Miller on Oncology

 
 
  • Finally! Data in Low-Risk HER2 Breast Cancer   Drs. Kathy Miller and Ian Krop talk about why a single-arm study in low-risk cancer is a huge advance for a population of understudied breast cancer patients.
  • 'Cutting Edge' in Local Breast Cancer Therapy Why has local therapy for breast cancer become more interesting, more complicated, and more important? Drs. Kathy Miller and Michael Dixon discuss the top studies in local therapy from SABCS 2013.
  • HOPE Gets the Breast Cancer Joint Rockin’ Exercise has many benefits for breast cancer survivors, including keeping them on their aromatase inhibitors. Drs. Kathy Miller and Jennifer Ligibel discuss results of the HOPE study from SABCS 2013.
  • Is Platinum the Silver Lining for TNBC? Drs. Kathy Miller and Hope Rugo discuss why platinum is a good option in triple-negative breast cancer, drawing from evidence presented at SABCS 2013.
  • The Whole Enchilada: What's Hot at SABCS 2013 Dr. Kathy Miller previews SABCS 2013, highlighting studies on platinum agents in triple-negative breast cancer, trends in local therapy, and whether CTC levels should guide therapy decisions.
  • Lifestyle Intervention: 5-Year Benefit in Prostate Cancer A 3-month lifestyle intervention showed benefit at 5 years in men with low-risk prostate cancer, underscoring for Dr. Kathy Miller the importance of lifestyle in the lives of cancer patients.
  • Best Adjuvant Regimen for Early Breast Cancer   Reviewing available data, Dr. Kathy Miller gives her pick for the best adjuvant therapy regimen in early breast cancer -- one that provides efficacy at a lower cost and with less toxicity.
  • CIGNA Restricts Coverage of Genetic Testing   Dr. Kathy Miller reports on the potential harm that may come as a result of CIGNA's new policy that no genetic testing will be covered unless the patient first sees a genetic counselor.
  • Call It Cancer and Do Nothing? Untenable!   Cancer requires treatment, but what if low-risk lesions are no longer called cancer? Drs. Kathy Miller and Maurie Markman look at possible effects on screening, treatment, and public perception.
  • Larry Norton: From A to B in Breast Cancer   Drs. Kathy Miller and Larry Norton talk about breast cancer presentations at ASCO, from data on axillary radiation, aTTom, and adjuvant chemotherapy to BOLERO-3.
  • ASCO Plenary Session: Not Your Usual Suspects   Dr. Kathy Miller previews the exceptional studies to be presented at the ASCO plenary session, ranging from rare tumors of the brain and thyroid to a screening strategy that has global implications.
  • Angelina Jolie and the Power of the Informed Decision   Dr. Kathy Miller comments on the importance of genetic testing in women at high risk for breast cancer so that they can make personal, informed decisions about their care, as Angelina Jolie has done.
  • What Is 'Clinically Meaningful Benefit'?   An ASCO committee charged with defining 'clinically meaningful benefit' explored initial chemotherapy in patients with metastatic triple negative disease. Dr. Kathy Miller asks: Did we get it right?
  • Should States Be Setting Breast Screening Policy?   Indiana will soon pass legislation requiring that women undergoing mammography be notified of their breast density and its associated risk for cancer. Dr. Kathy Miller questions whether this is wise.
  • You Will Remember This Day   The FDA's approval of trastuzumab emtansine (T-DM1) for metastatic breast cancer, says Dr. Kathy Miller, marks a historic day in the fight against breast cancer.
  • Taking a Break After 100 Cycles of Bevacizumab   The last patient on the ECOG-2100 trial has stopped therapy after 100 cycles, and Dr. Kathy Miller reminds clinicians to treasure the exceptions for they can point the direction to new interventions.
  • SABCS Preview: Watch for Sentinel Node Studies   Dr. Kathy Miller highlights studies topping the bill at the 2012 San Antonio Breast Cancer Symposium, including 2 on the role of sentinel node surgery.
  • Delayed Nausea After Chemotherapy: 3 Questions Answered   Dr. Kathy Miller discusses a study on the prevention of delayed nausea in patients receiving chemotherapy, the results of which are instructive for improved management and cost savings.
