Authors
Latest:
UFT Plus Calcium Folinate Plus Radiotherapy for Recurrent Rectal CancerUracil and tegafur (in a molar ratio of 4:1 [UFT]) plus calcium folinate comprise the components of the oral agent, Orzel, which appears to have activity comparable to intravenously administered 5-fluorouracil. This article
Latest:
A Large Cystic Pancreatic Mass in a 45-Year-Old FemaleThe patient is an otherwise healthy 45-year-old female who presented to her primary care physician with 6 weeks of increasing left upper quadrant abdominal pain with radiation to the back. She underwent an abdominal ultrasound, which revealed a large cystic abdominal mass.
Latest:
Larger Questions About Chemotherapy in Older PatientsDrs. Gillison and Chatta present an up-to-date review of the systemic treatments available to elderly patients with the most common types of cancer. The only point I might add in the context of their review is about recently reported, promising data on targeted therapies in acute leukemia patients. A large proportion of older patients have acute lymphocytic leukemia positive for a t(9;22) translocation (Philadelphia chromosome–positive ALL).
Latest:
Trastuzumab Resistance: Bringing Tailored Therapy to the ClinicAs Calabrich and colleagues illustrate in their comprehensive review in this issue of ONCOLOGY, there is a seemingly endless array of mechanisms by which the HER2-positive breast cancer cell can escape the control of trastuzumab (Herceptin).
Latest:
Flaws in Medicare coding interpretationsWe work with medical oncologists/hematologists across the country in both the private practice and hospital settings. Based on our experience, I'd like to point out a couple of key flaws in the current Medicare code interpretations.
Latest:
Persistence of Lymphedema Reduction After Noninvasive Complex Lymphedema TherapyWe treated 119 consecutive patients with lymphedema with complex lymphedema therapy (CLT). Lymphedema reductions after CLT averaged 62.6% in the 56 patients with one affected arm and 68.6% in the 38 patients with
Latest:
Management of Pain in the Older Person With Cancer Part 2: Treatment OptionsPain in older cancer patients is a common event, and many times it is undertreated. Barriers to cancer pain management in the elderly include concerns about the use of medications, the atypical manifestations of pain in the elderly, and side effects related to opioid and other analgesic drugs. The care of older cancer patients experiencing pain involves a comprehensive assessment, which includes evaluation for conditions that may exacerbate or be exacerbated by pain, affecting its expression, such as emotional and spiritual distress, disability, and comorbid conditions. It is important to use appropriate tools to evaluate pain and other symptoms that can be related to it. Pain in older cancer patients should be managed in an interdisciplinary environment using pharmacologic and nonpharmacologic interventions whose main goals are decreasing suffering and improving quality of life. In this two-part article, the authors present a review of the management of pain in older cancer patients, emphasizing the roles of adequate assessment and a multidisciplinary team approach.
Latest:
Molecular Testing to Optimize and Personalize Decision Making in the Management of Colorectal CancerRecent improvements in our understanding of the biology of colorectal cancer have led to the identification of several important prognostic and predictive markers of disease-associated risk and treatment response for the individual patient.
Latest:
Clinical Pearls for Treating Metastatic Colorectal CancerMarwan G. Fakih, MD, and Atif Hussein, MD, MMM, FACP, conclude their discussion with advice for clinicians treating patients with metastatic colorectal cancer.
Latest:
Management of Breakthrough Pain Due to CancerBreakthrough pain is defined as the transient exacerbation of pain occurring in a patient with otherwise stable, persistent pain. Breakthrough pain is relatively common among cancer patients, particularly those with moderate
Latest:
Biologic Basis for Radiation OncologyImproved understanding of the underlying biologic mechanisms that pertain to radiation oncology is providing an explanation for the cellular and tissue responses to ionizing radiation and is leading to the potential for novel
Latest:
Catalog of Human Cancer Genes: McKusick’s Mendelian Inheritance in Man for Clinical and Research Oncologists (Onco-MIM)The author of this reference, Dr. John J. Mulvihill, has a long-standing reputation for studying the complexities of human genetic disorders. His experiences, many publications, and collaborations have focused on various topics, including definition of the
Latest:
What Underlies PARP Inhibitor Resistance in Ovarian Cancer?New research examines the mechanisms underlying why most patients with high-grade serous ovarian cancer develop resistance to PARP inhibitors.
