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Despite significant improvements in the treatment of Hodgkin's lymphoma over the past 2 decades, physicians continue to face dilemmas in therapy for the disease, and many cured patients live with complications of treatment. Newer therapeutic options are still needed for the disease, to minimize complications and to improve the treatment of patients in relapse. This review considers the treatment of Hodgkin's lymphoma in younger patients, addressing such issues as which patients with early-stage disease may require radiotherapy, what prognostic factors provide information that can affect treatment choices in patients with advanced disease, and what we have learned about treatment complications in this setting.

There is an increased incidence of cancer in minority populations, accompanied by reduced survival. This review will address specific areas of disparity in cancer care, including prevention, diagnosis, treatment, and outcomes, and will consider steps toward resolving these issues.

It is commonly accepted that nonmedical issues, such as loss of benefits, employment concerns, and debt management, may negatively impact the outcomes of patients fighting cancer.

Three cancer organizations have joined in supporting FDA in an appeal to the District of Columbia Circuit Court of Appeals to overturn a decision that terminally ill patients have a fundamental right of access to experimental drugs.

Ultrasound-guided placement of a balloon catheter for partial breast brachytherapy can be safely delayed until after the final pathology report has confirmed that the patient is a candidate for the procedure, according to a new study.

Biogen Initiates Randomized Trial of Lumiliximab for Advanced CLL

In July 2005, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) issued a sentinel event alert on the prevention of inadvertent intrathecal (IT) administration of vincristine.

Congress finally resolved the current federal budget in mid-February, 4 months after fiscal year (FY) 2007 began, and raised the National Institutes of Health's funding to $28.9 billion, an increase of $619.5 million (2%) over its FY2006 appropriations.

Dr. Richard Schilsky, Dr. Edward Pan, Pam Kedziera

A mature 70-patient report by Chau T. Dang, MD, et al, on cardiac safetyof dose-dense AC (doxorubicin and cyclophosphamide, 60/600 mg/m2 X4) followed by Taxol with Herceptinfor 52 weeks in HER2-positivepatients, has concluded that theregimen is feasible; 3 of 70 patients (4%) had cessation oftrastuzumab because of asymptomaticLVEF decline, about 6 monthsinto the treatment period.

A second interimefficacy analysis of BCIRG 006 indicatessimilar survival benefit but significantlyless toxicity with a regimen oftrastuzumab (Herceptin) plus docetaxel(Taxotere), compared with trastuzumabplus doxorubicin.

As oncology professionals, we all look forward to seeing our successfully treated patients come in for their follow-up visits. In a busy day filled with making complex medical decisions, delivering bad news, managing symptoms, and dealing with insurance companies, it is a real highlight. These individuals are among the over 10 million cancer survivors in the United States and represent 3.5% of the population. However, along with these optimistic results come new challenges for survivors that require ongoing medical care and psychosocial support. Survivors face lifetime health risks that are dependent on the cancer, treatment exposures, genetic predispositions, comorbid health conditions, and lifestyle behaviors.

The risk of cancer increases with age, and as the US population rapidly ages, the number of older adults seeking treatment for cancer is also increasing dramatically. However, this growing population of older adults has been underrepresented in clinical trials that set the standards for oncology care. In addition, most clinical trials conducted to date have not addressed the problems that accompany aging, including reduced physiologic reserve, changes in drug pharmacokinetics, and the impact of comorbid medical conditions and polypharmacy on treatment tolerance. As a result, there are variations in treatment patterns between older and younger adults and few evidence-based guidelines accounting for the changes in physiology or pharmacokinetics that occur with aging. This article examines the demographics of cancer and aging, the barriers to enrollment of older adults on clinical trials, and approaches for future trials to address the needs of the older patient.

The risk of cancer increases with age, and as the US population rapidly ages, the number of older adults seeking treatment for cancer is also increasing dramatically. However, this growing population of older adults has been underrepresented in clinical trials that set the standards for oncology care. In addition, most clinical trials conducted to date have not addressed the problems that accompany aging, including reduced physiologic reserve, changes in drug pharmacokinetics, and the impact of comorbid medical conditions and polypharmacy on treatment tolerance. As a result, there are variations in treatment patterns between older and younger adults and few evidence-based guidelines accounting for the changes in physiology or pharmacokinetics that occur with aging. This article examines the demographics of cancer and aging, the barriers to enrollment of older adults on clinical trials, and approaches for future trials to address the needs of the older patient.

