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Although resection currently remains the standard of care for renalcarcinoma, the search for less invasive treatments has led to alternativesurgical approaches. Even less invasive, and appropriate for manygroups of patients, is percutaneous radiofrequency ablation, which inducestumor necrosis via lethal hyperthermia. Multiple series of renaltumors treated with percutaneous ablation in vivo and left in situ havebeen published; these series reveal that for small renal tumors,radiofrequency ablation results in complete necrosis at imaging in 79%to 100% of cases. Because current results come from tumors left in situwith short postablation follow-up, long-term results are necessary tocompare outcomes to surgical standards. Complication rates are lowerthan those following partial nephrectomy. Future reports will shed lighton the long-term outcomes of percutaneous ablation and the relativeadvantages and disadvantages of various technologies for thermal ablation.

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We still have much to do to fully understand the potential of complementary therapies as important elements in cancer treatment and health. Mind-body and body-based interventions may be able to improve health and prevent disease as effectively as pharmacologic agents-without the toxicities associated with pharmacologics, and as adjuncts to pharmacologic therapies they may help to maximize health and diminish disease with less toxicity.

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Many cancer patients experience cachexia. In collaboration with an interdisciplinary team including dietitians, oncology nurses are well positioned to implement proactive, multimodality interventions that improve clinical outcomes and quality of life for these patients.

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What single agent does the new ASCO guideline recommend for first-line treatment of patients with stage IV non-small-cell lung cancer without positive markers but with high PD-L1 expression? Is there an age limit for use of SBRT for early-stage lung cancer? Test your knowledge in our latest quiz.

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The patient, DB, is a 47-year-old woman who has been married 24 years. Her daughter is away at college and her son is a high school senior. Last summer, DB was diagnosed with invasive ductal carcinoma of the breast. She had one positive lymph node with an estrogen receptor/progesterone receptor strongly positive tumor.

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Consider the following case study, which illustrates the complex physical and psychosocial care required for the patient developing graft-versus-host disease (GVHD) following an allogeneic hematopoietic stem cell transplantation (HSCT): Mr. SR is a 38-year-old male with a diagnosis of anaplastic large cell non-Hodgkin’s lymphoma (NHL).

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In light of the recent FDA approval of HPV testing for women as a screening method for cervical cancer, we discuss changing guidelines with two experts.

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After an almost 40-year search for a primary regulatory of platelet production, thrombopoietin has recently been purified and cloned. Thrombopoietin regulates all stages in the production of platelets by promoting both the

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Opioid rotation involves changing from one opioid to another usingcorrect equianalgesic conversion techniques to achieve better analgesiaand/or fewer side effects. The strategy appears to work because ofsignificant interindividual variations in response to both analgesic activityand toxicity. Although there are many retrospective studies, fewprospective controlled trials of opioid rotation have been published.The practical and theoretical advantages of opioid rotation includeimproved analgesia, reduced side effects, cost reduction, and improvedcompliance. Disadvantages include problems related to inaccurate conversiontables, limited availability of certain opioid formulations, druginteractions, and the possibility of increased expense. Weighing theadvantages and disadvantages is essential prior to making a decisionabout opioid rotation selection.

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This article describes the clinical data that led to approval of these B-cell receptor inhibitors for the treatment of CLL, and highlights newer agents in clinical development that target the same kinases as the currently available therapies.

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Malignancies have been detected in approximately 40% of all patients with acquired immunodeficiency syndrome (AIDS) sometime during the course of their illness.

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Eliminating cancer disparities-not only for racial/minority groups but for all underserved populations-must be a priority for those involved in cancer care. For individual practitioners, the first step in addressing disparities is accomplished through understanding the possibility that disparities exist in varying depth and complexity for each racial or ethnic minority patient.

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Current US statistics on cancer reveal that more than 11 million cancer survivors live among us today, and that number is expected to double by 2050.[1,2] One important contributing trend has been a fall in cancer deaths driven by earlier detection and improved treatment. Deaths resulting from cancer declined from 206.7 per 100,000 population in 1980 to 185.7 per 100,000 in 2004. Meanwhile, the adjusted 5-year survival rate for cancers overall increased from 50% to 66% between 1975–1977 and 1996–2003,[3] and these statistics speak only to relatively short-term survival. About 1 in every 7 survivors today received their diagnosis more than 20 years ago.[4]

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This phase II trial was conducted to evaluate the percentage of objective responses and the toxicity profile of combination doxorubicin (Adriamycin) and paclitaxel (Taxol) with granulocyte colony-stimulating factor as first-line

