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As noted in part 1 of this two-part article, non-Hodgkin's lymphoma is one of a few malignancies that have been increasing in incidence over the past several decades. Likewise, these disorders are more common in elderly patients, with a median age of occurrence of 65 years. Therapy in elderly patients may be affected by multiple factors, especially attendent comorbidities. The approaches to management of these patients, with either indolent or aggressive disease processes, have been based on prospective clinical trial results, many of which have included a younger patient population. Fortunately over the past decade, results of treatment trials that have targeted an older patient population have emerged. The disease incidence and treatment approaches for both follicular (part 1) and diffuse aggressive (part 2) histologies in elderly patients are reviewed, as well as the impact of aging on the care of these patients.

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The unfortunate fact remains that the main chemotherapy option for patients with adult soft-tissue sarcoma is doxorubicin, a drug first identified 4 decades ago.

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This article discusses features that predict local recurrence and distant metastasis in rectal cancer, and how to use MRI to guide treatment decisions.

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In most cases, PCV chemotherapy will provide an edge in outcomes over TMZ for glioma patients, primarily because of the former regimen’s use of multiple drugs and their complementary interactions.

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Pennington and Leffell have reviewedthe literature with regardto the relative efficacy ofthe Mohs technique vs conventionalsurgery in the treatment of commonand uncommon cutaneous neoplasms.The reason for the success of Mohssurgery can be summarized simply: TheMohs surgeon examines the entire microscopicsurgical margin for tumor,whereas the pathologist working with aconventional surgeon does not.

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The importance of cancer as aproblem in the elderly is gainingincreasing appreciationdue, in part, to the demographicchanges taking place in this countryand around the world and their associationto the incidence of cancer.Ongoing epidemiologic research overthe past several decades has consistentlyconfirmed the continuing trendtoward an aging population. In theUnited States, an anticipated 20.1%of the population will be 65 years ofage or older by 2030, the number ofpeople 75 years of age or older willhave tripled, and the 85-or-older agegroup will have doubled.[1]

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Several large, prospective trials have evaluated tamoxifen compared with placebo for breast cancer risk reduction in women at increased risk for breast cancer. Analysis of the large, prospective breast cancer risk-reduction trials that used tamoxifen estimated that tamoxifen decreased breast cancer incidence by 38% on average and estrogen receptor–positive tumors by 48%.

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In 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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Over the past 50 years, great strides have been made in diagnosis, treatment, and survival of childhood cancer. In the 1960s the probability of survival for a child with cancer was less than 25%, whereas today it may exceed 80%. This dramatic change has occurred through significant and steady progress in our understanding of tumor biology, creation of specialized multidisciplinary care teams, incremental improvements in therapy, establishment of specialized centers with research infrastructure to conduct pivotal clinical studies, and the evolution of a cooperative group mechanism for clinical research. Most children with cancer in the United States, Europe, and Japan receive appropriate diagnosis and treatment, although access is limited in developing countries. The price of success, however, is the growing population of survivors who require medical and psychosocial follow-up and treatment for the late effects of therapy. Here we review the progress made in pediatric oncology over the past 3 decades and consider the new challenges that face us today.

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The second edition of Pediatric Hematolgy, edited by the text's original editors, John S. Lilleyman and Ian M. Hann, as well as a new editor, Victor S. Blanchette, completely updates and expands upon the first edition (published in 1992). The new edition grew from 15 to 40 chapters, with contributions by many of the most well-known investigators and clinicians in pediatric hematology in the world. The textbook will especially be of value to practicing clinicians, house staff, and students.

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When she learned that she had breast cancer, Patricia Garrett did what many people with cancer do: she continued working.

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Bruce Culliney and colleagues have provided a thorough and well written summary of the literature regarding multimodality treatment of patients with locoregionally advanced or unresectable head and neck malignancies. In particular, they offer a detailed outline of recent insights into radiation dosing and fractionation and their optimal use in the combined-modality setting.

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The goals of oncology social work are to facilitate patient and family adjustment to the diagnosis and treatment of the disease; to promote psychosocial recovery and rehabilitation

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Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most challenging and complex complications of cancer chemotherapy.

