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palliative care

House Calls With Her Physician Father Sparked an Interest in Palliative Care for Janet L. Abrahm, MD

Nationally regarded palliative care expert Janet L. Abrahm, MD, was born and reared in San Francisco. Her father was a solo practitioner who saw medicine as a great profession. “My father would come home from his office for dinner and when he finished, he’d do house calls, often bringing us with...

multiple myeloma

Robert A. Kyle, MD, Luminary in Myeloma Research: Journey From a One-Room Schoolhouse to Groundbreaking Research

In this installment of Living a Full Life, guest editor Jame Abraham, MD, FACP, interviewed multiple myeloma pioneer Robert A. Kyle, MD, whose groundbreaking work has changed the practice of hematology. Among his many honors are the David A. Karnofsky Memorial Award from ASCO and the Wallace H....

immunotherapy

The Microbiome: The Next Target in Cancer Therapy

With the recent breakthroughs in immunotherapy, treatments that modulate the immune system are now being used across numerous cancer types and across the spectrum of disease with significant success, but not all patients achieve objective responses. There is still a critical need to better...

issues in oncology

Full Disclosure: What Oncologists Must Tell Patients About Their Experience and Training

Informed consent is an important part of delivering quality cancer care. Traditional ethical and legal rules require clinicians to disclose three types of information: (1) the patient’s diagnosis; (2) the nature of the proposed intervention and its intended benefits, risks, and adverse effects;...

pain management

CDC Issues Clarification on Guideline for Prescribing Opioids for Chronic Pain in Patients With Cancer and Sickle Cell Disease

ASCO, the American Society of Hematology (ASH), and the National Comprehensive Cancer Network® (NCCN®) are pleased to acknowledge receipt of a key clarification from the Centers for Disease Control and Prevention (CDC) on prescribing opioids to manage pain from certain conditions. ...

breast cancer

AACR 2019: Does Primary Tumor Surgery Increase Survival in Patients With Advanced HER2-Positive Breast Cancer?

Surgery was associated with higher survival rates for patients with HER2-positive stage IV breast cancer compared with those who did not undergo surgery, according to results presented by Mudgway et al at the American Association for Cancer Research (AACR) Annual Meeting (Abstract 4873). Between...

FDA Commissioner Scott Gottlieb, MD, Resigns

ON MARCH 5, 2019, Scott Gottlieb, MD, announced his resignation as Commissioner of the U.S. Food and Drug Administration (FDA), a post he began in 2017. Dr. Gottlieb’s resignation will be effective in April. In a resignation letter to Alex M. Azar II, Secretary of Health and Human Services (HHS),...

issues in oncology

NCCN Summit Tackles Inequities in Access to Care

WHEN BRANDON CANYON’S mother Leone was diagnosed with uterine cancer, he drove her to treatment sessions at the nearest cancer center—a 200-mile round trip on rough roads. Gas was a significant expense, but their only other option was to forgo treatment. The Canyons are members of the Navajo...

issues in oncology

Caring: Isn’t That Why We Went to Medical School?

YOU CANNOT write about caring; you must practice it. None of us went to medical school thinking we would be an oncologist or a neurosurgeon or a stem cell biologist. But we did have vague aspirations of wanting to help others: to be involved in other lives. It was an altruistic avocation; how...

gynecologic cancers
immunotherapy

SGO 2019: Dendritic Cell–Based Immunotherapy in Combination With Chemotherapy in Recurrent Ovarian Cancer

Results from a clinical trial presented by Cibula et al at the Society of Gynecologic Oncology’s (SGO) 50th Annual Meeting on Women’s Cancer showed that a new immunotherapy treatment significantly prolongs survival in women with recurrent ovarian cancer when added to standard...

palliative care
supportive care

Sweet Surrender

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,...

WebMD Recognizes Seven Cancer Innovators With Its Health Heroes Award

On January 15, 2019, WebMD, an online and print health-care resource for consumers, presented its 2018 Health Heroes Award in New York City to 7 people who are making a difference in oncology care. The honorees include Karen M. Winkfield, MD, PhD, Associate Professor of Radiation Oncology at Wake...

sarcoma

Sarcoma Coalition Launched as Collaboration of Advocacy Organizations

Those dealing with sarcoma know that resources and support can be difficult to find. Members of the newly formed Sarcoma Coalition are working together to change that. The Sarcoma Coalition is a nonprofit collaboration of sarcoma advocacy organizations from around the country working toward a...

issues in oncology

Assessing the Clinical Utility of ASCO’s and ESMO’s Value Frameworks

In 2015, ASCO and the European Society for Medical Oncology (ESMO) introduced value frameworks that utilize algorithmic scales to evaluate the clinical benefit of cancer therapies and provide an objective assessment of outcomes and treatment toxicities experienced by patients.1,2 Although the two...

