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Developing Countries Cancer Problems
Started by Dr Kamal E.H.MOHAMED Sep 25, 2011. 0 Replies 0 Likes
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CA: A Cancer Journal for Clinicians
Cancer risks associated with external radiation from diagnostic imaging procedures
The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but increased potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate the widespread use of evidence-based appropriateness criteria for decisions about imaging procedures; oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives; development of electronic lifetime records of imaging procedures for patients and their physicians; and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures. CA Cancer J Clin 2012. © 2012 American Cancer Society.Cancer screening in the United States, 2012
Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are the latest data on the use of cancer screening from the National Health Interview Survey. CA Cancer J Clin 2012. © 2012 American Cancer Society.Thromboembolism is common and influences prognosis in patients with pancreatic cancer, study reports
Survivorship care plans in research and practice
The Institute of Medicine (IOM) recommends the use of survivorship care plans (SCPs) for all cancer survivors. Developing useful SCPs requires understanding what survivors and their providers need and how SCPs can be implemented in practice. Published studies investigating the perspectives of stakeholders (survivors, primary care providers, and oncology providers) were reviewed regarding the content and use of SCPs. All National Cancer Institute (NCI)-designated cancer centers were surveyed concerning the extent to which SCPs for survivors of breast and colorectal cancers are in use, their concordance with the IOM's recommendation, and details about SCP delivery. Survivors and primary care providers typically lack the information the IOM suggested should be included in SCPs. Oncology providers view SCPs favorably but express concerns about the feasibility of their implementation. Fewer than one-half (43%) of NCI-designated cancer centers deliver SCPs to their breast or colorectal cancer survivors. Of those that do, none deliver SCPs that include all components recommended by the IOM. Survivors' and providers' opinions about the use of SCPs are favorable, but there are barriers to implementation. SCPs are not widely used in NCI-designated cancer centers. Variation in practice is substantial, and many components recommended by the IOM framework are rarely included. CA Cancer J Clin 2012; © 2012 American Cancer Society.Oncology Headline News
Cancer Biotherapy & Radiopharmaceuticals - Table of Contents
Cure Today (Blog)
Drug shortage crisis averted, for now
Some 31,000 units of preservative-free methotrexate, equivalent to a month's supply of the drug for the entire nation, are currently on their way to hospitals around the country, said Michael Ball, CEO of the drug manufacturer Hospira, in a Food and ...Writing about cancer on the bathroom wall
We get many journals here at the CURE office as you can imagine. I picked up one this morning from the Oncology Nursing Society and found an interesting commentary on men's communication style in one article. It seems that in designing the North ...Want to get back to work after cancer? Here's help
Cancer and Careers is hosting a conference on June 22 in New York City for patients and survivors. The free conference explores the challenges people face as they try to balance their cancer treatment and recovery with finding and keeping a job. ...Happy Valentine's Day
The day is winding down and I hope that all of you have had a wonderful day! It has been a quiet day here, but nice in so many ways. Chloe climbed up in bed with us during the middle of the night. She woke up saying "happy sweetheart day" and it w...Dr. Bill's ultimate marathon
I recently joined CURE as managing editor of books and special projects. While I have been in journalism for many years now, this is my first foray, as an editor, into the complex world of cancer. But as a daughter--well, that's a different story. ...MEET OUR MEDIA PARTNERS
Blog Posts
First Personalized Cancer Medicine Allows Patients with Deadly Form of Metastatic Melanoma to Live Significantly Longer
Posted by Peter Hofland, PhD on February 20, 2012 at 11:30am 0 Comments 0 Likes
The European Commission has approved vemurafenib (ZelborafTM, Roche) as a monotherapy for the treatment of adult patients with BRAF V600 mutationpositive unresectable or metastatic melanoma. This form of melanoma is the most aggressive form of skin cancer. Vemurafenib is designed to target and inhibit mutated forms of the BRAF protein found in about half of all cases of melanoma.
