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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...

Breast Cancer
Symptom Management
Survivorship

Expert Point of View: Ann H. Partridge MD, MPH

Ann H. Partridge MD, MPH, Director of Adult Cancer Survivorship Program at the Dana-Farber Cancer Institute, praised the “tremendous work” of Dr. Paskett and her colleagues but referred to the findings as “disappointing to say the least.”1 “Developing interventions to prevent or treat lymphedema...

Breast Cancer
Symptom Management
Survivorship

Search Continues for Effective Way to Prevent Lymphedema in Breast Cancer Survivors

There was no difference in the incidence of lymphedema at 18 months in breast cancer patients randomized to a physical therapy intervention with education materials compared with a control.1 Although poor adherence to the intervention may have been a factor, these results, described as “very...

symptom management

Dexamethasone Mouthwash in Preventing Everolimus-Related Stomatitis in Women With Breast Cancer

In the phase II SWISH study reported in The Lancet Oncology, Rugo et al found that use of a dexamethasone-based mouthwash may prevent everolimus-related stomatitis in postmenopausal women receiving everolimus (Afinitor) for hormone receptor–positive, HER2-negative metastatic breast cancer....

cost of care
symptom management

Laura E. Panattoni, PhD, on Costs of Preventable Emergency Department Use

Laura E. Panattoni, PhD, of the Fred Hutchinson Cancer Research Center, discusses results from a regional study on emergency department costs during cancer treatment and the need to focus on managing symptoms (Abstract 2).

symptom management

Ethan M. Basch, MD, on Symptom Control and Quality: The Patient’s Voice

Ethan M. Basch, MD, of The University of North Carolina at Chapel Hill, discusses programs—now rolling out at various institutions—that use direct patient reporting of symptoms as a part of quality assessment (Posters 61, 81; Abstract 218).

symptom management

Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue

Exercise and/or psychological therapy may work better than medications to reduce cancer-related fatigue and should be recommended first to patients, according to a Wilmot Cancer Institute-led study published by Mustian et al in JAMA Oncology. “If a [patient with cancer] is having trouble...

symptom management

Feasibility of Patient Reporting of Adverse Events in Cancer Clinical Trials

In a study reported in JAMA Oncology, Basch et al found that use of patient-reported outcome questionnaires to report symptomatic adverse events was feasible in the setting of multicenter cancer treatment trials. Study Details In the study, 361 consecutive patients enrolled in 1 of 9 U.S....

symptom management

FDA Approves Telotristat Ethyl for Carcinoid Syndrome Diarrhea

On February 28, the U.S. Food and Drug Administration (FDA) approved telotristat ethyl (Xermelo) tablets in combination with somatostatin analog therapy for the treatment of adults with carcinoid syndrome diarrhea that somatostatin analog therapy alone has inadequately controlled. About...

symptom management

Patient-Reported Outcomes for Assessing Symptom Burden in Patients Receiving Oral Anticancer Therapy

In a study reported in the Journal of Oncology Practice, Mackler et al found that use of a validated symptom assessment tool for patient-reported outcomes was feasible in evaluating symptom burden in outpatients receiving oral anticancer treatment in the clinical setting. Study Details The study...

palliative care
symptom management

Palliative Radiation Therapy for Bone Metastases: Update of an ASTRO Evidence-Based Guideline

The American Society for Radiation Oncology (ASTRO) recently published an updated clinical guideline that underscores the safety and effectiveness of palliative radiation therapy for treating painful bone metastases. Based on recent clinical trial data, the guideline recommends optimal radiotherapy ...

symptom management

Managing Patients With Low-Risk Neutropenic Fever at Cleveland Clinic Taussig Cancer Institute

In a study reported in the Journal of Oncology Practice, Goodman et al described a management practice for low-risk neutropenic fever in cancer patients that has reduced in-patient stay with intravenous antibiotic use at Cleveland Clinic Taussig Cancer Institute. Study Details In the study,...

