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Promoting a More Balanced Approach to Cancer Prevention and Treatment

Margaret I. Cuomo, MD, is a board-certified radiologist who served for many years as an attending physician in diagnostic radiology at North Shore University Hospital, Manhasset, New York. Dr. Cuomo is the daughter of former New York Governor Mario Cuomo and sister to Governor Andrew Cuomo. She is...

Dr. Jimmie C. Holland’s Research Has Long Underscored the Importance of Caring for the Whole Patient

Although internationally recognized today as the founder of the subspeciality of psycho-oncology, the field of psychiatry held no interest for Jimmie C. Holland, MD, when she entered Baylor College of Medicine in Houston, Texas, in the mid-1940s. Born in 1928 at the dawn of the Great Depression,...

Study Explores Use of Radiotherapy in Last 30 Days of Life

While few patients receive radiation for cancer treatment in the last 30 days of life, almost 1 in 5 patients who do spend more than 10 of those days in treatment and more than half spend more than 5 days, according to a study published in the Journal of Clinical Oncology.1 The investigators used...

integrative oncology

Acupuncture: Does It Alleviate Symptoms Associated with Cancer Care?

A therapeutic modality of traditional Chinese medicine, acupuncture has been extensively investigated in Western medical settings. Its clinical use is increasingly common for the management of pain and other conditions. In the oncology setting, research demonstrates that acupuncture can...

The ‘True’ History of the Discovery of Prostate-specific Antigen

I am frequently asked about the “true” history of prostate-specific antigen (PSA). As PSA has become more important, a controversy about its discovery has increased. I lived through much of this history and have known many of the “players.” Here are the relevant facts, as I believe them to be ...

American Cancer Society Honors Waun Ki Hong, MD, for Outstanding Clinical Research

Distinguished physician, scientist, mentor, and leader Waun Ki Hong, MD, recently accepted the American Cancer Society 2012 Medal of Honor Award in recognition of his novel, high-impact clinical research that has extended the frontiers of cancer treatment and prevention. Dr. Hong is Vice Provost...

American Society of Hematology Launches ASH Foundation

The American Society of Hematology (ASH) has announced the creation of the ASH Foundation dedicated to curing blood diseases. The new foundation will complement and build on the work of the Society by harnessing the generosity of donors to expand the reach of successful ASH programs and develop new ...

Expert Point of View: Robert Jones, MD

“The data speak for themselves,” stated Robert Jones, MD, of the Beatson West of Scotland Cancer Center, Glasgow, UK, during discussion of the MAINSAIL trial at the 2012 ESMO Congress. The study raises some important questions, he continued: What are the implications for designing future trials?...

Top 10 Most Viewed Articles on ASCOPost.com for 2012

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal CancerBy Caroline HelwickThe novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease...

solid tumors
prostate cancer

Early Quality of Life Better with Proton-beam Therapy, but Late Effects Similar to Other Treatment Modalities for Prostate Cancer

Differing patterns of patient-reported quality of life for three-dimensional (3D) conformal radiotherapy, intensity-modulated radiation therapy, and proton-beam therapy were reported in a nonrandomized comparison of three modern cohorts of patients with prostate cancer. The study was presented at...

solid tumors
prostate cancer

Stereotactic Body Radiation Therapy Produces Impressive Results in Organ-confined Prostate Cancer

Stereotactic body radiation therapy (SBRT) delivered via the CyberKnife can achieve excellent outcomes with minimal toxicity in patients with prostate cancer. Importantly, this technique delivers therapeutic doses of radiation in four to five fractions, which reduces the number of clinic visits...

solid tumors
prostate cancer

Expert Point of View: Thomas Pisansky, MD

Commenting on this paper, Thomas Pisansky, MD, the Mayo Clinic, Rochester, Minnesota, reminded listeners that about 50% of patients treated with external-beam radiation therapy and about 33% of those treated with brachytherapy already have erectile dysfunction prior to treatment. After radiation...

issues in oncology
cost of care
health-care policy

The Ethics of Rationing Cancer Care

Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...

Clinical Cancer Advances 2012: ASCO’s Annual Report on Progress Against Cancer

Clinical research is continuously delivering new treatments that lengthen and improve the lives of patients with cancer. The abundance of advances reported in the past year illustrates our steady progress in cancer treatment and care. Clinical Cancer Advances 2012: ASCO’s Annual Report on Progress...

issues in oncology

Significant Reduction in Cancer Risk Seen with Daily Multivitamin Use in Middle-aged and Older Men

Large-scale trials over the past several years have shown a general lack of effect of single vitamins or small numbers of vitamins given at high doses in preventing cancer. However, as recently reported in JAMA by Gaziano and colleagues, the Physicians’ Health Study II has found a modest but...

breast cancer

Molecular Breast Imaging an Option for Early Detection in High-risk Women

Molecular breast imaging, also known as breast-specific gamma imaging, was a key topic of discussion at the Radiological Society of North America (RSNA) Annual Meeting, held recently in Chicago. Molecular breast imaging can detect breast cancer missed by mammography, according to clinical data...

breast cancer

Fox Chase Researchers Find Most Medicare Patients Wait Weeks before Breast Cancer Surgery

Although patients may feel anxious waiting weeks from the time of their first doctor visit to evaluate their breast until they have breast cancer surgery, new findings from Fox Chase Cancer Center in Philadelphia show that these waits are typical in the United States. Results were published...

breast cancer

Plenary Session Included Findings on Partial- vs Whole-breast Techniques and Patient Beliefs about Radiotherapy

When the dates were picked for the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), no one could have anticipated that the meeting would coincide with Hurricane Sandy’s devastation of parts of the northeast. As the storm approached on Monday and Boston shut down its...