When melanoma is…
Complexities of Non-Pharmacological Caregiving at the End of Life: "It's All About Satisfying Fundamental Human Needs"
Posted by Peter Hofland, PhD on February 15, 2012 at 5:30pm 0 Comments 0 Likes
Faced with the inevitability of death in late-stage palliative cancer care, relief of distress, optimized well-being and good caregiving during the final stage of life become primary treatment goals. A new study from Karolinska Institutet and Umeå University shows that non-pharmacological caregiving at the end of life in specialized palliative care is not as basic as one might…
ContinueInjectable Treatment for Blood Clots in Advanced Cancer Patients Increases
Posted by Peter Hofland, PhD on February 14, 2012 at 10:00am 0 Comments 0 Likes
The use of an injectable, clot-preventing drug known as Low Molecular Weight Heparin (LMWH) to treat patients with advanced cancer complicated by blood clots increased steadily between 2000 and 2007, according to a new study published in The Oncologist (February 14, 2012), funded by the National Cancer Institute and led by Kaiser Permanente…
ContinueNew Computer System Identifies Suitable Patients; Accelerate Cancer Trials - Helping New Drugs Reach Markets Faster
Posted by Peter Hofland, PhD on February 14, 2012 at 8:30am 0 Comments 0 Likes
Moffitt Cancer Center & Research Institute (Tampa, Florida) has received a new patent for a computerized system that efficiently selects the right patient for the right clinical trial. The newly patented system matches a registered patient's own molecular profile, warehoused in a database of thousands of patient-donated biological tissue or tumor samples, to the molecular design of the drug aimed at targeting their…
ContinueMolecular Breast Imaging Superior to Ultrasound and Mammography for the Detection of Breast Cancer
Posted by Peter Hofland, PhD on February 14, 2012 at 6:00am 0 Comments 0 Likes
According to a study published in the American Journal of Roentgenology (AJR) in January 2012, Molecular Breast Imaging (MBI), also known as Breast-Specific Gamma Imaging or BSGI, can detect cancers missed by the two most common breast imaging studies, mammography and ultrasound. To clearly differentiate between benign from malignant tissue after mammography, phycians perform BSGI/MBI. In this procedure a patient receives a…
ContinueProspective Analysis Links Breast and Pancreatic Cancer Risk With Lynch Syndrome
Posted by Peter Hofland, PhD on February 13, 2012 at 5:00pm 0 Comments 0 Likes
A new prospective study of patients with Lynch syndrome, an inherited disorder of cancer susceptibility caused by mutations in specific DNA repair genes, provides the first strong evidence that people with Lynch syndrome face significantly increased risks of breast and pancreatic cancers. The study also provided new, clearer estimates of the risks of cancers already recognized to be associated with Lynch syndrome, including those of the colon, uterus, ovary, kidney, stomach and…
ContinueEntinostat Enhanced Activity of Cancer Immunotherapies in Renal and Prostate Cancer Models
Posted by Peter Hofland, PhD on February 9, 2012 at 6:30am 0 Comments 0 Likes
Scientists at Roswell Park Cancer Institute have demonstrated that entinostat (Syndax Pharmaceuticals, Inc.), a class I benzamide histone deacetylase inhibitor also known as SNDX-275 and MS-275, has novel immunomodulatory properties that contribute to the enhanced activity of cancer immunotherapies in models of renal and prostate cancer.
Histone deacetylases (HDAC) are key enzymes that alter the…
Early Detection Results in 15 Percent Drop in Prostate Cancer Deaths
Posted by Peter Hofland, PhD on February 7, 2012 at 8:00am 0 Comments 0 Likes
While more men are being diagnosed with the prostate cancer, fewer are dying from the disease. Data from the North American Association of Central Cancer Registries and the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC) show that in 2012, incidence rates of prostate cancer will increase slightly, while death rates from the disease will decrease. In 2011, 33,720 men died from the disease,…
ContinueJX-594's Cancer Targeting Mechanism Driven by Genetic Traits Common in Solid Tumors
Posted by Peter Hofland, PhD on February 7, 2012 at 5:30am 0 Comments 0 Likes
A new study published in Molecular Therapy shows that JX-594, a first-in-class targeted oncolytic virus products for cancer being developed by Jennerex, Inc selectively targets and kills a broad range of cancer cells.
The study demonstrated that JX-594's cancer-selectivity was multi-mechanistic and…
Dietary Soy Supplements do Not Provide Protection Against Breast Cancer - Effects of Food on Cancer May be More Complex
Posted by Peter Hofland, PhD on February 3, 2012 at 7:30pm 0 Comments 0 Likes
Soy isoflavone supplements did not decrease breast cancer cell proliferation in a randomized clinical trial, according to a study published in the February 2012 issue of Cancer Prevention Research, a journal of the American Association for Cancer Research.
Lead researcher Seema A. Khan, M.D., professor of surgery at the…
Videos
Medscape Hematology-Oncology Headlines
Average Survival Now 16 Months With Melanoma Drug
A phase 2 study provides the longest-term survival data available.Medscape Medical News
Molecular Signature May Distinguish DCIS
Researchers have identified a set of molecules that distinguish ductal carcinoma in situ from invasive breast cancer.Medscape Medical News
Pixantrone Progresses Toward Approval in the European Union
The new lymphoma drug is edging closer to market in Europe, but has had another setback in the United States.Medscape Medical News
Can Aspirin Slow Cancer Progression?
