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breast cancer

Preventing Locoregional Recurrence of Breast Cancer Should Not Deter Efforts to Decelerate Therapy

“SURGEONS AND radiation oncologists are obsessed with locoregional recurrence of breast cancer,” Monica Morrow, MD, FASCO, remarked at the 2018 Lynn Sage Breast Cancer Symposium, Chicago. Working to prevent locoregional recurrence, “even if it may not be the major threat to mortality, is...

issues in oncology

ACCC 2018 Survey Finds Multiple Barriers to Cancer Program Growth

At a time of unprecedented advances in the science of cancer, growing complexity in cancer treatments, and ongoing health policy fluctuation, the Association of Community Cancer Centers (ACCC) 9th annual Trending Now in Cancer Care survey reveals how cancer programs across the country are ...

A Tribute to Arti Hurria, MD, FASCO, a Leader in Geriatric Oncology

The oncology community is deeply saddened by the untimely passing of Arti Hurria, MD, FASCO, a nationally regarded expert and advocate for elderly patients with cancer. Dr. Hurria died on November 7, 2018, in a traffic accident. At the time of her tragic death, Dr. Hurria was Director of the City...

gynecologic cancers

Comparing Survival Outcomes With Minimally Invasive and Open Surgical Approaches to Early-Stage Cervical Cancer

MINIMALLY INVASIVE radical hysterectomy for women with early-stage cervical cancer has been associated with reduced rates of disease-free and overall survival in the phase III LACC randomized noninferiority trial comparing minimally invasive and open abdominal radical hysterectomy. The results...

issues in oncology
global cancer care

Global Oncology Education and Professional Development: ASCO International’s Impact

ASCO is such a misnomer: the American Society of Clinical Oncology is far more than simply “American.” Over the past several years, I (a Canadian-born breast surgical oncologist, with an Indian-born mother and a Tanzanian-born father) have traveled to Zimbabwe, Bhutan, and the Philippines with this ...

supportive care
palliative care

Improving Palliative Care in Low-Resource Settings

In 2016, ASCO published an update to its Clinical Practice Guideline, “Integration of Palliative Care Into Standard Oncology Care,” which provides evidence-based recommendations for symptom management, clarification of treatment goals, support of coping and distress management, and coordination of...

breast cancer

KATHERINE Trial: Adjuvant T-DM1 Reduces Invasive Disease Risk by 50% vs Trastuzumab in HER2-Positive Early Breast Cancer

In patients with HER2-positive early breast cancer and residual disease after neoadjuvant chemotherapy, adjuvant treatment with trastuzumab emtansine (T-DM1; Kadcyla) reduced the risk of invasive disease by 50% over trastuzumab (Herceptin).1 The phase III KATHERINE study was presented at the 2018...

skin cancer
immunotherapy

Expert Point of View: Reinhard Dummer, MD

KEYNOTE-022’S invited discussant, Reinhard Dummer, MD, Professor of Dermatologic Oncology at the University Hospital Zurich Skin Cancer Center in Switzerland, told attendees, “We’ve been waiting for this small prospective randomized phase II trial, and the initial results appear very promising.”...

issues in oncology

Should Oncologists Recommend Cannabis?

A RECENT survey of 400 clinical oncologists found that 80% discuss the use of medical cannabis with their patients, and although nearly 50% recommend it, fewer than 30% consider themselves knowledgeable enough to make such recommendations.1 Oncologists are perhaps among the most evidence-demanding ...

leukemia
geriatric oncology

Expert Point of View: Susan M. O’Brien, MD

THE STUDY’S discussant, Susan M. O’Brien, MD, Associate Director for Clinical Science, Chao Family Comprehensive Cancer Center, University of California Irvine Health, said the results of the Alliance North American Intergroup Study A041202—demonstrating that ibrutinib (Imbruvica) is more...

issues in oncology

A Feminist Take on Health-Care Disparities

BOOKMARK Title: Doing Harm: The Truth About Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and SickAuthor: Maya DusenberyPublisher: HarperOnePublication date: March 2018Price: $27.99, hardcover, 400 pages Over the past year or so, there have been several books by women focused...

Denial’s Many Faces

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,...

