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Exercise After Cancer Diagnosis: Time to Get MovingExercise and physical activity are beneficial along the spectrum of care in cancer patients. However, much more research is needed to better understand this association and guide recommendations for patients.
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Continuous Low-Dose GM-CSF as Salvage Therapy in Refractory Recurrent Breast or Female Genital Tract CarcinomaGranulocyte-macrophage colony-stimulating factor (GM-CSF,sargramostim [Leukine]) is a powerful cytokine that is able to stimulatethe generation of dendritic cells. Adjuvant treatment with continuous lowdoseGM-CSF has been shown to prolong survival of stage III/IV melanomapatients. Data on continuous low-dose GM-CSF therapy in tumorsother than prostate cancer are still lacking.
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POINT: Is Lymphadenectomy Required in Endometrial Cancer for Adequate Surgical Staging?The diagnostic benefits of SLN evaluation include an ability to identify the extent of tumor dissemination and the utility of SLN mapping in guiding targeted adjuvant treatment in high-risk patients.
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Herb-Drug Interactions in Cancer CareIn this article, we describe the mechanisms via which interactions between herbs and prescription drugs may occur, and highlight four popular herbs and a medicinal mushroom commonly used by cancer patients, along with reports of their interactions with standard drugs.
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Face-Off: Award Presentation CeremonyFollowing a spirited debate, Joshua K. Sabari, MD, presents the winning team with the coveted title of victors of this CancerNetwork® Face-Off event.
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Encouraging Improvement in Cytopenias of Patients With Myelodysplastic Syndromes With ThalidomideMyelodysplastic syndrome patients present with variable cytopenias even though their bone marrows are generally hypercellular. Excessive cytokine-induced apoptosis of hematopoietic cells in the marrows has been proposed as a possible
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Efficiency of In Vivo Purging With Rituximab Followed by High-Dose Therapy With Autologous Peripheral Blood Stem Cell Transplantation in B-Cell Non-Hodgkin’s Lymphomas: A Single-Institution StudyHigh-dose therapy (HDT) with peripheral blood stem cell transplantation is a treatment option for patients with advanced follicular, marginal, and mantle cell lymphoma. In this setting, frequent contamination of peripheral blood stem cell harvests by
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PCR Analysis for the t(14;18) Translocation in Patients With Recurrent Follicular Lymphoma Following Immunotherapy With Rituximab (IDEC-C2B8)The chimeric monoclonal anti-CD20 antibody rituximab (Rituxan) has been shown to have clinical activity in patients with
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In Vivo Purging With Rituximab Prior to Stem Cell Collection Is Associated With Persistent Molecular Evidence of t(14;18) That Often Disappears Post-Transplant in Patients With Follicular LymphomaWe previously reported that “in vivo purging” with rituximab (Rituxan) during stem-cell collection is safe and does not adversely affect engraftment. We now report on our transplant experience with rituximab. From June 1998 to December
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In Vivo Purging With Rituximab Prior to Stem Cell Collection Is Associated With Persistent Molecular Evidence of t(14;18) That Often Disappears Post-Transplant in Patients With Follicular LymphomaWe previously reported that “in vivo purging” with rituximab (Rituxan) during stem-cell collection is safe and does not adversely affect engraftment. We now report on our transplant experience with rituximab. From June 1998 to December
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Commentary (Pierson): Detection of Nodal Micrometastases in Head and Neck Cancer by Serial Sectioning and ImmunostainingDrs. Ambrosch and Brinck appropriately emphasize the problems and limitations encountered when using routine pathologic procedures to examine lymph nodes from head and neck cancer specimens. Extraordinary processing techniques have repeatedly yielded a larger number of small nodes and, on occasion, have demonstrated the presence of micrometastases. The majority of these observations come from examination of breast specimens and their axillary dissections. Labor-intensive clearing techniques have varied to some extent, but generally involve progressive removal of opaque fat with alcoholic solvents of increasing percentages culminating in absolute alcohol (100%). Final visualization involves submerging the defatted specimen in cedarwood oil, followed by careful examination and dissection of the backlighted specimen.
