According to American Cancer Society (ACS) estimates, more than 46,930 new cases of endocrine neoplasms will be diagnosed in the United States in 2010, and approximately 2,570 deaths will result from... More »
A 28-year-old male has suffered from fever of unknown origin, high blood pressure, diarrhea, and rapid heart rate for several years. Examination revealed enlarged cervical lymph nodes and thyroid... More »
AstraZeneca today announced that the orphan drug vandetanib is now available to U.S. patients for the treatment of medullary thyroid cancer that cannot be removed by surgery or that has spread to... More »
Pazopanib represents a therapeutic option for patients with advanced differentiated thyroid cancers. A phase II trial conducted at the Mayo Clinic in Rochester, Minn., included 39 patients with... More »
Current treatment methods may offer little more than overtreatment, while follow up should not automatically mean expensive and unnecessary tests. More »
TORONTO—Two large, population-based studies with over 35 years of data revealed some of the factors that have influenced the incidence of thyroid cancer. Two key findings: Canadian men and people... More »
Lymphatic metastasis in papillary thyroidcancer (PTC) is eminent; however, the extent of central compartment lymph nodes dissection (CCD) is controversial and requires the knowledge of pattern and risk factors for central compartment lymph nodes metastasis (CCM). We did a prospective study of 47 cases with PTC who underwent total thyroidectomy (TT) with CCD with/without lateral lymph nodes dissection (LND). Clinicopathological profile including CCM as ipsilateral and contralateral was documented. On histopathology, the mean tumour size was 3.57 2.42cm 59.6% had CCM, which was bilateral in the majority (60.72%). The tumour-size was the most important predictor for lymph nodes metastasis-(P=0.018) whereas multicentricity-(P=0.002) and ipsilateral CCM-(P=0.001) were the predictors for contralateral CCM. The long-term morbidity of CCD done in primary setting is comparable with TT-alone. Bilateral CCD should be done with thyroidectomy in PTC, otherwise the risk of residual diseases
The incidence of thyroidcancer has doubled over the past decade. The reason for this dramatic increase in incidence is controversial. Some investigators have suggested that the increased incidence is because of increased detection of small primary tumors as a result of diagnostic scrutiny. Conversely, some investigators have demonstrated an increased incidence across all tumor sizes, suggesting that other factors may play a role. This study was undertaken to investigate the clinical, pathologic, and molecular changes present in papillary thyroidcancer over a 15-year period during which the incidence of papillary thyroidcancer doubled.|A total of 628 patients with conventional papillary thyroidcancer and 228 tumor samples from a single institution were analyzed from 1991 to 2005. Time-trend analyses of demographic, clinical, pathologic, and tumor genotype were performed over three 5-year time periods: group I (1991-1995), group II (1996-2000), and group III (2001-2005).|The authors
5-Aminoimidazole-4-carboxamide-ribonucleoside (AICAR) is an activator of 5'-AMP-activated protein kinase (AMPK), which plays a role in the maintenance of cellular energy homeostasis. Activated AMPK inhibits the protein kinase mechanistic target of rapamycin, thereby reducing the extent of protein translation and suppressing both cell growth and cell cycle entry. Recent reports indicate that AMPK-mediated growth inhibition is achieved via an action of the RAF-MEK-ERK mitogen-activated protein kinase pathway in melanoma cells harboring the V600E mutant form of the BRAF oncogene. In this study, we investigated the anti-cancer efficacy of AICAR by measuring its effects on proliferation, apoptosis, and cell cycle progression of BRAF wild-type and V600E-mutant thyroidcancer cell lines. We also explored the mechanism underlying these effects. AICAR inhibited the proliferation of BRAF V600E-mutant thyroidcancer cell lines more strongly than was the case with wild-type cell lines. The
