CA: A Cancer Journal for Clinicians最新文献

{"title":"Learning from prostate cancer statistics","authors":"Ruth Etzioni PhD, Lukas Owens BA","doi":"10.3322/caac.70037","DOIUrl":"10.3322/caac.70037","url":null,"abstract":"<p>The population represents the ultimate uncontrolled experiment, yet data on cancer statistics provide an opportunity to learn about real-world outcomes of cancer control activities and policies. In the case of prostate cancer, population data have been critically important in generating and confirming hypotheses about the impacts of screening and treatment advances on the population burden of the disease. Tracking prostate cancer statistics—incidence, mortality, and survival—and how they change over time is thus a prerequisite for understanding the success (or lack thereof) of efforts to control this most common cancer in American men. But population statistics are multifactorial; explaining them requires also considering their many potential drivers and the mechanisms by which disease control efforts play out in the population.</p><p>Consider the example of prostate cancer incidence, prominently reported in this issue’s update on prostate cancer statistics.<span><sup>1</sup></span> Prostate cancer incidence is influenced by prostate-specific antigen (PSA) screening rates in the population. Incidence increased dramatically during the early years of the PSA screening era, prompting concerns that screening was leading to overdiagnosis. Although overdiagnosis did indeed turn out to be a problematic outcome of screening, work by Feuer and Wun<span><sup>2</sup></span> in the early 1990s assured that increases in disease incidence were to be expected when a new screening test was adopted at the population level. The mechanism—initial depletion of the prevalent pool of cases by the screening test—leads to a predicted peak in incidence followed by declines because of the absence in the prevalent pool of those previously detected cases. Feuer and Wun demonstrated that the height and duration of the peak would be driven by the lead time, which is the time by which screening advances disease diagnosis. The lead time is critical not only in the timing of incidence swings after the adoption of screening but also in the delay until any effects of screening on disease mortality are observed. And the average lead time associated with prostate cancer screening is not short—estimates based on the first decade of PSA screening place the mean lead time between 5 and 7 years.<span><sup>3</sup></span></p><p>The update of prostate cancer statistics in this issue of <i>CA: A Cancer Journal for Clinicians</i> highlights more recent incidence trends, specifically the persistence of recent increases overall and in advanced-stage disease. These trends have generated concern because they are what one would expect in a population abandoning screening. Indeed, studies tracking both incidence and screening patterns have been on the alert for such trends, particularly after the issuance of the D recommendation against routine prostate cancer screening for all ages by the US Preventive Services Task Force in 2012.<span><sup>4</sup></span> Although some modest reductions in pro","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"473-474"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CA turns 75: Looking at the future but never forgetting the roots","authors":"Don S. Dizon MD, Sumanta Kumar Pal MD, Banu E. Symington MD, MACP, Razelle Kurzrock MD, Arif H. Kamal MD, Christina M. Annunziata MD, PhD, Shanthi Sivendran MD, MSCR, MBA, Ahmedin Jemal DVM, MPH, William L. Dahut MD","doi":"10.3322/caac.70040","DOIUrl":"10.3322/caac.70040","url":null,"abstract":"<p><i>CA: A Cancer Journal for Clinicians</i> (<i>CA</i>) began in 1950 as <i>CA: A Bulletin of Cancer Progress</i> (Figure 1) and, in 2025, celebrates its 75th year in continuous publication. Today, it is the flagship journal of the American Cancer Society (ACS) and is associated with the highest impact factor of any medical or scientific journal, inside and outside of oncology—a testament to its value, not only to professionals in this space but to the wider public at large. The core reason for its domestic and global reach is <i>cancer statistics</i>, a continuous and evolving effort to describe the incidence and mortality of cancers and how changes in exposures, diagnosis, and treatment affect them. We would be remiss if not acknowledging the 14 years of significant contributions made to the intellectual rigor and refined analyses of these reports, assembled under the guidance of Dr Ahmedin Jemal, Senior Vice President of the Surveillance and Health Equity Science Department.</p><p>Beyond cancer statistics, <i>CA</i> fulfills a major role: the dissemination of information about cancer across its continuum. It has provided our peers and the public contemporary and updated, expert, open-access reviews, at no cost, actively demonstrating a core value of the ACS on the widespread dissemination of cancer practice, research, and education. Reflecting the collaboration of the editorial team and authors, these reviews serve as a resource for everyone and do not require specialization in oncology to comprehend them.