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Allogeneic Marrow TransplantationAllogeneic marrow transplantation is used to reconstitute hematopoiesis in patients who have received myeloablative therapy for a hematologic malignancy or in patients with irreversible marrow failure, to reconstitute the immune system in patients with severe immunodeficiency, and to normalize metabolism in patients with select inherited metabolic deficiency disorders.
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Treatment of Stage I-III Non-Small-Cell Lung Cancer in the ElderlyElderly patients with stage I-III non-small-cell lung cancer (NSCLC) constitute a peculiar patient population and need specific therapeutic approaches. Limited resections are an attractive alternative for elderly patients with resectable NSCLC because of the potential reduction in postoperative complications. Curative radiation therapy is an acceptable alternative for elderly patients who are unfit for or refuse surgery. Hypofractionated stereotactic body radiation therapy is of particular interest for this population because of its favorable tolerance.
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Management of Breakthrough Pain Due to CancerThe most frequent pattern of pain related to cancer and cancer treatment consists of continuous pain punctuated by episodes of worsening pain. The cancer pain guidelines developed by the Agency for Health Care Policy and Research (AHCPR)
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Treatment Options for Patients With High-Risk NDMMConcluding their discussion on newly diagnosed multiple myeloma, expert panelists consider treatment options for patients with high-risk disease.
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Curbing Potential Radiation-Induced Cancer Risks in Oncologic Imaging: Perspectives From the ‘Image Gently’ and ‘Image Wisely’ CampaignsThe purpose of this review is to provide the oncology community with knowledge about the doses used in medical imaging, radiation-induced cancer risks from imaging, and considerations to keep in mind when balancing imaging benefits and risks in pediatric and adult oncologic settings.
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ACR Appropriateness Criteria® Resectable Stomach CancerFor resectable gastric cancer, perioperative chemotherapy or adjuvant chemoradiation with chemotherapy are standards of care. The decision making for adjuvant therapeutic management can depend on the stage of the cancer, lymph node positivity, and extent of surgical resection.
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The Safety of Paclitaxel/Platinum CombinationsThe effectiveness of paclitaxel (Taxol) in a range of tumors has been established in a large number of trials. In non–small-cell lung cancer, paclitaxel combined with cisplatin (Platinol) has been shown to be highly effective.
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Paclitaxel/Carboplatin vs Paclitaxel/Gemcitabine in Advanced Non–Small-Cell Lung CancerThe Hellenic Cooperative Oncology Group conducted a randomized phase III trial to compare paclitaxel (Taxol) 200 mg/m² IV 3-hour infusion on day 1 plus carboplatin (Paraplatin) at an area under the curve (AUC) of 6 (group
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Pathogenesis of AIDS-Related Kaposi's SarcomaEmmanoulides, Miles, and Mitsuyasu have written an excellent review summarizing our current understanding of the pathogenesis of AIDS-related Kaposi's sarcoma (AIDS/KS). The authors cover what is currently well established and also provide their viewpoint on future developments in AIDS/KS. My commentary will highlight some of the major questions related to this complex disease.
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Attacking a Moving Target: Understanding Resistance and Managing Progression in EGFR-Positive Lung Cancer Patients Treated With Tyrosine Kinase InhibitorsIn this article, we review the available literature addressing the competing treatment strategies in EGFR-Positive Lung Cancer and attempt to clarify best treatment practices, including the emerging role of T790M-directed therapies.
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Differentiated Thyroid Carcinoma: Risk Group Assignment and Management ControversiesIn this review, we provide a framework for clinical decision-making in the treatment of differentiated thyroid cancer. The clinical discussion and treatment recommendations are relevant to an adult population (more than 16
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Meta-analysis: Methods, Strengths, and WeaknessesMeta-analysis is a systematic, quantitative approach to the combination of data from several clinical trials that address the same question. This analytic approach can help resolve questions that remain unclear from the results
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Splenic Marginal Zone Lymphoma: Current Knowledge and Future DirectionsIn this article, we review the current knowledge on the biological findings, clinical features, and therapeutic approaches for splenic marginal zone lymphoma.
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Combination Therapies for Lung CancerAs part of our coverage of the AACR Annual Meeting, we discuss combination therapies and new research in the treatment of lung cancer.
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Triple- vs Double-Agent Chemotherapy for Advanced Non–Small-Cell Lung CancerIn our previous phase I/II studies, both the cisplatin (Platinol), gemcitabine (Gemzar), and vinorelbine (Navelbine) (PGV), and cisplatin, gemcitabine, and paclitaxel (Taxol) (PGT) regimens produced a median survival of
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Cancer Treatment and Cognitive Function: Chemotherapy Is Not the Only CulpritWith the growing number of cancer survivors, there is increased interest in understanding and preventing post-treatment sequelae that may limit full recovery to prediagnosis health.
