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Use Questions From Patients to Help Them Make Informed Treatment Decisions

Recent reports about treatment options for patients with ductal carcinoma in situ, and the ensuing debate and comments played out in the media, may prompt increased questions from patients. A review summarizing data about these treatment options concluded that surgery and radiation therapy “remain...

breast cancer

Surgery and Radiation Therapy Remain Standard of Care for Managing Ductal Carcinoma in Situ

A review of more than 50 studies (many randomized controlled trials) concluded that surgery and radiation therapy “remain standard-of-care treatment options” in the management of ductal carcinoma in situ.1 The review continues the widely reported discussion on managing ductal carcinoma in situ,...

solid tumors

Relatives of Patients With Carcinoma of Unknown Primary at Increased Risk for This and Other Cancers

Relatives of patients with carcinoma of unknown primary are at increased risk of developing this type of cancer themselves and several other malignant neoplasms, including lung, pancreatic, and colon cancers; non-Hodgkin lymphoma; and myeloma, according to a study published in JAMA Oncology. “Some...

prostate cancer
geriatric oncology

Significant Increased Risk of Noncancer Hospitalization Following Diagnosis of Prostate Cancer in the Elderly

Elderly men had a significant increase in the risk of noncancer hospitalizations following the diagnosis of prostate cancer, according to a population-based retrospective cohort study conducted by Amit D. Raval, PhD, and colleagues at West Virginia University, Morgantown. Results were published in...

Expect Questions About the New Rule on E-Cigarettes

“There are a lot of myths around new and emerging tobacco products, including e-cigarettes, and unfortunately, the biggest misconception is that these products are fairly or entirely harmless and risk-free,” Alexander V. Prokhorov, MD, PhD, said in an interview with The ASCO Post about a new...

issues in oncology

New FDA Rule Prohibits Sale of E-Cigarettes to Anyone Under Age 18 and Requires Warning Labels

A new rule extending U.S. Food and Drug Administration (FDA) oversight to all tobacco products, including electronic cigarettes (e-cigarettes), and banning the sale of these products to anyone under the age of 181 was hailed as a major advanced by many leaders of medical and health organizations....

breast cancer

Hormone Combination Therapy May Increase Risk of Breast Cancer in African American Women

The use of combination therapy with estrogen plus progestin, previously shown to be associated with an increased incidence of estrogen receptor–positive breast cancer in postmenopausal women in studies based largely on white women, has been shown to increase estrogen receptor–positive breast cancer ...

breast cancer

Some Diagnostic Variability in Interpreting Breast Biopsy Slides

Pathologists disagree about 8% of the time when interpreting a single breast biopsy slide, with more overinterpretation than underinterpretation in discordant cases, according to an analysis combining results from the B-Path (Breast Pathology) study with data on the prevalence of breast cancer...

breast cancer

Improved Survival With Shorter Delays Between Diagnosis and Surgery and Before Initiating Adjuvant Chemotherapy

The survival benefits of reducing the time to surgery following a diagnosis of breast cancer and the time to initiation of adjuvant chemotherapy following surgery were outlined in two articles and an accompanying editorial in JAMA Oncology. Analyzing two independent population-based studies with a...

prostate cancer

Severe Adverse Event Clusters Identified Using NCI Common Terminology Criteria

Using the National Cancer Institute’s Common Terminology Criteria for Adverse Events (CTCAE), researchers from Columbia University, New York, and Fred Hutchinson Cancer Research Center, Seattle, identified six severe adverse event clusters in patients with advanced prostate cancer. The clusters...

palliative care

Earlier Hospice Enrollment, Avoiding ICU Admissions, and Not Dying in the Hospital Associated With Perceptions of Better End-of-Life Care

Three measures of aggressive end-of-life care “were associated with relatively large differences in family member–reported quality ratings for end-of-life care and a lower likelihood that patients with advanced-stage cancer received care congruent with their preferences,” according to a study in...

Expect Questions About Potential Trade-Offs of Contralateral Prophylactic Mastectomy

Women who were diagnosed with breast cancer and had contralateral prophylactic mastectomy had only marginal improvement in psychosocial well-being, such as feeling confident and emotionally healthy, according to a study published in the Journal of Clinical Oncology.1 Those who also had breast...

breast cancer

Quality-of-Life Benefits of Contralateral Prophylactic Mastectomy May Be Too Small to Be Clinically Meaningful

Women diagnosed with breast cancer who chose contralateral prophylactic mastectomy reported improvement in psychosocial well-being and breast satisfaction, but “the magnitude of the effect may be too small to be clinically meaningful,” according to a study in the Journal of Clinical Oncology.1...

breast cancer

Hormone Combination Therapy May Increase Risk of Breast Cancer in African American Women

The use of combination therapy with estrogen plus progestin, previously shown to be associated with an increased incidence of estrogen receptor–positive breast cancer in postmenopausal women in studies based largely on white women, has been shown to increase this type of breast cancer...

breast cancer

Shorter Delays Between Diagnosis, Surgery, and Chemotherapy Initiation May Improve Survival in Breast Cancer