Dr. David Kerr reports on a study detailing the link between inflammation and colorectal carcinogenesis and how it might be exploited to slow tumor progression and possibly even prevent CRC.Medscape Hematology-Oncology
Vemurafenib for Melanoma Approved in Europe
The drug is indicated for patients whose tumors carry a BRAF mutation, which is found in about half of patients with melanoma.International Approvals
The Lancet Oncology
[Correspondence] A STEPP too far for FLEX?
In their post-hoc biomarker analysis of the FLEX phase 3 trial, Pirker and colleagues reported a putative predictive value for EGFR immunostaining expression, using a semi-quantitative H-score. Previous findings of the FLEX study have raised some unanswered questions, with an absolute gain in overall survival for patients receiving cetuximab of 1·2 months of uncertain clinical importance. In their new study, Pirker and colleagues used a cutpoint that was not prespecified to dichotomise the study population into subsets of patients with high (31%) or low (69%) EGFR tumour expression.[Comment] A tale of two tumours and a plea for progress
Melanoma and acute myeloid leukaemia (AML) share important characteristics: both are non-epithelial malignancies and affect a substantial proportion of young people, with roughly a third of patients diagnosed younger than 60 years. Notably, the incidence of primary melanoma is rising faster than that of any other common cancer and has quadrupled since the 1970s. Although most people with primary melanoma are cured, the incidence of metastatic disease is roughly equal to that of acute myeloid leukaemia, with about 2000 new cases per year in the UK.[Comment] Don't pick the loser: lessons from the GeparQuinto trial
In The Lancet Oncology, Michael Untch and colleagues report the first efficacy results from the GeparQuinto (GBG 44) study, a randomised phase 3 trial of lapatinib versus trastuzumab in combination with neoadjuvant anthracycline-based and taxane-based chemotherapy. 620 women with HER2-positive operable or locally advanced breast cancer were randomly assigned to receive lapatinib (a tyrosine-kinase inhibitor of HER1 and HER2) or trastuzumab (a monoclonal antibody to the HER2 receptor), concurrent with a planned regimen of four cycles of an anthracycline (epirubicin 90 mg/m2 plus cyclophosphamide 600 mg/m2) followed by four cycles of a taxane (docetaxel 100 mg/m2).[News] NICE guidance on rituximab for first-line treatment of symptomatic stage III–IV follicular lymphoma in previously untreated patients
On 25 Jan, 2012, the UK National Institute for Health and Clinical Excellence (NICE) published guidance recommending the use of rituximab in combination with certain chemotherapy regimens for the treatment of symptomatic stage III–IV follicular lymphoma in previously untreated patients. The chemotherapy regimens listed were: cyclophosphamide, vincristine, and prednisolone (CVP); cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP); mitoxantrone, chlorambucil, and prednisolone (MCP); cyclophosphamide, doxorubicin, etoposide, pred-nisolone and interferon α (CHVPi); and chlorambucil.[Comment] Easing acceleration of head and neck chemoradiotherapy
In the past 20 years, management of locoregionally advanced head and neck cancer has evolved from often devastating surgical resection towards radiotherapy, intensified either by altered fractionation or by addition of concurrent chemotherapy, with the aim of cure with functional preservation of organs. A key expectation was that intensification of radiotherapy would result in improved outcomes for patients, which would justify any extra morbidity.
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European Journal of Cancer
Reply letter to: Salvage radiotherapy: A plea for dose-escalation with intensity modulated radiotherapy
Publication year: 2012Source: European Journal of Cancer, Available online 21 February 2012
Nitin Ohri, Adam P. Dicker, Timothy N. Showalter
Carcinoma of endocrine organs: Results of the RARECARE project
Publication year: 2012Source: European Journal of Cancer, Available online 21 February 2012
Jan Maarten van der Zwan, Sandra Mallone, Boukje van Dijk, Magdalena Bielska-Lasota, Renée Otter, ...
The rarity or the asymptomatic character of endocrine tumours results in a lack of epidemiological studies on their incidence and survival patterns. The aim of this study was to describe the incidence, prevalence and survival of endocrine tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002, registered in 89 population-based cancer registries (CRs) with follow-up until 31st December 2003. These data give an unique overview of the burden of endocrine carcinomas in Europe.A list of tumour entities based on the third International Classification of Diseases for Oncology was provided by the project Surveillance of rare cancer in Europe (RARECARE) project. Over 33,594 cases of endocrine carcinomas were analysed in this study.Incidence rates increased with age and were highest in patients 65 years of age or older. In 2003, more than 315,000 persons in the EU (27 countries) were alive with a past diagnosis of a carcinoma of endocrine organs. The incidence of pituitary carcinoma equalled four per 1,000,000 person years and showed the strongest decline in survival with increasing age. Thyroid cancer showed the highest crude incidence rates (four per 100,000 person years) and was the only entity with a gender differen (female-to-male ratio: 2:9). Parathyroid carcinoma was the rarest endocrine entity with two new cases per 10,000,000 person years. For adrenal carcinoma, the most remarkable observations were a higher survival for women compared to men (40% compared to 32%, respectively) and a particularly low relative survival of 24% in patients 65 years of age or older.More high quality studies on rare cancers, with additional information, e.g. on stage and therapeutic approach, are needed and may be of help in partly explaining the observed variation in survival.
