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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...

colorectal cancer

Expect Questions About Colorectal Cancer Among Younger Adults

Publicity surrounding a recent study showing a sharp increase in colorectal cancer among young people, even those in their 20s,1 may result in increased patient visits and questions. Among people aged 20 to 39, colon cancer rates have increased 1% to 2.4%, and rectal cancer rates have increased...

gastrointestinal cancer
colorectal cancer
issues in oncology

Increased Recognition of Colorectal Cancer in Young Adults, Even Those Aged 20 to 29, as Evidence Continues to Accumulate

The incidence of colorectal cancer continues to increase among young adults, with the sharpest increase among those aged 20 to 29, according to a recent article in the Journal of the National Cancer Institute.1 This trend has been called disturbing and ominous, but the widely reported results of...

head and neck cancer

Developing Better Multidisciplinary Strategies

“More than any other disease, head and neck cancer requires constant interplay between a number of different specialties,”  Sandeep Samant, MD, Chief, Head and Neck Surgery, Northwestern Medicine, and Chair of the Multidisciplinary Head & Neck Symposium sponsored by the Robert H. Lurie...

head and neck cancer

Making the Case for Sentinel Node Biopsy in Early Cancers of the Oral Cavity

“The majority of patients with oral cavity cancers will undergo an unnecessary operation,” ­Sandeep Samant, MD, stated at a session on managing N0 neck cancer at the 2016 Lurie Cancer Center Multidisciplinary Head & Neck Symposium in Chicago.1 That operation is elective neck dissection, and it ...

gynecologic cancers

Expect Questions About the Cervical Cancer Mortality Study

A widely reported study found that cervical cancer mortality was higher and the racial disparity between black and white women greater than previously reported.1 The study omitted from the mortality estimates those women who had undergone hysterectomies, usually involving removal of the cervix....

gynecologic cancers

Cervical Cancer Mortality Is Higher and Racial Disparity Wider Than Previously Reported

Cervical cancer mortality rates were significantly higher, particularly among black women, when national data were corrected to exclude women who have had hysterectomies. For black women, the cervical cancer mortality rate rose from 5.7 to 10.1 per 100,000 when corrected for hysterectomy, an...

head and neck cancer

Immunotherapy for Head and Neck Cancer: ‘The Fourth Modality Has Arrived’

“This is a big deal. This is going to change all of oncology, not just head and neck cancer,”1 Tanguy ­Seiwert, MD, remarked following a summary by Jeffrey Sosman, MD, on advances in immunotherapy for treating cancer.2 Dr. Sosman, Director of the Melanoma Program and Clinical Director of Cancer...

colorectal cancer

Addition of Cetuximab to Chemoradiotherapy for Anal Carcinoma

In a phase II trial (Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group E3205) reported in the Journal of Clinical Oncology, Garg et al found that the addition of cetuximab (Erbitux) to definitive chemoradiotherapy appeared to reduce the rates of...

issues in oncology

Continued Reduction in Cancer Mortality Requires Increasing Healthy Behaviors and Removing Inequities in Care

Many news reports about the latest cancer statistics released by the American Cancer Society (ACS) have focused on the 25% reduction in cancer mortality since 1991. Several reports quoted ACS Chief Medical Officer Otis W. Brawley, MD, FACP, who said in a statement1 announcing the publication of...

issues in oncology
survivorship

Update on Fertility Outcomes Among Survivors of Childhood Cancer

“Estimates suggest that by the year 2020, there will be over 500,000 adult survivors of childhood cancer in the United States,” Daniel A. Mulrooney, MD, MS, of the Division of Cancer Survivorship, St. Jude Children’s Research Hospital, Memphis, reported at the 10th Oncofertility Conference in...

issues in oncology

Optimizing Access to Fertility Preservation Options

Ensuring that people with cancer understand how cancer treatment could affect their fertility and what options are available for preserving fertility were widely recognized as top priorities by attendees of the 2016 Oncofertility Conference in Chicago. As detailed at the conference, means of...

breast cancer
issues in oncology

Managing Breast Cancer in a Pregnant Patient

“One of the most challenging oncologic situations that I face as a clinician is the diagnosis of breast cancer in a young pregnant patient,” ­Jacqueline Jeruss, MD, PhD, Director of the Breast Care Center at the University of Michigan Comprehensive Cancer Center, Ann Arbor, told the more than 250...

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...

Expect Questions About Cardiovascular Risk Factors Among Cancer Survivors

Reports of rare, but in some cases fatal, cardiac complications when the checkpoint inhibitors ipilimumab (Yervoy) and nivolumab (Opdivo) are used in combination should be taken seriously but should not scare patients away from potentially life-saving drugs, according to Javid J. Moslehi, MD. Dr....

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,...

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 ...

breast cancer

Clinical Strategies for Improving Endocrine Therapy in Metastatic Breast Cancer

Most women with hormone receptor–positive breast cancer receive endocrine therapy as part of their treatment, but “the reality is that patients who receive antihormone therapy in the metastatic disease setting ultimately develop disease progression, ” William J. Gradishar, MD, stated at the 18th...

breast cancer

Androgen Receptor Antagonists May Meet ‘Unmet Need’ in Triple-Negative Breast Cancer

Although there are no androgen receptor antagonists currently approved for the treatment of breast cancer, clinical trials indicate that these agents benefit some patients with triple-negative breast cancer, Tiffany A. Traina, MD, told participants at the 18th Annual Lynn Sage Breast Cancer...

pain management
symptom management
supportive care
issues in oncology

Expect Questions About Medical Marijuana

“Whether or not individual professionals support the clinical use of herbal cannabis, all clinicians will encounter patients who elect to use it and therefore need to be prepared to advise them on cannabis-related clinical issues despite limited evidence to guide care,” according to a recently...

When Marijuana Was Legal in the United States

Marijuana, or cannabis, used to be legal in the United States and was “actually listed in the U.S. formulary in 1854,” according to Judith A. Paice, PhD, RN, Director, Cancer Pain Program, Division of Hematology-Oncology at Northwestern University, Feinberg School of Medicine, Chicago. “Many of...

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...

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