OBR Daily Commentary - Colorectal

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Complementary Medicine For Cancer Can Decrease Survival

(Yale News) July 19, 2018 - People who received complementary therapy for curable cancers were more likely to refuse at least one component of their conventional cancer treatment, and were more likely to die as a result, according to researchers from Yale Cancer Center and the Cancer Outcomes, Public Policy and Effectiveness Research Center (COPPER) at Yale School of Medicine. The findings were reported today online in JAMA Oncology. Use of complementary medicine — medical therapies that fall beyond the scope of scientific medicine — is growing in the United States and often used by patients with cancer.

H. Jack West, MD (Posted: July 20, 2018)

quotesVery unfortunate and very believable. Some proponents of complementary medicine note that "complementary" is intended to mean that these treatments are given alongside conventional therapies, rather than instead of them, as "alternative" medicines will be. Nevertheless, this work strongly indicts treatment philosophies that are not grounded in clinical evidence and shows that they clearly subtract more than they add for patients with treatable cancers, who are all too often presume that the "medicine" in complementary medicine is actually effective. That is the greater misnomer here, and it leads to net harm to the people gullible enough to pursue it.quotes

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How An Old Diabetes Drug Made A Big Splash At The Biggest Cancer Confab

(Forbes) June 7, 2018 - At the recently concluded annual meeting of the American Society of Clinical Oncology (ASCO) a group of researchers from Mexico City described a surprising discovery: In a phase 2 trial in patients with stage 4 lung cancer, a 24-year-old diabetes drug significantly improved survival when added to a standard therapy.

H. Jack West, MD (Posted: June 07, 2018)

quotesThis work is certainly provocative, but there are several issues that should lead us to be cautious about concluding that this should change practice. Not only was this not a large trial, but the patients in the control arm who received erlotinib alone demonstrated a response rate that was remarkably low for EGFR mutation-positive cancer, about half of what is more commonly seen. There have also been other trials that have been far less impressive but not publicized. Overall, it merits further study but needs validation before being considered a combination approach to pursue outside of an investigational strategy.quotes

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Opinions: There’s A Miraculous Chance To Cure Cancer. But We’ll Have To Pay For It.

(Washington Post) June 5, 2018 - New treatments are expensive and experimental, but they sure seem worth it.

Thomas Marsland, MD (Posted: June 06, 2018)

quotesSo back to the grind stone... in clinic today after and exciting ASCO AM. But as this article suggest there is no free lunch. All of these great exciting life prolonging therapies come at a great cost. The theme of the meeting was personalized care and certainly this offers opportunities to help control the costs but even there with the new (FDA approved) next generation testing we still are often left with many expensive choices for a given patient with really no knowledge of success rates. But there is I think hope on the horizon. I had the chance to meet with a group that is developing highly sophisticated computer programs that can actually predict which of the many mutations noted by the ngs testing will really result in a therapy with a high success rate. (and the flip side avoid those that don't.) The data bases are quite sophisticated and developed from true clinical trial materials. When these types of programs become universally available we really will have the idea of "personalized" therapy come to fruition. Then hopefully these costly treatments will be given to those who truly will benefit. quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

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Howard S. Hochster, MD

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