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Integrative Oncology
Palliative Care

Integrating Spirituality Into Palliative Care Services

Over the past couple of decades, the oncology community has made great strides in mediating the psychosocial needs of our patients. However, a patient’s spirituality is a subjective and uncomfortable issue for many oncologists, which leaves a gap in the continuum of care. To reach a better...

Palliative Care

A Swiss Psychotherapist Gives Her Perspective on Optimal Palliative Care

Over the past few decades, the oncology community has incorporated new evidence-based therapies to address the psychosocial needs of patients with cancer, especially those with advanced disease. To bring a global perspective to this evolving discipline, The ASCO Post recently spoke with Monika...

Palliative Care

Practicing the Humanistic and Holistic Approach to End-of-Life Care

In 1990, when Bruce (B.J.) ­Miller, MD, was an undergraduate at Princeton University, the practice of medicine was far from his mind. Then a student in Chinese and Asian studies and later an art history major, Dr. Miller would come to pursue a career specializing in palliative medicine after an...

Palliative Care

Evidence-Based Practice Needed in End-of-Life Care

Evidence-based oncology practice is a systematic approach to problem solving for cancer care providers, characterized by the use of the best evidence currently available for clinical decision-making. Over the past several decades, the oncology community, led by its major organizations such as ASCO...

Lung Cancer
Palliative Care

‘Substantial Number’ of Patients Requiring Palliative Radiotherapy for Stage IV NSCLC Are Overtreated

An analysis of data from 46,803 patients with stage IV non–small cell lung cancer (NSCLC) who received palliative chest radiation therapy found that 49% received radiotherapy for longer than 15 fractions, and 28% received more than 25 fractions. This treatment pattern “is inconsistent with the...

Palliative Care

Perceptions of End-of-Life Care Differ Sharply Between African Americans and White Americans

Studies demonstrate that patients with advanced cancer who are not actively engaged in planning their end-of-life care often receive overly aggressive, physically taxing, costly and unnecessary treatment toward life’s end. Recent findings indicate that African Americans appear to be more apt to...

Palliative Care

More, Earlier, and Better Goals-of-Care Conversations at the End of Life Are Feasible

An intervention called the Serious Illness Care Program helps clinicians to conduct more, earlier, and better conversations about goals of care with their seriously ill patients, according to ­Rachelle E. Bernacki, MD, MS, who presented the preliminary results of a study using this approach at the...

Palliative Care

ASCO and AAHPM Define Primary Palliative Care in Oncology

A new guidance statement from ASCO and the American Academy of Hospice and Palliative Medicine (AAHPM) could potentially lead to more standardized primary palliative care delivery across oncology settings, according to Kathleen E. Bickel, MD, MPhil, who presented the study findings at the 2015...

symptom management
palliative care
pain management

Samuel Chao, MD, on Improving the Consistency of Radiation Oncology Processes

Samuel Chao, MD, of Cleveland Clinic, discusses the QMAP program and data-driven management, which offer ways to improve consistency and drive quality in radiation oncology departments (Abstract 39).

palliative care
pain management
symptom management

Alysa M. Fairchild, MD, on Preventing Radiation-Induced Pain Flare

Alysa M. Fairchild, MD, of the Cross Cancer Institute and the University of Alberta, discusses her study on the use of dexamethasone to reduce pain flare in patients receiving palliative radiotherapy for bone metastases (Abstract LBA6663).

palliative care

More Than One-Third of Patients With Metastatic Cancer Continue to Work

A new analysis indicated that many patients continue working after being diagnosed with metastatic cancer, but a heavy burden of symptoms may prevent them from doing so. Published by Tevaarwerk et al in Cancer, the study illustrates the need to treat difficult symptoms so that patients can maintain ...

palliative care
breast cancer
issues in oncology

SABCS 2015: Phase III BELLE-2 Trial Meets Primary Endpoint of Progression-Free Survival

