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Androgen deprivation, as a form of treatment for prostate cancer,has been used for decades. Within the last decade, however, its use hasincreased significantly. Therefore, it is incumbent upon the physicianto be familiar with the side effects associated with this treatment. Someof these side effects (eg, osteoporosis, changes in lipid profiles, andanemia) may be associated with significant morbidity, whereas others(eg, impotence, decreased libido, fatigue, and hot flashes) primarilyaffect the patient’s quality of life. Prevention strategies and treatmentsexist for many of these side effects. In addition, alternative forms ofantiandrogen therapy such as intermittent hormone ablation andantiandrogen monotherapy may be effective, with the added benefit ofminimizing side effects. This review focuses on the wide range of sideeffects associated with androgen ablation as well as preventive and treatmentstrategies.

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Our objective was to evaluate the effects of darbepoetin alfa (Aranesp) on hemoglobin and transfusions in anemic patients with cancer undergoing chemotherapy, and the impact of age, sex, baseline hemoglobin, chemotherapy

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This article provides an overview of the current state of knowledge pertaining to exercise modulation of the inflammation-immune axis in cancer. The current evidence suggests that exercise may be a promising adjunctive strategy that can favorably alter numerous components of the immune system, which, in turn, may modulate tumorigenesis.

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In this interview we discuss the different types of T-cell lymphomas and how supportive care is used in the management of these malignancies.

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Cancer causes pain as it invades bone, compresses nerves, produces obstructive symptoms in the pulmonary, gastrointestinal, and genitourinary systems, and distends involved visceral organs. This manuscript reviews progress in cancer pain management during the past 2 decades. Since the 1980s, we have seen (1) genuine advances in research on the biology of pain, (2) new approaches to the treatment of cancer pain, and (3) important changes in the health-care system to ensure that pain is appropriately assessed and managed. Currently, clinicians have the appropriate diagnostic and therapeutic tools to ensure that the vast majority of patients with cancer pain can be comfortable during their illness. Nevertheless, too many patients with terminal malignancies continue to die in pain in nations around the globe. An effective strategy to make alleviating pain a major health-care priority remains the primary challenge to effectively palliating patients with cancer pain.

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The preservation and maintenance of quality of life (QoL)-the "extent to which one's usual or expected physical, emotional, [and] social well being [is] affected by the medical condition or its treatment" [1]-is an important aspect in understanding and approaching the overall management and evaluation of patients with myelodysplastic syndromes (MDS) by health care providers. MDS patients are treated with blood transfusions to improve their health-related QoL. Fortunately, recent advances in therapy have signifi cantly enhanced their ability to cope with MDS.

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The body of research addressing the palliative care−oncology collaboration continues to accumulate; however, sustained efforts are needed to ensure that we are providing the best possible care for our patients.

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This video examines the results of a prospective study that looked at associations between survival outcomes and fish and omega-3 fatty acid intake among colon cancer patients.

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In this interview we discuss the new American Cancer Society breast cancer screening guidelines and find out how they stack up with other recommendations for mammography screening.

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Preclinical advances offer an opportunity to further reduce morbidity and mortality from sarcomas over the next decade. Since no single institution or North American cooperative oncology group has the expertise or patient resources for histology-specific clinical and translational research on adult sarcomas, efforts have been made to develop funding from the National Cancer Institute (NCI). One such initiative was the Intergroup Coalition Against Sarcomas (ICAS), which, building upon the strengths of the multimodality cooperative oncology groups, provided an infrastructure for broad participation by investigators from all treatment disciplines in protocol development and patient entry. However, despite an excellent evaluation in formal peer review, the Division of Cancer Treatment of NCI has ended this initiative claiming insufficient available funds—to the detriment of adult sarcoma patients now and in the future.

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As an oncologist, I am always on the lookout for good patient education material. This book, which is based on the experience of the Stanford Integrative Medicine Clinic Cancer Supportive Care Program, is a good choice for a highly literate, print-oriented patient or family member. The book is divided into five parts: (1) Cancer: Diagnosis, Information, and Treatment, (2) The Role of the Mind, (3) The Care of the Body, (4) Supportive and Social Services for Life and Death Issues, (5) Planning for the Future, and (6) Resources. These five parts are divided into 50 individual chapters covering specific topics, and the chapters are focused, concise, and practical.