Latest:
Adapting to the Brave New World of Lung Cancer TreatmentIf we are to provide new options for the large numbers of NSCLC patients with no actionable mutation, we must focus on identifying new mutations through tissue acquisition. In the meantime, these patients are ideal candidates for the large number of available immunotherapy trials.
Latest:
Challenges of Rural Cancer Care in the United StatesRural cancer patients often face substantial barriers to receiving optimal treatment, including availability of cancer care providers, distance to services, lack of public transportation, financial barriers, and limited access to clinical trials. However, a number of promising approaches may address some of these challenges.
Latest:
Optimizing Endocrine Therapy for Premenopausal and Postmenopausal Women With Breast CancerThe majority of invasive breast cancer patients present with hormone receptor-positive disease, and modulation of estrogen receptor (ER) activation is an essential component of systemic adjuvant therapy for these women. While tamoxifen has traditionally been the primary adjuvant endocrine therapy for all ER-positive women, recent trials evaluating the use of aromatase inhibitors (AIs) have challenged this standard in postmenopausal women, and ongoing trials are examining the optimal use of endocrine therapy in younger women. Issues regarding the optimal approach to endocrine therapy in both pre- and postmenopausal women are examined in this review.
Latest:
HER2-Positive Breast Cancer: The Story Goes OnIt will be critically important to await the longer-term DFS and OS results from the neoadjuvant studies, as well as the adjuvant studies evaluating dual HER2 blockade, prior to these approaches truly becoming the standard of care.
Latest:
Prostate Cancer Risk Assessment ProgramProstate cancer is the most common form of cancer (except skin cancer) in men. Several factors have been associated with an increased risk for prostate cancer, including age, ethnicity, family history, lifestyle, and
Latest:
Fall Risk Assessment and PreventionPatient falls are a common cause of morbidity and are the leading cause of injury deaths in adults age 65 years and older. Injuries sustained as result of falls in a cancer hospital are often severe, regardless of patient age, due to the nature of the underlying cancer.
Latest:
Challenges on the Road to Treatment Advances for Pancreatic CancerLocalized pancreatic cancer, whether resectable or unresectable, is a separate entity from metastatic pancreatic cancer. Multiple studies have demonstrated that even in the setting of unresectable disease, the progression-free and overall survival of patients with localized pancreatic cancer exceeds that associated with metastatic pancreatic cancer.
Latest:
Controversies in the Management of Stage I SeminomaCurrent controversies in the treatment of stage I seminoma center on the relative roles of surveillance, adjuvant radiotherapy (RT), and adjuvant single-agent chemotherapy. Surveillance has been studied in over 800 patients,
Latest:
It’s Time for Clinicians to Reconsider Their Proscription Against the Use of Soyfoods by Breast Cancer PatientsRecently published research questions the need for the advised restriction against the use of soyfoods by women with a history of breast cancer.
Latest:
Treating Depression in Cancer PatientsAccording to three associated and recently published large randomized studies, while about 75% of cancer patients with major depression do not receive any treatment for their depression, a new system of integrating depression treatment into cancer patient care can transform patient outcomes.
Latest:
Practice-Changing FindingsRecent progress in lung cancer was a bright spot at the 2015 ASCO Annual Meeting. Several studies were presented that either are practice-changing or will likely lead to practice changes in the future.
