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Women who carry a germline mismatch-repair mutation causal to Lynch syndrome have increased risks of developing endometrial carcinoma and ovarian cancer, as well as colorectal carcinoma. This Viewpoint outlines the rationale for the use of lifesaving prophylactic gynecologic surgery in these women following childbearing, with testing and surveillance unless and until such surgery is performed.
Hypothyroidism seems to be a risk of sunitinib therapy for cancer. The authors of this Viewpoint review the evidence for the occurrence of hypothyroidism in this setting and discuss possible actions of thyroid hormone replacement in the cancer patient.
Active surveillance for favorable-risk prostate cancer has become increasingly popular in populations in which prostate cancer screening is widespread because of evidence that screening results in the detection of disease that is not clinically significant in many patients. This Review discusses the results of active surveillance, the criteria for patient selection and the appropriate thresholds for intervention.
Primary tumor removal is usually considered as intrinsically beneficial, but this can perturb metastatic homeostasis and, for some patients, results in the acceleration of metastatic cancer. This Review analyzes the recent evolution of two paradigms related to the development of breast cancer metastases, and discusses the limitations of these paradigms in terms of how they explain breast cancer recurrence dynamics for patients undergoing surgery with or without adjuvant chemotherapy.
The pathogenic relationship between bisphosphonates and osteonecrosis of the jaw is unclear, but there is evidence to indicate an association between high-dose bisphosphonate treatment and exposure to dental infections and oral surgical procedures. The authors of this Review highlight that a better knowledge of the interactions between these agents and of the jaw and maxillary bone biology will improve clinical and therapeutic approaches to osteonecrosis of the jaw.
Patients with primary plasma-cell leukemia (PCL) are usually treated with regimens used for multiple myeloma because no official guidelines exist for the treatment of PCL. Ballanti et al. discuss the case of a 68-year-old man with primary PCL who developed sustained ventricular tachycardia that was thought to be caused by thalidomide. The authors emphasize the need for complete cardiac evaluation and clinical monitoring of patients undergoing thalidomide treatment.
Tubercular lymphadenitis of the cervical lymph nodes can be easily confused with node metastases. Chaturvedi et al. present the case of a 66-year-old man who was diagnosed with tongue carcinoma. PET–CT imaging suggested extensive neck-node metastases but frozen sections revealed tuberculosis of the neck nodes. The patient underwent surgery and received multidrug antitubercular therapy. The need for cautious interpretation of PET–CT reports, especially in tuberculosis-endemic areas, is discussed.