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Iodine-131 Tositumomab for Patients With Low-Grade or Transformed Low-Grade Non-Hodgkin’s Lymphoma: Complete Response DataTositumomab/iodine-131 tositumomab (Bexxar) is a radioimmunotherapeutic agent in development for patients with low-grade or transformed non-Hodgkin’s lymphoma (NHL). This analysis focuses
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Measuring the Cost-Effectiveness of Cancer CareHistorically, new therapeutic strategies for cancer have been evaluated on the basis of safety and clinical efficacy. However, the current national emphasis on efficiency of resource allocation has led to the inclusion of economic assessments in oncology studies. Economic assessments measure patients' health status and resource consumption associated with a therapeutic strategy, and combine these in a cost-effectiveness analysis. Study design can include prospective analysis of clinical trials, retrospective analysis of a clinical trial or administrative databases, or a decision analytic model. Economic analysis is being used increasingly in oncology and will continue to provide meaningful data to assist clinicians in determining the optimal treatment strategies for cancer patients and to help inform health policy decision-makers about the importance of specific cancer therapeutic strategies. [ONCOLOGY 9(6):523-538, 1995]
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Consolidation TherapyWe previously reported the efficacy of concurrent cisplatin (Platinol)/etoposide (PE) and radiotherapy in stage IIIB non–small-cell lung cancer in which biopsy confirmation of T4 (noneffusion) or N3 status was required (S9019). In view of the activity of docetaxel (Taxotere) as second-line therapy and potential molecular mechanisms of action favoring taxane sequencing, we designed the present study to maintain a core of concurrent PE/radiotherapy, but to substitute docetaxel consolidation for the two additional cycles of PE.
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The Role of PET-CT Fusion in Head and Neck CancerPositron-emission tomography(PET) and computed tomography(CT) fusion imaging is arapidly evolving technique that is usefulin the staging of non–small-celllung cancer (NSCLC), Hodgkin’s disease,ovarian cancer, gastrointestinalstromal tumors, gynecologic malignancies,colorectal malignancies,and breast cancer. In their article,Rusthoven et al[1] describe the roleof PET-CT in head and neck malignanciesand include a review of allcurrently available literature. Accordingto the authors, PET-CT is usefulfor staging head and neck carcinomasand for target volume delineation duringradiation treatment planning.
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Childhood Cancer Survivors: Cured but With Long-Term Health RisksThis evolving issue is increasingly concerning, as studies regarding the causes of non-relapse late mortality in childhood cancer survivors consistently include cardiovascular disease as one of the major contributors to this mortality risk.
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Dose-Dense and Sequential Strategies in Adjuvant Breast Cancer TherapySeveral attempts have been made to improve the survival rates of breast cancer patients. The benefit of adjuvant chemotherapy was clearly shown, but the absolute difference of 2% to 11% in overall survival, depending on the
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Consolidation TherapyWe previously reported the efficacy of concurrent cisplatin (Platinol)/etoposide (PE) and radiotherapy in stage IIIB non–small-cell lung cancer in which biopsy confirmation of T4 (noneffusion) or N3 status was required (S9019). In view of the activity of docetaxel (Taxotere) as second-line therapy and potential molecular mechanisms of action favoring taxane sequencing, we designed the present study to maintain a core of concurrent PE/radiotherapy, but to substitute docetaxel consolidation for the two additional cycles of PE.
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Indications for Selective Neck Dissection: When, How, and WhySelective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases. Others have advocated its use for patients with
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Progressive Red-to-Violaceous Papules and Plaques on the Neck and Abdominal Skin of a 70-Year-Old WomanA 70-year-old woman developed red-to-violaceous papules, plaques, and nodule- like skin lesions several months prior to her presentation. The skin lesions mostly involved her lower neck and abdominal area. What is the most likely diagnosis?
