Endocrine therapy is the oldest form of treatment for metastatic breast cancer. The availability of numerous new endocrine agents during the past 10 years has led to significant changes in the use of this form of therapy. This article identifies
The National Cancer Institute (NCI) has published a new atlas, the Atlas
of Cancer Mortality in the United States, 1950-94
It is a propitious time for the publication of Dr. Wein’s thoughtful paper on sedation in the imminently dying. Although this intervention has been accepted by most palliative care specialists for many years, it seems to be unfamiliar to many oncologists. The numerous surveys[1-7] and published guidelines that have informed discussions of the technique have not appeared in the oncology literature and probably have been read by few of the front-line clinicians who care for dying cancer patients. Like the broader model of palliative care of which it is part, sedation in the imminently dying must be “mainstreamed”—ie, understood in all its complexity by clinicians whose patients may benefit most from its skillful application.
The National Institutes of Health (NIH) is sponsoring a Consensus
Development Conference on Adjuvant Therapy for Breast Cancer, to be
held in Bethesda, Maryland, on November 1-3, 2000.
Sedation is a clinically important therapeutic intervention in the imminently dying patient. As the patient with an advanced, irreversible illness nears the end of life, symptoms accumulate that are progressively more difficult to
Over the past decade, increased attention has focused on the care of dying patients. The role of the physician in caring for these patients has been the subject of renewed interest and intense, sometimes passionate, debate. Patient groups have formed to advocate for the promotion of compassion in the care of the dying, and some of these advocacy groups have asserted a fundamental “right” to physician-assisted suicide. The US Supreme Court has ruled against a constitutional right to physician-assisted suicide but has asserted its willingness to reconsider the issue if it learned that dying patients were not receiving appropriate, high-quality end-of-life care.
In addition to ovarian ablation by means of surgery or irradiation, a wide variety of endocrine agents are now available for the management of breast cancer, in both the metastatic and adjuvant settings. Currently available
Esophageal cancer is a relatively rare but deadly cancer in the United States. Even in patients with limited locoregional disease at the time of diagnosis, who have received aggressive multimodality therapies as part of clinical protocols, median survival is only 17 months and 3-year survival, only 30%.[1,2] Patients with metastatic disease have a 6-month median survival, which is not improved by the administration of chemotherapy.
Book Review: The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies
Many oncologists are barraged with questions
and declarations from patients regarding therapies and products that
At the 1999 San Antonio Breast Cancer
Symposium, Dr. Susan Love, noted breast surgeon, author, and patient
Deeply troubled by the profound and universal impact of cancer
on human life, human suffering, and on the productivity of nations;
Mayo Clinic investigators confirmed a recent study showing the activity of thalidomide (Thalomid) in advanced multiple myeloma. Although the drug needs to undergo further clinical trials, it may provide myeloma patients with a new treatment
In a study of previously untreated patients with lowgrade or follicular non-Hodgkin’s lymphoma (NHL), all patients responded to the combination of tositumomab and iodine I 131 tositumomab (Bexxar) and fludarabine (Fludara). When compared to
The article by Drs. Hainsworth and Greco is a timely review of the management of patients presenting with metastatic cancer in the absence of a documented site of origin (cancer of unknown primary site). These patients constitute a significant proportion (approximately 5%) of all patients with cancer.
In an admirably concise fashion, Dr.Pritchard summarizes the results of trials randomizing tens of thousands of women in order to evaluate various types and uses of endocrine treatment over more than 50 years. I would never have predicted these results
According to the first cost-effectiveness analysis of tamoxifen (Nolvadex), high-risk women who use tamoxifen to prevent breast cancer should be reimbursed by medical insurance in the same way as other preventive drugs and procedures are
Esophageal cancer, with an estimated number of 12,300 new cases in the year 2000, is relatively uncommon in the United States but produces a high number of annual deaths, estimated at 12,100. Moreover, the incidence of the
Researchers at the National Cancer Institute (NCI) have reported an antitumor effect in a small group of patients with lymphoma who were vaccinated with an experimental B-cell lymphoma vaccine over a 5-year period. These promising
Younger women who undergo lumpectomy to remove noninvasive breast cancer cells are significantly more likely to experience a recurrence than older patients, in part, because physicians may not be removing enough breast tissue during
The Charter of Paris Against Cancer was signed by more than 100
international leaders in government, patient advocacy, cancer
Esophageal cancer poses an interesting challenge for oncologists. Esophageal squamous cell cancer has the most varied geographical incidence of any cancer, suggesting the existence of critically important environmental and molecular epidemiologic factors. These factors remain largely unrecognized.
Local tumor recurrence after radiation therapy is due primarily to the failure to eradicate all of the tumor cells within the treatment fields. Theoretically, all cancers could be controlled locally if a sufficiently high radiation dose
Over the past 2 decades, advances in clinical oncology have occurred at a whirlwind pace, as new surgical, diagnostic, preventive, immunotherapeutic, chemotherapeutic, radiotherapeutic, and molecular resources and techniques have become available. As one result, the death rate from cancer in the United States has decreased during the past decade. Thanks to these advances, many patients have replaced feelings of hopelessness with hope for a cure.
Hormonal therapy with the goserelin acetate implant (Zoladex) significantly increases overall survival rates in patients with locally advanced prostate cancer when administered at the onset of conventional external irradiation and continued for 3 years.
Cancer of unknown primary site represents approximately 3% to 5% of all new cancer diagnoses. Adenocarcinomas account for 60% of all unknown primary cancers and poorly differentiated carcinomas or