Among women with locally advanced or metastatic hormone receptor–positive breast cancer that was resistant to hormone therapy, those who had mutated PIK3CA detected in their blood benefited from a combination of the investigational PI3K inhibitor buparlisib and fulvestrant (Faslodex),...

palliative care
leukemia

ASH 2015: Combination Therapy With Idelalisib Improves Progression-Free Survival vs Bendamustine/Rituximab Alone in Relapsed/Refractory CLL

In a phase III study to be presented by Zelenetz et al at the 57th American Society of Hematology Annual Meeting, idelalisib (Zydelig) plus bendamustine (Treanda) and rituximab (Rituxan), or BR, proved superior to BR alone in patients with relapsed/refractory chronic lymphocytic leukemia (CLL)...

palliative care
prostate cancer

Study Shows Abiraterone Acetate Is Useful Even in the Most Aggressive Prostate Cancers

In 1,048 prostate cancer patients previously treated with docetaxel, and 996 metastatic, castration-resistant patients, treatment with the androgen-lowering drug abiraterone acetate (Zytiga) led to longer overall disease control, even when a very high Gleason score indicated especially aggressive...

palliative care
breast cancer
issues in oncology
issues in oncology
issues in oncology
issues in oncology

Researchers Develop Mathematical Model to Forecast Metastatic Breast Cancer Survival Rates

University of Southern California (USC) researchers have developed a mathematical model to forecast metastatic breast cancer survival rates using techniques usually reserved for weather prediction, financial forecasting, and surfing the Web. For decades, medical schools have taught doctors that...

palliative care
issues in oncology
prostate cancer

Two Studies Find Protein May Inhibit Prostate Cancer Bone Metastasis

Scientists from Lawrence Livermore National Laboratory (LLNL), in collaboration with researchers from University of California Merced and Davis, have found that a secreted protein predominantly expressed in bone inhibits prostate cancer metastasis to bone. Their research was published recently by...

palliative care
lung cancer
issues in oncology

FDA Approves Osimertinib for EGFR T790M Mutation–Positive Non–Small Cell Lung Cancer After Progression on Prior EGFR-Blocking Therapy

The U.S. Food and Drug Administration (FDA) granted accelerated approval for an oral medication to treat patients with advanced non–small cell lung cancer (NSCLC). Osimertinib (Tagrisso) is now approved for patients whose tumors have a specific epidermal growth factor receptor (EGFR) mutation ...

palliative care
breast cancer
survivorship

ABC3: Experts Create New Consensus Guidelines for Advanced Breast Cancer Treatment

Although advanced breast cancer is incurable, there are some patients who have just a few small metastases who would respond well to systemic treatments such as chemotherapy and hormone therapy. In new guidelines agreed on by participants at the Advanced Breast Cancer Third International Consensus...

palliative care
supportive care

ASTRO 2015: Patients With Bone Metastases Undergoing Radiation Therapy for Symptom Control Have Lower Pain Flare Rates With Steroid Use

The steroid dexamethasone reduces radiation-induced pain flare in cancer patients with painful bone metastases, according to research presented by Chow et al (Abstract LBA1) October 18, 2015 at the American Society for Radiation Oncology’s (ASTRO’s) 57th Annual Meeting in San Antonio,...

prostate cancer
issues in oncology
palliative care

Aggressive End-of-Life Care More Frequent Among Black Than White Men With End-Stage Prostate Cancer

A study to examine racial disparities in end-of-life care among black and white patients dying of prostate cancer found that “significant racial disparities in end-of-life care" do exist. “Although diagnostic and therapeutic interventions are less frequent in black patients with...

palliative care
supportive care
palliative care

Clergy Religious Beliefs Are Associated With Greater ICU Care in Congregants’ Final Days

A survey exploring the relationship between spiritual support and end-of-life care by evaluating clergy members’ opinions and experiences related to care provided to congregants at the end of their life has found that a majority of clergy endorse religious beliefs regarding their...

