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Oncologic Imaging, Second EditionAlthough the title might be slightly misleading, Oncologic Imaging is actually a compendium of information on the detection, diagnosis, imaging, staging, and treatment of cancer. This is the second edition of a multiauthor book that first appeared in
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Addressing the Challenge of Managing Radiation Use in Medical Imaging: Paradigm Shifts and Strategic PrioritiesThe rise in utilization of medical imaging-especially computed tomography and nuclear medicine-and the issues of perceived, potential, theoretical, and known risks associated with ionizing radiation exposure from imaging have come to the forefront of public and professional awareness, raising concerns and controversies.
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The Emerging Role of Pemetrexed for the Treatment of Malignant MesotheliomaMalignant mesothelioma is a devastating disease with an onset 20to 60 years after exposure to asbestos. Although most cytotoxic agentshave been evaluated for the treatment of mesothelioma, few single agentshave consistently yielded response rates above 20%. Antimetabolitesare the most active drugs against mesothelioma, and of these, theantifolate group is the most widely studied and effective. Pemetrexed(Alimta), a new antifolate, may be more active because of its differentmechanism of action. Several clinical trials have evaluated pemetrexedalone and in combination with a platinum agent for patients with malignantmesothelioma. A pivotal phase III trial has demonstrated thatcombination chemotherapy with pemetrexed and cisplatin improvessurvival, response rate, pulmonary function, and quality of life comparedwith single-agent cisplatin. Additional trials are evaluatingpemetrexed in the neoadjuvant setting and in combination with othercytotoxic and targeted agents.
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Addressing the Common Mystery of the Solitary Pulmonary NoduleTo ultimately find what we are actually looking for, the invasive malignant nodule in a haystack of benign lesions, new strategies and qualitative and quantitative tools are needed to propel noninvasive evaluation of solitary pulmonary nodules into the 21st century.
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Radical Prostatectomy Reigns SupremeProstate cancer remains the most common solid organ malignancy diagnosed among men in the United States, with the American Cancer Society estimating that 1 in 6 men will be diagnosed with prostate cancer, and 1 in 35 will die of the disease.[1]
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Commentary (Larson/Nelson)-Laparoscopic Surgery for Cancer: Historical, Theoretical, and Technical ConsiderationsSurgery for cancer carries concerns of tumor dissemination related to tumor manipulation, tumor violation, and wound seeding. Minimally invasive surgery is now standard for several benign conditions, such as symptomatic cholelithiasis and surgical therapy of gastroesophageal reflux. With the minimally invasive surgery explosion of the 1990s, virtually every procedure traditionally performed via laparotomy has been performed successfully with laparoscopic methods, including pancreaticoduodenectomy for cancer. Shortly after the first descriptions of laparoscopic-assisted colectomy, reports of port-site tumor recurrences surfaced, raising concerns of using pneumoperitoneum-based surgery for malignancy. This review covers the development of laparoscopic surgery for cancer. Historical perspectives elucidate factors that helped shape the current state of the art. Theoretical concerns are discussed regarding surgery-induced immune suppression and its potential effects on tumor recurrence with both open and laparoscopic approaches. The concerns of laparoscopic port-site wound metastases are addressed, with a critical evaluation of the literature. Finally, a technical discussion of laparoscopic-assisted resections of hepatic and pancreatic tumors details patient selection, operative approach, and existing data for these operations.
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Textbook of Lung CancerLung cancer is a global problem fueled by the continuous use of tobacco in most countries, despite efforts at expanding smoking cessation programs. Several advances in the diagnosis and treatment of lung cancer were achieved in the past decade. This progress notwithstanding, most lung cancer patients succumb to their illness, and few enjoy long-term survival.
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Liquid Biopsy to Inform Targeted Tx of Colorectal CancerIn this video, Dr. Heinz-Josef Lenz outlines the many advantages that development of liquid biopsy is affording cancer patients.
