Cancer Care Issues - Advice From Dr. Cary Presant
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December 24, 2015

Breast Cancer Risk Assessment: Correlation of Negative Mammograms on Subsequent Breast Cancer Develo

Patients are relieved when a biopsy following an abnormal mammogram is found to be benign. Should those patients be followed up more closely, or with just the routine every 1 to 2 year mammograms?

 We are often asked this by our patients, our referring physicians, and even discuss this at tumor boards. Recent data shows us we should be more vigilant with these patients.

 L. Henderson and coauthors from the Breast Cancer Surveillance Consortium studied over 3.8 million mammograms from 1994 to 2009 (Cancer Epidemiology, Biomarkers and Prevention 2015; 24: 1882).  Breast cancer was diagnosed in 448,700 breast cancers were diagnosed. If a radiologist suggested a biopsy, which was not positive, subse...

Posted By: Cary Presant  

December 6, 2015

Looking for Bargains: Finding Affordable Cancer Care

Cancer care is becoming unaffordably expensive. Costs of drugs have increased at many times the rate of increase of other medical expenses. Radiation therapy costs have increased with the use of IMRT. Surgery has become more expensive (albeit with a shortening of length of hospital stay) with the nearly universal use of robotic methods. However, the costs of cognitive services...

Posted By: Cary Presant  

November 23, 2015

Cancer Screening Rates are Down: Good News or Bad News?

Mammography and PSA have been classic examples of successful promotion of cancer screening efforts by the NIH and American Cancer Society. Rates of screening were increasing as we entered the 21st century.

But after 2010, the USPTF and American Cancer Society began to take a closer look at issues such as false positives, and over-diagno...

Posted By: Cary Presant  

November 8, 2015

At What Age Should Doctors Recommend Starting Mammography?

The American Cancer Society has just delivered revised recommendations for breast cancer screening mammograms. Now women at average risk should begin at age 45, according to the ACS.

However, what advice should oncologists be giving to their patients, their families, and to other physicians in the community? Are the ACS guidelines correct or shoul...

Posted By: Cary Presant  

October 18, 2015

Overcoming Simpson’s Paradox in Breast Cancer Neoadjuvant Therapy

Dr. Lisa Carey has recently reviewed the topic of the association of breast cancer subtypes and survival following neoadjuvant chemotherapy (Clin Cancer Res 2015; 21: 4027).. Those subtypes with the highest pathologic complete response (pCR) rates had the worst overall survival. ER positive patients had...

Posted By: Cary Presant  

October 14, 2015

Can Enkephalins Predict Breast Cancer Risk?

All oncologists use the risk assessment tool of the NCI and /or gene testing for BRCA1 and 2 to help identify women at much higher risk of breast cancer. To supplement these tests, a recent article has identified a higher risk  with low pro-enkephalin (ProENK) concentration in serum (O Melander and coauthors J Clin Oncol 2015; 33: 2...

Posted By: Cary Presant  

September 22, 2015

When is “negative” Really “positive” in genomic testing?

Oncologists nearly universally test NSCLC specimens for actionable mutations in EGFR and ALK. And we follow the mutation results with appropriate targeted agents when mutations are found (“positive”) and proceed with chemotherapy when mutation testing is “negative”. How often could we be making a mistake?

An interesting art...

Posted By: Cary Presant  

September 14, 2015

Changing Cancer Genomic Signatures: Good News or Bad?

Oncologists are becoming addicted to the hope of increasing the use of genomic profiling to help predict the best therapy for our patients. Some mutations can already be targeted: EGFR mutations, Her2, BCR/ABL, ALK, ROS, and BRAF.

A recent report suggests that the cancer genome can be modified by statins. O. Buarnodottir and coworkers from Lund Un...

Posted By: Cary Presant  

August 18, 2015


We all want to maximize survival in our prostate cancer patients. Of course we use the standaard therapeutic agents as recommended in NCCN guidelines.

But now we have an excellent editorial by Derek Raghavan, one of the country's leading GU medical oncologists in HemOnc Today on 8-10-15. In his discussion he reviews the largely positive correlation between statin use and improved prosta...

Posted By: Cary Presant  

August 8, 2015

Effects of Mixed Messages on Breast Cancer Screening: Have We Won or Lost?

In 2009, the US Preventive Services Task Force (USPTF) revised the recommendations for annual breast cancer screening in women aged 40 to 75. The new recommendations called for no routine screening in women 40 to 49. And for women 50 to 75, biennial screening was recommended. Despite these recommendations, many organizations continued to recommend annual screening for women fr...

Posted By: Cary Presant  

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About This Blog

Dr. Cary Presant describes research results, observations on oncology issues, and discussions on current cancer care topics that can help improve your quality oncology care and your oncology practice.

Disclosure: Cary A. Presant, MD, has disclosed the following relevant financial relationships:
Served as a director, officer, partner, employee, advisor, consultant or trustee for: Diatech Oncology; Digital Medical Network
Received research grant from: Diatech Oncology
Have a 5% or greater equity interest in: Diatech Oncology; Digital Medical Network
Received income in an amount equal to or greater than $250 from: Diatech Oncology
Served on the Board of Directors for: Medical Oncology Association of South California; Cancer Schmancer

  • Cary Presant

    Cary A. Presant, MD, FACP, FASCO, is a hematologist and medical oncologist at City of Hope in Los Angeles. He has been director of cancer programs at Washington University School of Medicine, the Jewish Hospital of St. Louis, and the City of Hope National Medical Center in Los Angeles, California. He is currently Professor of Clinical Medicine at the University of Southern California School of Medicine. Dr. Presant's current research includes improvement of chemotherapy effectiveness by clinical trials, as well as the development of a new chemotherapy sensitivity test, based on apoptosis, for all types of cancer. He is the author of over 400 scientific articles in cancer treatment, cancer detection, chemotherapy, experimental tumor biology and pharmacology, liposomes for cancer diagnosis and therapy, magnetic resonance spectroscopy, measurement of quality of life in cancer patients, and quality care in oncology. As an author, Dr. Presant has written Surviving American Medicine, awarded the International Book Award for best book in health, and is a physician ccontributor for the Huffington Post. Dr. Presant is past president of the California Division of the American Cancer Society, Chairman of the Board of Directors of the Medical Oncology Association of Southern California (MOASC), past Director of the American Society of Clinical Oncology (ASCO), and past president of the Association of Community Cancer Centers (ACCC).

The content of this blog does not necessarily reflect the viewpoints of Medscape.
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