The Journal of Community and Supportive Oncology

For the September podcast for The Journal of Community and Supportive Oncology, Dr David Henry discusses 3 Original Reports: one on identifying the risk factors for hospital readmission among patients who have received a hematopoietic stem cell transplant and designing preventive measures to lower those risks and related readmissions; a second that focuses on young women with breast cancer who are from diverse populations and who face specific challenges in regard to their existing support systems and unmet needs for information and support; and the third that examines the effects of a self-care education program on the quality of life of in patients with gastric cancer after they have undergone gastrectomy. Dr Henry also highlights this month’s Community Translations article on the approval of nivolumab, the first immunotherapy to receive the go-ahead from the Food and Drug Administration for the treatment of for lung cancer, specifically, squamous cell non-small-cell lung cancer, and an accompanying Commentary by Dr Kartik Konduri. The podcast is rounded off with comments on an essay about the shift from practicing oncology as a generalist to the current more prevalent tendency to subspecialize, and an argument suggesting that the generalist approach offers a potentially useful perspective to help make sense of what can seem like an overwhelming amount of data on emerging new therapies and understanding of tumor biology.

Click on the download icon at the top of this introduction to listen to the podcast.

For the September podcast for The Journal of Community and Supportive Oncology, Dr David Henry discusses 3 Original Reports: one on identifying the risk factors for hospital readmission among patients who have received a hematopoietic stem cell transplant and designing preventive measures to lower those risks and related readmissions; a second that focuses on young women with breast cancer who are from diverse populations and who face specific challenges in regard to their existing support systems and unmet needs for information and support; and the third that examines the effects of a self-care education program on the quality of life of in patients with gastric cancer after they have undergone gastrectomy. Dr Henry also highlights this month’s Community Translations article on the approval of nivolumab, the first immunotherapy to receive the go-ahead from the Food and Drug Administration for the treatment of for lung cancer, specifically, squamous cell non-small-cell lung cancer, and an accompanying Commentary by Dr Kartik Konduri. The podcast is rounded off with comments on an essay about the shift from practicing oncology as a generalist to the current more prevalent tendency to subspecialize, and an argument suggesting that the generalist approach offers a potentially useful perspective to help make sense of what can seem like an overwhelming amount of data on emerging new therapies and understanding of tumor biology.

Click on the download icon at the top of this introduction to listen to the podcast.

For the September podcast for The Journal of Community and Supportive Oncology, Dr David Henry discusses 3 Original Reports: one on identifying the risk factors for hospital readmission among patients who have received a hematopoietic stem cell transplant and designing preventive measures to lower those risks and related readmissions; a second that focuses on young women with breast cancer who are from diverse populations and who face specific challenges in regard to their existing support systems and unmet needs for information and support; and the third that examines the effects of a self-care education program on the quality of life of in patients with gastric cancer after they have undergone gastrectomy. Dr Henry also highlights this month’s Community Translations article on the approval of nivolumab, the first immunotherapy to receive the go-ahead from the Food and Drug Administration for the treatment of for lung cancer, specifically, squamous cell non-small-cell lung cancer, and an accompanying Commentary by Dr Kartik Konduri. The podcast is rounded off with comments on an essay about the shift from practicing oncology as a generalist to the current more prevalent tendency to subspecialize, and an argument suggesting that the generalist approach offers a potentially useful perspective to help make sense of what can seem like an overwhelming amount of data on emerging new therapies and understanding of tumor biology.

Click on the download icon at the top of this introduction to listen to the podcast.

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Click on the PDF icon at the top of this introduction to read the full article.

Click on the PDF icon at the top of this introduction to read the full article.

Click on the PDF icon at the top of this introduction to read the full article.

Background About 1 in 7 of all hospitalized patients is readmitted within 30 days of discharge. The cost of readmissions is significant, with Medicare readmissions alone costing the health care system an estimated $28 billion a year.

Objective To identify the rates of and causes for readmission within 100 days of patients receiving a hematopoietic stem cell transplant.

Methods We performed a retrospective review of 235 consecutive transplant recipients (autologous, n = 144; allogeneic, n = 91) to determine rates and causes for readmission within 100 days of patients receiving a transplant. Medical records and hospital readmissions were reviewed for each patient.

Results 36 allogeneic patients accounted for 56 readmissions. 23 autologous patients accounted for 26 readmissions. Autologous transplant recipients were most commonly readmitted for the development of a fever (n = 15 patients) or cardiopulmonary issues (n = 4). The most prevalent reasons for readmission in the allogeneic recipients included a fever (n = 21) or the development or exacerbation of graft-versus-host disease (n = 5). The readmission length of stay was 6 days (median range, 1-91 days) for allogeneic patients and 4 days (median range, 1-22 days) for autologous patients. There was no difference in survival between the readmitted and the non-readmitted cohorts (P = .55 for allogeneic patients; P = .24 for autologous patients). Although allogeneic graft recipients demonstrated a higher readmission rate (39.6%) compared with autologous recipients (16%), none of the variables examined, including age, gender, performance status, diagnosis, remission status at the time of transplant, comorbidities, type of preparative chemotherapy regimen or donor type, identified patients at increased risk for readmission.