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Management of Comorbid Diabetes and CancerDiabetes mellitus is a frequent comorbidity of cancer patients. The growing epidemic of diabetes is anticipated to have tremendous impact on health care. Diabetes may negatively impact both cancer risk and outcomes of treatment. Oncology nurses are ideally positioned to identify patients at risk for complications that arise from cancer treatment in the setting of pre-existing diabetes. Additionally, oncology nurses may be the first to identify underlying hyperglycemia/hidden diabetes in a patient undergoing cancer treatment. Strategies for assessment and treatment will be discussed, along with specific strategies for managing hyperglycemia, potential renal toxicity, and peripheral neuropathy. Guidelines for aggressive treatment of hyperglycemia to minimize risks of complications will be reviewed. The role of interdisciplinary care, utilizing current evidence, is crucial to supporting patients and their families as they manage the challenges of facing two life-limiting diseases. Whole-person assessment and individualized treatment plans are key to maximizing quality of life for patients with cancer and diabetes.
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Current Clinical Trials of the Anti-VEGF Monoclonal Antibody BevacizumabGiven the well-established role of angiogenesis (or new blood vessel formation) in tumor growth and metastasis, antiangiogenic therapy, a concept first proposed by Dr. Judah Folkman,[1] has become increasingly recognized as a promising
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Does Neck Stage Predict Local Control After Irradiation for Head and Neck Cancer?The paper by Mendenhall et al addresses a very debatable issue, ie, the influence of nodal stage on local control for head and neck carcinomas treated by radiotherapy. The paper is well written and appropriately referenced, and the authors fairly conclude that, based on currently available data, nodal stage has no clear impact on the probability of primary local control after radiotherapy.
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Chemotherapy for Breast Cancer During Pregnancy, With Neonatal Lupus in the NewbornA 34-year-old, gravida 2, para 1, previously healthy African-American woman presented with a right breast mass on self-examination in the second trimester of pregnancy.
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Textbook of Medical Oncology, 2nd EditionIn this day of encyclopedic oncology texts, frequently updated online reference sites, and literature searches at the click of a button, is there a place for a basic medical oncology textbook? The second edition of the Textbook of Medical Oncology, edited by Drs. Cavalli, Hansen, and Kaye, is approximately 50% longer than the first edition, due in large part to the inclusion of newer therapeutic approaches.
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UFT/Leucovorin Combined With Paclitaxel for Anthracycline-Pretreated Advanced Breast CancerTaxanes are the most active drugs in the treatment of metastatic breast and ovarian cancer. Weekly therapy with paclitaxel produces notable activity, with remarkably low toxicity.
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Middle-Aged Man With Acute Thrombocytopenia Subsequent to Fluorouracil and Oxaliplatin Chemotherapy for Colorectal CancerA 44-year-old patient with a history of stage IIB colorectal cancer at the hepatic flexure, invading the duodenum and pancreas, was initially diagnosed in September 2005 and received modified Whipple surgery and 8 cycles of adjuvant chemotherapy with capecitabine and oxaliplatin every 3 weeks.
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ACR Appropriateness Criteria® Nonsurgical Treatment for Locally Advanced Non–Small-Cell Lung Cancer: Good Performance Status/Definitive IntentThe treatment of inoperable stage III non–small-cell lung cancer (NSCLC) remains a challenge due to high rates of distant metastasis, local recurrence, and toxicity associated with definitive therapy.
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Surgical Management of Pancreatic CancerPancreatic cancer is the fifth leading cause of cancer death in the United States, with an overall survival rate of 3%. Unfortunately, only a minority of patients present with localized disease amenable to surgical resection.
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Treatment of Estrogen Deficiency Symptoms in Women Surviving Breast Cancer, Part 6Problem: Several million women worldwide have survived breast cancer but are currently advised against the use of estrogen for the management of menopausal symptoms and for the prevention of early cardiovascular death and osteoporosis.
