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The European Medicines Agency Review of Decitabine (Dacogen) for the Treatment of Adult Patients With Acute Myeloid Leukemia: Summary of the Scientific Assessment of the Committee for Medicinal Products for Human Use
Maria Nieto, Pierre Demolis, Eliane Béhanzin, Alexandre Moreau, Ian Hudson, Beatriz Flores, Henry Stemplewski, Tomas Salmonson, Christian Gisselbrecht, David Bowen, Francesco Pignatti

The Oncologist 2016; 21:692-700; first published on April 18, 2016; doi:10.1634/theoncologist.2015-0298


Inhibition of Peripheral Synthesis of Serotonin as a New Target in Neuroendocrine Tumors
Javier Molina-Cerrillo, Teresa Alonso-Gordoa, Olga Martínez-Sáez, Enrique Grande

The Oncologist 2016; 21:701-707; first published on April 22, 2016; doi:10.1634/theoncologist.2015-0455


Cardiotoxicity and Cardiac Monitoring During Adjuvant Trastuzumab in Daily Dutch Practice: A Study of the Southeast Netherlands Breast Cancer Consortium
Shanly C. Seferina, Maaike de Boer, M. Wouter Derksen, Franchette van den Berkmortel, Roel J.W. van Kampen, Agnès J. van de Wouw, Manuela Joore, Petronella G.M. Peer, Adri C. Voogd, Vivianne C.G. Tjan-Heijnen


Best Practices in Chronic Myeloid Leukemia Monitoring and Management
Simona Soverini, Caterina De Benedittis, Manuela Mancini, Giovanni Martinelli

The Oncologist 2016; 21:626-633; first published on March 31, 2016; doi:10.1634/theoncologist.2015-0337


Membrane Localization of Human Equilibrative Nucleoside Transporter 1 in Tumor Cells May Predict Response to Adjuvant Gemcitabine in Resected Cholangiocarcinoma Patients
Giovanni Brandi, Marzia Deserti, Francesco Vasuri, Andrea Farioli, Alessio Degiovanni, Andrea Palloni, Giorgio Frega, Maria A. Barbera, Stefania de Lorenzo, Ingrid Garajova, Mariacristina Di Marco, Antonio D. Pinna, Matteo Cescon, Alessandro Cucchetti, Giorgio Ercolani, Antonietta D’Errico-Grigioni, Maria A. Pantaleo, Guido Biasco, Simona Tavolari, on behalf of G.I.CO. (Gruppo Italiano Colangiocarcinoma)

The Oncologist 2016; 21:600-607; first published on March 31, 2016; doi:10.1634/theoncologist.2015-0356


Obesity and Breast Cancer: Molecular Interconnections and Potential Clinical Applications
Valeria Simone, Morena D’Avenia, Antonella Argentiero, Claudia Felici, Francesca Maria Rizzo, Giovanni De Pergola, Franco Silvestris

The Oncologist 2016; 21:404-417; first published on February 10, 2016; doi:10.1634/theoncologist.2015-0351


Candidate Predictors of Health-Related Quality of Life of Colorectal Cancer Survivors: A Systematic Review
Martijn J.L. Bours, Bernadette W.A. van der Linden, Renate M. Winkels, Fränzel J. van Duijnhoven, Floortje Mols, Eline H. van Roekel, Ellen Kampman, Sandra Beijer, Matty P. Weijenberg

The Oncologist 2016; 21:433-452; first published on February 24, 2016; doi:10.1634/theoncologist.2015-0258


Phase II Trial of Bevacizumab in Combination With Temozolomide as First-Line Treatment in Patients With Metastatic Uveal Melanoma
Sophie Piperno-Neumann, Alhassane Diallo, Marie-Christine Etienne-Grimaldi, François-Clément Bidard, Manuel Rodrigues, Corine Plancher, Pascale Mariani, Nathalie Cassoux, Didier Decaudin, Bernard Asselain, Vincent Servois

The Oncologist 2016; 21:281-282; first published on February 24, 2016; doi:10.1634/theoncologist.2015-0501