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Role of Iron in Optimizing Responses of Anemic Cancer Patients to ErythropoietinMany patients with widespread cancer develop a hypoproliferative anemia,[1-3] which is often worsened by systemic cytotoxic chemotherapy. Some chemotherapeutic agents directly depress the capacity of bone marrow cells to proliferate,
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Cancer Vaccines: A New Frontier in Prevention and TreatmentVaccines have been exceptionally effective against diseases such as smallpox, measles, chickenpox, and polio. They are among the safest and most cost-effective agents for disease prevention. In recent years, vaccination has been considered for other diseases, including AIDS and cancer. Cancer vaccines can be categorized as preventive or therapeutic. Preventive vaccines, which are commercially available for cervical cancer and liver cancer, block infection with the causative agents of human papillomavirus and hepatitis B virus, respectively. The benefit of cancer treatment vaccines lies in their ability to "boost" the immune system response to cancer cells, which is generally low. Using vaccines in the treatment of cancer is relatively new, however, and chiefly experimental. Therapeutic vaccines for breast, lung, colon, skin, renal, prostate, and other cancers are now being investigated in clinical trials. Oncology nurses may play a significant role in reducing barriers to uptake of preventive vaccines among the general public and in increasing patients' acceptance of therapeutic cancer vaccines.
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Neoadjuvant Therapy As a Platform for Drug Development: Current Controversies and Regulatory PerspectivesThis commentary addresses our perspectives from a regulatory standpoint, as well as some controversies related to the use of neoadjuvant therapy as a platform for drug development.
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Communicating With Oncology Patients About Palliative CarePalliative care differs from other oncology care settings because it involves end-of-life discussions. This article is intended to help oncology nurses who deliver news that involves palliative care by describing components of breaking bad news, providing an example for how to break bad news, and suggesting methods for evaluating a nurse-patient interaction. One possible scenario for achieving a positive outcome after delivering unwelcome information will also be described. Applying the methods described in this article can help to promote a positive outcome when a nurse delivers bad news to a patient.
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Impact of UFT on Tumoral TS and DPD Levels in Colorectal CancerThis was an open lable, pilot translational clinical pharmacology study of a brief (7 day) course of UFT, 300 mg/m²/day, in combination with leucovorin, 90 mg/day, in six patients with newly diagnosed advanced colorectal cancer.
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Mounting Evidence for Postmastectomy Locoregional Radiation TherapyPostmastectomy locoregional radiation therapy markedly reduces the risk of locoregional recurrence. Several randomized trials, including two recently updated studies with 10- to 15-year follow-up, demonstrate an
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Dr. Patricia Eifel on the Shifts in Cervical Cancer TreatmentCancer Network spoke with Patricia Eifel, MD, of the University of Texas MD Anderson Cancer Center, about the current shifts in the treatment of cervical cancer.
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Patient Communication and Strategies for Managing FatigueFatigue is common in patients with cancer. Fatigue is very distressing to patients, who often view it as an indication that their disease is progressing or that treatment is ineffective.
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Toward Evidence-Based Management of the Dermatologic Effects of EGFR InhibitorsRecent results from prospective, controlled trials, specifically evaluating strategies for preventing or reducing the severity of the dermatologic effects of EGFR inhibitors, represent the first step toward an evidence-based approach to the prevention and management of these important effects.
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Oxaliplatin in Tumors Other Than Colorectal CancerOxaliplatin (Eloxatin) has demonstrated significant activity in a variety of tumor types in addition to colorectal cancer. Several studies have reported on the effectiveness of oxaliplatin as single-agent treatment or in
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Commentary (Baile/Parker)-Patient-Physician Communication in Oncology: What Does the Evidence Show?We are delighted to reviewthe article by Dr. TonyBack on communicationwith cancer patients. We applaud hiseffort to provide recommendations forenhanced communication with patientsand families based on findings fromthe literature. We agree that using thecancer trajectory to identify key communicationtasks provides a useful heuristicmodel because, by matchingcommunication tasks to "high-stakes"clinical encounters, this approach intuitivelyappeals to practicing clinicians.As clearly described by Dr. Back, thevast majority of recommendations forcommunication among oncologist, patient,and family are not derived fromevidence-based research. This underscoresthe importance of conductingadditional research to use as a basis forguiding clinicians in how to handlethese challenging communication tasks.
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Current Issues in the Treatment of Resistant Bloodstream InfectionsBloodstream infections cause significant morbidity and mortality for patients with hematologic malignancy. Antimicrobial drugs are the most reliable currently available treatment for infection, but several issues must be
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Metastatic Papillary Adenocarcinoma in a 22-Year-Old: Is Her History of Mayer-Rokitansky-Küster-Hauser Syndrome Causative or Incidental?A 22-year-old college student with primary amenorrhea due to Müllerian agenesis presented with a headache, dysarthria, nausea, vomiting, and left upper extremity weakness. MRI of the brain showed numerous intracranial lesions.
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Blood-Tumor Barrier’s Role in Brain MetsIn this video, Dr. Patricia Steeg discusses the role of the blood-tumor barrier in both development and treatment of brain metastases.