A Peaceful Transformation: The Origin of the Frederick National Laboratory

JUST 2 MONTHS before Congress passed what to this day is America’s most sweeping anticancer legislation, President Richard Nixon came to Fort Detrick in Frederick, Maryland, to declare his administration’s historic commitment to the fight. “I have come here today for the purpose of making an...

issues in oncology

Health-Care Fraud Prosecutions Are on the Rise

Prosecuting health-care fraud is a top priority for the U.S. Department of Justice (DOJ) and other federal government agencies.1,2 After all, the government earns a $6 return for every $1 that it spends on enforcement. In December 2018, the DOJ announced that it had obtained more than $2.5 billion...

ASH President Roy Silverstein, MD, Issues Comment on Maintenance of Certification Recommendations Draft

RECENTLY, THE American Society of Hematology (ASH) submitted feedback on draft recommendations for reforming Maintenance of Certification (MOC) to a commission appointed by the American Board of Medical Specialties (ABMS) and other entities. The “Vision Commission” released a report of its draft...

lung cancer

Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low

The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results,...

FDA Commissioner Scott Gottlieb, MD, Resigns

On March 5, 2019, Scott Gottlieb, MD, announced his resignation as Commissioner of the U.S. Food and Drug Administration (FDA), a post he began in 2017. Dr. Gottlieb’s resignation will be effective next month. In a resignation letter to Alex M. Azar II, Secretary of Health and Human Services ...

colorectal cancer
health-care policy

Effect of Affordable Care Act’s Medicaid Expansion on Colorectal Cancer Screening and Survival in Kentucky

Kentucky has been one of the most successful states in reducing its uninsured rate, which happened in part through the Affordable Care Act’s Medicaid expansion that took effect on January 1, 2014. In the past, Kentucky has reported low rates of colorectal cancer screening, and has ranked ...

issues in oncology

Eliminating the Taboo of Cancer

All homes and all families have or have had their own cancer experiences. Speaking about it dissolves the taboo and allows for earlier diagnosis, less discrimination, increased awareness, and higher commitment by authorities. It also helps those struggling with the disease feel like part of a...

supportive care
palliative care

National Consensus Project Releases 4th Edition of Clinical Practice Guidelines for Quality Palliative Care

As reported by Betty R. Ferrell, PhD, MA, FAAN, FPCN, of the Division of Nursing Research and Education, City of Hope Medical Center, Duarte, California, and colleagues in the Journal of Palliative Medicine, the National Consensus Project (NCP) of the National Coalition for Hospice and Palliative ...

issues in oncology
survivorship

Creating ‘Right-Sized’ Follow-up Care in Oncology as Number of Cancer Survivors Grows

An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will lead to challenges in delivering care for cancer survivors in the United States if systemic changes are not made, according to a commentary in the Journal of the National Cancer...

ASCO Convenes Stakeholders to Build Consensus for a Clinical Trial Data-Sharing Policy Among Journals That Publish Clinical Cancer Research

Jeffrey M. Drazen, MD, Editor-in-Chief of The New England Journal of Medicine, wrote in a 2016 editorial, “Data Sharing and the Journal,” that “[W]e believe there is a moral obligation to the people who volunteer to participate in these trials to ensure that their data are widely and responsibly...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

hematologic malignancies

Crizanlizumab Improves Prevention of Vaso-occlusive Crises in Patients With Sickle Cell Disease

For the first time in more than 20 years, patients with sickle cell disease may have another treatment option to reduce painful vaso-occlusive crises, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Results of the phase II, randomized,...

hematologic malignancies

Pilot Study Tests Novel Approach to Gene Therapy for Sickle Cell Disease

Initial findings from a first-in-human trial have provided proof of principle for a groundbreaking approach to gene therapy for sickle cell disease, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Early results of genetic targeting of...

issues in oncology

Former JAMA Editor Offers Perspective on Challenges Past and Present in American Health Care

BOOKMARK Title: Severed Trust: Why American Medicine Hasn’t Been FixedAuthor: George D. Lundberg, MD, With James StaceyPublisher: Basic BooksPublication date: March 2001Price: $28.00, hardcover, 336 pages Pathologist George D. Lundberg, MD, served as Editor-in-Chief of The Journal of the American...

issues in oncology

Physician Wellness: Time to Heal the Healer

Physician wellness is emblazoned upfront in the news with attention-seeking headlines on a daily basis. The fact that one or two physicians commit suicide every day in this country sometimes elicits more of a sympathetic acknowledgment than a committed call to address it. Moreover, these sobering...

issues in oncology

Artificial Intelligence and the Brave New World of Cancer Diagnostics

A study published in Nature Medicine found that an artificial intelligence program could distinguish between the histologic diagnosis of adenocarcinoma and squamous cell carcinoma.1 Experienced pathologists often struggle to differentiate these tumor types without confirmatory tests. The artificial ...

