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Ms. Hydzik's article on intraperitoneal chemotherapy (IPC) for the treatment of ovarian cancer provides the rationale for IPC, presents the supporting evidence, and describes nursing management of these patients through the Memorial Sloan-Kettering Cancer Center experience.

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The 5-year survival rate of cancer patients in the United States is about 66%, and today there are approximately 12 million cancer survivors in the US.

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Chemotherapy-induced febrile neutropenia (FN) predisposes patients to life-threatening infections and typically requires hospitalization. The goal was to investigate whether a risk assessment tool aligned with national guidelines could help identify patients at risk of FN and reduce FN-related hospitalizations. Beginning in October 2004, oncology nurses applied the new risk assessment tool to all patients initiating chemotherapy or a new regimen. Patients at risk for FN received prophylactic colony-stimulating factor. Charts for 189 patients receiving chemotherapy in fiscal year 2005 (FY05) were compared with charts of 155 patients receiving chemotherapy in FY04, before the tool was implemented. The incidence of FN-related hospitalization declined by 78%, from 9.7% in FY04 to 2.1% in FY05 (P = .003). Total hospital days decreased from 117 to 24. Routine systematic evaluation by oncology nurses improves recognition of patients at risk of FN and substantially reduces FN-related hospitalization.

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This list of chemotherapeutic agents covers the cancers each drug is used for, as well as the recommended dosage and possible toxicities of the therapy.

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Eliminating cancer disparities-not only for racial/minority groups but for all underserved populations-must be a priority for those involved in cancer care. For individual practitioners, the first step in addressing disparities is accomplished through understanding the possibility that disparities exist in varying depth and complexity for each racial or ethnic minority patient.

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Overweight and obesity increase the risk of developing several cancers.Once cancer develops, individuals may be at increased risk of recurrenceand poorer survival if they are overweight or obese. A statisticallysignificant association between overweight or obesity and breast cancerrecurrence or survival has been observed in the majority of populationbasedcase series; however, adiposity has been shown to have less of aneffect on prognosis in the clinical trial setting. Weight gain after breastcancer diagnosis may also be associated with decreased prognosis. Newevidence suggests that overweight/obesity vs normal weight may increasethe risk of poor prognosis among resected colon cancer patients and therisk of chemical recurrence in prostate cancer patients. Furthermore, obesecancer patients are at increased risk for developing problems followingsurgery, including wound complication, lymphedema, second cancers,and the chronic diseases affecting obese individuals without cancer suchas cardiovascular disease and diabetes. Mechanisms proposed to explainthe association between obesity and reduced prognosis include adiposetissue-induced increased concentrations of estrogens and testosterone,insulin, bioavailable insulin-like growth factors, leptin, and cytokines.Additional proposed mechanisms include reduced immune functioning,chemotherapy dosing, and differences in diet and physical activityin obese and nonobese patients. There have been no randomized clinicaltrials testing the effect of weight loss on recurrence or survival inoverweight or obese cancer patients, however. In the absence of clinicaltrial data, normal weight, overweight, and obese patients should beadvised to avoid weight gain through the cancer treatment process. Inaddition, weight loss is probably safe, and perhaps helpful, for overweightand obese cancer survivors who are otherwise healthy.

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The authors of "ALK-Targeted Therapy for Lung Cancer: Ready for Prime Time," in this issue of ONCOLOGY, address the newest developments in the field of targeted therapies for advanced non–small-cell lung cancer (NSCLC).

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In this review, we will first briefly summarize prior attempts to improve outcomes in advanced DLBCL using systemic therapy approaches, and then we will highlight the potential role of RT in advanced DLBCL.

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We speak with two experts to discuss breast cancer risk, genetics, and prevention options available to women at high risk of developing breast and ovarian cancer.

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Our better understanding of the complex interaction of multiple myeloma (MM) cells with their bone marrow microenvironment and the signaling pathways that are dysregulated in this process has resulted in a dramatic increase in the therapeutic agents available for this disease. A number of these new agents have demonstrated significant activity in patients with MM. Over the past 5 years, three drugs have received approval from the US Food and Drug Administration for therapy in MM—bortezomib, thalidomide, and lenalidomide. To date, the choice of therapy for MM is not individualized according to the biologic characteristics of the disease, but future studies should enable us to identify patients who may benefit most from certain therapeutic interventions, and thus develop individualized therapy for MM. In this review, we will present some of the treatment algorithms currently developed for patients with MM and focus on established advances in therapy, specifically with thalidomide, bortezomib, and lenalidomide. We will also discuss some of the emerging novel therapeutic agents showing promise in phase I/II clinical trials in MM.

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This article focuses on the recent debate regarding when-or whether-patients with ovarian cancer should undergo aggressive surgical resection.

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Colorectal cancer is the second most common cause of cancer death in the United States. It is estimated that about 55,000 patients will die this year due to advanced colorectal cancer. These grim statistics persist despite a marked increase in the rate of screening colonoscopies and improvements in adjuvant chemotherapy. Successful chemoprevention strategies may reduce the risk of new colorectal cancers, thus decreasing related overall morbidity and mortality.

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In this article, we will discuss some of the vaccination and oncolytic virus strategies being evaluated in the clinic for malignant gliomas. The vaccines reviewed here include the cell-based and the non–cell-based.

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Future studies of adult medulloblastoma should include whole genome sequencing and identification of the tumorigenic cell origin of adult medulloblastoma. Ultimately, quality prospective trials are needed in adult medulloblastoma patients in order to optimize the management of this rare and complex disease.

