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Surgical Management of Lung Metastases: Selection Factors and ResultsLung parenchyma is the most common site of metastases from either carcinomas or sarcomas. Depending on the status of the original primary, resection of lung metastases may be curative. Multiple variables must be
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Radiotherapeutic Management of MedulloblastomaDr. Paulino provides a concise yet complete review of the radiotherapeutic management of patients with medulloblastoma. Radiotherapy treatment planning for medulloblastoma is complex, requires considerable attention to detail, and remains the subject of debate and clinical research. Clearly, this is an area of neuro-oncology in which multidisciplinary research has played a significant role in improving survival for children and young adults with this disease.
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Commentary (Sartor): Emerging Role of EGFR-Targeted Therapies and Radiation in Head and Neck CancerThe past several years have seenthe fruition of a new era in cancertherapy-targeted approachesusing biologic modifiers.However, as the clinical experiencewith novel inhibitors grows, some ofthe premises on which the treatmentswere designed are being challenged,and clinical findings are leading to newparadigms. Drs. Song and Raben providea forward-thinking review of thestatus of epidermal growth factor receptor(EGFR)-targeted therapy in headand neck cancer, a paper that serves toboth highlight progress and raise issuesthat continue to challenge the implementationof targeted therapy.
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Tumor Lysis SyndromePhysical exam revealed an enlarged spleen and right axillary lymph node. Her bloodwork is remarkable for an elevated lactate dehydrogenase (LDH) of 550 U/L and a creatinine of 2.0 mg/dL. Mrs. Reynolds is a retired actress and lifelong nonsmoker who drinks 1 to 2 glasses of wine a week and denies illicit drug use. Her health history includes the vaginal delivery of two healthy babies in her 20s and hypercholesterolemia, which has been controlled by diet.
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Taxanes in Adjuvant and Neoadjuvant Therapies for Breast CancerPaclitaxel (Taxol) is a diterpene originally obtained from the bark of the Pacific Yew Tree, Taxus Brevifolia. Its mechanism of action is unique. it stabilizes microtubule polymerization, thus blocking cells in the G2/M phase of
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Caron A. Jacobson, MD, on Next Steps for the Phase 2 ZUMA-5 StudyInterim results from the study suggested that axicabtagene ciloleucel (axi-cel) demonstrated significant and durable clinical benefit in patients with relapsed or refractory indolent non-Hodgkin lymphoma.
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Intracystic Papillary Carcinoma of the Breast: Differential Diagnosis and ManagementWe present a case of intracystic papillary carcinoma of the breast associated with low-grade ductal carcinoma in situ in a young woman. This is a distinct subtype of intraductal carcinoma that typically presents in postmenopausal women with a favorable prognosis.
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Docetaxel Plus Cisplatin: An Active Combination Regimen in Non-Small-Cell Lung CancerDocetaxel (Taxotere) isa semisynthetic taxoid that possesses significant activity as a single
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Osteoporosis in a Young Breast Cancer SurvivorMore than 2.5 million breast cancer survivors live in the US today.[1] This number will continue to grow thanks to early detection and advances in treatment that are making early stage breast cancer an increasingly curable disease.
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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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UFT/Leucovorin Plus Weekly Paclitaxel in the Treatment of Solid TumorsThe palliation of symptoms and improvement of quality of life are important aspects of therapy in patients with incurable metastatic cancer. This article describes the preliminary results of a phase I study of uracil and tegafur, an orally available fluorouracil (5-FU) derivative combined with oral leucovorin plus weekly intravenous paclitaxel.
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Paclitaxel and UFT Plus Oral Calcium Folinate in Pretreated Metastatic Breast CancerThis phase I study was designed to determine the maximum tolerated dose (MTD) and dose-limiting side effects of combination treatment with paclitaxel (Taxol) and UFT (uracil and tegafur in a 4:1 molar ratio) plus oral
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Implementing EHRs in Community Oncology PracticesTo provide quality healthcare, communication is vital. Using an EHR, physicians can more easily communicate regarding current and past medical conditions with other providers in their practice, with referring or co-managing physicians, and with patients themselves.