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In this review, we describe how clinical investigators addressed some of the challenges in prostate cancer chemotherapy trials 20 years ago, and we indicate what has evolved in the field since that time. We consider the impact that prostate-specific antigen measurement had in this setting, evolving clinical paradigms, multidisciplinary programs, and the current armamentarium of cancer treatment, including targeted molecular therapy, for patients with hormone-refractory disease.

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Neil Iyengar, MD; Claudine Isaacs, MD; Virginia Kaklamani, MD; and Vijayakrishna Gadi, MD, PhD, share clinical pearls for the evolving treatment landscape of HER+ metastatic breast cancer.

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Normal and hyperplastic prostate glandular epithelium does not express somatostatin receptors. Neuroendocrine prostatic cells contain bioactive secretory products such as chromogranin A, serotonin, and neuron-specific enolase. The stromal smooth muscle cells around glandular epithelium and ganglion cells of the prostatic plexus are positive for somatostatin subtype 2 receptors (sst 2).[1] In prostate cancer, however, there is nonhomogeneous distribution of sst 1. In the peritumoral veins of prostate cancer, sst 2 receptors were found by Reubi et al in 14 of 27 samples.[2]

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Dr. Blum has written a comprehensive summary of the natural history, pathology, prevention, and management of anthracycline-induced cardiotoxicity. His excellent state-of-the-art review updates readers on most of the recent advances in this field.

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Panelists discuss how unmet needs in glioma treatment persist despite recent advances, highlighting key areas for future research and development to improve outcomes and quality of life for patients with gliomas.

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Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR), such as erlotinib (Tarceva) and gefitinib (Iressa), have shown remarkable activity in a portion of patients with non–small-cell lung cancer (NSCLC).

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Even though the small intestine contains 90% of the gastrointestinal tract mucosa and is located between the stomach and large intestine, two organs with a high cancer incidence, adenocarcinoma of the small intestine is 1/50th as common as adenocarcinoma of the large bowel. In several other respects, small-intestinal adenocarcinoma resembles large bowel adenocarcinoma; eg, it arises from adenomatous polyps, co-occurs in the same individuals, and has a similar pattern of incidence rates by country. Small-intestinal adenocarcinoma is diagnosed prior to surgery in only about 50% of cases and often occurs in conjunction with small bowel obstruction. The mainstay of treatment is surgery; prognosis depends on stage at presentation. Little is known about the use of radiotherapy and chemotherapy in this malignancy, but most physicians utilize therapeutic strategies modeled on the management of large-intestinal adenocarcinoma. Clarification of the reason for the low incidence of small-intestinal adenocarcinoma could lead to new interventions for the prevention of colorectal cancer. [ONCOLOGY 11(4):529-536, 1997]

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Despite attempted curative resection of localized adenocarcinoma of the pancreas, most patients experience a recurrence and die of their disease. The Gastrointestinal Tumor Study Group, European Organisation for Research and Treatment of Cancer, and European Study Group for Pancreatic Cancer trials have suggested the benefit of adjuvant therapy. However, the relatively few randomized trials available have not established a definite standard of care due to study limitations. Although these trials, and the recently published Charité Onkologie (CONKO)-001 trial, have shown a definite advantage of adjuvant chemotherapy, the most effective chemotherapy and the role of radiation therapy remain unclear. This review will discuss the data available from reported trials of adjuvant and neoadjuvant therapy in pancreatic cancer, address the issues leading to the ongoing controversies, and consider future directions for clinical trials.

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Perhaps we can now hope that primary immunoprevention of cancers that are engaged as people age may receive the attention, support, and legitimacy that will soon result in similar breakthrough stature.

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The development of metastatic disease in patients with paraganglioma is an unusual and challenging event. This case report and review describes the specific features of this disease and the multiple therapeutic options.

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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.

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Patient selection based on a much more comprehensive biologic assessment of both host and tumor is likely the key to further advances in the treatment of all bladder cancer patients. Until such time, there can be no compromise in the careful application of the rigorous therapy required to optimize outcomes.

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The mandate of the National Cancer Act of 1971 was “to support research and the application of the results of research, to reduce the incidence, morbidity, and mortality from cancer,” and we have done that.

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There are a number of important issues regarding neoadjuvant and adjuvant therapy for pancreatic cancer that must be considered as we design clinical trials in an effort to improve survival for this disease.

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Here we examine recent advances in the knowledge of this severe and heterogeneous malignancy, and we analyze the clinical significance of prognostic factors.