Authors
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Precision Medicine in NSCLC The Power of Molecular TestingPersonalized therapy for non–small cell lung cancer has evolved significantly with the advent of comprehensive molecular testing.
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Management of Myelodysplastic Syndromes: Just the BeginningDrs. Scott and Estey provide an excellent, concise review of current diagnostic and therapeutic approaches for patients with myelodysplastic syndromes (MDS). Both physicians are recognized world leaders in this area.
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Chemotherapy in Advanced Nasopharyngeal CancerChemotherapy is an integral part of treatment for patients with nasopharyngeal carcinoma. Chemotherapy can achieve long-term survival rates of up to 15% to 20%, even in patients with recurrent or metastatic disease. In
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Primary Carcinoid Tumors of the Lung: A Role for RadiotherapyPrimary neuroendocrine neoplasms of the lung represent a clinical spectrum of tumors ranging from the relatively benign and slow-growing typical carcinoid to the highly aggressive small-cell lung carcinoma. The rarity of carcinoids has made the role of radiation therapy in their management controversial. This review considers the results of published studies to generate treatment recommendations and identify areas for future research. Surgery remains the standard of care for medically operable disease. Histology plays the most important role in determining the role of adjuvant radiation. Resected typical carcinoids likely do not require adjuvant therapy irrespective of nodal status. Resected atypical carcinoids and large-cell neuroendocrine carcinomas have a significant risk of local failure, for which adjuvant radiation likely improves local control. Definitive radiation is warranted in unresectable disease. Palliative radiation for symptomatic lesions has demonstrated efficacy for all histologies. Collaborative group trials are warranted.
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Mucocutaneous Paraneoplastic Syndromes Associated With Hematologic MalignanciesA case report is followed by a review of the diagnosis and treatment of other cutaneous paraneoplastic syndromes that are associated with hematologic malignancies.
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Targeting the Androgen Receptor Signaling Axis to Reduce Testosterone Levels in Prostate Cancer: How Low Should We Go?It is now well established that castration-resistant disease can be effectively treated using newer androgen receptor-targeting agents such as abiraterone and enzalutamide.
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Long-Term Effects of Chemo on the Cognitive Function of Cancer PatientsIn this podcast we discuss the long-term effects of chemotherapy on the cognitive function of cancer patients and the current status of research in this field.
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Outwitting the Blood-Brain BarrierThe blood-brain barrier and the blood-cerebrospinal fluid barrier are major physical impediments to therapeutics targeting central nervous system neoplasms. We review this topic from the perspective of a group whose focus is on the neurovascular unit.
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The "Epidemic" of Breast Cancer in the U.S.--Determining the FactorsIt is widely accepted that the causation of cancer is the result of environmental exposures (including endogenous hormone exposure) and genetic susceptibility. Ultimately, to prevent breast cancer, we must understand both the environmental and genetic components.
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Future Perioperative Strategies in Non-Small Cell Lung CancerBefore closing out their discussion on non–small cell lung cancer, experts share excitement for possible improvements in the setting of perioperative therapy.
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Oncologic Imaging, Second EditionAlthough the title might be slightly misleading, Oncologic Imaging is actually a compendium of information on the detection, diagnosis, imaging, staging, and treatment of cancer. This is the second edition of a multiauthor book that first appeared in
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Addressing the Challenge of Managing Radiation Use in Medical Imaging: Paradigm Shifts and Strategic PrioritiesThe rise in utilization of medical imaging-especially computed tomography and nuclear medicine-and the issues of perceived, potential, theoretical, and known risks associated with ionizing radiation exposure from imaging have come to the forefront of public and professional awareness, raising concerns and controversies.
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The Emerging Role of Pemetrexed for the Treatment of Malignant MesotheliomaMalignant mesothelioma is a devastating disease with an onset 20to 60 years after exposure to asbestos. Although most cytotoxic agentshave been evaluated for the treatment of mesothelioma, few single agentshave consistently yielded response rates above 20%. Antimetabolitesare the most active drugs against mesothelioma, and of these, theantifolate group is the most widely studied and effective. Pemetrexed(Alimta), a new antifolate, may be more active because of its differentmechanism of action. Several clinical trials have evaluated pemetrexedalone and in combination with a platinum agent for patients with malignantmesothelioma. A pivotal phase III trial has demonstrated thatcombination chemotherapy with pemetrexed and cisplatin improvessurvival, response rate, pulmonary function, and quality of life comparedwith single-agent cisplatin. Additional trials are evaluatingpemetrexed in the neoadjuvant setting and in combination with othercytotoxic and targeted agents.
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Addressing the Common Mystery of the Solitary Pulmonary NoduleTo ultimately find what we are actually looking for, the invasive malignant nodule in a haystack of benign lesions, new strategies and qualitative and quantitative tools are needed to propel noninvasive evaluation of solitary pulmonary nodules into the 21st century.
