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Despite the widespread perception that herbal products are safe because they are “natural,” few of these products have been subjected to rigorous research. The potential risks associated with many herbal dietary supplements remain unknown.

Preface

About This Treatment Guide

A mobile MRI unit recently pulled up to the steps of Capitol Hill, launching the Brain Tumor Foundation's national campaign for early detection. Led by the Foundation's president and founder, Patrick J. Kelly, MD, free brain scans were offered to members of Congress and their staff, along with government officials. Good intentions aside, the effort was derided as doing more harm than good by many leading cancer experts.

In a decision that many in the oncology community view as penny-wise, dollar-foolish, CMS reversed its decision to cover CT colonograhpy as a screening tool in colorectal cancer. Proponents of CT colonography contend that the less invasive nature promotes adherence to regular screening; critics say CT colonography's inability to remove polyps creates unnecessary redundancy; if polys are detcted the gold standard optical method is then needed. Why not just do it the first time?

A substantial number of cancer patients turn to unconventional agents used as anticancer therapies. However, “alternative cures” are unproved and may be harmful. They are not supported by clinical research and they can jeopardize patients’ lives, especially when patients delay needed care. Amygdalin, promoted as a popular alternative cancer cure for over 40 years, is used by many cancer patients. No solid data supports its effectiveness.

A multi-institutional group has validated a predefined 1,550-gene expression profile for identifying tumor tissue of origin. Malignancies found in unexpected locations, or with poorly differentiated morphologies, can pose a challenge for tissue of origin determination.

Women’s healthcare company Hologic received FDA premarket approval for Cervista HPV HR test and the Cervista HPV 16/18 test. The tests are manufactured by Third Wave Technologies. The high-risk Cervista HPV HR test has been approved to screen patients with atypical squamous cells of undetermined significance from cervical cytology results and determine the need for referral to colposcopy. It can also be used adjunctively with cervical cytology to screen women 30 years and older to assess the presence or absence of high-risk HPV types.

Asian-American women who consumed large amounts of soy as children have a 58% reduced risk of breast cancer, according to a study conducted at National Cancer Institute’s Clinical Genetics Branch.

Researchers have identified a possible genetic cause for an increased risk for a more advanced form of colorectal cancer in blacks that leads to shorter survival, according to data published in Clinical Cancer Research (15:2406-2416, 2009).

A large meta-analysis of individual patient data from clinical trials of ESAs in cancer patients found that ESAs increased on-study mortality by 17% and overall survival by 6% in patients randomized to receive ESAs, compared with controls. When patients who were on chemotherapy were analyzed separately, the increased risk in on-study mortality and overall survival with ESAs was less pronounced, but cannot be excluded, said Dr. Bohlius from the University of Bern, Switzerland.

As yoga continues to grow in popularity worldwide, questions regarding its use as a therapeutic modality are becoming increasingly important,” said Dr. Dhruva, who is an assistant clinical professor at the University of California, San Francisco and at the UCSF Osher Center for Integrative Medicine.

Currently, the only definitive method for telling the difference between side effects of radiation therapy for brain tumors and tumor recurrence involves a biopsy of the brain tissue, said Dr. Ewell, an assistant professor in the department of radiation oncology at the University of Arizona in Tucson. MRS has the potential to eliminate the need for this invasive procedure.

David G. Mutch, MD, has been elected president of the Society of Gynecologic Oncologists. Dr. Mutch is the director of the division of gynecologic oncology and the Ira and Judith Gall Professor of Obstetrics and Gynecology at the Washington University School of Medicine in St. Louis.

Candida and Aspergillus are the most common causes of invasive fungal infections in immunocompromised patients. Over the past two decades, there has been a substantial rise among cancer patients in the incidence of life-threatening invasive fungal infections that pose significant clinical challenges for the oncology community (N Engl J Med 348:1546-1554, 2003).

When it comes to erythropoiesis-stimulating agents in cancer patients, there are three distinct schools of thought: These agents are quite straightforward; they are nothing short of a "minefield or morass"; or they are somewhere in between.

MR spectroscopy results can help determine if brain tumor patients with nonspecific lesions may bypass invasive biopsy for conservative management. A study by a multidisciplinary group in Ann Arbor, Mich., found that elevated levels of brain metabolites correlated with evidence of tumor recurrence. The researchers then developed a tumor recurrence model based on their data.

VIENNA-Yes, size does matter, but it is certainly not the only way to monitor the effi cacy of cancer treatment. Th e way in which lesions are measured is extremely important as well, according to a special focus session on the assessment of tumor response at the 2009 European Congress of Radiology.

Researchers from the division of neuro-oncology at the Hospital of the University of Pennsylvania found that the fraction of malignant histologic features in enhancing brain neoplasms that recur after treatment can be predicted by using the relative cerebral blood volume (rCBV) fraction on standard MR imaging studies.

Bioengineers at Duke University in Durham, N.C., have developed a light-based system that provides information about tumor oxygen levels while the tumor is still in vivo. This needle-based technique can provide pathologists with biological specifics of the tumor and help oncologists choose treatment options that would be most effective for that individual patient, according to the researchers.

The likely consolidation of four international drug companies has raised concerns about the range of oncology agents that will remain in the R&D pipeline once the newly merged companies streamline their operations.

Oncolytics Biotech announced positive results from its phase I-II trial of Reolysin, which combines a naturally occurring reovirus with platinum-based chemotherapy agents. The research was shared at the 2009 International Meeting on Replicating Oncolytic Virus Therapeutics, in Banff, Alberta, Canada.

Sen. Edward Kennedy (D-Mass.) and Sen. Kay Bailey Hutchison (R-Tex.) introduced the 21st Century Cancer Access to Life-saving Early detection, Research and Treatment Act. The goal of the ALERT Act is to modernize and advance the national cancer program in the U.S.

Avastin (bevacizumab) is likely to provide clinical benefit to people previously treated for glioblastoma, according to a unanimous vote by the FDA Oncologic Drugs Advisory Committee. The FDA is expected to decide whether to grant accelerated approval of Avastin for glioblastoma by May 5. A global phase III trial evaluating Avastin in people with newly diagnosed glioblastoma will be initiated later this year, according to manufacturer Genentech.

In the realm of cancer prevention, this week’s boon may be next week’s blacklisted substance. A trio of recently released studies offers up a new, chemoprotective spin on familiar compounds.

We have known for some time that endocrine-responsive patients should probably receive an AI, but studies presented at SABCS provided some answers to our questions: Should we start with tamoxifen and then switch to an AI or is the best approach to initiate treatment with an AI from the start?

Chronic lymphocytic leukemia (CLL) is a clonal malignancy that results from expansion of the mature lymphocyte compartment. This expansion is a consequence of prolonged cell survival, despite a varied cell. The affected lymphocytes are of B-cell lineage in 95% of cases, and the remaining cases involve T lymphocytes, representing a distinct disorder.

Although many cancer patients cope well with their disease, psychiatric disorders occur in almost 50% of patients in the setting of malignancy. Untreated psychological and neuropsychiatric disorders can compromise quality of life as well as treatment compliance. Three behavioral syndromes that are often encountered in clinical practice will be discussed here: depression, anxiety, and delirium.

DENVER—Candidate genes and epigenetics are key components in the effort to develop and deploy personalized cancer prevention and treatment. Several studies at the AACR took a closer look at both those research pathways.