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breast cancer
genomics/genetics

Expect Questions About Genetic Testing for Breast Cancer

A STUDY finding that pathogenic variants in 5 genes are associated with a high risk of triple-negative breast cancer and a 20% lifetime risk for overall breast cancer1 may increase interest in genetic testing. “This is the first study to establish which genes are associated with high lifetime risks ...

breast cancer
genomics/genetics

Mutations in Five Genes Linked to Higher Lifetime Risks for Aggressive Breast Cancer

USING MULTIGENE hereditary cancer panels to test for mutations in five genes can identify women at high risk for triple-negative breast cancer who may then benefit from more frequent screening, risk management, and potentially targeted therapies as well. A study that looked at multigene panel...

Be Prepared to Assist Patients to Make Informed Decisions About Breast Reconstruction Options

Two studies about postmastectomy breast reconstruction were recently published in JAMA Surgery. One study found overall complication rates of 32.9% at 2 years after reconstruction, with women having autologous reconstruction more likely to have complications than those having implant...

breast cancer

Breast Reconstruction: ‘A Process Not a Procedure’ With Potential Short- and Long-Term Complications

The complication rate among women who underwent postmastectomy breast reconstruction was 32.9% at 2 years postoperatively, and women undergoing autologous reconstruction “had significantly higher odds of developing any complication compared with those undergoing expander-implant reconstruction,”...

integrative oncology
breast cancer

Be Prepared to Answer—and Ask—Questions About Integrative Therapy

ASCO HAS ENDORSED the recommendations in the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer.1,2 The guidelines “are clear, thorough, and based on the most relevant scientific evidence,” wrote the ASCO expert panel that...

breast cancer
integrative oncology

ASCO Endorses Guidelines for Integrative Therapies During and After Breast Cancer Treatment

RECOMMENDATIONS IN the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer treatment “are clear, thorough, and based on the most relevant scientific evidence,” concluded an ASCO expert panel that reviewed the guidelines.1,2...

issues in oncology

In Cases Where Early Detection of Metastatic Disease Offers No Advantage, Why Conduct Routine Surveillance?

“What is a reasonable plan of follow-up for patients with cancers for which early detection of metastatic disease offers no advantage?” Posing that question during his Presidential Address at the 2018 Society of Surgical Oncology (SSO) Annual Cancer Symposium, Kelly M. McMasters, MD,PhD,...

pancreatic cancer

Using Neoadjuvant Therapy to Reduce Early Recurrences, Increase Survival in Patients With Pancreatic Cancer

USE OF THE FOLFIRINOX regimen (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a 4.9-month improvement in overall survival compared to gemcitabine/ nab-paclitaxel (Abraxane) in the neoadjuvant treatment of resectable and borderline-resectable pancreatic head...

When Patients Are Open to Lifestyle Changes: Take Advantage of ‘Unique Window of Opportunity'

Colon cancer survivors who followed guidelines for healthy eating, maintaining a healthy weight, and staying physically active had higher 5-year survival rates than those who did not adhere to those guidelines, according to a study among 992 patients treated with stage III colon cancer.1 The 5-year ...

solid tumors
colorectal cancer

Following Guidelines for Healthy Eating and Physical Activity May Improve Survival in Patients Treated for Colon Cancer

Following guidelines for proper nutrition, maintaining a healthy weight, and staying physically active may improve survival among patients treated for colon cancer, according to the results of a study with nearly 1,000 patients followed for a median of 7 years.1 “The study suggests that if...

skin cancer
immunotherapy

Surgery After Checkpoint Blockade for Selected Patients With Metastatic Melanoma

“In the era of improved systemic therapy, checkpoint blockade for metastatic melanoma and the ability to surgically resect all disease after treatment are associated with survival of 75%, better than what has been previously reported,” Danielle M. Bello, MD, said in summarizing study results during ...

Anticipate Concerns About Radiotherapy For Breast Cancer

A study examining the patient’s perspective on breast radiotherapy found that 68% of the patients surveyed responded that they had little or no prior knowledge of radiotherapy at the time of breast cancer diagnosis, making that an excellent time for physicians and other health-care professionals to ...

solid tumors
breast cancer

Dispel Fears About Breast Cancer Radiotherapy With ‘Real Truth’ About Modern Techniques and Side Effects

Nearly 85% of patients surveyed 6 or more months after completing radiotherapy as part of their treatment for breast cancer reported the side effects were not as bad as they had feared or expected. Approximately 92% of the 269 patients treated with breast conservation and 81% of the 58 patients...

