Oncology Vol 28 No 3

The rise in utilization of medical imaging-especially computed tomography and nuclear medicine-and the issues of perceived, potential, theoretical, and known risks associated with ionizing radiation exposure from imaging have come to the forefront of public and professional awareness, raising concerns and controversies.

In this issue of ONCOLOGY, Dr. Goske and colleagues present an excellent review of efforts to reduce radiation exposure from diagnostic medical imaging.[1]

A 70-year-old, otherwise healthy man presented to his primary care provider for an annual checkup, at which time a nontender right testicular mass was noted. He denied any symptoms, and his serum alpha-fetoprotein and beta-human chorionic gonadotropin levels were normal.

Surgery continues to advance with the availability of new technology, knowledge and skills gained through experience, and collaboration between specialties. Some tumors that were unresectable in years past are now resectable. Other tumors that we currently consider beyond our ability to remove may be conquered in the near future.

In summary, central lung cancers, when appropriately staged, are optimally treated by surgical resection. Initial evaluation is best done by a multidisciplinary team, involving a trained thoracic surgeon.

As a practicing hospital oncologist, I was troubled by the article “The 340b Drug Discount Program: Oncology’s Optical Illusion” in the November 2013 issue of ONCOLOGY.

We now have more tools than ever in the fight against tobacco-related death and disability, but unfortunately, there is not equal access to resources for smoking cessation, early lung cancer diagnosis, and treatment.

Contrary to some expectations, getting accelerated approval for neoadjuvant therapy does not look easy, and the pertuzumab story may be the exception that proves the rule.

At this point, there is expectation that pertuzumab given in the neoadjuvant setting will improve long-term efficacy. We welcome the opportunity to include pertuzumab in the neoadjuvant regimen of patients with HER2-positive breast cancer.

The purpose of this review is to provide the oncology community with knowledge about the doses used in medical imaging, radiation-induced cancer risks from imaging, and considerations to keep in mind when balancing imaging benefits and risks in pediatric and adult oncologic settings.

This article discusses the development of pertuzumab to date, with a particular focus on the accelerated approval decision. We highlight the need to identify reliable biomarkers of sensitivity and resistance to HER2-targeted therapy, which would make possible the individualization of treatment for patients with HER2-positive breast cancer.

Treatment optimization for centrally located lung cancers requires special considerations for determining resectability and patient selection.

The Hippocratic Oath underscores that harm to patients can result either from acts of commission or omission. Decisions about the use of diagnostic imaging are now under great scrutiny.