Predictive and Prognostic Role of Tumor-Infiltrating Lymphocytes for Early Breast Cancer According to Disease Subtypes: Sensitivity Analysis of Randomized Trials in Adjuvant and Neoadjuvant Setting
Luisa Carbognin, Sara Pilotto, Rolando Nortilli, Matteo Brunelli, Alessia Nottegar, Isabella Sperduti, Diana Giannarelli, Emilio Bria, Giampaolo Tortora

The Oncologist 2016; 21:283-291; first published on February 10, 2016; doi:10.1634/theoncologist.2015-0307


PSA tests on Planet Faraway: The Influence of Our Numerical System on Clinical Practice
Paul Martin Putora, Nikola Cihoric, Jan Oldenburg


Responding to Acute Care Needs of Patients With Cancer: Recent Trends Across Continents
Alison Young, Ernie Marshall, Monika Krzyzanowska, Bridget Robinson, Sean Brown, Fiona Collinson, Jennifer Seligmann, Afroze Abbas, Adrian Rees, Daniel Swinson, Helen Neville-Webbe, Peter Selby

Emergency presentations of cancer patients to health care services can be associated with high risks and poor outcomes. Systematic approaches are described to create best practice for these patients based on expert teams and careful organization of services in all hospitals. These approaches, called “acute oncology” in the U.K., may improve care and avoid unnecessary deaths.
The Oncologist 2016; 21:301-307; first published on February 26, 2016; doi:10.1634/theoncologist.2014-0341

Supplemental Case Discussions

Management of Malignant Ascites in the Acute Oncology Setting
Sean Brown, Helen Neville-Webbe

Treating Cancer Patients With Diabetes: The Need for a Multidisciplinary Approach
Jennifer Seligmann, Afroze Abbas, Adrian Rees, Daniel Swinson

Febrile Neutropenia
Alison C. Young, Fiona J. Collinson


The Changing Landscape of Smoldering Multiple Myeloma: A European Perspective
Jo Caers, Carlos Fernández de Larrea, Xavier Leleu, Roy Heusschen, Niklas Zojer, Olivier Decaux, Efstathios Kastritis, Monique Minnema, Artur Jurczyszyn, Yves Beguin, Ralph Wäsch, Antonio Palumbo, Meletios Dimopoulos, Maria Victoria Mateos, Heinz Ludwig, Monika Engelhardt

Emergency presentations of cancer patients to health care services can be associated with high risks and poor outcomes. Systematic approaches are described to create best practice for these patients based on expert teams and careful organization of services in all hospitals. These approaches, called “acute oncology” in the U.K., may improve care and avoid unnecessary deaths.
The Oncologist 2016; 21:333-342; first published on February 26, 2016; doi:10.1634/theoncologist.2015-0303


Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT
Sebastian Giebel, Myriam Labopin, Adalberto Ibatici, Paul Browne, Tomasz Czerw, Gerard Socie, Ali Unal, Slawomira Kyrcz-Krzemien, Andrea Bacigalupo, Hakan Goker, Mike Potter, Caroline L. Furness, Grant McQuaker, Dietrich Beelen, Noel Milpied, Antonio Campos, Charles Craddock, Arnon Nagler, Mohamad Mohty

Results of allogeneic hematopoietic cell transplantation (alloHCT) and other advanced oncological procedures may vary among countries and be related to various economic factors. This study, which included a homogenous population of patients with acute lymphoblastic leukemia, demonstrated significant associations of health care expenditure and the Human Development Index with nonrelapse mortality and overall survival after transplantation. The findings should be taken into account when clinical studies in the field of alloHCT are interpreted. The study should be followed by further investigation in other fields of oncology.
The Oncologist 2016; 21:377-383; first published on February 11, 2016; doi:10.1634/theoncologist.2015-0314


Outpatient Intraperitoneal Catumaxomab Therapy for Malignant Ascites Related to Advanced Gynecologic Neoplasms
Christian Martin Kurbacher, Olympia Horn, Jutta Anna Kurbacher, Susanne Herz, Ann Tabea Kurbacher, Ralf Hildenbrand, Reinhardt Bollmann

Catumaxomab (CATU) is a trifunctional antibody approved for intraperitoneal (i.p.) treatment of malignant ascites (MA) related to carcinomas expressing the epithelial cell-adhesion molecule (EpCAM). CATU is mostly given to hospitalized patients, although outpatient treatment seems appropriate in selected individuals. This observational trial sought to obtain more detailed information regarding the feasibility of CATU in outpatients with MA related to various gynecologic tumors, including epithelial ovarian (EOC) and metastatic breast cancer (MBC).
The Oncologist 2015; 20:1333-1341; first published on September 28, 2015; doi:10.1634/theoncologist.2015-0076