Limitations Variations in clinical care, physician practices, and patient characteristics need to be considered when examining readmission rates. Most of the allogeneic patient population included unrelated donor recipients (65%) who received nonmyeloablative conditioning regimens (81% of allogeneic recipients). These features may not be characteristic of other centers.

Conclusions In these high-risk patients, readmissions following a transplant are common. Enhanced predischarge education by nurses and pharmacists, along with ongoing outpatient education and rigorous outpatient follow-up through phone calls or social media may decrease readmission rates.

Click on the PDF icon at the top of this introduction to read the full article.

Background About 1 in 7 of all hospitalized patients is readmitted within 30 days of discharge. The cost of readmissions is significant, with Medicare readmissions alone costing the health care system an estimated $28 billion a year.

Objective To identify the rates of and causes for readmission within 100 days of patients receiving a hematopoietic stem cell transplant.

Methods We performed a retrospective review of 235 consecutive transplant recipients (autologous, n = 144; allogeneic, n = 91) to determine rates and causes for readmission within 100 days of patients receiving a transplant. Medical records and hospital readmissions were reviewed for each patient.

Results 36 allogeneic patients accounted for 56 readmissions. 23 autologous patients accounted for 26 readmissions. Autologous transplant recipients were most commonly readmitted for the development of a fever (n = 15 patients) or cardiopulmonary issues (n = 4). The most prevalent reasons for readmission in the allogeneic recipients included a fever (n = 21) or the development or exacerbation of graft-versus-host disease (n = 5). The readmission length of stay was 6 days (median range, 1-91 days) for allogeneic patients and 4 days (median range, 1-22 days) for autologous patients. There was no difference in survival between the readmitted and the non-readmitted cohorts (P = .55 for allogeneic patients; P = .24 for autologous patients). Although allogeneic graft recipients demonstrated a higher readmission rate (39.6%) compared with autologous recipients (16%), none of the variables examined, including age, gender, performance status, diagnosis, remission status at the time of transplant, comorbidities, type of preparative chemotherapy regimen or donor type, identified patients at increased risk for readmission.

Limitations Variations in clinical care, physician practices, and patient characteristics need to be considered when examining readmission rates. Most of the allogeneic patient population included unrelated donor recipients (65%) who received nonmyeloablative conditioning regimens (81% of allogeneic recipients). These features may not be characteristic of other centers.

Conclusions In these high-risk patients, readmissions following a transplant are common. Enhanced predischarge education by nurses and pharmacists, along with ongoing outpatient education and rigorous outpatient follow-up through phone calls or social media may decrease readmission rates.

Click on the PDF icon at the top of this introduction to read the full article.

Background About 1 in 7 of all hospitalized patients is readmitted within 30 days of discharge. The cost of readmissions is significant, with Medicare readmissions alone costing the health care system an estimated $28 billion a year.

Objective To identify the rates of and causes for readmission within 100 days of patients receiving a hematopoietic stem cell transplant.

Methods We performed a retrospective review of 235 consecutive transplant recipients (autologous, n = 144; allogeneic, n = 91) to determine rates and causes for readmission within 100 days of patients receiving a transplant. Medical records and hospital readmissions were reviewed for each patient.

Results 36 allogeneic patients accounted for 56 readmissions. 23 autologous patients accounted for 26 readmissions. Autologous transplant recipients were most commonly readmitted for the development of a fever (n = 15 patients) or cardiopulmonary issues (n = 4). The most prevalent reasons for readmission in the allogeneic recipients included a fever (n = 21) or the development or exacerbation of graft-versus-host disease (n = 5). The readmission length of stay was 6 days (median range, 1-91 days) for allogeneic patients and 4 days (median range, 1-22 days) for autologous patients. There was no difference in survival between the readmitted and the non-readmitted cohorts (P = .55 for allogeneic patients; P = .24 for autologous patients). Although allogeneic graft recipients demonstrated a higher readmission rate (39.6%) compared with autologous recipients (16%), none of the variables examined, including age, gender, performance status, diagnosis, remission status at the time of transplant, comorbidities, type of preparative chemotherapy regimen or donor type, identified patients at increased risk for readmission.

Limitations Variations in clinical care, physician practices, and patient characteristics need to be considered when examining readmission rates. Most of the allogeneic patient population included unrelated donor recipients (65%) who received nonmyeloablative conditioning regimens (81% of allogeneic recipients). These features may not be characteristic of other centers.

Conclusions In these high-risk patients, readmissions following a transplant are common. Enhanced predischarge education by nurses and pharmacists, along with ongoing outpatient education and rigorous outpatient follow-up through phone calls or social media may decrease readmission rates.

Click on the PDF icon at the top of this introduction to read the full article.