kidney cancer
immunotherapy

2019 GU Cancers Symposium: KEYNOTE-426: Pembrolizumab Plus Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma

Results from the randomized, phase III KEYNOTE-426 clinical trial show that first-line therapy with a combination of pembrolizumab and axitinib extended both overall survival (OS) and progression-free survival (PFS) for patients with clear cell metastatic renal cell carcinoma compared with the...

integrative oncology

Advancing the Science and Art of Integrative Oncology

In 2019, we will mark the 20th year of the establishment of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center (MSK), which helped lay the foundation for the emerging field of integrative oncology. Over the past 2 decades, academic cancer institutions, including The...

lymphoma

Living My Best Life

Five years ago, I was living my dream life. I was under contract as a commentator on Fox News, which necessitated commuting weekly from my home in Los Angeles to New York, and was building a new home in Palm Springs with my partner, Matt Lashey. Not only was my career and personal life going well,...

solid tumors
lymphoma
pancreatic cancer
symptom management

FDA Pipeline: Treatments for Tenosynovial Giant Cell Tumor and Pancreatic Cancer, Plus a Statement on Breast Implant–Associated Lymphoma

The U.S. Food and Drug Administration (FDA) recently granted the following designations and applications and also issued a statement: Priority Review for Pexidartinib in Tenosynovial Giant Cell Tumor The FDA has accepted a new drug application (NDA) and granted Priority Review for pexidartinib...

immunotherapy

Machine Learning Identifies Multiple Underlying Factors Predicting Response to Immunotherapy

A research team is using a branch of artificial intelligence known as machine learning to better target immunotherapy to those who will benefit. In a recent study published by Leiserson et al in PLOS One, the team used data from a clinical trial of patients with bladder cancer to...

issues in oncology

Essential Elements of an Effective Clinical Trials System: Business and Mission

Clinical trials aimed to improve health and quality of life are the cornerstone of progress in medicine. Support comes from academic medical centers, philanthropy, the National Institutes of Health (NIH), industry, or combinations thereof. Clinical trials need to be hypothesis-driven and address...

skin cancer
immunotherapy

How Effective Is Talimogene Laherparepvec Injection in Metastatic Melanoma?

Injection of a genetically modified virus that induces the body’s own immune cells to attack metastatic melanoma effectively treated almost 40% of patients with tumors that could not be surgically removed, according to findings published by Louie et al in the Journal of the American...

gynecologic cancers

HPV Testing Using Self-Collected vs Clinician-Collected Samples for the Detection of Cervical Intraepithelial Neoplasia

In a Dutch study (IMPROVE) reported in The Lancet Oncology, Polman et al found that human papillomavirus (HPV) testing with a clinically validated polymerase chain reaction (PCR)–based assay had similar accuracy using self-collected vs clinician-collected samples in detecting cervical...

lung cancer
lymphoma
skin cancer

FDA Pipeline: Updates on Treatments in NSCLC and Lymphomas, Plus New Dosimetry Software

The U.S. Food and Drug Administration (FDA) recently granted the following application, designations, and clearance: sBLA for Atezolizumab Plus Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC On January 17, the FDA accepted a supplemental biologics license application...

Community Oncology Alliance Elects New Officers and Board Members

THE COMMUNITY Oncology Alliance (COA) recently announced that Michael Diaz, MD, a practicing medical oncologist at Florida Cancer Specialists & Research Institute, has been elected President of COA. His 1-year term began on January 1, 2019. In addition, Kashyap Patel, MD, a practicing...

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 ...

colorectal cancer

23andMe Receives FDA Clearance for Direct-to-Consumer Genetic Test on a Hereditary Colorectal Cancer Syndrome

On January 22, 23andMe received U.S. Food and Drug Administration (FDA) clearance for a genetic health risk report on MUTYH-associated polyposis, a hereditary colorectal cancer syndrome. The clearance follows the FDA’s authorization for 23andMe’s BRCA1/BRCA2 (Selected Variants)...

MD Anderson President Emeritus, John Mendelsohn, MD, Dies at Age 82

John Mendelsohn, MD, President Emeritus of The University of Texas MD Anderson Cancer Center, died of glioblastoma on January 7, 2019, at his home in Houston at age 82. He was an internationally acclaimed leader in the field of medicine and scientist whose research helped pioneer a new type of...

issues in oncology
legislation
health-care policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

supportive care

Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Ying ...

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 ...

issues in oncology

How to Build a Clinical Trial Infrastructure in the Community Oncology Setting

HISTORICALLY, CLINICAL research has been viewed as an entity belonging to academic settings alone. With the advent of the Community Clinical Oncology Program (CCOP) in the 1980s and later with the Cancer Trials Support Unit, cancer clinical trials have begun to emerge in the community setting....

Should I Have Lied?

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,...

immunotherapy
skin cancer

Optimal Duration of Checkpoint Inhibition in Melanoma Is No More Than 2 Years

For patients with advanced melanoma, the concept of treating to disease progression does not always apply. With many patients responding to checkpoint inhibition for years, when can treatment be safely discontinued? This important clinical question was addressed at the European Society for Medical...

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