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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...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age May 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...

SIDEBAR: Expect Questions from Your Patients and Colleagues

Patients of the Women’s Cancer Center at Fox Chase Cancer Center in Philadelphia often ask about ovarian cancer risk, the center’s Director, Robert A. Burger, MD, told The ASCO Post. Moreover, the recent study showing that bilateral salpingo-oophorectomy reduced that risk generated discussion among ...

gynecologic cancers

Hormone Replacement and Ovarian Cancer: Competing Risks in Decisions about Bilateral Salpingo-oophorectomy

Recently reported findings that bilateral salpingo-oophorectomy and hysterectomy decreased the risk of ovarian cancer compared to ovarian conservation and hysterectomy, without increasing cardiovascular, fracture, and other cancer risks, should “challenge” current thinking about bilateral...

SIDEBAR: 'It's Darwinian'

Depriving breast cancer cells of estrogen, whether by oophorectomy or treatment with tamoxifen or aromatase inhibitors, will induce “a crisis point, and about 80% of the cells will die off,” V. Craig Jordan, OBE, PhD, DSc, reported. After a while, “by chance, some of the cells that have the right...

SIDEBAR: Essence of Translational Research

I like to do research where there is a clear implication for human beings. In the clinical research I have been doing year after year, we have discovered things about human beings that can now be understood in the context of laboratory research that is being done. That’s the essence of...

breast cancer

‘Paradoxical’ Result Tying Estrogen to Reduced Risk of Breast Cancer Is Consistent with Laboratory Data

Results from the Women’s Health Initiative1 showing a decreased incidence of breast cancer among postmenopausal hysterectomized women who took estrogen replacement therapy (ERT) may seem paradoxical, but “comply exactly” with laboratory research, according to V. Craig Jordan, OBE, PhD, DSc,...

SIDEBAR: Expect Questions from Your Patients

The study of concurrent HPV and Pap testing for cervical cancer was widely reported even before the recent ASCO Annual Meeting. In an interview with The ASCO Post, Barnett Kramer, MD, was asked how physicians can respond to questions about the study from patients. “You can tell a woman over the...

gynecologic cancers

Cervical Cancer Screening Study Should Reassure Physicians and Patients that a 3-Year Screening Interval Is Safe and Effective

Results of a large-scale cervical cancer screening study using concurrent human papillomavirus (HPV) and Pap testing should “reassure” women over 30 who test negative for HPV and have normal Pap tests that “it is extremely safe to go 3 years” before being tested again, Barnett S. Kramer, MD, MPH,...

issues in oncology

Is Subspecialization an Option or a Necessity in Community Practices?

Should oncologists in community practices subspecialize? What would that mean for them and for their patients? These are some of the issues tackled in a Journal of Oncology Practice (JOP) Strategies for Career Success article entitled “Subspecialization in Community Oncology: Option or Necessity?”...

SIDEBAR: First International Conference on Integrative Care

Last March, nearly 250 oncology professionals and representatives of patient organizations, insurance companies, and government agencies from 12 countries attended the First International Conference on Integrative Care for the Future held in Amsterdam. Barrie R. Cassileth, PhD, chaired the event....

SIDEBAR: Making Evidence-based Integrative Medicine Part of Mainstream Cancer Care

During the 1960s and 1970s, the concept of a holistic approach to treating disease that took into account the body, mind, and spirit grew in patient popularity and morphed into two basic categories: alternative and complementary, which later became known by its acronym CAM (complementary and...

SIDEBAR: Timing of Prostate Cancer Drugs: Earlier But Not Too Early?

While sipuleucel-T, abiraterone, and cabazitaxel have been approved for patients with advanced disease, they might also be used in patients with earlier-stage disease, according to Christopher J. Logothetis, MD, of MD Anderson Cancer Center. “I think it is fair to say that they will be used better...

SIDEBAR: Expect Questions from Your Patients

Drugs for the treatment of prostate cancer have been in the news because of recent approvals by the FDA, the costs connected with their use, and associated improvements in survival.1 More recently reported was the decision to allow Medicare coverage of sipuleucel-T treatment for men who met the FDA ...

prostate cancer

Optimizing Treatment for Advanced Prostate Cancer Requires Shifting Focus from Individual Drugs to Integrated Therapies

Newer drugs, including sipuleucel-T (Provenge), cabazitaxel (Jevtana), and abiraterone (Zytiga), can extend survival modestly and ease symptoms for men with advanced prostate cancer. Maximizing the benefit to patients will require shifting the focus from developing individual drugs to developing...

lymphoma

Combined Therapy Produces Good Outcomes in Primary Testicular Diffuse Large B-cell Lymphoma

Final results of an international phase II trial of first-line treatment for primary testicular diffuse large B-cell lymphoma show that using a combined treatment strategy including chemotherapy and central nervous system and testicular prophlaxis “was associated with a good outcome.” The results...

