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kidney cancer

Pulmonary Radiotherapy Can Usually Be Omitted for Nephroblastoma and Pulmonary Metastases

For the majority of patients with nephroblastoma and pulmonary metastases, pulmonary radiotherapy can be omitted and the patients will still have a relatively good outcome, according to a study published in the Journal of Clinical Oncology. “The rationale of omitting pulmonary [radiotherapy] for...

issues in oncology

Media Campaign with Real Smokers a Success

Real smokers sharing in graphic terms what it is like to live with disfiguring or disabling tobacco-related diseases were the featured spokespersons for the Centers for Disease Control and Prevention (CDC) national media campaign to encourage smokers to quit. Based on short-term response, the CDC...

lymphoma

Novel Mechlorethamine Gel Considered Safe and Effective for Treatment of Mycosis Fungoides

A novel mechlorethamine, 0.02%, gel produced comparable or higher response rates (depending on the measurement used) than did mechlorethamine, 0.02%, compounded ointment, in a randomized controlled, multicenter study among 260 patients with stage IA to IIA mycosis fungoides, the most common form of ...

SIDEBAR: Randomized Trial of Weight Loss and Cancer Risk Not Feasible

“We have not had a randomized controlled trial of weight loss among people at risk for cancer who don’t yet have the disease, where we can show that weight loss reduces the risk for cancer. And we never will,” Rachel Ballard-Barbash, MD, MPH, told The ASCO Post. “We know from a number of very...

Expect Questions from Patients about Impact of Weight on Prognosis

Increased awareness of the strong association between obesity and higher rates of cancer recurrence and mortality needs to be transmitted from oncologists to patients, but the message needs to concern more than just weight, according to Rachel Ballard-Barbash, MD, MPH, Associate Director of the...

Strong Association Increasingly Recognized Between Obesity and Cancer Incidence/Poor Prognosis

The rise in obesity in the United States coincides with greater recognition of the role of obesity in cancer and other diseases.1 While decades of research have indicated a strong association between obesity and cancer, “several forces have made that association increasingly recognized,” according...

Risk Reduction for Patients with Multiple Primary Cancers

The number of patients with multiple primary cancers is increasing so that second malignant neoplasms now represent approximately 16%, or 1 in 6 cancers reported to the Surveillance, Epidemiology, and End Results (SEER) Program. While some second malignant neoplasms are treatment-related, others...

Options Shifting for First-line Treatment of Renal Cell Carcinoma

Trials with pazopanib (Votrient) have “provided significant efficacy, toxicity, and tolerability data for pazopanib to be established as a first-line standard of care” for renal cell carcinoma,” Tim Eisen, PhD, of the University of Cambridge, United Kingdom, stated at the 11th International Kidney...

hepatobiliary cancer

Lower Risk of Recurrence in Patients with HBV-related Liver Cancer Receiving Nucleoside Analogs

Patients with hepatitis B virus (HBV)-related hepatocellular carcinoma who received nucleoside analogs after curative liver resection had an associated lower risk of hepatocellular carcinoma in a nationwide cohort study using data from the Taiwan National Health Research Data Base. The study was...

sarcoma

Interval-compressed Chemotherapy More Effective with No Increase in Toxicity

A randomized controlled trial among patients with newly diagnosed localized Ewing sarcoma found that “chemotherapy administered every 2 weeks is more effective than chemotherapy administered every 3 weeks, with no increase in toxicity,” investigators from the Children’s Oncology Group reported in...

breast cancer

Small Increase in Cardiac Events for Trastuzumab plus Anthracycline in HER2-positive Disease

A 7-year follow-up of the phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-31 found that the cumulative difference in the rate of cardiac events was 3.1% between patients with HER2-positive, node-positive breast cancer who received trastuzumab (Herceptin) in addition ...

cns cancers

Early Surgical Treatment of Low-grade Glioma Improves Survival vs Watchful Waiting

In a comparison of surgical treatment strategies for low-grade gliomas, patients in Norway treated at a hospital that generally favored early surgical resection had better overall survival than patients treated at a hospital that favored diagnostic biopsy and watchful waiting, according to a study...

