Authors
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New Concepts Regarding Testosterone and Prostate Cancer: A Breath of Fresh AirAre there ways in which testosterone administration may be beneficial? Basic science and a number of clinical experiences have suggested for years that steroid hormones may have bifunctional roles.
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Defining the Role of Post-Mastectomy Radiotherapy: The New EvidenceI will briefly comment on two points discussed by Pierce and Lichter in their thorough review: (1) the recently published Oxford overview analysis of locoregional therapies [1], and (2) which patients may benefit from postmastectomy radiotherapy.
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Management of Pain in Special Populations of Cancer PatientsChildren, the elderly, AIDS patients, and former narcotic drug abusers pose special problems in pain management that may lead to undermedication even more frequently than occurs in the general population of cancer patients with pain. A multidisciplinary panel of six pain experts with clinical experience in caring for these special groups met in Santa Fe, New Mexico, to discuss assessment methods and pharmacologic approaches to the treatment of pain in these patients. A summary of the roundtable discussion follows.
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Diffuse Large B-Cell Lymphoma: Current Treatment ApproachesThis article examines clinical and biological features of DLBCL patients with poor outcomes, and reviews recent studies addressing alternatives to standard front-line management strategies together with unresolved questions.
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The Horizon of Antiangiogenic Therapy for Colorectal CancerVascular endothelial growth factor (VEGF) plays a crucial role inthe growth and metastatic spread of cancer. Bevacizumab (Avastin) isthe first commercially available VEGF inhibitor, earning US Food andDrug Administration (FDA) approval in February 2004. In combinationwith fluorouracil (5-FU)-based chemotherapy, this agent significantlyprolongs overall and progression-free survival of patients withmetastatic colorectal cancer. This review details the emerging role ofthe drug, its unique side effects, and other practical considerations relatedto bevacizumab therapy. Ongoing trials attempting to define additionalindications for bevacizumab as well as the development ofother promising angiogenesis inhibitors are also reviewed.
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The Evolving Space of HER2+ Breast CancerKey opinion leaders discuss recent advancements and future directions in the HER2+ breast cancer space.
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Peripheral T-Cell Lymphoma: New Therapeutic StrategiesIn this article we briefly review the labeled indications for new agents for cutaneous and peripheral T-cell lymphoma, focus on data from the last 1 to 2 years, and on data from ongoing clinical trials, with the hope that in doing so we can help elucidate difficult treatment decisions.
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Cancer Management Chapter 23: Primary and metastatic brain tumorsIntracranial neoplasms can arise from any of the structures or cell types present in the cranial vault, including the brain, meninges, pituitary gland, skull, and even residual embryonic tissue. The overall annual incidence of primary brain tumors in the United States is 14 cases per 100,000 population.
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Independent Physician Associations and Outpatient Palliative Care: Challenges and OpportunitiesThe demand for early palliative care (PC) involvement has never been greater in the setting of capitated healthcare delivery systems. The review by Alesi et al is timely in that it illustrates innovative practice partnerships with oncology groups during a time when PC is being thrust into mainstream outpatient care.[1]
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Brachytherapy Boost Techniques for Locally Advanced Prostate CancerVicini and colleagues present an informative, compelling review of both past and recent clinical investigations of the use of brachytherapy in patients with prostate cancer, particularly those with locally advanced disease. The tables presented at the
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POINT: Is Immediate Radical Cystectomy Justified When Non–Muscle-Invasive Bladder Cancer First Presents as High-Grade T1 Urothelial Carcinoma on Re-Resection?After a thorough repeat TURBT, disease control can be achieved with intravesical BCG and a bladder-sparing approach.
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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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The Use of Serum hCG as a Marker of Tumor Progression and of the Response of Metastatic Urothelial Cancer to Systemic ChemotherapyA 55-year-old woman with a history of metastatic melanoma in remission for 8 years presented to the emergency department with gross hematuria. A CT scan, ordered because the patient was in menopause, demonstrated a bladder tumor.
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Adil Daud, MD, on the Importance of Testing Patients with Melanoma for BRAF MutationsAdil Daud, MD, spoke about the emergence of next-generation sequencing and the importance of testing patients with melanoma for BRAF mutations.
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Evaluation and Management of Testicular Cancer After Late RelapseThe clinical quandary by Langer et al discusses a contralateral late relapse of the original right nonseminomatous germ cell tumors.
