Current Oncology

10 pages, 174 KiB

Open AccessArticle

Cancer-Associated Thrombosis: Prevention and Treatment

by K. M. J. Brose and A. Y. Y. Lee

Curr. Oncol. 2008, 15(s1), 58-67; https://doi.org/10.3747/co.2008.177 - 1 Jan 2008

Cited by 51 | Viewed by 1381

Patients with cancer are at high risk to develop venous thromboembolism, and they are also more likely to develop complications from anticoagulant treatment. Because little research has focused on the oncology population to date, the optimal methods of prophylaxis and treatment remain uncertain [...] Read more.

Patients with cancer are at high risk to develop venous thromboembolism, and they are also more likely to develop complications from anticoagulant treatment. Because little research has focused on the oncology population to date, the optimal methods of prophylaxis and treatment remain uncertain in some clinical situations. Currently, low molecular weight heparin and warfarin are the most frequently used pharmacologic agents; however, they have their limitations. Other therapeutic options, such as inferior caval filters, are poorly studied and remain controversial. A summary of the most recent evidence on the prevention and treatment of venous thromboembolism in cancer patients is presented here. Full article

165 KiB

Open AccessReview

A Primer of Bone Metastases Management in Breast Cancer Patients

by B. Petrut, M. Trinkaus, C. Simmons and M. Clemons

Curr. Oncol. 2008, 15(s1), 50-57; https://doi.org/10.3747/co.v15i0.205 - 1 Jan 2008

Viewed by 56

Abstract

Bone is the most common site for distant spread of breast cancer. Following a diagnosis of metastatic bone disease, patients can suffer from significant morbidity because of pain and skeletal related events (sres). Bisphosphonates are potent inhibitors of osteoclastic function and the mainstay [...] Read more.

Bone is the most common site for distant spread of breast cancer. Following a diagnosis of metastatic bone disease, patients can suffer from significant morbidity because of pain and skeletal related events (sres). Bisphosphonates are potent inhibitors of osteoclastic function and the mainstay of bone-directed therapy for bone metastases. The aims of bisphosphonates are to prevent and delay sres, to reduce bone pain, and to improve quality of life. Bisphosphonate therapy appears to have revolutionized treatment of bone metastases, but bisphosphonate use has several limitations. Those limitations include the high cost of the agents and the need for return trips to the clinic for intravenous treatment. Moreover, many uncertainties surround bisphosphonate use—for example, the timing of bisphosphonate initiation, the choice of bisphosphonate to use, the optimal duration of treatment, and the appropriate means to identify patients who will and will not benefit. In addition, potentially serious adverse effects have been associated with bisphosphonate use—for example, renal toxicity, gastrointestinal side effects, and osteonecrosis of the jaw. The present review is intended as a primer for oncology specialists who treat patients with bone metastases secondary to breast cancer. It focuses on bisphosphonate treatment guidelines, the evidence for those guidelines, and a discussion of new therapeutic agents. It also discusses the use of biochemical markers of bone metabolism, which show promise for predicting the risk of a patient’s developing a sre and of benefiting from bisphosphonate treatment. Full article

169 KiB

Open AccessReview

Going Beyond Efficacy: Strategies for Cancer Pain Management

by J. Myers and N. Shetty

Curr. Oncol. 2008, 15(s1), 41-49; https://doi.org/10.3747/co.v15i0.201 - 1 Jan 2008

Viewed by 54

Abstract

Despite great advances in the fields of pain management and palliative care, pain directly or indirectly associated with a cancer diagnosis remains significantly undertreated. The present paper reviews the current standard for cancer pain management and highlights new treatments and targeted interventional techniques. [...] Read more.

Despite great advances in the fields of pain management and palliative care, pain directly or indirectly associated with a cancer diagnosis remains significantly undertreated. The present paper reviews the current standard for cancer pain management and highlights new treatments and targeted interventional techniques. Full article

11 pages, 186 KiB

Open AccessArticle

Cancer Treatment–Related Bone Loss: A Review and Synthesis of the Literature

by M.N. Khan and Aliya A. Khan

Curr. Oncol. 2008, 15(s1), 30-40; https://doi.org/10.3747/co.2008.174 - 1 Jan 2008

Cited by 42 | Viewed by 2318

Abstract

Cancer therapy can result in significant bone loss and increased risk of fragility fracture. Chemotherapy, aromatase inhibitors, and gonadotropin-releasing hormone analogues contribute to increases in the rate of bone remodelling and reduce bone mineral density. Patients with prostate cancer on androgen deprivation therapy [...] Read more.

Cancer therapy can result in significant bone loss and increased risk of fragility fracture. Chemotherapy, aromatase inhibitors, and gonadotropin-releasing hormone analogues contribute to increases in the rate of bone remodelling and reduce bone mineral density. Patients with prostate cancer on androgen deprivation therapy experience an increase in the risk of fracture. New research has demonstrated the key role played by bisphosphonates in preventing declines in bone density and increases in bone remodelling. Novel antiresorptive agents targeting receptor activator of nuclear factor κB ligand have great potential in skeletal protection and prevention of bone loss related to cancer therapy. Early assessment of skeletal health, followed by initiation of calcium, vitamin D, and an exercise program are valuable in the prevention and treatment of osteoporosis. In addition, individuals at increased risk for fracture should be offered antiresorptive therapy. Early data have demonstrated that bisphosphonates are able to prevent the bone loss and increased bone remodelling associated with cancer therapy, including aromatase inhibition and androgen deprivation therapy. The present paper reviews the new research and advances in the management of bone loss associated with both cancer therapy and estrogen deficiency in the postmenopausal female. Full article

14 pages, 203 KiB

Open AccessArticle

Matters of the Heart: Cardiac Toxicity of Adjuvant Systemic Therapy for Early-Stage Breast Cancer

by K. Towns, P.L. Bedard and Sunil Verma

Curr. Oncol. 2008, 15(s1), 16-29; https://doi.org/10.3747/co.2008.173 - 1 Jan 2008

Cited by 23 | Viewed by 885

Abstract

Breast cancer remains the most common malignancy in women. Since the late 1980s, significant advances have been made in the treatment of this cancer. Those advances, particularly the ones in the adjuvant setting, have led to declines in the mortality associated with breast [...] Read more.

