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Current Oncology

A Beswick
No abstract text is available yet for this article.
April 2018: Current Oncology
K J Jerzak, T Mancuso, A Eisen
Background: Despite the fact that heterozygosity for a pathogenic ATM variant is present in 1%-2% of the adult population, clinical guidelines to inform physicians and genetic counsellors about optimal management in that population are lacking. Methods: In this narrative review, we describe the challenges and controversies in the management of women who are heterozygous for a pathogenic ATM variant with respect to screening for breast and other malignancies, to choices for systemic therapy, and to decisions about radiation therapy...
April 2018: Current Oncology
M Pistelli, A Della Mora, Z Ballatore, R Berardi
Approximately 11% of patients with breast cancer (bca) are diagnosed before menopause, and because in most of those patients the tumour expresses a hormone receptor, treatment with endocrine interventions can be applied in any setting of disease (early or advanced). In the past, hormonal treatment consisted only of the estrogen receptor modulator tamoxifen, associated with luteinizing hormone-releasing hormone (lhrh); more recently, aromatase inhibitors (ais) have come into widespread use. The ais interfere with the last enzymatic step of estrogen synthesis in which androgens are converted into estrogens...
April 2018: Current Oncology
D Tomlinson, P D Robinson, S Oberoi, D Cataudella, N Culos-Reed, H Davis, N Duong, F Gibson, M Götte, P Hinds, S L Nijhof, P van der Torre, S Cabral, L L Dupuis, L Sung
Background: Our objective was to determine whether, compared with control interventions, pharmacologic interventions reduce the severity of fatigue in patients with cancer or recipients of hematopoietic stem-cell transplantation (hsct). Methods: For a systematic review, we searched medline, embase, the Cochrane Central Register of Controlled Trials, cinahl, and Psychinfo for randomized trials of systemic pharmacologic interventions for the management of fatigue in patients with cancer or recipients of hsct...
April 2018: Current Oncology
T A Koulis, A Dang, C Speers, R A Olson
Background: Radiation therapy (rt) after mastectomy for breast cancer can improve survival outcomes, but has been associated with inferior cosmesis after breast reconstruction. In the literature, rt dose and fractionation schedules are inconsistently reported. We sought to determine the pattern of rt prescribing practices in a provincial rt program for patients treated with mastectomy and reconstruction. Methods: Women diagnosed with stages 0-iii breast cancer between January 2012 and December 2013 and treated with curative-intent rt were identified from a clinicopathology database...
April 2018: Current Oncology
S Harricharan, K Biederman, A M Bombassaro, A Lazo-Langner, S Elsayed, A Fulford, J A Delport, A Xenocostas
Background: A twice-weekly galactomannan (gm) screening protocol was implemented in high-risk hematology inpatients. Study objectives were to determine adherence to the protocol, use of selected resources, and patient outcomes. Methods: This retrospective cohort study compared outcomes of interest before and after implementation of gm screening. Adults undergoing matched related allogeneic hematopoietic stem-cell transplantation or induction chemotherapy for acute leukemia were eligible...
April 2018: Current Oncology
Y Cao, H Xu
Background: We aimed to develop a new EGFR mutation-predictive scoring system to use in screening for EGFR -mutated lung adenocarcinomas (lacs). Methods: The study enrolled 279 patients with lac, including 121 patients with EGFR wild-type tumours and 158 with EGFR -mutated tumours. The Student t-test, chi-square test, or Fisher exact test was applied to discriminate clinical and computed tomography (ct) features between the two groups. Using a principal component analysis (pca) model, we derived predictive coefficients for the presence of EGFR mutation in lac...
April 2018: Current Oncology
K E Brennan, S F Hall, T E Owen, R J Griffiths, Y Peng
Background: The actual practices of routine follow-up after curative treatment for head-and-neck cancer are unknown, and existing guidelines are not evidence-based. Methods: This retrospective population-based study used administrative data to describe 5 years of routine follow-up care in 3975 head-and-neck cancer patients diagnosed between 2007 and 2012 in Ontario. Results: The mean number of visits per year declined during the follow-up period (from 7...
April 2018: Current Oncology
S Chae, K M Kang, H J Kim, E Kang, S Y Park, J H Kim, S H Kim, S W Kim, E K Kim
Background: The neutrophil-lymphocyte ratio (nlr) has been reported to correlate with patient outcome in several cancers, including breast cancer. We evaluated whether the nlr can be a predictive factor for pathologic complete response (pcr) after neoadjuvant chemotherapy (nac) in patients with triple-negative breast cancer (tnbc). Methods: We analyzed the correlation between response to nac and various factors, including the nlr, in 87 patients with tnbc who underwent nac...
