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Brachytherapy for Carcinoma of the LungAn estimated 157,000 patients died of lung cancer in the United States in the year 2000.[1] Although surgery can be curative, only about 20% of patients are amenable to complete surgical resection. Most of the other patients are treated with radiation
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Simultaneously Detected Bilateral Testicular Cancer of Different Histopathological OriginA 36-year-old male with a history of cryptorchidism of the right side, treated with orchidopexy at the age of 4, presented with bilateral testicular swelling. Investigations included laboratory workup, ultrasound of both testes, as well as CT-scan of the chest, abdomen, and pelvis. Initial treatment was bilateral orchiectomy.
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Are There Regional Differences in Survival Rates of Metastatic Breast Cancer?A new study examined differences in breast cancer recurrence and survival by region.
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Management of Resectable Pancreatic CancerThis video examines the management of resectable pancreatic cancer, including how this type of disease is best defined, the latest standard of care in the adjuvant setting, and emerging trends in surveillance.
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Commentary (Asch): Some Elements of Prognosis in Terminal CancerYou’ve got to accentuate the positive,Eliminate the negative,Latch onto the affirmative,Don’t mess with Mister In-between.-Johnny Mercer, 1944
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Expert Consultations in Breast Cancer: Critical Pathways and Clinical Decision MakingThis book is the 17th volume in the Basic and Clinical Oncology series edited by Bruce D. Cheson, MD. Like other volumes in this series, Expert Consultations in Breast Cancer follows a unique format and seeks to integrate advances in the basic understanding of breast cancer with promising new therapies and changing health- care economics. The integration of these different perspectives provides both a conceptual and pragmatic framework for clinical decision-making.
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Proton Radiation Therapy for Lung Cancer: Is There Enough Evidence?Proton radiation for cancer offers the ability to conform the high-dose region of radiation therapy to the tumor while reducing the dose of radiation to adjacent normal tissues. In lung cancer, this equates to greater sparing of uninvolved lung, heart, esophagus, and spinal cord. Sparing these normal tissues permits the delivery of higher-radiation doses to the tumor. Studies that compare the distribution of radiation doses for lung cancer show that proton radiation is superior, even when factors such as respiratory motion are considered. Clinical experience confirms the feasibility of proton radiation for early-stage non-small-cell lung cancers, and clinical trials are being conducted in locally advanced tumors: To date, evidence indicates that proton radiation should be further explored.
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Neuroendocrine Tumors: a Heterogeneous Set of NeoplasmsThe review of surgical management of neuroendocrine tumors (NETs) of the gastrointestinal tract, authored by Huang, Poultsides, and Norton, is both comprehensive and accessible for readers of all backgrounds.
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Commentary (Reardon): Locoregional Therapies for GliomaMalignant glioma, the mostcommon primary centralnervous system (CNS) tumorin adults, remains one of the greatesttherapeutic challenges in oncologytoday due to the limited impact ofconventional cytotoxic therapies onoverall survival for patients with thesetumors. Although surgery and external-beam radiotherapy (XRT) can prolongsurvival, the value of adjuvantchemotherapy has been negligible formost malignant glioma patients. Theexception has been those patients withanaplastic oligodendroglioma and accompanyingchromosomal 1p and 19qloss-a fairly uncommon subset ofmalignant glioma patients who respondvery favorably to alkylatorbasedchemotherapy.[1]
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Complete Guide to Colorectal CancerNearly 150,000 people will be diagnosed with colorectal cancer in the United States in 2006. The impact of this diagnosis will be felt by countless family members, coworkers, and friends. Although screening tests for colorectal cancer have been available and encouraged by medical associations such as the American Cancer Society (ACS) and others, public awareness and compliance has been dismal.
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Epidemiology and Pathogenesis of AIDS-Related LymphomasAmong patients with congenital and acquired immunodeficiencies, non-Hodgkin’s lymphomas (NHLs) are the most common tumors of the immune system. In the setting of human immunodeficiency virus (HIV) infection, as
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Advances in Colorectal Cancer ScreeningIn this interview, Dr. David Ahlquist, gastroenterologist and professor of medicine at the Mayo Clinic in Rochester in Minnesota, discusses early detection methods of colorectal cancer, touching on sigmoidoscopy, colonoscopies, fecal blood testing, and in particular, stool DNA screening.
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Irinotecan/Gemcitabine Followed by Twice-Weekly Gemcitabine/Radiation in Locally Advanced Pancreatic CancerEarly clinical studies combining irinotecan (CPT-11, Camptosar) and gemcitabine (Gemzar) have yielded encouraging results. Gemcitabine administered via a twice-weekly schedule results in an enhanced radiation-sensitizing effect.
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Regimen Improved Survival in Children With High-Risk Wilms TumorsIn this video, Dr. Dix, discusses the results of two phase III trials that showed that in children with high-risk Wilms tumor, treatment with vincristine and dactinomycin plus the addition of doxorubicin improved outcomes.
