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Current Issues in the Treatment of Resistant Bloodstream Infections

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

Implications of the New Face of Head and Neck Cancer

Although screening methods for HPV-OPSCC have not yet been developed, population-based prevention may be achievable through HPV vaccination, but only if concerted efforts are made to increase vaccine uptake in the United States.

Unexpected Benefit Links Hypertension to Better Ovarian Cancer Outcomes

New research suggests that hypertension and diabetes and the use of medications to treat these conditions may influence the survival of ovarian cancer patients.

Strategies for Identification and Clinical Evaluation of Promising Chemopreventive Agents

Strategies for chemopreventative drug development are based on the use of well-characterized agents, intermediate biomarkers correlating to cancer incidence, and suitable cohorts for efficacy studies. Since

High-Dose Chemotherapy With Autologous Stem Cell Rescue in the Outpatient Setting

Outpatient bone marrow transplant (BMT) strategies, as reviewed by Dix and Geller, have evolved for various reasons—from social to medical. If high-dose approaches are to become a viable treatment for common cancers, such as breast cancer, the refinement of transplants to a “kinder and gentler” approach is essential.

FDA simplifies patient access to investigational drugs

Rules balance access to promising new therapies against the need to protect patient safety.

Implementing Change: A View From the Trenches

With perhaps 100 patients scheduled for chemotherapy each day and about the same number of consultations, the nurses, physicians, and staff in any medium-sized oncology clinic are fully booked. Changing their routines may be the last thing anyone wants to think about.

3 Things You Should Know About Hemolytic Anemias

Hemolytic anemias are a collection of rare but severe diseases including paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome.

Commentary (Meltzer): The Role of PET-CT Fusion in Head and Neck Cancer

In their article, Rusthoven and colleagueshighlight the utility ofcombined positron-emission tomography/computed tomography(PET-CT) imaging for diagnosing primaryand recurrent head and neckcarcinoma, and for defining tumor targetvolumes for radiotherapy treatmentplanning in the head and neck. PEToffers noninvasive measures of tumorbiology yet suffers from limited spatialresolution; the physiologic informationobtained with PET is complementaryto the high-resolution structural informationobtained with CT or magneticresonance imaging (MRI).

Quality-of-Life End Points in Oncology Drug Trials

Many advances in the treatment and care of cancer patients have been closely linked to the availability of more effective pharmaceutical agents. As research continues to develop new and improved chemotherapeutic agents, it is heartening that the FDA maintains a flexible approach to the drug approval process and will consider an array of indicators of drug efficacy, including patient self-reports of health-related quality of life.

Prevalence of Complementary and Alternative Medicine Use in Cancer Patients

Interest in complementary and alternative medicine (CAM) has grown dramatically over the past several years. Cancer patients are always looking for new hope, and many have turned to nontraditional means. This study was

How Heterogeneous Cell Populations, Cancer Cell Dormancy, and Minimal Residual Disease Influence the Natural History of Cancers

The authors of “How Long Have I Had My Cancer, Doctor?” have addressed a question often contemplated by patients when they receive a diagnosis of cancer.

Surgical Management of Lung Metastases: Selection Factors and Results

Lung parenchyma is the most common site of metastases from either carcinomas or sarcomas. Depending on the status of the original primary, resection of lung metastases may be curative. Multiple variables must be

Radiotherapeutic Management of Medulloblastoma

Dr. Paulino provides a concise yet complete review of the radiotherapeutic management of patients with medulloblastoma. Radiotherapy treatment planning for medulloblastoma is complex, requires considerable attention to detail, and remains the subject of debate and clinical research. Clearly, this is an area of neuro-oncology in which multidisciplinary research has played a significant role in improving survival for children and young adults with this disease.

Commentary (Sartor): Emerging Role of EGFR-Targeted Therapies and Radiation in Head and Neck Cancer

The past several years have seenthe fruition of a new era in cancertherapy-targeted approachesusing biologic modifiers.However, as the clinical experiencewith novel inhibitors grows, some ofthe premises on which the treatmentswere designed are being challenged,and clinical findings are leading to newparadigms. Drs. Song and Raben providea forward-thinking review of thestatus of epidermal growth factor receptor(EGFR)-targeted therapy in headand neck cancer, a paper that serves toboth highlight progress and raise issuesthat continue to challenge the implementationof targeted therapy.

