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Lung cancer is not a discriminate disease, but the disease burden is especially high on African Americans in the U.S. The statistics are stark: African-American men are 37% more likely to develop lung cancer than white men and are 22% more likely to die of it. In addition, only 12% of African Americans live longer than five years after a diagnosis of lung cancer, compared with 16% of whites, according to a recent report by the American Lung Association.

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International physicians garner awards from ASCO while several U.S. institutions appoint new leaders. Read more about the latest appointments and accolades in the cancer community.

As genome-wide association studies (GWAS) have opened the door to systematic discovery of genetic factors for complex diseases, including cancers, the clinical utility of the findings remains to be determined. This is elegantly discussed in the article in this issue of ONCOLOGY by Stadler et al. The authors rightfully caution against the use of “personal genomic tests” based on cancer GWAS results for personal cancer risk prediction.

Genome-wide association studies (GWAS) have emerged as a new approach for investigating the genetic basis of complex diseases. In oncology, genome-wide studies of nearly all common malignancies have been performed and more than 100 genetic variants associated with increased risks have been identified. GWAS approaches are powerful research tools that are revealing novel pathways important in carcinogenesis and promise to further enhance our understanding of the basis of inherited cancer susceptibility. However, “personal genomic tests” based on cancer GWAS results that are currently being offered by for-profit commercial companies for cancer risk prediction have unproven clinical utility and may risk false conveyance of reassurance or alarm.

Breast cancer is predominantly a disease of older women. Many of these older patients with breast cancer have low-risk disease owing to low proliferation indices, positive hormone receptors, node-negativity, or p53-negative and HER-2 (human epidermal growth factor 2)-negative tumors.[1,2] They do well without chemotherapy and will receive adjuvant hormonal therapy with tamoxifen or an aromatase inhibitor. Yet there are older women who do not have these favorable tumor characteristics and so are potential candidates for chemotherapy. The review by Muss points out this issue, highlighting benefits of chemotherapy and describing appropriate treatment regimens for these patients.

Although increasing age is the major risk factor for breast cancer incidence and mortality, when adjusted for disease stage, breast cancer mortality is similar among younger vs older patients. Importantly, about 90% of older women with breast cancer present with early-stage disease. The biologic characteristics of breast tumors in older patients suggest they would derive benefit from adjuvant therapy, particularly endocrine therapy, but older women are still frequently undertreated, resulting in poorer survival. Studies suggest that focusing on comorbidity rather than “chronologic age” as a surrogate for life-expectancy is a key aspect of adjuvant decision-making for older patients. Morbidity and mortality from cancer in vulnerable patients with poorer health can be accurately predicted by the Comprehensive Geriatric Assessment (CGA), which evaluates comorbidities, functional status, cognition, social support, psychological state, nutritional status, and polypharmacy. Use of the CGA and newer versions of this tool can lead to interventions that maintain function and improve quality of life in older patients with breast cancer.

Vitamin E is a fat-soluble vitamin found in green leafy vegetables, whole grains, nuts and seeds, wheat germ, eggs, and in oils derived from soybeans, almonds, safflower, and sunflower. It is also an antioxidant and is said to confer protection against Alzheimer’s, Parkinson’s, cardiovascular disease, arthritis, and cancer. Although observational data suggest a correlation between high intake of foods rich in vitamin E and lowered risk of cancer, randomized trials using vitamin E supplements failed to validate those findings; some studies suggest that vitamin E supplementation can actually increase all-cause mortality.

Dr. Hy Muss is a well recognized expert in the treatment of elderly women with breast cancer, and his article “Adjuvant Chemotherapy of Breast Cancer in the Older Woman” is an extremely important addition to the limited existing literature on this topic. As he points out, nearly half of all breast cancer diagnoses occur in women over 65 years of age. As the total number of women in that demographic increases with the aging of our population, medical oncologists will be faced with a growing number of elderly breast cancer patients, for whom evidence-based recommendations on treatment are needed. As any medical oncologist who sits face-to-face with these older women knows, it is not acceptable to simply tell the patient that there are inadequate data to guide recommendations for adjuvant chemotherapy in her age group, though this is what the EBCTCG (Early Breast Cancer Trialists Collaborative Group) overview has concluded.

ASCO: Annual Meeting '10 Our on-site coverage of the American Society of Clinical Oncology's annual meeting: Five internationally regarded oncologists give exclusive interviews and expert perspective reports of the highlights of this year’s meeting…

Watch this page for ONCOLOGY’s on-site coverage of the annual meeting: Internationally regarded oncologists give exclusive interviews and expert perspective reports of the highlights of this year's meeting

Go back to the Eisenhower years and amid the gray flannel suits, rabid McCarthyism, and dread over nuclear war you’ll find rays of hope in the battle against cancer. Looking back from the 60s, it was easy to believe that this hope was unfounded, an unwarranted faith engendered by the conquest of polio. But it may have been that science simply was not ready.

As a psychiatrist who has cancer, I have developed a deep understanding of the ways in which our training can help us help patients who find themselves forced to deal with the complicated emotional aspects that accompany this disease. My hope is that my insights will help psychiatrists as they wrestle with the problems that plague their patients who are coping with this difficult disease.

Radiologists have come to expect rising demand for CT, which is why anecdotal reports of sudden and dramatic falls in CT volumes have sent a shudder through the community. All the more alarming is that the rumored drop-offs are coming at the request of patients who want nothing to do with CT because they fear its radiation will someday cause cancer. Instead they reportedly are demanding ultrasound or MRI because neither has ionizing radiation -- never mind that neither is indicated, nor, particularly in the case of ultrasound, has much chance of providing useful information.

Sentara Healthcare, located in Hampton Roads, VA is seeking an Experience RN for a Unit Manager Position on an Oncology Unit. This full-time position is located at Sentara Norfolk General Hospital, the region’s first Magnet Hospital. This level one trauma/teaching hospital is located in Norfolk, VA. The Hematology/Oncology Unit (HOU) is an 18-bed, self-contained unit providing a wide range of oncology services to a variety of diverse patient populations including the newly diagnosed through end of life, with specialties in chemotherapy and peripheral blood stem cell transplant.

Who's News

The AACR and ACCC elect new leaders. Read more about the latest accolades and appointments in the cancer care community.

Eli Lilly has joined SNM’s Clinical Trials Network, a collaborative effort designed to address the need for validated imaging biomarkers for streamlining the development and registration of investigational therapeutics.

Oncologists often do not give honest prognostic and treatment-effect information to patients with advanced disease, trying not to “take away hope.” The authors, however, find that hope is maintained when patients with advanced cancer are given truthful prognostic and treatment information, even when the news is bad.