Maurie Markman, MD

Articles

A Society That Worries About Risks Should Consider Cancer Prevention

November 23rd 2019

When discussing the topic of vaccination to prevent serious childhood illness, an increasing number of individuals refuse to accept the unequivocally demonstrated value of this public health strategy despite the very low risk of harm.

Cancer Research Versus Care: Just How Different Are the Goals?

November 13th 2019

The often intense and frequently highly focused effort to seek scientific purity in answering questions within cancer clinical trials raises serious concerns regarding the ethical foundation of certain studies.

Tips for Talking With Patients: "Mother Question" and Sleep Test

October 30th 2019

Certain themes and questions about individualized, scientifically unanswerable dilemmas often recur when talking with patients and families about treatment.

End-of-Life Treatment Has Important Nuances

October 13th 2019

Even if a disease is diagnosed as “incurable,” or progression to a state of incurability subsequently develops, the time between diagnosis and death is being prolonged and the quality of life improved with novel oncologic interventions, such that continued therapeutic efforts are justified.

Informed Consent Means Patients Should Be Informed

October 1st 2019

There is no more important principle in the conduct of legitimate therapeutic investigation than ensuring the adequacy of informed consent of the prospective clinical trial participant.

Small Subgroups May Hold Big Clinical Clues in Oncology

September 23rd 2019

With the revolution in our understanding of cancer’s basic molecular biology, it is increasingly evident that subgroups of cancer originating from specific regions of the body have unique natural histories and respond to very different therapeutics. For example, the importance of BRCA mutations, which define a subset of ovarian cancers impressively sensitive to PARP inhibitors, has striking altered the management of this group of gynecologic malignancies.

Rising Healthcare Costs Leave People Behind

August 23rd 2019

The cost of antineoplastic therapy and essential supportive care medications have a substantial negative impact on patients with cancer and their families.

Placebo Control Arms Are Deeply Flawed Scientific Tools

August 11th 2019

Particularly in the oncology arena, there are several serious scientific, ethical, and pragmatic concerns associated with ongoing reliance on placebo-controlled studies.

Control Arms Must Be Selected for Meaningful Comparison

July 24th 2019

Although concerns have been raised in recent years regarding the need for randomized trials to augment the body of clinical understanding, one critical issue that has failed to generate sufficient discussion is how the choice of the control arm affects the interpretation of an individual study’s outcome and potentially undermines the ethical basis for that particular study.

Open-Access Publishing Model May Introduce New Biases in Oncology

July 15th 2019

For clinical science, particularly oncology, there has never been a more exciting era than today.

Evolutionary Medicine May Provide Clues for Cancer Genetics

June 28th 2019

Today, with the routine performance of single gene or germline panel testing, as well as a critical focus on prospective follow-up of individuals with incompletely understood germline variants, clinicians are developing an increasingly robust appreciation for the influence of an individual’s genetic background on the likelihood of developing specific malignancies or a group of malignant conditions.

Vaccine Opponents Haven't Looked at the Evidence

June 11th 2019

It may be difficult for many who have not lived through an outbreak to appreciate how critical it is to never permit the disease to reappear.

Sometimes the Weight of Tradition Is Heavier Than Gold-Standard Evidence in Oncology

May 18th 2019

Evidence generated from the randomized study design may be largely ignored by an individual or a community of physicians if the results or strategies being examined do not align with existing beliefs or bias, local practice and referral patterns, and other potentially highly relevant factors unrelated to the trial outcome.

When the Quality of Evidence Just Doesn't Make the Grade in Cancer Care

May 10th 2019

The oncology clinical and research communities should demand that essential clinical trials and objectively valid evidence for efficacy and toxicity be obtained and reported before any regulatory agencies or national/international cancer societies support this strategy as a “standard of care” for cancer pain management.

Hope Versus Expectation: A Critical Distinction

April 26th 2019

It is critical to inquire what is wrong with hope, if it helps patients through their journey while not interfering with likely necessary end-of-life decisions when these are required to be made.

Old-Fashioned Biology Trumps Technological Potential

April 10th 2019

The recent technological advances in medicine and related fields have encouraged a belief among many that there is little technology will not be able to accomplish in improving cancer-related clinical outcomes, but it must be acknowledged that clinical medicine and cancer biology are extremely complex arenas.

Dose Modulation Should Not Be Undervalued in Oncology

March 28th 2019

Considering the decades of clinical investigation involving cytotoxic therapy of malignant disease, it is remarkable— even disconcerting—just how little is understood about the optimal delivery of this critical cancer treatment strategy.

When a Measure of Significance Is Not All That Significant

March 20th 2019

The term statistically significant is almost certainly beautiful music to the ears of clinical investigators and pharma/biotech companies. However, concern develops when one inquires how the most common test of significance, the P value, is used in clinical investigative efforts and whether at times this is more harmful than helpful within the domain of cancer medicine.

New Strategies and Novel Agents Transform Ovarian Cancer Into a Chronic Condition

March 7th 2019

The immediate future of clinical investigation in ovarian cancer is remarkably exciting, with a number of novel agents and combination strategies currently being examined in multiple clinical trials.

Germline Variants Assume Prominent Role in Oncology Treatment Paradigm

February 27th 2019

Stunning technological advances in the ability to examine the molecular structure of human DNA have significantly reduced the time and costs associated with this process.