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ACR Appropriateness Criteria® Recurrent Hodgkin LymphomaBy combining the most recent medical literature and expert opinion, this revised guideline can aid clinicians in the complex decision-making associated with the management of recurrent Hodgkin lymphoma.
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CTLA-4 Antibodies: New Directions, New CombinationsThis review will summarize the preclinical and clinical development of CTLA-4–blocking antibodies, discuss recent insights into the biology of CTLA-4 blockade, review the use of these antibodies in combination with established and novel therapeutic modalities, and comment on ongoing questions regarding their administration.
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Hodgkin's DiseaseAlthough there have been many advances in the treatment of Hodgkin's disease, diagnosis of the disease still rests on the identification of the Reed-Sternberg cell. This distinctive, though nonspecific, cell was first described by Sternberg in 1898 and further elucidated by Reed in 1902. In most biopsies, the Reed-Sternberg cell accounts for only 1% of the cells present, with the remainder consisting of lymphocytes, granulocytes, histiocytes, plasma cells, and fibroblasts
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Commentary (Berd)-Melanoma Vaccines: What We Know So FarThere have been an astoundingnumber of published reviewson human cancer vaccines, andI take responsibility for my share. Apparentlythe interest of the medicalcommunity in cancer vaccines remainsintense, despite the modest progressthat has been made in our field and thepaucity of convincing, positive clinicalresults. Somehow the idea of treatinga cancer by inducing an antitumorimmune response or strengthening theexisting one is strongly appealing bothto physicians and to patients. Whetherthis enthusiasm is justified by the scienceis a question that should troublethe sleep of all of us who call ourselvestumor immunologists.
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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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Microvessel Density in Needle Biopsies May Help Predict StageA total of 186 randomly selected needle biopsies were evaluated and radical prostatectomy samples were matched with preoperative PSA concentration and patient demographics. Gleason score and optimized microvessel density were determined from the needle biopsy samples; pathologic stage was verified by independent review of the prostatectomy samples. An automated digital image analysis system measured microvessel morphology and calculated the optimized microvessel density in biopsies. Using this system in combination with the Gleason score and serum PSA significantly increases the ability to predict extraprostatic extension of cancer preoperatively. [Oncol News Int 6(Suppl 3):13-14, 1997]
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Novel Combinations With OxaliplatinOxaliplatin (Eloxatin) is a novel antineoplastic platinum derivative that may exert its cytotoxic effects by blocking DNA replication/transcription, thus resulting in cell death in proliferating cells, as well as apoptosis.
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Proton Therapy for Prostate Cancer: Show Me the CER!Hoppe et al present an excellent review of the physics relevant to an understanding of proton therapy-and of the available literature assessing the use of proton beams in the management of prostate cancer.
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ACR Appropriateness Criteria® Localized Nodal Indolent LymphomaThe present guidelines review epidemiology, pathology, presentation, workup, staging, prognostic factors, and treatment options for patients with localized nodal indolent lymphoma, with an emphasis on radiation guidelines, including radiation dose, field design, and radiation techniques.
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Current Issues in the Treatment of Resistant Bloodstream InfectionsBloodstream infections cause significant morbidity and mortality for patients with hematologic malignancy. Antimicrobial drugs are the most reliable currently available treatment for infection, but several issues must be
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Further Considerations in the Treatment of Locally Advanced Lung CancerProbably no other topic in thoracic oncology has resulted in more controversy than that of the management of locally advanced non–small-cell lung cancer (NSCLC). Although recent large randomized studies have yielded more reliable and objective data on which to base treatment decisions than were available a decade ago, management of these patients is still influenced by specialty bias and philosophical beliefs.
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AL Amyloidosis: Who, What, When, Why, and WhereIn the current issue of ONCOLOGY, Gertz and Dispenzieri provide a scholarly review of the early recognition, diagnosis, and treatment of immunoglobulin light-chain (AL) amyloidosis.
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Commentary (Smith/Sandler)-Testicular Cancer: Maintaining the High Cure RateAs Dr. Raghavan has emphasizedin his excellent overviewof the current therapyfor testis cancer, it is critical that thesuccess of therapy for this diseasenot be compromised by a desire toavoid the complications of therapy.We would wholeheartedly agree withhis assertion that modifications intherapy must be introduced with athoughtful and structured approachto minimize the risk to efficacy.
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Physicians Must Unite Against New Bureaucratic ‘Hassles’ to Practicing MedicineI read with interest the article based on a presentation by Dr. David Hussey concerning physician competency reviews (December 2000). Dr. Hussey, who is president of the American Society for Therapeutic Radiology and Oncology
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Glioma-Associated Fatigue and Cognitive DysfunctionIn this interview we discuss fatigue, cognitive dysfunction, and psychiatric problems in patients with glioma and review which patients are more likely to encounter these issues.
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Age Matters... Or Does It?Anemia raises special concerns in older cancer patients. This review addresses the prevalence, causes, and mechanisms of anemia in older individuals, the complications of anemia in this population (including its impact on cancer treatment), and the appropriate management of anemia in the elderly.