April 2018: Current Oncology
K Tran, S Zomer, J Chadder, C Earle, S Fung, J Liu, C Louzado, R Rahal, R Shaw Moxam, E Green
Patient-reported outcomes measures (proms) are an important component of the shift from disease-centred to person-centred care. In oncology, proms describe the effects of cancer and its treatment from the patient perspective and ideally enable patients to communicate to their providers the physical symptoms and psychosocial concerns that are most relevant to them. The Edmonton Symptom Assessment System-revised (esas-r) is a commonly used and validated tool in Canada to assess symptoms related to cancer. Here, we describe the extent to which patient-reported outcome programs have been implemented in Canada and the severity of symptoms causing distress for patients with cancer...
April 2018: Current Oncology
J Lorentz, S K Liu, D Vesprini
Three groups of men are at high risk of developing prostate cancer: men with a strong family history of prostate cancer, men of West African or Caribbean ancestry, and men with a germline pathogenic variant in a prostate cancer-associated gene. Despite the fact that those men constitute a significant portion of the male population in North America, few recommendations for prostate cancer screening specific to them have been developed. For men at general population risk for prostate cancer, screening based on prostate-specific antigen (psa) has remained controversial despite the abundance of literature on the topic...
April 2018: Current Oncology
T Stockley, C A Souza, P K Cheema, B Melosky, S Kamel-Reid, M S Tsao, A Spatz, A Karsan
Epidermal growth factor receptor (egfr) tyrosine kinase inhibitors (tkis) are recommended as first-line systemic therapy for patients with non-small-cell lung cancer (nsclc) having mutations in the EGFR gene. Resistance to tkis eventually occurs in all nsclc patients treated with such drugs. In patients with resistance to tkis caused by the EGFR T790M mutation, the third-generation tki osimertinib is now the standard of care. For optimal patient management, accurate EGFR T790M testing is required. A multidisciplinary working group of pathologists, laboratory medicine specialists, medical oncologists, a respirologist, and a thoracic radiologist from across Canada was convened to discuss best practices for EGFR T790M mutation testing in Canada...
April 2018: Current Oncology
D Santa Mina, C M Sabiston, D Au, A J Fong, L C Capozzi, D Langelier, M Chasen, J Chiarotto, J R Tomasone, J M Jones, E Chang, S N Culos-Reed
Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources...
April 2018: Current Oncology
E Klimant, H Wright, D Rubin, D Seely, M Markman
This article reviews intravenous vitamin C (IV C) in cancer care and offers a rational approach to enable medical oncologists and integrative practitioners to safely provide IV C combined with oral vitamin C to patients. The use of IV C is a safe supportive intervention to decrease inflammation in the patient and to improve symptoms related to antioxidant deficiency, disease processes, and side effects of standard cancer treatments. A proposed rationale, together with relevant clinical safety considerations for the application of IV C in oncologic supportive care, is provided...
April 2018: Current Oncology
A T Chaudhry, T A Koulis, C Speers, R A Olson
Purpose: The mainstay of treatment for ductal carcinoma in situ (dcis) involves surgery in the form of mastectomy or lumpectomy. Inconsistency in the use of endocrine therapy (et) for dcis is evident worldwide. We sought to assess the variation in et prescribing for patients with dcis across a population-based radiotherapy (rt) program and to identify variables that predict its use. Methods: Data from a breast cancer database were obtained for women diagnosed with dcis in British Columbia from 2009 to 2014...
April 2018: Current Oncology
K Enright, T Desai, R Sutradhar, A Gonzalez, M Powis, N Taback, C M Booth, M E Trudeau, M K Krzyzanowska
Background: Overuse of surveillance imaging in patients after curative treatment for early breast cancer (ebc) was recently identified as one of the Choosing Wisely Canada initiatives to improve the quality of cancer care. We undertook a population-level examination of imaging practices in Ontario as they existed before the launch of that initiative. Methods: Patients diagnosed with ebc between 2006 and 2010 in Ontario were identified from the Ontario Cancer Registry...
April 2018: Current Oncology
A Mahmud, O Zalay, A Springer, K Arts, E Eisenhauer
Background: Clinical trials are vital for evidence-based cancer care. Oncologist engagement in clinical trials has an effect on patient recruitment, which in turn can affect trial success. Identifying barriers to clinical trial participation might enable interventions that could help to increase physician participation. Methods: To assess factors affecting physician engagement in oncology trials, a national survey was conducted using the online SurveyMonkey tool (SurveyMonkey, San Mateo, CA, U...
April 2018: Current Oncology
F Safa, M Pant, C Weerasinghe, R Felix, T Terjanian
Merkel cell carcinoma (mcc) is an uncommon malignancy of the skin arising from cells located in the deeper layers of the epidermis called Merkel cells. This malignancy rarely presents as a metastatic disease, and the field is therefore deficient in regards to management. We report the case of a 49-year-old woman who presented with a presumptive diagnosis of osteomyelitis of the left fifth digit that was resistant to treatment with antibiotics; she underwent debridement of the digit that revealed mcc and was later to have metastatic disease to her lungs, liver, and musculoskeletal system...
February 2018: Current Oncology
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