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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..

Curr. Oncol., Volume 20, Issue 1 (February 2013) – 21 articles

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441 KiB  
Meeting Report
Consensus Recommendations for Cancer Rehabilitation: Research and Education Priorities
by S. McEwen, M. Egan, M. Chasen, M. Fitch and
Curr. Oncol. 2013, 20(1), 64-69; https://doi.org/10.3747/co.20.1277 - 1 Feb 2013
Cited by 10 | Viewed by 695
Abstract
As cancer survivorship increases, there is a need for additional and more complex rehabilitation services. The Partners in Cancer Rehabilitation Research group held a 3-day invitational working meeting aimed at defining the state of the science in cancer rehabilitation research and identifying key [...] Read more.
As cancer survivorship increases, there is a need for additional and more complex rehabilitation services. The Partners in Cancer Rehabilitation Research group held a 3-day invitational working meeting aimed at defining the state of the science in cancer rehabilitation research and identifying key areas for development of research and education. In May 2012, 29 participants gathered to present their current work, review a synthesis of the current literature, generate ideas about research and education gaps, and develop consensus on priority areas. The conclusion of the meeting was that a main research priority is to develop and test personalized rehabilitation interventions and brief measures to identify the presence and severity of disabling sequelae. The education consensus statement concluded that a clear description of cancer rehabilitation and its mandate should be developed as a precursor to education activities, including both a conceptualization of complex interdisciplinary rehabilitation and the roles of individual professions, and further, that there is a great need to increase awareness among health professionals, patients, and families of the need for and general effectiveness of cancer rehabilitation. Numerous specific recommendations were also put forward, and it is hoped that those recommendations will provide the foundation for a new and productive era of research and will play a role in the improvement of functional health and participation outcomes for cancer survivors. Full article
420 KiB  
Editorial
Indicator Measures er/pr and her2 Testing among Women with Invasive Breast Cancer
by C. Sandoval, R. Rahal, T. Forte, J. Klein–Geltink, D. He and H. Bryant
Curr. Oncol. 2013, 20(1), 62-63; https://doi.org/10.3747/co.20.1290 - 1 Feb 2013
Cited by 11 | Viewed by 463
Abstract
As part of its System Performance initiative, the Canadian Partnership Against Cancer released Breast Cancer Control in Canada: A System Performance Special Focus Report in September 2012, presenting a broad range of system performance indicators that measure breast cancer control across the continuum. [...] Read more.
As part of its System Performance initiative, the Canadian Partnership Against Cancer released Breast Cancer Control in Canada: A System Performance Special Focus Report in September 2012, presenting a broad range of system performance indicators that measure breast cancer control across the continuum. [...] Full article
237 KiB  
Correction
Corrigendum: A First Look at Participation Rates in Cervical Cancer Screening Programs in Canada
by T. Forte, K. Decker, G.A. Lockwood, C.M. McLachlin, S. Fekete, H.E. Bryant and
Curr. Oncol. 2013, 20(1), 56; https://doi.org/10.3747/co.20.1343 - 1 Feb 2013
Cited by 1 | Viewed by 415
Abstract
K. Decker and and the Pan-Canadian Cervical Cancer Screening Initiative: Monitoring Program Performance Working Group is to be added to the author list. [...] Full article
291 KiB  
Letter
Advantages of Exercise in Breast Cancer Patients and Survivors in Addition to Its Mitigating Effect on Chest Wall Pain
by Shailendra Kapoor
Curr. Oncol. 2013, 20(1), 54-55; https://doi.org/10.3747/co.20.1194 - 1 Feb 2013
Cited by 3 | Viewed by 531
Abstract
The recent article by Wong et al. was highly interesting[...] Full article
299 KiB  
Letter
The Kiss of Death: HPV Rejected by Religion
by Sarah J.J. Touyz and Louis Z.G. Touyz
Curr. Oncol. 2013, 20(1), 52-53; https://doi.org/10.3747/co.20.1186 - 1 Feb 2013
Cited by 11 | Viewed by 572
Abstract
Human papilloma viruses (hpvs) are causally linked to cervical, head-and-neck, and oral cancers. [...] Full article
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Article
Endocrine Therapy for Postmenopausal Women with Hormone Receptor–Positive her2–Negative Advanced Breast Cancer after Progression or Recurrence on Nonsteroidal Aromatase Inhibitor Therapy: A Canadian Consensus Statement
by K.I. Pritchard, K.A. Gelmon, D. Rayson, L. Provencher, M. Webster, D. McLeod and S. Verma
Curr. Oncol. 2013, 20(1), 48-61; https://doi.org/10.3747/co.20.1316 - 1 Feb 2013
Cited by 24 | Viewed by 896
Abstract
Approximately 22,700 Canadian women were expected to be diagnosed with breast cancer in 2012. Despite improvements in screening and adjuvant treatment options, a substantial number of postmenopausal women with hormone receptor positive (hr+) breast cancer will continue to develop metastatic disease [...] Read more.
