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breast cancer

ECCO 2017: Low Cause-Specific Mortality in Women Over 50 Treated for Ductal Carcinoma in Situ

Women over 50 who have been treated for ductal carcinoma in situ (DCIS) are more likely to be alive 10 years later than women in the general population, according to new research presented by Elshof et al at the 2017 European Cancer Congress (ECCO) (Abstract 173). DCIS differs from breast cancer...

leukemia

Diagnosis and Management of AML in Adults: 2017 European LeukemiaNet Recommendations From an International Expert Panel

An international panel of experts has released updated evidence-based and expert opinion–based recommendations for the diagnosis and treatment of acute myeloid leukemia (AML) in adults. The recommendations were issued by the European LeukemiaNet (ELN) and published by Döhner et al in...

What Have We Got to Lose?

Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...

issues in oncology

Addressing Discrimination and Bias in Medical Education

“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat) and been asked questions like, ‘Where are you really from?’ or ‘How old...

leukemia

Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?

Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...

colorectal cancer

2017 GI Cancers Symposium: Watch-and-Wait Approach for Rectal Cancer Appears an Option for More Patients

Real-world data from a large observational study suggests that omitting surgery in strictly selected patients with a clinical complete response does not compromise outcomes in rectal cancer. The 3-year survival rate among patients who received “watch-and-wait” care after initial cancer...

issues in oncology

Preclinical Study Potentially Explains Vulnerability of Young Patients With Cancer to Treatment Toxicities

Despite many successes in treating pediatric cancer, young children remain at high risk for developing severe, long-lasting impairments in their brain, heart, and other vital organs from chemotherapy and radiation treatments. In adults, however, these tissues are relatively spared. This disparity, ...

issues in oncology
breast cancer
geriatric oncology

Study Suggests No Evidence for Screening Mammography Cutoff Age

An analysis of data from nearly 6 million screening mammograms found no evidence for a clear cutoff age to stop breast cancer screening. Screening mammography among women aged 75 years was associated with higher cancer detection and lower recall rates than among younger women in the study. These...

global cancer care
issues in oncology

Exploring Practical Strategies for Cancer Care in Low-Resource Settings

One of the featured “Big Debates” at the 2016 World Cancer Congress in Paris addressed this question: Are scarce resources best applied to prevention rather than treatment? Many experts do not see prevention vs treatment in such stark terms or even as a realistic scenario. It’s a false dichotomy,...

palliative care

Weighing the Benefits and Risks of Medical Marijuana

Despite the fact that 28 states and the District of Columbia have enacted laws to permit the use of cannabis and cannabinoid-based drugs to treat medical conditions, including cancer and symptoms from its treatment, federal law prohibits physicians from prescribing marijuana to their patients,...

Women in Oncology: Breaking Down Barriers and Looking to the Future

There has been no better time than the present for women in the field of oncology: Women at all stages of their careers are finding more opportunities and avenues to excel. At the time of the last ASCO workforce survey, women made up 28.4% of the oncologist workforce, and that proportion is rising...

supportive care

Cardiac Complications in Patients Receiving Combination Checkpoint Inhibitors Are Rare but Can Be Fatal

Cardiovascular toxicities associated with cancer treatments are not new. What is new, and what has prompted recent articles in The New England Journal of Medicine,1,2 is the explosion of cancer therapies, which has dramatically changed the natural course of many cancers but can lead to cardiac,...

Overcoming the Physical, Emotional, and Financial Effects of Cancer

Although my diagnosis of stage IIIB melanoma 5 years ago came as a shock, in hindsight, it shouldn’t have been so surprising. I had noticed a small freckle-like lesion on my upper left thigh that had become itchy and occasionally bled, but it didn’t fit the ABCDE (Asymmetry, Border irregularity,...

