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Ask Your Patients About Complementary and Alternative Therapies

The most common reason that patients with cancer do not tell their physicians about using complementary and alternative medicines is that their physicians do not ask, according to a nationwide survey.1 Among 3,118 survey participants who reported a history of cancer, 1,023 (33.3%) had used a...

supportive care

Are Your Patients Using Complementary and Alternative Therapies? You Might Not Know If You Don’t Ask

Nearly one-third of patients with cancer who reported that they used complementary and alternative therapies in a nationwide survey did not tell their physicians about the use of those therapies, and the most frequently cited reason for not telling their physicians was that their physicians did...

pancreatic cancer

Expect Questions About Screening for Pancreatic Cancer

Although the detection of pancreatic cancer at early stages would offer an improved chance for successful treatment and survival, symptoms of pancreatic cancer are usually vague or absent, and screening to detect pancreatic cancer earlier is not recommended for average-risk asymptomatic patients....

pancreatic cancer

Lifestyle Modifications and Screening of Patients at High Risk Can Reduce Deaths From Pancreatic Cancer

After disclosing that he had been diagnosed with stage IV pancreatic cancer, Alex Trebek, longtime host of the popular television game show Jeopardy!, vowed that he would beat the disease despite the low associated survival rate. His statement has brought pancreatic cancer back into the public...

issues in oncology

Assess and Address Weight Issues to Curtail Rise in Obesity-Related Cancers

THE RISK FOR developing several obesity-related cancers is rising more rapidly in people aged 25 to 49 than in those older than 50, with the magnitude of the rise steepest in the youngest age group, according to a study published in Lancet Public Health.1 In an interview with The ASCO Post, the...

issues in oncology

Rising Rates of Six Obesity-Related Cancers Among Younger Adults

PHYSICIANS SHOULD routinely assess the body mass index (BMI) of their patients and offer counseling and/or referrals to a nutritionist or dietician to patients with a BMI of > 30 kg/m2, Ahmedin Jemal, DVM, PhD, told The ASCO Post. Those actions plus community-level policies designed to increase...

Use Technology and Appreciate the Importance of Partners

Most oncologists are comfortable treating lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients with cancer, according to a survey of 149 oncologists from 45 National Cancer Institute–designated Comprehensive Cancer Centers, but not as confident in their knowledge of the...

issues in oncology

Knowing Gender Identity and Sexual Orientation of Patients Is a Vital Aspect of Medical Care

A survey of oncologists from National Cancer Institute (NCI)-designated Comprehensive Cancer Centers found that 95.3% of oncologists who responded are comfortable with treating lesbian, gay, and bisexual patients with cancer, and 82.5% are comfortable treating transgender patients with cancer.1...

head and neck cancer
immunotherapy

In Era of Immunotherapy, Radiation Therapy May Become Essential Component of Systemic Treatments of Cancer

“IN THIS era of immunotherapy, it is highly possible, and potentially probable, that radiation therapy may become not just a form of locoregional and palliative treatment, but an essential component of our systemic treatments of cancer,” according to Zachary S. Morris, MD, PhD, Vice-Chair,...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

Expect Questions About Bone Loss Among Younger Breast Cancer Survivors

Women diagnosed with breast cancer at age 50 or younger had twice the risk of developing either osteoporosis or osteopenia after adjuvant treatment than did women of the same age who did not have cancer, according to a study led by researchers from Johns Hopkins Bloomberg School of Public Health,...

breast cancer

Increased Risk of Bone Loss Extends to Younger Women Treated for Breast Cancer

Younger women who have been treated for breast cancer have a higher risk for osteopenia and osteoporosis than do their cancer-free peers, and that risk seems to rise when treatment involves chemotherapy plus hormone therapy or aromatase inhibitors alone. Researchers from Johns Hopkins Bloomberg...

breast cancer
immunotherapy

Challenge Moving Forward in Breast Cancer Treatment: To Show That New Approaches Change Outcomes

ADVANCES IN treating breast cancer over the past 20 years have brought us to the point where treatment can be confidently de-escalated for some patients, and immunotherapy and precision decision-making may change the way breast cancer is treated for others, William Gradishar MD, FASCO, told the...

breast cancer

Preventing Locoregional Recurrence of Breast Cancer Should Not Deter Efforts to Decelerate Therapy

