Authors

Latest:

Pressure ulcers are a common problem, with about 1.5 to 3 million individuals in the United Stated affected. Treatment may be costly, requiring lengthy periods of hospitalization. Central to the development of pressure

Latest:

The hereditary breast/ovarian cancer syndrome is responsible forapproximately 5% of all breast cancers and 10% of all ovarian cancers.Although this accounts for a small portion of these diseases, muchattention has been focused on this syndrome because of the abundanceof research in this area. The majority of the hereditary breast/ovariansyndrome can be attributed to germ-line mutations in the BRCA1 andBRCA2 genes. Reliable screening techniques for these mutations havebeen developed and are readily available in clinical practice. Forpatients who are thought to have the hereditary breast/ovarian cancersyndrome based on family history or genetic testing, options exist foreither intensive screening or prophylactic surgery. This review willdiscuss the mechanisms by which mutations in the BRCA genes lead tothe development of cancer, the limitations of currently available screeningtechniques, and the efficacy of prophylactic surgery. In general,prophylactic oophorectomy can be performed laparoscopically as anoutpatient procedure, carrying as its main drawback the associatedconsequence of surgical menopause. Prophylactic mastectomy is quiteeffective in reducing the risk of breast cancer but is a more extensivesurgical procedure and results in disfigurement. For any given patient,the best estimates of individual risk of breast or ovarian cancer shouldbe weighed against the benefits of prophylactic surgery and the patient’spersonal wishes.

Latest:

Although in centers where pancreatectomy is performed frequently,associated morbidity and mortality rates have improved, long-term outcomesin pancreatic adenocarcinoma patients remain poor when surgeryis the sole therapeutic modality. The impact of adjuvant chemotherapyon survival in patients with localized pancreatic cancer remainsincompletely defined. The European Study Group for Pancreatic Cancer(ESPAC)-1 trial has suggested that overall survival rates are superiorwhen chemotherapy is added to surgery, even when regimens believedto be relatively ineffective in the treatment of advanced diseaseare used. The role of radiotherapy given with chemotherapy is alsounresolved, but chemoradiation continues to receive consideration inthe multimodality approach to localized pancreatic cancer. Enhancedcollaboration and increased involvement by pancreatic surgeons havehelped in the recruitment of pancreatic cancer patients for large-scalerandomized clinical trials in Europe and the United States. Many newerchemotherapeutic agents with efficacy in gastrointestinal cancers haveyet to be investigated in the adjuvant and neoadjuvant settings.

Latest:

In this article, we detail the experience with immune checkpoint inhibitors in patients with autoimmune disease.

Latest:

A 56-year-old Caucasian woman presented to her primary care physician with a 3-month history of intermittent bright red rectal blood with defecation. At her initial visit, a digital rectal examination, anoscopy, and a pelvic examination with DNA testing for high-risk HPV were performed; all results were negative. She was referred for a colonoscopy, which revealed an abnormal area with a 3 × 4–cm mass in the rectum at a distance of 10 cm from the anal verge.

Latest:

We discuss colorectal cancer screening with two gastroenterologists, including results from two recently published studies showing long-term effects of screening.

Latest:

Management of patients who have head and neck cancer necessitates a multidisciplinary approach.[1,2] Comprehensive care must be initiated prior to therapy, maintained throughout course of treatment, and systematically coordinated for the rest of the patient’s life. As Dwyer and Minasian note, a multidisciplinary team that includes dental professionals, a speech/language pathologist, and a registered dietician is best suited for this complex management challenge. These individuals, working in conjunction with physicians, nurses, and other professionals, can provide patients with key preventive and therapeutic supportive care interventions.

Latest:

This review looks at the current data and guidelines for thoracoscopic resection of stage I NSCLC and discusses the potential for limited lung resection in patients with the disease.

Latest:

Latest:

The evaluation and treatment of osteosarcoma have evolved considerably over the past 2 decades, with corresponding dramatic improvements in prognosis. In large part, the improved outlook is attributable to

Latest:

Lamont et al have presented a very clear and concise review of current gene therapy strategies in the management of squamous cell carcinoma of the head and neck. While the presentation highlighted the most important work to date in this expanding field, it also made reference to some controversies and challenges that we are now facing. With this in mind, I would like to expand on and clarify several points raised by the authors.

Latest:

Well-differentiated thyroid cancer is something of an anomaly in the field of oncology for two primary reasons. First, the team of physicians who manage the patient consists primarily of endocrinologists, endocrine surgeons, and nuclear medicine physicians instead of medical oncologists, surgical oncologists, and radiation oncologists. Second, there is an extremely high rate of cure with remarkable 10- and 20-year survival rates due to the indolent nature of the tumor, even in the setting of lymph node metastases.

Latest:

The premise of Steen's book is that nearly everyone is confused about cancer prevention. The public, for whom the book is written, is the most confused, but cannot be faulted. According to Steen, the responsibility for their confusion lies with scientists and the press. Scientists make mistakes by reporting preliminary data from inadequate and mostly "workmanlike, undistinguished" (page 3) studies. The press, in turn, repeats these mistakes, adds some of its own, and so oversimplifies a complex topic that the public, in the end, receives "unconnected facts, partial truths, and outright lies" (page 3).

Latest:

Drs. Milsom and Hammerhofer review some of the controversies surrounding the use of laparoscopic procedures in the management of colorectal cancers. They detail the approach followed in the development of their technique, and outline the phase 3 clinical trials that they are currently conducting, which are aimed at demonstrating the usefulness and appropriateness of laparoscopic colon resection for the treatment of colorectal cancers.

