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Commentary (Barker/Garden): The Multidisciplinary Management of Paragangliomas of the Head and NeckWe have reviewed with interestthe article by Drs. Huand Persky and would liketo congratulate them on an excellentand comprehensive overview of theevaluation and management ofparagangliomas of the head and neck.Their review begins with an excellentlydetailed description of thedisease and staging work-up. Withmodern imaging, most paragangliomasare convincingly diagnosed basedon typical location (carotid bifurcation,nodose ganglia of the vagusnerve, middle ear along tympanic plexus,or near jugular bulb) and characteristicradiographic appearance(hypervascular, intensely enhancingmass). A tissue diagnosis is usuallyunnecessary for such lesions.
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Iron and the Anemia of Chronic Disease: Vindication for the Non-Essential Role of Iron SupplementationIt is somewhat ironic (no pun intended) that a review whose title, “Iron and the Anemia of Chronic Disease,” suggests content more appropriate to a hematology journal than one devoted to oncology, has been found to have lasting value by practicing oncologists.
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Ground-Glass Opacity Lung Nodules in the Era of Lung Cancer CT Screening: Radiology, Pathology, and Clinical ManagementThis review focuses on the radiologic and pathologic features of ground-glass opacity nodules, along with the clinical management of these lesions.
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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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Finding the Mechanisms of Immunotherapy ResistanceIn this interview we discuss a recent study that identified genetic mechanisms of immunoresistance to treatment with anti-PD-1 antibodies.
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Proposed Algorithm for Managing Ibrutinib-Related Atrial FibrillationAlthough ibrutinib-related atrial fibrillation (IRAF) occurs in up to 11% of patients in clinical trials, these studies have rarely fully characterized bleeding events or risk factors for bleeding when ibrutinib is combined with anticoagulation. Furthermore, guidelines do not provide direction regarding the preferred anti-arrhythmic agent for IRAF.
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How Long Have I Had My Cancer, Doctor?“How long have I had this cancer, Doctor?” This is a question that patients frequently ask their oncologist.
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Exploring Alternate Payment Models in OncologyAt the ACCC annual meeting, Jessica Turgon, MBA, from ECG Management Consultants discusses how and why providers and payers are beginning to work together to explore alternate payment models in oncology.
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Clinical Management of Uveal and Conjunctival MelanomaIn this review, we discuss current management strategies, as well as future directions, for the management of uveal and conjunctival melanoma.
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Combination Intravesical Hyperthermia and Chemotherapy for Bladder CancerThe review by Rampersaud and colleagues provides an excellent summary of the scientific rationale for using hyperthermia to treat cancer and of the current status of combinations of hyperthermia and chemotherapy or radiotherapy. In view of the demonstrated efficacy of the combination of intravescial hyperthermia and mitomycin C (MMC) therapy in preventing the progression and recurrence of non–muscle-invading bladder cancer (NMIBC) in several clinical trials, Rampersaud and colleagues advocate additional studies to further optimize the delivery of hyperthermia and to delineate its clinical utility in this disease.
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Colorectal Cancer With Peritoneal Metastases: A Plea for Cooperation Between Medical and Surgical OncologistsOur future goal should be to increase the resectability of patients with colorectal cancer and peritoneal metastases by improving selection criteria and by referring early, but also by using systemic therapies in the neoadjuvant setting.
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Current Challenges in the Management of Patients with Relapsed/Refractory Multiple MyelomaFor patients with multiple myeloma (MM) who experience relapse, important advances in medical therapies in the past decade have doubled the duration of survival, mainly because of the effectiveness of novel agents such as thalidomide (Thalomid), bortezomib (Velcade), and lenalidomide (Revlimid).[1]
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Propelling Immunotherapy Combinations Into the ClinicThis review summarizes promising new targets and immunotherapy combination strategies currently under clinical development.
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Ji Luo Elucidates the CRISPR Gene Editing Technology, and How It May Affect Cancer Therapy in the FutureIn this interview we discuss the CRISPR technology currently being used to “edit” genes and when we might see the technology in mainstream practice.
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Preclinical Studies Using the Intratumoral Aromatase Model for Postmenopausal Breast CancerTo determine the most effective strategies for the treatment of postmenopausal hormone dependent breast cancer, we recently developed a model system in nude mice. In this model, estrogen receptor-positive human breast cancer cells (MCF-7) stably transfected with the aromatase gene are inoculated into ovariectomized, immunosuppressed (nude) mice.
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Face-Off: Award Presentations and Event ConclusionJudy concludes the event and presents the awards.
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Next Generation of Targeted Molecules for Non-Hodgkin Lymphomas: Small-Molecule Inhibitors of Intracellular Targets and Signaling PathwaysThis review discusses the mechanisms of action, clinical development, and emerging applications of small-molecule inhibitors that target B-cell receptor signaling pathways, B-cell lymphoma-2 inhibitors, selective inhibitors of nuclear export, and epigenetic modifiers.
