survivorship
symptom management

ASCO 2018: More Choices for Treating Insomnia in Cancer Survivors: Acupuncture and Cognitive Behavioral Therapy

A Patient-Centered Outcomes Research Institute (PCORI)-supported randomized clinical trial of cancer survivors showed that 8 weeks of either acupuncture or cognitive behavioral therapy for insomnia (CBT-I) decreased the severity of insomnia among cancer survivors, though improvements were greatest...

issues in oncology
symptom management

National Survey Examines Oncologists' Practices, Beliefs on Medical Marijuana Use

Data from a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state...

Symptom Management

Planning for Potential Adverse Effects of Oral Chemotherapy

THE USE OF oral chemotherapy drugs is becoming more and more prevalent—for many types and stages of cancer, during different treatment phases, and for varying lengths of time. So it’s vital that physicians, nurses, and advanced practitioners understand all the potential adverse events of these...

Solid Tumors
Issues in Oncology
Symptom Management

NCCN Debuts Three New Sets of Guidelines

THE NATIONAL Comprehensive Cancer Network® (NCCN®) debuted three sets of completely new guidelines for treating patients with uveal melanoma, for treating patients who have cancer and the human immunodeficiency virus (HIV), and for managing immune-related toxicities.  Cancer in People Living With...

Symptom Management
Supportive Care
Solid Tumors
Breast Cancer

Acupuncture for Joint Pain Associated With Aromatase Inhibition

Although aromatase inhibitors are highly effective as adjuvant therapy in metastatic breast cancer and for prevention of breast cancer, the side effects can be difficult to tolerate and often lead to discontinuation of therapy. A phase III randomized trial has found that acupuncture may relieve...

issues in oncology
symptom management

Study of Patient-Reported Symptom Burden in First Year After Cancer Diagnosis

In a Canadian retrospective population-based study reported in the Journal of Clinical Oncology, Bubis et al found that patients with cancer reported higher symptom scores at 1 month after diagnosis and identified several factors associated with higher symptom scores. Study Details The study...

multiple myeloma
symptom management

Analysis of Carfilzomib-Related Cardiotoxicity

In a systematic review and meta-analysis reported in Leukemia & Lymphoma, Shah et al identified the risk of cardiotoxicity among patients, most with multiple myeloma, receiving carfilzomib (Kyprolis) in clinical trials. Study Details The study included data from 4,164 patients who received...

breast cancer
survivorship
symptom management

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors

In a Danish study reported in the Journal of the National Cancer Institute, Zachariae et al found that an Internet-delivered cognitive-behavioral therapy intervention improved insomnia among breast cancer survivors. Study Details In the study, 255 patients from a national sample of Danish breast...

hematologic malignancies
symptom management

Cognitive Decline Prevalent Among Elderly Patients With Hematologic Cancers

A sizable percentage of elderly patients with blood-related cancers such as leukemia and multiple myeloma are apt to show signs of diminished cognitive functioning—a decline that may impact their survival—a new study by investigators at Dana-Farber Cancer Institute and Brigham and...

Hematologic Malignancies
Symptom Management

EXPERT POINT OF VIEW: Robert Brodsky, MD

“THE RESULTS of these two trials are more similar than different. I think the best conclusion would be that we now have two trials with consistent results and can probably, in most cases, replace low–molecular-weight heparin with direct oral anticoagulants,” said Dr. Raskob, lead investigator of...

Hematologic Malignancies
Symptom Management

Use of Direct Oral Anticoagulants in Preventing VTE in Patients With Cancer

THE FIRST TWO randomized trials to directly compare direct oral anticoagulants vs low–molecular-weight heparin for management of venous thromboembolism (VTE) in patients with cancer suggest that direct oral anticoagulants may become the new standard of care.1,2 Direct oral anticoagulants appear to...

colorectal cancer
survivorship
symptom management

David Baraghoshi, on Colorectal Cancer and Cardiovascular Disease Risk

David Baraghoshi, of the Huntsman Cancer Institute at the University of Utah, discusses an assessment of cardiovascular risk more than 10 years after diagnosis for colorectal cancer survivors compared with a cancer-free general population cohort (Abstract 113).

supportive care
symptom management

ASCO and NCCN Provide Guidelines for Managing Immunotherapy Side Effects

Immunotherapy with immune checkpoint inhibitors is the first of a new generation of immunotherapy treatments, revolutionizing treatment for many different types of cancer. By unleashing the body's immune system to attack cancer, these treatments can send even the most hard-to-treat cancers into...