Approximately 22,700 Canadian women were expected to be diagnosed with breast cancer in 2012. Despite improvements in screening and adjuvant treatment options, a substantial number of postmenopausal women with hormone receptor positive (hr+) breast cancer will continue to develop metastatic disease during or after adjuvant endocrine therapy. Guidance on the selection of endocrine therapy for patients with hr+ disease that is negative for the human epidermal growth factor receptor 2 (her2–) and that has relapsed or progressed on earlier nonsteroidal aromatase inhibitor (nsai) therapy is of increasing clinical importance. Exemestane, fulvestrant, and tamoxifen are approved therapeutic options in this context. Four phase iii trials involving 2876 patients—efect, sofea, confirm, and bolero-2—have assessed the efficacy of various treatment options in this clinical setting. Data from those trials suggest that standard-dose fulvestrant (250 mg monthly) and exemestane are of comparable efficacy, that doubling the dose of fulvestrant from 250 mg to 500 mg monthly results in a 15% reduction in the risk of progression, and that adding everolimus to exemestane (compared with exemestane alone) results in a 57% reduction in the risk of progression, albeit with increased toxicity. Multiple treatment options are now available to women with hr+ her2– advanced breast cancer recurring or progressing on earlier nsai therapy, although current clinical trial data suggest more robust clinical efficacy with everolimus plus exemestane. Consideration should be given to the patient’s age, functional status, and comorbidities during selection of an endocrine therapy, and use of a proactive everolimus safety management strategy is encouraged. Full article
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Case Report
When the Tumour Is Not the Culprit: Avascular Necrosis of the Hip in a Patient with Castration-Resistant Prostate Cancer
by E. Chan, G. Chan, L. Ehrlich, P. Hull, H. Kreder, W. Chu, E. Chow and U. Emmenegger
Curr. Oncol. 2013, 20(1), 48-51; https://doi.org/10.3747/co.20.1206 - 1 Feb 2013
Cited by 4 | Viewed by 517
Abstract
Avascular necrosis (avn) of the hip is a well-documented side effect of corticosteroid therapy, but it has also been described as a complication of radiation and chemotherapy. Many prostate cancer patients undergo treatment with all three of those therapeutic modalities, and [...] Read more.
