The University of Colorado Health Sciences Center holds weekly second opinion conferences focusing on cancer cases that represent most major cancer sites. Patients seen for second opinions are evaluated by an oncologist. Their history, pathology, and radiographs are reviewed during the multidisciplinary conference, and then specific recommendations are made. These cases are usually challenging, and these conferences provide an outstanding educational opportunity for staff, fellows, and residents in training.
Adjuvant therapy is defined as any treatment administered after surgical resection of a primary tumor with the intent of improving the patient’s outcome by eliminating any occult, viable tumor cells that may have remained after surgery.
To treat, or not to treat—the decision to use adjuvant chemotherapy plagues medical oncologists and patients harnessed with the diagnosis of stage II colon cancer. A look to the literature does not simplify the decision, as significant controversy exists regarding the magnitude of benefit associated with 6 months of adjuvant chemotherapy. Dr. Kopetz and colleagues provide a well-organized review of the current literature examining the benefit of adjuvant chemotherapy in stage II disease, and discuss potential prognostic markers that may help determine who would most likely benefit from treatment.
Lung cancer is the leading cause of cancer mortality in the United States. Local recurrence after surgery for operable disease has long been recognized as a hindrance to long-term survival. Postoperative radiation therapy was logically explored as a means to improve local control and survival. Multiple randomized trials were conducted, many showing improved local control, but none demonstrated a statistically significant survival benefit.
Drs. Kelsey, Marks, and Wilson open their excellent review article by asking “Where do we stand?” with respect to postoperative radiation therapy (PORT) for non–small-cell lung cancer (NSCLC). Frankly, PORT has not exactly been standing tall for the past decade—leaning, crouching, or perhaps squatting might be a better verb.
Kelsey et al have written an excellent review on postoperative radiotherapy (PORT) for non–small-cell lung cancer (NSCLC). As pointed out in this thorough yet concise review, there are inconsistencies in the recommendation of PORT for NSCLC.
Breast cancer is the most common life-threatening malignancy in women, and the second leading cancer killer of women, claiming the lives of over 40,000 American women annually. Breast cancer incidence increases with advancing age until age 80, and the median age at diagnosis is 61.
The adjuvant treatment of breast cancer is facing a challenging phase due to the increasing knowledge of breast cancer biology and consequent need to personalize treatments. Medical oncologists are asked to practice evidence-based medicine, but their approach is often based on results of trials conducted in extremely heterogeneous populations.
The development of metastatic disease in patients with paraganglioma is an unusual and challenging event. This case report and review describes the specific features of this disease and the multiple therapeutic options.
In this edition of Clinical Quandaries, Trombetta et al present a 64-year-old man who seeks care because of a new, asymptomatic right midneck mass. Because the mass is not warm or tender and the patient does not have an elevated temperature, an infectious etiology is unlikely. We are not told if he is a smoker or drinker and we assume he does not have any other signs or symptoms (such as recent-onset hoarseness) that would point us to a head and neck cancer as a primary source.
New data revealing decreasing trends in cancer deaths in the United States overall, and in colorectal cancer deaths in particular, highlight the remarkable benefits of colorectal cancer screening tests, but the lifesaving potential of these tests is unrealized for many Americans, according to experts from the American College of Gastroenterology (ACG).
Two targeted agents designed to treat HER2-positive breast cancer are being tested in a new study involving 8,000 participants in 50 countries across six continents—a clinical trial that investigators hope will provide a new model for global cancer research.
The US Food and Drug Administration (FDA) granted accelerated approval for bevacizumab (Avastin), in combination with paclitaxel chemotherapy, for the treatment of patients who have not received chemotherapy for metastatic HER2-negative breast cancer.
Researchers have reported finding a blood biomarker that enables close to 98% accuracy in predicting the spread of prostate cancer to regional lymph nodes. Their study is published in the March 1 issue of Clinical Cancer Research, a journal of the American Association for Cancer Research. The new blood test measures levels of endoglin, a plasma biomarker that has been previously shown to predict the spread of colon and breast cancer.