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In the year 2009, an estimated 70,980 new cases of bladder cancer will be diagnosed in the United States, and approximately 14,330 patients will die of this disease.Urothelial cancers encompass carcinomas of the bladder, ureters, and renal pelvis; these cancers occur at a ratio of 50:3:1, respectively. Cancer of the urothelium is a multifocal process. Patients with cancer of the upper urinary tract have a 30% to 50% chance of developing cancer of the bladder at some time in their lives. On the other hand, patients with bladder cancer have a 2% to 3% chance of developing cancer of the upper urinary tract. The incidence of renal pelvis tumors is decreasing.

As discussed in chapter 3, there are two major subdivisions of lung cancer: small-cell lung cancer (SCLC), for which chemotherapy is the primary treatment, and non–small-cell lung cancer (NSCLC). SCLC is decreasing in frequency in the United States, with recent data showing it represents only 14% of lung cancers. This chapter provides information on the staging and prognosis, pathology and pathophysiology, treatment, and follow-up of long-term survivors of SCLC and concludes with brief discussions on mesothelioma and thymoma.

In 2009, approximately 35,720 men and women (25,240 men and 10,480 women) in the United States will be diagnosed with cancer of the oral cavity and pharynx, and 7,600 will succumb to these diseases. Further, an estimated 12,290 men and women (9,920 men and 2,370 women) in the United States will be diagnosed with laryngeal cancer, and 3,660 will die from this malignancy. Most patients with head and neck cancer have metastatic disease at the time of diagnosis (regional nodal involvement in 43% and distant metastasis in 10%).

Endocrine malignancies, although relatively uncommon, are often difficult to diagnose and treat effectively. According to American Cancer Society (ACS) estimates, more than 39,000 new cases of endocrine neoplasms will be diagnosed in the United States in 2009, and approximately 2,470 deaths will result from these cancers. This chapter will focus on thyroid and parathyroid cancers. (A discussion of carcinoid tumors, insulinomas, gastrinomas, and other gastrointestinal neuroendocrine tumors, as well as adrenocortical cancer, can be found in chapter 11.)

In our exclusive on-site coverage of this event, ONCOLOGY has engaged nationally recognized breast cancer specialist Harold J. Burstein, MD, PhD, Associate Professor of Medicine, Harvard Medical School to provide insight on the meeting’s most clinically relevant sessions.

On Feb. 28 President Obama was screened for colorectal cancer using CT colonography. The results from this exam, also called virtual colonoscopy, along with those from the rest of the president’s annual physical, which was done at the National Naval Medical Center in Bethesda, described the president as “fit for duty.”

It’s a kind of man bites dog story: unusual, remarkable, yet oddly plausible. The Centers for Medicare and Medicaid Services has told its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule for the first 10 business days of March.

The journal ONCOLOGY presents exclusive on-site coverage of the 27th Annual Miami Breast Cancer Conference. Nationally recognized breast cancer specialist Harold J. Burstein, MD, PhD, Associate Professor of Medicine, Harvard Medical School provides expert insight into the optimal multidisciplinary management of patients with breast cancer and the application of innovative approaches to practice-coverage includes special emphasis on sessions dealing with the rapidly changing advances in the treatment of metastatic disease.

The RIBBON-2 trial met its primary endpoint of prolonged progression-free survival.

The FDA granted accelerated approval for the use of lapatinib (Tykerb) with letrozole (Femara) as a first-line, oral treatment for women with metastatic disease.

Higher doses of the estrogen-receptor antagonist fulvestrant (Faslodex) may increase treatment benefit without increasing toxicity, according to results from the international, randomized, double-blind phase III CONFIRM trial.

Also, French surgical oncologists discuss their experience with treament of heterogenous Merkel cell carcinoma.

Fulvestrant-anastrozole combination did not demonstrate advantage despite a better dose loading schedule and compelling preclinical data.

The U.S. Radiation Therapy Oncology Group has greenlighted the routine use of SBRT, but physicians overseas call for more scientific evidence to support its widespread use.

Modeling study calculates that the adoption of proton therapy is possible if it is based on clinical evidence and not market forces.

The colon, or large intestine, is the last part of the bowel where nutrients are absorbed. Stools are stored in the colon and excreted as a bowel movement.

El colon, o intestino grueso, es la última parte del intestino donde se absorben los nutrientes. Las heces se guardan en el colon y se excretan en forma de una evacuación intestinal.

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most challenging and complex complications of cancer chemotherapy.

Concerned that erythropoiesis-stimulating agents may actually undo what chemotherapy has done, promoting tumor progression or recurrence and shortening overall survival, the FDA is clamping down on these products, marketed by Amgen as Aranesp (darbepoetin alfa) and Epogen (epoetin alfa), and by Centocor Ortho Biotech Products as Procrit (epoetin alfa).

Lea and Calzone have provided an outstanding overview of genetics and genomic research applicable to the subspecialty of oncology nursing.

As a new decade unfolds, we are very fortunate to have an increasing number of new interventions available because of the recent tremendous advances in genetics and genomics.

Ginger, the rhizome of Zingiber officinale Roscoe, is best known for its role as a flavoring agent for food in Asian and Indian recipes.

Genetic and genomic research is creating new and more individualized approaches to better manage a person's disease or predisposition to disease, including cancer.

The epigenetic control of gene expression has been shown to play an important role in cancer initiation, progression, and resistance. Thus, agents that modify the epigenetic environment of tumors will likely be an important addition to the anticancer arsenal. Specifically, there is much interest in modulating histone acetylation using a new class of drugs, histone deacetylase (HDAC) inhibitors. Preclinical data have demonstrated the efficacy of various HDAC inhibitors as anticancer agents, with the greatest effects shown when HDAC inhibitors are used in combination with other therapies. As a result of encouraging preclinical data, numerous HDAC inhibitors are being investigated in clinical trials either as monotherapies or in conjunction with other treatments such as chemotherapy, biologic therapy, or radiation therapy. In fact, vorinostat and depsipeptide, two actively studied HDAC inhibitors, were recently approved for the treatment of refractory cutaneous T-cell lymphoma. Although the use of HDAC inhibitors has generated great enthusiasm, a significant amount of work still needs to be done in order to understand their mechanisms of action, as well as to determine the appropriate patient characteristics and subsets of cancer for which HDAC inhibitors hold the most potential for effective treatment.

Shabason and colleagues’ review of the development of histone deacetylase (HDAC) inhibitors as treatment for cancers is timely, with an emphasis on therapeutic strategies combining HDAC inhibitors and radiation therapy. As the authors indicate, vorinostat (Zolinza)-originally known as suberoylanilide hydroxamic acid, or SAHA-was the first of the HDAC inhibitors approved by the US Food and Drug Administration (FDA) for clinical use in the treatment of cutaneous T-cell lymphoma (CTCL).[1] In November 2009, a second HDAC inhibitor-romidepsin (Istodax)-received FDA approval for the treatment of CTCL. Currently there is a great deal of competition in the HDAC inhibitor field, as several new and, hopefully, more effective compounds are being developed and entering clinical trials.[2]

Shabason et al have written a thoughtful review of an exciting new class of agents, histone deacetylase (HDAC) inhibitors. While the authors focus primarily on the role of HDAC inhibitors in combination with radiation therapy, we would like to highlight some potential strategies combining these agents with systemic therapies for the treatment of cancer.

ASCO and RSNA elect new presidents while the Children's Oncology Group selects a new leader. Read more about the latest awards and appointments in oncology and cancer care.