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Cancer Journal

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https://www.readbyqxmd.com/read/28731949/cancer-screening-in-the-elderly-a-review-of-breast-colorectal-lung-and-prostate-cancer-screening
#1
Ashwin A Kotwal, Mara A Schonberg
There are relatively limited data on outcomes of screening older adults for cancer; therefore, the decision to screen older adults requires balancing the potential harms of screening and follow-up diagnostic tests with the possibility of benefit. Harms of screening can be amplified in older and frail adults and include discomfort from undergoing the test itself, anxiety, potential complications from diagnostic procedures resulting from a false-positive test, false reassurance from a false-negative test, and overdiagnosis of tumors that are of no threat and may result in overtreatment...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731948/managing-cancer-pain-in-older-adults
#2
Emily J Guerard, James F Cleary
Managing cancer pain in older adults can be complex and challenging. Understanding the unique needs of older patients with cancer is important to safe and effective pain management. The goals of this review are to discuss the assessment of older adults with cancer-related pain, treatment of cancer pain, and adverse effects or potential risks from treatment that are unique to older patients. A detailed pain assessment and when possible utilizing the geriatric assessment are vital to developing a cancer pain management plan...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731947/early-stage-cancer-in-older-adults-prostate-avoiding-overtreatment-and-undertreatment
#3
Vikram Narayan, Song Jiang, Christopher A Warlick
The diagnosis of prostate cancer in elderly men is likely to increase over the next several decades, owing to changing demographics and a rising population of men older than 65 years. Given the heterogeneity and well-documented challenges in screening, diagnosing, and managing indolent versus aggressive prostate cancer, the geriatric patient population is particularly vulnerable to prostate cancer treatment nuances. Clinicians must become familiar with geriatric assessment tools to better answer life-expectancy questions prior to counseling patients on treatment options...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731946/treatment-minimization-in-older-patients-with-early-stage-breast-cancer
#4
Tara M Hansen, Richard C Zellars
The management of early-stage breast cancer in older patients is complex and requires a careful balance of the risk of cancer death with the competing risks of comorbidities and treatment-related toxicity in women with largely favorable disease. As the US population continues to age, oncologists will increasingly encounter this clinical challenge. Several strategies involving each core component of breast cancer therapy have been investigated to minimize treatment in these patients while still maintaining acceptable outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731945/the-changing-paradigm-of-radiotherapy-in-the-elderly-population
#5
Myer Raphael Pfeffer, Philip Blumenfeld
There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731944/cancer-immunotherapy-in-older-patients
#6
Kristen A Marrone, Patrick M Forde
Advancing age remains one of the most significant risk factors for cancer development. Changes in the immune system occur with aging, and likely play a role in the increased incidence of malignancy in older patients. With the advent of immune checkpoint inhibitors, and their use in a variety of malignancies, there has been an explosion of clinical trials evaluating their use. Unfortunately, these trials have not shown consistent results in elderly patients, nor have age-specific outcomes been consistently reported...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731943/the-impact-of-polypharmacy-on-patient-outcomes-in-older-adults-with-cancer
#7
Ginah Nightingale, Emily Skonecki, Manpreet K Boparai
Polypharmacy is prevalent in older adults with cancer and may be advantageous for the management of certain chronic disease states, but uncertainty exists regarding potential hazards and consequences. Cancer-related therapy adds to the prevalence of polypharmacy, which can lead to compromised cancer management plans (i.e., postoperative complications, treatment delays, and/or premature treatment discontinuation). Polypharmacy has been identified as one of the domains commonly included in the Comprehensive Geriatric Assessment likely because of the potential influence on health outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731942/geriatric-assessment-and-tools-for-predicting-treatment-toxicity-in-older-adults-with-cancer
#8
Daneng Li, Enrique Soto-Perez-de-Celis, Arti Hurria
Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The geriatric assessment is a multidisciplinary evaluation that provides detailed information about a patient's functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731941/the-biology-of-aging-and-cancer-frailty-inflammation-and-immunity
#9
Xinwen Zhang, Xin Meng, Yiyin Chen, Sean X Leng, Haiyan Zhang
The majority of patients with common malignancies are older adults. Intrinsic complex biological changes of aging along with inflammation, immunosenescence, age-associated chronic diseases, and extrinsic environmental and psychosocial factors have significant impact on not only development and behavior of individual malignancies, but also physiologic reserve and vulnerability of older patients who suffer from them. As a result, clinical practice of geriatric oncology demands integration of careful geriatric assessment and management...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731940/introduction-decision-making-with-older-cancer-patients
#10
Gary R Shapiro
No abstract text is available yet for this article.