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Circulating Tumor DNA as a Liquid Biopsy: Current Clinical Applications and Future DirectionsHere we review the clinical data supporting these different plasma genotyping methodologies, and present a practical approach to the interpretation of the results of these tests.
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Implementing Survivorship Care Plans Within an Electronic Health RecordSurvivorship care is “a distinct phase of care for cancer survivors that includes four components: (1) prevention and detection of new cancer or recurrent cancer; (2) surveillance for cancer spread, recurrence, or second cancers; (3) intervention for consequences of cancer and its treatment; and (4) coordination between specialists and primary care providers to ensure that all of the survivor’s health needs are met.”
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Cancer Metabolism as a Therapeutic Target: Metabolic Synthetic LethalityDrugs targeting different metabolic pathways induced in tumors may be used in combination with one another to induce synthetic lethality in cancer cells, while preserving the survival of normally proliferating cells.
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Erlotinib/Gemcitabine for First-Line Treatment of Locally Advanced or Metastatic Adenocarcinoma of the PancreasErlotinib (Tarceva) is a human epidermal growth factor receptor type 1/epidermal growth factor receptor (HER1/EGFR) tyrosine kinase inhibitor initially approved by the US Food and Drug Administration for the treatment of patients with locally advanced or metastatic non–small-cell lung cancer after failure of at least one prior chemotherapy regimen. In this report, we present the pivotal study that led to the approval of erlotinib in combination with gemcitabine (Gemzar) in patients with locally advanced/metastatic chemonaive pancreatic cancer patients. The combination demonstrated a statistically significant increase in overall survival accompanied by an increase in toxicity. Physicians and patients now have a new option for the treatment of locally advanced/metastatic adenocarcinoma of the pancreas.
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Commentary (Beart/Ortega): Role of Laparoscopic Techniques in Colorectal Cancer SurgeryThe authors have nicely reviewed many of the issues surrounding laparoscopic colon cancer surgery. However, we would like to offer a slightly different perspective on several points which they make.
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The Evolving Role of Multi-Gene Tests in Breast Cancer ManagementIf MGTs could predict which patients were most prone to late recurrence and thus might benefit from extended adjuvant endocrine therapy, it would be a huge advancement in the care and survivorship of our patients. More studies of MGTs are required to clarify their role in evaluating prognosis and predicting response to therapy in breast cancer.
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A Patient With Newly Diagnosed Metastatic Type 2 Papillary Renal Cell CarcinomaA 42-year-old man presented with increasing right hip pain that limited his ability to walk. Magnetic resonance imaging (MRI) revealed a right lytic acetabular lesion. Further work-up included a computed tomography (CT) scan, which revealed an 8-cm left kidney tumor.
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Exciting Developments in Relapsed/Refractory Multiple MyelomaThe panel concludes the discussion by offering future perspectives on the evolving treatment landscape in multiple myeloma, highlighting exciting developments and ongoing research.
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Should Men Diagnosed With Prostate Cancer Hit the Gym?Despite the clearly established overall health benefits of exercise, its role in reducing prostate cancer risk is unclear. Whereas some studies found often dramatic reductions in prostate cancer risk, others found no effect.
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Molecular Classification of Diffuse GliomasSignificant progress has been made in defining molecular signatures in diffuse gliomas. The clinically significant genetic alterations identified to date probably represent the tip of the iceberg, since new, potentially significant biomarkers are continuously described.
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Treatment of Pancreatic Cancer: Current Limitations, Future PossibilitiesIn an attempt to improve the grave prognosis associated with the diagnosis of pancreatic cancer, researchers have explored a number of novel therapies. These include hormonal therapy, immunotherapy, radiopharmaceuticals, and novel chemotherapeutic agents.
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Cost-Effectiveness of Genomic Testing for Colorectal Cancer: Are We There Yet?Although genomic testing can improve the cost-effectiveness of a treatment, assessing the cost-effectiveness of genomic testing outside the context of its impact on treatment is not practical.
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Intraoperative Radiotherapy for Breast Cancer: Its Perceived SimplicityWith many centers seeking to adopt IORT, there are licensing, proctoring, staffing, technical support, and reimbursement issues that need to be considered. We have reviewed the current international experience and describe one community cancer center’s experience with initiating an IORT breast cancer program.
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Prostate Cancer Risk Assessment ProgramProstate cancer is the most common form of cancer (except skin cancer) in men. Several factors have been associated with an increased risk for prostate cancer, including age, ethnicity, family history, lifestyle, and
