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Showing 601 - 650Breast Reconstruction Has Increased Over Time but Varies Widely by Region
Analysis of data from 20,560 women undergoing mastectomy for breast cancer found that breast reconstruction use “increased from 46% in 1998 to 63% in 2007 (P< .001), with increased use of implants and decreased use of autologous techniques over time (P < .001),” according to a report...
Expect Questions From Patients
Results from the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4), showing that men with early-stage prostate cancer, particularly men under 65 years old, treated with radical prostatectomy had increased survival compared to those assigned to watchful waiting, has raised concerns among...
Prostate Cancer Study Showing Increased Survival for Younger Men Undergoing Prostatectomy Not Expected to Increase Surgeries
Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...
Have You Heard?
“It’s not a matter of if a child will be seriously poisoned or killed. It’s a matter of when.” Lee Cantrell, PharmD, Director of the San Diego Division of the California Poison Control System and Professor of Clinical Pharmacy at the University of California, San Francisco, commenting on the...
Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?
Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...
Identifying One Main Provider and Involving Oncology Specialist Are Key to High-Quality Rating for Follow-up Care
Long-term cancer survivors are more likely to rate their follow-up care as high-quality when one main provider is identified and an oncology specialist is involved, according to results of a population-based cross-sectional study among adult survivors of breast, prostate, colorectal, endometrial,...
Brentuximab Vedotin Shows Antitumor Activity in Patients With Relapsed Peripheral T-Cell Lymphoma
In a phase II study, the 34 evaluable patients with peripheral T-cell lymphomas who received brentuximab vedotin (Adcetris) had an overall response rate of 41%, including an overall response rate of 54% among the 13 patients with angioimmunoblastic T-cell lymphoma. The median progression-free...
Desensitization Protocols May Allow Reintroduction of Chemotherapeutic Agents After Hypersensitivity Reactions
Hypersensitivity reactions to chemotherapeutic agents used to treat ovarian cancer are “increasingly common and can greatly limit their use,” according to an article published in the Journal of the National Comprehensive Cancer Network. “Drug desensitization has emerged as a safe and effective way...
Exemestane to Reduce Invasive Breast Cancer Risk Has Small Negative Impact on Quality of Life
Detailed quality-of-life data from the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) Mammary Prevention 3 (MAP.3) trial showed that exemestane given for the prevention of breast cancer “has limited negative impact on menopause-specific and health-related [quality of life] in...
Food and Drug Interactions Could Reduce Effectiveness of Oral Chemotherapy
Oral chemotherapy agents are associated with drug and food interactions that can significantly reduce the effectiveness of oral chemotherapy and possibly result in harm to patients, according to a study in the Journal of Oncology Practice. It is important therefore, according to the study’s...
Adjuvant Chemotherapy Accelerates Pace of Physiologic Aging in Women Treated for Breast Cancer
“Adjuvant chemotherapy for breast cancer is gerontogenic,” accelerating the pace of physiologic aging, according to an analysis of blood and clinical data from 33 women with stage I to III breast cancer. “We have shown that cytotoxic chemotherapy potently induces the expression of markers of...
Tadalafil Did Not Prevent Erectile Dysfunction Among Men Receiving Radiotherapy
Daily use of tadalafil (Cialis) did not improve erectile function compared to placebo or prevent erectile dysfunction among men undergoing radiotherapy for prostate cancer, according to results of a stratified, placebo-controlled, double-blind, parallel-group study with 1:1 randomization at 76...
Genitourinary Toxicity More Likely With Stereotactic Body Radiotherapy Than With Intensity-Modulated Radiotherapy
A retrospective analysis of patients with prostate cancer receiving primary treatment with either stereotactic body radiation therapy or intensity-modulated radiation therapy found that those receiving stereotactic body radiotherapy had greater rates of genitourinary toxicity during 2-year...
Can Empathy Really Be Taught?
In an op-ed article in The New York Times (February 27, 2014) about the challenges of designing training courses to help physicians communicate more effectively with patients about important topics such as end-of-life care, Timothy D. Gilligan, MD, and Mikkael A. Sekeres, MD, of the Cleveland...
