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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
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Commentary (Stanford/Ostrander): Prostate Cancer Risk Assessment ProgramBruner et al describe a model for risk assessment and genetic counseling of individuals and families at increased risk for prostate cancer. This model includes the establishment of a prostate cancer risk registry and screening clinic for unaffected
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Hypofractionation for Breast Cancer: Lessons Learned From Our Neighbors to the North and Across the PondIn this review we discuss the rationale and underlying radiobiologic concepts for hypofractionation, and review the clinical trials and ASTRO guidelines supporting hypofractionated radiation in the treatment of breast cancer.
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Hereditary Renal Tumor Syndromes and the Use of mTOR InhibitorsA 47-year-old woman with a history of drug-resistant epilepsy during childhood presented to the emergency department with sudden dyspnea and chest pain. Upon admission, her oxygen saturation was 88%.
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ACR Appropriateness Criteria® Ductal Carcinoma in SituManagement of ductal carcinoma in situ (DCIS) commonly involves excision, radiotherapy, and hormonal therapy. Radiotherapy is employed for local control in breast conservation. Evidence is evolving for several radiotherapy techniques exist beyond standard whole-breast irradiation.
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Can Locoregional Therapies Be Used in Metastatic Gastroesophageal Cancers?As part of our coverage of the 2018 GI Cancers Symposium, we discussed the role of locoregional therapies for patients with metastatic esophageal and gastric cancers.
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Using Genetic Testing to Help Prevent Colon CancerIn this interview we discuss the role of genetic testing in patients with colon cancer.
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Approaching Use of CDK4/6 Inhibitors in Metastatic HR+, HER2- Breast CancerAn otherwise healthy 58-year-old woman with a history of breast cancer presents to the clinic with newly diagnosed metastatic disease; eventual abdominal CT showed a mass in the transverse colon with ascites and peritoneal nodularity. What is the best initial systemic treatment for her?
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Further Thoughts on Adjuvant Treatment for Older Breast Cancer PatientsThe adjuvant treatment of breast cancer is facing a challenging phase due to the increasing knowledge of breast cancer biology and consequent need to personalize treatments. Medical oncologists are asked to practice evidence-based medicine, but their approach is often based on results of trials conducted in extremely heterogeneous populations.
