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Evolving Treatment Landscape of RCC: Future Directions in CareClosing out their program on renal cell carcinoma management, key opinion leaders share closing thoughts on emerging therapies and how the field is evolving.
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ACR Appropriateness Criteria® Postradical Prostatectomy Irradiation in Prostate CancerThe purpose of this article is to present an updated set of American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of radiation therapy in postprostatectomy prostate cancer.
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Perspectives on Follicular Lymphoma Treatment From New and Experienced Clinicians: New, Old, & Old Is NewJonathan R. Day, MD, PharmD, and Brian K. Link, MD, give their perspective on emerging treatments for follicular lymphoma.
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A Young Woman With Multiple Kidney LesionsThe patient is a 26-year-old woman with a complex oncologic history. At 1 year of age, she was diagnosed with a stage III abdominal neuroblastoma, which was treated, and again at age 9, she had a recurrence of neuroblastoma in the left axilla. She was in her usual state of good health until 18 months ago, when she presented with hematuria and was found to have a right-sided kidney mass.
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RHIOs Allow Exchange of Electronic InfoOver the past several years, new structures known as Regional Health Information Organizations, or RHIOs, have begun to appear on the healthcare scene.
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Role of Laparoscopy in the Staging of Gastrointestinal CancerAccurate staging plays a primary role in determining the appropriate treatment of gastrointestinal malignancies. Recently, laparoscopy has emerged as a staging modality that is more sensitive and specific in staging most
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Radium-223 in Bone-Metastatic Prostate Cancer: Current Data and Future ProspectsThis article will describe the historic background of Ra-223; outline the clinical studies which led to phase III trials of this agent; highlight key results of these phase III studies; and explore possible future directions for use of Ra-223 and other alpha particles-both in prostate cancer and for management of other diseases.
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Predicting Endocrine Responsiveness: Novel Biomarkers on the HorizonHistorically, breast tumor classification and therapeutic decisions have relied on immunohistochemical (IHC) techniques for characterizing biomarkers such as estrogen receptor (ER), progesterone receptor (PR), and the epidermal growth factor receptor 2 (HER2), as described in the review by Ma and colleagues. However, these markers have been found to be inadequate for fully predicting a patient’s response to a given breast cancer treatment such as endocrine therapy.
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Diffuse Large B-Cell Lymphoma: Challenging Patients and Evolving ManagementDr. Brian Link discusses challenges in managing very elderly patients with diffuse large B-cell lymphoma and looks ahead to future management of DLBCL in general.
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Preclinical Studies Using the Intratumoral Aromatase Model for Postmenopausal Breast CancerTo determine the most effective strategies for the treatment of postmenopausal hormone dependent breast cancer, we recently developed a model system in nude mice. In this model, estrogen receptor-positive human breast cancer cells (MCF-7) stably transfected with the aromatase gene are inoculated into ovariectomized, immunosuppressed (nude) mice.
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Diagnostic Evaluation of Hepatocellular Carcinoma in a Cirrhotic LiverHepatocellular carcinoma (HCC) is one of the world’s most common cancers. It is closely associated with cirrhosis, especially that due to viral hepatitis. The incidences of viral hepatitis and HCC are rising steadily in the United
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Molecular Profiling in the Practice of Radiation OncologyAs specific candidate genes become more well established and gene expression assays gain sophistication, the value in clinical outcomes prediction and treatment selection is expected to transform the practice of radiation oncology.
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45-Year-Old Female With Gross Hematuria Post Partial NephrectomyA 45-year-old female presents with gross hematuria 5 days after a laparoscopic partial nephrectomy for renal cell cancer. What is your diagnosis?
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Guillain-Barré Syndrome After Treatment With Sunitinib Malate?Sunitinib malate (Sutent, SU011248) is an oral multitargeted tyrosine kinase inhibitor used for treatment of renal cell carcinoma and gastrointestinal stromal tumor. We report a case of a patient who developed Guillain-Barré syndrome after initial treatment with sunitinib, with recurrent symptoms upon reintroducing the drug. This is the first report of such an effect. The literature on chemotherapy-induced Guillain-Barré syndrome is also reviewed. Oncology providers should be aware of this rare but potentially serious possible adverse effect of sunitinib.