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,...

breast cancer

Radiation Therapy Extends Survival in Elderly Women with Early Breast Cancer 

Chronologic age alone should not preclude use of radiation in elderly women with early breast cancer, suggest two studies presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO). Both studies showed a survival improvement in elderly women with early breast cancer ...

Current Perspectives on Triple-negative Breast Cancers

Triple-negative breast cancer—which lacks expression of the estrogen receptor, progesterone receptor, and HER2 oncogene—is a challenge for oncologists. The emergence of data showing strong heterogeneity for this subtype of breast cancer creates even more confusion regarding prognosis and...

Screening for Ovarian Cancer: A Gynecologic Oncologist’s Perspective

The recent U.S. Preventive Services Task Force (USPSTF) Reaffirmation Recommendation Statement concluded that in the population of asymptomatic women without known genetic mutations that increase risk for ovarian cancer, clinicians should not screen for ovarian cancer using transvaginal ultrasound...

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...

multiple myeloma

Persistent Survival Benefit in Patients with Untreated Disease Treated with Bortezomib Added to Melphalan and Prednisone

A final analysis of the phase III VISTA trial (Velcade as Initial Standard Therapy in Multiple Myeloma: Assessment with Melphalan and Prednisone) found a persistent significant benefit in overall survival with VMP (bortezomib, melphalan, prednisone) vs MP (melphalan, prednisone) in patients with...

head and neck cancer

Four-plus Cups of Coffee Daily Linked to Lower Risk of Death from Oral/Pharyngeal Cancer 

Consuming four or more cups per day of caffeinated coffee could almost halve the risk of dying from oral/pharyngeal cancer compared to drinking no coffee or drinking it only occasionally, researchers reported in the American Journal of Epidemiology. “A dose-related decline in relative risk was...

leukemia

Chlorambucil, but Not Fludarabine, Confers Significant Benefit in Older Patients with CLL

Among patients aged 70 years and older with chronic lymphocytic leukemia (CLL), “front-line therapy with fludarabine does not improve outcomes” compared to chlorambucil (Leukeran), according to an analysis of patients enrolled in successive front-line Cancer and Leukemia Group B (CALGB) studies...

lung cancer

Volume-doubling Time May Help Distinguish Aggressive Cancer from Slow-growing Tumors

Changes in the size of lung tumors over time, as measured by volume-doubling times on low-dose computed tomography, can be used to distinguish aggressive lung cancer from slow-growing or indolent tumors and reduce overdiagnosis that could result in overtreatment and unnecessary morbidity. Results...

breast cancer

Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality

An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...

gynecologic cancers

Screening and Risk-reduction without Testing Positive for BRCA Mutation

Many women who do not test positive for a BRCA mutation undergo additional ovarian cancer screenings and risk-reducing procedures, despite limited data to determine the effectiveness of these interventions among an average-risk population. Results of an analysis of data from 1,077 women who were...

colorectal cancer

Patients Treated for Colon Cancer Can Reduce Risk of Recurrence with Balanced Diet and Lower Carbohydrate Intake 

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. Patients who have received standard...

integrative oncology

Green Tea

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

New Appointments at Cancer Centers Nationwide

Two new physicians have joined a growing team of cancer experts at Carolinas HealthCare System’s Levine Cancer Institute in Charlotte, North Carolina. Joshua S. Hill, MD, surgical oncologist, joins Levine Cancer Institute after completing a fellowship in surgical oncology at The University of Texas ...

Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven

That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman,...

issues in oncology

NCI Director Assesses Barriers to Faster Progress in Cancer Research

At a National Press Club media event in Washington, DC, on September 25, 2012, National Cancer Institute (NCI) Director Harold E. Varmus, MD, addressed a group of 75 reporters and officials. His discussion focused on impediments—biologic, economic, institutional, and cultural—to faster cancer...

issues in oncology

Teens and Young Adults with Cancer Want a Voice in End-of-life Care

A top the list of concerns of adolescents and young adults with a life-threatening cancer are these two considerations: being able to choose the kind of medical treatment they want (or do not want) and expressing their wishes to family and friends about how they want to be remembered, according to...