Latest:
Nasal NK/T-cell Lymphoma: Where Are We Now?Since the creation of the World Health Organization’s nasal natural killer (NK)/T-cell lymphoma category, the attempt to further classify, describe, and improve treatment in this entity has been underway. There has been quite a bit of confusion and frustration regarding diagnosis, staging, and treatment approaches. With his article in this issue of ONCOLOGY, Dr. Au has attempted to improve our knowledge of current approaches to NK/T-cell lymphomas, providing a thorough and contemporary review of the clinical management of these difficult tumors. The following commentary reflects a deep appreciation for the author’s work and expands upon a few points not previously highlighted.
Latest:
Metastatic Breast CancerIn 1995, it is projected that there will be 183,400 new cases of breast cancer and 46,240 deaths from the disease, despite an emphasis on early detection [1]. Fewer than 10% of patients will present with metastatic disease, but nearly 50% of newly diagnosed patients may eventually develop it. Unfortunately, advanced breast cancer is incurable. In a classic study of untreated patients, the median survival was 2.7 years from the onset of symptoms [2].
Latest:
Health Resource Utilization in ABMT With and Without G-CSF in Stage III/IV Breast Cancer PatientsG-CSF has been available since 1991 for use in patients receiving high-dose chemotherapy/ABMT, and while it has been shown to effectively reduce the risk of febrile neutropenia, its cost effectiveness has been open to question. In this small retrospective study, five indicators of the consumption of health care resources were examined in stage III/IV breast cancer patients who received high-dose chemotherapy with ABMT or peripheral stem cell support. The study covered the time periods before and after the availability of G-CSF. The results showed that patients who received G-CSF had reductions in length of hospital stay of 20% (the purged marrow group) and 17% (nonpurged group), compared with similar groups that did not receive the growth factor; the shortest lengths of stay were seen in the peripheral stem cell group, all of whom received G-CSF. Other findings, including number of days the ANC fell below 500, total days of G-CSF use, and total days of antibiotic use, are presented. [ONCOLOGY 9(Suppl):107-110, 1995]
Latest:
Quality-of-Life Issues Important in Neuro-Oncologic TreatmentAs part of our Society of Neuro-Oncology annual meeting coverage, we discuss quality of life issues and neurologic rehabilitation in patients with neuro-oncologic diseases.
Latest:
Management of Anal Cancer in the HIV-Positive PopulationSquamous cell anal cancer remains an uncommon entity; however,the incidence appears to be increasing in at-risk populations, especiallythose infected with human papillomavirus (HPV) and human immunodeficiencyvirus (HIV). Given the ability to cure this cancer using synchronouschemoradiotherapy, management practices of this disease arecritical. This article considers treatment strategies for HIV-positive patientswith anal cancer, including the impact on chemoradiation-inducedtoxicities and the role of highly active antiretroviral therapy in the treatmentof this patient population. The standard treatment has beenfluorouracil (5-FU) and mitomycin (or cisplatin) as chemotherapy agentsplus radiation. Consideration to modifying the standard treatment regimeis based on the fact that patients with HIV tend to experience greatertoxicity, especially when CD4 counts are below 200; these patients alsorequire longer treatment breaks. Additional changes to the chemotherapydosing, such as giving 5-FU continuously and decreasing mitomycin dose,are evaluated and considered in relation to radiation field sizes in an effortto reduce toxicity, maintain local tumor control, and limit need forcolostomy. The opportunity for decreasing the radiation field size andusing intensity-modulated radiation therapy (IMRT) is also considered,particularly in light of the fact that IMRT provides dose-sparing whilemaximizing target volume dose to involved areas. The impact of the immunesystem in patients with HIV and squamous cell carcinoma of theanus and the associated response to therapy remains unknown. Continuedstudies and phase III trials will be needed to test new treatment strategiesin HIV-infected patients with squamous cell cancer of the anus todetermine which treatment protocols provide the greatest benefits.
Latest:
Oral Oncolytics: Part 2-Legislation Targeting Cost & Access, and Other Initiatives to Reduce CostsWe examine efforts to correct cost inequities of oral anti-cancer agents through legislation, and we look at further efforts to reduce the cost of oral chemotherapy via cycle management and waste reduction.