Avascular necrosis (avn) of the hip is a well-documented side effect of corticosteroid therapy, but it has also been described as a complication of radiation and chemotherapy. Many prostate cancer patients undergo treatment with all three of those therapeutic modalities, and yet reported cases of avn of the hip in prostate cancer patients are rare. Symptoms that might potentially alert physicians to this complication are nonspecific and may be attributed to cancer progression, in particular to progressive bone metastasis. Here, we report on a 79-year-old man diagnosed with castration-resistant prostate cancer whose diagnosis of avn of the hip was confounded by his underlying malignancy. We discuss risk factors and diagnostic clues in this differential diagnosis of acute hip pain in patients with castration-resistant prostate cancer. Physicians might maintain a high index of suspicion for avn of the hip in prostate cancer patients presenting with new-onset hip pain. Surgical intervention may help to prevent the appearance of avn-associated pain and the negative impact of advanced avn on overall quality of life. Full article
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Case Report
Conservative Management for an Entero-Adnexal Fistula at Initial Presentation of Advanced Ovarian Carcinoma
by A. Shai, E. Grikshtas, Y. Segev, M. Moskovitz, A. Bitterman, M. Steiner and O. Lavie
Curr. Oncol. 2013, 20(1), 44-47; https://doi.org/10.3747/co.20.1196 - 1 Feb 2013
Cited by 4 | Viewed by 448
Abstract
Gastrointestinal fistulae can occur in ovarian cancer patients, usually in the setting of advanced relapsed disease. Treatment typically involves immediate surgery. Here, we describe a case of an abscess resulting from an intestinal fistula as the first manifestation of advanced epithelial ovarian cancer, [...] Read more.
Gastrointestinal fistulae can occur in ovarian cancer patients, usually in the setting of advanced relapsed disease. Treatment typically involves immediate surgery. Here, we describe a case of an abscess resulting from an intestinal fistula as the first manifestation of advanced epithelial ovarian cancer, and we review the current literature on this subject. The patient was successfully treated with a combination of chemotherapy, antibiotics, and delayed surgery. Optimal debulking was achieved without a need for bowel resection. This report is the first of conservative management of a fistula in an ovarian cancer patient in the chemotherapy-naïve setting. Full article
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Perspective
Canadian Trends in Liver Cancer: A Brief Clinical and Epidemiologic Overview
by P. De, D. Dryer, M.C. Otterstatter and R. Semenciw
Curr. Oncol. 2013, 20(1), 40-43; https://doi.org/10.3747/co.20.1190 - 1 Feb 2013
Cited by 9 | Viewed by 653
Abstract
Although primary liver cancer is rare, its incidence rate has been rising quickly in Canada, more than tripling since the early 1980s. This cancer is more common in men than women, and the age-specific incidence rates in men have been increasing significantly in [...] Read more.
Although primary liver cancer is rare, its incidence rate has been rising quickly in Canada, more than tripling since the early 1980s. This cancer is more common in men than women, and the age-specific incidence rates in men have been increasing significantly in all age groups from 40 years of age onward. The death rate has followed a similar upward trajectory, in part because of the low 5-year survival rate of 18% in both sexes. Infection with the hepatitis B or C virus continues to be the most common risk factor, but other factors may also play a role. Risk reduction strategies, such as viral hepatitis screening, have been recommended in other countries and warrant consideration in Canada as part of a coordinated strategy of disease prevention and control. Full article
599 KiB  
Article
Evaluation of CancerChatCanada: A Program of Online Support for Canadians Affected by Cancer
by J. Stephen, A. Rojubally, K. MacGregor, D. McLeod, M. Speca, J. Taylor–Brown, K. Fergus, K. Collie, J. Turner, S. Sellick and G. Mackenzie
Curr. Oncol. 2013, 20(1), 39-47; https://doi.org/10.3747/co.20.1210 - 1 Feb 2013
Cited by 30 | Viewed by 1156
Abstract
Background: Professional-led cancer support groups can improve quality of life and address unmet needs, but most Canadians affected by cancer do not have access to or do not make use of cancer support groups. A collaborative interdisciplinary team developed, operated, and evaluated [...] Read more.