Profound Answers to Simple Questions

A few years ago, I had the good fortune to join a research team that intended to create a device to help dying children express their wants and needs despite communication challenges. The brain tumor team at SickKids [also known as The Hospital for Sick Children] had cared for several children...

survivorship

Integrating AYA Oncology Care Into the Worlds of Pediatric and Adult Oncology Care to Improve Cancer Outcomes

GUEST EDITORAdolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon M. Hayes-Lattin, MD, FACP, Associate Professor of Medicine and...

Make Funding for Cancer Research a Global Priority, Say European and American Organizations

The European Organisation for Research and Treatment of Cancer (EORTC) and the American Association for Cancer Research (AACR) are calling on policymakers and leaders throughout the world to provide robust and sustained funding for cancer research. The two organizations say there has been a...

Johns Hopkins Kimmel Cancer Center Expands Cancer Care and Research Facility at Sibley Memorial Hospital in Washington, DC

Cancer experts from the Johns Hopkins Kimmel Cancer Center are now embedded in a newly expanded facility within Johns Hopkins Medicine–owned Sibley Memorial Hospital in northwest Washington, DC. Sibley recently opened the 30,000-square-foot medical oncology facility—part of its new...

issues in oncology

Disparities of Care: Navigation System Helps Connect Underserved Populations to Cancer Services

Although we’ve seen substantial progress in cancer treatment, screening, diagnosis, and prevention over the past decades, certain underserved populations have not reaped the benefits of many of these advances. Turning research into actionable programs in this area was highlighted by a presentation ...

lung cancer

Experts Consider the New Immunotherapy Paradigm in Advanced Lung Cancer

One immune checkpoint inhibitor has now moved to the front of the line for treating advanced non–small cell lung cancer (NSCLC). Based on pivotal studies presented at the 2016 European Society for Medical Oncology (ESMO) Congress, pembrolizumab (Keytruda) became a first-line option, and it is...

hematologic malignancies
symptom management

ASH 2016: New Data Shed Light on Potential Advantages of Pacritinib for Patients With Myelofibrosis

Compared with standard therapy, pacritinib significantly reduces spleen size among people with myelofibrosis who have very low levels of platelets, according to a late-breaking study presented by Mascarenhas et al during the 58th American Society of Hematology (ASH) Annual Meeting & Exposition...

hematologic malignancies
supportive care

ASH 2016: Preventative Antibiotics Could Prevent Clostridium difficile Among Stem Cell Transplant Recipients

It may be possible to safely prevent one of the most common—and costly to treat—infections contracted by hospitalized patients undergoing bone marrow transplantation for the treatment of blood cancers, according to a study from the Abramson Cancer Center at the University of...

leukemia

ASH 2016: New Chemotherapy Delivery Method Improves Survival After Bone Marrow Transplant in Older Patients With AML

A new analysis presented by Lancet et al at the 58th American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 906) found older patients with acute myeloid leukemia (AML) survived longer after receiving an allogeneic stem cell transplant if they were first treated with the...

breast cancer

Expect and Encourage Questions About Breast Reconstruction

An article in The New York Times about women who had chosen not to have reconstruction following breast cancer surgery might prompt questions from newly diagnosed patients considering their options.1 Deanna J. Attai, MD, FACS, told The ASCO Post that whenever an article on breast cancer appears in...

breast cancer

Helping Patients With Breast Cancer Decide Whether to Have Reconstruction

A “nascent movement to ‘go flat’” is how an article in The New York Times characterized the decisions by some women to opt out of reconstruction following surgery for breast cancer.1 The article examined the reasons several patients made that decision, which included avoiding multiple surgeries and ...

Dave, Dave, Dave

It was 1983, and I was in my third year as an attending physician at a major East Coast university medical center and just 5 years out of fellowship. As was common at the time, I saw and treated all malignancies except leukemia and gynecologic cancers. In the middle of a typically busy day at the ...

palliative care

How When Breath Becomes Air Is Helping the Public—and Physicians—Confront Their Mortality

It should not come as a surprise to anyone who has read Dr. Paul Kalanithi’s brilliant—and unforgettable—memoir, When Breath Becomes Air (Random House, 2016), that nearly a year after publication, it remains on The New York Times best-seller list, its popularity only increasing with time. Written...

issues in oncology

The Emergence of Philanthropy to Fund High-Risk, High-Reward Cancer Research

Earlier this year, Sean Parker, the cofounder of the music streaming service Napster and an early president of Facebook, joined a growing list of entrepreneurs who are committing large portions of their wealth to funding cancer research. In April, Mr. Parker announced he was donating $250 million...

