This was an open lable, pilot translational clinical pharmacology study of a brief (7 day) course of UFT, 300 mg/m²/day, in combination with leucovorin, 90 mg/day, in six patients with newly diagnosed advanced colorectal cancer.
Postmastectomy locoregional radiation therapy markedly reduces the risk of locoregional recurrence. Several randomized trials, including two recently updated studies with 10- to 15-year follow-up, demonstrate an
Cancer Network spoke with Patricia Eifel, MD, of the University of Texas MD Anderson Cancer Center, about the current shifts in the treatment of cervical cancer.
Fatigue is common in patients with cancer. Fatigue is very distressing to patients, who often view it as an indication that their disease is progressing or that treatment is ineffective.
Recent results from prospective, controlled trials, specifically evaluating strategies for preventing or reducing the severity of the dermatologic effects of EGFR inhibitors, represent the first step toward an evidence-based approach to the prevention and management of these important effects.
Oxaliplatin (Eloxatin) has demonstrated significant activity in a variety of tumor types in addition to colorectal cancer. Several studies have reported on the effectiveness of oxaliplatin as single-agent treatment or in
We are delighted to reviewthe article by Dr. TonyBack on communicationwith cancer patients. We applaud hiseffort to provide recommendations forenhanced communication with patientsand families based on findings fromthe literature. We agree that using thecancer trajectory to identify key communicationtasks provides a useful heuristicmodel because, by matchingcommunication tasks to "high-stakes"clinical encounters, this approach intuitivelyappeals to practicing clinicians.As clearly described by Dr. Back, thevast majority of recommendations forcommunication among oncologist, patient,and family are not derived fromevidence-based research. This underscoresthe importance of conductingadditional research to use as a basis forguiding clinicians in how to handlethese challenging communication tasks.
Bloodstream infections cause significant morbidity and mortality for patients with hematologic malignancy. Antimicrobial drugs are the most reliable currently available treatment for infection, but several issues must be
A 22-year-old college student with primary amenorrhea due to Müllerian agenesis presented with a headache, dysarthria, nausea, vomiting, and left upper extremity weakness. MRI of the brain showed numerous intracranial lesions.
In this video, Dr. Patricia Steeg discusses the role of the blood-tumor barrier in both development and treatment of brain metastases.
Remarkably, within 2 years of the introduction of ipilimumab and vemurafenib into the clinic, major new advances have been reported in both the immune checkpoint blockade and small-molecule kinase inhibition arenas.
Primary debulking surgery by a gynecologic oncologist remains thestandard of care in advanced ovarian cancer. Optimal debulking surgeryshould be defined as no residual tumor load. In retrospective analyses,neoadjuvant chemotherapy followed by interval debulking surgerydoes not seem to worsen prognosis compared to primary debulking surgeryfollowed by chemotherapy. However, we will have to wait for theresults of future randomized trials to know whether neoadjuvant chemotherapyfollowed by interval debulking surgery is as good as primarydebulking surgery in stage IIIC and IV patients. Interval debulking isdefined as an operation performed after a short course of induction chemotherapy.Based on the randomized European Organization for Researchand Treatment of Cancer–Gynecological Cancer Group (EORTC-GCG)trial, interval debulking by an experienced surgeon improves survival insome patients who did not undergo optimal primary debulking surgery.Based on Gynecologic Oncology Group (GOG) 152 data, intervaldebulking surgery does not seem to be indicated in patients who underwentprimarily a maximal surgical effort by a gynecologic oncologist.Open laparoscopy is probably the most valuable tool for evaluating theoperability primarily or at the time of interval debulking surgery.
Twenty years of research in controlling symptoms such as pain andnausea have shown persistent suboptimal performance by the US oncologysystem. The data suggest that some of the tools of palliative careprograms can improve physical symptoms of seriously ill patients at acost society can afford. To fix these problems will require recognitionof the symptoms or concerns, a system such as an algorithm or careplan for addressing each, measurement of the change, and accountabilityfor the change. Symptom assessment scales such as the EdmontonSymptom Assessment Scale or Rotterdam Symptom Check List work tomake symptoms manifest. Listing symptoms on a problem list is a necessarystep in addressing them. Physical symptoms such as pain can beimproved by use of computer prompts, algorithms, dedicated staff time,team management, or combinations of these strategies. Less concreteproblems such as medically appropriate goal-setting, integrating palliativecare into anticancer care sooner, and informing patients aboutthe benefits and risks of chemotherapy near the end of life require morecomplex solutions. We review what is known about symptom control inoncology, how and why some programs do better, and make suggestionsfor practice. Finally, we suggest a practical plan for using symptomassessment scales, listing the problems, and managing them accordingto algorithms or other predetermined plans.