palliative care
supportive care
palliative care

Palliative Care 2015: Collaboration Between Radiation Oncologists and Palliative Care Specialists Improves Care for Patients With Advanced Cancer

An innovative service model that partners radiation oncology with palliative care leads to better results for patients, according to a new analysis. The model of care, established at Mount Sinai Medical Center, is one of only a handful in the country. The study (Abstract 110) will be presented at...

supportive care
palliative care

Palliative Care 2015: Study Finds the Answer to One Question Can Help Identify Patients Nearing the End of Life

Determining the answer to a simple question, “Would you be surprised if this patient died within the next year?” can be an important tool to help predict which patients with cancer may be in their final year of life, according to the findings from a study by Vick et al. The tool, known...

palliative care

New Agent Targeting Epigenetic Modifications Shows Activity in Advanced Cancer

In a dose-escalation phase I study reported in The Lancet Oncology, Reid et al found that RRx-001, a representative of a new class of compounds called dinitroazetidines (sourced from the aerospace industry) that act on the tumor microenvironment, had activity in advanced cancers and a promising...

palliative care
skin cancer

Combining Interleukin-2 With Imiquimod and Topical Retinoid Therapy May Be Effective Against Cutaneous Metastatic Melanoma

A novel combination therapy appears to be effective in treating patients with melanoma skin metastases, according to new research from the University of California (UC) Davis. Led by Emanual Maverakis, MD, of the UC Davis Department of Dermatology, the research found that interleukin-2...

palliative care
issues in oncology
issues in oncology
palliative care

Study Shows Palliative Chemotherapy in Patients With End-Stage Cancer Did Not Improve Quality of Life and May Be Harmful

Although palliative chemotherapy is used to improve quality of life for patients with end-stage cancer, a study evaluating its use found that palliative chemotherapy did not improve quality of life near death for patients with a moderate or poor performance status and that it worsened quality of...

palliative care
issues in oncology
palliative care

Aggressive Cancer Treatment Near End of Life Persists, Despite Rise in Advance Planning Efforts

In a review of nearly 2,000 surveys with people whose loved ones died of cancer, researchers led by Johns Hopkins School of Medicine experts said they found a 40% increase over a 12-year period in the number of patients with cancer who participated in one form of advance care...

issues in oncology
palliative care

Many Teens and Young Adults With Cancer Use Aggressive End-of-Life Measures

More than two-thirds of adolescents and young adults dying of cancer utilized one or more aggressive interventions in the last month of life, according to a retrospective study from researchers at Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Kaiser Permanente Southern...

palliative care
issues in oncology
multiple myeloma

Daratumumab Expanded Access Program Open to Eligible U.S. Patients With Heavily Pretreated Multiple Myeloma

Janssen Biotech, Inc, announced the opening of a daratumumab expanded access program for eligible U.S. patients. Daratumumab is an investigational human anti-CD38 monoclonal antibody being evaluated in clinical trials as a treatment for patients with multiple myeloma. The multicenter, open-label...

palliative care
issues in oncology
issues in oncology

ESMO World GI 2015: Second-Line Cetuximab Active Beyond Progression in Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer that are free of mutations in the KRAS, NRAS, BRAF, and PIK3CA genes showed a significant benefit from continuing antiepidermal growth factor receptor (EGFR) therapy beyond progression following first-line chemotherapy and an anti-EGFR monoclonal antibody. ...

palliative care
issues in oncology
colorectal cancer

ESMO World GI 2015: Studies Confirm Regorafenib Benefit in Pretreated Metastatic Colorectal Cancer

The phase IIIb CONSIGN trial has confirmed the benefit of regorafenib (Stivarga) in patients with previously treated metastatic colorectal cancer, researchers announced July 3 at the European Society for Medical Oncology World Congress on Gastrointestinal Cancer in Barcelona, Spain (Abstract...