Predicting Ovarian Activity in Women Affected by Early Breast Cancer: A Meta-Analysis-Based Nomogram
Agnese Barnabei, Lidia Strigari, Paolo Marchetti, Valentina Sini, Liana De Vecchis, Salvatore Maria Corsello, Francesco Torino

The meta-analysis of data pooled from the selected studies showed that both age and serum AMH are reliable predictors of post-treatment ovarian activity in breast cancer patients. Importantly, ROC/AUC analysis indicated AMH was a more reliable predictor of post-treatment ovarian activity in patients aged younger than 40 years (0.753; 95% confidence interval [CI]: 0.602–0.904) compared with those older than 40 years (0.678; 95% CI: 0.491–0.866). We generated a nomogram describing the correlations among age, pretreatment AMH serum levels, and ovarian activity at 1 year from the end of chemotherapy.
The Oncologist 2015; 20:1111-1118; first published on September 4, 2015; doi:10.1634/theoncologist.2015-0183


Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue of the Salivary Glands: A Multicenter, International Experience of 248 Patients (IELSG 41)
Amie E. Jackson, Michael Mian, Christina Kalpadakis, Gerassimos A. Pangalis, Anastasios Stathis, Elena Porro, Annarita Conconi, Sergio Cortelazzo, Gianluca Gaidano, Armando Lopez, Guillermo, Peter W. Johnson, Maurizio Martelli, Giovanni Martinelli, Catherine Thieblemont, Ellen D. McPhail, Christiane Copie-Bergman, Stefano A. Pileri, Andrew Jack, Elias Campo, Luca Mazzucchelli, Kay Ristow, Thomas M. Habermann, Franco Cavalli, Grzegorz S. Nowakowski, Emanuele Zucca

Salivary gland MALT lymphoma has an excellent prognosis regardless of initial treatment, and patients with Sjögren disease have improved survival. Risks for long-term complications must be weighed when determining initial therapy.
The Oncologist 2015; 20:1149-1153; first published on August 12, 2015; doi:10.1634/theoncologist.2015-0180


Afatinib in Non-Small Cell Lung Cancer Harboring Uncommon EGFR Mutations Pretreated With Reversible EGFR Inhibitors
David F. Heigener, Christian Schumann, Martin Sebastian, Parvis Sadjadian, Ingo Stehle, Angela Märten, Anne Lüers, Frank Griesinger, Matthias Scheffler, for the Afatinib Compassionate Use Consortium (ACUC)

Afatinib is clinically active and well tolerated in many TKI-pretreated NSCLC patients harboring uncommon EGFR mutations. Compared with results reported in TKI-naïve patients, activity was also indicated in patients with T790M and exon 20 insertion mutations.
The Oncologist 2015; 20:1167-1174; first published on September 9, 2015; doi:10.1634/theoncologist.2015-0073


Perspectives of Medical Specialists on Sharing Decisions in Cancer Care: A Qualitative Study Concerning Chemotherapy Decisions With Patients With Recurrent Glioblastoma
Janine C. De Snoo-Trimp, Linda Brom, H. Roeline W. Pasman, Bregje D. Onwuteaka-Philipsen, Guy A.M. Widdershoven

Medical specialists recognized the importance of patient involvement but experienced difficulty in sharing decision making in practice. Elements of shared decision making are partly followed but do not guide decision making. To improve cancer care, education of medical specialists and adjustment to the elements are needed to involve patients.
The Oncologist 2015; 20:1182-1188; first published on August 5, 2015; doi:10.1634/theoncologist.2015-0095


Prospective Biomarker Analysis of the Randomized CHER-LOB Study Evaluating the Dual Anti-HER2 Treatment With Trastuzumab and Lapatinib Plus Chemotherapy as Neoadjuvant Therapy for HER2-Positive Breast Cancer
Valentina Guarneri, Maria Vittoria Dieci, Antonio Frassoldati, Antonino Maiorana, Guido Ficarra, Stefania Bettelli, Enrico Tagliafico, Silvio Bicciato, Daniele Giulio Generali, Katia Cagossi, Giancarlo Bisagni, Samanta Sarti, Antonino Musolino, Catherine Ellis, Rocco Crescenzo, PierFranco Conte

