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ONCOLOGY Vol 23 No 2

The patient is a 39-year-old man who presents with pelvic lymphadenopathy. He has a history of ureteral reflux disease, recurrent nephrolithiasis, right nephrectomy, ileal loop diversion of the left ureter, and radical cystectomy for “bladder cancer,” which he underwent 3 years ago. The lymphadenopathy was discovered incidentally during recent imaging.

The review by LoRusso is a critical update to what could be considered the most significant dermatologic toxicity in modern oncology. This increased importance of dermatologic toxicities to epidermal growth factor receptor (EGFR) inhibitors can be attributed to several factors: 45% to 100% of patients will develop a papulopustular rash; the rash occurs in cosmetically sensitive areas (the face and upper trunk); it is associated with symptoms of pain and pruritus; and superinfections occur in approximately 30% of patients receiving these agents-all of which lead to dose modification by 76% and discontinuation by 32% of oncologists.

Historically, breast tumor classification and therapeutic decisions have relied on immunohistochemical (IHC) techniques for characterizing biomarkers such as estrogen receptor (ER), progesterone receptor (PR), and the epidermal growth factor receptor 2 (HER2), as described in the review by Ma and colleagues. However, these markers have been found to be inadequate for fully predicting a patient’s response to a given breast cancer treatment such as endocrine therapy.

States population will be over 65 years old, with 2% of the population over 84. The corresponding projections for 2050 are 21% and 5%, respectively.[1] These projections underscore the aging of the population, with most recent estimates of life expectancy hitting a record high of 78.1 years.[2] With Americans living longer than ever before, physicians are already seeing larger numbers of elderly patients with cancers whose incidence increases with age, including colon cancer.

The Hippocratic principle of not harming the patient has remained up to this day an undisputed dogma in medicine. It reminds the physician of the possible detrimental, if not lethal, outcome of the treatment he prescribes and implicitly enforces good medical practice, although the true impact will unlikely be known. Oncology is one subspecialty of Medicine where this dilemma-ie, the pros and cons of treatment-is continuously put to the test, as the physician must decide on treatment for an often life-threatening illness while taking into account individual factors such as the patient’s will, performance status, available standard treatment options, and possible experimental approaches.

Acai demonstrated antioxidant and apoptotic effects in in vitro and in vivo studies, but no human studies have been conducted. Despite the lack of supportive data, acai, like many herbal products, is promoted to cancer patients on the ­Internet, often with false claims of cure.