Palliative Care Trailblazer, Charles von Gunten, MD, PhD, Shares Insights With Advanced Practitioners

“The data are in, and they are clear and convincing. Palliative care leads to better outcomes for patients. The major challenge now is to make it part of standard cancer care everywhere in the United States and then everywhere else in the world, said Charles von Gunten, MD, PhD, a medical...

A Pediatric Oncologist Recounts 7 Years at a Hospital in Jerusalem

Elisha Waldman, MD, is a pediatric oncologist and Associate Chief in the Division of Palliative Care at the Ann and Robert H. Lurie Children’s Hospital in Chicago. He grew up in a Connecticut suburb, the son of a conservative rabbi. Early on, Dr. Waldman majored in religious studies and felt...

How to Tell Patients They Have Cancer

The following essay by Stan Winokur, 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...

pain management
supportive care

Parenteral Opioid Shortage Threatens Appropriate Pain Care for Patients With Cancer

In response to the opioid-overdose epidemic, several measures have been put in place, such as the reclassification of hydrocodone as a Schedule II opioid and new requirements for physician review of prescription drug–monitoring program databases in most states. Moreover, the Surgeon General and...

lung cancer

Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance

In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S....

prostate cancer
symptom management

NCRI 2018: COMPARE Study: Side Effects and Quality of Life Associated With Prostate Cancer Care

Men who have been newly diagnosed with prostate cancer say they would trade some improvement in their odds of survival for improvements in side effects and quality of life, according to research presented by Ahmed et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference...

skin cancer

NCRI 2018: Mortality in Men With Malignant Melanoma

The rate of men dying from malignant melanoma has risen in populations around the world, whereas in some countries, mortality rates for the disease are steady or falling for women, according to research presented by Yang et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference...

gynecologic cancers

Results Reported for Olaparib Maintenance in Ovarian Cancer

TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...

issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

symptom management

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

issues in oncology
cost of care

Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More

Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...

solid tumors
breast cancer

The Persephone Trial Reconsidered

The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...

head and neck cancer

2018 ASTRO: Liquid Biopsy in HPV-Associated Oral Cancer Surveillance

A highly sensitive blood test that detects minute traces of cancer-specific DNA has been shown to accurately determine whether patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) are free from cancer following radiation therapy. Findings were presented by...

Humbled by Challenges, Renowned Hematologist Kanti R. Rai, MD, Recalls a Rich Career

For this installment of the Living a Full Life series, guest editor, Jame Abraham, MD, interviewed Kanti R. Rai, MD, Professor of Medicine at the Karches Center for Oncology Research, Feinstein Institute for Medical Research, Manhasset; Professor of Medicine at Zucker School of Medicine at...

I’m Not Dying of Cancer: I’m Living With Cancer

I’m a psychiatrist, so I don’t say this lightly: receiving a diagnosis of stage IV gastric adenocarcinoma made me insane. I had remembered the horrible deaths due to abdominal cancer I had seen during my medical training and was terrified that would be my fate as well. I knew from looking at the...

Big Data and Breast Cancer: Moving the Field Forward Through Comprehensive Analysis

To gain further insight into, among other things, optimizing big data and the latest on hormonal breast cancer treatment, The ASCO Post recently spoke with pioneering oncologist Christopher C. Benz, MD, a breast cancer specialist and Director of the Cancer & Developmental Therapeutics Program, ...

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...

gynecologic cancers

ESMO 2018: SOLO-1: Olaparib Maintenance Extends Progression-Free Survival in BRCA1/2-Mutated Advanced Ovarian Cancer

Two-year maintenance therapy with olaparib (Lynparza), a poly ADP-ribose polymerase (PARP) inhibitor, led to a substantial improvement in progression-free survival (PFS) in newly diagnosed patients with advanced ovarian cancer and a BRCA1/2 mutation, results from the phase III SOLO-1 trial...

issues in oncology

Quality Improvement: Worth the Effort but Not Always Easy to Execute

According to Kaveh Shojania, MD, the keynote speaker at the 2018 ASCO Quality Care Symposium, dedicated quality improvement work can help repair a fragmented health-care delivery system, but it’s challenging, and there are multiple things that can go wrong during the process.1 “I’ve developed this ...

breast cancer

ESMO 2018: SOLAR-1: Alpelisib in Patients With PIK3CA-Mutated HR-Positive, HER2-Negative Advanced Breast Cancer

Targeting a common mutation in patients with hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer with the alpha-specific phosphatidylinositol-3-kinase (PI3K) inhibitor alpelisib improved progression-free survival, according to...

