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global cancer care
health-care policy

Cancer Care in Rwanda: A Model of Creative Partnerships

While disparities in cancer care remain problematic in wealthy industrial nations like the United States, the challenges faced in poorer regions of the world are, by comparison, inestimable. Nationally regarded health-care expert Lawrence N. Shulman, MD, of Dana-Farber Cancer Institute, is part of...

ASCO Launches Oncology Practice Census

How many oncologists are in private practice and how many are employed by hospitals and academic medical centers in the United States? No one knows the answer for sure, but ASCO is undertaking an ambitious national effort to determine where oncologists are practicing these days. Online Survey...

lung cancer
issues in oncology

After a Decade of Decline in Smoking Rates, Progress Has Stalled

Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer...

Genomics vs Site of Cancer Origin as Basis for Treatment of Cancer Is ‘False Dichotomy’

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Despite recent news reports...

A Physician, Who Is Also a Cancer Patient, Talks about Medical Errors

In a whispered but resolute voice, Itzhak Brook, MD, MSc, led off his presentation at the 2012 ASCO Annual Meeting1  by telling the audience his voice is weak because he doesn’t have vocal cords. He spoke with the aid of a tracheoesophageal voice prosthesis. “I have practiced medicine for more than ...

health-care policy

Maintenance of Certification: One Size Should Not Fit All

After a conference call and having returned several phone calls, I again opened my ASCO Medical Oncology Self Evaluation Program (SEP) book hoping to steal an hour to reread the chapter on multiple myeloma, and begin digging deeper into head and neck cancer. It was March 2011, and my Maintenance of ...

The Problem of Monitoring Remission

How wonderful it is that we now have to concern ourselves with survivorship issues! The ever-increasing success of cancer therapy means that more and more patients can look to a life beyond cancer diagnosis and treatment. But living with cancer creates its own problems. While treatment often may be ...

prostate cancer

Letter to the Editor: Dr. Ablin’s Reply

Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and...

SIDEBAR: Progression-free Survival Curve for Regorafenib Hints at Subgroup Effect

In all likelihood, only a subset of patients given regorafenib derive benefit, as suggested by the progression-free survival curve seen in the CORRECT trial, according to Dr. Overman. “This is a very interesting curve. The medians don’t really capture the difference.… If you look more at the area...

supportive care

2012 Is ‘Banner Year’ for Research on Symptom Management

The year 2012 was “a banner year for symptom management,” according to Debra L. Barton, RN, PhD, of the Mayo Clinic, Rochester, Minnesota, who presented data on patient and survivor care at the Best of ASCO San Diego meeting. “I have been doing symptom management for about 20 years, and it seems...

prostate cancer

Link Found between Aspirin and Reduced Risk of Death Due to Prostate Cancer

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Over the past few weeks, Stanley L....

breast cancer

Starting Over after Cancer Treatment

When bloody discharge started oozing from the nipple on my left breast, I knew instinctively that it was serious. Although I was just 43, having lost two aunts to breast cancer, I knew my family history increased my risk for developing the disease. So when I saw my gynecologist for an exam, I was...

Einstein-Montefiore Scientists Awarded NCI Grants to Study ‘Provocative Questions’ in Cancer Research

Two research teams at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, the University Hospital for Einstein, have each been awarded grants from the National Cancer Institute (NCI) as part of their “Provocative Questions” program. The innovative effort is...

21-gene Recurrence Score Predicts Outcomes of Node-positive, ER-positive Patients after Adjuvant Chemoendocrine Therapy

The 21-gene recurrence score (obtained with Oncotype DX) can help identify patients with estrogen receptor (ER)-positive, node-positive breast cancer who do not respond well to adjuvant chemoendocrine therapy, according to a retrospective analysis of the National Surgical Adjuvant Breast and Bowel...

multiple myeloma

Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma

Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...

leukemia

Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies

Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...

issues in oncology

Challenging Times: A Day in the Life of a Community Oncologist

Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...

Nobel Laureate E. Donnall Thomas, MD, Dies at 92

In his 1990 Nobel Prize Lecture, Eduard Donnall Thomas, MD, with characteristic humility, acknowledged that the success he celebrated “was made possible by the work of many others in this and related fields.” Dr. Thomas, whose groundbreaking work in bone marrow transplantation marked a new era in...

breast cancer

Surrounded by Breast Cancer

Nine women on my mother’s side of the family have been diagnosed with breast cancer, and nearly half have died from their disease, including my mother. With odds like these, I was determined to do what I could to stay ahead of this dreaded monster I thought was surely coming for me. First Tests...