The risk of cancer increases with age, and as the US population rapidly ages, the number of older adults seeking treatment for cancer is also increasing dramatically. However, this growing population of older adults has been underrepresented in clinical trials that set the standards for oncology care. In addition, most clinical trials conducted to date have not addressed the problems that accompany aging, including reduced physiologic reserve, changes in drug pharmacokinetics, and the impact of comorbid medical conditions and polypharmacy on treatment tolerance. As a result, there are variations in treatment patterns between older and younger adults and few evidence-based guidelines accounting for the changes in physiology or pharmacokinetics that occur with aging. This article examines the demographics of cancer and aging, the barriers to enrollment of older adults on clinical trials, and approaches for future trials to address the needs of the older patient.

Mr. CH is a 71-year-old retired naval officer who works full time as an aerospace engineer. He began experiencing increasing lethargy and malaise in August 2000 at the age of 65. He was finding it difficult to concentrate and became tired by the end of the day. An evaluation by his primary care physician revealed anemia and iron deficiency. CH received a trial of iron and erythropoietin with no substantial improvement. His anemia progressed; he required his first red blood cell transfusion in September 2001. He was referred to a hematologist at a regional comprehensive cancer center.

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About 6% of colorectal cancers are caused by genetic mutations associated with hereditary colorectal cancer syndromes. The most common hereditary cancer syndromes nurses are likely to encounter include hereditary nonpolyposis colon cancer or Lynch syndrome, familial adenomatous polyposis, attenuated familial adenomatous polyposis, and MYH polyposis. Current colorectal cancer recommendations for risk management, screening, and surveillance are complex and based on level of colorectal cancer risk and whether an individual carries a genetic mutation associated with a hereditary colorectal cancer syndrome. Caring for patients with hereditary colorectal cancer syndromes requires nurses to understand how to identify individuals and families at risk for hereditary colorectal cancer, refer to appropriate resources, and provide accurate information regarding screening, surveillance, and management. Nurses play a critical role in assessing colorectal cancer risk, obtaining an accurate family history of cancer, and providing information concerning appropriate cancer screening and surveillance.

Adding rituximab (Rituxan) to CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) significantly improves the time to treatment failure and overall survival in elderly patients with previously untreated advanced-stage follicular lymphoma (FL)

Total cancer deaths decreased in the United States for the second consecutive year in 2004, a drop of 3,014 deaths from the toll recorded in 2003. The number of deaths in 2003 declined 369 from the total in 2002.

As government pressure to reduce healthcare spending increases, gaps in Medicare coverage for participation in clinical trials is a potential barrier that could compromise the ability to conduct valuable medical research.

Accelerated partial breast irradiation (APBI) may be an effective and well-tolerated alternative to standard radiotherapy in early-stage breast cancer, and partial breast irradiation with interstitial brachytherapy also appears feasible in women who have had a recurrence after previous breast radiotherapy

Infusion of bone-marrow-derived mesenchymal stem cells (MSCs) appears to be a promising treatment for severe, steroid-resistant graft-vs-host disease (GVHD)

Four years of follow-up have confirmed that the front-line combination of all-trans-retinoic acid, or ATRA (tretinoin, Vesanoid), and arsenic trioxide (Trisenox) is beneficial for the treatment of patients with newly diagnosed acute promyelocytic leukemia (APL)

A phase III trial has shown that using arsenic trioxide (Trisenox) after standard first-line chemotherapy for acute promyelocytic leukemia (APL) significantly improves event-free survival and provides better overall survival, compared to standard therapy alone.

Over the past several years, new structures known as Regional Health Information Organizations, or RHIOs, have begun to appear on the healthcare scene.

An online survey of the impact of cancer on the careers and working environment of patients revealed strong support from employers, with 75% to 79% granting time off for doctor's appointments and allowing flexible work schedules and tele-commuting.

In the clinical practice setting, almost a quarter of women treated for breast cancer stop tamoxifen within 1 year, a rate twice as high as indicated by previous studies.