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Simultaneously Detected Bilateral Testicular Cancer of Different Histopathological OriginA 36-year-old male with a history of cryptorchidism of the right side, treated with orchidopexy at the age of 4, presented with bilateral testicular swelling. Investigations included laboratory workup, ultrasound of both testes, as well as CT-scan of the chest, abdomen, and pelvis. Initial treatment was bilateral orchiectomy.
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Adjuvant Trials of Toremifene vs Tamoxifen: The European ExperienceWhen results from the phase II trials of toremifene (Fareston) and tamoxifen (Nolvadex) in metastatic breast cancer were published, the Finnish Breast Cancer Group began to plan the first trial of toremifene in an adjuvant setting. This multicenter, randomized trial is comparing toremifene (40 mg/d) to tamoxifen (20 mg/d) in postmenopausal lymph node-positive breast cancer patients.
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The Challenges of Treating Lobular Carcinoma In SituOppong and King present a clear and concise review of the current data regarding lobular carcinoma in situ (LCIS) and discuss the rationale behind the current management recommendations for this disease.
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Clinical Presentation and Management of Hemolytic AnemiasThe hallmark of hemolysis is shortened red blood cell survival in the peripheral blood. Hemolysis results in anemia only when bone marrow cannot keep up with the rate of red cell destruction. Even though anemia is very commonly observed in most cancer patients, hemolytic anemias are rather rare.
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Combination Therapy for Advanced Breast Cancer: Cyclophosphamide, Doxorubicin, UFT, and TamoxifenWe evaluated combination therapy for advanced and recurrent breast cancer with cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), uracil and tegafur (UFT), and tamoxifen (Nolvadex) (CAUT), designed as
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Frontline CLL Therapy: Changes in ParadigmSignificant progress has been made in the treatment of chronic lymphocytic leukemia with the addition of options such as the tyrosine kinase inhibitor ibrutinib, the monoclonal antibody obinutuzumab, and the BCL2 inhibitor venetoclax.
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Non-Small-Cell Lung Cancer Adjuvant Therapy: Translating Data Into RealitySurgery remains the initial treatment for patients with early-stage non-small-cell lung cancer (NSCLC). Additional therapy is necessary because of high rates of distant and local disease recurrence after surgical resection. Early trials of adjuvant chemotherapy and postoperative radiation were often plagued by small patient sample size, inadequate surgical staging, and ineffective or antiquated treatment. A 1995 meta-analysis found a nonsignificant reduction in risk of death for postoperative cisplatin-based chemotherapy. Since then, a new generation of randomized phase III trials have been conducted, some of which have reported a benefit for chemotherapy in the adjuvant setting. The role of postoperative radiation therapy remains to be defined. It may not be beneficial in early-stage NSCLC but still may have utility in stage IIIA disease. Improvement in survival outcomes from adjuvant treatment are likely to result from the evaluation of novel agents, identification of tumor markers predictive of disease relapse, and definition of factors that determine sensitivity to therapeutic agents. Some of the molecularly targeted agents such as the angiogenesis and epidermal growth factor receptor inhibitors are being incorporated into clinical trials. Preliminary results with gene-expression profiles and lung cancer proteomics have been promising. These techniques may be used to create prediction models to identify patients at risk for disease relapse. Molecular markers such as ERCC1 may determine response to treatment. All of these innovations will hopefully increase cure rates for lung cancer patients by maximizing the efficacy of adjuvant therapy.
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Risk of Breast and Ovarian Cancer in Women With Strong Family HistoriesAssessing the risk of breast and ovarian cancer starts with obtaining a complete and accurate family history. This can reveal evidence of inherited cancer risk. The highest risk of cancer is associated with germ-line abnormalities
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Possible Interactions Between Dietary Antioxidants and ChemotherapyThe use of alternative therapies among cancer patients has increased dramatically since the 1970s. A recent review of published surveys found that anywhere from 7% to 64% of adult cancer patients were using such therapies.[1] Preliminary