Don’t Always Expect Questions From Patients About Prognosis
Although most patients want to know about the potential outcome of their disease and whether treatment is likely to have a significant impact on it, the information needs of patients and how best to fulfill those needs are very variable, Walter F. Baile, MD, told The ASCO Post. Dr. Baile is...
Breaking Bad News Badly Can Add to Upset
When the prognosis is poor, breaking the bad news badly can exacerbate the distress experienced by cancer patients and their families. A lack of sensitivity to patient and family emotions and not being attuned to how individual patients would prefer to be informed about their prognoses can result...
Elevated Morbidity/Mortality Risks for Childhood Cancer Survivors Further Increase After Fourth Decade
An analysis of the first generation of childhood cancer survivors, who are now aging into their fourth and fifth decades, shows further increases in the survivors’ morbidity and mortality risks. “By age 50 years, more than half of survivors have experienced a severe, disabling, or life-threatening...
For Hospitalized Cancer Patients, Thromboprophylaxis Often Prescribed Without Regard to Risk Factors
Pharmacologic thromboprophylaxis is commonly prescribed to hospitalized patients with cancer without regard to concomitant risk factors for venous thromboembolism, according to a prospective, cross-sectional study of patients with cancer at five academic medical centers. Results were reported in...
Cancer Patients at High Recurrence Risk for Venous Thromboembolism Should Be Considered for Secondary Prophylaxis
The risk of recurrence of venous thromboembolism in cancer patients can be stratified. “In particular, patients with brain, lung, stage IV pancreatic or ovarian cancer, myeloproliferative or myelodysplastic disorders, [other] stage IV cancer, cancer stage progression or leg paresis have the highest ...
Increased Hospice Use Among Minority Patients Treated in Provider-Based Research Networks
Minority patients with lung cancer who receive treatment in practices affiliated with provider-based research networks “have greater hospice enrollment than those treated in academic and community practices,” concluded Dolly C. Penn, MD, MSCR, and colleagues at the University of North Carolina...
Encourage Questions and Actions About the High Cost of Cancer Drugs
Physicians are now more likely to discuss cancer drug prices, “which was a rarity in the past,” Hagop M. Kantarjian, MD, told The ASCO Post. “Oncologists are starting to incorporate the price as a side effect, because if the price is too high, that is a financial side effect to patients, who can go ...
Speaking Up Against High Cancer Drug Prices
Physicians have a duty to speak up against high cancer drug prices,” Hagop M. Kantarjian, MD, resolutely stated in an interview with The ASCO Post. “We should speak up because high drug prices are harming patients.” A leader in the effort to drive down the cost of drugs needed to treat patients...
Long-Term Follow-up Confirms Low Incidence of Cardiac Events Associated With Trastuzumab
At a median follow-up of 8 years, patients receiving trastuzumab (Herceptin) sequentially after chemotherapy and radiotherapy in the Herceptin Adjuvant (HERA) trial had a low incidence of cardiac events and these were reversible in the vast majority of patients. This long-term assessment confirms...
Colorectal Cancer Screening Recommended Past Age 75 for Previously Unscreened Patients
Colorectal cancer screening is cost-effective and “should be considered well beyond age 75 years” for individuals not previously screened, according to a computer simulation study published in the Annals of Internal Medicine. The researchers noted that while the U.S. Preventive Services Task Force...
Expect Questions From Patients
With the extensive media coverage of a study indicating that injections with the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) may offer a new option for preserving fertility among women treated for breast cancer, physicians can expect questions from interested patients....
New Option for Preserving Fertility in Women Being Treated With Chemotherapy for Early-Stage Breast Cancer
One of the most reported studies emanating from the 2014 ASCO Annual Meeting involves the use of the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) to reduce the risk of ovarian failure among women being treated with chemotherapy for early-stage breast cancer, and to...