palliative care
colorectal cancer

ESMO World GI 2015: Low Body Mass Index Associated With Poorer Survival in Metastatic Colorectal Cancer

Although being overweight with a high body mass index (BMI) has long been associated with a higher risk for colorectal cancer, thinner patients might not fare as well as previously expected after treatment for advanced cancer, according to a new study from Duke Medicine. The study, which was...

palliative care
colorectal cancer
head and neck cancer

Development of New Blood Vessels Not Essential to Growth of Lymph Node Metastases

While the use of antiangiogenesis drugs that block the growth of new blood vessels can improve the treatment of some cancers, clinical trials of their ability to prevent the development of new metastases have failed. Now a study from the Massachusetts General Hospital (MGH) Cancer Center may have...

palliative care
issues in oncology
prostate cancer
issues in oncology
cost of care

Chemotherapy May Be Preferred Option for Some With Advanced Prostate Cancer

In a small clinical trial, scientists at Johns Hopkins Kimmel Cancer Center and James Buchanan Brady Urological Institute found that men with advanced prostate cancer and detection of androgen receptor splice variant-7 (AR-V7) respond to chemotherapy just as well as men who lack the variant. The...

palliative care
cns cancers
issues in oncology
issues in oncology

ASCO 2015: Gene Therapy Paired With Traditional Surgical Resection Benefits Patients With Glioblastoma

Houston Methodist Neurological Institute neurosurgeon David Baskin, MD, presented preliminary data from a phase II clinical trial that suggests gene therapy  (AdV-Tk therapy), which uses a mediated herpes simplex virus, combined with a traditional treatment—surgical resection—could ...

palliative care
issues in oncology
skin cancer
issues in oncology

Pooled Analysis Shows Similar Efficacy of Nivolumab in BRAF V600–Mutant and BRAF Wild-Type Advanced Melanoma

A pooled analysis of four clinical trials of nivolumab (Opdivo) in advanced melanoma, reported by Larkin et al in JAMA Oncology, suggested similar response rates in patients with BRAF V600–mutant and BRAF wild-type disease. Study Details The retrospective analysis included data from adult...

palliative care
pancreatic cancer
issues in oncology

Two Studies Highlight Benefit of Stereotactic Body Radiotherapy in Locally Advanced Pancreatic Cancer

Two studies from researchers at Johns Hopkins Kimmel Cancer Center add to preliminary evidence that high-dose radiation treatment, or stereotactic body radiotherapy, appears to be safe and as effective as standard radiation treatment for certain patients with locally advanced pancreatic cancer....

palliative care
pancreatic cancer
supportive care

German Trial Shows Reduced Risk of Venous Thromboembolism With Prophylactic Enoxaparin in Ambulatory Patients With Advanced Pancreatic Cancer

In the German CONKO-004 trial reported in the Journal of Clinical Oncology, Pelzer et al found that prophylactic treatment with the low-molecular-weight heparin enoxaparin reduced the risk of symptomatic venous thromboembolic events in ambulatory patients receiving first-line chemotherapy for...

palliative care
lung cancer

ASCO 2015: Experimental Immunotherapy Shows High Response Rate in Advanced Lung Cancer

An early-phase study testing the anti–PD-L1 agent MPDL3280A in combination with standard chemotherapy in the treatment of advanced non–small cell lung cancer (NSCLC) has provided promising early results, prompting multiple phase III studies in lung cancer. The findings are being...

palliative care
prostate cancer

ASCO 2015: Adding Chemotherapy to Initial Therapy Improves Survival in Patients With Advanced, Hormone-Naive Prostate Cancer

The UK-led STAMPEDE trial found that adding docetaxel chemotherapy to standard hormone therapy markedly improved survival for men with newly diagnosed advanced prostate cancer not previously treated with hormone therapy (hormone-naive). Men who received docetaxel plus standard therapy lived on...