Embryonal cancers in Europe
Publication year: 2012Source: European Journal of Cancer, Available online 20 February 2012
Gemma Gatta, Andrea Ferrari, Charles A. Stiller, Guido Pastore, Gianni Bisogno, ...
Embryonal cancers are a heterogeneous group of rare cancers which mainly occur in children and adolescents. The aim of the present study was to estimate the burden (incidence, prevalence, survival and proportion of cured) for the principal embryonal cancers in Europe (EU27), using population-based data from cancer registries (CRs) participating in RARECARE.We identified 3322 cases diagnosed from 1995 to 2002 (latest period for which data are available): 44% neuroblastoma, 35% nephroblastoma, 13% retinoblastoma and 6% hepatoblastoma. Very few cases of pulmonary blastoma (43 cases) and pancreatoblastoma (seven cases) were diagnosed.About 2000 new embryonal cancers were estimated every year in EU27, for an annual incidence rate of 4 per million (1.8 neuroblastoma, 1.4 nephroblastoma, and 0.5 retinoblastoma); 91% of cases occurred in patients under 15 years. Five-year relative survival for all embryonal cancers was 80% (99% retinoblastoma, 90% nephroblastoma, 71% hepatoblastoma and 68% neuroblastoma). Overall survival was lower in adolescents and adults than in those under 15 years. The cure rate was estimated at 80%. Slightly less than 40,000 persons were estimated alive in EU27 with a diagnosis of embryonal cancer in 2008. Nephroblastoma was the most prevalent (18,150 cases in EU27), followed by neuroblastoma (12,100), retinoblastoma (5200), hepatoblastoma (2700) and pulmonary blastoma (614).This is the first study to delineate the embryonal cancer burden in Europe by age, sex and European region. Survival/cure rate is generally high, but there are considerable gaps in our understanding of the natural histories of these rare diseases particularly in adults.
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American Journal of Clinical Oncology - Current Issue
Radioembolization for the Treatment of Liver Tumors: General Principles
Radioembolization aims to selectively target radiation to all liver tumors while limiting the dose to normal liver parenchyma. The deposition of yttrium-90 (90Y) microspheres delivered through the hepatic artery are preferentially implanted within liver tumors in a 3:1 to 20:1 ratio compared with a normal liver. The principles and mode of action of radioembolization are fundamentally different from the conventional embolization of liver tumors through transarterial embolization or chemoembolization. A meticulous work-up, involving computed tomography scanning, contrast-enhanced magnetic resonance imaging, and transfemoral hepatic angiogram, is essential to assess the appropriateness of the patient for treatment. A simulation of the treatment, done with technetium-99m-labeled macroaggregated albumin particles, which approximate the size of microspheres, is used to identify the shunting of microparticles to the lungs or gastrointestinal tract, thus helping to determine patient selection. Whole-liver or unilobar treatment approaches are chosen according to the anatomic distribution of the tumors, concomitant factors affecting liver function, and institutional preferences. Optimal periprocedural care, discharge planning, and follow-up care are essential to assess treatment response and ensure that short-term side effects of radioembolization are adequately managed. The expanding literature on radioembolization shows that this is an effective treatment for the management of both primary and metastatic tumors.Weekly Paclitaxel and Carboplatin Induction Chemotherapy Followed by Concurrent Chemoradiotherapy in Locally Advanced Squamous Cell Carcinoma of the Head and Neck
Objective: To perform a phase II trial evaluating dose dense induction chemotherapy for locally advanced head and neck cancer. Patients and Methods: Thirty-five patients received 6 weekly doses of carboplatin (area under the curve=2) and paclitaxel (135 mg/m2) followed by concurrent weekly paclitaxel (40 mg/m2) and carboplatin (area under the curve=1) and daily radiation (66-72 Gy). Results: There was 1 induction death from neutropenic sepsis and 1 sudden death during chemoradiotherapy. The overall response rate with induction was 79%. With >40 months of follow-up, the 36-month overall survival was 67% and squamous cell carcinoma of the head and neck survival 84%. Patients undergoing biopsy of the primary tumor site after the therapies had 17/18 (94%) pathologic complete response rate. The locoregional relapse rate was 40% (24 mo 28%) and distant relapse rate was 8% with only 1 distant site. Conclusions: Therapy was active but patients must be carefully selected and monitored. Compared with the historical controls, dose dense and intense induction chemotherapy decreased distant failure rate without compromising the locoregional control.Postoperative Low Pelvic Radiotherapy and Chemotherapy for Stage II and III Rectal Cancer