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Overview and Management of Cardiac and Pulmonary Adverse Events in Patients With Relapsed and/or Refractory Multiple Myeloma Treated With Single-Agent CarfilzomibThis article presents an overview of the cardiac and pulmonary safety profile of single-agent carfilzomib therapy in patients with relapsed and/or refractory multiple myeloma from an analysis of four phase II clinical studies, and provides practical recommendations for the management of patients at risk for cardiac events and pulmonary complication.
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Genetic Testing and Counseling in Familial Adenomatous PolyposisTesting for adenomatous polyposis coli (APC), the gene responsible for familial adenomatous polyposis (FAP), can now be offered to family members in FAP kindreds. With the availability of this test, genetic counseling has become a crucial tool for helping FAP patients and their relatives understand the syndrome and its implications and for assisting at-risk individuals in making informed decisions about whether or not to undergo genetic testing. Genetic counseling can occur at several time points: when FAP is diagnosed, when an FAP patient is considering reproductive options, when a patient is deciding whether to have his or her children screened, and when an at-risk person is considering genetic testing.
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Commentary (Stopfer/Domchek): Evaluation and Management of Women With BRCA1/2 MutationsMore than a decade has passedsince the cancer predispositiongenes BRCA1 andBRCA2 were cloned. Collectively,these genes are responsible for virtuallyall hereditary breast/ovarian cancerfamilies as well as a smaller subsetof hereditary site-specific breast cancerfamilies.[1] Their discovery helped usherin a new age of predictive and preventivemedicine for those at risk ofbreast and ovarian cancer, two of themost common forms of cancer in womenin the United States.[2] Peshkin andIsaacs provide an excellent summaryof cancer susceptibility due to inheritedmutations in BRCA1 and BRCA2,including approaches to assessing personaland family history for the likelihoodof finding these mutations, theirassociated cancer risks, and options forclinical management.
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Stress and Burnout in OncologyThis article identifies the professional stressors experienced by nurses, house staff, and medical oncologists and examines the effect of stress and personality attributes on burnout scores. A survey was conducted of 261 house
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Mitomycin as a Modulator of Irinotecan Anticancer ActivityIrinotecan and mitomycin (Mutamycin) possess significant single-agent activity against several tumor types, and mitomycin activates topoisomerase I, the cellular target of irinotecan. We conducted a phase I dose-escalation study of irinotecan and mitomycin in 37 evaluable patients with solid tumors. Antitumor responses included 2 complete responses, 5 partial responses, 10 minor responses, and a CA 19-9 tumor marker response.
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QOL and Outcomes Research in Prostate Cancer Patients With Low Socioeconomic StatusThe VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quality-of-life (QOL) information from prostate cancer patients, spouses, and physicians at six VA medical centers. Currently, 601 men with prostate
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Sonography better to monitor small testicular lesionsThere is a lack of scientific evidence about the risk of testicular cancer associated with testicular lesions, but the conventional treatment approach has been immediate surgical removal because of the possibility of malignancy. A more conservative approach has served one Canadian institution well when it comes to active surveillance of small, incidentally discovered testicular masses.
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Clinical Hypnosis for the Palliative Care of Cancer PatientsClinical hypnosis has been defined as a mind-body therapy that involves a deeply relaxed state, individualized mental imagery, and therapeutic suggestion.
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"OMG, How Long Is This Going to Take?"It is hard to realize that an elderly patient's visit to you is likely the only trip outside his or her apartment for the week and the only contact with someone other than family or an aide. Doctor visits sometimes become the elderly's primary contact with the larger world.
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Managing Depression in Patients With CancerThe diagnosis and treatment of depression in the cancer setting can improve patients’ quality of life, their adherence to therapy recommendations, and the illness experience, all of which may affect survival outcomes.
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Molecular Testing to Optimize and Personalize Decision Making in the Management of Colorectal CancerRecent improvements in our understanding of the biology of colorectal cancer have led to the identification of several important prognostic and predictive markers of disease-associated risk and treatment response for the individual patient.
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Epirubicin, Cisplatin, Oral UFT, and Calcium Folinate in Advanced Gastric CarcinomaUFT (uracil and tegafur in a 4:1 molar ratio) plus calcium folinate treatment has favorable activity and tolerable toxicity in patients with advanced gastric carcinoma. High response rates have been reported in patients with
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Uterine Sarcomas: The Latest Approaches for These Rare but Potentially Deadly TumorsIn this review we discuss preoperative diagnosis and the role of pathology, and we summarize the current literature regarding the management of uterine sarcomas.