hematologic malignancies
symptom management

ASH 2017: Low–Molecular-Weight Heparin/Edoxaban vs Dalteparin for VTE Associated With Cancer

People with cancer face an increased risk for venous thromboembolism (VTE). Under current guidelines, cancer patients who develop VTE are prescribed low–molecular-weight heparin, an anticoagulant that must be injected under the skin daily for several months. While effective, this regimen can...

hematologic malignancies
symptom management

ASH 2017: Abatacept Nearly Eliminates Severe Acute GVHD After Hematopoietic Stem Cell Transplant

Results from a phase II clinical trial presented by Kean et al at the 59th American Society of Hematology (ASH) Annual Meeting (Abstract 212) show that the drug abatacept (Orencia) nearly eliminated life-threatening severe acute graft-versus-host disease (GVHD) in patients receiving hematopoietic...

Integrative Oncology
Symptom Management

Cognitive Behavior Therapy for Insomnia: Sleeping Well With Cancer and Beyond

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Sheila N. Garland, PhD, R Psych, and Jun J. Mao, MD, MSCE, present...

Symptom Management

FDA Approves Intravenous Rolapitant for Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting

ON OCTOBER 25, the U.S. Food and Drug Administration (FDA) approved intravenous (IV) rolapitant (Varubi) in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including...

palliative care
symptom management

Eric Roeland, MD, on Symptom Management: Expert Perspective

Eric Roeland, MD, of the University of California, San Diego, summarizes key papers delivered at the Palliative Care Symposium on managing insomnia, fatigue, nausea, and the ways in which physical therapy and nausea can reduce the side effect burden.

symptom management

Early Study Suggests Potential Role of Paclitaxel in Peripheral Neuropathy and Possible Preventive Measures

In discovering how certain chemotherapy drugs cause peripheral neuropathy, researchers at Dana-Farber Cancer Institute have found a potential approach to preventing this common and troublesome side effect of cancer treatment. Their findings were published by Pease-Raissi et al in Neuron. The...

symptom management

FDA Approves Intravenous Rolapitant for Delayed Chemotherapy-Induced Nausea and Vomiting

On October 25, the U.S. Food and Drug Administration (FDA) approved intravenous (IV) rolapitant (Varubi) in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including,...

Symptom Management

ASCO Clinical Practice Guideline Update on Antiemetics in Patients With Cancer

AS REPORTED BY Paul J. Hesketh, MD, of Lahey Hospital and Medical Center, Burlington, Massachusetts, and colleagues in the Journal of Clinical Oncology, ASCO has updated its clinical practice guideline on the use of antiemetics in patients with cancer.1 The update was based on an expert panel...

breast cancer
symptom management

Cryotherapy for Preventing Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer

A self-controlled clinical trial by Hanai et al investigating the efficacy of cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy in patients with breast cancer treated with paclitaxel has found that cryotherapy resulted in a clinically and statistically significant...

supportive care
symptom management

Tibetan Yoga Practice May Improve Sleep Quality for Patients With Breast Cancer Undergoing Chemotherapy

Participating in twice-weekly practice of Tibetan yoga may reduce sleep disturbances and improve sleep quality in breast cancer patients receiving chemotherapy, according to a study published by Chaoul et al in Cancer. The study, led by researchers from The University of Texas MD Anderson Cancer...

issues in oncology
symptom management

Assessing and Managing CAR T-Cell Treatment Toxicities

Immune-cell based therapies opening a new frontier for cancer treatment carry unique, potentially lethal side effects that provide a new challenge for oncologists—one addressed by a team led by clinicians at The University of Texas MD Anderson Cancer Center with proposed guidelines for...

Symptom Management

FDA Approves Betrixaban for Prophylaxis of Venous Thromboembolism

ON JUNE 23, 2017, the U.S. Food and Drug Administration (FDA) approved betrixaban (Bevyxxa) for the prophylaxis of venous thromboembolism in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderate or severe restricted mobility and...