Objectives: To evaluate whether postoperative low pelvic radiotherapy (RT) combined with chemotherapy is an appropriate treatment for stage II and III rectal cancer. Methods: Between November 1997 and May 2006, 104 patients with stage II and III rectal cancer underwent surgery as the primary treatment followed by postoperative RT combined with chemotherapy in our institute and were reviewed retrospectively. Sixty-nine patients received low pelvic RT only (upper margin at 1 cm above the low end of the sacroiliac joint; median dose 54 Gy) (low pelvic RT group) and the other 35 patients received whole pelvic RT (upper margin at the mid L5; median dose 43.2 Gy) and subsequently received a boost to the low pelvis (total median dose 54 Gy) (whole pelvic RT group). Results: The 5-year overall survival rate, local control rate, and distant metastasis-free rate were 72% versus 63%, 86% versus 84%, and 66% versus 62% for low pelvic versus whole pelvic RT group. There were no statistical differences in these 2 groups. Two patients (2.9%) of the low pelvic RT group and 2 patients (5.7%) of the whole pelvic RT group developed upper pelvis relapse, which was out of the low pelvic field. The incidence of Grade 3 to 5 small bowel late complications of the low pelvic RT group was significantly less than that of the whole pelvic RT group (4.3% vs. 20%) (P=0.029). Conclusions: Low pelvic RT significantly reduces small bowel late complications and does not compromise the overall survival rate, local control rate, and distant metastasis-free rate.Impact of Postoperative Radiation on Survival for High-grade Soft Tissue Sarcoma of the Extremities After Limb Sparing Radical Resection
Objectives: To use the Surveillance, Epidemiology, and End Results (SEER) Database to analyze the impact of postoperative radiation after limb sparing surgery for high-grade extremity soft tissue sarcomas (STS). Methods: We identified patients, aged 20 to 79, who were diagnosed between 1988 and 2006 with high-grade STS of the extremities and underwent radical limb sparing surgery with or without postoperative external beam radiation. Kaplan-Meier and Cox regression analyses were performed to evaluate the effect of postoperative external beam radiation therapy on overall survival (OS) and disease-specific survival (DSS). Results: A total of 983 patients met the selection criteria: 788 (80.2%) received postoperative radiation and 195 (19.8%) underwent surgery alone. For the whole cohort, there were no differences between the groups in OS (P=0.06) or DSS (P=0.20). On subgroup analysis, for tumors ≤5 cm there remained no significant differences in OS (P=0.8) or DSS (P=0.93). However, for tumors >5 cm the 3-year OS improved with the addition of postoperative radiation from 55.6% to 73.4% (P<0.001). Similarly, the 3-year DSS improved from 68.1% to 80.6% (P=0.005). Conclusions: Because of the retrospective nature of this study and inherent limitations of the SEER database, a large prospective study is needed to further elucidate the relationship between postoperative radiation and survival. However, these data do support the use of adjuvant radiation for patients with high-grade extremity STS measuring >5 cm.Randomized Phase II Study of Carboplatin-Paclitaxel or Gemcitabine-Vinorelbine in Patients With Advanced Nonsmall Cell Lung Cancer and a Performance Status of 2: West Japan Thoracic Oncology Group 0004
Objectives: The aim of the present study was to evaluate the efficacy and safety of carboplatin plus paclitaxel versus gemcitabine plus vinorelbine in patients with advanced nonsmall cell lung cancer (NSCLC) and an Eastern Cooperative Oncology Group performance status (PS) of 2. Methods: Chemotherapy-naive patients with NSCLC of stage IIIB or IV and a PS of 2 were eligible. The patients received 3-week cycles of carboplatin (area under the curve of 6) plus paclitaxel (200 mg/m2) on day 1 (CP) or gemcitabine (1000 mg/m2) plus vinorelbine (25 mg/m2) on days 1 and 8 (GV). The primary end point was 1-year survival rate for selection of the better treatment arm for further study. Results: Of the 89 patients enrolled, 84 were assessable (41 in the CP arm, 43 in the GV arm). The overall response rate, median survival time, and 1-year survival rate were 29.3%, 5.9 months, and 22.0%, respectively, for the CP arm and 20.9%, 6.0 months, and 27.9% for the GV arm. Common toxicities of grade 3 or 4 included neutropenia (67.5% for the CP arm vs. 65.1% for the GV arm), febrile neutropenia (20% vs. 14%), and infection (25.0% vs. 23.2%). The frequency of nausea of grade 3 was greater for the CP arm (17.5% vs. 2.3%), whereas that of anemia of grade 3 or 4 (30.2% vs. 12.5%) or treatment-related death (7.0% vs. 2.4%) was greater for the GV arm. Conclusions: The 1-year survival rate did not exceed 30% for either doublet chemotherapy. Furthermore, each treatment was associated with a substantial degree of toxicity.Journal of Clinical Oncology - Last 3 Issue (ASCO)