palliative care
issues in oncology
palliative care

Surgical Interventions for Terminal Cancer Patients Remain Prevalent

The number of surgeries performed on terminally ill cancer patients has not dropped in recent years, despite more attention to the importance of less invasive care for these patients to relieve symptoms and improve quality of life. But new research from the University of California, Davis, also...

palliative care
breast cancer

AACR 2015: Dual mTOR Inhibitor-Fulvestrant Combination Feasible, With Clinical Benefit for Advanced Breast Cancer Patients

The dual mTOR inhibitor AZD2014, when combined with the hormonal therapy fulvestrant (Faslodex), was found to be safe in patients with advanced estrogen receptor–positive breast cancer, and some of them experienced clinical benefit from the drug combination, according to phase I clinical...

palliative care
skin cancer

AACR 2015: Combining Two Investigational Immunotherapy Drugs Safe, With Early Signs of Effectiveness

Combining the immunostimulatory anti-CD40 monoclonal antibody CP-870,893 with the immune checkpoint inhibitor tremelimumab was found to be safe, with clinical evidence of response in patients with advanced melanoma, according to phase I clinical trial data presented at the AACR Annual Meeting 2015, ...

palliative care
skin cancer

AACR 2015: Improved Responses With Ipilimumab-Nivolumab Combination vs Ipilimumab Alone in Advanced Melanoma

Giving the two immunotherapies ipilimumab (Yervoy) and nivolumab (Opdivo) simultaneously yielded better treatment responses than ipilimumab alone in patients with advanced melanoma who received no prior treatment, according to phase II clinical trial data presented at the AACR Annual Meeting 2015,...

palliative care
gynecologic cancer
pancreatic cancer
solid tumors

AACR 2015: Investigational CART-meso Immunotherapy Feasible for Patients With Advanced Cancers

Patients with advanced cancers who received mesothelin-directed chimeric antigen receptor–modified T cells (CART-meso), a type of investigational adoptive immunotherapy, tolerated the treatment well, and there was evidence that the infused immune cells persisted in the patients’ blood...

lung cancer
palliative care

Identifying Processes That Lead to Discontinuation of Chemotherapy for Patients With NSCLC at End of Life

According to a recent study by Perl et al published in the Journal of Oncology Practice, the administration of chemotherapy near death is recognized by patients, their families, and oncologists as “aggressive and poor-quality care.” Despite this, rates of end-of-life chemotherapy have...

palliative care
breast cancer

Women With Diabetes More Likely to be Diagnosed With Advanced-Stage Breast Cancer

Diabetes is associated with more advanced stage breast cancer, according to a new study by the Institute for Clinical Evaluative Sciences (ICES) and Women's College Hospital. The findings, published by Lipscombe et al in Breast Cancer Research and Treatment, confirm a strong link between diabetes...

pancreatic cancer
supportive care
palliative care

Palliative Care Consultation Associated With Less Aggressive End-of-Life Care in Advanced Pancreas Cancer

In a study reported in the Journal of the National Cancer Institute, Jang et al found that palliative care consultation was associated with decreased use of chemotherapy near death and lower risks of ICU admission, multiple emergency department visits, and multiple hospitalizations near death in...

palliative care

Japanese Study Indicates Death at Home Is Better for Terminally Ill Cancer Patients

In a Japanese study reported in the Journal of Clinical Oncology, Kinoshita et al found that death at home vs palliative care units or hospitals was better for terminally ill cancer patients and was not associated with an increased caregiver burden. Study Details The study included two...

palliative care
supportive care

Meaning-Centered Group Psychotherapy Improves Psychological Well-Being in Patients With Advanced Cancer

In a randomized trial reported in the Journal of Clinical Oncology, Breitbart et al found that meaning-centered group psychotherapy significantly improved psychological well-being compared with supportive group psychotherapy in patients with advanced or terminal cancer. Meaning-centered group...

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