breast cancer

Lumpectomy Rates Inconsistent with Response Rates in Early Breast Cancer

Achieving a pathologic complete response to neoadjuvant chemotherapy does not always reduce the aggressiveness of breast cancer surgery, according to an analysis of the NeoALLTO trial presented at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna.1 Carmen Criscitiello, MD, of ...

issues in oncology

ASCO Report Encourages Further Discussion to Improve REMS Development, Communication

The oncology community—including providers, patients, and industry—and the FDA should continue to work together to improve the agency’s Risk Evaluation and Mitigation Strategies (REMS) program, according to the report of the ASCO REMS Working Group published online by the Journal of Oncology...

survivorship

New ASCO Statement Outlines Agenda to Advance Cancer Survivorship Care

In response to the needs of a growing population of cancer survivors, ASCO has released a position statement, recently published online in the Journal of Clinical Oncology. Developed through the work of the ASCO Cancer Survivorship Committee, the statement outlines a comprehensive agenda for...

solid tumors

Gene Profiling Directs Site-specific Therapy for Carcinoma of Unknown Primary Site

Patients with carcinoma of unknown primary site usually receive empiric therapy (eg, with taxane/platinum or gemcitabine/platinum regimens), resulting in a median overall survival of approximately 9 months. As reported recently in Journal of Clinical Oncology, Hainsworth and colleagues have shown...

issues in oncology

National Comprehensive Cancer Network Appoints New CEO

The National Comprehensive Cancer Network (NCCN) recently appointed nationally regarded breast cancer expert Robert W. Carlson, MD, as its new CEO. Previously, Dr. Carlson was Professor of Medicine in the Division of Oncology and Medical Informatics, Stanford University Medical Center; he first...

hematologic malignancies
leukemia

Pivotal Trial Shows Robust Activity of Ponatinib in Some Heavily Pretreated Leukemias

The pivotal phase II Ponatinib Ph+ ALL and CML Evaluation (PACE trial) found that 1 year of treatment with the novel investigational drug ponatinib achieved robust activity in heavily pretreated patients with chronic myeloid leukemia (CML) and Philadelphia chromosome–positive acute lymphoblastic...

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...

Expert Point of View: Peter Ravdin, MD and Sandra M. Swain, MD, FACP

Putting these results in perspective, Peter Ravdin, MD, moderator of a San Antonio Breast Cancer Symposium press conference where ATLAS findings were discussed, said that in the United States, there is currently a different strategy for pre- and postmenopausal women. Tamoxifen is used as primary...

breast cancer

Adjuvant Tamoxifen for Women with ER-positive Breast Cancer: 10 Years Superior to 5 Years

Five years of tamoxifen has long been considered the standard of care as adjuvant therapy for women with estrogen receptor–positive breast cancer. However, extending tamoxifen treatment for 10 years reduced the risk of dying by 29% during the second decade after diagnosis compared with standard...

lung cancer
issues in oncology

E-mail Reminders to Providers May Improve Documentation of Code Status in Patients with Advanced Disease 

E-mail reminders to providers at the start of each new chemotherapy regimen may improve the rate and timing of code status documentation for patients with advanced lung cancer, according to a study in the Journal of Clinical Oncology. Jennifer S. Temel, MD, and colleagues from Massachusetts General ...

prostate cancer

No Difference in Toxicity with Proton Radiotherapy vs Less Costly Intensity-modulated Radiotherapy 

A national sample of Medicare beneficiaries treated for prostate cancer with intensity-modulated radiation therapy or proton radiotherapy found that proton radiotherapy “was rare and expensive and associated with only a modest and transient reduction in genitourinary toxicity,” reported James B....

breast cancer

Younger Patients with Family History of Breast Cancer at Similar Risk of Bilateral Disease as Those with BRCA Mutations 

Women who are diagnosed with breast cancer before age 55 and have a first-degree family history of bilateral disease have risks of contralateral breast cancer similar to women with deleterious mutations of BRCA1 and BRCA2, according to a study recently published in the Journal of Clinical Oncology, ...

SIDEBAR: Expect Questions from Patients

Results from the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) study “will have a follow-on effect of being able to guide physicians about the advantages of longer than 5 years of therapy for the premenopausal woman,” said V. Craig Jordan, OBE, PhD, DSc, Scientific Director at the Lombardi...

breast cancer

'Practice-changing' ATLAS Study Supports 10 vs 5 Years of Tamoxifen Therapy in Women with Breast Cancer

"Practice-changing" is the term several physicians and researchers used when asked by the media to describe the results of a study showing that extending tamoxifen therapy from 5 to 10 years for women with estrogen receptor (ER)-positive breast cancer further reduced recurrence and mortality....

leukemia
breast cancer

Oncology Trailblazer James F. Holland, MD, Recalls a Time of Unbridled Scientific Excitement 

James F. Holland, MD, began his journey into oncology when it was still a nascent discipline, working alongside groundbreaking pioneers in the field such as Drs. Emil “Tom” Frei and C. Gordon Zubrod. Dr. Holland recently shared a glimpse of his role in oncology’s formative years with The ASCO Post. ...

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