ONCOLOGY Vol 24 No 4 | Oncology

Capsaicin

April 15, 2010

Capsaicin, the active component derived from the fruit of capsicum, is used to relieve pain, to improve circulation, to treat cluster headaches and psoriasis, and for weight loss. Capsicum or cayenne pepper, a shrub prevalent in many tropical and subtropical climates, is an important ingredient of many cuisines around the world. It has been used in traditional medical systems as a remedy for digestive and circulatory problems, poor appetite, and to relieve muscle and arthritic pain. Capsaicin is currently available in capsule form and as an ingredient in topical creams.

Adjuvant Hormonal Therapy in Premenopausal Women With Operable Breast Cancer: Not-So-Peripheral Perspectives

April 15, 2010

While optimal adjuvant hormonal therapies for premenopausal women with operable breast cancer have yet to be defined, discussions and reviews of the state of the art and “areas of confusion” often fail to consider developments that are germane to keeping evidence-based clinical practice truly up-to-date.

Current Management of Nasal NK/T-cell Lymphoma

April 15, 2010

With better disease definition, staging, and monitoring, treatment of extranodal NK/T-cell lymphoma is becoming more rational. A large proportion of patients with localized nasal disease may enjoy prolonged disease-free survival. On the other hand, early HSCT or novel therapy may be recommended for aggressive extranasal disease.

Extranodal NK/T-cell Lymphoma: Basic Questions Remain

April 15, 2010

Extranodal natural killer/T-cell lymphoma (ENKTL), nasal type, is a distinct entity of non-Hodgkin lymphoma with interesting unique biologic and clinicopathologic features. The tumor is characterized by ethnic preponderance, a consistent association with Epstein-Barr virus (EBV) infection, peculiar histopathologic findings, and a predilection to affect primarily the upper aerodigestive tract, inclusive anatomically of the nasal cavity, nasopharynx, paranasal sinuses, oral cavity, hypopharynx, and larynx. The characteristic clinical features are nasal stuffiness, relentless, nonhealing ulcers, or symptoms due to obstruction of the aforementioned areas. Distant metastasis at time of diagnosis is uncommon.

Nasal NK/T-cell Lymphoma: Where Are We Now?

April 15, 2010

Since the creation of the World Health Organization’s nasal natural killer (NK)/T-cell lymphoma category, the attempt to further classify, describe, and improve treatment in this entity has been underway. There has been quite a bit of confusion and frustration regarding diagnosis, staging, and treatment approaches. With his article in this issue of ONCOLOGY, Dr. Au has attempted to improve our knowledge of current approaches to NK/T-cell lymphomas, providing a thorough and contemporary review of the clinical management of these difficult tumors. The following commentary reflects a deep appreciation for the author’s work and expands upon a few points not previously highlighted.

Management of Anal Cancer in 2010 Part 1: Overview, Screening, and Diagnosis

April 15, 2010

Although anal cancer is a rare disease, its incidence is increasing in men and women worldwide. The most important risk factors are behaviors that predispose individuals to human papillomavirus (HPV) infection or immunosuppression. Anal cancer is generally preceded by high-grade anal intraepithelial neoplasia (HGAIN), which is most prevalent in human immunodeficiency virus (HIV)-positive men who have sex with men. There is a general consensus that high-risk individuals may benefit from screening. Meta-analysis suggests that 80% of anal cancers could be avoided by vaccination against HPV 16/18. Nearly half of all patients with anal cancer present with rectal bleeding. Pain or sensation of a rectal mass is experienced in 30% of patients, whereas 20% have no tumor-specific symptoms. According to the Surveillance Epidemiology and End Results (SEER) database, 50% of patients with anal cancer have disease localized to the anus, 29% have regional lymph node involvement or direct spread beyond the primary, and 12% have metastatic disease, while 9% have an unknown stage. Clinical staging of anal carcinoma requires a digital rectal exam and a computed tomography scan of the chest, abdomen, and pelvis. Suspicious inguinal lymph nodes should be subject to pathologic confirmation by fine-needle aspiration. The 5-year relative survival rates are 80.1% for localized anal cancer, 60.7% for regional disease, and 29.4% for metastatic disease. Part 2 of this two-part review will address the treatment of anal cancer, highlighting studies of chemoradiation.

Breast Cancer Prognosis: Weighing the Evidence on Weight and Physical Activity

April 15, 2010

Traditionally host factors such as weight and physical activity have not been considered in the overall treatment of breast cancer patients. In this issue of ONCOLOGY, Nagaiah and Abraham review the epidemiologic and biologic evidence evaluating the relationships among obesity, physical activity, and both breast cancer recurrence and mortality, and in doing so, advocate weight management and exercise for breast cancer patients.