Bladder cancer is the VA’s fourth-most-diagnosed cancer, and early diagnosis is important because, if the tumor spreads outside the bladder, the five-year survival rate is only about 38%.
VA AIR Report Outdated Because Pandemic Effects Weren’t Considered
Some of the data which the VA used to support the recommendations made in its Asset and Infrastructure Report (AIR) is outdated and flawed, VA leaders recently admitted.
Acute Stress Reactions Can Endanger Military Combat Teams, Others
A recent report from military researchers put the spotlight on combat-related acute stress reactions (ASRs) in servicemembers.
Speech Therapist Finds Way to Make Dining More Dignified at CLCs
For residents of VA’s Community Living Centers, dignity is a precious resource. Patients who are there for short rehab stays may be struggling with new, frustrating limitations.
Even With Equal Care, Advanced Prostate Cancer Rates Are Higher for Blacks
DURHAM, NC—Despite its status as the most common cancer in American men, prostate cancer remains significantly understudied in terms of its epidemiology. Previous research has shown a higher risk for prostate cancer overall among Black men, but whether that difference...
Could Adding a Checkpoint Inhibitor Improve Response to Belamaf in Multiple Myeloma?
INDIANAPOLIS—A number of drugs have recently been approved or are in clinical trials for treatment of relapsed/refractory multiple myeloma. Among them, belantamab mafodotin (Belamaf) has demonstrated the ability to eliminate myeloma cells both by direct cytotoxicity...
Quality Measures “Markedly Improve” NSCLC Surgery Outcomes for Veterans
LOUIS -- Surgery remains the first choice treatment for stage 1 non-small cell lung cancer (NSCLC) for patients who can withstand it. As a result, most patients with early stage disease and their physicians opt for surgery. A new study asks: Could establishment of a...
The Role of Social Determinants in Cancer in Young Women
Oncology research continues to better understand and quantify the role that social determinants play in the development of cancers to help find ways to reduce the burden of cancer on society and individuals.
Choosing the Appropriate Treatment for Fragile Patients with RCC
Targeted therapies have vastly improved survival in renal cell carcinoma (RCC), despite not offering a cure for many patients. More problematically, patients often develop resistance to the drugs.
Treatment Quandary Continues for Non-metastatic Castration-resistant PCa
While most men with non-metastatic prostate cancer respond to androgen-deprivation therapy initially, many later experience rising prostate-specific antigen levels that indicate they have developed castration resistance.
Women with Pathogenic Variants Excluded from Germline Testing after DCIS
Every year, 60,000 women in the United States receive a diagnosis of ductal carcinoma in situ (DCIS), a noninvasive form of breast cancer. Accounting for one in five breast cancer diagnoses, DCIS has increased with the adoption of routine mammography, but it is far more than just an artifact of imaging.
What Matters in Survival, Treatment of Lymphoid Cancers?
Oncologists balance the most effective treatment against the likelihood of adverse effects for every patient with cancer. Generally, the assumption is that older patients and those with more comorbidities and poorer performance status will experience more negative effects, including potentially fatal toxicity, from aggressive treatment. A study presented at the American Society of Clinical Oncology annual meeting in June calls into question this assumption for at least some patients and specific malignancies.
For Prostate Cancer, Liquid Biopsy Offers New Genomic Profiling Opportunities
Nearly a decade ago, the U.S. Food and Drug Administration approved the first liquid biopsy assay to monitor patients with prostate, breast, and colon cancer by measuring circulating tumor cells (CTC) in patients’ blood.
Choosing the Right Regimen for Elderly Patients with Advanced RCC
Most clinical trials provide limited guidance on the appropriate treatment of patients seen in clinical practice. Particularly in oncology, participants in trials tend to be significantly younger and in substantially better health than the average patient. Renal cell carcinoma (RCC) provides a clear example of the challenge.
nCRC, Sequencing Offers Better Guidance than Staining When Results Differ
Chemotherapy has long been a component in the first-line treatment for advanced or metastatic colorectal cancer (mCRC). A number of studies in recent years indicate that a subset of patients with specific genetic mutations do not respond well to the recommended 5-fluorouracil-based regimens, such as FOLFOX (5-FU, oxaliplatin, and leucovorin) or FOLFIRI (5-FU, irinotecan, and leucovorin) alone or in combination with other agents.
MHS Care Outshines Civilian Medicine in Multiple Myeloma
When a cure is not possible, longer life is the goal. For patients with multiple myeloma, extending survival is the best available option today, and one of the best ways to achieve that is to receive care through the U.S. Military Health System.
Response Rates for Waldenström Macroglobulinemia Improve With Use of New First-Line, Better-Tolerated Treatments
As the number of first-line treatments for Waldenström Macroglobulinemia increased, older adults experienced marked improvements in survival Among older patients, median progression-free survival improved from 28.3 months in the early era to 63.3 months in the modern era, according to a new study. Younger patients, on the other hand, showed almost no improvement in median progression-free survival between eras, the authors pointed out.