SIDEBAR: Expect Questions and Respond with Reasoned Explanations

“Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver,” three physicians from Memorial Sloan-Kettering Cancer Center (MSKCC) in New York...

MSKCC’s Decision Not to Purchase New Cancer Drug Sparks Editorial and Unprecedented Actions

“At Memorial Sloan-Kettering Cancer Center, we recently made a decision that should have been a no-brainer: we are not going to give a phenomenally expensive new cancer drug to our patients.” That was the opening sentence of a New York Times op-ed piece written by three physicians from Memorial...

Study Explores Use of Radiotherapy in Last 30 Days of Life

While few patients receive radiation for cancer treatment in the last 30 days of life, almost 1 in 5 patients who do spend more than 10 of those days in treatment and more than half spend more than 5 days, according to a study published in the Journal of Clinical Oncology.1 The investigators used...

kidney cancer

What Combinations Should Be Tested? 

If the therapy combinations tested in the BeST trial don’t deserve to move on to phase III trials, what other combinations do show enough promise against renal cell carcinoma to merit being tested in phase III trials? “None at the present time,” maintained Bernard Escudier, MD, of the Institut...

Combination Therapy Not Better than Single-agent Bevacizumab for Advanced Renal Cell Carcinoma in BeST Trial

None of three combination therapies tested among patients with advanced renal cell carcinoma in the BeST trial came close to achieving the primary objective of a 67% improvement in median progression-free survival compared to single-agent bevacizumab (Avastin), Keith T. Flaherty, MD, reported at...

prostate cancer
issues in oncology

Medical and Behavioral Variables Have More Impact on Physical Functioning Than Finasteride Treatment

Taking finasteride over a 7-year period as part of the Prostate Cancer Prevention Trial (PCPT) “did not affect any of the three primary health-related quality-of-life domains—physical function, mental health, or vitality—either positively or negatively,” according to a study published in the...

multiple myeloma

Persistent Survival Benefit in Patients with Untreated Disease Treated with Bortezomib Added to Melphalan and Prednisone

A final analysis of the phase III VISTA trial (Velcade as Initial Standard Therapy in Multiple Myeloma: Assessment with Melphalan and Prednisone) found a persistent significant benefit in overall survival with VMP (bortezomib, melphalan, prednisone) vs MP (melphalan, prednisone) in patients with...

head and neck cancer

Four-plus Cups of Coffee Daily Linked to Lower Risk of Death from Oral/Pharyngeal Cancer 

Consuming four or more cups per day of caffeinated coffee could almost halve the risk of dying from oral/pharyngeal cancer compared to drinking no coffee or drinking it only occasionally, researchers reported in the American Journal of Epidemiology. “A dose-related decline in relative risk was...

leukemia

Chlorambucil, but Not Fludarabine, Confers Significant Benefit in Older Patients with CLL

Among patients aged 70 years and older with chronic lymphocytic leukemia (CLL), “front-line therapy with fludarabine does not improve outcomes” compared to chlorambucil (Leukeran), according to an analysis of patients enrolled in successive front-line Cancer and Leukemia Group B (CALGB) studies...

lung cancer

Volume-doubling Time May Help Distinguish Aggressive Cancer from Slow-growing Tumors

Changes in the size of lung tumors over time, as measured by volume-doubling times on low-dose computed tomography, can be used to distinguish aggressive lung cancer from slow-growing or indolent tumors and reduce overdiagnosis that could result in overtreatment and unnecessary morbidity. Results...

breast cancer

Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality

An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...

gynecologic cancers

Screening and Risk-reduction without Testing Positive for BRCA Mutation

Many women who do not test positive for a BRCA mutation undergo additional ovarian cancer screenings and risk-reducing procedures, despite limited data to determine the effectiveness of these interventions among an average-risk population. Results of an analysis of data from 1,077 women who were...

