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MRI can identify cancer foci that are not evident clinically or detected by mammography. The detection of additional cancer with MRI has been interpreted as evidence that the imaging procedure is beneficial to patients; however, the available data do not support this contention. The author of this Viewpoint discusses why the routine incorporation of MRI into the presurgical workup should not be included for the vast majority of patients with breast cancer.
For patients with colorectal cancer and liver metastases, hepatic resection is the only potential curable treatment. The role of adjuvant chemotherapy in this setting is still under debate. The authors of this Viewpoint discuss the final results of the EORTC Intergroup randomized phase III study 40983 and whether FOLFOX4 should be the new standard in patients with resectable colorectal cancer and liver metastases.
Cytoreductive nephrectomy has been a standard treatment for patients with metastatic renal cell carcinoma. The introduction of targeted agents has generated interest in using these drugs pre-operatively. The authors discuss the use of molecular targeted therapy and the benefits of cytoreductive nephrectomy.
The combination of dyspnea, exercise limitation and muscle weakness is known as cancer fatigue syndrome. Dyspnea is an important symptom in patients with cancer and also in patients with chronic heart failure. The authors of this Viewpoint hypothesize that cancer fatigue syndrome represents clinically non-overt heart failure, and postulate that cardiac-like symptoms in cancer develop in a similar manner to symptoms of chronic heart failure.
The value of sentinel-node biopsy for the management of localized primary melanoma has been questioned. In this Viewpoint, the authors discuss the data that support the routine use of sentinel-node biopsy, and assert why this technique should be considered the standard approach for staging patients with clinically localized, intermediate-thickness melanoma.
Over 80% of men with advanced prostate cancer respond to standard treatment with continuous androgen deprivation therapy. Most of these patients, however, go on to develop androgen resistance and disease progression. The authors of this Viewpoint propose that intermittent androgen deprivation should be the standard therapy in advanced prostate cancer.
Over half of all newly-diagnosed diffuse large B-cell lymphoma patients can be cured with first line treatment based on the combination of rituximab with anthracycline-based chemotherapy regimens. The authors of this Viewpoint discuss the use of high-dose therapy and autologous hematopoietic stem cell support in patients with DLBCL who have relapsed or are refractory to first line treatment.
Estrogen-receptor expression is a useful predictive marker of response to endocrine therapy in patients with breast cancer. The authors of this Viewpoint discuss the use of gene-expression profiles and predictive markers for determining the optimum treatment strategy for women with breast cancer.
The incidence of breast cancer in the US dropped sharply between 2002 and 2003. In this Viewpoint, the author discusses two theories to account for this observation: the decrease in use of hormone-replacement therapy and a decline in the US screening mammography rates.
Gastrointestinal stromal tumors that metastasize cannot be controlled by systemic chemotherapy or radiotherapy; however, tumor control in such patients can be achieved with imatinib. The author of this Viewpoint discusses whether imatinib should be used as adjuvant therapy in patients who are at risk for developing metastasis, and whether tumor size is an appropriate criterion for such therapy.
The incidence of skin cancer as a result of exposure to ultraviolet radiation, either through sunlight or artificial tanning facilities, is increasing. In this Viewpoint the authors discuss the risks of melanoma for adolescents using artificial tanning facilities and call on authorities to restrict access to such facilities.
Ensuring adherence to cancer treatment is as important to successful treatment as the development of new therapies. In this Viewpoint the author discusses the issues surrounding compliance to medical therapy and factors affecting patient behavior.
