ONCOLOGY REVIEW (US) – VOLUME 1 ISSUE 1 – SPRING 2005

Cancer is the second leading cause of death in developed countries, accounting for nearly one in five deaths. The costs of such a widespread killer are staggering, affecting both the individual and society as a whole.The US National Institutes of Health (NIH) estimated the overall annual costs for cancer in 2003 at US$189.5 billion. This […]

Despite years of clinical research, the odds of achieving complete resolution of metastatic disease with current treatment strategies remain low.2-4 The majority of patients with advanced disease achieve various degrees of objective remission, usually transient, with conventional treatments, and develop evidence of progressive disease within 12 to 24 months of initiating treatment.4 For these patients, […]

Similar dose distributions can be achieved for some other cancer sites as well. The ability to deliver radiation doses with small uncertainties (in both location and magnitude) increases the need to accurately define anatomical location and the extent of tumor volumes, and to determine biological properties of individual tumors.A better understanding of tumor extent and […]

Aromatase inhibitors, which block the formation of estrogen in post-menopausal women, are not a new class of drug, but older aromatase inhibitors, such as aminogluthethimide were not selective in purely blocking the conversion of androgens to estrogens, and were somewhat abandoned as breast cancer therapies when tamoxifen was noted to have a superior toxicity profile.The […]

The use of extensive debulking procedures, which may include resections of the gastrointestinal (GI) or urinary tracts, can decrease the tumour burden for cytotoxic chemotherapy and help to prolong survival. The addition of taxanes to platinum-based therapy have led to significant improvement in both progression-free and overall survival in patients with either optimally reduced or […]

The 37% of patients diagnosed with stage III disease and some of the 28% of patients with stage II disease will be offered chemotherapy to eradicate micrometastatic disease for cure. Approximately 85,000 people yearly will receive chemotherapy for colorectal cancer. 5-fluorouracil (5FU) has been the cornerstone of therapy for the treatment of colorectal cancer for […]

In the recent revised classification of neuroendocrine tumors,6 the size of 2cm seems to be a crucial value over which carcinoid tumors start to exhibit malignant behavior. In other words, if resection is accomplished in time, no local recurrence might be encountered and a normal survival might be expected in the absence of metastatic disease.7 […]

For the few selected 15% to 20% of patients who present with a resectable tumor by radiographic criteria and undergo surgery, the five-year survival rate is only 20% and it is worse in node-positive patients.2,3 Determining resectability is an important first step and in most cases can be accomplished by a computerized tomography (CT) scan […]

The introduction of prostate-specific antigen (PSA) screening made an enormous impact on the incidence of prostate cancer, which increased in the early 1990s and is currently down to pre-PSA screening levels. Screening has caused a change in pattern of disease to an earlier stage but not lower grade. Death rates due to prostate cancer diminished […]

“The continued measurable declines for overall cancer death rates and for many of the top 15 cancers, along with improved survival rates, reflect progress in the prevention, early detection, and treatment of cancer. However, racial and ethnic disparities in survival and the risk of death from cancer, and geographic variation in stage distributions suggest that […]

Increased expression of intracellular annexin I is seen in bronchial epithelial cells grown in the presence of dexamethasone,9 and secreted annexin I appears to be proteolytically degraded by the human neutrophil elastase to an inactive form.10,11 Annexin I is a critical mediator of apoptosis.12 15 While over-expression of annexin I has been observed in pancreatic,16 […]

The disease results from malignant plasma cells, which infiltrate the bone marrow.Although much is known about the nature of MM, the causes remain unknown. Genetic abnormalities are common and varied.2 The disease is predominantly localized to the bone marrow.The malignant plasma cells adhere to bone marrow stromal cells (BMSCs), resulting in the up- regulation of […]

The reason that so few women choose BCT is largely due to the inconvenience of attending six to seven weeks of daily radiation treatments (RT). Often women, especially in the heartland of America, are many hours away from the nearest radiation facility, and many do not have the ability to take time away from employment […]

Over the past decade, improvements in computers and networking, radiotherapy treatment planning software, and medical imaging modalities computerized tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), and positron emission tomography (PET) have been incorporated into radiotherapy practice. This has lead to the development of image-guided radiotherapy radiotherapy that uses cross-sectional images of the patient s […]