Tumor Lysis Syndrome

Physical exam revealed an enlarged spleen and right axillary lymph node. Her bloodwork is remarkable for an elevated lactate dehydrogenase (LDH) of 550 U/L and a creatinine of 2.0 mg/dL. Mrs. Reynolds is a retired actress and lifelong nonsmoker who drinks 1 to 2 glasses of wine a week and denies illicit drug use. Her health history includes the vaginal delivery of two healthy babies in her 20s and hypercholesterolemia, which has been controlled by diet.

Taxanes in Adjuvant and Neoadjuvant Therapies for Breast Cancer

Paclitaxel (Taxol) is a diterpene originally obtained from the bark of the Pacific Yew Tree, Taxus Brevifolia. Its mechanism of action is unique. it stabilizes microtubule polymerization, thus blocking cells in the G2/M phase of

Intracystic Papillary Carcinoma of the Breast: Differential Diagnosis and Management

We present a case of intracystic papillary carcinoma of the breast associated with low-grade ductal carcinoma in situ in a young woman. This is a distinct subtype of intraductal carcinoma that typically presents in postmenopausal women with a favorable prognosis.

Docetaxel Plus Cisplatin: An Active Combination Regimen in Non-Small-Cell Lung Cancer

Docetaxel (Taxotere) isa semisynthetic taxoid that possesses significant activity as a single

Osteoporosis in a Young Breast Cancer Survivor

More than 2.5 million breast cancer survivors live in the US today.[1] This number will continue to grow thanks to early detection and advances in treatment that are making early stage breast cancer an increasingly curable disease.

Large Bladder Mass and Renal Failure in a 14-Year-Old Boy

A 14-year-old, otherwise healthy adolescent male originally presented to his primary care physician with abdominal pain and distention. Ultrasound revealed a complex mass with cystic components along the superior pole of the bladder and bilateral hydroureteronephrosis down to the level of the bladder.

UFT/Leucovorin Plus Weekly Paclitaxel in the Treatment of Solid Tumors

The palliation of symptoms and improvement of quality of life are important aspects of therapy in patients with incurable metastatic cancer. This article describes the preliminary results of a phase I study of uracil and tegafur, an orally available fluorouracil (5-FU) derivative combined with oral leucovorin plus weekly intravenous paclitaxel.

Paclitaxel and UFT Plus Oral Calcium Folinate in Pretreated Metastatic Breast Cancer

This phase I study was designed to determine the maximum tolerated dose (MTD) and dose-limiting side effects of combination treatment with paclitaxel (Taxol) and UFT (uracil and tegafur in a 4:1 molar ratio) plus oral

Implementing EHRs in Community Oncology Practices

To provide quality healthcare, communication is vital. Using an EHR, physicians can more easily communicate regarding current and past medical conditions with other providers in their practice, with referring or co-managing physicians, and with patients themselves.

“De-Shackling” Biases in Oncology Care for Incarcerated Populations

QOL and Outcomes Research in Prostate Cancer Patients With Low Socioeconomic Status

The 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

Geographical Information Systems: Applications and Limitations in Oncology Research

This review describes the development and technical capabilities of GIS, potential applications of Geographical Informational Systems in cancer research, and the limitations of such work.

Emotional and Behavioral Responses to Genetic Testing for Susceptibility to Cancer

As genetic testing for susceptibility to cancer becomes more widely available, cancer-care providers will become more involved in counseling patients about cancer risks and the meaning of genetic test results. As a result, oncologists and oncology nurses need to be aware of the unique psychological issues and challenges posed by genetic testing for cancer susceptibility. This paper first describes a psychological profile of individuals who are likely to opt for such testing, based on extrapolation from studies of people at high risk of cancer.

Cancer Management Chapter 41: Fluid complications

Malignant pleural effusion complicates the care of approximately 150,000 people in the United States each year. The pleural effusion is usually caused by a disturbance of the normal Starling forces regulating reabsorption of fluid in the pleural space, secondary to obstruction of mediastinal lymph nodes draining the parietal pleura.

Commentary (Barden/Daly): Surgery in the Older Patient

The elderly population in the United States increased by a factor of 11 in the past century, while the under age 65 population tripled in that same period.[1] Given that the majority of cancers occur in patients over 65 years old, there is an increasing need for surgical interventions in the elderly.