“SURGEONS AND radiation oncologists are obsessed with locoregional recurrence of breast cancer,” Monica Morrow, MD, FASCO, remarked at the 2018 Lynn Sage Breast Cancer Symposium, Chicago. Working to prevent locoregional recurrence, “even if it may not be the major threat to mortality, is...

breast cancer

Risk of Local Recurrence in Breast Cancer: Impact of Molecular Subtype and Surgical Approach

THE RISK of local recurrence in breast cancer “does not differ substantially based on the operation we perform, but it does differ substantially by subtype,” Tari A. King MD, FACS, stated at the 2018 Lynn Sage Breast Cancer Symposium in Chicago.1 At 10-year follow-up, Dr. King reported, local...

gynecologic cancers

Welcome Questions About Cervical Cancer Treatment Options

TWO STUDIES reported in The New England Journal of Medicine1,2 showed that patients with early-stage cervical cancer had reduced disease-free and overall survival when treated with minimally invasive radical hysterectomy vs open or radical hysterectomy. The findings of these studies have been...

gynecologic cancers

Comparing Survival Outcomes With Minimally Invasive and Open Surgical Approaches to Early-Stage Cervical Cancer

MINIMALLY INVASIVE radical hysterectomy for women with early-stage cervical cancer has been associated with reduced rates of disease-free and overall survival in the phase III LACC randomized noninferiority trial comparing minimally invasive and open abdominal radical hysterectomy. The results...

breast cancer
supportive care

Has Scalp Cooling Reached the Level of Standard of Care?

Does evidence of the effectiveness and safety of scalp cooling to reduce hair loss among women being treated for breast cancer mean that scalp cooling is a new standard of care? “I would suggest that it is,” stated Mikel Ross, MSN, RN, AGNP-BC, of the Breast Medicine Service, Memorial Sloan...

breast cancer
immunotherapy

Current Perspectives on the Treatment of Breast Cancer

“We are on the cusp of a new way to treat breast cancer,” Mary L. (Nora) Disis, MD, said in summarizing advances using immunology to treat breast cancer. Immune checkpoint inhibitors, adaptive T-cell therapies, and vaccines can enlist and rev up the immune system and be combined with chemotherapy...

issues in oncology
genomics/genetics
breast cancer

ADVISE PATIENTS ABOUT THE IMPLICATIONS OF RACIAL DISPARITIES FOR BREAST CANCER SCREENING

“BLACK WOMEN are more likely to develop breast cancer at a younger age, compared with white American women, and at all ages, younger and older individuals are more likely to develop triple-negative breast cancers,” Lisa A. Newman, MD, MPH, told The ASCO Post. “So, I think it is very clear that if...

issues in oncology
breast cancer
genomics/genetics

Obligation to Evaluate Racial/Ethnic Features That May Affect Outcomes for Patients With Breast Cancer

"WE ABSOLUTELY have an obligation to evaluate all of the features describing our patients with cancer when we are trying to figure out why some patients do better than others,” Lisa A. Newman, MD, MPH, reminded the nearly 700 participants at the 2018 Lynn Sage Breast Cancer Symposium, hosted by...

Expect Patient Concerns and Some Fear About Radiation Therapy for Early-Stage Follicular Lymphoma

Radiation therapy to the limited disease in patients with early-stage follicular lymphoma “achieves local control in over 90% of lesions, and almost 50% of patients remain free of any lymphoma event (cured) for decades,” Joanna C. Yang, MD, MPH, and Joachim Yahalom, MD, wrote in a recent editorial...

Many Patients With Early-Stage Follicular Lymphoma May Not Receive Guideline-Recommended Radiation Therapy

Radiation therapy for early-stage follicular lymphoma “is underused,” Joanna C. Yang, MD, MPH, and Joachim Yahalom, MD, declared in a recent editorial in the Journal of Clinical Oncology.1 This underuse of radiation therapy can result in overtreatment with systemic therapies or overconfidence in...

breast cancer
genomics/genetics

Expect Questions About Genetic Testing for Breast Cancer

A STUDY finding that pathogenic variants in 5 genes are associated with a high risk of triple-negative breast cancer and a 20% lifetime risk for overall breast cancer1 may increase interest in genetic testing. “This is the first study to establish which genes are associated with high lifetime risks ...

breast cancer
genomics/genetics

Mutations in Five Genes Linked to Higher Lifetime Risks for Aggressive Breast Cancer

USING MULTIGENE hereditary cancer panels to test for mutations in five genes can identify women at high risk for triple-negative breast cancer who may then benefit from more frequent screening, risk management, and potentially targeted therapies as well. A study that looked at multigene panel...