Norman Wolmark, MD, and Bernard Fisher, MD, Honored for Leadership of NSABP

NORMAN WOLMARK, MD, and Bernard Fisher, MD, received the Society of Surgical Oncology (SSO) Distinguished Service Award for their work leading the National Surgical Adjuvant Breast and Bowel Project (NSABP). Dr. Wolmark, who succeeded Dr. Fisher as Chair of the NSABP and is currently Group Chair...

The Clinical Significance of Clinicaltrials.gov

“I think I found the trial that is going to save your life,” Stefanie Joho’s sister said after checking out the ClinicalTrials.gov website. “And sure enough, it did. That is not an exaggeration. That is exactly what happened,” Ms. Joho, a health advocate and consultant based in Philadelphia, told...

immunotherapy

Encourage Patients To Promptly Report Immunotherapy Side Effects

Physicians can be proactive in alerting patients to possible adverse effects of immunotherapy and in encouraging patients to report them. “It is important to emphasize that whenever a patient develops a new symptom, always considering that this might be an immune-related side effect. We need to...

solid tumors
supportive care
immunotherapy

Physician-Patient Partnership Is Key to Recognizing and Managing Side Effects of Immune Checkpoint Inhibitors

“Immunotherapy has a completely different side-effect profile than chemotherapy, and that has caught physicians off guard,” noted Drew Pardoll, MD, PhD, in an article published earlier this year in The Washington Post.1 Since then, efforts have moved forward on several fronts to bring physicians,...

issues in oncology
survivorship

Adolescent and Young Adult Cancer Survivors Often Struggle With Reproductive and Sexual Health Concerns

FOR MANY adolescents and young adults (AYAs), the most distressing and troubling phase of the cancer continuum that began with diagnosis is survivorship, and among the toughest challenges are those involving sexual health and reproduction, Jessica Gorman, PhD, MPH, stated at the 11th Annual...

solid tumors
prostate cancer

Combined Medical and Psychological Approach May Help Couples Reclaim Intimacy After Prostate Cancer Treatment

“To what extent do treatments for prostate cancer impact sexual functioning? To a great extent,” Christian Nelson, PhD, Chief, Psychiatry Service, Memorial Sloan Kettering Cancer Center, New York, told participants at the 11th Annual Oncofertility Consortium Conference in Chicago.1 Most men with...

Expect Questions About Necessity of Chemotherapy for Early-Stage Breast Cancer

“For patients with early-stage breast cancer, we’ve seen a significant decline in chemotherapy use over the past few years without a real change in evidence,” or in national guidelines and recommendations, reported Allison W. Kurian, MD, MSc, lead author of a study on chemotherapy recommendations ...

solid tumors
breast cancer

Steep Decline in Chemotherapy Use for Early-Stage Breast Cancer

The use of chemotherapy to treat women with early-stage breast cancer “declined markedly over time,” according to analysis of data from 2,926 women between the ages of 20 and 79. The trends documented “are remarkable for their steepness of decline, independent of clinical factors and despite no...

issues in oncology
survivorship

Preserving Sexual Function in Women Treated for Cancer

“There is huge potential to positively influence a patient’s experience and outcomes” by addressing concerns about sexual function after cancer treatment early in the course of treatment planning, Stacy Tessler Lindau, MD, MA, stated in her keynote address at the 11th Annual Oncofertility...

Expect Questions About Link Between Alcohol and Cancer

With headlines such as “Cutting back on alcohol can prevent cancers”1 and “Even light drinking may raise your cancer risk,”2 media reports may be generating questions from patients about the ASCO statement summarizing evidence linking alcohol to an increased risk of cancer.3 “What I personally...