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537966/the-affordable-care-act-and-cancer-care-for-young-adults
#11
Xuesong Han, Ahmedin Jemal
The Affordable Care Act (ACA) requires health plans that provide coverage for dependents to cover adult children to age 26 years. Extensive evidence has shown that since its implementation in September 2010 insurance coverage and access to care for young adults in the general population have increased. This article reviews the studies that have evaluated the impacts of the ACA on access to cancer care and outcomes for young adults aged 19 to 25 years. Current literature shows that the ACA increased insurance rate and cancer diagnosis at early stage for young adults...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537965/the-affordable-care-act-and-end-of-life-care-for-patients-with-cancer
#12
Ravi B Parikh, Alexi A Wright
The Affordable Care Act (ACA) expanded access to high-quality end-of-life care for Americans with serious illness, including cancer. Before the ACA was enacted in 2010, nearly 715,000 patients died in hospitals annually, despite evidence that most Americans prefer to die at home. Moreover, fewer than half of Medicare beneficiaries used hospice before death, despite evidence that hospice services improve cancer patients' quality of life near death and caregivers' bereavement outcomes. The ACA-stipulated programs and subsequent efforts were designed to address these deficiencies in access to high-quality end-of-life care...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537964/the-impact-of-the-affordable-care-act-on-cancer-survivorship
#13
Christine Leopold, Elyse R Park, Larissa Nekhlyudov
In 2010, the Patient Protection and Affordable Care Act (ACA) was implemented with the aim of expanding access to quality, affordable care. In this review, we describe the ACA provisions that are most relevant for cancer survivors, provide available published evidence, and offer insights for future research. We found that provisions focusing on access to preventive care, access to quality and coordinated care, and coverage expansion and increased affordability suggest beneficial effects. However, we identified research gaps specifically addressing the intended and unintended consequences of the ACA on cancer survivorship care...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537963/out-of-pocket-spending-under-the-affordable-care-act-for-patients-with-cancer
#14
Matthew S Dixon, Ashley L Cole, Stacie B Dusetzina
The Patient Protection and Affordable Care Act (ACA) included several key provisions aimed at lowering the out-of-pocket cost burden for patients. In this review, we summarize the effect of 3 provisions under Medicaid, Medicare, and commercial insurance, respectively: expansion of Medicaid eligibility, closing the doughnut hole for Medicare Part D beneficiaries, and requiring an annual limit on out-of-pocket spending for commercially insured patients. Through this review, we find early evidence that these 3 ACA provisions have reduced the out-of-pocket burden or increased access to health insurance for many patients...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537962/effects-of-affordable-care-act-marketplaces-and-medicaid-eligibility-expansion-on-access-to-cancer-care
#15
John A Graves, Katherine Swartz
PURPOSE: The aim of this study was to inform oncologists about how repealing the Affordable Care Act (ACA) may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. METHODS: We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#16
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537960/the-aca-and-cancer-screening-and-diagnosis
#17
Lindsay M Sabik, Georges Adunlin
The Patient Protection and Affordable Care Act (ACA) included multiple provisions expected to increase cancer screening and subsequently early diagnosis of cancer. Key provisions included new coverage options for low-income adults and young adults, as well as elimination of cost sharing for recommended preventive services across most health insurance plans. This article reviews relevant quantitative studies published since the ACA's passage to assess whether the goal of increasing access to preventive services has been met...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537959/from-the-guest-editor-the-affordable-care-act-and-cancer-care
#18
Nancy L Keating
No abstract text is available yet for this article.
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28410303/personalized-therapy-tumor-antigen-discovery-for-adoptive-cellular-therapy
#19
REVIEW
Cassian Yee, Gregory A Lizee
Adoptive cell therapy using endogenous T cells involves the ex vivo isolation and expansion of antigen-specific T cells from the peripheral blood and is uniquely suited for validating and translating antigen discovery. Endogenous T-cell therapy does not require accessible tumor as a source of infiltrating T cells and is free of regulatory and logistical constraints associated with engineering T cells. Candidate epitope peptides identified through antigen discovery may be rapidly implemented as targets in clinical trials of endogenous T-cell therapy and even incorporated as an "ad hoc" approach to personalized treatment when autologous tumor is available...
March 2017: Cancer Journal
https://www.readbyqxmd.com/read/28410302/tumor-infiltrating-lymphocyte-therapy-and-neoantigens
#20
REVIEW
Paul F Robbins
The adoptive cell transfer (ACT) of autologous tumor-infiltrating lymphocytes has been shown to be effective at mediating tumor regression in more than half of patients with metastatic melanoma and in mediating long-term complete regression in approximately one fourth of all patients with this cancer. The success of this approach in patients with cholangiocarcinoma and colon cancer supports efforts to expand ACT therapies to treatment of patients bearing a wide array of cancer types. Recent improvements in deep sequencing of the patient cancers, combined with extensive immunological testing of autologous tumor-infiltrating lymphocytes, indicate that T cells targeting epitopes arising from nonsynonymous somatic mutations, termed neoantigens, play important roles in mediating many of the effective cancer immunotherapies seen in response to ACT...
March 2017: Cancer Journal
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