SIDEBAR: Expect Questions from Patients

A study finding that a diet high in total carbohydrates can increase the risk of cancer recurrence and mortality doesn’t mean that patients need to totally avoid carbohydrates, any more than previous findings about increased risk from a Western pattern diet means patients can’t eat any red meat....

colorectal cancer

Patients Treated for Colon Cancer Can Reduce Risk of Recurrence with Balanced Diet and Lower Carbohydrate Intake 

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. Patients who have received standard...

lung cancer
issues in oncology

E-mail Reminders to Providers May Improve Documentation of Code Status in Patients with Advanced Disease 

E-mail reminders to providers at the start of each new chemotherapy regimen may improve the rate and timing of code status documentation for patients with advanced lung cancer, according to a study in the Journal of Clinical Oncology. Jennifer S. Temel, MD, and colleagues from Massachusetts General ...

prostate cancer

No Difference in Toxicity with Proton Radiotherapy vs Less Costly Intensity-modulated Radiotherapy 

A national sample of Medicare beneficiaries treated for prostate cancer with intensity-modulated radiation therapy or proton radiotherapy found that proton radiotherapy “was rare and expensive and associated with only a modest and transient reduction in genitourinary toxicity,” reported James B....

breast cancer

Adding Temsirolimus to Letrozole Did Not Improve Survival but Might Benefit Patients under 65

Adding temsirolimus (Torisel) to letrozole did not improve progression-free survival in patients with aromatase inhibitor–naive, estrogen receptor (ER)-positive advanced breast cancer, but exploratory analysis indicated the combination could benefit postmenopausal patients ≤ 65. In their Journal of ...

breast cancer

Younger Patients with Family History of Breast Cancer at Similar Risk of Bilateral Disease as Those with BRCA Mutations 

Women who are diagnosed with breast cancer before age 55 and have a first-degree family history of bilateral disease have risks of contralateral breast cancer similar to women with deleterious mutations of BRCA1 and BRCA2, according to a study recently published in the Journal of Clinical Oncology, ...

SIDEBAR: Expect Questions from Patients

Results from the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) study “will have a follow-on effect of being able to guide physicians about the advantages of longer than 5 years of therapy for the premenopausal woman,” said V. Craig Jordan, OBE, PhD, DSc, Scientific Director at the Lombardi...

breast cancer

'Practice-changing' ATLAS Study Supports 10 vs 5 Years of Tamoxifen Therapy in Women with Breast Cancer

"Practice-changing" is the term several physicians and researchers used when asked by the media to describe the results of a study showing that extending tamoxifen therapy from 5 to 10 years for women with estrogen receptor (ER)-positive breast cancer further reduced recurrence and mortality....

supportive care

Cisplatin Linked to Significantly Increased Risk of Venous Thromboembolism

Patients with advanced solid tumors treated with cisplatin-based chemotherapy had a significantly increased risk of venous thromboembolic events, according to a meta-analysis of 38 randomized phase II and III trials evaluating cisplatin-based vs non–cisplatin-based chemotherapy. The trials involved ...

leukemia

Patients Receiving Higher-intensity Chemotherapy for ALL Are at Greater Risk for Cognitive Deficits, Researchers Report 

Omitting cranial irradiation from the treatment regimen for acute lymphoblastic leukemia (ALL) may help preserve global cognitive abilities. “Treatment with chemotherapy alone is not without risks,” however, noted researchers from St. Jude Children’s Research Hospital in Memphis. “The St. Jude...

skin cancer

Tremelimumab Not Better Than Standard-of-care Chemotherapy in Patients with Advanced Melanoma 

Tremelimumab did not produce a statistically significant advantage in overall survival compared to first-line standard-of-care chemotherapy in a phase III randomized trial reported in the Journal of Clinical Oncology. At final analysis, median overall survival by intent to treat was 12.6 months...

issues in oncology

Failure to Screen Patients for Hepatitis B Virus Could Result in Fatal Complications 

Although hepatitis B virus (HBV) reactivation is a potentially fatal complication of chemotherapy, “provided that HBV carriers are recognized, HBV reactivation can be largely prevented through the administration of oral antinucleoside analogs,” researchers at the University of Toronto noted in an...

cns cancers

Surgery of Primary Tumor Site Has No Impact on Local Control and Outcome in Patients ≥ 18 Months with Stage IV Disease 

“In intensively treated patients with stage IV neuroblastoma age 18 months or older at diagnosis, surgery of the primary tumor site has no impact on local control rate and outcome,” according to findings from the German prospective clinical trial NB97. “The results of the study,” the researchers...

colorectal cancer

Even at NCCN Institutions, a 'Sizable Minority' of Patients with Rectal Cancer Are Not Treated per NCCN Guidelines 

Even at the eight cancer centers participating in the National Comprehensive Cancer Network (NCCN) Colorectal Cancer Outcomes project, a “sizable minority” of patients with stage II/III rectal cancer treated with curative intent neoadjuvant chemoradiotherapy did not complete postoperative...