Background: Professional-led cancer support groups can improve quality of life and address unmet needs, but most Canadians affected by cancer do not have access to or do not make use of cancer support groups. A collaborative interdisciplinary team developed, operated, and evaluated Internet-based, professional-led, live-chat support groups (osgs) for cancer patients, caregivers, and survivors across Canada. Objective: Our study aimed to report participant and participation characteristics in the pan-Canadian initiative known as CancerChatCanada, and to understand participant perspectives about the quality of communication and professional facilitation, overall satisfaction, and psychosocial benefits and outcomes. Methods: Participants in osgs provided informed consent. Participant and participation characteristics were gathered from program data collection tools and are described using frequencies, means, and chi-squares. Patient, survivor, and caregiver perspectives were derived from 102 telephone interviews conducted after osg completion and subjected to a directed qualitative content analysis. Results: The 55 professional-led osgs enrolled 351 participants from 9 provinces. More than half the participants came from rural or semirural areas, and more than 84% had no received previous cancer support. The attendance rate was 75%, the dropout rate was 26%, and 80% of participants were satisfied or very satisfied. The convenience and privacy of osgs were benefits. Meaningful communication about important and difficult topics, kinship and bonding with others, and improved mood and self-care were perceived outcomes. Conclusions: Our results demonstrate that this collaborative initiative was successful in increasing reach and access, and that pan-Canadian, professional-led osgs provide psychosocial benefit to underserved and burdened cancer patients, survivors, and family caregivers. Full article
382 KiB  
Article
PYNK : Breast Cancer Program for Young Women
by A. Ali and E. Warner
Curr. Oncol. 2013, 20(1), 34-39; https://doi.org/10.3747/co.20.1131 - 1 Feb 2013
Cited by 32 | Viewed by 730
Abstract
Consider this scenario: A 35-year-old recently married woman is referred to a surgeon because of a growing breast lump. After a core biopsy shows cancer, she undergoes mastectomy for a 6-cm invasive lobular cancer that has spread to 8 axillary nodes. By the [...] Read more.
Consider this scenario: A 35-year-old recently married woman is referred to a surgeon because of a growing breast lump. After a core biopsy shows cancer, she undergoes mastectomy for a 6-cm invasive lobular cancer that has spread to 8 axillary nodes. By the time she sees the medical oncologist, she is told that it is too late for a fertility consultation, and she receives a course of chemotherapy. At clinic appointments, she seems depressed and admits that her husband has been less supportive than she had hoped. After tamoxifen is started, treatment-related sexuality problems and the probability of infertility contribute to increasing strain on the couple’s relationship. Their marriage ends two years after the woman’s diagnosis. Six years after her diagnosis, this woman has completed all treatment, is disease-free, and is feeling extremely well physically. However, she is upset about being postmenopausal, and she is having difficulty adopting a child as a single woman with a history of breast cancer. Could this woman and her husband have been offered additional personalized interventions that might have helped them better cope with the breast cancer diagnosis and the effects of treatment? Compared with their older counterparts, young women with breast cancer often have greater and more complex supportive care needs. The present article describes the goals, achievements, and future plans of a specialized interdisciplinary program—the first of its kind in Canada—for women 40 years of age and younger newly diagnosed with breast cancer. The program was created to optimize the complex clinical care and support needs of this population, to promote research specifically targeting issues unique to young women, and to educate the public and health care professionals about early detection of breast cancer in young women and about the special needs of those women after their diagnosis. Full article
451 KiB  
Article
Factors Associated with Referral to Medical Oncology and Subsequent Use of Adjuvant Chemotherapy for Non-Small-Cell Lung Cancer: A Population-Based Study
by J. Kankesan, F.A. Shepherd, Y. Peng, G. Darling, G. Li, W. Kong, W.J. Mackillop and C.M. Booth
Curr. Oncol. 2013, 20(1), 30-37; https://doi.org/10.3747/co.20.1178 - 1 Feb 2013
Cited by 21 | Viewed by 698
Abstract
Background: Adjuvant chemotherapy (act) for non-small-cell lung cancer (nsclc) is associated with improved survival in the general population, but may be underutilized. We explored the factors associated with referral to medical oncology and subsequent use of act among all [...] Read more.