The goal of radiation treatment has always been to destroy the cancer without harming normal structures and cells. Normal structure tolerance is the greatest limitation of successful treatment. In order to accomplish this goal, treatment is delivered in discreet fractions or applications that allow for the maximum radiobiological effect to destroy cancer cells but spare […]

In addition, the need for supplemental XRT or androgen deprivation therapy (ADT) to optimize biochemical outcome is increasingly in doubt.5,6 With high quality brachytherapy, the vast majority of patients can be successfully managed without such supplemental therapies.5 With the emergence of brachytherapy as a mainstream treatment for clinically localized prostate cancer, a rapidly expanding body […]

Testosterone, the primary circulating androgen, is converted to its active form, alphadihydrotestosterone, by 5-alpha-reductase, and forms a complex with the dihydrotestosterone-binding domain of the androgen receptor. This complex then alters the structure of the DNA-binding domain allowing it to reversibly bind DNA sequences and androgen response elements in promoter or enhancer regions of androgenregulated genes. […]

Position Emission Tomography Positron emission tomography (PET) is one of the most exciting advances in the diagnosis of many cancers, including that of the lung. Briefly, the technique uses the radiolabeled glucose analog F 18 fluorodeoxyglucose. The compound is injected intravenously and is taken up preferentially by metabolically active cells, such as those found in […]

The presence of this condition can be emotionally distressing to the patient and family. Although options do exist to stimulate appetite, prevent further weight loss, and even at times cause weight gain, such measures do not improve survival or global quality of life. In addition, patients who suffer from this syndrome do not appear to […]

It is postulated that patients who maintain better nutritional status and body composition during and after primary therapy, are better and more willing candidates for therapy should the cancer recur. Significant increases or decreases in a patient-s weight and body composition are undesirable for anyone going through cancer treatment.This understanding allows a consistent and integrated […]

Severe OM may result in dose reduction, dose delay, and even in termination of planned therapy.In addition, OM is associated with considerable cost implications, ranging from US$12,000 in patients with solid tumors 7,8 to US$42,000 in HCT patients.9 In radiation-induced OM, initial mucosal whitening may occur prior to erythema and mucosal ulceration. Mucosal lesions that […]

This variability is accounted for by three factors:  medical factors (site, stage, treatment, clinical course of the cancer, and the presence of pain); psychologic factors of prior adjustment, coping ability, emotional maturity, the disruption of life goals, and ability to modify plans; and  social factors such as the availability of emotional support offered by family, […]

Inflammatory cytokines, especially interleukin (IL-1), interferon-gamma (IFN- ?), and tumour necrosis factor (TNF), reduce erythropoietin (EPO) production, suppress the bone marrow’s response to EPO, and alter ferrokinetics.5 The majority of anemic cancer patients will not represent a ‘pure’ anemia of cancer as approximately 75% will have had chemotherapy and/or irradiation at some point historically,6 with […]

A major concern related to the possibility of a pregnancy after breast cancer is the fear that silent micrometastases still present after primary treatment of breast cancer may be re’activated by the hormonal changes experienced during pregnancy, and negatively affect the outcome. Furthermore, breast cancer at a young age is considered to have a more […]

While the melanoma etiologic pathways are critical in developing prevention strategies, the increase in this disease has propelled melanoma into the sixth most common cancer and a significant cause for death of patients in their prime of life. Metastatic disease remains a formidable hurdle for oncologists today. The prognosis of a patient with melanoma is […]

Introduction Prostate cancer is one of the most common cancers affecting men worldwide.1 Current cancer statistics estimate that more than 200,000 men are diagnosed with prostate cancer in the US each year,2 and five-year worldwide prevalence is approaching 2.5 million cases.3 Approximately 50% of patients will experience disease recurrence after local therapy consisting of radiation […]

This article summarizes the evolution of commonly employed surgical remedies and concludes with a description of trends in current surgical approaches. Among the earliest reports of tumor removal in the female is a reference in 1862 by Edwin Smith, an Egyptologist, who was able to date abdominal excisions of the ovary as early as 1600BC […]