  • Brave New World of Breast Cancer Therapy?   Dr. Kathy Miller reports on 2 high-profile genomic studies whose findings revolutionize concepts of sensitivity to therapy as well as acquired and intrinsic resistance.
  • Can Imaging Results Lead the Oncologist Astray?   Dr. Kathy Miller, who reports 2 cases of ER+ breast cancer in which radiology misidentified metastases, worries that oncologists are relying more on technology than on their own clinical savvy.
  • Between HIPAA and a Hard Place   Dr. Kathy Miller reports on an ethical dilemma: Should she violate HIPAA or let a terminally ill nurse return to work where his weakened capacity endangers himself and the patients under his care?
  • How Physicians Influence Patient Choices   The quality of information that physicians give patients affects their decisions, concludes Dr. Kathy Miller, who reports on a recent study in which a video helped patients to make end-of-life decisions.
  • Medicaid: Is Greater Access Worth It?   Given the Supreme Court's ACA ruling that will allow states to expand Medicaid coverage, the issue remains: Does greater access do good or harm -- and at what cost? Dr. Kathy Miller looks at a study that may provide answers.
  • Can Efficacy Be Derailed by Toxicity?   Dr. Kathy Miller discusses how treatment of patients with metastatic disease requires negotiation between the most effective and the most tolerable therapies, if durable PFS is to be achieved.
  • Plenary Session: 4 Critical Advances in Oncology   Dr. Kathy Miller previews the ASCO plenary session studies in breast cancer, prostate cancer, lymphoma, and oligodendroglioma, all 4 of which signal significant advances in science and treatment.
  • Early Reports on T-DM1 Breast Cancer Trial   Dr. Kathy Miller comments on early reports that a phase 3 trial of T-DM1 shows "substantially" increased survival in HER2-positive breast cancer patients.
  • Does Elevated Risk Require MRI?   Dr. Kathy Miller commends the American College of Radiology Imaging Network (ACRIN) for a recent study assessing the value of MRI in women at intermediate risk for breast cancer.
  • HER2-Positive Breast Cancer: The Next Testis Cancer?   With cure rates for HER2-positive breast cancer climbing, Dr. Kathy Miller says research may soon follow the direction taken in testis cancer: finding similar cure rates with less therapy and less toxicity.
  • How We Do Harm   Dr. Kathy Miller provides a short book review of Dr. Otis Brawley and Paul Goldberg's essential review of the US healthcare system.
  • Rebiopsy: Should New Finding Redirect Therapy?   If biopsy of metastatic breast cancer shows a phenotype that differs from that found at diagnosis, should the new finding redirect therapy? Dr. Kathy Miller gives her take on this complex issue.
  • Exercise: A Way to Outdistance Breast Cancer?   Dr. Kathy Miller reports on a study that shows that exercise can lessen the risk for breast cancer in sedentary postmenopausal women. Can exercise also improve breast cancer prognosis?
  • Must All DCIS Patients Undergo Radiation?   Dr. Kathy Miller reports on a new look at an old study that indicates how to identify DCIS patients at sufficiently low risk for local recurrence such that they do not need radiation after lumpectomy.
  • HER2-Positive Breast Cancer and Long Life   Dr. Kathy Miller takes another look at CLEOPATRA and predicts that dual HER2 blockade, when offered in the adjuvant setting, will make HER2+ breast cancer a disease patients can live with, for years.
  • Sniper Attacks in the War on Cancer   Drs. Kathy Miller and George Sledge talk about strategies, past and future, in the war on cancer.
  • Bevacizumab Gone: Where to From Here?   The FDA's withdrawal of bevacizumab for breast cancer prompts Dr. Kathy Miller to ask where we go from here for patients receiving benefit and for future studies in the metastatic setting.
  • SABCS Preview: New Data, Old Controversies   Dr. Kathy Miller previews studies to be presented at the San Antonio Breast Cancer Symposium, including the eagerly awaited CLEOPATRA trial.
  • Breast Cancer Prevention: The New Primary Care?   If primary care physicians treat hypertension to prevent heart attacks, reasons Dr. Kathy Miller, why shouldn’t they prescribe SERMs and AIs to at-risk patients to prevent breast cancer?
  • When Therapies Are Ineffective   Dr. Kathy Miller discusses the negative data on lapatinib from the ALTTO trial in HER2-positive breast cancer and questions how best to share information with patients on ineffective therapies.
