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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...

breast cancer

Is Observation Without Surgery a Viable Strategy for Managing Ductal Carcinoma in Situ?

In a spirited debate, abounding with citations of clinical trials and other evidence, but not without humor and mutual respect, E. Shelley Hwang, MD, MPH, and Armando E. Giuliano, MD, reviewed the data and their clinical experience managing ductal carcinoma in situ and reached opposite...

breast cancer
supportive care

Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression

“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...

gynecologic cancers

Expect Questions About the FDA Discouraging Use of Ovarian Cancer Screening Tests

The release of a U.S. Food and Drug Administration (FDA) Safety Communication “alerting women about the risks associated with the use of tests being marketed as ovarian cancer screening tests”1 and recommending against using these tests comes not as a result of startling new studies, but from an...

gynecologic cancers
issues in oncology

The FDA Urges Physicians and Patients to Forgo Ovarian Cancer Screening Tests

In a Safety Communication directed at women and physicians, the U.S. Food and Drug Administration (FDA) alerted women “about the risks associated with the use of tests being marketed as ovarian cancer screening tests” and recommended “against using currently offered tests to screen for ovarian...

issues in oncology
lymphoma
solid tumors

Media Reports of Dramatic Responses to Immunotherapy After All Else Fails May Prompt Patients to Seek It Out

Immunotherapy has received “a lot of attention, mainly because of the media coverage,” Anas Younes, MD, medical oncologist and Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York, said in an interview with The ASCO Post. “Many patients inquire, not about a specific...

colorectal cancer

Multiple Strategies for Colorectal Cancer Screening Offer an Opportunity for Shared Decision-Making

Screening for colorectal cancer should start at age 50 and continue until age 75, according to the updated recommendation from the U.S. Preventive Services Task Force (USPSTF).1 “Exactly what screening gets done is something that doctors and patients should decide together,” USPSTF Chair Kirsten...

colorectal cancer

Multiple Means to Realize the Benefits of Colorectal Cancer Screening

In an updated recommendation statement, the U.S. Preventive Services Task Force (USPSTF) continues to strongly recommend screening for colorectal cancer for asymptomatic adults aged 50 through 75; but rather than emphasize specific screening strategies, it notes there are multiple screening...

hematologic malignancies

Four-Biomarker Panel Identified for Chronic Graft-vs-Host Disease

In a study reported in the Journal of Clinical Oncology, Jeffrey Yu, MD, of the Indiana University School of Medicine, Indianapolis, and colleagues identified a four-biomarker panel that was predictive of chronic graft-vs-host disease after allogeneic hematopoietic cell transplantation. Discovery...

gastrointestinal cancer

Increased Risk of Gallbladder Cancer May Be Associated With Consuming Large Amounts of Sweetened Beverages

A large prospective Swedish study reported by Susanna C. Larsson, PhD, of the Unit of Nutritional Epidemiology at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden, and colleagues found a 2.2-fold increased risk of gallbladder cancer in people who consumed two or ...

colorectal cancer

Adding Adjuvant Oxaliplatin to Fluoropyrimidine May Be of Benefit in Deficient Mismatch Repair Colon Cancer

In a French retrospective study reported by David Tougeron, MD, PhD, of Poitiers University Hospital, Poitiers, France, and colleagues in the Journal of the National Cancer Institute, the addition of adjuvant oxaliplatin to fluoropyrimidine treatment improved disease-free survival in patients with...

cns cancers

Retroviral Replicating Vector That Delivers Cytosine Deaminase to Cancer Cells Active in Recurrent Glioblastoma

A phase I study by Timothy F. Cloughesy, MD, Director of the Neuro-Oncology Program at the UCLA Jonsson Comprehensive Cancer Center, and colleagues published in Science Translational Medicine investigated the effectiveness of vocimagene amiretrorepvec (Toca 511), an experimental nonlytic,...

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...

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