American Thyroid Association guidelines currently recommend the selective use of radioactive iodine (RAI) therapy in patients with well differentiated thyroidcancer (WDTC). Despite these guidelines, RAI ablation has been used routinely in all but the very lowest risk patients with thyroidcancer over the last 30 years. The objective of this study was to evaluate patterns of RAI use and elevated risk of secondary primary malignancies (SPM) in patients with low-risk (T1N0) WDTC.|The Surveillance, Epidemiology, and End Results (SEER) database was used to analyze trends in RAI use over time in the United States. To determine the excess risk of SPM, the standardized incidence ratio (SIR) and excess absolute risk (EAR) of various cancers were calculated in the 2 cohorts. Between 1973 and 2007, 37,176 patients with WDTC were followed in the SEER Program, equating to 408,750 person-years at risk (PYR). In total, 14,589 patients received RAI, and SPMs were observed in 3223 patients.|During
Emerging evidence suggests that Ret oncoproteins expressed in medullary thyroidcancer (MTC) might evade the pro-apoptotic function of the dependence receptor proto-Ret by directly impacting the apoptosis machinery. Identification of the molecular determinants of the interplay between Ret signaling and apoptosis might provide a relevant contribution to the optimization of Ret-targeted therapies. Here, we describe the cross-talk between Ret-M918T oncogenic mutant responsible for type 2B multiple endocrine syndrome (MEN2B), and components of death receptor-mediated extrinsic apoptosis pathway. In the human MEN2B-type MTC cell line MZ-CRC-1 expressing Ret-M918T, Ret was found associated with Fap-1, known as inhibitor of the CD95 death receptor trafficking to the cell membrane, and with procaspase-8, the initiator pro-form caspase in the extrinsic apoptosis pathway. Cell treatment with the anti-tumor Ret kinase inhibitor RPI-1 inhibited tyrosine phosphorylation of procaspase-8, likely
The management of patients with colorectal cancer that has metastasized to the liver is a common clinical problem. The general poor outcome for patients with metastatic
Hormone Replacement and Breast Cancer Risk: The Authors Reply Dan Labriola, ND
Kathleen Pratt, ND
Patrick Bufi, ND
Northwest Natural Health®, A Specialty Care Clinic
and Swedish Cancer Institute,
Swedish Medical Center
Seattle, Washington , November 12, 2009
Our commentary in the July 2009 issue of ONCOLOGY concluded that the current level of evidence for safety and efficacy of “natural” hormone replacement therapy (NHRT) is not conclusive.
Hormone Replacement and Breast Cancer Risk: Reconsidering the Data William T. Creasman, MD
Department of Obstetrics and Gynecology
Medical University of South Carolina
Charleston, South Carolina
Philip J. DiSaia, MD
Department of Obstetrics and Gynecology
University of California, Irvine
Irvine, California, November 12, 2009
In their recent commentary (Oncology 23:639-641, 2009), Labriola and colleagues reviewed the data on “natural” hormone replacement and breast cancer risk.
New Menus for CLL Treatment Michael Hallek, MD
Director, Clinic I for Internal Medicine
University of Cologne
Cologne, Germany, November 11, 2009
Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with an extremely variable course. Survival after diagnosis can range from months to decades
John G. Gribben, MD, DSc
Professor of Experimental Cancer Medicine
Institute of Cancer
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
London, United Kingdom
, November 11, 2009
One of the greatest challenges facing the physician caring for patients with chronic lymphocytic leukemia (CLL) is the heterogeneity of this disease. Over the past decade, there have been major advances in understanding the pathophysiology of CLL, and in the identification of biomarkers that are helpful to predict the clinical course for individual patients. Over the same period, the available therapeutic options have developed dramatically, exemplified by the introduction of combination therapy with purine analogs and monoclonal antibodies, resulting in significant opportunities to induce complete remission (CR) in CLL patients.
Matthew Kaufman, MD
Assistant Professor
Department of Medicine
Division of Hematology-Oncology
Albert Einstein College of Medicine
Long Island Jewish Medical Center
Jason Rubin, MD
Fellow
Department of Medicine
Division of Hematology-Oncology
Long Island Jewish Medical Center
Kanti Rai, MB, BS
Professor
Department of Medicine
Division of Hematology-Oncology
Albert Einstein College of Medicine
Long Island Jewish Medical Center
New Hyde Park, New York
, November 11, 2009
Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the Western hemisphere. Both the Rai and Binet staging systems have been important clinical tools for predicting outcomes of this heterogeneous disease.