PIK3CA mutations seem to identify patients who are less likely to benefit from dual anti-HER2 inhibition. p95-HER2 and markers of phosphoinositide 3-kinase pathway deregulation are not confirmed as markers of different sensitivity to trastuzumab or lapatinib.
The Oncologist 2015; 20:1001-1010; first published on August 5, 2015; doi:10.1634/theoncologist.2015-0138


Changing the Paradigm—Multistage Multiarm Randomized Trials and Stratified Cancer Medicine
Mark Lawler, Rick Kaplan, Richard H. Wilson, Tim Maughan, on behalf of the S-CORT Consortium

The increasing fragmentation of clinically recognized diseases into multiple separate biologically defined subtypes threatens the current cornerstone of evidence-based medicine—the randomized controlled trial.
The Oncologist 2015; 20:849-851; first published on June 12, 2015; doi:10.1634/theoncologist.2015-0014


Real-Life Use and Effectiveness of Adjuvant Trastuzumab in Early Breast Cancer Patients: A Study of the Southeast Netherlands Breast Cancer Consortium
Shanly C. Seferina, Dorien J.A. Lobbezoo, Maaike de Boer, M. Wouter Dercksen, Franchette van den Berkmortel, Roel J.W. van Kampen, Agnès J. van de Wouw, Bart de Vries, Manuela A. Joore, Petronella G.M. Peer, Adri C. Voogd, Vivianne C.G. Tjan-Heijnen

This study shows that in real life, patients treated with trastuzumab in early-stage HER2-positive breast cancer had a 5-year disease-free and overall survival comparable to prior randomized trials. For informative decision making, real-life data are of additional value, providing insight on outcome of patients considered ineligible for treatment.
The Oncologist 2015; 20:856-863; first published on June 22, 2015; doi:10.1634/theoncologist.2015-0006


Prospective Clinical Utility Study of the Use of the 21-Gene Assay in Adjuvant Clinical Decision Making in Women With Estrogen Receptor-Positive Early Invasive Breast Cancer: Results From the SWITCH Study
Joseph Gligorov, Xavier B. Pivot, William Jacot, Hervé L. Naman, Dominique Spaeth, Jean-Louis Misset, Rémy Largillier, Jean-Loup Sautiere, Anne de Roquancourt, Christophe Pomel, Philippe Rouanet, Roman Rouzier, Frederique M. Penault-Llorca, for The Francilian Breast Intergroup

Because it is not possible to extrapolate data from one country to another, we considered generating specific data from French oncology centers to be highly relevant for making more accurate estimates of the health and economic impact of Oncotype DX use in the French health care system.
The Oncologist 2015; 20:873-879; first published on June 25, 2015; doi: 10.1634/theoncologist.2014-0467


Patterns of Care and Clinical Outcomes of First-Line Trastuzumab-Based Therapy in HER2-Positive Metastatic Breast Cancer Patients Relapsing After (Neo)Adjuvant Trastuzumab: An Italian Multicenter Retrospective Cohort Study
Matteo Lambertini, Arlindo R. Ferreira, Francesca Poggio, Fabio Puglisi, Antonio Bernardo, Filippo Montemurro, Elena Poletto, Emma Pozzi, Valentina Rossi, Emanuela Risi, Antonella Lai, Elisa Zanardi, Valentina Sini, Serena Ziliani, Gabriele Minuti, Silvia Mura, Donatella Grasso, Andrea Fontana, Lucia Del Mastro

In our study, we observed that trastuzumab-based therapy is an effective first-line therapy for patients exposed to (neo)adjuvant trastuzumab. However, trastuzumab-naïve patients showed a better PFS and a trend toward a better response rate to first-line trastuzumab-based therapy than did patients with previous exposure to (neo)adjuvant trastuzumab.
The Oncologist 2015; 20:880-889; first published on June 22, 2015; doi:10.1634/theoncologist.2015-0020


