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The effective use of cancer chemotherapy requires a thorough understanding of the principles of neoplastic cell growth kinetics, basic pharmacologic mechanisms of drug action, pharmacokinetic and pharmacodynamic variability, and mechanisms of drug resistance.

Myelodysplastic syndromes (MDS) are a group of hematologic malignanciesof the pluripotent hematopoietic stem cells. These disorders arecharacterized by ineffective hematopoiesis, including abnormalities inproliferation, differ­entiation, and apoptosis.

Chronic lymphocytic leukemia (CLL) is a clonal malignancy that results from expansion of the mature lymphocyte compartment. This expansion is a ­consequence of prolonged cell survival, despite a varied cell turnover. The affected lymphocytes are of B-cell lineage in 95% of cases, and the remaining cases involve T lymphocytes, representing a distinct disorder. CLL is the most common leukemia in adults in Western countries, accounting for approximately 25%-30% of all leuke­mias. The proportion of cases diag­nosed with the early stages of the disease (Rai stage 0) has risen from 10% to 50%, probably because of earlier diagnosis (routine automated blood counts).  

Chronic myelogenous leukemia (CML) is a clonal myeloproliferative disor­der resulting from the neoplastic transformation of the primitive hemato­poie­tic stem cell. The disease is monoclonal in origin, affecting myeloid, mono­cytic, erythroid, megakaryocytic, B-cell, and, sometimes, T-cell linea­ges. Bone marrow stromal cells are not involved.

Head and neck cancers encompass a diverse group of uncommon tumors that frequently are aggressive in their biologic behavior.

The use of multidrug chemotherapy and bone marrow transplantation in cancer treatment has made the utilization of reliable, long-term venous access (LTVA) an essential component of cancer therapy. The placement of LTVA devices not only permits the delivery of these complex therapeutic regimens but also drastically improves patients’ quality of life.

Psychiatricdisorders are common in the setting of malignant disease, occurring inalmost 50% of patients.

The Oncology Group, a division of CMPMedica, publisher of the journal ONCOLOGY and the news magazine Oncology News International, as well as the comprehensive cancer website, cancernetwork.com, is pleased to bring you the 10th annual edition of Cancer Management: A Multidisciplinary Approach.

Patients aged 65 years and older represent 12% of the US population yet account for approximately 56% of cancer cases and 69% of all cancer mortalities. The overall cost of cancer in 2005 was $209.9 billion—$74 billion for direct medical costs and $118.4 billion for indirect mortality costs. This paper considers the direct, indirect, and out-of-pocket expenditures incurred by cancer patients ‚â • 50 years of age. Several major empirical studies on supportive care for older patients and cancer-related costs were reviewed. Insurance coverage, hematologic malignancies, squamous cell carcinoma of the head and neck, and cancers of the breast, prostate, colorectum, and lung were evaluated. Major sources of direct medical expenditures covered by third-party insurers for patients aged 65 years and older include extended length of hospital stay, home health assistance following hospital discharge, adjuvant prescription medications, lower-risk treatment (for prostate cancer), and advent of new pharmaceuticals (for colorectal cancer). The mean total direct medical cost for breast cancer is $35,164, and the cumulative cost for prostate cancer is $42,570. Emerging targeted cancer drug costs range from $20,000 to $50,000 annually per patient. Additional clinical trials and cost-effective treatments are needed for older patients to ameliorate the disproportionate economic burden among older individuals with cancer. Additional research about cancer costs may also lead to reforms in cancer care reimbursement, and therefore provide access to affordable health care for older patients.

Over the past 50 years, great strides have been made in diagnosis, treatment, and survival of childhood cancer. In the 1960s the probability of survival for a child with cancer was less than 25%, whereas today it may exceed 80%. This dramatic change has occurred through significant and steady progress in our understanding of tumor biology, creation of specialized multidisciplinary care teams, incremental improvements in therapy, establishment of specialized centers with research infrastructure to conduct pivotal clinical studies, and the evolution of a cooperative group mechanism for clinical research. Most children with cancer in the United States, Europe, and Japan receive appropriate diagnosis and treatment, although access is limited in developing countries. The price of success, however, is the growing population of survivors who require medical and psychosocial follow-up and treatment for the late effects of therapy. Here we review the progress made in pediatric oncology over the past 3 decades and consider the new challenges that face us today.

