Concepts in Oncology

Ritalin for cancer fatigue – pro

Lay Summary:   Amphetamines are useful for supporting cancer patients with fatigue. Amphatamines are occasionally used by oncologists to manage opioid side effects or to treat cancer fatigue. Methylphenidate (Ritalin®; Novartis Pharmaceuticals Corporation, East Hanover, NJ) is a central nervous system (CNS) stimulant that is structurally related to amphetamines. A recent publication found seven clinical trials (22%) of methylphenidate for the

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Is Waldenstrom’s a “cancer”? – pro

Waldenstrom's (WM) should be considered cancer since it is a  presentation of a lymphoma. WM is an uncommon lymphoproliferative disorder characterized primarily by bone marrow infiltration and IgM monoclonal gammopathy. It should be considered a distinct clinicopathological entity rather than a clinical syndrome secondary to IgM secretion. Waldenström macroglobulinemia is a clonal disorder of B lymphocytes. This condition is considered to be lymphoplasmacytic

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CellCept Circulating Tumor Cell system – pro

The CellSearch™ System identifies and counts circulating tumor cells (CTCs) in a blood sample to predict progression-free survival and overall survival in patients with metastatic breast, colorectal or prostate cancer, and can do so earlier than the current standard of care. The contention is that the results of serial testing for CTCs with the CellSearch™ System provide additional information to the oncologist and does so earlier than other

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Is Langherhan’s Hystiocytosis a cancer? – pro

The pathogenesis of Langerhans cell histiocytosis (LCH) is a mater of debate. LCH is a rare disease that can invade tissues and spread but otherwise looks like a reactive process. There is ongoing contrversy as whether it is a cancer. Supporting the reactive nature of LCH is its propensity for spontaneous remissions, the extensive secretion of multiple cytokines by dendritic cells and bystander-cells (a phenomenon known as cytokine storm), favorable

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Ajuvant chemotherapy for lung cancer – pro

Lay Summary: Adjuvant chemotherapy is now standard for lung cancer. There is evidence to recommend platinum-based chemotherapy regimens as post-operative adjuvant therapy in the management of patients with completely resected stage II and IIIA NSCLC. Cisplatin-based treatment is preferred, although a carboplatin-based regimen can be used as an alternative if there is a contraindication to cisplatin. There is uncertainty about a benefit to patients

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Standard chemotherapy for endometrial cancer – pro

Lay Summary: Adjuvant chemo is standard for endometrial cancer and has a limited role for metastatic disease. However, chemotherapy may be useful for metastatic cases. There is currently little hope for cure in patients with metastatic endometrial carcinoma. Selected patients will respond to hormonal therapy, particularly progestins; however, for most women with advanced disease, chemotherapy is currently the standard antineoplastic treatment option.

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Second line chemo for non small cell lung cancer – pro

Lay Summary: Treating with new chemo drugs after first attempt at chemo fails in non-small cell lung cancer is supported by credible evidence.   Two randomized clinical trials have been reported that addressed the issue of second-line treatment in patients with advanced NSCLC that progresses after they have received first-line platinum-based chemotherapy. Both trials used docetaxel because this agent had shown significant activity in this patient

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Chemosensitivity and EDR testing – pro

Lay Summary: The status of chemosensitivity testing. The issue of chemosensitivity testing is complex and controversial. The recent article by Schrag et al1 criticized the field of chemosensitivity and drug resistance, concluding that these types of in vitro assays are not yet ready for prime time. The panel of authors attempted to present evidence that in vitro drug response assays should not be used clinically. This issue was first addressed by

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Neoadjuvant chemo for lung cancer – pro

Lay Summary: Chemotherapy has at least three distinct roles in various non-small lung cancer situations. Neoadjuvant therapy for locally advanced non-small cell lung cancer has evolved rapidly near the turn of the century. Historically, radiation used to be the only treatment for unresectable non-small cell lung cancer. In 1990, Dillman et al introduced the use of neoadjuvant cisplatin-based chemotherapy before radiation with better survival, and

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Folfox for adjuvant therapy of colon cancer – pro

Lay Summary: Folfox is a standard of care treatment for stage III and probably stage II colon cancer. It is recommended by NCCN and other guidelines. It is FDA approved: ELOXATIN, used in combination with infusional 5-FU/LV, is indicated for adjuvant treatment of stage III colon cancer in patients who have undergone complete resection of the primary tumor. and treatment of advanced colorectal cancer. Approximately 80,000 patients will be diagnosed

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