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The identification of predictive or surrogate markers of response toHER1/epidermal growth factor receptor (EGFR) inhibitor treatmentwould permit selection of patients most likely to respond to such treatment.Markers could consist of tumor characteristics (eg, characteristicsof the receptor or downstream signaling molecules and determinantsof resistance) or host characteristics (eg, pharmacokinetic parametersand toxicities). The occurrence of rash may constitute a surrogatemarker of response to erlotinib (Tarceva) treatment in patientswith non–small-cell lung cancer and other cancers. The erlotinib markeridentification program has been designed to identify and investigateother candidate markers by analysis of a large number of clinicalsamples from patients enrolled in erlotinib trials in non–small-cell lungcancer, including the phase III TALENT and TRIBUTE trials oferlotinib combined with chemotherapy and the phase III BR.21 trial oferlotinib monotherapy in advanced non–small-cell lung cancer. Thisprogram should both contribute to understanding of the molecular biologyof HER1/EGFR inhibition and result in identification of potentialmarkers that can be evaluated in the clinical setting.

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Dr. Correa discusses her work on brain tumors and genetics, and their contribution to adverse side effects.

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Traditionally, cytotoxic drugs have played a limited role in the treatment of brain tumors, but important advances in chemotherapy have occurred during the past decade. Certain central nervous system (CNS) malignancies are

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Although almost all pituitary tumors are benign adenomas, a surprisingly large number of these tumors invade tissues outside of the pituitary gland. Such invasion, by itself, is not diagnostic of pituitary carcinomas, which are

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The patient is a 58-year-old woman who was diagnosed at an outside hospital with a World Health Organization (WHO) grade III non–contrast-enhancing right frontal anaplastic astrocytoma, with spread into the genu of the corpus callosum.

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In this video reviews the management of nodular lymphocyte-predominant Hodgkin lymphoma.

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Bleeding and thrombosis in cancer patients cause significant morbidity and are a leading cause of mortality well before the malignancy is directly life-threatening.

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In this interview we discuss the impact of the Affordable Care Act (ACA) on health disparities, as well as the challenges the law will present for physicians.

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Of particular relevance for clinicians is the possible recommendation of omitting concurrent chemotherapy with CSI in adults, due to the lower marrow reserves and overall lack of data for clear efficacy of concurrent chemotherapy in adults. Additional refinement of these therapeutic regimens for adult medulloblastoma awaits further advances in both the molecular prognostic associations for these tumors and the potentially exciting development of targeted therapies for specific molecular subtypes.

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Approximately 70% of patientswith life-threatening diseasestreatable with allogeneic bloodstem cell transplantation do not havematched related donors. The NationalMarrow Donor Program (NMDP) wasestablished in 1986 to provide humanleukocyte antigen (HLA)-matched,volunteer unrelated donors for thesepatients. The NMDP performs thistask by maintaining a registry of morethan 4.9 million volunteer donors ofmarrow and peripheral blood stemcells (PBSC) and 12 cord blood bankscontaining more than 25,000 units ofumbilical cord blood.

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Burkitt lymphoma (BL) is a unique B-cell lymphoma characterized by a high proliferation rate and cytogenetic changes related to c-myc proto-oncogene overexpression. Burkitt lymphoma is a highly aggressive B-cell lymphoma that is most frequently seen in children and young adults in endemic areas.

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Obliteration of the tumor vasculature is an effective means of achieving tumor regression. Antiangiogenic agents have begun to enter cancer clinical trials. Ionizing radiation activates the inflammatory cascade and increases the

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Tumors of the superior pulmonary sulcus (Pancoast tumors) are bronchogenic carcinomas that occur at the thoracic inlet and typically involve, by direct extension, the lower trunks of the brachial plexus, the intercostal nerves, the stellate ganglion, and adjacent ribs and vertebrae. These tumors are rare, comprising 5% of all lung cancers. Treatment of Pancoast tumors has traditionally consisted of preoperative radiation to a dose of 3,000 to 4,500 cGy followed by surgical resection. Overall 5-year survival rates range from 30% to 50%. Even if treatment achieves local disease control, distant failure (brain or bone) is common. Recent treatment efforts have focused on the use of induction chemoradiation followed by surgery and further chemotherapy. This combined-modality approach may become the new treatment paradigm for Pancoast tumors. [ONCOLOGY 11(6):781-785, 1997]

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The non-Hodgkin’s lymphomas are a biologically heterogeneous group of diseases with varying clinical presentations and outcomes. A number of studies have identified variables that carried independent prognostic significance. Although several staging systems had evolved that incorporated these prognostic variables, they were still unable to predict outcome. Ideally, the object of a staging system is to predict the likelihood of treatment response, time to progression or disease-free survival, and overall survival, and to provide a way to compare the outcome of similar groups of patients among various clinical trials. The need for such a system led to the creation of prognostic models such as the M. D. Anderson Tumor Score and, more recently, the International Prognostic Index. These prognostic models may identify those patients at highest risk for treatment failure, thereby identifying those patients who may require different therapeutic approaches. [ONCOLOGY 12(Suppl 8):17-24, 1998]