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Small Steps Forward in the Land of Small TumorsMetastatic well or moderately differentiated neuroendocrine tumors of the gastrointestinal tract and lung (NETs) are a fascinating and markedly heterogeneous group of generally indolent, but relentless cancers.
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Diagnostic DilemmaA 48-year-old man is referred for evaluation. He has a history of hypercholesterolemia and obesity. Treatment with cholesterol-lowering medication was associated with elevated liver chemistries. When the elevated liver chemistries persisted
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Changing Concepts in the Management of Endometrial CancerThe authors present the major issues and controversies surrounding the treatment of endometrial cancer. A variety of therapeutic approaches have been used in the past, including surgery alone, preoperative radiation and surgery, surgery and
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Planned Radiation in Axillary Management of Breast CancerThis video examines how planned radiation will impact management of the axilla in breast cancer patients undergoing mastectomy.
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Vaccine Therapy, Oncolytic Viruses, and GliomasIn this article, we will discuss some of the vaccination and oncolytic virus strategies being evaluated in the clinic for malignant gliomas. The vaccines reviewed here include the cell-based and the non–cell-based.
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Higher Facility Volume Linked With Better Radiation Outcomes for Head and Neck CancersA study presented last month at ASTRO found that better radiation outcomes for head and neck cancer were associated with higher facility volume.
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Clinical Selection of Candidates for Mutational Testing for Cancer SusceptibilityAdvances in molecular genetics have evolved at such a fast pace that physicians may be bewildered about their clinical translation into patient care. However, genetic counselors, particularly those trained in cancer genetics, have been extremely helpful. The challenge to the physician, however, calls for an understanding of the natural history of hereditary cancer syndromes, which is often reflected in the pedigree. Pedigree/family history information must be compiled in sufficient detail to arrive at the most likely hereditary cancer syndrome diagnosis so that the molecular geneticist can search for the mutation. Finally, the challenge to the clinician is melding this into an accurate diagnosis, in order to provide highly targeted screening and management for high-risk patients. This article is an attempt to crystallize all of these issues in a format that will help physicians—particularly those in the oncology community—to meet this challenge effectively.
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Role of Adjuvant Therapy in Resected Stage II/IIIA Non-Small-Cell Lung CancerThe search for effective postoperative adjuvant therapy for patients with resected non-small-cell lung cancer (NSCLC) has been spurred by a high rate of failure after definitive surgery. Except for patients with resected T1, N0, M0 lesions, failure rates exceed 30%. Widespread application of adjuvant therapy has been reined in by a disappointing lack of effectiveness in this setting.
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Handbook of Brain Tumor ChemotherapyAfter 2 decades of minimal progress, there have been important advances in the treatment of brain tumors with chemotherapy. A trial conducted by the European Organization for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC) recently demonstrated the benefit of radiation therapy with concomitant and adjuvant temozolomide (Temodar) chemotherapy for glioblastomas. There is also increasing evidence that chemotherapy may be beneficial for anaplastic and low-grade gliomas, as well as a variety of less common tumors.
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Neoadjuvant Strategies for Pancreatic CancerWe have made much progress over the past 30 years in the surgical management of pancreatic cancer, and perioperative mortality rates are low in centers with experience in the treatment of this disease. However, surgical resection is clearly limited in achieving local and systemic control of pancreatic cancer, and chemoradiation will likely become a part of any successful pancreatic cancer treatment program.
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Use of Molecular Biomarkers to Inform Adjuvant Therapy for Colon CancerIn this review, we will discuss adjuvant chemotherapy in non-metastatic colon cancer, the existing prognostic and predictive molecular biomarkers in the field, and how to integrate these molecular biomarkers into the decision about whether to administer adjuvant therapy.
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The Costs of Cancer Care in the United States: Implications for ActionThe total annual cost of cancer care in the United States (including direct and indirect costs) has been estimated at more than $96 billion. Although third-party payers have led the effort to reduce these costs, such high
