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Improving Outcomes in Resectable Gastric Cancer: A Review of Current and Future StrategiesHere we review the evidence supporting current approaches to resectable gastric cancer, including discussion of the optimal extent of surgery and lymphadenectomy, adjuvant chemotherapy, postoperative chemotherapy with chemoradiation, and perioperative chemotherapy.
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An 84-Year-Old Woman With an Indolent B-Cell LymphomaAn 84-year-old woman with a history of Graves disease, hyperlipidemia, and hypertension presented to her physician with progressive fatigue and palpable bilateral axillary lymphadenopathy.
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Targeted Therapy in Squamous Cell Cancers of the Head and NeckThe 5-year survival of patients with locally advanced squamous cell cancers of the head and neck is still less than 30%. Treatment of these cancers involves significant functional impairment, diminished quality of life, and considerable time and expense. Local recurrence and distant metastases are still fairly common, and the development of second primary cancers has a significant impact on survival in patients with initial early-stage disease. Despite the success of combination chemoradiation in locally advanced head and neck cancers, these facts stress the need for improved treatment of this disease.
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Clinical Manual for the Oncology Advanced Practice NurseThis book is intended to serve as a quick reference for advanced practice nurses (APNs) caring for oncology patients, from diagnosis through treatment and rehabilitation. With the advances made over the past several years in prevention, early
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Health Literacy: Improving Patient UnderstandingThe review of health literacy and its impact on older adults by Amalraj and colleagues in this issue of ONCOLOGY brings much-needed attention to this very critical issue. The impact of limited health literacy is made even more critical given the increasing number of older adults in the United States, estimated to be 20% of the US population by the year 2030, and the fact that limited health literacy disproportionately affects them.
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Watch Where You Sit!A recent study examined the influence of social interactions between cancer patients during chemotherapy sessions, finding that patients who spent time with other patients who died within 5 years had an increased risk of dying within 5 years themselves. Pardon me for being underwhelmed.
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Hurricane-Hit Practice Offers Lessons in Disaster PlanningIn a recent conversation with the ONCOLOGY Nurse Edition, Ms. Donohue discussed the short- and long-term effects of these disasters on patient care, and offered recommendations for emergency preparation in any setting.
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Interdisciplinary Breast Cancer Care: Declaring and Improving the StandardThe Susan G. Komen BreastCancer Foundation joins authorDr. Barbara Rabinowitz in underscoringthe importance and valueof interdisciplinary/multidisciplinarybreast care. We agree, as well, thatthe multimodal approach that Dr.Rabinowitz carefully outlines in herarticle should be adopted more consistentlyand recognized as this nation’sstandard of breast care. Herarticle provides the perspective neededto understand why this is so.
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Improving Outcomes in Resectable Gastric Cancer: A Review of Current and Future StrategiesHere we review the evidence supporting current approaches to resectable gastric cancer, including discussion of the optimal extent of surgery and lymphadenectomy, adjuvant chemotherapy, postoperative chemotherapy with chemoradiation, and perioperative chemotherapy.
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Oslerian Genomics for Prostate Cancer OncologyThe great strength of the PCWG3 is the recognition that second- , third- , and fourth-line treatments offer new possibilities for extending overall survival.
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The Role, Timing, and Clinical Use of ADT in Prostate CancerThe role, timing, and clinical use of androgen deprivation therapy (ADT) in prostate cancer remain a controversial topic for clinicians. Drs. Fang, Merrick, and Wallner provide a compelling review of the clinical benefits and side effects of ADT in high-risk prostate cancer. The number of patients presenting with advanced disease remains significant despite the stage migration of prostate cancer during the PSA (prostate-specific antigen) era.
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Practical Management of Adverse Events Associated With AfatinibIn this video from the 2015 ONS meeting, Dr. Sipples talks about effective management of side effects for patients taking afatinib, an oral, targeted agent for lung cancer.
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Coalition Urges U.S. Panel to Approve CT Colonography for Routine ScreeningA growing body of evidence supports the use of CT colonography for colon cancer screening, and a U.S. panel should reverse its decision to not endorse the procedure, according to the CT Colonography Coalition.
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A 35-Year-Old Woman With a Change in HER2 Expression Following Neoadjuvant Chemotherapy for Invasive Breast CancerA 35-year-old woman noticed a mass in her right breast and underwent a diagnostic workup, including a mammogram that revealed a 2.4-cm mass and ultrasound that showed two adjacent masses, as well as enlarged axillary lymph nodes.
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Radiologic Diagnosis of Extrathoracic Metastases to the LungBecause many types of cancers metastasize to the lungs, early detection may affect both tumor staging and treatment planning. On the other hand, it is also important to refrain from subjecting patients to procedures that
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Adenocarcinoma of the Esophagus: Risk Factors and PreventionEsophageal cancer poses an interesting challenge for oncologists. Esophageal squamous cell cancer has the most varied geographical incidence of any cancer, suggesting the existence of critically important environmental and molecular epidemiologic factors. These factors remain largely unrecognized.
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UFT/Leucovorin Plus Vinorelbine Combination for Advanced Breast CancerThis phase I study was undertaken to define the maximum tolerated dose, the dose-limiting toxicity, and the recommended dose of UFT plus leucovorin and vinorelbine in combination treatment of patients with metastatic breast cancer previously treated with one chemotherapy regimen. The pharmacokinetics of UFT and vinorelbine were also evaluated.