Background: Adjuvant chemotherapy (act) for non-small-cell lung cancer (nsclc) is associated with improved survival in the general population, but may be underutilized. We explored the factors associated with referral to medical oncology and subsequent use of act among all patients with resected nsclc in Ontario, Canada. Methods: The Ontario Cancer Registry was used to identify all incident cases of nsclc diagnosed in Ontario during 2004–2006. We linked electronic records of treatment and of physician billing to identify surgery, act, and medical oncology consultation. A multivariate logistic regression model was used to evaluate factors associated with referral to medical oncology and subsequent use of act. Results: Among 3354 cases of nsclc resected in Ontario during 2004–2006, 1830 (55%) were seen postoperatively by medical oncology, and 1032 (31%) were treated with act. Patients more than 70 years of age were less likely than younger patients to have a consultation [odds ratio (or): 0.4; p < 0.001]. A higher proportion of cases with stage ii or iii nsclc than with stage i disease were referred (ors: 2.7, 2.0 respectively; p < 0.005). We observed substantial geographic variation in the proportion of surgical cases referred (range: 32%–88%) that was not explained by differences in case mix. Among cases referred to medical oncology, older patients (age 60–69 years, or: 0.4; age 70+ years, or: 0.1; p < 0.001) with greater comorbidity (Charlson comorbidity index: 3+; or: 0.5; p < 0.05) and a longer postoperative stay (median length of stay: 7+ days; or: 0.7; p = 0.001) were less likely to receive act. Use of act was greater in patients with stage ii or iii than with stage i disease (ors: 3.0, 2.7 respectively; p < 0.001); use also varied with geographic location (range: 46%–63%). Conclusions: The initial decision to refer to medical oncology is associated with age and stage of disease, and those factors have an even greater effect on the decision to offer act. Comorbidity and postoperative length of stay were not associated with initial referral, but were associated with use of act in patients seen by medical oncology. Full article
494 KiB  
Article
Clinical Outcomes of Women with Metastatic Breast Cancer Treated with Nab-Paclitaxel: Experience from a Single Academic Cancer Centre
by S. Dent, J. Fraser, N. Graham, M. Campbell, S. Hopkins and G. Dranitsaris
Curr. Oncol. 2013, 20(1), 24-29; https://doi.org/10.3747/co.20.1202 - 1 Feb 2013
Cited by 13 | Viewed by 725
Abstract
Background: Nab-paclitaxel is a solvent-free, taxane-based chemotherapy approved for the treatment of metastatic breast cancer (mbc). This study reports clinical benefit and toxicities experienced by women with mbc treated with nab-paclitaxel at the Ottawa Hospital Cancer Centre. Methods: Women [...] Read more.
Background: Nab-paclitaxel is a solvent-free, taxane-based chemotherapy approved for the treatment of metastatic breast cancer (mbc). This study reports clinical benefit and toxicities experienced by women with mbc treated with nab-paclitaxel at the Ottawa Hospital Cancer Centre. Methods: Women with mbc treated with single-agent nab-paclitaxel between June 2006 and December 2010 were included in this analysis. Retrospective data obtained included demographics, disease characteristics, prior chemotherapy, nab-paclitaxel treatment, toxicity, and survival. Clinical benefit was defined as partial or complete response or stable disease (by clinical or radiologic evaluation, or both) at 6 months or more. Results: Of 43 women (mean age: 57.0 years; range: 34–74 years), most had disease positive for estrogen or progesterone receptor (72.1%, 58.1%), or both. Nab-paclitaxel was administered weekly (qw: 44.2%), every 3 weeks (q3w: 46.5%), q3w switched to qw (7.0%), or qw switched to q3w (2.3%). Median duration of therapy was 5.1 months (qw) and 3.0 months (q3w). Sensory neuropathy was the primary toxicity (45.4% qw, 38.1% q3w; p = 0.62). Clinical