Expert Point of View: Axel Le Cesne, MD

“The debate about perioperative chemotherapy in localized high-grade soft-tissue sarcoma is never-ending. Can this study resolve the debate?” asked formal discussant Axel Le Cesne, MD, of the Institute de Cancerologie Gustave-Roussy, Villejuif, France. “Surgery remains the standard of care for all ...

supportive care
pain management
issues in oncology
symptom management

Medical Marijuana: The Topic You Can’t Escape

With reports about new marijuana dispensaries sprouting up as more states approve the legal use of medical marijuana, and patients and family members questioning how to get it, medical marijuana is a “topic you can’t escape,” noted Judith A. Paice, PhD, RN.1 Dr. Paice is Director of the Cancer...

issues in oncology
supportive care

Talking to Children With Cancer: Sometimes Less Is More

I still remember the day I met Kensie. It was Valentine’s Day. I had sneaked out of the hospital to get my wife a Valentine’s Day card, taking my place among scores of other husbands and boyfriends in front of the rapidly emptying rack of cards. As I started browsing, my beeper sounded. It was the ...

issues in oncology

Forging Collaboration Between Children’s and Adult Oncology Groups in Designing Trials for Adolescents and Young Adults

Nonrhabdomyosarcoma soft-tissue sarcomas account for about 5% of all childhood malignancies and are also diagnosed in adolescents and young adults, as well as in older adults, and can require different approaches to treatment based on a patient’s age and stage of disease. These sarcomas comprise...

Expert Point of View: Bernard Escudier, MD

Formal discussant of this trial, Bernard Escudier, MD, Chairman of the Renal Cancer Unit at Institut Gustave Roussy, Villejuif, France, said: “The main question is whether this study will change practice.” He is not so sure it will and would like more data. Dr. Escudier told listeners that the...

head and neck cancer

New Data Suggest Changes Needed to Guidelines for Determining Prognosis in Patients With Thyroid Cancer

A study from the Duke Cancer Institute (DCI) has found a lack of statistical evidence to support the current practice of treating thyroid cancer patients under age 45 differently from those 45 and older. The study, published recently by Adam et al in the Journal of Clinical Oncology,...

health-care policy

How ASCO Is Preparing Members for MACRA

On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) announced its final policy on what physicians need to do to begin implementing the Quality Payment Program outlined in the Medicare Access and CHIP Reauthorization Act of 2015 ­(MACRA). The Quality Payment Program is a...

colorectal cancer

Study Shows International Trends in Anal Cancer Incidence Rates

A new American Cancer Society study finds that incidence of anal cancer has been increasing in women or in both men and women in 13 of 18 countries studied, particularly in the Americas, Northern/Western Europe, and Australia. The authors say population-based preventive measures, including human...

issues in oncology

‘Dear Presidential Candidates’: A Letter From an Oncologist

Dear Presidential Candidates: Wouldn’t it be great if history’s Alexander the Great was actually Dr. Alexander Fleming, the doctor-scientist who saved millions of lives by discovering penicillin, rather than the other Alexander, who conquered and killed thousands of innocent people? Wouldn’t it be...

gynecologic cancers
issues in oncology

The FDA Urges Physicians and Patients to Forgo Ovarian Cancer Screening Tests

In a Safety Communication directed at women and physicians, the U.S. Food and Drug Administration (FDA) alerted women “about the risks associated with the use of tests being marketed as ovarian cancer screening tests” and recommended “against using currently offered tests to screen for ovarian...

cns cancers

Which Factors Influence Radiotherapy for Brain Metastases?

