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External Beam Radiotherapy for Metastatic CancerPalliation of bone metastases aims at relief of pain, preservation of function, and maintenance of skeletal integrity. Analgesics relieve pain but do not arrest or reverse the disease process. Chemotherapy is
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Metastatic Papillary Adenocarcinoma in a 22-Year-Old: Is Her History of Mayer-Rokitansky-Küster-Hauser Syndrome Causative or Incidental?A 22-year-old college student with primary amenorrhea due to Müllerian agenesis presented with a headache, dysarthria, nausea, vomiting, and left upper extremity weakness. MRI of the brain showed numerous intracranial lesions.
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Don’t Be Fooled by DCISA 46-year-old woman had a routine screening mammogram that showed new calcifications in the posterior left breast. A diagnostic mammogram showed several small punctate calcifications, and a 6-month interval follow-up was recommended.
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Ovarian CancerDespite the fact that it is highly curable if diagnosed early, ovarian cancer causes more mortality in American women each year than all other gynecologic malignancies combined.
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Study Finds Average Insolvency Rates Rise Fourfold Within Five Years of Cancer DiagnosisResearchers measured the rate of bankruptcy after a first cancer diagnosis and identified factors that increased bankruptcy risk among people with common cancers.
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Major Advances and Alternative Approaches to Antiemetic TherapyA review of "Chemotherapy-Induced Nausea and Vomiting: Which Antiemetic for Which Therapy?"
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Call to oncologists and administratorsCommunity Oncology Alliance calls for action; cuts in cancer care reimbursement would have devastating impact on community practices
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HER2-Positive Breast Cancer: Beyond TrastuzumabThis review explores the use of several such agents, including lapatinib (Tykerb), HSP90 inhibitors, T-DM1, and other tyrosine kinase inhibitors. Emerging data from trials of these agents indicate that the HER2 pathway remains a valid therapeutic target following disease progression on trastuzumab.
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Cancer Nursing: Principles and Practice, 5th EditionCancer Nursing: Principles and Practice is widely considered to be the basic textbook on cancer nursing. With this edition, every chapter has been updated to reflect the latest research and references, and many of the chapters now include
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OncView™ Podcast: Connie Batlevi, MD, PhD on R/R Follicular Lymphoma Therapy UpdatesConnie Batlevi, MD, PhD, detailed important updates in therapies for relapsed/refractory follicular lymphoma in this episode of CancerNetwork’s® podcast.
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Commentary (Pendergrass/Griffin): What the Physician Needs to Know About Lynch Syndrome: An UpdateDr. Henry Lynch was one ofthe first to recognize the existenceof hereditary nonpolyposiscolorectal cancer (HNPCC).While a relatively small percentage offamilies have this cancer predispositionsyndrome, identification of individualsat risk is now standard of careand includes the potential for the preventionof colorectal cancer. Dr. Lynchand Jane Lynch have written a guidehighlighting key points for physiciansregarding the diagnosis, surveillance,and management of this disorder. Severalaspects of clinical care mentionedin the article are expanded upon here.
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Response of the Normal Eye to High Dose RadiotherapyRadiation therapy of tumors near the eye or optic nerves often requires incidental irradiation of these structures, even when they are not clinically involved by tumor. Depending on the radiation treatment volume and dose required, radiation injury to the lens, lacrimal apparatus, retina, or optic nerve may result. The time to expression and severity of injury are dose-dependent. This paper reviews the results of 157 patients who were followed for a minimum of 3 years after radiotherapy for primary extracranial tumors at the University of Florida, in which the lacrimal gland, lens, retina, and/or optic nerve(s) received irradiation. This review shows that, after treatment at approximately 1.8 to 2.0 Gy per fraction, the incidence of severe dry-eye syndrome, retinopathy, and optic neuropathy appears to increase steeply after doses of 40, 50, and 60 Gy, respectively. [ONCOLOGY 10(6):837-852, 1996]
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Paclitaxel and Carboplatin as First-Line Chemotherapy for Advanced Breast CancerIn a phase II study, 66 patients with advanced breast cancer (median age 56 years; range, 28 to 75 years) were treated with paclitaxel (Taxol), 175 mg/m² infused over 3 hours, and carboplatin (Paraplatin), dosed to attain an
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MGUS and Smoldering Myeloma: the Most Prevalent of Plasma Cell DyscrasiasMonoclonal gammopathy of undetermined significance (MGUS) is the most prevalent of the plasma cell dyscrasias and is characterized by a low level of production of serum monoclonal (M) protein (classically less than 3 g/dL).
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Outline of Oncology TherapeuticsOutline of Oncology Therapeutics is a well-written, concise, and up-to-date book providing detailed descriptions of a variety of medications and issues important to the overall care and treatment of patients with cancer. Oncology practice today
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Current Approach to PheochromocytomaPheochromocytomas are tumors of the neural crest-derived chromaffin cells. The hallmark of this rare and fascinating neoplasm is the synthesis and secretion of catecholamines in an unregulated and potentially life-threatening manner. Most pheochromocytomas produce an abundance of norepinephrine. Epinephrine- or dopamine-secreting pheochromocytomas are less common.[1] Pheochromocytomas can also be nonfunctional.[1] Approximately 10% of pheochromocytomas can be categorized as either bilateral, multifocal, extra-adrenal, familial, or malignant; thus, pheochromocytomas are often remembered by medical students as the "10% tumor." Newer reports, however, suggest that pheochromocytomas may be extra-adrenal in up to 30% of cases.[2,3] This brief review will address the diagnosis and management of benign and malignant pheochromocytoma.