Symptom Management

New ASCO Recommendations for Controlling Nausea and Vomiting Related to Cancer Treatment

AN UPDATE of the ASCO Clinical Practice Guideline covers new medicines for nausea and vomiting related to cancer treatment. The update, issued by Hesketh et al in the Journal of Clinical Oncology,1 provides new evidence-based information on the appropriate use of olanzapine, neurokinin 1 (NK1)...

issues in oncology
symptom management

Patients With Advanced Cancer Presenting to Emergency Departments With Delirium Likely to Die Earlier

According to a new study published by Elsayem et al in The Oncologist, patients with advanced cancer who are diagnosed with delirium when presenting to emergency departments are more likely to be hospitalized and more likely to die earlier than patients without delirium. This shows the importance...

supportive care
symptom management

FDA Expands Ibrutinib Indications to Chronic Graft-vs-Host Disease

On August 2, 2017, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica) for the treatment of adult patients with chronic graft-vs-host disease after failure of one or more lines of systemic therapy. This is the first FDA-approved therapy for the treatment of chronic...

symptom management

Understanding and Managing Radiation-Induced Bystander Effect

More than half of patients with cancer undergo radiotherapy. Due to a phenomenon known as radiation-induced bystander effect, in which irradiated cells leak chemical signals that can travel some distance to damage unexposed healthy cells, many suffer side effects such as hair loss, fatigue, and...

Hematologic Malignancies
Symptom Management
Supportive Care
Head and Neck Cancer
Pancreatic Cancer
Solid Tumors

NCCN Panelists Relay ‘What’s Hot’ in Their Fields

AT THE NATIONAL Comprehensive Cancer Network® (NCCN®) 22nd Annual Conference, experts from several fields met with journalists to highlight “what’s hot” in their specialties. The ASCO Post captured that conversation.  Myeloproliferative Neoplasms Guidelines  NCCN HAS LAUNCHED new NCCN Clinical...

Symptom Management

Expert Point of View: Joshua Jones, MD

ASCO EXPERT Joshua Jones, MD, Assistant Professor of Radiation Oncology at the Hospital of the University of Pennsylvania, Philadelphia, commented on the study at a press briefing.  “This is a case where less is more. This is an important study and the first to show equal outcomes and meaningful...

Symptom Management

Radiation Therapy for Spinal Cord Compression: One Treatment Is Sufficient

SPINAL CORD COMPRESSION associated with metastatic cancer can be effectively treated with a single dose of radiotherapy, according to the results of a phase III British study that showed multiple radiotherapy doses to be no better than one treatment.1  Up to 10% of all patients with cancer will...

hematologic malignancies
symptom management

FDA Approves Betrixaban for the Prophylaxis of Venous Thromboembolism

On June 23, 2017, the U.S. Food and Drug Administration (FDA) approved betrixaban (Bevyxxa) for the prophylaxis of venous thromboembolism (VTE) in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderate or severe restricted mobility...

Symptom Management

Expert Point of View: Monika K. Krzyzanowska, MD, MPH

Formal discussant of the trial, Monika K. Krzyzanowska, MD, MPH, of the Princess Margaret Cancer Center in Toronto, Canada, commented on this trial assessing patient-reported outcomes for symptom monitoring. “This abstract is relevant to all of us, regardless of what cancers we treat or where we...

Symptom Management

Online Self-Reporting of Symptoms Improves Quality of Life, Extends Survival

When patients with metastatic cancer used a Web-based tool to self-report symptoms proactively during treatment, they lived 5 months longer than did patients assigned to usual care. In addition, they had improved quality of life and fewer emergency room visits and hospitalizations compared with...

Breast Cancer
Symptom Management

Lymphedema Risk: It’s Not Just About the Surgery

In a study from the Mayo Clinic, Rochester, Minnesota, the risk of lymphedema in a population-based breast cancer cohort was related to multimodality therapy and not axillary surgery alone, investigators reported at the American Society of Breast Surgeons (ASBrS) Annual Meeting.1 “Most patients...

issues in oncology
cost of care
symptom management

ASCO 2017: Many Emergency Department Visits Among Patients With Cancer Appear Preventable

Among patients with cancer, as many as 53% of emergency department visits that do not require admission could be avoided with better symptom management and greater availability of outpatient care tailored to their needs, according to a new study from Fred Hutchinson Cancer...

symptom management

ASCO 2017: Web-Based System for Self-Reporting Symptoms Helps Patients Live Longer

A randomized clinical trial of 766 patients shows that a simple intervention—a Web-based tool that enables patients to report their symptoms in real time, triggering alerts to clinicians—can have major benefits, including longer survival. Patients with metastatic cancer who used the...