benefit was observed in most women (76.2% qw, 57.1% q3w; p = 0.20). Women receiving nab-paclitaxel had a median overall survival of 13.6 months qw (range: 8.1–28.3 months) and 10.8 months q3w (range: 5.9–17.9 months; p = 0.03). Regardless of dosing schedule, women experiencing clinical benefit lived significantly longer than those not experiencing a benefit (17.3 months vs. 7.7 months; hazard ratio: 0.14; 95% confidence interval: 0.06 to 0.33). Conclusions: Our clinical experience demonstrates that most women treated with nab-paclitaxel experienced some clinical benefit. Patients achieving clinical benefit lived significantly longer than those who did not. Nab-paclitaxel was well tolerated, with the primary toxicity being mild sensory neuropathy. Nab-paclitaxel represents another treatment option, with a favourable toxicity profile, for women with mbc. Full article
960 KiB  
Article
Alignment of Practice Guidelines with Targeted-therapy Drug Funding Policies in Ontario
by R. Ramjeesingh, R.M. Meyer, M. Brouwers, B.E. Chen and C.M. Booth
Curr. Oncol. 2013, 20(1), 21-33; https://doi.org/10.3747/co.20.1166 - 1 Feb 2013
Cited by 2 | Viewed by 565
Abstract
Background: We evaluated clinical practice guideline (cpg) recommendations from Cancer Care Ontario’s Program in Evidence-Based Care (pebc) for molecularly targeted systemic treatments (tts) and subsequent funding decisions from the Ontario Ministry of Health and Long-Term Care. Methods: [...] Read more.
Background: We evaluated clinical practice guideline (cpg) recommendations from Cancer Care Ontario’s Program in Evidence-Based Care (pebc) for molecularly targeted systemic treatments (tts) and subsequent funding decisions from the Ontario Ministry of Health and Long-Term Care. Methods: We identified pebc cpgs on tt published before June 1, 2010, and extracted information regarding the key evidence cited in support of cpg recommendations and the effect size associated with each tt. Those variables were compared with mohltc funding decisions as of June 2011. Results: From 23 guidelines related to 17 tts, we identified 43 recommendations, among which 38 (88%) endorsed tt use. Among all the recommendations, 38 (88%) were based on published key evidence, with 82% (31 of 38) being supported by meta-analyses or phase iii trials. For the 38 recommendations endorsing tts, funding was approved in 28 (74%; odds ratio related to cpg recommendation: 29.9; p = 0.003). We were unable to demonstrate that recommendations associated with statistically significant improvements in overall survival [os: 14 of 16 (88%) vs. 8 of 14 (57%); p = 0.10] or disease- (dfs) or progression-free survival [pfs: 16 of 21 (76%) vs. 3 of 5 (60%); p = 0.59] were more likely to be funded than those with no significant difference. Moreover, we did not observe significant associations between funding approvals and absolute improvements of 3 months or more in os [6 of 6 (100%) vs. 3 of 6 (50%), p = 0.18] or pfs [6 of 8 (75%) vs. 10 of 12 (83%), p = 1.00]. Conclusions: For use of tts, most recommendations in pebc cpgs are based on meta-analyses or phase iii data, and funding decisions were strongly associated with those recommendations. Our data suggest a trend toward increased rates of funding for therapies with statistically significant improvements in os. Full article
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Article
Do Current Cancer Follow-Up Care Practices Meet the Needs of Young Adult Cancer Survivors in Canada? A Aualitative Inquiry
by B. Miedema, J. Easley and L.M. Robinson
Curr. Oncol. 2013, 20(1), 14-22; https://doi.org/10.3747/co.20.1207 - 1 Feb 2013
Cited by 27 | Viewed by 559
Abstract
Purpose: The purpose of the present study was to assess whether current cancer follow-up care practices meet the needs of young adult cancer survivors in Canada. Methods: This qualitative study used a constructivist grounded theory framework to analyze telephone interviews with [...] Read more.