Be Prepared to Assist Patients to Make Informed Decisions About Breast Reconstruction Options

Two studies about postmastectomy breast reconstruction were recently published in JAMA Surgery. One study found overall complication rates of 32.9% at 2 years after reconstruction, with women having autologous reconstruction more likely to have complications than those having implant...

breast cancer

Breast Reconstruction: ‘A Process Not a Procedure’ With Potential Short- and Long-Term Complications

The complication rate among women who underwent postmastectomy breast reconstruction was 32.9% at 2 years postoperatively, and women undergoing autologous reconstruction “had significantly higher odds of developing any complication compared with those undergoing expander-implant reconstruction,”...

integrative oncology
breast cancer

Be Prepared to Answer—and Ask—Questions About Integrative Therapy

ASCO HAS ENDORSED the recommendations in the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer.1,2 The guidelines “are clear, thorough, and based on the most relevant scientific evidence,” wrote the ASCO expert panel that...

breast cancer
integrative oncology

ASCO Endorses Guidelines for Integrative Therapies During and After Breast Cancer Treatment

RECOMMENDATIONS IN the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer treatment “are clear, thorough, and based on the most relevant scientific evidence,” concluded an ASCO expert panel that reviewed the guidelines.1,2...

issues in oncology

In Cases Where Early Detection of Metastatic Disease Offers No Advantage, Why Conduct Routine Surveillance?

“What is a reasonable plan of follow-up for patients with cancers for which early detection of metastatic disease offers no advantage?” Posing that question during his Presidential Address at the 2018 Society of Surgical Oncology (SSO) Annual Cancer Symposium, Kelly M. McMasters, MD,PhD,...

pancreatic cancer

Using Neoadjuvant Therapy to Reduce Early Recurrences, Increase Survival in Patients With Pancreatic Cancer

USE OF THE FOLFIRINOX regimen (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a 4.9-month improvement in overall survival compared to gemcitabine/ nab-paclitaxel (Abraxane) in the neoadjuvant treatment of resectable and borderline-resectable pancreatic head...

When Patients Are Open to Lifestyle Changes: Take Advantage of ‘Unique Window of Opportunity'

Colon cancer survivors who followed guidelines for healthy eating, maintaining a healthy weight, and staying physically active had higher 5-year survival rates than those who did not adhere to those guidelines, according to a study among 992 patients treated with stage III colon cancer.1 The 5-year ...

solid tumors
colorectal cancer

Following Guidelines for Healthy Eating and Physical Activity May Improve Survival in Patients Treated for Colon Cancer

Following guidelines for proper nutrition, maintaining a healthy weight, and staying physically active may improve survival among patients treated for colon cancer, according to the results of a study with nearly 1,000 patients followed for a median of 7 years.1 “The study suggests that if...

skin cancer
immunotherapy

Surgery After Checkpoint Blockade for Selected Patients With Metastatic Melanoma

“In the era of improved systemic therapy, checkpoint blockade for metastatic melanoma and the ability to surgically resect all disease after treatment are associated with survival of 75%, better than what has been previously reported,” Danielle M. Bello, MD, said in summarizing study results during ...

Anticipate Concerns About Radiotherapy For Breast Cancer

A study examining the patient’s perspective on breast radiotherapy found that 68% of the patients surveyed responded that they had little or no prior knowledge of radiotherapy at the time of breast cancer diagnosis, making that an excellent time for physicians and other health-care professionals to ...

solid tumors
breast cancer

Dispel Fears About Breast Cancer Radiotherapy With ‘Real Truth’ About Modern Techniques and Side Effects

Nearly 85% of patients surveyed 6 or more months after completing radiotherapy as part of their treatment for breast cancer reported the side effects were not as bad as they had feared or expected. Approximately 92% of the 269 patients treated with breast conservation and 81% of the 58 patients...