SIDEBAR: Shout-out to Policymakers on Diabetes Education

“If we could just give a shout-out to policymakers to understand that in the long term,” when patients who have diabetes and cancer receive adequate diabetes education, “we are cutting our length of stay, we are decreasing hospital costs, we are decreasing readmission rates,” June McKoy, MD, MPH,...

SIDEBAR: Expect Questions from Patients with Diabetes and Cancer

Patients with diabetes and cancer need to know that some chemotherapy drugs and adjuvant agents may require modifications in how they manage their diabetes. For example, patients who are receiving steroids might have to further restrict their diet to keep blood sugar levels under control. “You...

issues in oncology

Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have 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. Cancer and diabetes can be comorbid...

SIDEBAR: Ask Patients about Their Smoking Status  

“Receiving a cancer diagnosis represents a ‘teachable moment’ for delivering smoking cessation and relapse prevention interventions,” concluded a study in the journal Cancer1 about smoking relapse in patients with thoracic cancer or head and neck cancer. Previous research by two of the study’s...

head and neck cancer
lung cancer
issues in oncology

Patients with Cancer Need to Know That It Is Never Too Late to Quit Smoking 

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. Patients with head and neck or lung...

Medication Safety at Home 

A risk assessment to identify how errors occur when oral chemotherapies are used by pediatric patients at home (and to propose risk-reduction strategies) relied on input from those primarily in charge of oral chemotherapy use at home—the parents. A total of 18 parents were recruited at three...

issues in oncology

Enhanced Electronic Module Aims to Prevent Errors in Oral Chemotherapy Prescribing

An oral chemotherapy prescription-writing module grafted to a shared electronic medical record is part of a series of quality improvement efforts undertaken at Dana-Farber Cancer Institute in Boston to prevent errors in prescribing oral chemotherapy agents. While oncologists have readily accepted...

multiple myeloma

Thalidomide/Prednisone Maintenance after Stem Cell Transplant Improves Progression-free but Not Overall Survival

Maintenance therapy with thalidomide (Thalomid) and prednisone after autologous stem cell transplantation in patients with multiple myeloma improved progression-free survival but not overall survival, according to results of a phase III trial reported in Blood. Patients receiving maintenance...

lung cancer

Modified and Updated Risk-prediction Model Is More Efficient in Identifying Persons for Lung Cancer Screening

An updated and modified lung-cancer risk-prediction model developed from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial “was more sensitive” for lung cancer detection than criteria from the National Lung Cancer Screening Trial (NLST), according to a study in TheNew...

head and neck cancer

Two Studies Focus on Treatment Strategies for Preserving the Larynx While Increasing Survival

Two recent studies in the Journal of Clinical Oncology focused on treatment strategies to preserve the larynx while increasing survival of patients with cancer of larynx. RTOG 91-11 Ten-year results from the Radiation Therapy Oncology Group (RTOG) 91-11 trial found that both chemotherapy regimens...

SIDEBAR: Expect Questions from Your Patients 

Recently reported data from the Prostate Cancer Outcome Study (PCOS) can “serve as a tool for a medical oncologist, a urologic oncologist, or a radiation oncologist to say, ‘Here is what could happen on average at 2, 5, 15 years after treatment with either surgery or radiation,’” according to the...

prostate cancer

Recently Reported Long-term Outcomes Could Motivate More Men with Prostate Cancer to Consider Active Surveillance 

Fifteen years after being treated with radical prostatectomy or external-beam radiation for localized prostate cancer, “the prevalence of erectile dysfunction was nearly universal,” among men enrolled in a long-term functional outcomes analysis of the Prostate Cancer Outcomes Study (PCOS). There...

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