Oncologists Urged to Be Proactive in Advising Patients to Reduce Risk of Alcohol-Related Cancers

A recently released ASCO statement summarizing extensive evidence linking alcohol use to an increased risk of several leading cancers, including breast, colon, and head and neck, called on oncologists “as front-line providers for cancer patients” to help patients reduce excessive alcohol use.1...

solid tumors
breast cancer

Preparing for Steep Increase in Breast Cancer Among the Elderly

“We are in the midst of a steep increase” in the incidence of breast cancer among women aged 65 years and older, Arti Hurria, MD, reported at the 19th Annual Lynn Sage Breast Cancer Symposium, Chicago.1 “Are we prepared as a health-care system and as providers to address this burgeoning need?” she...

issues in oncology
pain management

EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION

INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...

pain management

Relieving Pain During an Opioid Epidemic

“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...

breast cancer

Computer-Based Support May Allow Physicians to Spend More Time on ‘Human Aspects of Cancer Care’

As computer-based physician support systems for decision-making in cancer management continue to evolve, “we will come to embrace this as something that liberates us to spend more time on the human aspects of cancer care,” Andrew D. Seidman, MD, told participants at the 2017 Lynn Sage Breast Cancer ...

breast cancer

What Can We Do Differently for Premenopausal Patients With Breast Cancer?

While age remains a major risk factor for breast cancer, with nearly 80% of new cases occurring in women aged 50 years and older, women diagnosed at a younger age generally have poorer outcomes. This is partly because premenopausal women are more likely to have triple-negative breast cancer, which ...

solid tumors
breast cancer

Where Are We Now in Triple-Negative Breast Cancer?

The treatment of triple-negative breast cancer is rapidly evolving, as clinical trials continue to test chemotherapy agents and combinations and immunotherapy studies promise potentially “game-changing” interventions early in the course of disease, Joyce O’Shaughnessy, MD, reported at the 19th...

solid tumors
breast cancer

Gauging the Impact of Weight Loss Intervention on Breast Cancer Outcomes

“Growing research suggests that body weight is not only related to the risk of developing malignancy, but also prognosis after diagnosis, especially in breast cancer,” said Jennifer A. Ligibel, MD, of Dana-Farber Cancer Institute and Harvard Medical School, at the 19th Annual Lynn Sage Breast...

BE PREPARED TO ENCOURAGE HPV VACCINATION

“Human papillomavirus (HPV) vaccination coverage lags behind coverage for the other vaccines recommended for preteens,” according to the Centers for Disease Control and Prevention (CDC).1 A recent report about vaccination coverage in the United States among adolescents aged 13 to 17 found that...

issues in oncology

For HPV Vaccine to Have Optimal Impact, ‘Provider Hesitancy’ Must Be Overcome

Honoring National Cancer Institute researchers Douglas R. Lowy, MD, and John T. Schiller, PhD, with the Lasker-DeBakey Clinical Medical Research Award for advances in technology that enabled the development of human papillomavirus (HPV) vaccines to prevent cervical cancer and other tumors caused by ...

cns cancers

Expect Questions About Glioblastoma Symptoms

WITH THE MANY NEWS REPORTS about Senator John McCain being diagnosed with glioblastoma, patients may be asking if symptoms such as headaches and vision or speech problems should signal the need for screening or diagnostic tests. “There has never been any suggestion that doing routine screening,...

cns cancers

‘Substantial Improvements’ in the Treatment of Glioblastoma

NEWS ARTICLES about Senator John McCain’s diagnosis of glioblastoma accurately describe glioblastoma as aggressive and having a poor prognosis. But as Walter J. Curran, Jr, MD, pointed out in one of those reports, “substantial improvements in surgical approaches” have enabled more patients to...

Look for Opportunities to Lower Barriers to ­Participation of Older Patients in Oncology Clinical Trials

Practicing evidence-based medicine requires evidence, but the evidence for efficacy and safety of new and evolving cancer therapies in older adults is wanting due to their underrepresentation in oncology clinical trials. “It is difficult to practice evidence-based medicine in an older population...

geriatric oncology
issues in oncology

‘Slow, Incremental Changes’ Are Increasing Participation of Older Adults in Clinical Trials

Older adults continue to be proportionally underrepresented in oncology clinical trials, but the participation rate of adults aged 65 and older is increasing by “slow, incremental changes,” Stuart M. Lichtman, MD, noted in an interview with The ASCO Post. Prompting those changes are the rapidly...

genomics/genetics

Convergence of Precision Medicine and Immuno-oncology

“THE CONVERGENCE of two very hot and interesting topics—precision medicine and immuno-oncology”—is being advanced by next-generation sequencing, Douglas B. Johnson, MD, MSCI, made clear at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine,” sponsored by the Robert H. Lurie ...