The anthracyclines doxorubicin (A) and epirubicin (E) are among the most active agents for breast cancer.
Oncology nurses must play an integral role in improving the treatment of breakthrough pain-one patient, one in-service for colleagues, and one clinical research study at a time.
This testicular cancer management guide covers the diagnosis, staging, and treatment of germ-cell tumors and seminoma.
It was not until 1995 that a phase III randomized trial demonstrated that autologous stem cell transplants (ASCT) improve the progression-free and overall survival of patients with relapsed refractory diffuse aggressive non-Hodgkin’s lymphoma. Investigators are now focusing on improving the clinical benefit of transplants. The relative contributions made by more intensive preparative regimens, purging, concomitant immunotherapy, and the timing of transplants are under study. Also, as transplant trials shift from relapsed disease to initial therapy, anticipated benefits must be balanced against both short-term and long-term toxicities.[ONCOLOGY 12(Suppl 8):56-62, 1998]
The goal of palliative radiotherapy is to treat symptoms as rapidly and efficiently as possible, with the fewest side effects.[1] For many years, pain medication, radiotherapy, and surgery were the only tools available for the treatment of bone metastases. This has changed significantly over the past 15 years. New systemic agents, including bisphosphonates such as zoledronic acid (Reclast, Zometa), are available to prevent the development of new lesions, strengthen the bone, and improve symptoms. In addition, targeted treatments directed at achieving tumor ablation now include radiofrequency ablation and stereotactic body radiation therapy (SBRT).
Chemotherapy-induced peripheral neuropathy is a serious yet common side effect of cancer treatment. This devastating complication, which typically manifests as tingling and numbness in the hands and feet, has an enormous influence on patients’ quality of life.
Patrick Forde, MBBCh, and the Oncology Brothers discuss treatment practices for patients with unresectable non–small cell lung cancer.
Advances 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.
This review will highlight the survival impact that rituximab therapy has had on major lymphoid malignancies, such as diffuse large B-cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, follicular lymphoma, and mantle cell lymphoma. We will also discuss alternative anti-CD20 monoclonal antibodies.
Pediatric soft-tissue sarcomas are managed with a multimodality treatment program that includes surgery, chemotherapy, and external-beam radiotherapy (teletherapy). The use of teletherapy in young children can
The focus of this review will be the multidisciplinary approach to management of anorectal infection, neutropenic enterocolitis, appendicitis, and cholecystitis in the neutropenic cancer patient.
With the introduction of increasingly effective antiretroviral agents for the management of AIDS, the life expectancy of appropriately treated patients will continue to lengthen, as will the length of time during which infected patients may develop malignancies, both HIV-related and non-HIV-related. The management of such patients will require careful consideration of the impact of all oncologic therapy on the immune system's ability to hold the virus at bay. Radiation therapy, with its recognized immunosuppressive effects, plays an important role in the management of the major AIDS-defining neoplasms, Kaposi's sarcoma, primary central nervous system lymphoma, and cervical carcinoma, and is used in approximately 50% of patients with non-HIV-related malignancies at some point in the disease course. The judicious use of radiation therapy and proper integration of aggressive antiretroviral therapy can result in control of malignancies without contributing to the rapid progression of HIV disease. [ONCOLOGY 11(5):683-694, 1997]
Locally advanced or metastatic adenocarcinoma of the stomach still carries a poor prognosis, with 5-year survival rates of < 15%. Palliative chemotherapeutic regimens for this disease are largely 5-FU–based. We
Dr. Paulino has written an excellent review of our present knowledge of Wilms' tumor. Not everyone would agree, however, that ultrasound has replaced the intravenous pyelogram (IVP). The National Wilms' Tumor Study Group (NWTSG) recommends IVP together with real-time ultrasonography as the preoperative imaging studies for the abdomen.[1] The former is used to establish the presence of a functioning opposite kidney and of any congenital abnormality. The latter identifies the presence and status of inferior vena cava thrombi.
The purpose of this article is to present an updated set of American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of radiation therapy in postprostatectomy prostate cancer.
There is no evidence that PCV is more effective than TMZ for the treatment of glioblastoma. However, there is unequivocal evidence that PCV is more toxic than TMZ.