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Squamous Cell Carcinoma of the Anal MarginBased on our experience and a review of the literature, we conclude that superficial, well- to moderately differentiated T1 cancers of the anal margin may be successfully treated with radiotherapy alone or local
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N+, M0 Prostate Cancer: Local Therapy for Systemic DiseaseNode-positive prostate cancer without distant metastases (T any, N+, M0) currently is encountered rarely, primarily because of the shift to diagnosis at earlier stages, a result of widespread PSA testing.
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Active Surveillance for African-American Men With Prostate Cancer: Proceed With CautionActive surveillance seems to be generally safe, yet African-American men tend to have more aggressive prostate cancers. Thus, it is imperative that we learn the characteristics and outcomes of African-American men considering surveillance.
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Hyperthermia as a Treatment for Bladder CancerModern cancer care is characterized by a focus on organ-sparing multi-modal treatments. In the case of non–muscle-invasive bladder cancer this is particularly true; treatment is focused on reducing the frequency of low-risk recurrences and preventing high-risk progression. Deep regional hyperthermia is an oncologic therapeutic modality that can help achieve these two goals. The combination of hyperthermia with chemotherapy and radiotherapy has improved patient outcomes in several tumor types. In this review, we highlight the biology of therapeutic fever-range hyperthermia, discuss how hyperthermia is administered and dosed, demonstrate how heat can be added to other treatment regimens, and summarize the data supporting the role of hyperthermia in the management of bladder cancer.
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Outwitting the Blood-Brain BarrierThe blood-brain barrier and the blood-cerebrospinal fluid barrier are major physical impediments to therapeutics targeting central nervous system neoplasms. We review this topic from the perspective of a group whose focus is on the neurovascular unit.
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The Information Age, Cyberspace, and CancerOncologists and their patients are facing disruptive changes in healthcare, research, and communication. This dramatic increase in the quantity and quality has changed our lives forever. However, many of us remain frustrated with our inability to control this information overload.
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Prostate Cancer Clinical Trials of the Southwest Oncology GroupThe changing clinical dynamics of prostate cancer have resulted in a broadening of the research focus of the Genitourinary (GU) Cancer Committee of the Southwest Oncology Group (SWOG). Beginning with an emphasis on hormone-refractory disease in its early years, SWOG prostate cancer trials now cover the entire spectrum of the disease: localized, locally advanced, metastatic and hormone-refractory disease. As the world's largest GU cancer research group, the GU committee of SWOG has pioneered studies in combined androgen therapy for metastatic disease, quality-of-life (QOL) assessments for patients with localized and advanced disease, adjuvant therapy models, and prostate cancer chemoprevention. The committee has also formed the GU Global Group, whose purpose is to convene the chairs of the GU committees of all the major national and international oncology cooperative groups. Meeting semiannually, this group discusses activities within their respective organizations, plans collaborative strategies and protocols, and establishes global strategy in prostate cancer clinical research. The future directions of national and international prostate cancer trials will build on this broad foundation of well-conceived, logically sequenced studies. [ONCOLOGY 11(8):1155-1170, 1997]
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Commentary (Laws): Current Management of MeningiomasDr. DeMonte has used an interesting case report to provide an excellent summary of the state of the art in the management of meningiomas of the brain.
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Face-Off: Award CeremonyFollowing a comprehensive debate on the treatment of patients with non–small cell lung cancer, Edward Kim, MD, presents the winning team with the title of victors of this CancerNetwork® Face-Off event.
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Metastatic Breast CancerIn 1995, it is projected that there will be 183,400 new cases of breast cancer and 46,240 deaths from the disease, despite an emphasis on early detection [1]. Fewer than 10% of patients will present with metastatic disease, but nearly 50% of newly diagnosed patients may eventually develop it. Unfortunately, advanced breast cancer is incurable. In a classic study of untreated patients, the median survival was 2.7 years from the onset of symptoms [2].
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Cardiovascular Risk Associated With Androgen Deprivation TherapyProstate cancer is the second leading cause of cancer-related death among men in the United States.[1] Androgen deprivation therapy (ADT) is a common treatment for prostate cancer. ADT includes gonadotropin-releasing hormone (GnRH) agonists (leuprolide, goserelin, triptorelin), bilateral orchiectomy, and anti-androgen receptor blockers such as flutamide and bicalutamide. Several studies have now shown conflicting evidence that anti-androgen therapy may lead to increased cardiovascular morbidity and mortality.[2-5] None of these studies has provided conclusive evidence for causality or a direct link to cardiovascular disease, but they have proposed that therapy side-effects increase parameters that are similar to those of the metabolic syndrome.
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Planning Treatment for Women With Recurrent Epithelial Ovarian CancerIt is important to help patients with recurrent ovarian cancer recognize and acknowledge when further therapy is likely to be futile. For some patients this might occur very early in their disease course, while for others it may be after many years of treatment.
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Management of Benign and Aggressive Intracranial MeningiomasUsually considered benign tumors, meningiomas can display aggressive behavior characterized by multiple recurrences and invasion of the brain, dura, and adjacent bone. The aggressive or malignant phenotype is difficult
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Brain TumorsWhile the majority of primary central nervous system (CNS) tumors occur in patients over the age of 45 years, they are also the most prevalent solid neoplasms of childhood. About 16% of patients with brain tumors have a family history of cancer, and evidence points to chromosomal and genetic abnormalities. Magnetic resonance imaging (MRI) is superior to computed tomography (CT) in localizing tumors and in evaluating edema, hydrocephalus, and hemorrhage.
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Plasma Glutamine as a Prognostic Biomarker in Localized Prostate Cancer: Comparison of Conventional Variables in Risk StratificationThis study investigated the biomarker potential of glutamine among known prognostic variables in localized prostate cancer.