Retention Rates Remain Low for Substance Use Disorder Programs
A common explanation for the high dropout rate and failure of a substance use disorder program is that patients fear symptoms of opioid withdrawal. A new study suggested that is for good reason, especially since patients who are exposed to full opioid agonists chronically are recommended to already be experiencing moderate withdrawal symptoms before they can get drugs to alleviate the symptoms. That’s why the FDA has approved new alternatives, including auricular stimulators, to help patients through the difficult withdrawal symptoms.
COVID-19 Infection Increased Suicide Attempts in Some Younger Veterans With Schizophrenic, Schizoaffective Disorder
Authors of a new study strongly urged that patients with schizophrenia or schizoaffective disorder who have a history of suicide attempt and are younger than 59 or obese, should be monitored closely during the COVID-19 pandemic. They warned of the possibility of symptom exacerbation in those patients when they have severe COVID-19 since postmortem examination of brains in that cohort have revealed infection-related impaired brain neurotransmission.
Low Muscle Mass Along with High Tumor IL-6 Expression Strongly Associated with Mortality in Renal Cancer
The combination of low muscle mass and high tumor IL-6 expression predicts early death in patients with clear cell renal cell carcinoma, according to a new study. As with some other malignancies, cachexia is a major cause of mortality in ccRCC, the authors warned, noting that the combination of low muscle mass and high tumor IL-6 expression should raise alarms.
Treatment Options Expand for Older Veterans With Castration-Resistant PCa
In most recurrent prostate cancer patients, androgen-deprivation therapy works for a while. Eventually, however, most men end up developing castration-resistant prostate cancer. Now, expanding treatment options are especially benefitting older men in that situation, who often didn’t fare well with chemotherapy.
VA Pharmacists Take On Even More Critical Roles Because of Pandemic
For years, pharmacists working at the VA, as well as the DoD, have had broader scope of practice than those in the community. The COVID-19 pandemic expanded it even more, with VA pharmacists playing essential roles in identifying, treating and prevention SARS-C0V-2.
The Fungus Really Is Among Us: Its Role in Airway Disease, Nasal Polyps
What is the role of fungus in allergic airway diseases? VA researchers found that many conditions, including chronic rhinosinusitis (CRS), allergic fungal rhinosinusitis, asthma, allergic bronchopulmonary mycosis/aspergillosis, and cystic fibrosis (CF have a shared immunological signature. In some cases, nasal polyps can occur.
A Rare Cancer Prompts Sleuthing at the VA; New Options for MDS
VA researchers solved a mystery involving younger veterans who developed unusual and deadly cancers. They determined that patients currently using certain drugs, thiopurines, had triple the risk of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) on an adjusted basis compared to those never exposed. The risks resolved with discontinuation.
Smoking Cessation Success Rate Low Even in Veterans With Lung Cancer
With a range of smoking cessation program, the VA is having some success reducing the percentage of veterans who use tobacco. Still, data show that veterans find it hard to quit, even when they have been diagnosed with lung cancer and continued smoking affects their overall survival.
Early Colonoscopy in Veterans With IBD Lowers Overall Mortality
Well-timed colonoscopy appears to improve overall survival in inflammatory bowel disease patients, but many VA patients aren’t getting screened regularly. A new study supported current VA practice guidelines that recommend colonoscopy intervals from one year to three years among patients with IBD who have extensive colitis or left-sided colitis.
Risk Factors Change for HCC With More Effective Hepatitis C Treatment
Risk factors for hepatocellular carcinoma have undergone dramatic changesin recent years. Metabolic conditions such as obesity and diabetes, as well as associated nonalcoholic fatty liver disease, now sit at the top of the list. Alcohol use disorders also are on the increase, fueling alcoholic liver disease and alcoholic cirrhosis. At the same time, however, with more effective treatment and prevention, hepatitis C and hepatitis B infections have decreased in prevalence.
VA Researchers Look at Role of Estrogen, Menopause In Elevated Rates of Glaucoma in Women
Women represented less than 10% of U.S. veterans in 2017, according to the National Center for Veterans Analysis and Statistics, but the number of women veterans receiving VHA care has increased by 22.1%, from 423,642 in 2014 to 517,241 in 2018 and is predicted to burgeon even more in the future. That’s why studies such as one examining the role of estrogen and menopause in glaucoma are so important to the VA.
Diabetes Patients With CKD Use More Insulin, Even Though Combination Raises Risk of Severe Hypoglycemia
Conventional wisdom has suggested that insulin requirements go down with advanced chronic kidney disease in Type 2 diabetes patients. That does not always appear to be the case, however. A recent study found that patients with both T2D and CKD are at much higher risk of severe hypoglycemia with insulin use.
In-hospital Continuous Glucose Monitoring Protects Patients, HCPs
Hyperglycemia and diabetes are common in hospitalized patients. Managing that amid the restrictions of the COVID-19 pandemic, including the more recent staff shortages, has been extremely difficult at the VA and elsewhere. Increased use of continuous glucose monitoring has helped the situation.
