Dr. Raghavan is to be commendedfor a concise andcomprehensive overview ofthe management of germ cell tumors.As he suggests, given the demographicsof this relatively uncommon diseaseand the high cure rate that canbe achieved with proper treatmentand follow-up, it behooves us to maintainthese excellent results, even whilestriving to reduce the toxicity of treatment.We will highlight a few additionalpoints to complement thissuperb review.
WASHINGTON-Testicular cancer is a highly curable disease, but many of the young men who survive it are left with fatigue, loss of libido, depression, and weight loss due to low testosterone levels. This has usually been treated with painful, deep intramuscular injections of an oil-based testosterone preparation every 2 to 3 weeks. Testosterone patches were developed as an alternative but cause skin rashes in some patients.
Drs. Lieberman and Schold have presented a comprehensive up-to-date review of paraneoplastic syndromes affecting the nervous system. The points are all well made, but a few deserve special comment:
Paraneoplastic disorders of the nervous system are important to the practicing oncologist, because these syndromes, although uncommon, produce significant neurologic dysfunction and disability. The neurologic disorder may be the first manifestation of an unrecognized systemic malignancy, and appropriate diagnosis of the paraneoplastic disorder can lead to a focused search for an underlying cancer. Paraneoplastic disorders may involve any component of the central or peripheral nervous system, and diagnosis requires careful neurologic assessment. The diagnosis is made by recognition of clinical neurologic syndromes and the use of selected laboratory studies as indicated by the clinical picture. Over the past 10 years, the application of molecular biologic techniques to the study of these disorders has elucidated much about the mechanisms that cause neurologic injury. In most cases, disordered humoral and cellular immunity has been demonstrated, and the role of novel targets for autoimmune attack is being clarified. For some paraneoplastic disorders, treatment of the underlying tumor may lead to improvement of the neurologic disorder. For others, various forms of immunosuppressive therapy may be indicated. Unfortunately, for several of the more common paraneoplastic syndromes such as paraneoplastic cerebellar degeneration or limbic encephalitis, treatment is still unsatisfactory, and further research into the exact pathophysiology is clearly needed. [ONCOLOGY 16:1539-1556, 2002]
The first descriptions of neurologic disorders in patients with cancer identified those who had peripheral neuropathy. Most neurologists thought these patients actually had a peripheral neuropathy secondary to the inanition associated with their cancer. Still other patients clearly had peripheral neurologic damage from chemotherapy (eg, vincristine).
WASHINGTON-President Bush has named LaSalle D. Leffall, Jr., MD, of Howard University College of Medicine, to head the President’s Cancer Panel (PCP), and John E. Niederhuber, MD, of the University of Wisconsin School of Medicine, to chair the National Cancer Advisory Board (NCAB).
WASHINGTON-The incidence of testicular cancer, which predominantly targets young men aged 15 to 35, has nearly doubled in the past 70 years and continues to increase. Few in the vulnerable age group, however, are aware of the simple
PHILADELPHIA-Energy conservation and activity management training (ECAM) reduces fatigue levels and helps patients maintain normal activities despite treatment-related fatigue, Andrea M. Barsevick, RN, DNSc, reported. Dr. Barsevick is director of nursing research and education at Fox Chase Cancer Center in Philadelphia.
NEW YORK-The invention of the manufactured cigarette in Cuba in 1875 sparked "the manmade epidemic of lung cancer" and other smoking-related diseases that emerged in the 20th century, said Prof. Peter Boyle, director of the Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
ST. PETERSBURG, Florida-As cancer survival increases, outcomes research must focus on both quality of life and length of survival, and must define and quantify late effects of cancer treatment, Noreen Aziz, MD, PhD, MPH, said at the Late Effects of Normal Tissues (LENT) IV workshop on late effects criteria and applications.
Only a few studies have assessed the economic outcomes of palliative therapy. The major areas of interest include hospice care, the process and structure of care, symptom management, and palliative chemotherapy
ORLANDO-Patients with primary testicular lymphomas treated with CHOP plus intrathecal methotrexate and scrotal radiotherapy had no testicular or central nervous system (CNS) relapses in pilot study data reported by researchers from
A 60-year-old attorney presents with chronic heartburn and regurgitation. His symptoms have steadily increased over the last 2 years, and he is currently using daily therapy with a proton pump inhibitor. There is no history of gastrointestinal bleeding, dysphagia, or weight loss.
It has been roughly 20 years since chemotherapy dose escalation was proposed as a possible strategy for improving outcomes in patients with breast cancer.[1,2] This concept has sustained a series of remarkable rollercoaster-like controversies, with heated arguments at national meetings, substantial lay press coverage, patients suing their insurance companies seeking coverage, legislative fiats requiring third-party payment long before critical data were available, and a well-publicized episode of clinical scientific fraud that is nearly unprecedented in its audacity. How did we get here from there?
A new bill called the Men’s Health Act of 2001 aims to focus more attention on diagnosing and treating men with prostate cancer. Rep. Randy Cunningham’s (R-Calif) Men’s Health
The National Cancer Institute’s Dr. Robert Biggar has probably studied the impact of the acquired immunodeficiency syndrome (AIDS) epidemic on cancer trends at least as thoroughly as anyone in the field. His long-term experience is reflected in this comprehensive and well-written overview, which summarizes the evidence concerning highly active antiretroviral therapy (HAART). Indeed, patients are developing fewer opportunistic infections and living significantly longer than they did before the advent of these potent anti-human immunodeficiency virus (HIV) drugs. However, the question remains as to what extent this treatment might also change the incidence of cancers?
Highly active antiretroviral therapy (HAART) has shown great efficacy in reducing human immunodeficiency virus levels, increasing immunity, and prolonging the survival of persons with acquired immunodeficiency
Drs. Wooldridge, Anderson, and Perry have succinctly reviewed the use of corticosteroids in patients with advanced cancer. The common uses of corticosteroids-namely, the treatment of nausea and vomiting, hypersensitivity reactions, and appetite stimulation-are well covered. In addition, the use of corticosteroids for the treatment of spinal cord compression and bone pain are also reviewed. The authors provide a definitive summary of the available published literature.
PHILADELPHIA-To date, epidemiologic studies looking for a link between adult diet and cancer risk have proved disappointing. But research focusing on in utero nutrition and preschool and adolescent diet may be more fruitful, suggests Karin Michels, ScD, an epidemiologist and assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.
Testicular cancer is a highly curable cancer. However, 30% of patients are refractory to standard therapy and will need additional therapy. This article focuses on the use of high-dose chemotherapy in germ-cell tumors.
Testicular cancer is a highly curable cancer. However, 30% of patients are refractory to standard therapy and will need additional therapy. This article focuses on the use of high-dose chemotherapy in germ-cell tumors.
Testicular cancer is a highly curable cancer. However, 30% of patients are refractory to standard therapy and will need additional therapy. This article focuses on the use of high-dose chemotherapy in germ-cell tumors.
Testicular cancer is a highly curable cancer. However, 30% of patients are refractory to standard therapy and will need additional therapy. This article focuses on the use of high-dose chemotherapy in germ-cell tumors.
Thrombocytopenia occurs at various grades of severity in patients with nonmyeloid malignancies undergoing chemotherapy with myelosuppressive agents. Frequently, it is the major dose-limiting hematologic toxicity, especially in the treatment of potentially curable malignancies such as leukemia, lymphomas, and pediatric cancers.
Venous thromboembolism is a common complication in patients with cancer. The management of deep-vein thrombosis and pulmonary embolism can be a considerable challenge in these patients. Diagnosing venous
