ONCOLOGY Vol 26 No 1

It may not be appropriate, nor always considered standard, to recommend neoadjuvant chemotherapy for all patients for whom adjuvant therapy was recommended before surgery. Indeed, tumor size and nodal status play a role, as do hormone receptors, in determining the appropriate extent of adjuvant therapy.

Treatment of HER2-positive cancers has improved rapidly over the past decade, and the pace of progress continues to accelerate. The advances have been fueled in part by the conduct of neoadjuvant studies, which have aided in the development of novel therapies and more effective combination regimens.

In this paper, Dr. Cherny beautifully reviews how to balance the patient's right to be adequately informed about his or her disease with the powerful cultural beliefs held in many parts of the world.

Beginning with its provocative opening case vignette, Nathan Cherny's article provides an opportunity for us to reflect on and possibly redirect our own attitudes and habits regarding difficult ethical issues in communication with our patients and their families, especially in the setting of cultural and religious diversity.

After several decades with only modest changes in the therapeutic paradigm, rapid progress in understanding the biology of advanced prostate cancer has been translated into more accurate terminology, such as “castration-resistant” (as opposed to “hormone-refractory” or “androgen-independent”) prostate cancer, as well as clinically meaningful therapeutic developments.

These are, indeed, exciting times for patients with metastatic prostate cancer and the clinicians who care for them.

Until we fully engage in understanding the biologic mechanisms that separate NMZL from other indolent NHLs, however, we will continue to deliver “impersonalized medicine” that does not exploit the unique properties of the former.

Typically, when one authors a commentary piece, a good template to follow is to start with some background material, review the major findings of the paper in question, and then focus on areas of controversy and unanswered questions.

Of all diseases, cancer probably elicits the strongest emotional reaction, and this is even more true if one is an affected patient.

The aim of this review is twofold: to summarize descriptions of the clinical presentation provided in published series in order to help clinicians recognize and treat patients, and to discuss diagnostic difficulties faced by hematopathologists when dealing with these lesions and others in the differential diagnosis that must be distinguished from one another.

We have entered a period of accelerated drug development and optimism in the care of advanced prostate cancer. The treatment paradigm for these patients is rapidly evolving, with future study needed to define the optimal sequencing and potential combinations of these new agents.

Nationally, the number of drug shortages has tripled since 2005. Our county’s hospice agency has experienced shortages of liquid morphine, scopolamine patches, and medications to relieve nausea. Other generic drug shortages in our clinic have included paclitaxel, leucovorin, and doxorubicin. We have had limited ability to order fluorouracil (5-FU) and mitomycin.

This article provides a comprehensive summary of the knowledge gained from recent neoadjuvant trials conducted with agents targeting HER2, and will put them into perspective with current treatment recommendations from American and European guidelines.

This article addresses some of the most common major challenges in oncologist-patient communication with a nuanced approach to the concepts of autonomy, paternalism, and culture.