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Radical Prostatectomy Reigns SupremeProstate cancer remains the most common solid organ malignancy diagnosed among men in the United States, with the American Cancer Society estimating that 1 in 6 men will be diagnosed with prostate cancer, and 1 in 35 will die of the disease.[1]
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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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Textbook of Lung CancerLung cancer is a global problem fueled by the continuous use of tobacco in most countries, despite efforts at expanding smoking cessation programs. Several advances in the diagnosis and treatment of lung cancer were achieved in the past decade. This progress notwithstanding, most lung cancer patients succumb to their illness, and few enjoy long-term survival.
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Liquid Biopsy to Inform Targeted Tx of Colorectal CancerIn this video, Dr. Heinz-Josef Lenz outlines the many advantages that development of liquid biopsy is affording cancer patients.
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Management of Comorbid Diabetes and CancerDiabetes mellitus is a frequent comorbidity of cancer patients. The growing epidemic of diabetes is anticipated to have tremendous impact on health care. Diabetes may negatively impact both cancer risk and outcomes of treatment. Oncology nurses are ideally positioned to identify patients at risk for complications that arise from cancer treatment in the setting of pre-existing diabetes. Additionally, oncology nurses may be the first to identify underlying hyperglycemia/hidden diabetes in a patient undergoing cancer treatment. Strategies for assessment and treatment will be discussed, along with specific strategies for managing hyperglycemia, potential renal toxicity, and peripheral neuropathy. Guidelines for aggressive treatment of hyperglycemia to minimize risks of complications will be reviewed. The role of interdisciplinary care, utilizing current evidence, is crucial to supporting patients and their families as they manage the challenges of facing two life-limiting diseases. Whole-person assessment and individualized treatment plans are key to maximizing quality of life for patients with cancer and diabetes.
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Current Clinical Trials of the Anti-VEGF Monoclonal Antibody BevacizumabGiven the well-established role of angiogenesis (or new blood vessel formation) in tumor growth and metastasis, antiangiogenic therapy, a concept first proposed by Dr. Judah Folkman,[1] has become increasingly recognized as a promising
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Does Neck Stage Predict Local Control After Irradiation for Head and Neck Cancer?The paper by Mendenhall et al addresses a very debatable issue, ie, the influence of nodal stage on local control for head and neck carcinomas treated by radiotherapy. The paper is well written and appropriately referenced, and the authors fairly conclude that, based on currently available data, nodal stage has no clear impact on the probability of primary local control after radiotherapy.
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Chemotherapy for Breast Cancer During Pregnancy, With Neonatal Lupus in the NewbornA 34-year-old, gravida 2, para 1, previously healthy African-American woman presented with a right breast mass on self-examination in the second trimester of pregnancy.
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Textbook of Medical Oncology, 2nd EditionIn this day of encyclopedic oncology texts, frequently updated online reference sites, and literature searches at the click of a button, is there a place for a basic medical oncology textbook? The second edition of the Textbook of Medical Oncology, edited by Drs. Cavalli, Hansen, and Kaye, is approximately 50% longer than the first edition, due in large part to the inclusion of newer therapeutic approaches.
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UFT/Leucovorin Combined With Paclitaxel for Anthracycline-Pretreated Advanced Breast CancerTaxanes are the most active drugs in the treatment of metastatic breast and ovarian cancer. Weekly therapy with paclitaxel produces notable activity, with remarkably low toxicity.
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Middle-Aged Man With Acute Thrombocytopenia Subsequent to Fluorouracil and Oxaliplatin Chemotherapy for Colorectal CancerA 44-year-old patient with a history of stage IIB colorectal cancer at the hepatic flexure, invading the duodenum and pancreas, was initially diagnosed in September 2005 and received modified Whipple surgery and 8 cycles of adjuvant chemotherapy with capecitabine and oxaliplatin every 3 weeks.
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ACR Appropriateness Criteria® Nonsurgical Treatment for Locally Advanced Non–Small-Cell Lung Cancer: Good Performance Status/Definitive IntentThe treatment of inoperable stage III non–small-cell lung cancer (NSCLC) remains a challenge due to high rates of distant metastasis, local recurrence, and toxicity associated with definitive therapy.
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Surgical Management of Pancreatic CancerPancreatic cancer is the fifth leading cause of cancer death in the United States, with an overall survival rate of 3%. Unfortunately, only a minority of patients present with localized disease amenable to surgical resection.
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Treatment of Estrogen Deficiency Symptoms in Women Surviving Breast Cancer, Part 6Problem: Several million women worldwide have survived breast cancer but are currently advised against the use of estrogen for the management of menopausal symptoms and for the prevention of early cardiovascular death and osteoporosis.
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Small Steps Forward in the Land of Small TumorsMetastatic well or moderately differentiated neuroendocrine tumors of the gastrointestinal tract and lung (NETs) are a fascinating and markedly heterogeneous group of generally indolent, but relentless cancers.