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Systemic Therapy in Renal Cell Carcinoma: Advancing ParadigmsRenal cell carcinoma (RCC) had historically been regarded as a disease that was refractory to therapy once surgical options had been exhausted.
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Retroperitoneal Neuroblastoma Causing Urinary Obstruction in a 5-Month-Old BoyThe patient is a 5-month-old Caucasian boy with no developmental abnormalities who presented Christmas Eve 2004 to his pediatrician with increasing fussiness, emesis, and inability to tolerate oral intake. He had a temperature of 100.2°F but otherwise normal vital signs. Physical exam at that time revealed a distended abdomen. He was sent home with a diagnosis of viral gastroenteritis.
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Supraclavicular Extraskeletal Myxoid Chondrosarcoma Presenting With a Sensorimotor Polyneuropathy Associated With Anti-Hu AntibodiesThis case shows the importance of searching for antineural antibodies in oncologic patients with new neurologic deficits, and of having a judicious workup for occult malignancies in patients with known antineural antibodies.
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Chemotherapy-Induced Peripheral NeuropathyChemotherapy-induced peripheral neuropathy (CIPN) is a common treatment-related side effect of several widely used drugs. Agents known to cause CIPN include platinum analogs, antitubulins, proteasome inhibitors, immunomodulatory agents, and some of the newer biologics.
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Efstathios Kastritis, MD, on Main Takeaways From Trial Examining Daratumumab Plus VCd to Treat AL AmyloidosisHematologic responses improved for patients treated with daratumumab plus VCd versus VCd alone in the ANDROMEDA trial.
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Small-Cell Lung Cancer: Is There a Standard Therapy?For more than 25 years, chemotherapy has been the cornerstone of treatment for small-cell lung cancer. Many studies have tested a wide variety of drugs in different combinations, resulting in a number of standard
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Imaging Prostate Cancer: Current and Future ApplicationsVarious treatment options are available for adenocarcinoma of the prostate-the most common malignant neoplasm among men in the United States. To select an optimum management strategy, we must be able to identify an organ-confined disease (in which local therapy such as surgery or radiation may be beneficial) vs prostate cancer beyond the confines of the gland (for which other treatment approaches may be more appropriate). At present, no standard imaging modality can by itself reliably diagnose and/or stage adenocarcinoma of the prostate. Standard transrectal ultrasound, magnetic resonance imaging (MRI), computed tomography, bone scans, and plain x-ray are not sufficiently reliable when used alone. Fortunately, advances in imaging technology have led to the development of several promising modalities. These modalities include color and power Doppler ultrasonography, ultrasound contrast agents, intermittent and harmonic ultrasound imaging, MR contrast imaging, MRI with fat suppression, MRI spectroscopy, three-dimensional MRI spectroscopy, elastography, and radioimmunoscintigraphy. These newer imaging techniques appear to improve the yield of prostate cancer detection and staging, but are limited in availability and thus require further validation. This article reviews the status of current imaging modalities for prostate cancer and identifies emerging imaging technologies that may improve the diagnosis and staging of this disease. [ONCOLOGY 15(3):325-342, 2001]
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TKI Discontinuation Possible for Some CML PatientsAhead of the 2017 ASCO Annual Meeting, we discuss the discontinuation of TKIs in some chronic myeloid leukemia patients.
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Quality of Life After Radiation Therapy for Base of Tongue CancerThe article by Moore provides an example of much needed research evaluating clinical outcomes in head and neck oncology. Measuring the quality of life (QOL) of patients with head and neck cancer presents some unique challenges. First, head and neck cancer profoundly influences some of the most fundamental functions of life, including breathing, eating, and communication. Second, treatment of head and neck cancer does not always improve these functional deficits, and in many instances, the treatment itself results in further deterioration of these functions. Finally, "traditional" outcome measures (disease-free survival, overall survival, local and regional control, response rates) do not adequately assess the global impact of this disease and/or its treatment on patients' perception of life satisfaction.
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Clarifying the Use of Ruxolitinib in Patients With MyelofibrosisIn this article, we provide updated data on ruxolitinib therapy for patients with myelofibrosis and offer expert opinion on the appropriate use of this agent in the community practice.
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Pituitary Adenomas: Current Methods of Diagnosis and TreatmentIn a well-written and focused article, Drs. Buatti and Marcus review the diagnosis and treatment of pituitary adenomas.
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Challenges in the Modern Treatment of Muscle-Invasive Bladder CancerStill missing in our treatment of bladder cancer are the tools to accurately predict response to a specific therapy, whether it be chemotherapy, radiation, or transurethral resection alone. Once we have these tools, we will be well on our way to applying a more intelligent, true personalized medicine approach to the treatment of this disease.
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Starting at the Front Line in Metastatic Pancreatic Cancer As New Options Emerge, How Do You Select and Sequence?Experts in gastrointestinal cancer focus on frontline therapy options for patients with pancreatic cancer.
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Apoptosis and Response to Radiation: Implications for Radiation TherapyQuantitative radiation biology was revolutionized in 1956 when Puck and Marcus published the first cell survival curve, relating radiation dose to the fraction of cells surviving.[1] The term "survival" generated a great deal of discussion at that time and led to the definition of such terms as "reproductive death," "reproductive integrity," and "clonogenicity" (among others), all designed to explain that the end point of cell culture experiments is the loss of the cell's ability to divide indefinitely and produce a sizable visible clone.
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Combination Therapy for Advanced Breast Cancer: Cyclophosphamide, Doxorubicin, UFT, and TamoxifenWe evaluated combination therapy for advanced and recurrent breast cancer with cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), uracil and tegafur (UFT), and tamoxifen (Nolvadex) (CAUT), designed as
