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APBI is a technique that offers women with early-stage breast cancer a choice. The preponderance of evidence supports the efficacy and safety of this technique, and it should continue to be offered to appropriately selected patients on and off protocol.

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This management guide covers the screening, diagnosis, staging, and treatment of cervical cancers.

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Childhood Leukemias is a comprehensive text that encompasses every aspect of leukemia in children, ranging from general diagnosis, classification, and pathobiology to management and supportive care.

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The person diagnosed with cancer typically is confronted with a variety of difficult challenges. Treatment for cancer can be physically arduous, it generally disrupts patients’ social and work life, and it may even limit their ability to care for themselves or live independently for some period of time. In addition to these physical and functional burdens, cancer patients often face fears of death or disability, and may be prone to feelings of isolation or depression.

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Management of ductal carcinoma in situ (DCIS) commonly involves excision, radiotherapy, and hormonal therapy. Radiotherapy is employed for local control in breast conservation. Evidence is evolving for several radiotherapy techniques exist beyond standard whole-breast irradiation.

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The article written by Chadha and Axelrod provides a timely discussion of several critical issues in the current debate over the use of axillary lymph node dissection in early-stage breast cancer. As new information and techniques become available, they and others have reassessed the value of axillary lymph node dissection in four key areas:

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Assessing outcome after ablation is difficult because few studies with good long-term followup have evaluated local recurrence, disease-free survival, and overall survival after ablation. This and other limitations make it difficult to draw meaningful conclusions.

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Most patients with advanced cancer, and up to 60% of patients with any stage of the disease, experience significant pain. The WHO estimates that 25% of all cancer patients die with unrelieved pain.

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A 46-year-old woman had a routine screening mammogram that showed new calcifications in the posterior left breast. A diagnostic mammogram showed several small punctate calcifications, and a 6-month interval follow-up was recommended.

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A phase I, single-center, open-label, dose-escalation study (University of Alabama [UAB] 9614) has been undertaken to evaluate the feasibility and safety of uracil and tegafur (in a molar ratio of 4:1 [UFT]) plus oral

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s. L is a married 41-year-old woman with recently diagnosed stage I breast cancer. She comes to her oncologist's office for a routine visit following her third cycle of preoperative doxorubicin hydrochloride (Adriamycin) and cyclophosphamide (Cytoxan). Ms. L's major complaint is fatigue. The oncologist had started Ms. L on paroxetine (Paxil), a selective serotonergic reuptake inhibitor (SSRI), at 20 mg qhs 2 months earlier because of concerns that Ms. L might be depressed, based on her complaints about depressed mood, difficulties sleeping, and other depressive symptoms.

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The outcomes for patients with metastatic or recurrent esophagealcancer are dismal, with 1-year survival rates of approximately 20%. Inthis phase II study, we studied the combination of docetaxel (Taxotere)and irinotecan (CPT-11, Camptosar) in patients with metastatic orrecurrent esophageal cancer. Eligible patients included those withhistologic or cytologic diagnosis of adenocarcinoma or squamouscancer of the esophagus or gastroesophageal junction who had receivedno previous chemotherapy for metastatic esophageal cancer. Previouschemotherapy in the neoadjuvant or adjuvant setting was allowed.Patients received irinotecan at 160 mg/m2 over 90 minutes followed bydocetaxel at 60 mg/m2 intravenously over 1 hour, with chemotherapycycles repeated every 21 days. Patients were reevaluated every twocycles. Of a planned 40 patients, 15 were enrolled, with 14 patientsevaluable for toxicity and 10 evaluable for response and survival. Thecombination of docetaxel and irinotecan resulted in a response rate of30%. An additional 40% achieved stable disease. The median survivalwas 130 days, with three patients still alive at the time of this analysis.The toxicities included 71% incidence of grade 4 hematologic toxicities,with 43% febrile neutropenia. One patient died of cecal perforationafter one cycle. There was no evidence of pharmacokinetic interaction,as systemic clearance of both drugs was similar to that seen after singleagentadministration. In conclusion, the regimen of docetaxel andirinotecan is active in metastatic or recurrent esophageal cancer.However, this combination chemotherapy regimen has an unacceptablerate of febrile neutropenia. This regimen needs to be modified toreduce the incidence of febrile neutropenia.