symptom management
pain management

Peter Hoskin, MD, on Spinal Compression: Results From the SCORAD III Trial

Peter Hoskin, MD, of Mount Vernon Cancer Centre, discusses study findings on single-dose radiotherapy compared with multifraction radiotherapy in patients with metastatic spinal canal compression. (Abstract LBA10004)

symptom management

ASCO 2017: Remote Therapy Program Improves Quality of Life, Lowers Distress After Cancer Diagnosis

Most patients experience significant distress after they are diagnosed with cancer. This distress not only erodes quality of life, but can also negatively affect the course of the disease and the patient’s ability to tolerate treatment. Yet few patients with cancer receive psychological...

pain management
symptom management

ASCO 2017: Single-Dose Radiotherapy as Effective as Multiple Fractions in Relieving Symptoms of Spinal Cord Compression

Spinal cord compression is a common complication in people with metastatic cancer and is a major detriment to quality of life. Radiation treatment is widely used to relieve pain and other symptoms, but there is no standard recommended schedule, and approaches currently vary. Findings from a phase...

Breast Cancer
Symptom Management

OPTIMIZE-2 Trial Offers Reassuring Data on Deescalation of Bisphosphonate Therapy for Breast Cancer–Related Bone Metastases

Bisphosphonates were first synthesized more than a century ago, with their initial usage restricted to a range of industrial processes until their potential clinical relevance was appreciated in the late 1960s.1 Then, following development for the treatment of osteoporosis and Paget’s disease of...

Breast Cancer
Symptom Management

Zoledronic Acid Every 12 Weeks Noninferior to Every 4 Weeks in Skeletal-Related Event Rate for Breast Cancer With Bone Metastases

In the phase III OPTIMIZE-2 trial reported in JAMA Oncology, Gabriel N. Hortobagyi, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that an every-12-week schedule of zoledronic acid was noninferior to an every-4-week schedule with regard to skeletal-related event...

symptom management

Update to Guideline for Management of Fever and Neutropenia in Children With Cancer and HSCT Recipients

An update to the 2012 International Pediatric Fever and Neutropenia Guideline Panel recommendations for management of fever and neutropenia in children with cancer and hematopoietic stem cell transplantation (HSCT) recipients was reported by Lehrnbecher et al in the Journal of Clinical Oncology....

Breast Cancer
Symptom Management

Saving My Hair Changed My Perception of Having Cancer

Getting a callback after a routine screening mammogram in 2013 did not set off any alarm bells. Having dense breasts has almost guaranteed receiving the dreaded callback ever since I started getting annual screenings. But when I got a second callback after additional images of a suspicious lesion...

breast cancer
symptom management

Joint Position Statement on Management of Aromatase Inhibitor–Associated Bone Loss in Postmenopausal Women With Hormone-Sensitive Breast Cancer

A new position statement, jointly published by seven international and European organizations, identifies fracture-related risk factors in patients treated with aromatase inhibitors and outlines key management strategies to help prevent bone loss and related fractures. It was published by Hadji et...

Supportive Care
Symptom Management

Utilizing Physiatrists to Evaluate and Manage Cancer-Related Cognitive Impairment

Chemotherapy-associated cognitive dysfunction, often referred to as “chemobrain” or “chemofog,” is a common occurrence during active cancer treatment and may continue after treatment is completed. However, since treatment other than chemotherapy, including radiation therapy, surgery, and hormonal...

hematologic malignancies
symptom management

FDA Removes Risk Evaluation and Mitigation Strategy Requirements for Erythropoiesis-Stimulating Agents

On April 13, the U.S. Food and Drug Administration (FDA) removed the risk evaluation and mitigation strategy (REMS) requirements for the use of epoetin alfa and darbepoetin alfa to treat patients with anemia due to associated myelosuppressive chemotherapy. The Agency's announcement regarding...

symptom management

Preclinical Research Suggests Potential Therapy for 'Chemobrain'

Findings offered by a University of Kansas (KU) researcher at the national meeting of the American Chemical Society in early April suggest a possible therapeutic intervention for “chemobrain,” the cognitive impairment that plagues up to a third of cancer patients following chemotherapy. ...

Supportive Care
Integrative Oncology
Symptom Management
Breast Cancer

Acupuncture for the Management of Hot Flashes

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, present a case study...

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