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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 current method for assessing response to therapy of glial tumors is based on the Macdonald et al. criteria; however, these criteria are ambiguous in key features such as the appropriate threshold for lesion size and the actual methods for applying the stated criteria. The authors of this Review identify the strengths and shortcomings of the current approach and also discuss technological advances in both drug therapy and imaging that necessitate reassessment of the Macdonald et al. criteria.
Five adjuvant breast cancer trials have clearly demonstrated the benefit of trastuzumab in reducing the recurrence rate and mortality in patients with aggressive HER2-positive disease. The controversies and challenges relating to the use of trastuzumab in the adjuvant setting, such as the optimal timing and duration, its use with taxanes and radiotherapy, its role in small node-negative tumors and cost-effectiveness are discussed.
Cardiovascular disease in patients with cancer and cardiac complications of cancer therapy is an increasing clinical problem. Optimum management of cardiovascular disease can allow patients with cancer to successfully receive cancer therapies and it can reduce morbidity and mortality caused by cardiovascular disease in cancer survivors. The authors of this review discuss management strategies for cardiovascular disease in patients with cancer, focusing on the prevention and treatment of congestive heart failure and myocardial infarction.
There have been considerable advances in external-beam delivery and brachytherapy techniques for prostate cancer. Combined-modality therapy with external-beam radiotherapy and brachytherapy is an attractive treatment option for a selected group of patients with clinically localized prostate cancer. Hurwitz discusses the indications for use of combination therapy, choice of low-dose-rate versus high-dose-rate brachytherapy boost, and toxicity and quality of life issues.
The treatment options for patients with chemoresistant diffuse large B-cell lymphoma are limited. Fenske et al. describe the case of a 41-year-old man with chemorefractory lymphoma, who was treated with yttrium-90 microsphere embolization of his hepatic tumors. The patient's lymphoma progressed and he died, but there was no evidence of recurrence in the liver. The authors discuss yttrium-90 microsphere embolization for patients who have chemoresistant lymphoma with involvement of the liver.