Further Considerations About Lymphoblastic Lymphoma Yasser Abou Mourad, MD
Michael Barnett, BM, FRCPC, FRCP, FRCPath
Leukemia/Bone Marrow Transplant Program of British Columbia
Vancouver General Hospital
British Columbia Cancer Agency
University of British Columbia
Vancouver, Canada, November 10, 2009
Lymphoblastic lymphoma (LBL) is a rare disease, most commonly of T-cell origin, that shares biologic features with acute lymphoblastic leukemia (ALL). Indeed, LBL and ALL are considered a
Lymphoblastic lymphoma (LBL) is a rare disease, comprising about 2% of all non-Hodgkin lymphomas (NHLs) in adults.[1] It is a highly aggressive subtype of lymphoma, most commonly of precursor T-cell origin, occurring most frequently in adolescents and young adults, with male predominance and frequent mediastinal, bone marrow, and central nervous system (CNS) involvement.
Thomas B. Julian, MD
Associate Director, Breast Care Center
Allegheny General Hospital
Associate Professor, Human Oncology
Drexel University College of Medicine
Yongbok Kim, MD
Senior Medical Physicist
Department of Radiation Oncology
Allegheny General Hospital
Assistant Professor
Drexel University College of Medicine
E. Day Werts, PhD
System Director, Education and Clinical Research
Department of Radiation Oncology
Allegheny General Hospital
Drexel University College of Medicine
David Parda, MD
Chairman, Department of Radiation Oncology
Allegheny General Hospital
Associate Professor, Radiation Oncology
Drexel University College of Medicine
Pittsburgh, Pennsylvania, October 23, 2009
Repeat lumpectomy and retreatment radiotherapy following ipsilateral breast tumor recurrence (IBTR) by either external-beam irradiation or brachytherapy in lieu of salvage mastectomy is an area of significant recent clinical interest. Multiple authors have reported their results, with encouraging numbers of patients avoiding mastectomy.
Active Surveillance: Not Your Father’s Watchful Waiting David F. Penson, MD, MPH
Professor of Urologic Surgery
Director, Vanderbilt Center for Surgical Quality and Outcomes Research
Department of Urologic Surgery
Institute of Medicine and Public Health
Vanderbilt University
Nashville, Tennessee , October 13, 2009
Active surveillance is becoming a very reasonable and appropriate “treatment” strategy for men with low-risk localized prostate cancer, as Large and Eggener eloquently describe in this review article.
Scott E. Eggener, MD
Assistant Professor, Section of Urology
University of Chicago Medical Center
Chicago, Illinois , October 13, 2009
There is no universally accepted strategy for the screening, diagnosis, and treatment of prostate cancer. However, once a patient is diagnosed, his risk of cancer progression may be estimated using serum prostate-specific antigen (PSA), biopsy findings, and clinical stage.
Martin G. Sanda, MD
Director, Prostate Cancer Center
Urology Division
Department of Surgery
Beth Israel Deaconess Medical Center
Associate Professor of Surgery
Harvard Medical School
Boston, Massachusetts, October 13, 2009
Standard treatment options for prostate cancer patients include surveillance, surgery, external-beam radiotherapy, brachytherapy, the combination of external-beam and brachytherapy, and the combination of radiotheraputic modalities with hormonal therapy, for appropriately chosen patients.
Eric A. Klein, MD
Chairman, Glickman Urologic and Kidney Institute
Cleveland Clinic
Cleveland, Ohio, October 13, 2009
As treatments for prostate cancer, brachytherapy and surgery share logistics in that they both involve a procedure that may be performed in one intervention. Beyond that, one sees similarities and differences depending on the point of comparison being examined.
Breast-conservation therapy (BCT) is a well-characterized treatment for early-stage breast cancer that has been studied for decades. The risk of local recurrence following BCT for invasive breast cancer ranges from 8.8% to 14.3% at 20 years.[
'What They Should Really Teach in Medical School' Julie Schopps, MD , February 6, 2012 The North Carolina-based pediatrician weighs in on why she thinks the real learning doesn't take place until students are out of the classroom.
Improve EHR Systems by Rethinking Medical Billing Daniel Essin, MA, MD, February 6, 2012 Separating billing-related data from other clinical documentation and transmitting it to a billing system is not difficult …no matter how the charting is done.
The combined-modality care of the patient with colon or rectal cancer metastatic to the liver demands a team approach. It is little wonder that there is much confusion about this topic, given the number of unique treatment options that are delivered in a sequential and reiterative process.