Latest:

BUENOS AIRES--The tanning salon industry has grown enormously in recent years, with as many as 2 million regular patrons in the United States, and 1 million people visiting daily, W. L. Morrison, MD, of Johns Hopkins University, said at the Sixth World Congress on Cancers of the Skin.

Latest:

Developed initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested

Latest:

While patients with in-transit disease represent a wide spectrum of disease that requires individualized therapy, great opportunity exists to learn from our treatment interventions in these individuals.

Latest:

This testicular cancer management guide covers the diagnosis, staging, and treatment of germ-cell tumors and seminoma.

Latest:

Drs. Pisters, Wolff, Crane, andEvans have provided an excellentoverview of contemporaryapproaches to staging, surgicalmanagement, and treatment ofpatients with potentially resectablepancreatic cancer. Given the impressiveadvances in our understandingof the biology and genetics of pancreaticcancer, we would agree thatcurrent opportunities for progressagainst this malignancy are encouraging.The reality, however, is thatmortality rates still exceed 95%.While the article addresses the clinicalmanagement of patients with operablepancreatic cancer, this subsetof patients constitutes only 10% to15% of all patients with the disease.This group as well as patients withlocally advanced and metastatic diseaseare in need of new and innovativetreatment strategies. In thisreview, we will highlight several ofthe points made by the authors.

Latest:

In this interview we discuss which distant metastases in thyroid cancer are appropriate targets for I-131 treatment, appropriate dosing, and more.

Latest:

The prospect of even more compressed radiotherapy options for women requiring adjuvant breast radiotherapy is exciting. However, we urge readers to be cautious in their interpretation of the current intraoperative literature as they implement their programs.

Latest:

Some clinicians are so discouraged by nonstandard CD-ROMs generated at imaging centers they are calling on the radiology community to improve the way it transfers imaging data to referring physicians.

Latest:

In this issue of ONCOLOGY, Golan and Javle provide an excellent update on targeting the insulin-like growth factor 1 receptor (IGF-1R) in gastrointestinal cancers.

Latest:

If an annual screening test could detect ovarian tumors smaller than 0.5 cm, could it reduce deaths from serous ovarian cancer by 50%? What grade 3 or higher toxicities are associated with olaparib maintenance therapy. Test your knowledge in our latest quiz.

Latest:

Locally advanced breast canceraccounts for up to 70% ofbreast cancer cases worldwide.[1] In the past decade, neoadjuvantsystemic therapy has emerged asa therapeutic option for early breastcancer. The main goal of neoadjuvanttreatment is to downstage breast tumors,rendering them operable or permittingbreast-conserving surgery.The therapy has been used increasinglyin patients who have large breasttumors and are candidates for mastectomy,but in whom tumor shrinkageallows for less extensive surgeryand better cosmetic results.[2] Thedegree of the tumor’s responsivenessto preoperative therapy could serveas a surrogate for the response ofmicrometastasis to therapy and theconsequent outcome.[3]

Latest:

A 46-year-old woman had a routine screening mammogram that showed new calcifications in the posterior left breast. A diagnostic mammogram showed several small punctate calcifications, and a 6-month interval follow-up was recommended.

Latest:

Until recent studies were reported, immunotherapy was thought to be ineffective for colorectal cancer; this article provides guidance on how to incorporate immunotherapy into this setting.

Latest:

On November 20, 2008, the US Food and Drug Administration (FDA) granted accelerated approval for eltrombopag (Promacta Tablets, GlaxoSmithKline) for the treatment of thrombocytopenia in patients with chronic immune thrombocytopenic purpura (ITP) who have had an insufficient response to corticosteroids, immunoglobulin therapy, or splenectomy.

Latest:

Adhesion molecules have traditionally been thought of simply as receptors that permit anchorage to other cells or to the underlying extracellular matrix (ECM). However, within the past decade it has become apparent that adhesion molecules such as integrins mediate critical cytosolic signaling events that have a dramatic impact upon cell proliferation, survival, and motility. Integrins act to regulate both physiologic and pathologic events, including complex processes such as angiogenesis, tumor growth, and metastasis. For these reasons, integrins have become attractive targets for drug development, and several effective integrin antagonists are now under clinical evaluation. In turn, the use of integrin-targeted reagents has provided additional mechanistic insights into the workings of the receptor. In particular, it has become apparent that integrins are "mechanosensory" receptors that operate in a context-dependent manner. While integrins that ligate substrate-immobilized ligands typically transduce positive signals into the cell, antagonized or unligated integrins promote negative signaling into the cell, leading to cell cycle arrest or apoptosis. Thus, integrins appear to fulfill a biosensor function, wherein they constantly interrogate the local ECM, and modulate cell behavior accordingly. These new roles that integrins play reinforce the choice of integrins as a therapeutic target, even as they lead us to reassess and optimize current clinical strategies.

Latest:

Chronic pain occurs in about one-third of all cancer patients and in about three-quarters of those with advanced disease.[1] A major factor in the undertreatment of cancer pain is inadequate pain assessment.[2] Pain assessment provides the basis for inferred pathophysiology that directs diagnostic evaluation and treatment decisions. Pain syndrome identification plays an important role in this process-much of clinical medicine is based on pattern recognition of symptoms and signs, leading to a specific diagnosis and therapeutic strategy.