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Reducing Tobacco Use: A Report of the Surgeon General-2000Tobacco use, particularly smoking, remains the number 1 cause of preventable disease and death in the United States. This report of the Surgeon General on smoking and health is the first to offer a composite review of the various methods used to
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The "Epidemic" of Breast Cancer in the U.S.--Determining the FactorsBreast cancer incidence rates in the United States rose by 24% between 1973 and 1991. Mortality during this period, however, remained stable. Both the 5-year relative survival rate and the rates of in situ and stage I
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Colon, Rectal, and Anal CancersThis management guide covers the risk factors, symptoms, diagnosis, staging, and treatment of colorectal and anal cancers.
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Uterine Corpus TumorsCarcinoma of the epithelial lining (endometrium) of the uterine corpus is the most common female pelvic malignancy. Factors influencing its prominence are the declining incidence of cervical cancer, longer life expectancy, and earlier diagnosis.
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Outlook for 2017: Myeloma, Lymphoma, and MPNsThis look ahead at hematologic malignancies in 2017 focuses on new agents being studied for the treatment of multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma, and myeloproliferative neoplasms.
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Imagery and Hypnosis in the Treatment of Cancer PatientsMany patients with cancer often seek some means of connecting their mental activity with the unwelcome events occurring in their bodies, via techniques such as imagery and hypnosis. Hypnosis has been shown to be an
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Salvage Therapy for Ovarian CancerPatients with epithelial ovarian cancer must receive optimal surgical care and state-of-the-art chemotherapy in the primary treatment setting. The salvage treatment of women with recurrent or persistent ovarian cancer remains a
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Cancer Management Chapter 26: Hodgkin lymphomaIn 2009 approximately 8,510 new cases of Hodgkin lymphoma (HL) will be diagnosed in the United States. Over the past 4 decades, advances in radiation therapy and the advent of combination chemotherapy have tripled the cure rate of patients with HL. In 2009, more than 80% of all newly diagnosed patients can expect a normal, disease-free life span.
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Annual Lung Cancer Screening Will Be Reimbursed for Select PatientsIn this interview we discuss the recent CMS decision to cover low-dose CT screening for lung cancer in patients who fit specific criteria.
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Psychological Complications of Prostate CancerThe authors challenge the notion that men with prostate cancer exhibit little psychological difficulty. In fact, we do not know much about actual distress rates in men with prostate cancer because few studies have directly measured distress in this population. Likewise, we do not know if the distress experienced by prostate cancer patients is qualitatively different from that of other cancer patients. By assuming that all men with prostate cancer "do well," we, as clinicians and researchers, may fail to ask patients important questions.
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Stem Cell Transplant Approaches for Patients With Blood CancersDr. Scadden discusses which blood cancer patients are eligible for stem cell transplantation, as well as the latest advances in the field.
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Pelvic MRI for Guiding Treatment Decisions in Rectal CancerThis article discusses features that predict local recurrence and distant metastasis in rectal cancer, and how to use MRI to guide treatment decisions.
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Commentary (Bouda)-Opioids in Cancer Pain: Common Dosing ErrorsIread with pleasure this articlefrom the staff of the Harry R.Horvitz Center for Palliative Medicine,an institution with expertiseand experience to draw upon. Allmultidisciplinary cancer centersshould have an expertise in palliativemedicine if not a formalized program,as one of the most important jobs ofoncologists is to relieve pain and sufferingfor patients and their families.When pain is effectively addressed,the patient’s aggregate quality of lifeis optimized and time spent with familyand friends is more enjoyable.
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Invasive Aspergillosis in Cancer PatientsThe incidence of invasive aspergillosis is increasing parallel to the intensity of immunosuppressive and myelosuppressive anticancer treatments. Successful management is linked to an understanding of the
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CT Screening for Lung Cancer: How to Fulfill the PromiseRadiologic screening for lung cancer had a long and unsuccessful history until the advent of low-dose computed tomography (CT) screening and the completion of the National Lung Screening Trial, which demonstrated an improvement in lung cancer–specific mortality in a high-risk population.
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Chronic Inflammation and Cancer: The Role of the MitochondriaWe review the evidence implicating a strong association between chronic inflammation and cancer, with an emphasis on colorectal and lung cancer.
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Sentinel Lymph Node Mapping in Breast CancerAs Dr. Cody points out, sentinel lymph node mapping of axillary nodes in patients with invasive breast cancer will probably become the standard of care for patients with early breast cancer, and will replace standard axillary dissection for many of these patients. With mammography increasing the detection of small, nonpalpable breast cancers, which pose a very low risk of axillary metastases, it is difficult to justify the continued use of standard axillary dissection. To my mind, it is also difficult to justify omitting axillary dissection of any type in these settings.