skin cancer

Spark Discussions About Indoor-Tanning Devices

“Strong evidence suggests that using a tanning bed during adolescence or young adulthood can increase the risk of early-onset melanoma by over 40%,” Jeffrey E. Gershenwald, MD, wrote in an opinion piece for Newsweek.1 Dr. Gershenwald is Professor of Surgical Oncology, Medical Director of the...

skin cancer

Educating Young People on Sun-Safe Behaviors and Reducing the Risk of Melanoma

“If minors don’t tan, then they may never become adult tanners,” Jeffrey E. Gershenwald, MD, said in explaining the emphasis on teaching sun safety behaviors to young children as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center, Houston. Dr. Gershenwald is ...

issues in oncology

What About Sharing Clinical Data?

IN RESPONSE to a question during the Lurie Cancer Center OncoSET Symposium about sharing clinical data, Warren Kibbe, PhD, Acting Deputy Director of the National Cancer Institute, acknowledged “it is still very problematic,” but “there is an opportunity for meaningful use.” He said that the...

solid tumors
genomics/genetics
hematologic malignancies

Update on NCI Projects Aimed at Advancing Precision Medicine

“PRECISION MEDICINE will lead to fundamental understanding of the complex interplay among genetics, epigenetics, nutrition, environment and clinical presentation, and direct effective, evidence-based prevention and treatment. We can’t measure all that all at once right now, but we are starting to...

genomics/genetics

Identifying Genetic Basis for Extraordinary Clinical Responses May Accelerate Development of New Therapies

Accelerating the discovery of targeted cancer therapies requires defining the targets present in individual tumors, and there are two main ways to do this, David B. Solit, MD, told participants at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine in Chicago.1 The...

prostate cancer

Expect Questions About Shift in Prostate Cancer Screening Recommendation

A draft recommendation from the U.S. Preventive Services Task Force (USPSTF) advises that for men aged 55 to 69, the decision to be screened for prostate cancer should be an individual one, based on the man’s own values and priorities and discussions with a clinician about the potential benefits...

prostate cancer

USPSTF Emphasizes Importance of Informed Discussions About PSA Screening for Men Aged 55 to 69 Years

For a man aged 55 to 69 years, the decision to be screened for prostate cancer should be an individual one, based on the man’s own values and priorities and discussions with a clinician about the potential benefits and harms of screening, the U.S. Preventive Services Task Force (USPSTF) advised in ...

Expect Questions From Patients Who ‘Do Everything Right’ but Still Develop Cancer

A study reported in Science found that more than two-thirds of human cancers are caused by random mutations made during DNA replication.1 “The main message we would like to convey is that even for many patients who follow all of the guidelines from the advisory bodies—they don’t smoke, exercise...

genomics/genetics

Recognizing Major Role of Random Mutations in Causing Cancer Does Not Diminish Importance of Primary Prevention

Random mistakes made during DNA replication are responsible for about two-thirds of the mutations that cause human cancers, according to a study reported in Science.1 Recognizing the role of these replication errors “does not diminish the importance of primary prevention but emphasizes that not all ...

skin cancer

Expect Questions About Continued Risk of Melanoma

Survivors of melanoma are more likely to limit their exposure to ultraviolet radiation than those who have not had the disease, but more than 10% continue to intentionally tan, according to a study published in Cancer Epidemiology, Biomarkers and Prevention.1 The study surveyed 724 people diagnosed ...

skin cancer

Some Melanoma Survivors Continue to Seek Sun Exposure, Risking Second, Potentially More Serious Melanoma

Long-term survivors of melanoma are more likely than those who have not been diagnosed with the disease to use sunscreen, protective clothing, and other means to limit exposure to the sun, according to a survey of melanoma survivors and controls about ultraviolet radiation exposure and protective...

head and neck cancer

Deintensifiying Treatment of HPV-Positive Oropharyngeal Cancer Could Reduce Toxicity While Maintaining Function and Survival

“The status quo for HPV [human papillomavirus]-associated oropharyngeal squamous cell carcinoma is not sufficient.… Our treatment is effective, but the toxicity associated with it is not tolerable.” And HPV-associated oropharyngeal cancer “is a cancer of relatively younger patients,” said Nishant...

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