Purpose: The purpose of the present study was to assess whether current cancer follow-up care practices meet the needs of young adult cancer survivors in Canada. Methods: This qualitative study used a constructivist grounded theory framework to analyze telephone interviews with cancer survivors from across Canada diagnosed between the ages of 18 and 39 years. The focus was specifically on cancer follow-up care (cfc). Results: Interviews were conducted with 55 participants, and 53 interviews were used for the analysis. The overall theme that emerged from the data was the lack of age-specific cfc. Some of the subthemes that emerged were the absence or inadequacy of fertility and infertility treatment options; of psychological services such as family, couples, and sexuality counseling; of social supports such as assistance with entry or re-entry into the education system or workplace; of access to supplemental health insurance; and of survivorship care plans. Based on the data resulting from the interviews, we developed a conceptual model of young-adult cfc incorporating the major themes and subthemes that emerged from our study. The proposed model aims to ensure a more age-appropriate and comprehensive approach to cfc for this group of cancer patients. Conclusions: Current Canadian cfc practices are inadequate and do not provide comprehensive care for young adult cancer survivors in Canada. The conceptual model presented here aims to ensure a more comprehensive approach to cfc that meets the needs of this unique cancer population and reduces further possible physical, psychological, or social cancer sequelae. Full article
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Article
Randomized Clinical Trial of Zoledronic Acid in Multiple Myeloma Patients Undergoing High-Dose Chemotherapy and Stem-Cell Transplantation
by A. Avilés, N. Neri, J. Huerta–Guzmán and M.J. Nambo
Curr. Oncol. 2013, 20(1), 13-20; https://doi.org/10.3747/co.20.1055 - 1 Feb 2013
Cited by 20 | Viewed by 831
Abstract
Background: A growing body of evidence is demonstrating that the nitrogen-containing bisphosphonate zoledronic acid (zol) improves clinical outcomes in various cancer settings, including multiple myeloma. Those findings provided the rationale for conducting an open-label randomized controlled phase iii trial to evaluate [...] Read more.
Background: A growing body of evidence is demonstrating that the nitrogen-containing bisphosphonate zoledronic acid (zol) improves clinical outcomes in various cancer settings, including multiple myeloma. Those findings provided the rationale for conducting an open-label randomized controlled phase iii trial to evaluate the effect of zol on overall survival (os) and progression-free survival (pfs) in patients with previously untreated high-risk multiple myeloma. Methods: The trial randomly assigned 308 adult patients less than 65 years of age with previously untreated symptomatic multiple myeloma (1:1) to receive zol 4 mg intravenously once every 28 days for 24 months (n = 151) or no zol (n = 157). Before autologous stem-cell transplantation (asct), all patients received a high-dose noncytotoxic induction regimen of dexamethasone, all-trans-retinoic acid, and interferon alpha 2b. Results: After a median follow-up of 69.8 months (range: 36.5–96 months), the 10-year pfs (66% vs. 52%, p < 0.001) and os (67% vs. 48%, p < 0.001) rates were significantly higher in treated patients than in control patients. Overall response (77% zol vs. 75% control), complete response (52% vs. 46%), and very good partial response (25% vs. 29%) rates were similar between the groups. Treatment was generally well tolerated, with no reports of renal impairment or osteonecrosis of the jaw. Conclusions: In symptomatic previously untreated multiple myeloma patients, zol combined with high-dose therapy followed by asct improved os and pfs without appreciable toxicity. These findings provide additional evidence of the meaningful anticancer activity of zol in this patient population. Full article
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Commentary
When Jurisdictional Boundaries Become Barriers to Good Patient Care
by J. Stephen, K. Fergus, S. Sellick, M. Speca, J. Taylor–Brown, J. Turner, K. Collie, D. McLeod and A. Rojubally
Curr. Oncol. 2013, 20(1), 10-13; https://doi.org/10.3747/co.20.1209 - 1 Feb 2013
Viewed by 644
Abstract
Canada is a pioneer in remote cancer care delivery to underserved populations; however, it is trailing behind on policies that would support clinicians in providing care using distance technologies. The current policy framework is disjointed, and discussions by professional boards about online jurisprudence [...] Read more.