Treatment of Metastatic Breast Cancer in a Real-World Scenario: Is Progression-Free Survival With First Line Predictive of Benefit From Second and Later Lines?
Marta Bonotto, Lorenzo Gerratana, Donatella Iacono, Alessandro Marco Minisini, Karim Rihawi, Gianpiero Fasola, Fabio Puglisi

This study supports evidence showing that the absence of a 6-month benefit in terms of progression-free survival with first-line therapy predicts a lack of benefit from subsequent therapeutic lines in metastatic breast cancer.
The Oncologist 2015; 20:719-724; first published on May 27, 2015; doi:10.1634/theoncologist.2015-0002


Reducing Cancer Mortality in the European Union
Carlo La Vecchia, Matteo Rota, Matteo Malvezzi and Eva Negri

Since the peak rate reached in 1988, overall age-standardized cancer mortality rates in the European Union have declined by approximately 20% through 2010. This study reviews different mortality analyses to allow comparisons among different years and countries with different age distributions.
First Published Online April 17, 2015; doi: 10.1634/theoncologist.2015-0011


External Quality Assessment Unravels Interlaboratory Differences in Quality of RAS Testing for Anti-EGFR Therapy in Colorectal Cancer
Véronique Tack, Marjolijn J.L. Ligtenberg, Lien Tembuyser, Nicola Normanno, Sara Vander Borght, J. Han van Krieken, Elisabeth M.C. Dequeker

Regulations for the selection of patients with metastatic colorectal cancer for anti-EGFR treatment changed at the end of 2013. A European external quality assessment scheme monitored the performance of laboratories and evaluated the implementation of the new regulations. The findings show great variety in the quality of cancer biomarker testing and should raise awareness about the importance of selecting reliable laboratories for biomarker testing in the context of targeted therapy decisions.
The Oncologist 2015; 20:257-262; first published on February 5, 2015; doi:10.1634/theoncologist.2014-0382


Helical Tomotherapy in Head and Neck Cancer: A European Single-Center Experience
Dirk Van Gestel, Danielle Van den Weyngaert, Geert De Kerf, Bie De Ost, Olivier Vanderveken, Carl Van Laer, Pol Specenier, Yasmyne Geussens, Kristien Wouters, Els Meulemans, Kin Jip Cheung, Vincent Grégoire, Jan B. Vermorken

This article reports on a European single-center clinical experience with helical tomotherapy (HT) in the treatment of head and neck cancer to give a realistic reflection of the role of HT in daily practice for patient candidates for radiotherapy. HT alone or in combination with systemic therapy (ST) is feasible and promising, and it has a low late fatality rate. However, late toxicity is nearly twice as high when ST is added to HT.
The Oncologist 2015; 20:279-290; first published on February 11, 2015; doi:10.1634/theoncologist.2014-0337


 

Brentuximab Vedotin in Patients With Hodgkin Lymphoma and a Failed Allogeneic Stem Cell Transplantation: Results From a Named Patient Program at Four Italian Centers
Carmelo Carlo-Stella, Francesca Ricci, Serena Dalto, Rita Mazza, Michele Malagola, Francesca Patriarca, Simonetta Viviani, Domenico Russo, Laura Giordano, Luca Castagna, Paolo Corradini, Armando Santoro

The aim of this study was to retrospectively evaluate the efficacy and safety of brentuximab vedotin (BV) in a multicenter setting of classical Hodgkin lymphoma relapsing or progressing after allogeneic stem cell transplant. Results showed that BV therapy is an effective and safe approach for achieving transient disease control in these patients. To improve disease control, future studies should explore the combination of BV with targeted agents.
The Oncologist 2015; 20:323-328; first published on February 10, 2015; doi:10.1634/theoncologist.2014-0420

 


 

The European Medicines Agency Review of Pomalidomide in Combination With Low-Dose Dexamethasone for the Treatment of Adult Patients With Multiple Myeloma: Summary of the Scientific Assessment of the Committee for Medicinal Products for Human Use
Zahra Hanaizi, Beatriz Flores, Robert Hemmings, Jorge Camarero, Arantxa Sancho-Lopez, Tomas Salmonson, Christian Gisselbrecht, Edward Laane, Francesco Pignatti

