What Do Cars, TVs, and Lung Cancer Have in Common?
March 1st 2013Most Americans are aware that technical experts from Consumer Reports magazine consistently rank televisions and automobiles manufactured by Japanese companies higher than their US counterparts, but I believe that neither Consumer Reports nor US physicians understand how much better lung cancer treatment results are in Japan.
Latest Advances and Challenges in Radiation Oncology
February 26th 2013Along with chemotherapy and surgery, radiation therapy remains one of the three main treatments for cancer. A new article in Science Translational Medicine reviews the recent advances and current challenges in radiation oncology today.
Rationing Healthcare: Who's Responsible?
February 16th 2013To place responsibility for rationing chemotherapeutics on the oncologist not only increases his or her emotional burden, but it also strains the doctor-patient relationship. We should not allow oncologists to become bedside healthcare rationers simply because no one else wants to do the job.
A Common Theme Among Ethical Issues in Oncology: The Need to Individualize Advanced Cancer Care
February 16th 2013Oncologists would be well advised to consider their obligations to the patient, as well as other stakeholders, and be prepared to resolve potential conflicts that go beyond the focus of their clinical training.
Diffuse Large B-Cell Lymphoma in the Very Elderly: The Case for Refining Our Clinical Trials
February 16th 2013Further prospective clinical trials in very elderly patients with DLBCL are clearly needed. Complementing the growing need for such trials, an evolving clinical trial infrastructure, geriatric oncology support, and novel therapeutics are making such studies feasible in the current era.
When Can R-CHOP Not Be Used in an Elderly Patient?
February 16th 2013Elderly patients may have several such comorbidities, but their impact on normal life is minimal-and so most of these patients may receive a curative treatment such as R-CHOP. Very elderly patients have more comorbidities with greater impact, with the result that some of their vital organs exhibit functional deficiency.
Diffuse Large B-Cell Non-Hodgkin Lymphoma in the Very Elderly: Challenges and Solutions
February 16th 2013In this review, we critically analyze clinical trials that were specifically designed for the very elderly, and we discuss the challenges encountered by investigators who are conducting studies in this patient population. We conclude by proposing an algorithm to help clinicians determine the optimal therapeutic strategy for treatment of DLBCL in very elderly patients.
"OMG, How Long Is This Going to Take?"
February 16th 2013It is hard to realize that an elderly patient's visit to you is likely the only trip outside his or her apartment for the week and the only contact with someone other than family or an aide. Doctor visits sometimes become the elderly's primary contact with the larger world.
Financial Toxicity, Part I: A New Name for a Growing Problem
February 15th 2013Costs of care continue to rise; new cancer drugs are more expensive than ever before, and more patients are being treated with these drugs. While patients and claims datasets consistently report an association between financial burden and quality of care, the impact on traditional disease-related outcomes-survival, for example-have not been assessed.
Ethical Challenges in Oncology, Explored Through a Series of Vignettes
February 15th 2013In this article, we have chosen to focus on three ethical challenges that we believe practicing oncologists might commonly encounter with their patients. The ethical dilemmas are presented in a case-based approach in the hope of better joining the ethical theory to clinical practice.
Are We Treaters, Passers, or Doctors?
February 8th 2013As often as not, the decision whether to treat or deny treatment to any elderly patient with cancer is a result of an oncologist’s impression of the individual person’s ability to benefit from and withstand the side effects of therapy. And that decision is usually based on a clinical assessment that is far more intuitive than it is scientific.
The Ethics of Quality and the Quality of Ethics
February 6th 2013My suggestion, as unrealistic as it is, would be to encourage the creation and maintenance of parallel groups of quality measures: one set to satisfy the reportable measures of quality that affect reimbursements and pay for performance, and a second set that would be developed by and adapted to each institution to measure and drive improvements in those things we felt were true measures of high quality care.
“I Can’t Afford Any More Advances in Cancer Care, Doc!”
January 29th 2013The reality is that new biological agents are often priced like a Ferrari, and patients who are covered under a pharmacy benefit are required to fork over not a fixed copay but a percentage of the pill’s cost, each and every month ‘til eternity or death, whichever comes first.
ASCO GI: Phase III Bevacizumab Results of the AVEX and TRIBE Trials
January 28th 2013The same week that bevacizumab (Avastin) received a new indication for the treatment of metastatic colorectal cancer, results from two phase III trials involving the drug were presented at the American Society of Clinical Oncology 2013 Gastrointestinal Cancers Symposium (ASCO GI) held January 24–26 in San Francisco.
Everolimus Reduces Size of Noncancerous Kidney Tumors
January 17th 2013The mTOR inhibitor everolimus (Afinitor) has been found to significantly reduce the size of angiomyolipomas, the slow-growing benign tumors commonly associated with tuberous sclerosis complex (TSC) and sporadic lymphangioleiomyomatosis, according to the results of the phase III EXIST-2 study.
How to Maximize the Potential of mTOR Inhibitors in Breast Cancer-More Questions Than Answers
January 15th 2013Such a systematic review of the current status of mTOR inhibitors in the treatment of breast cancer demonstrates holes in our knowledge of the role of the tumor, the host, and metabolic factors in breast cancer progression.
mTOR Inhibitors in the Treatment of Breast Cancer
January 15th 2013Efforts to identify clinical biomarkers of response or resistance to mTOR inhibitors are ongoing. This review will summarize results of preclinical and clinical studies as well as ongoing clinical trials with mTOR or dual PI3K/mTOR inhibitors.
Annual Report: Deaths From Cancer Are Declining
January 11th 2013The annual report to the nation on the status of cancer in the United States, published Monday, shows cancer death rates overall continue to decline. The number of people who die as a result of their cancer has been steadily declining since the 1990s, and over the 9-year period between 2000 and 2009, the report shows a 1.8% decrease in death rates per year among men and a 1.4% decrease among women.
Study: US Cancer Screening Rates Declined Over Last Decade
January 4th 2013There has been a decline in overall cancer screening among the US population. Only colorectal cancer screening rates met current screening goals. Cancer survivors specifically met current national screening goals with the exception of cervical cancer screening.