In this month’s podcast for The Journal of Community and Supportive Oncology, Dr David Henry highlights a Review article on the role of targeted therapy in HIV-positive patients with lung cancer and 2 Original Reports, one on the impact of bladder volume on radiation dose to the rectum in patients with prostate cancer and a second on treatment outcomes in stage IIIA non-small-cell lung cancer in a community cancer center setting. Also discussed are a Commentary by David Cella and Lynne Wagner about re-personalizing precision medicine, and a Feature article on genomic oncology, the foundation of targeted, personalized therapies.  A Community Translations article on the recent approval of the histone deacetylase inhibitor panobinostat demonstrates how a novel mechanism of action has been harnessed to produce a therapy that can extend progression-free survival in patients with relapsed multiple myeloma, and 2 Case Reports document the presentation and treatment of 2 patients with rare conditions – nonislet cell tumor-induced hypoglycemia and drug-induced immune hemolytic anemia.

In this month’s podcast for The Journal of Community and Supportive Oncology, Dr David Henry highlights a Review article on the role of targeted therapy in HIV-positive patients with lung cancer and 2 Original Reports, one on the impact of bladder volume on radiation dose to the rectum in patients with prostate cancer and a second on treatment outcomes in stage IIIA non-small-cell lung cancer in a community cancer center setting. Also discussed are a Commentary by David Cella and Lynne Wagner about re-personalizing precision medicine, and a Feature article on genomic oncology, the foundation of targeted, personalized therapies.  A Community Translations article on the recent approval of the histone deacetylase inhibitor panobinostat demonstrates how a novel mechanism of action has been harnessed to produce a therapy that can extend progression-free survival in patients with relapsed multiple myeloma, and 2 Case Reports document the presentation and treatment of 2 patients with rare conditions – nonislet cell tumor-induced hypoglycemia and drug-induced immune hemolytic anemia.

In this month’s podcast for The Journal of Community and Supportive Oncology, Dr David Henry highlights a Review article on the role of targeted therapy in HIV-positive patients with lung cancer and 2 Original Reports, one on the impact of bladder volume on radiation dose to the rectum in patients with prostate cancer and a second on treatment outcomes in stage IIIA non-small-cell lung cancer in a community cancer center setting. Also discussed are a Commentary by David Cella and Lynne Wagner about re-personalizing precision medicine, and a Feature article on genomic oncology, the foundation of targeted, personalized therapies.  A Community Translations article on the recent approval of the histone deacetylase inhibitor panobinostat demonstrates how a novel mechanism of action has been harnessed to produce a therapy that can extend progression-free survival in patients with relapsed multiple myeloma, and 2 Case Reports document the presentation and treatment of 2 patients with rare conditions – nonislet cell tumor-induced hypoglycemia and drug-induced immune hemolytic anemia.

In this month’s podcast for The Journal of Community and Supportive Oncology, Dr David Henry discusses a Community Translations article on lenvatinib, which was approved earlier this year for the treatment of patients with advanced differentiated thyroid cancer whose disease has progressed after radioactive iodine therapy. Also in the line-up are two Original Reports, one on health care expenditures associated with depression in adults with cancer and another on maximizing accessibility to and the efficacy of a weekly speech and language therapy service for patients with head and neck cancer who are receiving radiotherapy. A Case Report on a patient with inflammatory metastatic breast cancer with gallbladder metastases, a Feature article on new lung cancer treatments, and a summary of key findings from the 2015 annual meeting of the American Society of Clinical Oncology, round off the podcast.

In this month’s podcast for The Journal of Community and Supportive Oncology, Dr David Henry discusses a Community Translations article on lenvatinib, which was approved earlier this year for the treatment of patients with advanced differentiated thyroid cancer whose disease has progressed after radioactive iodine therapy. Also in the line-up are two Original Reports, one on health care expenditures associated with depression in adults with cancer and another on maximizing accessibility to and the efficacy of a weekly speech and language therapy service for patients with head and neck cancer who are receiving radiotherapy. A Case Report on a patient with inflammatory metastatic breast cancer with gallbladder metastases, a Feature article on new lung cancer treatments, and a summary of key findings from the 2015 annual meeting of the American Society of Clinical Oncology, round off the podcast.

In this month’s podcast for The Journal of Community and Supportive Oncology, Dr David Henry discusses a Community Translations article on lenvatinib, which was approved earlier this year for the treatment of patients with advanced differentiated thyroid cancer whose disease has progressed after radioactive iodine therapy. Also in the line-up are two Original Reports, one on health care expenditures associated with depression in adults with cancer and another on maximizing accessibility to and the efficacy of a weekly speech and language therapy service for patients with head and neck cancer who are receiving radiotherapy. A Case Report on a patient with inflammatory metastatic breast cancer with gallbladder metastases, a Feature article on new lung cancer treatments, and a summary of key findings from the 2015 annual meeting of the American Society of Clinical Oncology, round off the podcast.