Norman Wolmark, MD, and Bernard Fisher, MD, Honored for Leadership of NSABP

NORMAN WOLMARK, MD, and Bernard Fisher, MD, received the Society of Surgical Oncology (SSO) Distinguished Service Award for their work leading the National Surgical Adjuvant Breast and Bowel Project (NSABP). Dr. Wolmark, who succeeded Dr. Fisher as Chair of the NSABP and is currently Group Chair...

The Clinical Significance of Clinicaltrials.gov

“I think I found the trial that is going to save your life,” Stefanie Joho’s sister said after checking out the ClinicalTrials.gov website. “And sure enough, it did. That is not an exaggeration. That is exactly what happened,” Ms. Joho, a health advocate and consultant based in Philadelphia, told...

immunotherapy

Encourage Patients To Promptly Report Immunotherapy Side Effects

Physicians can be proactive in alerting patients to possible adverse effects of immunotherapy and in encouraging patients to report them. “It is important to emphasize that whenever a patient develops a new symptom, always considering that this might be an immune-related side effect. We need to...

solid tumors
supportive care
immunotherapy

Physician-Patient Partnership Is Key to Recognizing and Managing Side Effects of Immune Checkpoint Inhibitors

“Immunotherapy has a completely different side-effect profile than chemotherapy, and that has caught physicians off guard,” noted Drew Pardoll, MD, PhD, in an article published earlier this year in The Washington Post.1 Since then, efforts have moved forward on several fronts to bring physicians,...

issues in oncology
survivorship

Adolescent and Young Adult Cancer Survivors Often Struggle With Reproductive and Sexual Health Concerns

FOR MANY adolescents and young adults (AYAs), the most distressing and troubling phase of the cancer continuum that began with diagnosis is survivorship, and among the toughest challenges are those involving sexual health and reproduction, Jessica Gorman, PhD, MPH, stated at the 11th Annual...

solid tumors
prostate cancer

Combined Medical and Psychological Approach May Help Couples Reclaim Intimacy After Prostate Cancer Treatment

“To what extent do treatments for prostate cancer impact sexual functioning? To a great extent,” Christian Nelson, PhD, Chief, Psychiatry Service, Memorial Sloan Kettering Cancer Center, New York, told participants at the 11th Annual Oncofertility Consortium Conference in Chicago.1 Most men with...

Expect Questions About Necessity of Chemotherapy for Early-Stage Breast Cancer

“For patients with early-stage breast cancer, we’ve seen a significant decline in chemotherapy use over the past few years without a real change in evidence,” or in national guidelines and recommendations, reported Allison W. Kurian, MD, MSc, lead author of a study on chemotherapy recommendations ...

solid tumors
breast cancer

Steep Decline in Chemotherapy Use for Early-Stage Breast Cancer

The use of chemotherapy to treat women with early-stage breast cancer “declined markedly over time,” according to analysis of data from 2,926 women between the ages of 20 and 79. The trends documented “are remarkable for their steepness of decline, independent of clinical factors and despite no...

issues in oncology
survivorship

Preserving Sexual Function in Women Treated for Cancer

“There is huge potential to positively influence a patient’s experience and outcomes” by addressing concerns about sexual function after cancer treatment early in the course of treatment planning, Stacy Tessler Lindau, MD, MA, stated in her keynote address at the 11th Annual Oncofertility...

Expect Questions About Link Between Alcohol and Cancer

With headlines such as “Cutting back on alcohol can prevent cancers”1 and “Even light drinking may raise your cancer risk,”2 media reports may be generating questions from patients about the ASCO statement summarizing evidence linking alcohol to an increased risk of cancer.3 “What I personally...

Oncologists Urged to Be Proactive in Advising Patients to Reduce Risk of Alcohol-Related Cancers

A recently released ASCO statement summarizing extensive evidence linking alcohol use to an increased risk of several leading cancers, including breast, colon, and head and neck, called on oncologists “as front-line providers for cancer patients” to help patients reduce excessive alcohol use.1...

solid tumors
breast cancer

Preparing for Steep Increase in Breast Cancer Among the Elderly

“We are in the midst of a steep increase” in the incidence of breast cancer among women aged 65 years and older, Arti Hurria, MD, reported at the 19th Annual Lynn Sage Breast Cancer Symposium, Chicago.1 “Are we prepared as a health-care system and as providers to address this burgeoning need?” she...

issues in oncology
pain management

EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION

INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...

pain management

Relieving Pain During an Opioid Epidemic

“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...

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