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Functional Assessment of the Older Patient With CancerThe population of the United States and other industrialized nations is aging rapidly. The increased life span allows for longer exposure to carcinogens and the accumulation of genetic alterations. Thus, the incidence of cancer is increasing along with the aging of the population.
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QOL and Outcomes Research in Prostate Cancer Patients With Low Socioeconomic StatusThe VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quality-of-life (QOL) information from prostate cancer patients, spouses, and physicians at six VA medical centers. Currently, 601 men with prostate
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Geographical Information Systems: Applications and Limitations in Oncology ResearchThis review describes the development and technical capabilities of GIS, potential applications of Geographical Informational Systems in cancer research, and the limitations of such work.
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Emotional and Behavioral Responses to Genetic Testing for Susceptibility to CancerAs genetic testing for susceptibility to cancer becomes more widely available, cancer-care providers will become more involved in counseling patients about cancer risks and the meaning of genetic test results. As a result, oncologists and oncology nurses need to be aware of the unique psychological issues and challenges posed by genetic testing for cancer susceptibility. This paper first describes a psychological profile of individuals who are likely to opt for such testing, based on extrapolation from studies of people at high risk of cancer.
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Cancer Management Chapter 41: Fluid complicationsMalignant pleural effusion complicates the care of approximately 150,000 people in the United States each year. The pleural effusion is usually caused by a disturbance of the normal Starling forces regulating reabsorption of fluid in the pleural space, secondary to obstruction of mediastinal lymph nodes draining the parietal pleura.
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Commentary (Barden/Daly): Surgery in the Older PatientThe elderly population in the United States increased by a factor of 11 in the past century, while the under age 65 population tripled in that same period.[1] Given that the majority of cancers occur in patients over 65 years old, there is an increasing need for surgical interventions in the elderly.
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The Neutropenic Diet....Still Ageless?As practicing doctors and a practicing nutritionist in a large pediatric oncology program, we applaud Nicole Fox and Alison Freifeld for questioning the utility of the neutropenic diet.
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ACR Appropriateness Criteria® Ductal Carcinoma in SituManagement 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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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.
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Should expectant management serve as the primary treatment option in prostate cancer?Prostate cancer experts agree on one issue: No single treatment can be considered universal for men diagnosed with prostate cancer. There are myriad choices and considerations to be reviewed with every diagnosis. In addition, there are conflicting data about when, or if, men require screening for prostate cancer as well as when to start therapy for confirmed disease.
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PALB2-Positive Breast Cancer in a 40-Year-Old ManIn July 2003, an asymptomatic 40-year-old man presented to his primary care physician for routine care and was found to have a palpable right axillary lymph node.
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Sixty Is the New Forty-or Is It the Other Way Around?Until more data are available, we reserve bisphosphonates for women with evidence of decreased bone mineral density who are at increased risk of fracture and for those on clinical trials.
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Treatment of Ovarian Cancer With Intraperitoneal ChemotherapyOvarian cancer is the most deadly gynecologic malignancy. In the US alone, an estimated 21,500 new cases will be diagnosed in 2009, and an estimated 14,600 women will die from this disease.
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Should We Recommend Screening Mammography for Women Aged 40 to 49?Although there is general agreement that screening women over age 50 years with mammography reduces mortality from breast cancer, there has been controversy over the effectiveness of mammography in women 40 to 49 years old. Until 1993, the most widely accepted recommendation for screening mammography included baseline mammography between ages 35 and 40, mammography every 1 to 2 years between ages 40 and 50, and annual mammograms after age 50.
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Nodal Marginal Zone Lymphoma: Impersonalized MedicineUntil we fully engage in understanding the biologic mechanisms that separate NMZL from other indolent NHLs, however, we will continue to deliver “impersonalized medicine” that does not exploit the unique properties of the former.
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Physical Activity Across the Cancer ContinuumIn our commentary, we will address ways to consider this research across the cancer continuum, with a focus on the cancer survivor, highlighting some of the challenges in interpreting the research evidence for translation into clinical practice and noting some research gaps.
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Cancer- and Treatment-Related Cognitive Changes: What Can We Do Now? What Lies Ahead?Much of the existing research into the phenomenon commonly referred to as “chemobrain” has been descriptive, and we know enough now to identify some patients at risk for cognitive changes after a diagnosis of cancer.