Oncology
Front & Back Matter
Oncology 2012;82:X (DOI:10.1159/000337286)Sorafenib Dose Escalation in the Treatment of Advanced Hepatocellular Carcinoma
Oncology 2012;82:119–125 (DOI:10.1159/000336082)Front & Back Matter
Oncology 2011;81:X (DOI:10.1159/000337149)Contents Vol. 81, 2011
Oncology 2011;81:I–V (DOI:10.1159/000336250)Acknowledgement to the Reviewers
Oncology 2011;81:410–412 (DOI:10.1159/000336249)Case Reports in Oncology
Multifocal Epithelioid Hemangioendothelioma Derived from the Spine Region: Case Report and Literature Review
Case Rep Oncol 2012;5:91–98 (DOI:10.1159/000336947)Presacral Teratocarcinoma Presenting as Anal Fistula and Rectal Adenocarcinoma: A Unique Case Presentation and Literature Review
Case Rep Oncol 2012;5:84–90 (DOI:10.1159/000336579)Bacillary Prostatitis after Intravesical Immunotherapy:A Rare Adverse Effect
Case Rep Oncol 2012;5:80–83 (DOI:10.1159/000336445)A Pleomorphic Rhabdomyosarcoma Mimicking an Inguinal Hernia: A Case Report and Review of the Literature
Case Rep Oncol 2012;5:74–79 (DOI:10.1159/000336158)Invasive Ductal Carcinoma Arising from an Ectopic Pancreas in the Gastric Wall: A Long-Term Survival Case
Case Rep Oncol 2012;5:69–73 (DOI:10.1159/000335870)MEET OUR SPONSOR
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Cancer Epidemiology
Time trends in testicular cancer in Croatia 1983–2007: Rapid increases in incidence, no declines in mortality
Abstract: Testicular cancer, although a rare malignancy, represents the most common cancer in young male populations of Western origin. While increasing incidence trends of testicular cancer have been reported, mortality is declining in many high-resource settings. Using national data from the Croatian National Cancer Registry for the period 1983–2007, time trends were analysed by joinpoint regression and Age–Period–Cohort models. The present study is the first to analyse the testicular cancer trends in the Croatian population. Over the 25-year period, a mean number of 89 incident cases and 13 deaths were reported annually. The observed mean annual increases in age-standardised rates were 7.0% for incidence and 1.6% for mortality, with no abrupt linear changes (joinpoints) identified. The incidence rates of testicular cancer incidence have been steeply increasing in successive cohorts born since the mid-1930s. The rapid rise in testicular cancer incidence in the Croatian population appears to be one of the highest rates of increase recorded in Europe and worldwide. The lack of decline in the mortality rates over time, while based on relatively few deaths, highlights a need for improvements in diagnostics and management of therapy in Croatia in order to improve the survival and quality-of-life of testicular cancer patients.Revisiting the association between alcohol drinking and oral cancer in nonsmoking and betel quid non-chewing individuals
Abstract: Background: Alcohol drinking is an oral cancer (OC) risk factor; tobacco smoking (TS) and betel quid chewing (BQC) are oral carcinogens and effect modifiers of drinking. Although the assessment of the independent effect of drinking on OC must necessarily account for effect modifiers, no observational study has included interaction terms between drinking, TS, BQC in regression analyses. In order to assess the independent association between drinking and OC, this pooled analysis focused on subjects who were not exposed to such effect modifiers. Methods: Case-control studies on OC, which discriminated non TS/non BQC drinkers from multiexposed drinkers were searched. Exposed subjects (≥1 drink daily, ≥10 years) were compared to unexposed subjects (non/occasional drinkers). Unadjusted odds ratios (ORs) were extracted/calculated. Pooled ORs were assessed with the random-effect method, which assumed high between-study heterogeneity (assessed with Cochran's Q). Robustness of estimates was investigated through use of adjusted ORs, correction for publication bias, sensitivity analysis to inclusion criteria. The drinking–TS interaction was assessed with the Interaction Contrast Ratio (ICR) and the Attributable Proportion due to Interaction (AP). Results: Sixteen studies were used, with substantially high heterogeneity. The pooled OR was 0.787 (95CI, 0.677–0.914). Use of adjusted ORs, correction for publication bias, sensitivity analysis corroborated these results. ICR and AP were 2.444 and 54.6%. Conclusions: Consistent with stratified analyses reporting non significant/negative associations between alcohol drinking and OC in non multiexposed subjects, an OC preventive activity of drinking is inferable. However, given the high prevalence and the oral carcinogenicity of concomitant drinking and smoking, drinking control policies remain essential.Africa's growing cancer burden: Environmental and occupational contributions