The survival benefits of reducing the time to surgery following a diagnosis of breast cancer, and time to initiation of adjuvant chemotherapy following surgery were outlined in two articles and an accompanying editorial in JAMA Oncology. Analyzing two independent population-based studies with a...

prostate cancer

Significantly Increased Risk of Noncancer Hospitalizations Following Diagnosis of Prostate Cancer in the Elderly

Elderly men had a significant increase in the risk of noncancer hospitalizations following the diagnosis of prostate cancer, according to a population-based retrospective cohort study conducted by Amit D. Raval, PhD, and colleagues at West Virginia University, Morgantown. Results were published in...

solid tumors
lymphoma
multiple myeloma

Relatives of Patients With Carcinoma of Unknown Primary at Increased Risk for This and Other Cancers

Relatives of patients with carcinoma of unknown primary are at increased risk of developing it themselves as well as several other malignant neoplasms, including lung, pancreatic, and colon cancers; non-Hodgkin lymphoma; and myeloma, according to a study published in JAMA Oncology. “Some of...

breast cancer

Some Diagnostic Variability in Interpreting Breast Biopsy Slides

Pathologists would disagree about 8% of the time when interpreting a single breast biopsy slide, with more overinterpretation than underinterpretation in discordant cases, according to an analysis combining results from the B-Path (Breast Pathology) study with data on the prevalence of breast...

geriatric oncology
breast cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was published in the Journal of Oncology Practice. The corresponding author...

skin cancer

Most Patients With Melanoma Had Few Nevi, None Atypical

Although nevi are considered among the strongest risk factors for melanoma, most patients with melanoma had few total nevi and no atypical nevi, according to an analysis of 566 patients with invasive cutaneous melanoma. “Three notable findings emerged from this case study,” Alan C. Geller, MPH, RN, ...

issues in oncology

Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy

Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

solid tumors

High Rate of Overuse of Serum Tumor Marker Testing

A retrospective review to evaluate the frequency of serum tumor marker testing “found a high rate of serum tumor marker testing overuse and extreme overuse in patients with advanced solid tumors,” Melissa K. Accordino, MD, of Columbia University College of Physicians and Surgeons, New York,...

colorectal cancer

Fecal Immunochemical Test Highly Sensitive and Effective When Used for Colorectal Cancer Annual Screening Programs

Annual screening with the fecal immunochemical test is highly sensitive for detecting colorectal cancer and “is feasible and effective for population-level colorectal cancer screening,” according to a large-scale retrospective cohort study assessing this test over four rounds of annual screening....

Expect Questions and Heightened Interest About Bilateral Mastectomy

Recently released data from the Agency for Healthcare Research and Quality (AHRQ) showed that the rate of mastectomies increased between 2005 and 2013, with much of that increase attributed to bilateral mastectomies among women with early-stage cancer in one breast opting for bilateral...

breast cancer

The Perplexing Increase in Bilateral Mastectomies

The increased rate of bilateral mastectomies, as shown in recently released data from the Agency for Healthcare Research and Quality (AHRQ), is “perplexing,” Ismail Jatoi, MD, PhD, told The ASCO Post. “We are seeing more and more women with unilateral breast cancer opt for bilateral mastectomy,...

prostate cancer
supportive care

Severe Adverse Event Clusters Identified Using NCI Common Terminology Criteria in Advanced Prostate Cancer

Using the National Cancer Institute’s Common Terminology Criteria for Adverse Events (CTCAE), researchers from Columbia University, New York, and Fred Hutchinson Cancer Research Center, Seattle, identified six severe adverse events clusters in patients with advanced prostate cancer. The...

supportive care

Family Perspectives Support Advance Care Planning With Patient Preferences in End-of-Life Care

Three measures of aggressive end-of-life care “were associated with relatively large differences in family member–reported quality ratings for end-of-life care and a lower likelihood that patients with advanced-stage cancer received care congruent with their preferences,”...

issues in oncology

Cultural Awareness and Sensitivity Among Surgeons Do Not Always Result in Culturally Competent Care

A survey of oncology surgeons from six hospitals in Washington State found that the surgeons in the sample “displayed and valued cultural awareness and sensitivity” but that “cultural awareness and sensitivity did not necessarily result in culturally competent behavior.” These findings highlight...

skin cancer

Melanoma-Specific Survival Significantly Higher With Wider Excision Margins

Among patients with high-risk, primary cutaneous melanomas, the risk of death from melanoma, at a median follow-up of 8.8 years, was significantly higher among those randomized to surgery with a 1-cm excision margin than among those randomized to surgery with a 3-cm excision margin. Although...

hematologic malignancies
leukemia

Increasing the Dose of Obinutuzumab Monotherapy Raised the Response Rate

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a 2,000 mg vs 1,000 dose. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

Questions From Younger Patients About Colorectal Cancer Should Be Addressed Promptly

A study in Cancer1 finding an increasing rate of colorectal cancer among patients under the age of 50 should serve to raise awareness about the need for testing among those with “red-flag” symptoms and earlier screening for those at high risk, the study’s corresponding author, Samantha Hendren, MD, ...

gastrointestinal cancer

‘Red-Flag’ Symptoms That Could Signal Colorectal Cancer in Patients Under 50 Years Old Should Be Taken Seriously