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Commentary (Larson/Nelson)-Laparoscopic Surgery for Cancer: Historical, Theoretical, and Technical ConsiderationsSurgery for cancer carries concerns of tumor dissemination related to tumor manipulation, tumor violation, and wound seeding. Minimally invasive surgery is now standard for several benign conditions, such as symptomatic cholelithiasis and surgical therapy of gastroesophageal reflux. With the minimally invasive surgery explosion of the 1990s, virtually every procedure traditionally performed via laparotomy has been performed successfully with laparoscopic methods, including pancreaticoduodenectomy for cancer. Shortly after the first descriptions of laparoscopic-assisted colectomy, reports of port-site tumor recurrences surfaced, raising concerns of using pneumoperitoneum-based surgery for malignancy. This review covers the development of laparoscopic surgery for cancer. Historical perspectives elucidate factors that helped shape the current state of the art. Theoretical concerns are discussed regarding surgery-induced immune suppression and its potential effects on tumor recurrence with both open and laparoscopic approaches. The concerns of laparoscopic port-site wound metastases are addressed, with a critical evaluation of the literature. Finally, a technical discussion of laparoscopic-assisted resections of hepatic and pancreatic tumors details patient selection, operative approach, and existing data for these operations.
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Sentinel Lymphadenectomy: Accurate Histopathologic Staging of the AxillaWe agree with the need to reexamine the routine use of axillary dissection in the management of breast cancer patients, as advocated by Manjeet Chadha and Deborah Axelrod, in their article, "Is Axillary Dissection Always Indicated in Invasive
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Antiemetic Therapy: Much Progress, Much More to be DoneA review of "Chemotherapy-Induced Nausea and Vomiting: Which Antiemetic for Which Therapy?"
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The Prostate Cancer Intervention Versus Observation Trial (PIVOT)The Prostate Cancer Intervention Versus Observation Trial (PIVOT) is a randomized trial designed to determine whether radical prostatectomy or expectant management provides superior length and quality of life for men with clinically localized prostate cancer. Conducted at Department of Veterans Affairs and National Cancer Institute medical centers, PIVOT will enroll over 1,000 individuals less than 75 years of age. The primary study end point is all-cause mortality. Secondary outcomes include prostate cancer- and treatment-specific morbidity and mortality, health status, predictors of disease-specific outcomes, and cost-effectiveness. Within the first 3 years of enrollment, over 400 men have been randomized. Early analysis of participants' baseline characteristics indicate that enrollees are representative of men diagnosed with clinically localized prostate cancer throughout the United States. Therefore, results of PIVOT will be generalizable. These results are necessary in order to determine the preferred therapy for clinically localized prostate cancer. [ONCOLOGY 11(8):1133-1143, 1997]
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Changing Perspectives on Palliative CareIn their article, Drs. Choi and Billings address a number of strategic areas in palliative care. These topics include the definition and scope of the evolving field, the complexities involved in the use of modalities that carry burden or risk (such as artificial nutrition and bowel decompression), and the underappreciated importance of communication skills and a capacity for ethical reasoning.
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Gemcitabine in Combination With New Platinum Compounds: An UpdateCombinations of gemcitabine (Gemzar) with cisplatin (Platinol) are among the most active new chemotherapy regimens developed for advanced non-small-cell lung cancer. Carboplatin (Paraplatin) is a platinum analog
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Late Effects Clinic: Cardiovascular Late EffectsChronic or late cardiovascular effects are estimated to occur in less than 5% of patients who receive chemotherapy and mediastinal radiation for all types of cancer.
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Anthracycline Cardiotoxicity After Breast Cancer TreatmentAnthracyclines are among the most effective and widely prescribed anticancer agents. They were first isolated from cultures of Streptomyces peucetius by Dr. Federico Arcamone in the early 1960s.[1] Anthracyclines have since become an essential component of breast cancer treatment, and their use in combination regimens as adjuvant therapy is the standard of care for most women with early-stage disease.[2] Two commonly used anthracyclines in breast cancer are doxorubicin and epirubicin, a semisynthetic derivative of doxorubicin.
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The Role of Physical Activity in Cancer Prevention, Treatment, Recovery, and SurvivorshipThis article will review these intersections of exercise and oncology, discuss the known mechanisms by which exercise exerts its salutary effects, and touch upon the future directions of exercise research in the oncology setting. Finally, recommendations are provided for clinicians to help patients with and without cancer take advantage of the benefits of physical activity.
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ASCO: Biomarkers in Cancer PreventionDr. Brenner discusses the role of chemopreventives, biomarkers, and early detection for cancer prevention.
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Combined-Modality Therapy for Bladder CancerRadical cystectomy remains standard management for patients with locally advanced T2 through T4, N0, M0 transitional cell carcinoma of the urinary bladder.
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Biphasic Tumors of the Female Genital TractIn this installment of Second Opinion, we are presenting two cases of tumors of the female genital tract, specifically, the ovary and uterus, which contain both epithelial and mesenchymal components and therefore have unique diagnostic and therapeutic implications. The first has an unusually poor prognosis and the second is notoriously difficult to diagnose.
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ACR Appropriateness Criteria® Postradical Prostatectomy Irradiation in Prostate CancerThe purpose of this article is to present an updated set of American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of radiation therapy in postprostatectomy prostate cancer.