The advent of more effective systemic therapies, which extend patients’ lives, has also resulted in an increasing incidence of brain metastases, for which clinicians must determine appropriate treatment. Whole-brain radiotherapy has been the traditional treatment modality, but stereotactic...

issues in oncology
supportive care
palliative care

Why Care About the Caregivers?

Caregivers of patients with cancer provide invaluable health-care services, but they are an underserved and undervalued group, with many unmet needs. Early palliative care may provide important benefits to these often tireless individuals, according to J. Nicholas Dionne-Odom, PhD, RN, ACHPN, of...

issues in oncology
palliative care

Immunotherapy Brings Unique Challenges for Clinicians

The advent of immunotherapies has created a number of interesting challenges for oncology providers. At the 2016 Palliative Care in Oncology Symposium, specialists in the field tackled these issues. “There is a lot of newness to how we approach patient care with immunotherapies on board,” said...

issues in oncology
health-care policy
survivorship

Why Curing Cancer Will Take Decades

This past summer, Eric S. Lander, PhD, President of the Broad Institute of the Massachusetts Institute of Technology and Harvard in Cambridge, Massachusetts, and Co-Chair of the President’s Council of Advisors on Science and Technology, raised a few eyebrows at the Aspen Ideas Festival when he...

kidney cancer
breast cancer

I’ve Survived Cancer for Over 71 Years

Even though I was just 3 years old when my symptoms first appeared, the memory is still fresh in my mind to this day, 71 years later. I had just come home from a friend’s birthday party and was sitting on the front patio steps immobilized by severe stomach pain. My parents said I was feeling ill...

issues in oncology

Recognizing the Unique Experiences of Cancer Among Adolescent and Young Adult Survivors

Studies show that adolescent and young adult cancer survivors experience distinct challenges and quality-of-life issues from those experienced by either younger or older adult cancer survivors and that those challenges and issues can persist long after the cancer diagnosis and the end of...

issues in oncology

Why Patients’ Understanding of Their Prognosis Often Differs From Their Oncologists’

A recent study1 published in the Journal of Clinical Oncology (see “Breaking the ‘Conspiracy of Silence’” in this issue of The ASCO Post) found that just 1 in 20 patients with advanced, incurable cancer has sufficient understanding of his or her prognosis or life expectancy. Now, another new study ...

issues in oncology
lymphoma
solid tumors

Media Reports of Dramatic Responses to Immunotherapy After All Else Fails May Prompt Patients to Seek It Out

Immunotherapy has received “a lot of attention, mainly because of the media coverage,” Anas Younes, MD, medical oncologist and Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York, said in an interview with The ASCO Post. “Many patients inquire, not about a specific...

Oncologist’s Guilt

The best part of my day is hearing that little voice yell, “It’s ­Momma!” as my son rushes to greet me with a hug. It is humbling, and sometimes terrifying, to realize that I brought a little person into the world who is completely dependent on my husband and me for survival. Few would argue...

The Best Oncology Lesson

I was 2 months into my first-year fellowship at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, when I learned the best oncology lesson of my career. I owned a copy of DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology and had read Cancer Treatment...

gynecologic cancers

Study Examines Global Trends in Ovarian Cancer Mortality Rates

Deaths from ovarian cancer fell worldwide between 2002 and 2012, and are predicted to continue to decline in the United States, European Union (EU) and Japan by 2020, according to new research published by Malvezzi et al in Annals of Oncology. The main reason is the use of oral contraceptives and...

bladder cancer
kidney cancer
prostate cancer

Multitude of Mentors Help Shape an Illustrious Career in Oncology

Sumanta K. Pal, MD, has had a longer career in oncology than many other colleagues his age. Perhaps the reason for that may center on his starting college at the age 13 and medical school at the age of 17. Today this internationally recognized leader in genitourinary cancers is Assistant Professor ...

skin cancer

Management of Merkel Cell Carcinoma

A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the...

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