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Update on the Management of Primary CNS LymphomaPrimary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in
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Comparing Radical Prostatectomy and Brachytherapy for Localized Prostate CancerRadical prostatectomy and ultrasound-guided transperinealbrachytherapy are both commonly used for the treatment of localizedprostate cancer. No randomized trials are available to compare thesemodalities. Therefore, the physician must rely on institutional reportsof results to determine which therapy is most effective. While some investigatorshave concluded that both therapies are effective, others haveconcluded that radical prostatectomy should remain the gold standardfor the treatment of this disease. This article reviews the major seriesavailable for both treatments and discusses the major controversiesinvolved in making these comparisons. The data indicate that for lowriskdisease, both treatments are effective, controlling disease in over80% of the cases, with no evidence to support the use of one treatmentover the other. Similarly, for intermediate-risk disease, the conclusionthat one treatment is superior to the other cannot be drawn. Brachytherapyshould be performed in conjunction with external-beam radiationtherapy in this group of patients. For patients with high-risk disease,neither treatment consistently achieves biochemical control rates above50%. Although radical prostatectomy and/or brachytherapy may playa role in the care of high-risk patients in the future, external-beamradiation therapy in combination with androgen deprivation has thebest track record to date.
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Study Results of Maximum Androgen Blockade Not ClearcutAndrogen suppression, primarily castration, has been the key objective of treatment of metastatic prostate cancer. Surgical castration, achieved by the use of bilateral orchiectomy, produces a short-term symptomatic and objective tumor response in 70% to 80% of patients.[1] Medical castration, by the use of leuteinizing hormone-releasing hormone (LHRH) agonists, produces an almost equivalent effect. However, use of medical or surgical castration eliminates only 90% to 95% of the daily testosterone production. The remainder is produced in the adrenal glands.
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Sinking Health Care Ship Could Bring Down the EconomyOur nation's health care systemis facings an economicmeltdown of unprecedentedproportions. Overthe past 20 years, medicalinflation has averaged double the generalinflation rate.
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Contemporary Management of Small Renal MassesDespite improved understanding of the molecular features of renal tumors, increasing expertise in surgical management of localized renal cancers, and multiple effective systemic therapies for metastatic cancer, mortality from renal cell carcinoma remains largely unchanged.
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Large Bladder Mass and Renal Failure in a 14-Year-Old BoyA 14-year-old, otherwise healthy adolescent male originally presented to his primary care physician with abdominal pain and distention. Ultrasound revealed a complex mass with cystic components along the superior pole of the bladder and bilateral hydroureteronephrosis down to the level of the bladder.
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Easy methods curtail toxins in food linked to cancer in AfricaWASHINGTON, DC- In much of the developing world, exposure to mycotoxins, which are generated by various types of fungus that grow on food, is ubiquitous. Th e most well-known mycotoxin, aflatoxin, is commonly found on nuts and is a known carcinogen, according to the International Agency for Research on Cancer (IARC).
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Gastrointestinal Cancers With Peritoneal Carcinomatosis: Surgery and Hyperthermic Intraperitoneal ChemotherapyThis review focuses on the underlying rationale for the use of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CS + HIPEC) in the treatment of patients with primary gastrointestinal tumors with metastatic peritoneal disease.
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Recommendations for Women With Lobular Carcinoma In Situ (LCIS)This article will review current management trends for women with classical lobular carcinoma in situ (LCIS).
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How Can We Effectively Address the Medical and Psychological Concerns of Survivors of Pelvic Malignancies?Sexual and urinary morbidities resulting from treatment of pelvic malignancies are common. Awareness of these complications is critical in order to properly counsel patients regarding potential side effects and to facilitate prompt diagnosis and management.
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Prevalence of Complementary and Alternative Medicine Use in Cancer PatientsInterest in complementary and alternative medicine (CAM) has grown dramatically over the past several years. Cancer patients are always looking for new hope, and many have turned to nontraditional means. This study was
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The Complexity of Hereditary Cancer SyndromesCounseling women at high risk for ovarian and uterine cancer is a complex process, from genetic diagnosisto the management of at-risk women. Rimes andcolleagues have presented these challenging issues, andsuggested ways to manage them, very well.
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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.
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UFT Plus Oral Calcium Folinate/Vinorelbine for Advanced Breast CancerThis phase I study was undertaken to define the maximum tolerated dose, dose-limiting toxicity, and recommended dosage of UFT (uracil and tegafur) plus oral calcium folinate (Orzel) and vinorelbine (Navelbine) in
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How Can We Effectively Address the Medical and Psychological Concerns of Survivors of Pelvic Malignancies?Sexual and urinary morbidities resulting from treatment of pelvic malignancies are common. Awareness of these complications is critical in order to properly counsel patients regarding potential side effects and to facilitate prompt diagnosis and management.
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The Role of Radiotherapy in Node-Positive Prostate CancerThis article summarizes the existing literature on use of radiotherapy for node-positive prostate cancer, as well as the associated outcomes.
