The landscape for managing prostate cancer is changing rapidly. In recent months, we have seen two new drugs approved for hormone refractory advanced disease: sipuleucel T (Provenge) and cabazitaxel (Jevtana). As Dr Robert Dreicer addresses in “Novel Agents in the Management of Castration-Resistant Metastatic Prostate Cancer,” more therapies may lie just over the horizon. Abiraterone acetate and MDV3100 are both promising agents being studied as monotherapy and in combination with other drugs. New therapies for advanced prostate cancer are sorely needed, because the prognosis for patients who progress on or following androgen-deprivation therapy (ADT) is universally grim. In addition, as Dr Leonard Gomella discussed at the International Prostate Cancer Congress (reviewed on page 21), ADT is associated with a host of unpleasant side effects. Although most are largely manageable, newer treatments might cause less toxicity.
In this issue, we revisit maintenance therapy in non–small cell lung cancer, which Dr Howard West discussed in the Winter 2009 issue of Contemporary Oncology
. On page 27, Dr Mark Socinski provides updated information from some of the pivotal studies on this issue and reassesses whether it is time to adopt maintenance therapy as a new standard in practice.
Dr Britta Stordal, a researcher in Ireland, updates us on the latest data concerning the early detection of ovarian cancer. While there appear to have been no major leaps on this front, a few studies have shown increased effectiveness by combining different screening modalities. As is often the case in cancer, answering one question generates many others, like who, when, and how often to screen and whether it is affordable. We have been debating these issues for decades in breast and prostate cancer, ever since effective screening tools were identified. Dr Stordal also reviews biomarker discoveries in ovarian carcinoma that have the potential to shape treatment decisions or aid in developing novel targeted therapies.
We did something unusual with our Patient Perspectives this month—we invited the patient to write his story. Eugene Feit received a diagnosis of stage III/advanced pancreatic cancer almost 3 years ago. While Mr Feit considers himself fortunate, there are a few things he would like to see handled differently for patients with cancer who, like him, manage to beat the odds. His psycho-oncologist, Steven D. Passik, PhD, from Memorial Sloan-Kettering Cancer Center, shares his view on how long-term survival affects patients like Mr Feit. One way we can help as oncologists is by working to foster good communication between our patients and the physicians, nurses, and other providers they see. I have always felt strongly about this and to facilitate better communication, I wrote the book Common Bonds: Reflections of a Cancer Doctor
to provide patients and loved ones with insight into oncologists’ thoughts and feelings. On page 69, you will find the patient handout “10 Questions for Your Cancer Care Team.” I encourage you to photocopy this article and hand it out to patients or keep it in your waiting room, where it can serve as a first step toward opening the door to better communication between provider and patient.
The last article in this issue—No Bones About It: The Pharmacist’s Role in Managing Cancer Therapy-Induced Bone Loss
—is a Continuing Education opportunity for the pharmacy specialists who receive Contemporary Oncology
, which has been reprinted with permission from Pharmacy Times
. Although the rest of you will not earn credit for completing the online educational activity, the article provides a comprehensive overview of the causes and management of this common complication and is worth a read.
Like always, I invite you to submit articles for Contemporary Oncology
. We are also accepting submissions from oncology/hematology fellows or from physicians on issues pertinent to fellows for a new publication we are starting that is appropriately titled Fellows
. To request a copy of the Authorship Guidelines or to comment on one of the features in this issue, e-mail the editors at email@example.com