunotherapy in patients with Merkel cell carcinoma and new data for its use in the neoadjuvant setting. The results drew high interest from attendees and a number of questions were raised following the...

skin cancer

Human Papillomavirus Vaccine in Cutaneous Basaloid Squamous Cell Carcinomas

Squamous cell carcinoma is the second-most-common form of skin cancer. Evidence suggests the human papillomavirus (HPV) plays a role in the development of some types of this skin cancer. Two years ago, a 97-year-old woman whose right leg was covered with squamous cell tumors went to see...

Excerpt From the 2018 ASCO Presidential Address: ‘Delivering Discoveries: Expanding the Reach of Precision Medicine’

In my area of research, lung cancer, precision medicine is indeed transforming the treatment of this disease and has important implications for other cancers and for the future of our patients with cancer. Today’s achievement of being able to systematically identify genomic changes that can be...

A Humble Beginning Built on Commitment: The Life and Times of Lee S. Schwartzberg, MD, FACP

  In this edition of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed medical oncologist Lee S. Schwartzberg, MD, FACP, Executive Director at the West Cancer Center, Memphis. Dr. Schwartzberg’s major research interests are new therapeutic approaches to breast cancer,...

lung cancer

Genome Sequencing of Blood Samples May Lead to Detection of Early- Stage Lung Cancer

IF THE INITIAL promise of research presented at the 2018 ASCO Annual Meeting bears fruit, we may one day have a simple blood test to screen for early-stage lung cancer and possibly other cancers. Although it is still very early days for this test, an initial report from the ongoing Circulating...

Lessons in the Chill of Early Morning

The following essay by Sushil Bhardwaj, MD, is adapted, with permission, 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...

issues in oncology
cost of care

Expensive Cancer Drugs Don’t Work if Patients Can’t Afford Them

Eight years ago, I was having a series of colds I couldn’t shake and pain that radiated throughout my back. Still, my symptoms weren’t concerning until, on Halloween morning in 2010, I stepped out of bed and fell to the floor in excruciating pain, unable to move. A visit to the emergency room and a ...

integrative oncology
supportive care

Mindfulness in Cancer Care: Hype or Help?

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York.   “Mindfulness” has gained significant popularity in the lay press in recent...

issues in oncology
survivorship

Raising Awareness of the Financial Impact of Cancer on Young Adult Survivors

GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Associate Professor of Medicine and Medical...

hematologic malignancies

From Italy to Boston, A Love of Molecular Diagnostics Shapes a Career for Valentina Nardi, MD

Valentina Nardi, MD, is a staff pathologist at Massachusetts General Hospital, and her current clinical work includes implementing molecular assays for hematologic malignancies at the Center for Integrated Diagnostics. “I was born in Rome, but I did my high school and college education in Genoa. I ...

solid tumors
gastrointestinal cancer
colorectal cancer

Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer

With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...

palliative care
issues in oncology

AMA Rejects Recommendation to Reaffirm Opposition to Medical Aid in Dying

On June 11, the American Medical Association (AMA) House of Delegates voted 56% to 44% to reject a report by its Council on Ethical and Judicial Affairs (CEJA) that recommended the AMA maintain its Code of Medical Ethics’ opposition to medical aid in dying. Instead, the House of Delegates...

prostate cancer

AUA 2018: Finasteride Reduces Risk of Prostate Cancer and Is Safe, Long-Term Results Show

Twenty-five years after it opened for enrollment, the Prostate Cancer Prevention Trial (PCPT) has delivered a final verdict: finasteride, a common hormone-blocking drug, reduces men's risk of getting prostate cancer without increasing their risk of dying from the disease. Initial study...

lung cancer

Despite USPSTF Recommendations, Majority of Heavy Smokers Not Screened for Lung Cancer

AN ANALYSIS of 1,800 lung cancer screening sites nationwide found that only 1.9% of more than 7 million eligible current and former heavy smokers were screened for lung cancer in 2016, despite U.S. Preventive Services Task Force (USPSTF) and ASCO screening recommendations. Results from this...

‘Pearls of Wisdom’ for Leadership and Success in Academic Medicine Gathered Over a 35-Year Career

Dr. Hayes, ASCO President 2016–2017, is Professor of Internal Medicine; Stuart B. Padnos Professor in Breast Cancer; and Clinical Director of the Breast Oncology Program at the University of Michigan Comprehensive Cancer Center, Ann Arbor. AS I COMPLETE my 3-year term as ASCO President, I am...

lymphoma
leukemia

Adherence to Oral Anticancer Treatment: Priorities in Lymphoma and CLL

ADVANCES IN cancer treatment have been nothing short of breathtaking in recent years. Among the most important has been the advent of effective oral therapies, marking a significant change in the way many patients receive treatment and in the oversight required by the cancer care team. As with...

solid tumors
gynecologic cancers

HPV Vaccine Could Have Prevented My Cancer

In the fall of 2015, I was feeling great. At age 37, I had just completed running my fourth half-marathon and regularly hiked trails near my home in Arlington, Texas, to stay fit in-between races. The only symptom that foretold what was in my future was some light watery discharge I was...

solid tumors
breast cancer

The X-Ray Era: 1901–1915

The text and photographs on this page are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photos below are from the volume titled “The X-Ray Era: 1901–1915.” The photographs...

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