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For women with a gynecologic cancer, reproductive concerns may vary not only by site of disease but also by the presentation and manifestation of the disease. Gynecologic cancer can present before childbearing has been started or completed, during pregnancy, or can even arise out of pregnancy.

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Low-frequency electromagnetic radiation had previously been thought to cause human injury only by generation of excess heat or by shock from direct contact with electric current. Information accumulating over the past few

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In this article, we provide a case-based expert opinion on the duration of extended adjuvant endocrine therapy, use of biomarkers in guiding this decision, and toxicities to be considered when recommending this treatment.

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Monoclonal antibodies are increasingly becoming a standard part of clinical cancer treatment. Eight monoclonal antibodies are approved by the Food and Drug Administration for the treatment of cancer in the United States. Oncology nurses are expected to be familiar with these agents, their indications, and their adverse effects, to provide appropriate care and symptom management to patients receiving these agents, and to adequately educate patients and families about these treatments and their specific and overlapping side effects. Monoclonal antibody mechanisms of action and indications, infusion guidelines, and symptom management are outlined in this article.

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Diagnosis and treatment of cancer are potential traumatic stressors.[1,2] Others may include but are not limited to interpersonal violence, military combat, natural and man-made disasters, and displacement.[2] In response to the intense fear, helplessness, terror, and uncertainty that traumatic stressors can provoke, post-trauma symptoms (PTS) classically develop in three clusters: re-experiencing, avoidance/numbing, and hyperarousal.[2]

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The diagnosis and treatment of depression in the cancer setting can improve patients’ quality of life, their adherence to therapy recommendations, and the illness experience, all of which may affect survival outcomes.

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This is an exciting time in the treatment of PTCL, but with this opportunity comes responsibility. The challenge of how to optimize a plethora of promising new therapies for a small number of patients will drive therapeutic decision making for the foreseeable future.

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Predisposition testing (ie, genetic testing that provides information about a person’s susceptibility to disease) is now available for several inherited forms of cancer. Individuals who are found to have an altered gene (eg, a

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In this video from MBCC we discuss a poster presentation on genomic and protein alterations in 126 triple-negative metaplastic breast cancers.

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Prostate 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

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Panel testing has important advantages but is being misused due to payer constraints and laboratory marketing pressures. Much testing is haphazard and results in utilization of limited genetic counseling resources in the discussion of variants of uncertain significance and low-penetrance gene mutations.

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Elucidation of the underlying mechanisms of action for Ra-223 will soon expand its clinical utility with respect to improved patient selection and integrated bone-targeted therapies.

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Angiogenesis is a pathologic hallmark of glioblastoma and continues to be an appealing therapeutic target in cancer, including high-grade gliomas.

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Given that no therapeutic methods of postoperative adjuvant chemotherapy for non-small-cell lung cancer have been established, we selected UFT (tegafur and uracil) for investigation because UFT is less injurious to the host

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Champlin and colleagues haveelegantly summarized the conceptof nonmyeloablativestem cell transplantation (NST),stressing the importance of this newlyemerging procedure for the treatmentof patients with life-threateningmalignant hematologic and nonhematologicdiseases. This review doesnot include a description of the safetyand efficacy of NST for the treatmentof many life-threateningnonmalignant diseases for which noalternative therapy exists. This categoryencompasses a long list of geneticdisorders, diseases caused by adeficiency of stem cell products, andsyndromes associated with immunedeficiency. However, discussion ofthese illnesses is beyond the scopeof this review, which focuses oncancer.

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Precise mediastinal staging of non-small-cell lung cancer is extremely important, as mediastinal lymph node metastases generally indicate unresectable disease. Reliance on computed tomography (CT) and positron-emission tomography (PET) alone to stage and determine resectability is limited by false-positive results. Whenever possible, pathologic confirmation of metastases is desirable. Mediastinoscopy and transbronchial fine-needle aspiration are widely established but imperfect modalities. Endoscopic ultrasound fine-needle aspiration (EUS-FNA) has emerged as a diagnostic and staging tool because of its safety, accuracy, and patient convenience. We reviewed 13 prospective studies evaluating the comparative performance of EUS for staging lung cancer. We conclude that EUS is a valuable staging modality. Further studies of the role of EUS compared to other modalities such as integrated PET/CT and endobronchial ultrasound (EBUS) are forthcoming.