Breast Cancer
Symptom Management

Randomized Trial Demonstrates Benefit of Scalp-Cooling in Prevention of Chemotherapy-Induced Hair Loss

A scalp-cooling device was found safe and effective in preventing chemotherapy-induced hair loss in women undergoing adjuvant treatment for breast cancer in an interim analysis of the first prospective, randomized trial of a modern scalp-cooling system. The study was presented at the 2016 San...

symptom management

How Does Sublingual Fentanyl Measure Up Against Subcutaneous Morphine in Managing Cancer Pain?

An Italian single-center trial compared treatment with sublingual fentanyl tablets and subcutaneous morphine in managing severe pain episodes in cancer patients receiving opioid treatment. In the Journal of Clinical Oncology, Zecca et al reported that the trial did not show noninferiority of...

breast cancer
symptom management

Electra D. Paskett, PhD, on Preventing Lymphedema: Results of a CALGB Study

Electra D. Paskett, PhD, of The Ohio State University Comprehensive Cancer Center, discusses an intervention that increased knowledge of lymphedema in breast cancer, and the personal story that drove her research (Abstract 104).

Hematologic Malignancies
Symptom Management

Expert Point of View: Kanti R. Rai, MD

Kanti R. Rai, MD, Professor of Medicine, Hofstra Northwell School of Medicine, New Hyde Park, New York, commented on these study findings. “I congratulate the investigators for a work done with discipline, excellent collaboration, and speed.” “All of us who have become familiar with ibrutinib...

Hematologic Malignancies
Symptom Management

Ibrutinib: A Potential Option for Chronic Graft-vs-Host Disease?

Currently, there is no U.S. Food and Drug Administration (FDA)-approved therapy for chronic graft-vs-host disease—a life-threatening consequence of stem cell or bone marrow transplant—that has not responded to corticosteroids, but this may be about to change. Ibrutinib (Imbruvica) achieved...

symptom management

Survivorship Symposium 2017: Physical and Psychological Factors Contribute to Decreased Physical Activity in 75% of Patients With Cancer

Although, in the past, patients with cancer were often counseled by their physicians to rest and reduce their physical activity, according to the American Cancer Society, emerging data are showing that exercise is not only safe and possible during cancer treatment, it can improve patients’...

breast cancer
symptom management

No Increased Risk of Skeletal Events in Patients With Bone Metastases Taking Zoledronic Acid

A new study published in JAMA reported that patients with bone metastases due to breast cancer, prostate cancer, or multiple myeloma who used zoledronic acid every 12 weeks compared with every 4 weeks did not have in an increased risk of skeletal events over 2 years. In this study, Andrew L....

symptom management

Comparison of Scales for Assessing Cisplatin-Related Ototoxicity in Children

In a study reported in the Journal of Clinical Oncology, Knight et al of the Children’s Oncology Group found that the Society for Industrial and Organizational Psychology Ototoxicity (SIOP) scale may be more sensitive than other classification systems in detecting ototoxicity in children...

breast cancer
symptom management

Effectiveness of Electroacupuncture for Sleep Disturbances in Patients With Breast Cancer and Hot Flashes

Studies suggest that approximately 30% to 40% of women with breast cancer report persistent hot flashes. Nocturnal hot flashes are among the most problematic because they can contribute to poor sleep. A new study published by Garland et al in Menopause shows that electroacupuncture may be effective ...

breast cancer
symptom management

Patricia A. Ganz, MD: Aromatase Inhibitors Data Review

Patricia A. Ganz, MD, of the UCLA Jonsson Comprehensive Cancer Center, summarizes two studies on using duloxetine for aromatase inhibitor–associated musculoskeletal symptoms, and aromatase inhibitors’ effect on endothelial function and heart disease (Abstracts S5-06 and S5-07).

breast cancer
symptom management

Anne Hudson Blaes, MD, on Aromatase Inhibitors and Cardiovascular Disease

Anne Hudson Blaes, MD, of the University of Minnesota, discusses the association between aromatase inhibitors, endothelial function, and early heart disease (Abstract S5-07).

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