Modest Improvement in Progression-Free but Not Overall Survival With Selumetinib vs Chemotherapy
Patients with uveal melanoma treated with selumetinib had modestly improved progression-free survival and response rate compared to patients treated with chemotherapy, but no improvement in overall survival, according to results of a randomized, open-label, phase II trial. “Improvement in clinical...
Limited Public Awareness of Head and Neck Cancers Raises Concerns About Prevention and Detection
Public awareness of head and neck cancer is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV), according to results of a cross-sectional online survey reported in JAMA...
Underuse of Trimodality Treatment for Patients With Inflammatory Breast Cancer Negatively Impacts Survival
Analysis of data for 10,197 women treated for nonmetastatic inflammatory breast cancer treated over a 12-year-period found that the use of trimodality treatment (chemotherapy, surgery, and radiation therapy) fluctuated annually between 58.4% and 73%. “Underutilization of trimodality therapy...
Expect Questions but Not a Lot of Resistance
Stopping statin therapy is safe for patients with cancer who have a life expectancy of no more than a year, according to a randomized study reported at the 2014 ASCO Annual Meeting. Discontinuing statins did not shorten survival, reduced symptom burden, improved overall quality of life, and led...
Discontinuing Statins Near the End of Life Is Safe, Can Reduce Symptom Burden, and Is Generally Acceptable to Patients
Discontinuing statins for patients near the end of life is safe, saves money, spares patients from swallowing yet another pill and from the symptoms associated with statins, and is generally welcomed by patients. That last bit might come as a surprise to some physicians who worry that discontinuing ...
'Physician Education Is Key' to Continued Advances in Geriatric Oncology
Several times during his lecture at the 2014 ASCO Annual Meeting, Stuart M. Lichtman, MD, FACP, FASCO, the recipient of the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology, emphasized, “Physician education is the key” to continued advances in geriatric oncology. He specified that ...
Following ‘Fruitful’ Year of Collaboration, Advocacy, and Growth, Pediatric Hematology/Oncology Moves to Next Level
Finishing up a 2-year term as President of the American Society of Pediatric Hematology/Oncology (ASPHO), A. Kim Ritchey, MD, summarized ASPHO’s achievements in advocacy, education, and professional development in his State of the Society address at the ASPHO 27th Annual Meeting in Chicago. He also ...
High Response Rate and Good Safety Profile for Carfilzomib Plus Cyclophosphamide and Dexamethasone
A multicenter, open-label phase II trial found that the selective proteasome inhibitor carfilzomib (Kyprolis), in combination with cyclophosphamide and dexamethasone produced high complete response rates and was associated with low toxicity in patients with newly diagnosed multiple myeloma....
Colorectal Cancer Survivors Prefer More Information on Late Effects of Treatment and Recurrence Risks
Survivors of nonmetastatic colorectal cancer, when surveyed about their needs and preferences for survivorship information, responded that they would prefer receiving more information about late effects of treatment, challenges to expect, general health maintenance, and risks of recurrence. Most of ...
Women With Small, Node-Negative Breast Tumors Have Excellent Prognosis Without Chemotherapy
Women who have small (≤ 1 cm), node-negative breast tumors “have an excellent prognosis without chemotherapy,” concluded the authors of a prospective cohort study involving 4,113 women with T1a,b, N0, M0 breast cancer. “Size and tumor subtype may identify patients in whom the rate of recurrence...
ASPHO Abstracts Cover Broad Range of Topics
More than 400 abstracts—a record—were submitted for the 27th Annual Meeting of the American Society of Pediatric Hematology/Oncology in Chicago. Here is a small sampling of those studies, with comments from the abstract authors. Token Economy to Improve Compliance BMT Bucks form the basis of a...
Higher-Dose Carfilzomib Produces ‘Remarkable’ Response Duration in Relapsed/Refractory Multiple Myeloma
Higher-dose carflizomib (Kyprolis) “provided a high overall response rate with a remarkable duration of response in patients with relapsed or refractory multiple myeloma” in a phase II study, Nikoletta Lendvai, MD, PhD, and colleagues from Memorial Sloan Kettering Center, New York, wrote in Blood....