On August 5, 2013, a marketing authorization valid throughout the European Union was issued for pomalidomide in combination with dexamethasone for the treatment of adult patients with relapsed and refractory multiple myeloma who have received at least two prior treatment regimens, including both lenalidomide and bortezomib, and have demonstrated disease progression on the last therapy. This paper summarizes the scientific review of the application leading to that approval.
The Oncologist 2015; 20:329-334; first published on February 11, 2015; doi:10.1634/theoncologist.2014-0073

 


 

The European Medicines Agency Approval of Axitinib (Inlyta) for the Treatment of Advanced Renal Cell Carcinoma After Failure of Prior Treatment With Sunitinib or a Cytokine: Summary of the Scientific Assessment of the Committee for Medicinal Products for Human Use
Kyriaki Tzogani, Venke Skibeli, Ingunn Westgaard, Marianne Dalhus, Hege Thoresen, Karsten Bruins Slot, Per Damkier, Kenneth Hofland, Jeanett Borregaard, Jens Ersbøll, Tomas Salmonson, Ronny Pieters, Richard Sylvester, Gerald Mickisch, Jonas Bergh, Francesco Pignatti

Based on a positive opinion from the European Medicines Agency, a marketing authorization valid throughout the European Union (EU) was issued for axitinib (Inlyta) for the treatment of advanced renal cell carcinoma after failure of prior treatment with sunitinib or a cytokine. This paper summarizes the scientific review of the application leading to approval in the EU.
The Oncologist 2015; 20:196-201; first published on January 23, 2015; doi:10.1634/theoncologist.2014-0177

 


 

Public Perception of Cancer Care in Poland and Austria
Mariusz Jȩdrzejewski, Christiane Thallinger, Magda Mrozik, Gabriela Kornek, Christoph Zielinski, Jacek Jassem

A one-time survey was conducted to compare the public perception of cancer treatment in Poland and Austria. In total, 3,649 subjects, representing the general population, cancer patients, and cancer patients' family members, were surveyed. Vast differences in the perceptions of the two populations of cancer care reflect actual cancer outcomes and the national per capita spending on health-related issues.
The Oncologist 2015; 20:28-36; first published on December 17, 2014; doi:10.1634/theoncologist.2014-0226

 


 

Chemotherapy Dose Adjustment for Obese Patients Undergoing Hematopoietic Stem Cell Transplantation: A Survey on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Noga Shem-Tov, Myriam Labopin, Leila Moukhtari, Fabio Ciceri, Jordi Esteve, Sebastian Giebel, Norbert-Claude Gorin, Christopher Schmid, Avichai Shimoni, Arnon Nagler, Mohamad Mohty

An electronic survey was used to assess current practice of dose adjustment of chemotherapy in obese and overweight patients undergoing hematopoietic stem cell transplantation. It revealed large diversity among transplant centers regarding dose-adjustment practice. This novel survey is an important step toward defining the right dose adjustment for pretransplantation conditioning to improve efficacy, to reduce toxicity, and thus to improve transplantation outcome.
The Oncologist 2015; 20:50-55; first published on December 5, 2014; doi:10.1634/theoncologist.2014-0187

 


 

What Keeps Oncologists From Addressing Palliative Care Early on With Incurable Cancer Patients? An Active Stance Seems Key
Timo A. Pfeil, Katsiaryna Laryionava, Stella Reiter-Theil, Wolfgang Hiddemann, Eva C. Winkler

This qualitative study, based on a survey of care providers in a hospital in Munich, Germany, explores the factors that hinder sympathetic and frank communication about the terminal nature of advanced cancer and reconstructs how physicians and nurses in oncology perceive their roles in preparing patients for end-of-life decisions. The findings suggest that oncologists recognized a risk of nourishing patients' overly optimistic views in not talking openly and that it would be better to prepare patients proactively for decisions toward the end of life.
The Oncologist 2015; 20:56-61; first published on October 31, 2014; doi:10.1634/theoncologist.2014-0031

 


 

International Collaboration and the Importance of Eubiosia
Stephan Tanneberger

The call of the oncologist is to improve quality of life, and to do so, oncologists can look beyond technology and expensive medications; these may not be necessary for patients to achieve eubiosia: no more pain and dignity of life until the last moment of life. Simple gestures of companionship, family, and care can make a difference.
The Oncologist 2015; 20:86-87; first published on December 9, 2014; doi:10.1634/theoncologist.2014-0427