Patients aged 65 years and older represent 12% of the US population yet account for approximately 56% of cancer cases and 69% of all cancer mortalities. The overall cost of cancer in 2005 was $209.9 billion—$74 billion for direct medical costs and $118.4 billion for indirect mortality costs. This paper considers the direct, indirect, and out-of-pocket expenditures incurred by cancer patients ‚â • 50 years of age. Several major empirical studies on supportive care for older patients and cancer-related costs were reviewed. Insurance coverage, hematologic malignancies, squamous cell carcinoma of the head and neck, and cancers of the breast, prostate, colorectum, and lung were evaluated. Major sources of direct medical expenditures covered by third-party insurers for patients aged 65 years and older include extended length of hospital stay, home health assistance following hospital discharge, adjuvant prescription medications, lower-risk treatment (for prostate cancer), and advent of new pharmaceuticals (for colorectal cancer). The mean total direct medical cost for breast cancer is $35,164, and the cumulative cost for prostate cancer is $42,570. Emerging targeted cancer drug costs range from $20,000 to $50,000 annually per patient. Additional clinical trials and cost-effective treatments are needed for older patients to ameliorate the disproportionate economic burden among older individuals with cancer. Additional research about cancer costs may also lead to reforms in cancer care reimbursement, and therefore provide access to affordable health care for older patients.

Approximately one-third of patients with non-small cell lung cancer (NSCLC) present with locally advanced disease, the majority of whom are treated with concurrent chemotherapy and thoracic radiation therapy. Concurrent chemoradiation therapy is superior to sequential chemotherapy followed by thoracic radiation therapy or thoracic radiation therapy alone.

This paper provides an overview of several prominent articles and empirical studies on supportive care and cancer-related costs faced by older cancer patients. It focuses primarily on individuals 65 years of age and over and reviews several types of cancer.

The huge cost of modern day cancer drugs hurts everybody, from the patients who cannot afford them to the pharmaceutical companies who spend millions to develop them

Last month, ONI launched a new interactive feature: an electronic Reader Poll located on The Oncology Group website

In the era of pay-for-performance in cancer care, the electronic medical record (EMR) is a "must-have" for maximizing practice efficiency.

With increased referrals to the outpatient department, hospitals must monitor outpatient revenues to remain financially competitive in today's market,

Dr. Andrew von Eschenbach, Dr. Mina Bissell, Lance Armstrong

When patients with hepatocellular carcinoma (HCC) still have viable tumor after radiofrequency ablation (RFA), further treatment with chemoembolization using doxorubicin-eluting beads increases the ablation volume by an average of 61%,

A 45-year-old man with chronic ulcerative colitis for more than 10 years presents with diarrhea for 4 days. The diarrhea is nonbloody, watery, and associated with abdominal pain, nausea, vomiting, low-grade fevers, and chills for 2 days. The abdominal pain was diffuse, but worse in the right upper quadrant.

Nonchemotherapeutic (bland) embolization with superabsorbent polymer microspheres can provide prolonged control of hepatocellular carcinomas (HCCs) in the majority of patients

Since the Medicare Modernization Act (MMA) of 2003 was signed, the Centers for Medicare & Medicaid (CMS) has initiated a series of fairly dramatic structural changes in reimbursement policies covering drugs and services provided in cancer care.

Many cancer patients who have heart attacks often are not treated with lifesaving aspirin given the belief in the medical community that they could experience lethal bleeding.

Clinicians, researchers, and survivorship communities are beginning to recognize the late effects of cancer treatment, such as infertility, and the negative impact this can have on cancer survivorship. Reproductive concerns that emerge within cancer experiences have been shown to be negatively associated with quality of life. Gynecologic cancer can present before childbearing has been started or completed, during pregnancy, or can even arise out of pregnancy, as is the case with gestational trophoblastic disease. Parenthood has been cited as an important aspect of cancer survivorship. As a result, interest concerning fertility preservation, reproductive concerns, and family-building options in cancer survivorship has increased, in addition to awareness of the emotional ramifications of cancer-related infertility. Education and support are clearly an essential component of cancer survivorship. Furthermore, more attention and investigation is still needed about the reproductive issues of gynecologic cancer survivors in the future.

Clinicians, researchers, and survivorship communities are beginning to recognize the late effects of cancer treatment, such as infertility, and the negative impact this can have on cancer survivorship. Reproductive concerns that emerge within cancer experiences have been shown to be negatively associated with quality of life. Gynecologic cancer can present before childbearing has been started or completed, during pregnancy, or can even arise out of pregnancy, as is the case with gestational trophoblastic disease. Parenthood has been cited as an important aspect of cancer survivorship. As a result, interest concerning fertility preservation, reproductive concerns, and family-building options in cancer survivorship has increased, in addition to awareness of the emotional ramifications of cancer-related infertility. Education and support are clearly an essential component of cancer survivorship. Furthermore, more attention and investigation is still needed about the reproductive issues of gynecologic cancer survivors in the future.

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.

Palliative 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.

Oncology is undergoing a sea change. Because of sophisticated cancer screening, combined with increasingly effective treatments, the majority of cancer patients are surviving beyond the period of active treatment. As a consequence, cancer care teams are striving to confront the new—and very welcome—challenge of caring for long-term cancer survivors.

Transgene S. A. has announced that the first patients have been enrolled in a two-step phase II trial of its immunotherapy product candidate TG 1042 (Ad-IFNϒ) to treat relapsing cutaneous B-cell lymphoma (CBCL).