Highlights: ► Africa's cancer burden will at least double between 2008 and 2030. ► High levels of environmental/occupational carcinogenic exposures arise from difficulties to enforce health standards, use of out-dated machinery, lack of personal protective measures and of hazard knowledge. ► Exposure sources/settings include mining, pesticide-intensive agriculture, chemical industries, chrysotile asbestos use, hazardous wastes, air pollution. ► Unique exposure patterns provide research opportunities to clarify the role of possibly-carcinogenic agents. ► Regulation and surveillance of exposure levels and of cancer are needed for locally-tailored cancer control plans.Abstract: Background: Primary prevention measures are needed for Africa's cancer burden (715,000 new cases and 542,000 deaths in 2008), a burden projected to double by 2030 due to demographic changes alone. Control of cancer-causing infections and lifestyle-related carcinogens will play a significant role in prevention, but less often addressed are environmental and occupational contributions. Methods: We review environmental issues that contribute to Africa's Cancer burden. Results: We demonstrate evidence of the impact of environmental carcinogens on the cancer burden as of now and that circumstances present today may increase their contribution further. Suboptimal implementation and monitoring of environmental protection and of occupational health standards, including in the informal sector, use of outdated technologies in industry and lack of awareness of potential hazards in the specific employment structure give rise to high levels of exposures. Carcinogens of concern include (i) those that have been long present (e.g. indoor air pollution) whose contribution may increase as life-expectancy increases and long latency periods for cancer are realised, (ii) exposures in mining and agricultural sectors and (iii) modern environmental hazards, including urban air pollution and agents arising from the mis-management of hazardous waste from local, industrial and trans-boundary sources. Conclusions: Actions taken to reduce exposures and research to fill gaps in knowledge, adapted to local settings, could help mitigate the cancer burden.
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Journal of Geriatric Oncology Current
Influence of age on the pharmacokinetics of i.v. vinflunine: Results of a phase I trial in elderly cancer patients
Abstract: Objective: Vinflunine (VFL) is a novel microtubule inhibitor indicated in the treatment of advanced or metastatic urothelial transitional cell cancer after failure of a prior platinum-containing regimen at the recommended dose of 320mg/m² q3 weeks. This trial was designed to assess the pharmacokinetic (PK) behavior and tolerance of VFL in elderly patients (pts), and to propose dose-adjustments if necessary.Material and methods: Three groups of cancer pts over 70years old (y) were open to recruitment: 70–75y, 75–80y and ≥80y. Each group of pts received intravenous VFL, respectively at 320, 280 and 250mg/m² on cycle 1. Pharmacokinetics and safety data were collected at cycle 1 and were compared to reference values from younger pts <70y.Results: 46 pts were treated. For pts 70–75y and 75–80y, there was no statistically age-related change for VFL PK. For pts ≥80y, VFL blood total clearance (Cltot) was significantly decreased by 18%. The most common adverse events observed in this elderly population were not different from those seen in younger pts. No toxic death was recorded. Main toxicities were neutropenia (Grade 3/4: 73% of pts), constipation (all grade: 63%) and asthenia (all grade: 56%), without any relationship between the observed incidence and the ageing of pts.Conclusion: Based on PK and safety data, a dose reduction at 280mg/m² and 250mg/m² is recommended in pts 75–80y and ≥80y respectively.First Asian Congress on Cancer in Older Patients Kuching, Malaysia 22–23rd January 2011
Abstract: SIOG 2011-First Asian Congress on Cancer in Older Patients organized by Sarawak Hospice Society, was held in Kuching, Sarawak, Malaysia from 22 to 23rd January 2011 under the chair of Riccardo A. Audisio and Matti A. Aapro. The meeting was accredited by ACOE and ESMO and endorsed by UICC and ESSO and first to be held in Asia.The congress was well attended with 500 participants from 16 countries. The participants included doctors, nurses, pharmacists and X-ray technologists. The topics included the global and South East Asian perspective on older patients, under treatment, clinical assessment tools, surgical treatment of breast, lung and esophageal cancers, supportive care for breast cancer, cultural barriers in Malaysia, newer radiotherapy techniques that can be used in older patients, targeted treatment of lung, colorectal cancers and hematology. Preliminary findings of using the Groningen Frailty Index in an Asian oncology patient population were presented. An interesting topic on the cultural barriers to cancer care in the elderly from the three ethnic groups in Sarawak was presented. The findings revealed the challenges faced by the public as well as the healthcare professionals. The topics discussed were relevant to the local needs of the participants so that they could apply the knowledge when they returned home.The Meeting Highlights collect the views of the panelists: to update on the cutting edge of present knowledge, in order to improve our understanding of the malignant disease affecting the senior patients and its implication in the Asian setting and to optimize the management.Determination of an adequate screening tool for identification of vulnerable elderly head and neck cancer patients treated with radio(chemo)therapy
