Discuss Prostate Screening With Your Doctor, Experts Now Say


“Older men should talk to their doctors about the pros and cons of prostate cancer screening and make an individual decision that is right for them, an influential national panel of experts has proposed.

“The new recommendation, based on new data from a European trial as well as changes in the way men with prostate cancer are treated, modifies an earlier panel guideline from 2012 that advised men to skip prostate cancer screenings altogether. Screening is typically done using a blood test that measures levels of a protein released by the prostate gland called prostate-specific antigen, or PSA, which may indicate the presence of prostate cancer when elevated. But increased levels can also be caused by less serious medical conditions, like inflammation.”

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When the Doctor Recommends Against the Surgery a Breast Cancer Patient Wants


“More women with breast cancer are electing to have both breasts removed, even when cancer affects only one breast. The procedure, called contralateral prophylactic mastectomy (CPM), is a more complex surgery that has not been shown to improve survival.

“A new study from the University of Michigan Comprehensive Cancer Center examines the complex interaction between patients’ desires for the most extensive and surgeons’ responsibility to minimize harm.

“The population-based survey, published in JAMA Surgery, found that few patients sought a second opinion or went to a different hospital when their surgeon recommended against CPM. Further, patients were overwhelmingly satisfied with their treatment, even when their surgeon dismissed CPM with little discussion.”

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ASCO Issues New Guideline on Use of Biomarkers to Guide Early Breast Cancer Therapy Decisions

“The American Society of Clinical Oncology (ASCO) today issued a new clinical practice guideline for women with early-stage invasive breast cancer and known hormone receptor and human epidermal growth factor 2 (HER2) receptor status. The guideline includes evidence-based recommendations on the appropriate use of breast tumor biomarker tests to guide decisions on adjuvant systemic therapy.

” ‘In the era of precision medicine, the role of biomarkers in guiding clinical care is greater than in the past. An extensive number of new tests have come out in the last 5-10 years, but not all have sufficient evidence of clinical utility,’ said Lyndsay N. Harris, MD, co-chair of the ASCO expert panel that developed the guideline. ‘These latest recommendations truly inform physicians about which tests need to be performed. But this is not all that goes into patient care—doctors need to continue discussions with patients to develop individualized treatment plans.’ “

Recommendation to Omit Radiation Therapy After Lumpectomy Is Not Frequently Implemented

“Nearly two thirds of U.S. women age 70 or older with stage I breast cancer who undergo lumpectomy and are eligible to safely omit subsequent radiation therapy (RT) according to national cancer guidelines still receive this treatment, according to new study results. The researchers looked at more than 205,000 cases of breast cancer nationwide, and their study is published as an ‘article in press’ on the Journal of the American College of Surgeons website in advance of print publication.

“After a lumpectomy, also called a breast-sparing or breast-conserving operation, radiation usually is given to the breast to reduce the chance of the cancer returning. However, treatment recommendations changed in 2004 for a select group of elderly breast cancer patients after research found that postoperative RT did not significantly prolong their survival over five years compared with women who received no RT.”

'Very Big Deal': NCCN Okays Watching More Prostate Cancer

“In a groundbreaking recommendation, the National Comprehensive Cancer Network (NCCN) has broadened the scope of prostate cancers that qualify for active surveillance in the United States to include men with ‘favorable’ intermediate-risk disease.

” ‘I think this is a very big deal,’ said James Mohler, MD, a urologist from Roswell Park Cancer Institute in Buffalo, New York, who is chair of the NCCN prostate cancer guideline panel.

“The recommendations of the NCCN are often followed by clinicians, insurers, and institutions, and the NCCN is the first major organization in the United States to make this recommendation.”

Medical Societies Recommend Testing for Lung Cancer Biomarkers

New guidelines recommend lung cancer patients be genetically tested to determine whether they are amenable to a class of drugs called tyrosine kinase inhibitors. Patients with EGFR or ALK mutations could benefit more from such targeted therapies, and suffer fewer side effects, than with chemotherapy. Continue reading…