This week, researchers published a comparison of radiation treatments for nasopharyngeal carcinoma.  This is the kind of study I wish we saw more of.  This is a head-to-head comparison of IMRT and conventional radiotherapy in a (thankfully) uncommon form of throat cancer.

The results were not as strongly in favor of the newer IMRT (intensity-modulated radiotherapy) as I would have expected.  Disease free survival, the simplest outcome to wrap my head around, was a little better, but not enough to show statistical significance.  There is no mention of overall survival, which would have been a nice outcome to track, considering this was a retrospective review.

US Federal Court ruled at the end of March to end Myriad's patent of breast cancer susceptibility genes, known as BRCA1 and BRCA2.  Myriad, of course, is planning to fight in Appeals Court, and vows to take the case to the Supreme Court, if needed.  Myriad shares are trading lower following the ruling.

Mary Claire-King, discoverer of the BRCA gene, applauded the decision. 

There are not too many drugs that improve overall survival in prostate cancer.  Right now, the list is pretty short: Taxotere.

So the announcement that researchers have survival improvement with a new drug, cabazitaxel, is pretty exciting for us oncologists.

It's easy to become discouraged, but once in a while we get something to be happy about.  Today is one of those moments.

Can anyone really be surprised?  I remember Dr. Brawley talking to us young fellows about the hazards of prostate cancer screening as far back as 2003.  As I recall, he was even mad that there was a prostate cancer postage stamp! 

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This was in NEJM this week. 

"Ten years after treatment, accelerated, hypofractionated whole-breast irradiation was not inferior to standard radiation treatment in women who had undergone breast-conserving surgery for invasive breast cancer with clear surgical margins and negative axillary nodes."

I recently had a health journalist interview me about the new guidelines for mammography under 50.

You may recall a storm of controversy was touched off in December 2009, when the US Preventive Services Task Force recommended that mammography begin at 50.  Sarah Palin went so far as to compare these recommendations to "death panels" under health care reform.  The controversy died down, and health care reform legislation was rewritten to ensure access to mammographic screening.

I was ready to pass on blogging about WSJ's review of UnitedHealthcare's study of oncology prescribing practices until I saw this statistic: 31% of colon cancer patients are getting Avastin in the postop setting.  This is clearly outside the lines of conventional treatment, and turns on its ear the concept that doctors, left to their own devices, will provide appropriate care.

Podcast file: 

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1-26-10.mp3

How aggressive should the chemo for rectal cancer be? A newly published study doesn't make the question any easier.

Publishing in Lancet Oncology, a British group treated patients with a combination of Xeloda and oxaliplatin initially, then Xeloda and radiation, then surgery.

In the 105 patients studied with poor risk disease, recurrences were rare at five years.