Explaining Research to Patients

Everyone understands the need for medical research, especially regarding cancer. However, only a minority of the public understand what is actually involved in taking part in a clinical trial. As professionals, we are responsible for designing relevant studies, for their conduct and analysis, and...

SIDEBAR: Mammography Study Stokes Overdiagnosis Debate

Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...

Seeking Solutions to the Dilemmas of Overdiagnosis and Overtreatment

Widespread use of screening technologies has markedly increased early detection rates of cancer, saving countless lives. However, while screening technologies have remarkable sensitivity, their  inability to identify which tumors will progress and which will not has created the phenomenon of...

SIDEBAR: Expect Questions and Respond with Reasoned Explanations

“Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver,” three physicians from Memorial Sloan-Kettering Cancer Center (MSKCC) in New York...

Genetic Variation in Vitamin D Pathway Is Tied to Colorectal Cancer Risk among African Americans

African Americans’ risk of colorectal cancer varies according to whether they have certain genetic variants that affect vitamin D metabolism, according to a study presented at the Fifth American Association for Cancer Research (AACR) Conference on The Science of Cancer Health Disparities, held...

health-care policy

How Sequestration May Affect Cancer Research

Senator Sherrod Brown (D-Ohio) began his political career in 1974 as a state representative in Ohio. He served as Ohio’s Secretary of State between 1983 and 1991, went on to serve in the U.S. Congress from 1993 to 2006, and was elected to the Senate in 2006. A supporter of biomedical and cancer...

Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?

Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center,...

Combination Therapy Not Better than Single-agent Bevacizumab for Advanced Renal Cell Carcinoma in BeST Trial

None of three combination therapies tested among patients with advanced renal cell carcinoma in the BeST trial came close to achieving the primary objective of a 67% improvement in median progression-free survival compared to single-agent bevacizumab (Avastin), Keith T. Flaherty, MD, reported at...

Gene-expression Profiles of Triple-negative Breast Cancers Differ between African American and Native African Women

Triple-negative breast cancers in African-American women and native African women have differing gene-expression profiles that may have implications for treatment, according to the first study to directly compare tumor gene expression between these populations. Results were reported at the Fifth...

Recognizing and Managing Physician Burnout in Oncology

Although job burnout occurs in all professions, it is more common among physicians, according to a study published recently in Archives of Internal Medicine.1 Physicians on the front line of care, such as those working in emergency rooms or in family medicine, experience the highest rates of...

issues in oncology

Never a Dull Moment: A Day in the Life of an Oncology Fellow

Oncology fellows represent the future of cancer care, bringing the best and brightest young doctors into a rigorous training environment that molds their future career paths. Due to an impending workforce shortage in cancer care, the public health-care demands placed on today’s oncology fellows...

issues in oncology

Are We Winning the War on Cancer?

On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...

kidney cancer

Social Media Is Helping My Brother Fight Kidney Cancer 

My brother, Rick Thomas, is a great guy. I’m not just saying that because he’s my brother. He’s funny, warm, and kind to everyone he meets. He became a commercial airline pilot for American Airlines after flying C-5s in the Air Force for 12 years and has always been a responsible person and a...

issues in oncology

Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have Cancer 

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Cancer and diabetes can be comorbid...

breast cancer

A Look at the Patient Navigator Program in Breast Cancer 

In 1990, Harold P. Freeman, MD, established the nation’s first patient navigation program at Harlem Hospital Center in New York (see accompanying article here). Since then, Dr. Freeman’s vision has gained national attention and is currently being looked at in a demonstration project across multiple ...

lymphoma

Solving a 30-year Mystery

When I began experiencing severe neck and back pain about 9 years ago, I had no idea it could be a late side effect from the radiation therapy I had received 31 years ago to treat my Hodgkin lymphoma. And none of the doctors I’ve seen over the past decade have been able to make the connection...

breast cancer

My Life Will Never Be Normal 

After being diagnosed with stage II invasive ductal carcinoma in my right breast in 2004, I did an Internet search to learn more about my treatment options so I could be prepared when I met with my oncologist to discuss my treatment plan. I was especially interested in therapies that would be...