Breast cancer remains the most common malignancy in women. Since the late 1980s, significant advances have been made in the treatment of this cancer. Those advances, particularly the ones in the adjuvant setting, have led to declines in the mortality associated with breast cancer. But another result has been treatments that are more complex and that potentially carry more toxicity. One key toxicity related to the adjuvant therapy of breast cancer is cardiac toxicity. Some of the agents commonly used for the treatment of breast cancer, including anthracyclines, trastuzumab, and possibly even aromatase inhibitors, have been associated with cardiac toxicity. The present article reviews the current understanding of cardiac toxicity risk and strategies to minimize cardiac morbidity associated with cytotoxic chemotherapy, trastuzumab therapy, and hormonal therapy with aromatase inhibitors for early-stage breast cancer. Full article

6 pages, 158 KiB

Open AccessArticle

Erythropoiesis-Stimulating Agents: Benefits and Risks in Supportive Care of Cancer

by Barb Melosky

Curr. Oncol. 2008, 15(s1), 10-15; https://doi.org/10.3747/co.2008.172 - 1 Jan 2008

Cited by 13 | Viewed by 1027

Abstract

Anemia, already common in cancer patients, is often exacerbated by chemotherapy. Cancer patients who are anemic have been shown to have a blunted response for production of endogenous erythropoietin growth factor. This anemia can be corrected with exogenous erythropoietin growth factors, of which [...] Read more.

Anemia, already common in cancer patients, is often exacerbated by chemotherapy. Cancer patients who are anemic have been shown to have a blunted response for production of endogenous erythropoietin growth factor. This anemia can be corrected with exogenous erythropoietin growth factors, of which three available are worldwide: epoetin alfa, epoetin beta, and darbepoetin alfa. Collectively, these drugs are known as erythropoiesis-stimulating agents (ESAS). Orders for ESAS have been used not only to reverse anemia so as to avoid blood transfusion, but also to improve quality of life. Guidelines have been developed for initiation, dosage titration, and termination of these agents. Since the late 1990s, trials have been conducted using esas in unapproved dosing regimens or to reach hemoglobin levels outside of approved guidelines, raising several safety concerns. The present article explores the risks and benefits of ESAS. Full article

6 pages, 151 KiB

Open AccessArticle

Chemotherapy- and Cancer-Related Nausea and Vomiting

by David G. Warr

Curr. Oncol. 2008, 15(s1), 4-9; https://doi.org/10.3747/co.2008.171 - 1 Jan 2008

Cited by 45 | Viewed by 1718

Abstract

Approximately one half of cancer patients will experience nausea or vomiting during the course of their disease either because of the cancer itself or because of their treatment. Emesis attributable to cancer warrants a careful investigation to determine whether a treatable underlying cause [...] Read more.

Approximately one half of cancer patients will experience nausea or vomiting during the course of their disease either because of the cancer itself or because of their treatment. Emesis attributable to cancer warrants a careful investigation to determine whether a treatable underlying cause is responsible. Interventions using dexamethasone and octreotide may reduce vomiting attributable to bowel obstruction. In the absence of a bowel obstruction or a correctable cause, the usual approach is a sequential trial of antiemetics guided by considerations of cost and side effects. Major progress in managing chemotherapyinduced emesis followed from the use of a combination of a corticosteroid and 5-hydroxytryptamine3 (5-HT₃) receptor antagonist for moderately to highly emetogenic chemotherapy. Nevertheless, vomiting still occurred in approximately 40% of women receiving chemotherapy containing an anthracycline plus cyclophosphamide and in approximately 50% of patients receiving high-dose cisplatin. The addition of aprepitant, a neurokinin 1 receptor antagonist, improved control of emesis by a further 15%–20%, and that agent is now recommended as part of standard antiemetic therapy for patients at high risk of emesis. Based largely on anecdotal experience, cannabinoids and olanzapine are sometimes also recommended in patients with refractory emesis. Phase III trials are required to confirm their efficacy as addons to a corticosteroid, a 5-HT₃ receptor antagonist, and possibly aprepitant. Full article

1 pages, 128 KiB

Open AccessArticle

Going Beyond Efficacy: Supportive Care and Addressing the Toxicity of Systemic Therapy

by S. Verma

Curr. Oncol. 2008, 15(s1), 3; https://doi.org/10.3747/co.v15110001 (registering DOI) - 1 Jan 2008

Cited by 5 | Viewed by 996

Abstract

Significant advances in oncology have been made in recent decades. In general, the mortality rates associated with most cancers are now decreasing, and a significant number of new treatments are now available for cancer patients [...] Full article

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Curr. Oncol., Volume 15, Issue s1 (January 2008) – 8 articles

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