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Patients with papillary thyroid cancer typically undergo a triad of consecutive initial treatments, comprising surgery, radioiodine therapy, and thyroid hormone suppression of serum thyrotropin (thyroid-stimulating hormone, or TSH).

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Most thyroid cancers are slow-growing, easily treatable tumors with an excellent prognosis after surgical resection and targeted medical therapy. Unfortunately, 10% to 15% of thyroid cancers exhibit aggressive behavior and do not follow an indolent course. Approximately one-third of patients with differentiated thyroid cancers will have tumor recurrences. Distant metastases are present in about 20% of patients with recurrent cancer.

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In this interview we discuss a joint statement from MD Anderson and 68 other NCI-designated cancer centers that calls for increased HPV vaccination for the prevention of cancer.

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Sarcomas are a group of tumors with highly variable character istics and clinical outcomes. Their locations in almost all body locations present unique challenges for diagnosis and management. These challenges have presented opportunities for evaluation and validation of new imaging techniques. Positron-emission tomography (PET) has been evaluated for use in cancer over the years, and in particular, it has been evaluated in sarcoma diagnosis and treatment evaluation.

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Based on preclinical data, we designed a phase I/II clinical trial to determine the efficacy and toxicity of doxorubicin followed by paclitaxel in the treatment of advanced breast cancer (either untreated or relapsed after

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In this issue, Love and Vogel bring attention to the fact that most breast cancers are not inherited but are the result of several, varied hormonal influences. This is an important message because prevention of breast cancer for some women can be accomplished by hormone manipulation from moderate exercise, maintaining low body mass, abstention from alcohol, and lactation. The authors discuss the physiologic role of delayed pregnancy but avoid the issue in terms of preventive strategy. Many women choose to delay pregnancy in pursuit of career development for economic reasons. This makes for a difficult choice in terms of breast cancer risk, but one that should be addressed. The article proposes that lobular maturation and exposure of the breast to hormones are two key processes in breast cancer. Indeed, emerging data also suggest that excess hormonal exposure in utero may influence adult breast cancer risk.

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Bladder cancer is the most common urologic malignancy and is expected to affect approximately 54,000 people in 1998. Superficial bladder tumors (Tis, Ta, and T1 lesions) account for approximately 70% to 80% of these

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Because most patients now want to know the truth about their diagnosis and prognosis, the ability to discuss the cancer diagnosis, disease recurrence, or treatment failure, and to solicit patients’ views about resuscitation

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Mycosis fungoides is an indolent primary cutaneous T-cell lymphoma (CTCL) that usually progresses from localized skin lesions to systemic disease. Sézary syndrome is a distinct variant characterized by generalized

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In this interview we discuss why patient-centered research is important, why this type of information is frequently ignored, and paths toward implementing this information into cancer trials.

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Various 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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Extended pelvic lymph node dissection represents the most accurate procedure for the detection of lymph node metastases in prostate cancer.

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When administered as a single agent in pretreated patients with advanced breast cancer, paclitaxel (Taxol) exhibits remarkable antitumor activity. This trial was undertaken to compare paclitaxel with standard

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Octreotide acetate (Sandostatin), a somatostatin receptor subtype 2 (sst 2)-preferring somatostatin analog, inhibits angiogenesis in a dose-dependent fashion in the chicken chorioallantoic membrane model (CAM) and in the human placental vein angiogenesis model (HPVAM).[1,2] To explain these antiangiogenic effects, sst 2 gene expression in normal (resting) full-thickness human placental vein segments was compared to tissue-matched counterparts that initiated an angiogenic response in culture. Using polymerase chain reaction (PCR) techniques, the sst 2 gene was found to be uniquely up-regulated in the angiogenic vessels, but not present in the tissue-matched resting (nonproliferative) vein segments.

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The use of live viruses for the treatment of cancer has been extensively studied in several preclinical and clinical models, as discussed in Nemunaitis’ thorough historical review of the subject.

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Drs. Sonis and Fey are to be commended for their timely and thorough article on the oral complications of cancer therapies. It has been our experience that these side effects are not being adequately addressed in the clinical setting. This is especially true the further one is removed from large cancer treatment centers in urban areas.

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The Internet is rapidly becoming a third party in the doctor-patient relationship. The World Wide Web, electronic mail (e-mail), and discussion groups have dramatically increased the quantity of medical and health

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While 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.