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Volume 4, Number 8 (August 2007) | |||||
Letter from the Editor |
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Offering our highest quality cancer care Wilshire Oncology Medical Group, Inc., La Verne, CA Articles in this month’s issue continue to enhance our readers’ ability to deliver a high level of care in their private oncology practices. Topics range from an exploration of the newly approved renal cell cancer drug temsirolimus; to another article in our continuing series on how to implement clinical trials; to practical reports on managing the toxic effects of bortezomib and on creating a survivorship program; to a review of robotic laparoscopic surgery in gynecologic malignancies. That and more.
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Community Translations |
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Temsirolimus for advanced renal cell carcinoma Temsirolimus (Torisel) has been approved by the US Food and Drug Administration for the treatment of renal cell carcinoma (RCC), following on the heels of sorafenib (Nexavar) and sunitinib (Sutent). An inhibitor of the mammalian target of rapamycin kinase, temsirolimus seems relatively straightforward to administer with a “traditional cytotoxic” profile, apart from a novel need to monitor and possibly treat patients for hyperlipidemia. A thorough review of the data and a commentary by a community oncologist detail the ways in which RCC treatment has become more complex and more effective, thanks to the availability of new novel agents. | ||||
FROM THE COMMUNITY ONCOLOGIST'S PERSPECTIVE California Pacific Medical Center, San Francisco, CA
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Managing Side Effects |
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Managing and avoiding bortezomib toxicity Northwest Cancer Specialists, Portland, OR Bortezomib, the only currently approved proteasome inhibitor, is used in the treatment of relapsed/refractory multiple myeloma and mantle cell lymphoma. The most frequent toxicities of bortezomib are gastrointestinal symptoms, thrombocytopenia, asthenia, and peripheral neuropathy. Thrombocytopenia, the most common grade 3/4 toxicity, usually resolves before the next cycle of bortezomib therapy begins. Other symptoms can be managed symptomatically, or by modifying the dose and schedule of bortezomib administration. The author offers practical steps to help your patients.
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Implementing Clinical Trials |
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Managing drug accountability McKesson Specialty, San Rafael, CA Protecting human research subjects is your single most important duty when conducting clinical trials in your practice. You are well on the road to protecting human subjects when you can ensure that a qualified institutional review board (IRB) or ethics committee approves the conduct of the study, you obtain informed consent from each patient enrolled, and you accurately manage and document drug accountability. This article focuses on the last task, with specific steps and tips you can tailor to your practice.
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Challenging Cases/Rare Cancers |
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Paraneoplastic limbic encephalitis associated with small-cell lung cancer University of Pennsylvania School of Medicine, Philadelphia, PA Limbic encephalitis is characterized by personality changes, irritability, depression, seizures, memory loss, and sometimes dementia. In more than half of cases, limbic encephalitis is paraneoplastic and indicates the presence of an underlying cancer. Symptoms of limbic encephalitis often precede the diagnosis of cancer or mimic other complications of cancer or its treatment, confusing the differential diagnosis. Detection of antibodies has provided diagnostic tests that allow for recognition of the disorder as paraneoplastic and direct the search for the tumor to selected organs. Treatment of the tumor is critical to improving or stabilizing the neurologic disorder.
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Psychosocial Oncology |
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Developing and implementing a survivorship program in a community cancer center Helen F. Graham Cancer Center, Newark, DE Advances in the early detection and treatment of cancer have led to an increased number of cancer survivors. This article introduces the most recent definition of cancer survivor and the empirical data demonstrating the barriers to optimal quality of life that cancer survivors often face after treatment. The article then describes a novel set of psychosocial interventions used to overcome these barriers in a community cancer center setting.
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Original Contribution |
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Update on minimally invasive surgery in the management of gynecologic malignancies: focus on robotic laparoscopic systems The West Clinic, Memphis, TN Laparoscopic management of gynecologic malignancies has expanded greatly in the past 10 to 15 years, driven by tremendous advances in technology, medicine, and surgical techniques. The best example of this comes from the adoption of robotic technology for minimally invasive procedures. These and other minimally invasive laparoscopic procedures are now being explored and defined and are gaining wide acceptance for the treatment of endometrial, cervical, and ovarian cancers. When compared with standard open techniques in large studies, minimally invasive procedures seem to offer similar or improved survival with the added benefits of faster recovery, decreased blood loss, reduced pain, and improved quality of life.
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Washington Update |
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Senators Specter and Casey introduce Community Cancer Care Preservation Act Community Oncology Alliance, Memphis, TN The impetus behind the Community Cancer Care Preservation Act (S 1750) now before Congress is to help community oncologists adversely affected by reforms under the Medicare Modernization Act (MMA). Both S 1750 and its House companion bill, HR 1190, seek to bring about balanced reform for cancer care reimbursement. The Community Oncology Alliance, which worked closely with Senator Arlen Specter on this legislation, is encouraging a massive outreach to members of the House and Senate, asking them to cosponsor the bills.
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© 2007 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. |
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