Abstract: Objectives: We evaluated two proposed screening tools, the Vulnerable Elders Survey-13 (VES-13) and the G8, to identify patients who could benefit from a comprehensive geriatric assessment (CGA).Materials and Methods: All consecutive patients aged ≥65years with primary head and neck cancer were assessed with VES-13, G8 and CGA. Receiver operating characteristics (ROC)-analysis was used to determine diagnostic performance of both screening instruments.Results: Fifty-one patients were recruited, of which 39.2%, 66.7% and 68.6%, were defined vulnerable when evaluated with VES-13, G8 and CGA, respectively. The area under the ROC-curves (AUC±SE) of VES-13 (0.889±0.045) and G8 (0.909±0.040) did not significantly differ (P=0.7083). A sensitivity and specificity of respectively 57.1% and 100% for VES-13 (cut-off ≥3) and 85.7% and 75.0% for G8 (cut-off ≤14) was obtained. The combined score “VES-13+(maximum-G8)” (AUC=0.971±0.019) showed a superior AUC to G8 (P=0.0242) and VES-13 (P=0.0237). The most optimal cut-off score of 5 for the combined test resulted in a sensitivity of 91.4% and a specificity of 93.8%. Positive and negative predictive values were 100% and 51.6%, 88.2% and 70.6%, and 97.0% and 83.3% for the VES-13, G8 and combined test respectively.Conclusion: Both tools were found to have good diagnostic performance. However, at the proposed cut-off scores, our data suggest the G8 as the most optimal screening tool. Moreover, the combined tool could represent an interesting alternative.Understanding the link between cancer and neurodegeneration
Abstract: There is growing evidence that cancer shares a number of biological pathways with common neurodegenerative diseases of aging. In epidemiologic studies, Parkinson's and Alzheimer's disease seem to be associated with a decreased cancer risk. Genes associated with neurodegeneration have important functions in protein folding and processing, but often play a role in the cell cycle. Activation and deregulation of the cell cycle is a core feature of both diseases; in the neuron, the end result is apoptosis, while in the malignant cell, it is uncontrolled proliferation. Successful aging requires a careful balance between the forces that promote tissue renewal and those that suppress the cell cycle. Proteins such as p53 and Pin1 might explain why some individuals are relatively protected from cancer but at increased risk of neurodegeneration. This article reviews the available epidemiologic evidence linking neurodegenerative disease and cancer, discusses the cellular pathways and genes which might account for this unexpected relationship, and explores the potential therapeutic implications of this area of research.Oncology Tube
Thought Leader Conversations with A. Oliver Sartor, MD
Filmed during IMER's "Expert Video Viewpoints on Castration-Resistant Prostate Cancer: Care Across the Continuum" Video Viewpoint. IMER's medical director Dr. Libia Scheller speaks with A. ...
Author: imeronline
Added: 02/13/2012
Thought Leader Conversations with Leonard G. Gomella, MD, FACS
Expert Video Viewpoints on Castration-Resistant Prostate Cancer: Care Across the Continuum" Video Viewpoint. IMER's medical director Dr. Libia Scheller speaks with Leonard G. Gomella, MD, FACS ...
Author: imeronline
Added: 02/13/2012
Thought Leader Conversations with Emmanuel Antonarakis, MBBCh
Filmed during IMER's "Expert Video Viewpoints on Castration-Resistant Prostate Cancer: Care Across the Continuum" Video Viewpoint. IMER's medical director Dr. Libia Scheller speaks with Emm...
Author: imeronline
Added: 02/13/2012
New Cancer Mentality: Dr. David Stewart- Regulations leading to Impeded Progress in Cancer (Part 1)
Dr. David Stewart discusses many aspects of Cancer that he feels need to be changed to make more progress in the field. He also discusses the importance of genetic testing before putting patients into...
Author: davidfarzam
Added: 02/13/2012
Treating Liver Metastases with Hepatic Arterial Infusion Therapy
Hepatic arterial infusion (HAI) therapy is a method for treating liver metastases in patients with colorectal cancer. In HAI therapy, doctors implant a pump inside the patient that delivers chemothera...
Author: mskcc
Added: 02/08/2012
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