Oncology Vol 27 No 10

All of us treating patients with melanoma must educate our patients about the importance of participating in clinical trials with these new agents so that we can systematically validate the benefits and risks of these agents in prospectively defined patient settings.

Any minimization of therapy in the name of reducing morbidity requires careful consideration. Reducing morbidity in melanoma is certainly a laudable goal, but locoregional disease control and cure must remain our primary objectives.

ACOs can provide the structure, but it’s up to the stakeholders to establish mutually agreeable goals for this new care delivery model. Achieving these goals will require a different set of dialogues and conversations among stakeholders, and patients and their advocates must have seats at the table.

A prospective trial needs to be done in order to create a safe and responsible environment in which to offer patients the watch-and-wait option for rectal cancer.

We also propose that limiting the watch-and-wait strategy to patients with T1/T2N0 rectal cancer and using adequate T staging with MRI will result in improvements in local control and patient outcomes.

A 55-year-old woman with a history of metastatic melanoma in remission for 8 years presented to the emergency department with gross hematuria. A CT scan, ordered because the patient was in menopause, demonstrated a bladder tumor.

As advances in treatment strategies continue to focus on individualization of therapy, the identification of disease subsets is crucial to strategizing optimal therapeutic approaches.

The facts presented about screening should be tailored to the patient’s exact situation, and the patient’s values should be used to guide the final decision. For younger, healthy men, PSA screening should continue to be strongly considered.

The Task Force’s recommendation against PSA screening for prostate cancer is based on the best available science and the knowledge that, while we all want to prevent suffering and death from prostate cancer, PSA screening simply does not get us there.

Once a patient has been appropriately educated by an informed healthcare provider about the possible benefits of PSA screening, then patient preference as part of shared decision making regarding PSA screening should be considered in all cases.

It may be appropriate to offer prostate cancer screening to carefully selected men with a previous history of colorectal cancer. However, the risks and benefits of establishing the diagnosis in this setting need to be considered and discussed with them.

Not all patients with colorectal cancer are candidates for such screening, however, as a remaining life expectancy of at least 10 years is generally required in order for PSA screening to yield a significant mortality benefit.

Here we review some of the most significant changes in the surgical management of melanoma that have reduced morbidity and thereby improved patient outcomes.

This article reviews current evidence in support of a watch-and-wait approach to rectal cancer management, and discusses the challenges and limitations of this approach.

In this review, the results and limitations of studies concerning adjuvant radiation therapy and chemotherapy for endometrial cancer will be discussed, focusing on evidence that can help to guide treatment decisions.

Kinder, gentler cancer therapy is neither of those things if it fails to be as effective in controlling the cancer. When an area of completely clinically regressed cancer is excised, there is commonly residual cancer present.

Future directions, including nomograms, multi-modality approaches, and more individualized patient care based on genomic profiles, may help to tailor each endometrial cancer patient’s therapy to her individual risk.