Miller on Oncology

• 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.
  Medscape Oncology, September 20, 2013
• 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.
  Medscape Oncology, September 16, 2013
• 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.
  Medscape Oncology, August 28, 2013
• 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.
  Medscape Oncology, June 10, 2013
• 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.
  Medscape Oncology, May 23, 2013
• 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.
  Medscape Oncology, May 17, 2013
• 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?
  Medscape Oncology, May 03, 2013
• 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.
  Medscape Oncology, April 26, 2013
• 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.
  Medscape Oncology, February 21, 2013
• 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.
  Medscape Oncology, February 04, 2013
• 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.
  Medscape Oncology, November 26, 2012
• 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.
  Medscape Oncology, October 24, 2012
• 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.
  Medscape Oncology, August 15, 2012
• 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.
  Medscape Oncology, August 13, 2012
• 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?
  Medscape Oncology, July 26, 2012
• 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.
  Medscape Oncology, July 25, 2012
• 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.
  Medscape Oncology, July 06, 2012
• 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.
  Medscape Oncology, July 02, 2012
• 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.
  Medscape Oncology, May 17, 2012
• 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.
  Medscape Oncology, April 13, 2012
• 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.
  Medscape Oncology, April 06, 2012
• 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.
  Medscape Oncology, March 16, 2012
• 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.
  Medscape Oncology, March 13, 2012
• 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.
  Medscape Oncology, February 23, 2012
• 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?
  Medscape Oncology, February 17, 2012
• 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.
  Medscape Oncology, January 12, 2012
• 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.
  Medscape Oncology, January 09, 2012
• Sniper Attacks in the War on Cancer   Drs. Kathy Miller and George Sledge talk about strategies, past and future, in the war on cancer.
  Medscape Oncology, December 20, 2011
• 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.
  Medscape Oncology, December 02, 2011
• 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.
  Medscape Oncology, November 23, 2011
• 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?
  Medscape Oncology, November 11, 2011
• 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.
  Medscape Oncology, October 31, 2011
• 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.
  Medscape Oncology, August 17, 2011
• 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.
  Medscape Oncology, July 22, 2011
• 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.
  Medscape Oncology, May 27, 2011
• 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.
  Medscape Oncology, May 24, 2011
• 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?
  Medscape Oncology, April 25, 2011
• 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.
  Medscape Oncology, April 08, 2011
• 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.
  Medscape Oncology, March 29, 2011
• 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.
  Medscape Oncology, February 23, 2011
• 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.
  Medscape Oncology, February 15, 2011
• 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.
  Medscape Oncology, January 24, 2011
• 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.
  Medscape Oncology, January 07, 2011
• 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.
  Medscape Oncology, December 03, 2010
• 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.
  Medscape Oncology, November 17, 2010
• 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.
  Medscape Oncology, November 09, 2010
• 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.
  Medscape Oncology, November 08, 2010
• 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.
  Medscape Oncology, October 28, 2010
• 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.
  Medscape Oncology, September 20, 2010
• 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.
  Medscape Oncology, August 31, 2010
• 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.
  Medscape Oncology, July 29, 2010
• 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.
  Medscape Oncology, July 26, 2010
• 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.
  Medscape Oncology, July 13, 2010
• 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.
  Medscape Oncology, May 28, 2010
• 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.
  Medscape Oncology, May 14, 2010
• 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.
  Medscape Oncology, May 07, 2010
• 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.
  Medscape Oncology, April 27, 2010
• 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.
  Medscape Oncology, April 26, 2010
• 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.
  Medscape Oncology, April 20, 2010
• 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.
  Medscape Oncology, April 15, 2010
• 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.
  Medscape Oncology, March 04, 2010
• 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.
  Medscape Oncology, February 12, 2010
• 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.
  Medscape Oncology, February 02, 2010
• 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.
  Medscape Oncology, February 01, 2010
• 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.
  Medscape Oncology, January 05, 2010
• 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.
  Medscape Oncology, December 23, 2009
• 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.
  Medscape Oncology, December 10, 2009
• 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.
  Medscape Oncology, November 25, 2009
• 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.
  Medscape Oncology, November 11, 2009
• 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.
  Medscape Oncology, November 02, 2009