SIDEBAR: Value-based Effective Care 

The study by Chen and colleagues addresses the extremely important topic of the use and delivery schedule for radiotherapy in palliation for patients with metastatic lung cancer. The number of patients who will be considered candidates for such therapy in the United States and around the world each ...

colorectal cancer

Cancer Has Made Me A Better Doctor

After six recurrences of colorectal cancer, the chances it will recur again are high. But if I concentrate on that, I couldn’t live my life. In retrospect, I should have paid attention sooner to the abdominal pain I was experiencing and not dismiss it as a simple case of gas. But at age 47 and with ...

prostate cancer

Recently Reported Long-term Outcomes Could Motivate More Men with Prostate Cancer to Consider Active Surveillance 

Fifteen years after being treated with radical prostatectomy or external-beam radiation for localized prostate cancer, “the prevalence of erectile dysfunction was nearly universal,” among men enrolled in a long-term functional outcomes analysis of the Prostate Cancer Outcomes Study (PCOS). There...

issues in oncology

The Future of Clinical Guidelines in Oncology 

Clinical guidelines, like those of ASCO and the National Comprehensive Cancer Network (NCCN), clearly have represented the standard of care and, to a large extent, the basis for coverage policy, especially in the area of medical oncology. However, guidelines increasingly seem to be in the shadow of ...

leukemia

Gene Transfer Therapy Is Producing Prolonged Remissions in Patients with Advanced Leukemia 

In August 2011, researchers from the University of Pennsylvania published their breakthrough findings of a pilot study showing sustained remissions of up to 1 year in a small number of patients with advanced chronic lymphocytic leukemia (CLL) who had been treated with genetically engineered...

gynecologic cancers

Most Women with Ovarian Cancer Do Not Get Guideline-specified Treatment Linked to Survival Benefits 

Most women with ovarian cancer are not receiving adequate treatment, as specified in National Comprehensive Cancer Network (NCCN) Guidelines,1 and as a result are being deprived of the survival benefits correlated with guideline-recommended treatment, according to a study presented at the Society...

gynecologic cancers

Combinatorial Immunologic Approach Yields Benefit in Preliminary Study of Recurrent Ovarian Cancer

A two-step immunologic approach that includes a personalized dendritic cell vaccine for each patient followed by adoptive T-cell therapy holds promise for the treatment of recurrent ovarian cancer, according to results of two consecutive phase I studies presented at the American Association for...

hematologic malignancies

Majority of Children Readmitted to Hospital Following Stem Cell Transplant

Nearly two-thirds of children receiving stem cell transplants returned to the hospital within 6 months for treatment of unexplained fevers, infections, or other problems, according to a study performed at Dana-Farber/Children’s Hospital Cancer Center in Boston. Children who received donor cells...

Focus on the Delaware Society for Clinical Oncology 

Although the state of Delaware comprises just 2,489 square miles, giving it an area ranking of 49 out of 50 states, its small size gives its population of nearly 1 million an advantage many larger states do not have: ready access to local politicians to address complex issues such as improving...

A New Center for Lymphoid Malignancies Aims to Provide Precision Patient Care  

In January, New York-Presbyterian Hospital/Columbia University Medical Center opened the Center for Lymphoid Malignancies, a 3,700 square foot outpatient clinic, in the heart of Midtown Manhattan. The Center is solely focused on the treatment of all forms of Hodgkin and non-Hodgkin lymphoma,...

Expert Point of View: Andrew D. Zelenetz, MD, PhD

In a separate interview, Andrew D. Zelenetz, MD, PhD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center in New York, said that he found the relapse rate of 20% observed in this study to be quite low, and he wanted to know the characteristics of the 537 patients included in the ...

For Renowned Researcher, Seeing Basic Science Turn into Promising Therapies Is the 'Holy Grail' of Oncology

“From bench to bedside” is a phrase that captures the essence of modern oncology: Researchers at the bench seek to solve the biologic puzzles of cancer that can translate into the development of therapeutics delivered at the bedside. Owen N. Witte, MD, has spent most of his career as a basic bench...

colorectal cancer

Living Without Fear 

Even before I had a colonoscopy to determine the cause of abdominal pains I had been having, I instinctively knew that the news wouldn’t be good. A colonoscopy and subsequent pathology report confirmed stage IIIC colorectal cancer. Because I was just 47 years old at the time of my diagnosis and had ...

Focus on the Georgia Society of Clinical Oncology 

With a roster of over 600 members that includes community and institutional oncologists, administrators, registered nurses, and patient navigators, the Georgia Society of Clinical Oncology (GASCO) is one of ASCO’s largest State Affiliates. Founded in 1986, the Atlanta-based Society is active in...

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