  • Paradoxical Findings in Local Breast Cancer Therapy   Paradoxical findings from recent studies suggest that what have been considered equivalent therapies for local breast cancer may not be, as reported by Dr. Kathy Miller.
  • Objective Response Rates: No Such Thing   A study in the variability of tumor measurements on repeat CT scans suggests to Dr. Kathy Miller that objective response rates in clinical trials may be anything but.
  • Breast Cancer: New Data on Prevention and Treatment   Dr. Kathy Miller highlights what she expects to be the big news at ASCO in breast cancer, from prevention to metastatic disease.
  • ASCO® Plenary Session: 5 Practice-Changing Studies   Dr. Kathy Miller says that the plenary session, which features 5 studies that are certain to change practice, and the AACR/ASCO session with Nobel Prize winner Elizabeth Blackburn are not to be missed.
  • What It Takes to Beat Metastatic Disease   Dr. Kathy Miller reports on indisputable evidence for why oncologists should get tissue samples from patients with metastatic disease. If patients are willing to take this step, why aren’t oncologists?
  • Balancing Treatment Efficacy and Toxicity   Dr. Kathy Miller reports on 2 trials in which investigators examine how to maximize the benefit of treatment while minimizing its drawbacks.
  • ASCO: Early Bird Report   Dr. Kathy Miller reports that the breadth and depth of abstracts submitted to the ASCO Program Committee -- coupled with an easily navigated program -- will make this year's meeting a quality experience.
  • Are You as Smart as This Fourth Grader?   Dr. Kathy Miller wants to recruit to her staff a fourth-grade student who won top honors in a science fair for her discovery in regard to patients who receive chemotherapy.
  • Iniparib News Leaves Breast Cancer Patients in Limbo (Again)   The announcement that a trial of iniparib in breast cancer did not meet a primary endpoint prompted Dr. Kathy Miller to call for immediate disclosure of the data, the lack of which affects treatment.
  • HER2 Testing: Accuracy Remains an Issue   A review of HER2 testing by experts found discordant results, suggesting to Dr. Kathy Miller that oncologists must confer with pathologists and retest samples if there is any question of HER2 status.
  • Bevacizumab: Is Cost the Elephant in the Room?   Dr. Kathy Miller says that drug approval in the United States jumbles issues of cost and benefit and that a discussion is long overdue to determine what we want from medicine and how to pay for it.
  • SABCS: Focus on Adjuvant and Neoadjuvant Therapy   Dr. Kathy Miller gives an overview of key studies to be presented at SABCS, which this year highlight breast cancer therapy in the adjuvant and neoadjuvant settings.
  • Pink Ribbons: The Good, the Bad, and the Backlash   Pink ribbons have raised awareness for breast cancer, but Dr. Kathy Miller sees a downside to the symbol and advocates that national focus be directed to research into all cancers, not just the pink kind.
  • Rework but Do Not Repeal Healthcare Reform   Flawed as the Affordable Care Act may be, it provides important healthcare benefits to patients, which Dr. Kathy Miller worries may be lost if the law is repealed.
  • Lessons From the Wright Brothers -- and Cancer Cells   Dr. Kathy Miller sees a parallel between the approach used by the Wright brothers to achieve flight and the ability of cancer cells to proliferate -- both provide a lesson for scientific discovery.
  • Cancer Screening Overutilized in Patients With Advanced Cancer   Dr. Kathy Miller reports on a study that indicates routine cancer screening tests are overutilized in patients with advanced cancer and grossly underutilized in healthy patients over 65.
  • Bevacizumab Ruling: FDA Delay Is Worst Possible Decision   Dr. Kathy Miller takes aim at the FDA for skirting the Avastin decision and effectively putting breast cancer patients, researchers, and treating physicians in limbo for another 3 months.
  • Palliative Care Integrated With Chemotherapy Improves Survival in NSCLC   Dr. Kathy Miller praises a study indicating patients with metastatic NSCLC who receive early palliative care live longer and have better quality of life than those receiving regular therapy.
  • Clinical Trials: A WEIRD and Cautionary Tale   A recent anthropology study prompts Dr. Kathy Miller to question the practice of generalizing clinical trial results achieved in a subset of patients to a wider population.