Canada is a pioneer in remote cancer care delivery to underserved populations; however, it is trailing behind on policies that would support clinicians in providing care using distance technologies. The current policy framework is disjointed, and discussions by professional boards about online jurisprudence associated with licensure appear to be regressive. We hope that by addressing the discrepancies in interjurisdictional practice and focusing on the key issue of “where therapy resides,” we will be able to nudge dialogue and thinking closer toward the reasoning and recommendations of national telehealth organizations. We present this discussion of jurisdictional issues and e-health practice in the context of a pan-Canadian online support program developed for cancer patients and family members. Although the present paper uses online support groups as a springboard to advocate for e-health, it ultimately addresses a broader audience: that of all Canadian health care stakeholders. Full article
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Editorial
Breast Cancer and the Environment: What Is Left to Learn?
by S.A. Narod
Curr. Oncol. 2013, 20(1), 8-9; https://doi.org/10.3747/co.20.1326 - 1 Feb 2013
Cited by 3 | Viewed by 360
Abstract
Public interest in the link between the environment and breast cancer has waxed in recent months. [...] Full article
282 KiB  
Editorial
Current Oncology: It All Started 20 Years Ago...
by L. Cooper
Curr. Oncol. 2013, 20(1), 7; https://doi.org/10.3747/co.20.1337 - 1 Feb 2013
Viewed by 498
Abstract
As Current Oncology approaches its 20th year of publication, the time is right to share with our readers a brief history of its humble beginnings. [...] Full article
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Article
Multidisciplinary Assessment of Fitness to Drive in Brain Tumour Patients in Southwestern Ontario: A Grey Matter
by E. Chan, A.V. Louie, M. Hanna, G.S. Bauman, B.J. Fisher, D.A. Palma, G.B. Rodrigues, A. Sathya and D.P. D’Souza
Curr. Oncol. 2013, 20(1), 4-12; https://doi.org/10.3747/co.20.1198 - 1 Feb 2013
Cited by 3 | Viewed by 516
Abstract
Background: Neurocognitive impairments from brain tumours may interfere with the ability to drive safely. In 9 of 13 Canadian provinces and territories, physicians have a legal obligation to report patients who may be medically unfit to drive. To complicate matters, brain tumour [...] Read more.
Background: Neurocognitive impairments from brain tumours may interfere with the ability to drive safely. In 9 of 13 Canadian provinces and territories, physicians have a legal obligation to report patients who may be medically unfit to drive. To complicate matters, brain tumour patients are managed by a multidisciplinary team; the physician most responsible to make the report of unfitness is often not apparent. The objective of the present study was to determine the attitudes and reporting practices of physicians caring for these patients. Methods: A 17-question survey distributed to physicians managing brain tumour patients elicited: (1) Respondent demographics; (2) Knowledge about legislative requirements; (3) Experience of reporting Barriers and attitudes to reporting. Fisher exact tests were performed to assess differences in responses between family physicians (fps) and specialists. Results: Of 467 physicians sent surveys, 194 responded (42%), among whom 81 (42%) were specialists and 113 (58%) were fps. Compared with the specialists, the fps were significantly less comfortable with reporting, less likely to consider reporting, less likely to have patients inquire about driving, and less likely to discuss driving implications. A lack of tools, concern for the patient–physician relationship, and a desire to preserve patient quality of life were the most commonly cited barriers in determining medical fitness of patients to drive. Conclusions: Legal requirements to report medically unfit drivers put physicians in the difficult position of balancing patient autonomy and public safety. More comprehensive and definitive guidelines would be helpful in assisting physicians with this public health issue. Full article
352 KiB  
Commentary
Effect of Cancer on Ovarian Function in Patients Undergoing In Vitro Fertilization for Fertility Preservation: A Reappraisal
by I. Levin and B. Almog
Curr. Oncol. 2013, 20(1), 1-3; https://doi.org/10.3747/co.20.1193 - 1 Feb 2013
Cited by 7 | Viewed by 471
Abstract
The past decade has witnessed an increase in cancer survival rates[...] Full article
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