Focus on Cancer

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Rates of genetic testing for BRCA1 and BRCA2 mutations have increased among younger women diagnosed with breast cancer, according to a new study. The study focused on nearly 900 women diagnosed with breast cancer at age 40 or younger. Researchers looked at rates of genetic testing, barriers to testing, and how the test results affected treatment decisions.

In 2006, the rates of BRCA testing were in the seventy percent range and by 2012 that proportion rose to ninety-five percent. While the majority of women reported being tested for BRCA 1 and 2, many were not, and a small minority reported that no one had discussed genetic risk or testing options. The study authors note that the overall goal of genetic testing is to help women make informed treatment decisions. Assessment of a young woman's genetic risk after a breast cancer diagnosis can affect treatment decisions and the results can also have health implications for her relatives.

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Host: Renée Simone Yolanda Allen, MD, MHSc., FACOG

What is the role and importance of the Ob-Gyn Oncologist, especially for women diagnosed with pelvic cancers? What are some barriers patients face in seeing an Ob-Gyn Oncoloogist? And how can clinicians better partner with this group of specialists? In this episode, host Dr. Renee Allen explores answers to these questions with guest expert Dr. Evelyn Reynolds, board certified physician in both General Obstetrics & Gynecology and Gynecologic Oncology. She is also an Associate Professor and Division Director of Gynecologic Oncology at the Morehouse School of Medicine.

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To some, end of life care in the United States is considered resource intensive, expensive, and inattentive to patients' needs. So how does the United States compare to other countries? A new study examined several health care measures at the end of life for cancer patients in five European countries, Canada and the United States.

Researchers from the University of Pennsylvania Perelman School of Medicine compared the health care experience for cancer patients older than 65, in Canada, Belgium, Germany, England, the Netherlands, Norway and the United States. They examined several clinical measures during the final six months of life.

The United States and Netherlands had the lowest percentage of patients dying in the hospital. The United States also had the fewest hospitalizations and the smallest number of days patients spent in the hospital. In contrast, intensive care admissions were twice as common in the United States compared to the other countries.

During the last six months of life, patients in Norway and Canada had higher hospital costs than patients in the United States. There was less spending in Germany and Belgium, but the lowest expenditures were in the Netherlands and …

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Glioblastoma is the most devastating form of brain cancer in adults; most patients die within one to two years of diagnosis. A new study examined whether using tumor-treating fields, a type of electromagnetic therapy, combined with maintenance chemotherapy in patients with glioblastoma who had already completed standard chemotherapy and radiation, could increase survival.

Researchers from University Hospital in Zurich, Switzerland are conducting a worldwide trial with 695 glioblastoma patients. One out of three received a standard maintenance course of chemotherapy, while the other two received maintenance therapy plus the tumor treating fields for up to two years.

The current results are for the first 315 patients. Researchers found that use of the tumor-treating fields increased both progression-free survival and overall survival. Overall survival is prolonged by an average of three months in patients getting the tumor-treating fields therapy.

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Host: Amy Mackey, MD

Guest: Marshall Austin, MD

The Pap smear has been the most effective cancer screening test in medical history. However, newer screening options are available, including use of both the Pap smear and the HPV test, also called co-testing. Although Pap and HPV co-testing is preferred in current American Cancer Society Guidelines, a number of doctors’ offices still do not routinely offer this screening option for women 30 and older. In this special edition of Advances in Women's Health, host Dr. Amy Mackey welcomes guest Dr. Marshall Austin, Medical Director of Cytopathology and staff pathologist in Gynecologic and Breast Surgical Pathology at the University of Pittsburgh Medical Center, to discuss his recently coauthored article comparing cervical cancer screening outcomes among over 250 thousand women in multiple clinical practices. Learn today what the results suggest about best practices in cervical cancer screening, whether they coincide with the latest guidelines, and how clinicians can improve detection and care for at-risk patients. Click here to learn more about other women's health programs in this special series.

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Successful treatment of stage II or stage III rectal cancer relies on surgical removal of the tumor. However, researchers from Baylor University Medical Center wanted to know if a "minimally invasive" procedure called a laparoscopy, would be as effective as a standard or "open" operation for patients with rectal cancer.

Researchers assigned 486 patients to receive either a standard open operation or the less invasive laparoscopic approach. All procedures were done by forty-six highly trained surgeons. Specimens from each procedure were examined to see whether all the tumor was removed ("complete resection").

Results found that 90 percent of the patients who underwent the open operation had a complete resection, where patients who underwent the laparoscopy only had an 81 percent success rate. The researchers concluded that these findings do not support laparoscopic removal of rectal cancer.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

Host: Maurice Pickard, MD

Guest: Olufunmilayo (Funmi) Olopade, MD, FACP

Host Dr. Maurice Pickard welcomes Dr. Funmi Olopade, Walter L. Palmer Distinguished Service Professor in Medicine and Human Genetics, Director of the Hematology/Oncology Fellowship Program, and Director of the Center for Clinical Cancer Genetics at the University of Chicago. Dr. Olopade discusses disparities in health outcomes for black women with breast cancer. Dr. Olopade is an expert in cancer risk assessment and individualized treatment for the most aggressive forms of breast cancer, having developed novel management strategies based on an understanding of the altered genes in individual patients. She stresses comprehensive risk reduction and prevention strategies in high-risk populations, as well as earlier detection through advanced imaging technologies.

Host: Jennifer Caudle, DO

Lung cancer is the leading cause of cancer death and the second most common cancer among both men and women in the United States. But how can clinicians increase awareness and screening for this disease within their practices? Dr. Jennifer Caudle welcomes Dr. Nina Maouelainin, Director of Interventional Pulmonology at The Lung Center of Grand View Health in Sellersville, PA, to discuss the facts about lung cancer, screening approaches, and her personal journey in increasing awareness among primary care providers.

Host: Matt Birnholz, MD

Joining host Dr. Matt Birnholz is special guest, Dr. Clifford A. Hudis, President of the American Society of Clinical Oncology (ASCO) and Chief of the Breast Cancer Medicine Service and an attending physician at Memorial Sloan-Kettering Cancer Center. Dr. Hudis will provide an executive summary of the recently released State of Cancer Care in America: 2014 report, which will help cancer care providers, policy makers, and others more effectively shape the future of cancer care during these uncertain times.

Download and listen to this update!

And, to learn more about the websites that Dr. Hudis references in this interview, please visit:

• State of Cancer Care in America: 2014 report
• CancerLinq

Guest: Constance Roche

Host: Mimi Secor, DNP, FNP-BC, FAANP

It's estimated that one in eight women will be diagnosed with breast cancer in their lifetime. 75% of women who are diagnosed have no known risk factors. But the incidence and mortality rate of breast cancer has declined over the last couple of decades. The government released controversial amendments to screening recommendations last year based on mortality outcomes from breast cancer. What are the implications for our patients, and what screening guidelines should advanced practice clinicians recommend to patients? Nurse practitioner Constance Roche, a clinical coordinator at the Avon Comprehensive Evaluation Center in Boston, Massachusetts, joins host Mimi Secor to discuss how to identify high risk patients, the best screening techniques and how primary care providers can find the best specialist for their patients.