The goals of care for patients with hormone receptor (HR)-positive advanced breast cancer include prolongation of disease-free and overall survival, amelioration of symptoms, and improvement in quality of life.

A considerable number of women with breast cancer are diagnosed during their reproductive years. In the short period of time in which newly diagnosed women will need to make decisions about surgical options and adjuvant therapy, younger women with breast cancer also face the potential impairment or complete loss of their fertility.

The Case: A 48-year-old perimenopausal woman noted a lump in her left breast. She had had a mammogram 9 months earlier without abnormality. After ultrasound imaging confirmed a solitary mass measuring about 1.5 cm, a core needle biopsy demonstrated a poorly differentiated mammary carcinoma with chondroid features.

In my experience, being treated for low-volume Gleason 6 tumors is the norm, not the exception, for men in the United States. Surveillance may be discussed as an option, but it is not taken seriously.

The concept of active surveillance is based on the observation that Gleason 6 (pattern 3) prostate cancer is an indolent condition that poses little or no threat to the patient’s life. Conservative management is thus appropriate for these patients.

I looked after one of my partner’s patients who is approaching death from advanced, refractory ovarian cancer. She asked me not to talk about anything negative with her. We can’t really make any decisions without discussing negative things. Should I just remain silent about them at her request?

Ongoing studies are attempting to understand the reasons that tumor cells engage in aerobic glycolysis in lieu of oxidative phosphorylation. In this review, we discuss known benefits to tumor cells from this metabolic switch, and we highlight key enzymes that play a role in aerobic glycolysis. We also describe novel therapeutic options targeting glucose metabolism.
• Metabolic Synthetic Lethality
• Finding the Right Target(s) in the Context of Tumor Heterogeneity, Evolution, and Metabolic Plasticity

DLBCL of any stage remains a systemic disease with early hematogenous spread. Thus, arguments advocating the role of IFRT do not truly address disease biology, and all future efforts to cure patients will require improved systemic therapy.

If systemic treatment is effective enough to reliably control not only microscopic but also bulky disease, there will be little role for radiotherapy. And if systemic treatment cannot even reliably control microscopic disease, let alone macroscopic disease, there will be little role for radiotherapy, either. However, there are patients who fall into neither of these categories, and in them radiotherapy may well have a role.

This review will describe the well-known use of VEGF antibodies; the current uses of EGFR and ALK tyrosine kinase inhibitors; newer agents being used against MET, FGFR, and other intracellular targets; insights regarding the field of immunotherapy in lung cancer; and finally, newer developments in chemotherapy.
• Lessons From Considering the Cancer Landscape
• Adapting to the Brave New World of Lung Cancer Treatment

Nurses from a New Jersey cancer center have adapted several key plans from the CDC, ONS, and other societies to create a comprehensive infection-control plan.

In this interview, Laura Zitella will be discussing challenges and considerations for management and prevention of infection in the oncology setting—in both patients with solid tumors and those with hematologic malignancies.

A team of nurses and physicians from Huntsman Cancer Institute successfully implemented key changes in their Patient Acute Change Team that increased nurse involvement and reduced the number of codes by 90% in the outpatient setting since they were put in place 2 years ago.

Oncology nurses from a community hospital in Cincinnati, Ohio implemented a two-pronged process for the safe handling of chemotherapy, improving nurses’ satisfaction and comfort levels regarding chemotherapy safety.

This interview covers standards for healthcare provider competency in offering comprehensive genetic services, and highlights genetics/genomics resources for nurses.