In clinical practice, Samantha Hendren, MD, MPH, has been “shocked by what a large proportion of patients we are seeing who are under 50 and presenting with colorectal cancer,” often with advanced disease due to delayed diagnosis. “And that is because patients and physicians don’t even think of...

breast cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older With Breast Cancer

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was reported by Shachar et al in the Journal of Oncology Practice. The...

skin cancer

Study Finds Most Patients With Melanoma Had Few Total Nevi and No Atypical Nevi

Although nevi are considered among the strongest risk factors for melanoma, most patients with melanoma had few total and no atypical nevi, according to a study of 566 patients with invasive cutaneous melanoma. “Three notable findings emerged from this case study,” Alan C. Geller, MPH, ...

issues in oncology

Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy

Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of...

solid tumors

Increased Cancer Mortality Among Recipients of Solid-Organ Transplants

Solid-organ transplant recipients have a higher rate of cancer mortality than that expected in the general population, according to a Canadian study published in JAMA Oncology. Cancer mortality among transplant recipients “was significantly elevated compared with the Ontario population,” with a...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

Expect Questions About Updated Dietary Guidelines

The 2015–2020 Dietary Guidelines for Americans1 have generated comments and controversy, with some organizations expressing concern that the guidelines did not recommend limiting the consumption of red and processed meat. These organizations include the American Institute for Cancer Research...

issues in oncology

Failure of Updated Dietary Guidelines to Advise Limiting Red and Processed Meat Deemed a ‘Missed Opportunity’

“A missed opportunity” is how Susan Higginbotham, PhD, RD, Vice President for Research, American Institute for Cancer Research (AICR), described the “failure” of updated dietary guidelines to recommend limiting consumption of red and processed meat. Doing so would have “the potential to save...

issues in oncology

Cultural Awareness and Sensitivity Among Oncology Surgeons Do Not Necessarily Result in Culturally Competent Care

A survey of oncology surgeons from six hospitals in Washington State found that the surgeons in the sample “displayed and valued cultural awareness and sensitivity” but that “cultural awareness and sensitivity did not necessarily result in culturally competent behavior.”...

solid tumors
issues in oncology

Serum Tumor Marker Testing Overused, Especially for Solid Tumors

A retrospective review to evaluate the frequency of serum tumor marker testing “found a high rate of serum tumor marker testing overuse and extreme overuse in patients with advanced solid tumors,” Melissa K. Accordino, MD, of Columbia University College of Physicians and Surgeons, New...

colorectal cancer
issues in oncology

Fecal Immunochemical Test Sensitive and Effective for Annual Colorectal Cancer Screening

Annual screening with the fecal immunochemical test is highly sensitive for detecting colorectal cancer and “is feasible and effective for population-level colorectal cancer screening,” according to a large-scale retrospective cohort study assessing the fecal immunochemical...

skin cancer

Melanoma-Specific Survival Significantly Higher With Wider Excision Margins

Among patients with high-risk, primary cutaneous melanomas, the risk of death from melanoma at a median follow-up of 8.8 years was significantly higher among those randomized to surgery with a 1-cm excision margin than among those randomized to surgery with a 3-cm excision margin. Although overall...

Expect Questions About Ovarian Cancer Screening

The authors of an ovarian cancer screening study published in The Lancet1 and many of the experts commenting on the study in the media agree that the results of multimodal screening are encouraging and could reduce mortality from ovarian cancer, but further follow-up is needed. Considering that the ...

Same Study, Different Interpretations

An article in The New York Times1 about an ovarian cancer screening study published in The Lancet2 is headlined, “Early Detection of Ovarian Cancer May Become Possible,” and leads with the promise of reduced mortality with multimodal screening for ovarian cancer. An article in MedPage Today3 about...

gynecologic cancers
issues in oncology

Could a Screening Test That Would Reduce Deaths From Ovarian Cancer Be on the Way?

"A solid triple but not a home run” is how Karen H. Lu, MD, characterized a study in The Lancet reporting a reduction in deaths from ovarian cancer with the use of multimodal ovarian cancer screening.1 Dr. Lu’s remark was one of several, mostly but not universally, favorable and optimistic comments ...

issues in oncology

Quality Improvement Projects Aim at Reducing Prescribing Errors for Chemotherapy

Two quality improvement projects described by Bryant-Bova in the Journal of Oncology Practiceresulted in reduced errors in prescribing intravenous and oral chemotherapy. A project at The University of Texas Medical Branch at Galveston outpatient infusion centers first identified 15 different types ...

colorectal cancer
hepatobiliary cancer
lung cancer
lymphoma

Increased Cancer Mortality Rate Among Recipients of Solid-Organ Transplants

Solid-organ transplant recipients have a higher rate of cancer mortality than what is expected in the general population, according to a Canadian study by Acuna et al published in JAMA Oncology. Cancer mortality among transplant recipients was significantly elevated compared with data for the...

leukemia

Increased Response Rate With Higher Dose of Obinutuzumab Monotherapy for Patients With Chronic Lymphocytic Leukemia

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a dose of 2,000 mg vs 1,000. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

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