SIDEBAR: Age at Diagnosis and Importance of Long-term Considerations

"Patients are willing to accept self-limited acute adverse effects associated with recovery” after brachytherapy and radical prostatectomy, according to the study authors. These effects “have been well documented for both modalities and are quite different. Late effects have been less well...

SIDEBAR: The Anonymity Advantage

This study has the advantage of not only being patient-reported but also of patient anonymity; the questionnaires were not administered or discussed with the patients by any of the treating physicians,” the study authors reported. “I know that patients often want to please their doctor. They don’t ...

prostate cancer

At 5 Years, Brachytherapy Shows Quality-of-life Advantages over Radical Prostatectomy for Favorable-risk Prostate Cancer

Five years after treatment for favorable-risk prostate cancer, men who either chose or were randomly assigned to receive brachytherapy reported quality-of-life advantages in urinary and sexual domains and in patient satisfaction compared to men who received radical prostatectomy, according to a...

SIDEBAR: Higher Postmastectomy Radiotherapy Rates at NCCN Institutions

While the investigators reported that overall only 54.8% of patients with high-risk breast cancer received postmastectomy radiation therapy, they also cited a report that 83.6% of high-risk patients treated at National Comprehensive Cancer Network (NCCN) institutions received such treatment....

SIDEBAR: Expect Questions from Your Patients

Women who have already undergone mastectomy and chemotherapy may question why additional breast cancer treatment is needed. Benjamin D. Smith, MD, of MD Anderson Cancer Center in Houston said that he frequently has patients referred to him who initially express their preference to avoid radiation...

breast cancer

Many Women Treated for High-risk Breast Cancer Do Not Receive Recommended Postmastectomy Radiation Therapy

Despite major studies showing that postmastectomy radiation therapy improves survival for women with high-risk breast cancer and evidence-based guidelines supporting the use of postmastectomy radiotherapy, 45% of these patients do not receive such treatment, according to an analysis of data from...

SIDEBAR: ASCO’s Role Recognized

One point that Paul H. Sugarbaker, MD, and David P. Ryan, MD, agreed on was that ASCO has done a service to the oncology community by presenting their debate about cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. That debate, conducted at the 2011 ASCO Annual Meeting, sparked...

SIDEBAR: Expect Questions from Patients and Colleagues

Among the merits of good clinical studies, according to David P. Ryan, MD, of Massachusetts General Hospital Cancer Center and Harvard Medical School, is being able to cite them when a physician sits down with a patient to explain the possible benefits and drawbacks of treatment. Dr. Ryan stressed, ...

colorectal cancer

‘Hot Chemotherapy’ Generates Heated Debate about Its Use with Cytoreductive Surgery to Manage Peritoneal Metastases

"Hot chemotherapy” has become the common term for hyperthermic intraperitoneal chemotherapy (HIPEC), which together with cytoreductive surgery is being used by some surgeons to treat patients with carcinomatosis from colorectal cancer. While HIPEC is not considered the most important component of...

SIDEBAR: Expect More Answers in the Future

“We are still following patients from the initial cohort,” reported Martin G. Sanda, MD, principal investigator of the study published in JAMA, “Prediction of Erectile Function Following Treatment for Prostate Cancer.” At a median follow-up now of about 6 years, “there is evidence that there might...

SIDEBAR: Expect and Encourage Questions from Your Patients

Patients and physicians need to be active coparticipants in discussions about prostate cancer treatment: “patients, by asking questions and making sure that doctors know their preferences—for example, how important sexual function or control of urination is to them—and clinicians, by inviting...

prostate cancer

Physicians Can Help Patients Set Realistic Expectations for Sexual Functioning after Treatment for Prostate Cancer

Models that can be personalized to predict erectile function of individual patients following treatment for early-stage prostate cancer have been developed and validated in a study involving a total of 2,940 men, and are ready for use in clinical practice, according to Martin G. Sanda, MD, the...

lung cancer

Time to Reconsider Treatment Paradigm for Elderly Patients with Advanced Non–Small Cell Lung Cancer?

