ONCOLOGY (US) – VOLUME 5 – SPRING 2009

This issue of US Oncology covers a broad variety of topics. All of this knowledge is important for providing optimal care of patients with cancer. On the one hand, we oncologists can be proud of recent achievements that have substantially improved survival and quality of life; on the other hand, we experience everyday clinical situations […]

Cancer treatments and their side effects are often perceived as more debilitating than the actual cancer by many patients.1–3 Nausea and vomiting (NV) are still among the most common, expected, and feared side effects among patients receiving chemotherapy.1–3 In fact, some cancer patients who experience chemotherapy-induced nausea and vomiting (CINV) will delay chemotherapy treatments and […]

Approximately 72 million surgeries are performed in the US every year,1 with over 20 million involving major inpatient procedures.2 Despite the proliferation of new pain-management modalities, over 75% of all surgical patients experience moderate to severe post-operative pain.3 Higher post-operative pain scores alone have been documented to be associated with longer length of hospital stay […]

Anthracycline Extravasation For 40 years, the use of anthracycline anticancer drugs has been a mainstay in the curative and palliative treatment of many solid tumors and hematological malignancies. Millions of patients have received treatment with doxorubicin, epirubicin, daunorubicin, and several newer analogs. Regrettably, a small fraction of patients have suffered from the unintentional extravasation of […]

Current Treatment Options for Cutaneous T-cell Lymphoma Cutaneous T-cell lymphomas (CTCLs) are a heterogeneous group of extranodal non-Hodgkin’s lymphomas characterized by their surface markers and biological behavior. Mycosis fungoides (MF) and its leukemic variant Sézary syndrome (SS) are the most frequently encountered CTCLs resulting from a progressive clonal expansion of CD4+CD45RO+CLA+CCR+ helper/memory T cells. The […]

While ATC is characterised by an almost fatal outcome, with survival that rarely exceeds one year regardless of the available therapy,1 unselected patients suffering from MTC have an overall 10-year survival of approximately 70% following primary surgery.3,4 However, little effective therapy has existed until recently for patients with unresectable MTC.4 Because of the rarity of […]

Over the past 25 years, systemic chemotherapy has been intensively investigated in the management of squamous cell head and neck cancer. Although modest palliative benefits have been identified for those patients with relapsed or refractory disease, it is when chemotherapy is coupled with definitive radiation in newly diagnosed patient that a significant improvement in the […]

Lung cancer is the main cause of cancer deaths for both men and women in the US and worldwide. In the US, there were approximately 232,270 new cases diagnosed and 166,280 deaths due to this disease by the end of 2008.1 Non-small-cell cancer (NSCLC) accounts for approximately 80% of all cases of lung cancer, the […]

Advances in gene expression and molecular profiling have clarified that breast cancer is not a single disease entity, but a heterogeneous disease with multiple subtypes. Breast cancers can now be categorized into the luminal subtypes, which express estrogen receptors (ERs), the human epidermal growth factor receptor 2 (HER2)-positive subtypes, which express ERBB2, and the basal […]

Although breast cancer is still the most common cancer diagnosis among women, long-term survival rates have been steadily increasing since 1990, and there are currently over 2.5 million breast cancer survivors in the US.1 However, now that the majority of breast cancer patients are surviving for longer, there has also been increasing clarity and concern […]

Gastrointestinal stromal tumor (GIST) is the most prevalent mesenchymal tumor of the gastrointestinal tract, primarily arising in the stomach and small intestine.1,2 It can be a life-threatening disease, with an expected incidence of approximately 5,000 new cases each year in the US.3,4 Surgery is the standard of care for primary GISTs and the goal of […]

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal malignancy in the gastrointestinal tract. These sarcomas often originate in the stomach or small intestine, but have also been found to affect extraintestinal sites such as the mesentery and omentum. Since discovering that these tumors express the cell surface growth factor receptor KIT,1 greater understanding of […]

Hepatocellular carcinoma (HCC) is the sixth most common malignancy and the third most common cause of death from cancer worldwide.1 The incidence of HCC in the US is increasing because of the rise in the prevalence of hepatitis C virus infection.2,3 HCC-related mortality is high because most cases are diagnosed at an advanced stage, when […]

Colorectal liver metastases (CRLMs) are common and can either present at the time of initial colorectal cancer diagnosis (synchronous) or develop later (metachronous). There has been increasing interest in the treatment of CRLMs in recent years due to the development of new therapies and improving prognoses. A major factor in the treatment of CRLMs is […]

The aim of systemic treatment in any cancer is to cure the disease, prolong survival by three to four months or relieve symptoms more than occasionally.6 Despite the relatively poor outcomes in treatment of pancreatic cancer, treatment is warranted if we can achieve one of these goals. A number of genetic changes have been identified […]

In 2008, primary kidney malignancies accounted for a predicted 4% of all cancer diagnoses in the US. There were an estimated 54,390 new diagnoses of renal cell carcinoma (RCC), which constitute approximately 90% of all malignant kidney tumors (approximately 85% clear-cell histology), and 13,010 kidney cancer deaths.1 The Surveillance, Epidemiology and End Results (SEER) data […]

Second-line Therapy Development of resistance to one kind of hormonal therapy does not preclude a second or even third line of hormonal manipulation. The androgen receptor often remains active despite low serum testosterone levels.3 Several classes of therapeutic options are available, including: adrenal androgen inhibitors;4 antiandrogens, e.g. flutamide, nilutamide and bicalutamide;5 oestrogens and progestins;6 and […]

Despite many years of trials, there is no single evidence-driven best regimen for newly diagnosed, advanced (defined as stage II or greater, i.e. extra-ovarian spread) epithelial ovarian cancer and its counterparts, fallopian tube cancer and primary peritoneal cancer. Instead, there is agreement that the essential components of treatment are surgical debulking and chemotherapy containing a […]

While gynecologists have used laparoscopy for nearly 50 years, it was not until the 1990s that laparoscopy gained acceptance among gynecological oncologists for advanced procedures such as hysterectomy with lymphadenectomy for endometrial cancer. More recently, total laparoscopic radical hysterectomy (TLRH) for earlystage cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stages IA2 and IB1) […]

Health disparities are defined as the “differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States. These population groups may be characterized by gender, age, ethnicity, education, income, social class, disability, geographic location, or sexual orientation.”1 There are currently more […]