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Older Age Itself Rarely a Restriction to Treatment of Lung CancerAhead of the 2017 ASCO Annual Meeting, we discuss how to approach treatment for older patients with lung cancer.
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Molecular Profiling for Cytotoxics and Targeted Agents: Ready for Prime Time?Lung cancer is the leading cause of cancer-related mortality. Improved understanding in the molecular biology and genetics of lung cancer has resulted in the identification of individual genes, gene expression profiles, and molecular pathways that may be useful for clinical management decisions.
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Ovarian Tumors of Low Malignant PotentialClinical and laboratory reports suggest that ovarian tumors of lowmalignant potential (LMP) represent a “grab bag” of tumors, withdifferent etiologies, molecular biologies, and prognoses. As a result,data on incidence and prognosis may be quite unreliable. Diagnosis isbest made on permanent section. Half of women under age 40 undergoconservative, fertility-sparing surgery when diagnosed with anovarian tumor of LMP, but no adjuvant therapy has been shown toprolong survival in this population. In addition to the various controversiessurrounding LMP tumors, this review will address prognosticmarkers, risk of malignant transformation, treatment of progressivedisease, surveillance after conservative surgery, and future directionsfor research.
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Isolated Limb Perfusion for Stage III Melanoma: Does It Still Have a Role in the Present Era of Effective Systemic Therapy?Effective systemic therapy for the treatment of stage III melanoma has emerged. Whether this influences treatment choice in stage III melanoma patients with in-transit metastases is the subject of this review.
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Current Perspectives on Locally Advanced Pancreatic CancerThis year, approximately 40% of the 28,300 patients diagnosed with pancreatic carcinoma in the United States will present with locally advanced disease. Radiotherapeutic approaches are often employed, as these patients
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How Budget Affects Physicians Who See Medicare PatientsThe fiscal year (FY) 1998 Balanced Budget Act contains several important changes in the Medicare program that affect physicians, including a go-ahead for provider-sponsored organizations (PSOs) (closed networks run by hospitals, doctors, and other providers instead of insurance companies) and new opportunities for the private sector to compete in the Medicare+Choice plans.
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Testicular CancerThis testicular cancer management guide covers the diagnosis, staging, and treatment of germ-cell tumors and seminoma.
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The Pharmacologic Management of Cancer PainThe Pharmacologic Managementof Cancer Pain” by NathanCherny is an excellent, comprehensive,yet concise paper on thetreatment of cancer pain. It even goesbeyond its stated intention of discussingpharmacologic treatment, as it ventures-in a very appropriate, balanced,and succinct manner-to delve intothe issues of psychological therapiesand physiatric and invasive analgesictechniques.
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Targeting IDH in Acute Myeloid LeukemiaThis video examines the targeting of IDH1/IDH2 mutations in patients with relapsed or refractory acute myeloid leukemia.
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A Multidisciplinary Approach to Perianal and Intra-Abdominal Infections in the Neutropenic Cancer PatientThe focus of this review will be the multidisciplinary approach to management of anorectal infection, neutropenic enterocolitis, appendicitis, and cholecystitis in the neutropenic cancer patient.
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Will We Be Able To Care For Cancer Patients In The Future?The number of cancer patients and cancer survivors continues to increase rapidly amid predictions of a shortfall in physicians to care for them. In addition, newer cancer therapies have become increasingly complex and resource-intensive, compounding the impending workforce shortage. Simultaneously, the growing understanding of the biologic heterogeneity of cancer and the development of pharmacogenomics have opened up the possibility of personalized approaches to cancer diagnosis and treatment. Such personalization has been promulgated as a means of decreasing the cost of drug development, improving the efficacy of treatments, and reducing treatment toxicity. Although there have been notable successes, the fulfillment of these promises has been inconsistent. Providing care for future cancer patients will require the development of innovative delivery models. Moreover, new approaches to clinical research design, to the assessment of therapeutic value, and to the approval of and reimbursement for diagnostics and treatments are needed.
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Treatment of Dyspnea in Cancer PatientsA 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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A 72-Year-Old Man With Prostate CancerThe patient, L.E., is a 72-year-old white male who has been under our care for 10 years. He initially presented to our clinic in 1992, with a diagnosis of localized prostate cancer.
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Management of Venous Thromboembolism in Cancer PatientsDrs. Lee and Levine have written a thoughtful, thorough review of the management of venous thromboembolism in cancer patients. Venous thromboembolism remains an important, common, and potentially fatal complication of cancer and many of its therapies. Certainly, the incidence of upper extremity and catheter-related thrombosis has increased significantly in recent years with the widespread use of central venous catheters. On the other hand, recent years have also brought new, less invasive methods of diagnosis and the promise of still more new diagnostic methods to come.