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Here we present the case of a 3-year-old girl with generalized lymphadenopathy and fever, in whom the cause of the symptoms was initially thought to be infectious. Ultimately, however, anaplastic large cell lymphoma (ALCL) was diagnosed. Using this case as a backdrop, we discuss the wide range of systemic illnesses that the differential diagnosis of generalized lymphadenopathy encompasses.

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A 54-year-old female seeks medical attention with a complaint of worsening exertional dyspnea of 3 to 4 weeks’ duration. She has a history of small-cell lung carcinoma, first diagnosed 3 months previously, and has had an excellent response to treatment, which included both chemotherapy and external-beam radiation. Consistent with her cancer diagnosis, she has a 30 pack-year history of cigarette smoking, and her pulmonary function tests indicate mild airflow obstruction, slight hyperinflation on lung volumes, and a mildly decreased diffusion capacity. In addition to her dyspnea with exertion, the patient describes symptoms of an intermittently productive cough, fatigue, and, recently, a poor appetite.

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Neuroendocrine tumors manifest in the gastrointestinal tract mainly as carcinoid and pancreatic islet-cell tumors. They comprise an interesting group of rare neoplasms that are derived from neuroendocrine cells interspersed within the gastrointestinal system amd throughout the body. Neuroendocrine tumors are well known for producing various hormonal syndromes and for their indolent clinical course in most patients, although some of these tumors do not produce hormones of clinical significance. Patients may have symptoms for many years before the diagnosis is suspected and confirmed.

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In this video, Dr. El-Khoueiry discusses results from a phase I/II study that suggest the PD-1 inhibitor nivolumab is safe and effective in advanced hepatocellular carcinoma.

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It is perhaps not surprising that the increased incidence of a disease that has a major impact on mortality in young women (even though the absolute risk of death from breast cancer in this age group is low) should create so much interest. Yet, despite decades of research, it is by no means clear that everyone would agree with King and Schottenfeld that the appropriate approach to breast cancer prevention is one that "focuses on the physiologic effects of the sex steroid hormones and their potential interactions with family history." However, this tantalizing statement appearing at the end of the abstract of their article fortunately is elaborated upon at the end of the article itself. This elaboration refers specifically to physical activity, energy consumption, obesity, pregnancy history and exogenous estrogens and their potential interactions with family history, with which many will agree.

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As an oncologist, I am always on the lookout for good patient education material. This book, which is based on the experience of the Stanford Integrative Medicine Clinic Cancer Supportive Care Program, is a good choice for a highly literate, print-oriented patient or family member. The book is divided into five parts: (1) Cancer: Diagnosis, Information, and Treatment, (2) The Role of the Mind, (3) The Care of the Body, (4) Supportive and Social Services for Life and Death Issues, (5) Planning for the Future, and (6) Resources. These five parts are divided into 50 individual chapters covering specific topics, and the chapters are focused, concise, and practical.

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We review available strategies for screening and risk reduction through chemoprevention or risk-reducing surgery, as well as challenges for management of breast cancer in patients with prior exposure to radiation for Hodgkin lymphoma.

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Recent improvements in our understanding of the biology of colorectal cancer have led to the identification of several important prognostic and predictive markers of disease-associated risk and treatment response for the individual patient.

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Halsted first proposed the concept of "radical surgery" for cancer in 1882, theorizing that cancer, along with all of its supporting tissues and regional lymph nodes, needs to be removed en bloc for the best chance of cure. Radical mastectomy with en bloc removal of the axillary nodes and pectoral muscles became the standard treatment for breast cancer. En bloc radical vulvectomy with complete superficial and deep inguniofemoral lymph node dissection became the standard of care for vulvar cancer. Subsequently, unilateral or bilateral pelvic node dissection extended the scope of the regional node dissection for vulvar cancer patients with metastases to groin nodes. Unquestionably, this surgically comprehensive technique improved cancer control rates for patients with locally extensive vulvar cancer, compared to results from piecemeal approaches that characterized surgical therapy in prior eras.

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Tamoxifen is currently the endocrine therapy of choice for early and advanced breast cancer. Attempts to improve the therapeutic efficacy have included altering the triphenylethylene ring structure of tamoxifen, forming

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The majority of women with ovarian cancer present with advanced-stage disease. Women with early-stage ovarian cancer have a much better chance of achieving a cure than do women with late-stage disease. This

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Infusion reactions are a well-known phenomenon in cancer treatment, occurring with both cytotoxic and biologic agents. The severity, symptomatology, and time course of these hypersensitivity events differ significantly among agents, ranging from simple cutaneous manifestations and urticaria to life-threatening hypotension, bronchospasm, and vascular collapse. They can occur despite adequate preparation and premedication.

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A number of molecularly targeted agents directed at critical pathways involved in cell survival and cell proliferation have recently entered clinical evaluation in children with cancer. These agents offer the potential for more effective anticancer therapy while diminishing acute and long-term toxic effects. Systematic evaluations of agents such as these are essential if continuing improvements in outcome are to be achieved in children with cancer. Brief summaries of the rationale for conducting studies of several agents in children are provided below. Following these summaries is a listing of phase I, phase I/II, phase II, and pilot studies of these agents in pediatric populations

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Optimal supportive care for patients with pancreatic cancer is essential. Putting these interventions into practice requires that oncologists and oncology teams incorporate innovations at both the individual and the system level.

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Drs. Eulau and Corn comprehensively review the emerging use of combined androgen suppression and local therapies in locally advanced carcinoma of the prostate. These strategies have been developed since the recognition of the inadequacy of

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