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ASTRO 2017: Updates in HPV-Positive Head and Neck CancerThis video highlights studies on HPV-positive head and neck cancer presented at the 2017 ASTRO Annual Meeting.
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Geriatric Syndromes and Assessment in Older Cancer PatientsOlder individuals are at risk for adverse events in all settings where cancer is treated. Common geriatric syndromes can complicate cancer therapy, and thus, increase patient morbidity and the costs of care. Furthermore,
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Adjuvant Treatment of Stage IB Lung Cancer: Untangling the ControversyThe article by Calhoun and colleagues, published in this issue of ONCOLOGY, is a timely review of one of the more controversial questions in thoracic oncology: whether or not patients with stage IB non–small-cell lung cancer (NSCLC) should receive adjuvant chemotherapy.
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Evaluating the Role of Serine Protease Inhibition in the Management of Tumor MicrometastasesManagement of patients with neoplastic disease has shifted from searchand-destroy approaches employing radical surgery, chemotherapy,and radiotherapy to novel strategies that target specific molecular orgenetic characteristics or modify growth factors, angiogenesis, and cell-cell interactions.Attention has also been focused on modifying the production and function ofcertain enzymes pivotal to the genesis of disseminated disease.
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The Role of Intraperitoneal Therapy in Advanced Ovarian CancerIntraperitoneal (IP) chemotherapy is a preferred treatment option that should be offered to all women for front-line treatment of stage III optimally debulked ovarian cancer. Patients should be provided with information on the survival and toxicity for both IP and intravenous (IV) therapies, as well as practical information about the administration of each regimen, so that they may play an active role in the decision-making process. When making a decision between IP and IV therapeutic options, the experience and preference of the oncologist are critical factors in determining appropriate therapy for each woman.
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Systemic Treatment Options for Brain Metastases from Non–Small-Cell Lung CancerIn this review, we discuss recent clinical investigations that highlight the effects of novel compounds targeting EGFR, ALK, and other receptor oncogenes, as well as the promise of immunotherapy in lung cancer CNS disease.
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Managing the Patient With Borderline Resectable Lung CancerDespite recent therapeutic advances, lung cancer continues to be one of the leading causes of cancer-related mortality. Of the various histologic subtypes, non–small-cell lung cancer (NSCLC) is the most common-accounting for approximately 85% of all lung cancers-and will be the focus of this article. In general, the treatment of lung cancer may include surgery, radiation therapy, systemic therapy (eg, chemotherapy with or without targeted therapy), or a combination of the above. Surgery continues to offer the best chance of long-term cure. The initial treatment of stage I and II NSCLC usually entails surgical resection, whereas stage IV disease is primarily treated with systemic agents, in light of the lack of curative potential with surgery and/or radiation therapy alone. It is locally advanced NSCLC, including stage IIIA and IIIB disease, that continues to pose a therapeutic dilemma, given its heterogeneous nature.
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Lung Cancer Screening: Has Its Time Come?The simple answer, according to some, is that lung cancer screening’s time has come. However, in my opinion, the answer is not that simple.
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Use of Molecular Biomarkers to Inform Adjuvant Therapy for Colon CancerIn this review, we will discuss adjuvant chemotherapy in non-metastatic colon cancer, the existing prognostic and predictive molecular biomarkers in the field, and how to integrate these molecular biomarkers into the decision about whether to administer adjuvant therapy.
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Indolent B-Cell Non-Hodgkin’s LymphomasB-cell non-Hodgkin’s lymphomas (NHL) are an increasingly common cause of cancer morbidity and mortality. In 1996, approximately 52,700 new cases of NHL were diagnosed, representing a marked increase in incidence. Indeed, the incidence rose from 8.5 per 100,000 population in 1973 to 15.1 per 100,000 in 1992.[1] About 20% to 30% of these are NHLs of the indolent varieties.
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Commentary (Seres/Harrison): Nutritional Support of Patients Undergoing Radiation Therapy for Head and Neck CancerDr. Colasanto and his associatesare to be commended forskillfully and comprehensivelyreviewing the issues concerning theprovision of nutritional support to patientsundergoing radiation therapy.Their recommendations are well supportedby review of scientific studies,and the article is written in such a wayas to be accessible to those not fullyversed in prescribing nutritional support.There remain a few points thatdeserve discussion.
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Leveraging “Exciting” CAR T-Cell Therapy Advancements in Multiple MyelomaWhether CAR T-cell therapy or T-cell engagers should dominate the multiple myeloma landscape may be hard to determine, says David S. Siegel, MD.
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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.