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UFT Plus Oral Calcium Folinate/Vinorelbine for Advanced Breast CancerThis phase I study was undertaken to define the maximum tolerated dose, dose-limiting toxicity, and recommended dosage of UFT (uracil and tegafur) plus oral calcium folinate (Orzel) and vinorelbine (Navelbine) in
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Docetaxel Combined With Vinorelbine: Phase I Results and New Study DesignsThis was a phase I dose-finding and pharmacokinetic study of vinorelbine (Navelbine) and docetaxel (Taxotere) as first-line chemotherapy for metastatic breast cancer. Vinorelbine dose, 20 or 22.5 mg/m², on days 1 and 5, was followed on day 1 by docetaxel every 21 days, in doses increasing from 60 to 100 mg/m².
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Cutaneous T-Cell Lymphoma: From Genetics to Clinical PracticeThis challenging supplement to ONCOLOGY is based on the proceedings of a closed expert symposium, and provides an overview of our current knowledge on primary cutaneous T-cell lymphomas (CTCL). The complete spectrum from genetics to clinical practice is covered.
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Proton-Beam vs Intensity-Modulated Radiation Therapy: Too Soon for a Randomized TrialThe authors address the “theoretical” advantages of protons vs photons as well as what they consider to be key issues and uncertainties in proton therapy. Essentially, the paper concedes certain advantages of proton therapy, such as its high degree of conformability with the use of fewer beams and its reduced-volume integral dose with respect to intensity-modulated x-ray therapy (IMXT), and notes some future directions in proton therapy in terms of partial prostate boosting, intensity-modulated proton therapy (IMPT), and in vivo dosimetry verification with positron-emission tomography (PET).
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Low-Risk Papillary Thyroid Cancer: Treatment Options and Patient PerceptionsDifferentiated thyroid cancer, the most common endocrine malignancy, can touch the lives of young and old individuals. It is generally associated with a normal lifespan whether it is completely eradicated or held in check with judicious medical interventions.
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Molecular Targets on Blood Vessels for Cancer Therapies in Clinical TrialsThis review covers progress to date in the identification of molecular targets on blood vessels in cancers, as well as agents that act on those targets, with emphasis on those currently in clinical trials. Current vascular-targeting therapies comprise two general types—antiangiogenic therapy and antivascular therapy. Advances in antiangiogenic therapies, particularly inhibitors of vascular endothelial growth factors and their receptors, have clarified the capacity of these inhibitors to change tumor-associated vessel structure to a more normal state, thereby improving the ability of chemotherapeutics to access the tumors. The responses of other antiangiogenesis target molecules in humans are more complicated; for example, αvβ3 integrins are known to stimulate as well as inhibit angiogenesis, and cleavage of various extracellular proteins/proteoglycans by matrix metalloproteinases produces potent regulators of the angiogenic process. Antivascular therapies disrupt established blood vessels in solid tumors and often involve the use of ligand-based or small-molecule agents. Ligand-based agents, irrespective of the antiangiogenic capacity of the ligand, target antivascular effectors to molecules expressed specifically on blood vessels, such as aminopeptidase N, fibronectin extra-domain B, and prostate-specific membrane antigen. Small-molecule antivascular agents, which are not targeted to molecules on blood vessels, rely on physical differences between the vasculatures in tumors and those in normal tissues.
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Gemcitabine and Paclitaxel as Salvage Therapy in Metastatic Breast CancerIn a phase II trial, 29 patients with anthracycline-pretreated or anthracycline-resistant metastatic breast cancer in whom anthracycline-containing first- or second-line chemotherapy failed received combination paclitaxel
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Unknown Primary Carcinomas: Diagnosis and ManagementUnknown primary carcinomas are a significant health problem, constituting 3% to 10% of all tumors diagnosed in the United States each year [1,2]. While the majority of patients with metastatic carcinoma of unknown primary origin have short survival times and disease resistant to treatment, recent findings suggest that certain subsets of patients have tumors that are responsive to chemotherapy. Others can be successfully treated with regional therapy.
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The Absent-Minded Professor: An Unusual Complication of MelanomaThe University of Colorado Health Sciences Center holds weekly second opinion conferences focusing on cancer cases that represent most major cancer sites. Patients seen for second opinions are evaluated by an oncologist.
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POINT: Primary Debulking Surgery vs Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian CancerCytoreductive Surgery Is the Best Way to Affect Survival Outcomes
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Ultrasound-based elastogram spots skin cancersThe imaging technique has the potential to measure the extent and depth of skin lesions.
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Postmastectomy Radiotherapy After Neoadjuvant Chemotherapy: A Review of the EvidenceMultiple randomized trials and their meta-analysis have demonstrated an overall survival benefit from postmastectomy radiotherapy in women with node-positive breast cancer. However, none of the patients treated in these trials received neoadjuvant chemotherapy, which is now an increasingly common approach.
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Cancer of the Cervix: Current Management and New ApproachesThis article summarizes the current management of patients with newly diagnosed cervical cancer. The topics range from the management of early-stage disease to the phase III randomized studies that have established the current standard of care for patients with locally advanced cancer of the cervix. New approaches to combined-modality therapy with the goal of improving outcomes and decreasing complications are also described.