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...

A Pathologic Fascination With Humanity

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,...

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...

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...

hematologic malignancies
leukemia

Beat AML Trial Seeking to Change Treatment Paradigm

The Beat AML Master Clinical Trial seeks to change the treatment paradigm and outcomes in acute myeloid leukemia (AML) by personalizing therapy and ultimately facilitating the approval of novel targeted agents. Co-investigator William Blum, MD, of the Winship Cancer Institute at the Emory...

issues in oncology

Wear That White Coat—With Pride

These days it can be hard for physicians. Many in the physician workforce wonder whatever happened to the ideals and expectations that drew them to this noble profession. The genuine passion to heal the sick and infirm and in turn improve the health of the entire society The ability to touch human ...

breast cancer
genomics/genetics

Mutations in Five Genes Linked to Higher Lifetime Risks for Aggressive Breast Cancer

USING MULTIGENE hereditary cancer panels to test for mutations in five genes can identify women at high risk for triple-negative breast cancer who may then benefit from more frequent screening, risk management, and potentially targeted therapies as well. A study that looked at multigene panel...

Mayo Clinic Physicians Receive SU2C Award for Melanoma Research

MAYO CLINIC physicians Matthew Block, MD, PhD, and Tina Hieken, MD, have received a Stand up to Cancer (SU2C) Catalyst Award to fund melanoma research and a neoadjuvant clinical trial. “This study, “Neoactivate,” will test two novel approaches to the treatment of patients with high-risk, stage 3...

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...

issues in oncology

Are E-Cigarettes a Dangerous Alternative to Traditional Cigarettes?

Several studies published earlier this year present preliminary but compelling evidence that electronic cigarettes, also known as e-cigarettes, which deliver nicotine through aerosols without burning tobacco, may pose serious health consequences to users, including cardiovascular disease and...

issues in oncology
immunotherapy
hematologic malignancies
leukemia

CAR T-Cell Therapy for CLL

A pair of new studies from researchers at the Abramson Cancer Center of the University of Pennsylvania are shedding light on why patients with advanced chronic lymphocytic leukemia (CLL) respond or do not respond to chimeric antigen receptor (CAR) T-cell therapy. Although CAR T-cell therapy is...

issues in oncology

An Invitation to Be Quiet No Longer

My male colleagues sometimes broach the topic of #MeToo or sexual harassment in medicine by saying how uncomfortable it makes them. Ah, yes. How uncomfortable the sexual harassment I  have faced for years makes you. I casually bring up microaggressions—subtle verbal or nonverbal slights against...

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...

A Daughter Struggles Through Her Father’s Battle With Cancer

BOOKMARK Title: White Hot Grief Parade: A Memoir Author: Alexandra Silber Publisher: Pegasus Books Publication date: July 2018 Price: $25.95, hardcover; 288 pages   The sudden death of a loved one produces a different type of trauma for family and friends than the protracted fading away of cancer. ...

Improving the Lives of Patients With Cancer Is Richard L. Schilsky’s Lifelong Mission

In 2009, as Richard L. Schilsky, MD, FACP, FSCT, FASCO, was preparing his Presidential Address for that year’s ASCO Annual Meeting, he came across his 6th grade essay titled “My Ambition,” which foretold with eerie specificity the career path he would follow over the next 6 decades. In the paper,...

issues in oncology

First Large-Scale Survey of Advanced Practice Providers in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants

Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology published by Bruinooge et al in the Journal of Oncology Practice....

issues in oncology
survivorship

Impact of Doctor-Patient Communication on Outcomes in Cancer Survivors

A new study from the American Cancer Society has found that patients with cancer who reported greater satisfaction in the way their provider communicated with them received more efficient care, with fewer office visits and better health outcomes. These findings were published by Rai et al in...

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