Cancer

Black women have lower specificity of diagnostic mammography and, consequently, more unnecessary workups than White women. Black women have higher sensitivity of diagnostic mammography, with cancers that are larger and more advanced than White women.

Angiosarcoma of the breast is a rare clinical entity that can occur sporadically or after radiation therapy. The 5-year overall survival rate for all patients is 38%.

A four-session couples' counseling intervention to address sexual problems (after treatment for prostate carcinoma) was developed and evaluated. For those couples completing the intervention, improvements were noted throughout 3-month follow-up in male overall distress, male global sexual function, female global sexual function, and utilization of medical treatments for erectile dysfunction.

A monoclonal antibody against HER2, 2C4, is effective in inhibiting the growth of ovarian carcinoma cells in vitro and in vivo. These findings raise the possibility that 2C4 may prove effective in the treatment of ovarian carcinomas.

Aberrations in cyclin D1 gene (CCND1) numbers appear to be valuable in identifying patients at high risk of late lymph node metastasis in TNM Stage I and II oral squamous cell carcinomas. Analysis of CCND1 numerical aberrations using fluorescence in situ hybridization on fine-needle aspiration biopsy specimens may be useful in selecting patients for elective cervical lymph node dissection.

The histone deacetylase inhibitor, valproic acid (VPA), has been shown to overcome the differentiation block in leukemic blasts, an effect enhanced by all-trans retinoic acid (ATRA). In a clinical trial including 26 patients with poor-risk acute myeloid leukemia (AML), treatment with VPA and ATRA resulted in transient disease control in a subset of patients with an AML that had evolved from a myeloproliferative disorder but not in patients with a primary or myelodysplastic syndrome-related AML.

Conventional postremission therapy for patients with acute myeloid leukemia (three courses of standard-dose consolidation and six courses of maintenance therapy) was replaced successfully by a shorter duration of four courses of standard-dose consolidation therapy without the need for additional maintenance therapy.

Autologous stem-cell transplantation is effective in aggressive non-Hodgkin lymphoma in patients with a poor prognosis, with a 3-year survival estimated at 61%. However, careful long-term follow-up is recommended because of the increase in nonmalignant (34%) and malignant toxicities (3.7%).

The addition of rituximab to fludarabine in 60 symptomatic, untreated patients with B-cell chronic lymphocytic leukemia (B-CLL) categorized mainly as intermediate Rai stage, achieved both a higher complete remission (CR) rate (78%) and a longer progression-free survival (PFS) rate (68% at 3 yrs). However, significantly shorter CR and PFS rates were obtained in patients who had ZAP-70-positive B-CLL (28 of 60 patients).

Biliary tract carcinoma is an aggressive cancer, with median survival rarely exceeding 6 months. There is currently no established palliative standard of care. A Phase II trial was conducted to study a combination of oral capecitabine and gemcitabine (CapGem) as first-line therapy in patients with advanced and/or metastatic biliary carcinoma.

A Phase II study was conducted to evaluate the efficacy and toxicity of an irinotecan plus capecitabine combination, a new nonplatinum regimen, in chemonaive patients with advanced nonsmall cell lung carcinoma.

The efficacy and toxicity of first-line platinum-based chemotherapy in patients < 65 and ≥ 65 years was analyzed in cohorts of age from the 1218 nonsmall cell lung carcinoma (NSCLC) patients enrolled in TAX 326, a randomized Phase III study that compared three regimens of platinum-based therapy. Docetaxel–platinum was shown to be an active first-line treatment option with a favorable benefit:risk profile for elderly good performance status patients with advanced NSCLC.

Survivin was overexpressed and positively correlated with proliferative index, overall daily growth, and microvessel density, whereas it was inversely correlated with the apoptotic index in brain gliomas. Survivin may play an important role in malignant proliferation, antiapoptosis, and angiogenesis of brain gliomas.

Brain metastases were evaluated and outcomes were compared between patients with the best survival and the poorest survival to determine clinical and treatment patterns that potentially were responsible for different outcomes. The results indicated that selected patients who receive effective intracranial and extracranial care can have prolonged, good-quality survival.

Malignant diffuse brainstem gliomas constitute at least 10% of all childhood brain tumors and continue to have a dismal prognosis regardless of the treatment used. Surgery is not feasible without a high risk of life-threatening neurologic complications and conventional radiotherapy is reported to result in a short median survival. In the current study, the authors evaluated the survival and toxicity observed in children with newly diagnosed brainstem gliomas who were treated with daily radiotherapy with topotecan used as a radiosensitizer.

The age-adjusted incidence rates of glioblastoma multiforme (GBM) increased over the past 30 years. Older age, male gender, higher socioeconomic status, and non-Latino white race were associated with increased rates of GBM.

In this population-based study of incident epithelial ovarian carcinomas, the authors demonstrated that the frequency of BRCA1 and BRCA2 mutations among women with ovarian carcinoma was higher than reported previously. The current data suggested that it may be reasonable to offer genetic counseling to any woman with invasive epithelial ovarian carcinoma, because family history is not sufficiently accurate to predict the presence or absence of a mutation.

The incidence of cancer in patients with schizophrenia has been conversely reported to be higher, lower, or similar to that in the general population. The effects of lifestyle factors such as excess smoking, exposure to neuroleptic medications, and genetic factors that may influence the incidence of cancer in this group are not clear. The current study was conducted to evaluate the frequency of cancer in a large cohort of patients with schizophrenia.

Symptomatic venous thromboembolism is a frequent complication of chemotherapy. An elevated prechemotherapy platelet count is associated with a nearly threefold greater risk of developing venous thromboembolism.

The examination of pancreatic juice cytology could hypothetically contribute to the establishment of a definite diagnosis of malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas. The current study was conducted to assess the diagnostic value of pancreatic juice cytology in patients with IPMN and to examine the usefulness of peroral pancreatoscopy in sampling pancreatic juice.

This retrospective study found that patients older than 1 year of age with metastatic neuroblastoma who underwent gross total resection of the primary tumor before chemotherapy had a significant survival advantage compared with patients who underwent gross total resection after induction chemotherapy. Prospective studies are warranted to confirm the value of this treatment approach.

In the current study, transdermal fentanyl was found to be a safe and well tolerated alternative to oral opioid treatment for children ages 2–16 years who were previously exposed to opioid therapy.

The objective of the current study was to compare chemotherapy dose modification in obese (a body mass index [BMI] > 95%) and nonobese (a BMI ≤ 95%) pediatric patients with acute lymphoblastic leukemia (ALL). Overall, obese ALL patients exhibited a 7% decrease in the mean relative modification of L-asparaginase during induction chemotherapy compared with their nonobese counterparts.

Advanced cancer patients who are vulnerable to psychiatric illness are receptive to utilizing mental health services, yet only 45% with a major psychiatric disorder accessed mental health services. Cancer patients who had discussed psychological concerns with mental health staff and white patients were more likely than others to receive mental health services.

Extrapulmonary tuberculosis was common in younger patients with active Mycobacterium tuberculosis infection receiving care at the study tertiary care cancer center. These infections were often initially misdiagnosed as cancer and a delay in correct diagnosis was associated with increased risk of infection-associated death.