Significantly longer median overall survival among elderly patients with advanced non–small cell lung cancer (NSCLC) receiving doublet chemotherapy rather than monotherapy yielded a 36% reduction in mortality risk in a phase III randomized trial. “We saw a survival benefit with doublet chemotherapy ...

SIDEBAR: Expect Questions from Your Patients

Young women with early-stage breast cancer “should be counseled appropriately regarding their treatment options, and should not choose a mastectomy based on the assumption of improved survival,” maintained investigators presenting a retrospective study at the 2011 Breast Cancer Symposium. Their...

breast cancer

Challenging Perceptions about Treatment Options for Younger Women with Early-stage Breast Cancer

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “There is a perception out there...

lung cancer

Improved Survival with Concurrent Chemotherapy plus Radiotherapy for Patients with Stage III Non–Small Cell Lung Cancer

Five-year survival was statistically significantly higher for patients with stage III non–small cell lung cancer (NSCLC) who received concurrent rather than sequential cisplatin-based chemotherapy combined with thoracic radiotherapy, according to the phase III Radiation Therapy Oncology Group...

breast cancer

Tamoxifen vs Surgery Study Shows Older Patients with Breast Cancer Can Achieve a ‘Personal Cure’

A truly final review—when all the patients in the trial have died and the cause of death is known for each—of a randomized trial comparing tamoxifen to surgery in patients over the age of 70 with operable breast cancer found no differences in the survival rates or deaths attributable to breast...

issues in oncology
solid tumors
hematologic malignancies

Solid Organ Transplant Recipients Have Increased Risk for Broad Range of Malignancies

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. The Transplant Cancer Match Study, a ...

SIDEBAR: Adding Trastuzumab to Adjuvant Chemotherapy

Adding trastuzumab (Herceptin) to adjuvant chemotherapy significantly improved disease-free survival of patients with resected stage I to III invasive HER2-positive breast cancer in the phase III North Central Cancer Treatment Group (NCCTG) N9831 trial. There was also a trend toward a further...

SIDEBAR: Expect Questions from Your Patients

“The message” of a meta-analysis of 17 randomized trials of breast-conserving surgery with or without radiation, “should be that the benefits of radiation are not temporary, that it provides an increased chance of cure,” Thomas A. Buchholz, MD, told The ASCO Post. The meta-analysis was conducted by ...

breast cancer

Benefits of Radiation after Breast-conserving Surgery Cut Risk of Recurrence in Half

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “After breast-conserving surgery,...

lung cancer

Presurgical Gemcitabine/Cisplatin Improves Survival in Lung Cancer

Preoperative gemcitabine plus cisplatin had a statistically significant impact on outcomes among patients with stage IIB/IIIA non–small-cell lung cancer in a phase III randomized study comparing surgery alone or surgery plus preoperative chemotherapy. The 3-year progression-free survival rates were ...

SIDEBAR: Expect Questions from Your Patients

The current lack of awareness about the high risk of venous thromboembolism (VTE) among people being treated for cancer as outpatients means “there’s a great role for provider education,” Alok Khorana, MD, told The ASCO Post. Here are Dr. Khorana’s answers to some likely questions from patients....

SIDEBAR: Clinical Trials of VTE Prophylaxis for Outpatients

Several studies are investigating low-molecular-weight heparins to reduce the risk of venous thromboembolism (VTE) among patients with cancer. “I enrolled patients in SAVE-ONCO,” Alok Khorana, MD, said, “but that trial used drug called semuloparin, which is not currently available in the United...

supportive care

Outpatients Need to Be Aware of High Risk of Developing Venous Thromboembolism

Most patients who develop venous thromboembolisms (VTE) while being treated for cancer, do so as outpatients, according to results of a retrospective, observational study comparing the incidence of VTE among inpatients and outpatients with cancer. Yet many outpatients do not even realize that they...

integrative oncology

Acupuncture Continues to Secure Position within Integrative Oncology

More than 14 years after an NIH Consensus Panel finding of “efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting,” an informal show-of-hands poll at the Eighth International Society for Integrative Oncology (SIO) Conference indicated acupuncture was not yet fully...

integrative oncology

NIH Director Calls for Rigorous Evaluation of Integrative Medicine to Provide Evidence of Efficacy

“Many new frontiers exist in integrative medicine,” NIH Director Francis Collins, MD, PhD, stated in his keynote address at the Eighth International Conference of the Society for Integrative Oncology (SIO) in Cleveland. “The evidence is overwhelming that these approaches are being used by many...

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