Identifying and Managing Distress in Patients With Head and Neck Cancers
A quality improvement initiative at the Norris Cotton Cancer Center in Lebanon, New Hampshire, resulted in biweekly screening rates for psychological distress among patients treated at the head and neck medical oncology clinic increasing from 0% to 74% within a 2-year period. “Distress screening...
Everolimus Did Not Improve Survival in Hepatocellular Cancer After Progression on Sorafenib
“Despite the strong scientific rationale and preclinical data, everolimus [Afinitor] plus best supportive care failed to improve survival over placebo plus best supportive care” among patients with advanced hepatocellular cancer that progressed during or after receiving sorafenib (Nexavar), or who...
High False-Positive Rate of Elevated CEA Seen in Patients With Resected Colorectal Cancer
A retrospective study finding a 49% false-positive of carcinoembryonic antigen (CEA) testing among patients with a history of resected colorectal cancer, “suggests that confirmation of an ongoing increase in CEA level should be universal practice before an extensive workup is initiated,” Anya...
Selected Patients With Lung Cancer and Poor Performance Status May Benefit From Standard Therapy
Patients with poor performance status have an increased incidence of adverse effects from therapy and worse overall outcomes than those with good performance status, but “a selected proportion may still benefit from standard therapy,” according to a review article published in the Journal of the...
Less Than 1% Absolute Survival Benefit at 20 Years Found for Contralateral Prophylactic Mastectomy
Theorizing that an exaggerated perceived benefit from contralateral prophylactic mastectomy may have led to the substantial increase in its use in recent years, researchers from the University of Minnesota in Minneapolis used a Markov simulated decision-analytic model to evaluate the magnitude of...
Expect Questions From Patients
An updated study reporting a 20% increased risk of advanced prostate cancer and a 19% increased risk of lethal prostate cancer among men who have had vasectomies generated coverage by the medical and major media, including CBS News and The New York Times, and can be expected to prompt questions...
‘Reasonable’ to Advise Men Who Have Had Vasectomies That They Have a Small Increased Risk for Lethal Prostate Cancers
Long-term results from the Health Professionals Follow-up Health Study have shown a 20% increased risk of advanced prostate cancer and a 19% increased risk of lethal prostate cancer among men who had vasectomies.1 According to the study’s lead author, Mohummad Minhaj Siddiqui, MD, it is...
Getting Results: How Oncologists and Pathologists Can Work Together to Facilitate Molecular Testing
Advances in molecular testing mean that highly specific information can be detailed about the molecular characteristics of a patient’s tumor, as well as indications of potential responsiveness to targeted therapy. But getting those detailed results from the pathologists can be a challenge to many...
First Prospective Study of Rare Lymphoma Shows Promising but Inconclusive Results With DA-EPOCH-R
Presenting “the first prospective study” of mediastinal gray zone lymphoma, researchers from the National Cancer Institute reported that DA-EPOCH-R (infusional dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine, prednisone, and rituximab (Rituxan) and filgrastim (Neupogen)...
Simple Bedside Assessment of Pain and Itch Is Valuable Tool for the Evaluation of Suspicious Skin Lesions
A prospective, clinicopathologic study involving 268 patients with biopsy-proven basal cell carcinoma, squamous cell carcinoma, malignant melanoma, or melanoma in situ “revealed that pain is associated with histologic features that involve deeper dermal processes in [squamous cell carcinoma]...
Patient, Tumor Characteristics Associated With BRAF and KRAS Mutations
KRAS and BRAF V600E mutations were nearly mutually exclusive and associated with specific patient and tumor characteristics, such as age and smoking status, according to an analysis of data from the N0147 phase III trial for stage III colon cancer. Primary tumors were assessed for KRAS and BRAF...
Prolonged TV Viewing, Other Sedentary Behaviors Linked to Increased Risk of Particular Cancers
“Prolonged TV viewing and time spent in other sedentary pursuits is associated with increased risks of certain types of cancer,” concluded a meta-analysis of data from 43 observational studies including more than 4 million people and 68,936 cancer cases. A positive association with overall...