  • Do You Want a Cola or a Cure?   Dr. Miller reports that US funds for cancer research amount to 69 cents per person per week. Put another way, cancer research dollars amount to one sixth of what Americans spend on soft drinks.
  • Is Mandatory Biopsy in Clinical Trials Justifiable?   Dr. Kathy Miller weighs the ethical concerns about requiring biopsies to participate in breast cancer clinical trials against the critical gains in therapeutic efficacy those biopsies permit.
  • Where to Find Secret Pearls at ASCO® 2010   Dr. Kathy Miller highlights the patient and survivor care sessions at ASCO that abound in science and practical methods for improving the lives of cancer patients.
  • A Commitment to the Cure Well Outside the Normal Range   Dr. Kathy Miller lauds her colleagues who spearheaded the tissue bank at the IU Simon Cancer Center and the 1000 women who donated normal breast tissue to support breast cancer research.
  • Predicting Brain Metastases: Is It a Good Thing?   The development of a tool that accurately predicts brain metastases in patients with metastatic breast cancer prompts Dr. Kathy Miller to consider the potential benefit and harm of such information.
  • CYP2D6 Testing: Not Ready for Prime Time   Studies have examined whether CYP2D6 testing can identify breast cancer patients who ought (or ought not) to be treated with tamoxifen, but Dr. Kathy Miller says the jury is still out on this assay.
  • The Decline in Scientific Literacy and Its Impact on Medicine   The public decline in scientific literacy, according to Dr. Kathy Miller, may be the most important problem facing medicine.
  • Exercise May Put Breast Cancer on the Run   Dr. Kathy Miller discusses a study that found that sedentary postmenopausal women who exercise regularly experience changes in estradiol and SHBG levels consistent with a lower risk for breast cancer.
  • Can Aspirin Prevent Breast Cancer Recurrence?   Dr. Kathy Miller reviews findings from the Nurses Health Study suggesting that regular aspirin consumption is associated with a decreased risk for distant recurrence and breast cancer death.
  • Breast Cancer Testing: A Matter of Medicine or Marketing?   Direct-to-consumer marketing for BRCA analysis leads women to question whether to be tested, prompting Dr. Kathy Miller to advise physicians to talk to their patients about breast cancer risk.
  • DCIS and the Power of Words   The word carcinoma impacts how patients and physicians think about ductal carcinoma in situ. Dr. Kathy Miller considers whether a change in name could influence a change in practice.
  • Can Acupuncture Control Hot Flashes in Breast Cancer Patients?   Vasomotor symptoms are common side effects of antiestrogen hormone treatment in breast cancer care. In this video blog, Dr. Kathy Miller discusses acupuncture as a promising therapy for hot flashes.
  • Lymph Nodes May Provide Clues for Targeted Breast Cancer Treatment   In this video blog, Dr. Kathy Miller talks about differences in receptor expression between primary and nodal disease that may help identify subsets of breast cancer cells most likely to metastasize.
  • How Low Would You Go?   In this video blog, Dr. Kathy Miller discusses factors affecting the use of systemic adjuvant therapy for HER2 breast cancer patients who have small tumors.
  • Mining the Data of Clinical Trials   Re-examining clinical data proves a goldmine of new information for other areas of cancer study, as examined by Dr. Kathy Miller in this video blog from SABCS.
  • The Real Issue in the Debate Over the USPSTF Guidelines   In this video blog, Dr. Kathy Miller identifies the real issue in breast cancer screening: One third of American women who would benefit do not get screened because of lack of access.
  • Breast Cancer Screening: How Important Is Breast Self-Examination?   In this video blog, Dr. Kathy Miller discusses a large Chinese study that found that breast self-examination did not improve disease stage at diagnosis or overall survival.
  • Joint Pain Associated With Aromatase Inhibitors in Patients With Breast Cancer   In her latest video blog, Dr. Kathy Miller comments on a new study examining the incidence of arthralgia associated with aromatase inhibitor therapy in patients with breast cancer.
  • Can Doctors Ever Tell Patients They Are Cured of Cancer?   In her first Medscape video blog, Dr. Kathy Miller asks whether doctors should avoid using the term cured to describe patients who have been in remission for several years.