</p><p>As <i>CA</i> celebrated its 60th year, the editorial team led by Dr Ted Gansler reflected on seminal publications during its first decade, from the Papanicolaou smear for the early detection of cervical cancer to prognostic disclosure in clinician–patient communication.<span><sup>1</sup></span> It seems fitting then that, as members of the editorial board, we offer our own perspective as we highlight significant publications since that first decade. Finally, we collectively reflect on our mission as we move into the future.</p><p>Colorectal cancer (CRC) is the fourth most common diagnosed cancer and the second leading cause of cancer death in the United States, effecting over 150,000 people and accounting for over 50,000 deaths.<span><sup>2</sup></span> In 2017, Siegel et al. reported increased CRC incidence rates in both men and women younger than 55 years, whereas rates continued to decline in aged 55 years or older.<span><sup>3</sup></span> Consequently, the proportion of CRC being diagnosed in people younger than 55 years rose from 11% of all cases in 1995 to 20% in 2019.<span><sup>2</sup></span> The increase in young-onset CRC is a global phenomenon, with rates rising in parts of Europe, South America, Oceania, and Asia as well as in Canada.<span><sup>4, 5</sup></span> Work is underway to understand the biologic and systemic factors that account for early onset CRC and ways to improve early detection and treatment.</p><p>A testa","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"469-472"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The contemporary management of prostate cancer","authors":"Deep Chakrabarti MD,&nbsp;Peter Albertsen MD,&nbsp;Aidan Adkins MA,&nbsp;Amar Kishan MD,&nbsp;Vedang Murthy MD,&nbsp;Chris Parker MD,&nbsp;Angela Pathmanathan MDRes,&nbsp;Alison Reid PhD,&nbsp;Oliver Sartor MD,&nbsp;Nicholas Van As MDRes,&nbsp;Jochen Walz MD,&nbsp;Alison Tree MDRes","doi":"10.3322/caac.70020","DOIUrl":"10.3322/caac.70020","url":null,"abstract":"<p>Prostate cancer is the most common cancer in two thirds of the world, with an expected doubling in both incidence and mortality in the next two decades. No strong environmental associations exist for the development of prostate cancer; therefore, lifestyle measures are unlikely to mitigate this increasing burden. The last three decades have seen rapid developments in the diagnostic and therapeutic landscape of prostate cancer, including multiparametric magnetic resonance imaging, positron emission tomography, robotic surgery, image-guided hypofractionated and stereotactic radiotherapy, novel anti-androgens and radioligand therapies. Prostate cancer is unique in that not everyone with a diagnosis needs treatment, and active surveillance is the preferred option for some. This review discusses the contemporary management of all stages of prostate cancer in the light of these modern developments, enabling holistic individualization of treatment, and describes the promise of future research to further improve outcomes.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"552-586"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary assessment of patients with extensive stage small cell lung cancer: A geriatric tumor board","authors":"Humera Khurshid MD,&nbsp;Sakeena Raza MD,&nbsp;Robert Brunault PharmD,&nbsp;Brittany Duffy RD,&nbsp;Michael Kavanaugh MD","doi":"10.3322/caac.70026","DOIUrl":"10.3322/caac.70026","url":null,"abstract":"&lt;p&gt;GB, a 74-year-old female with no significant past medical history and active tobacco use disorder of 61 pack-years, underwent a screening computed tomography (CT) of the chest in July 2024. The CT revealed a new, 4.3 × 2.5–cm, spiculated mass in the right upper lobe along with adjacent septal thickening, emphysema, and multiple, stable, subcentimeter pulmonary nodules (Figure 1).&lt;/p&gt;&lt;p&gt;A positron-emission tomography–CT confirmed the size and location of the lung lesion, showing intense fluorodeoxyglucose uptake and extensive lymphadenopathy above and below the diaphragm. The scan also revealed numerous additional foci of increased skeletal fluorodeoxyglucose uptake in the axial and left iliac crest regions (Figure 1). A staging brain magnetic resonance image (MRI) showed no suspicious lesions.&lt;/p&gt;&lt;p&gt;GB underwent a diagnostic bronchoscopy and endobronchial ultrasound 1 month after her initial presentation. A biopsy of the station 4R lymph node revealed an aggressive neuroendocrine tumor, which tested positive for thyroid transcription factor 1, synaptophysin, and insulinoma-associated protein 11, with an elevated Ki-67 proliferative index. The final diagnosis was extensive-stage small cell lung cancer (ES-SCLC) with bone and liver metastases.&lt;/p&gt;&lt;p&gt;Given her advanced age, physicians referred GB to the geriatric-oncology multidisciplinary clinic (GO-MDC) to assess her frailty and stratify her chemotherapy toxicity risk.&lt;/p&gt;&lt;p&gt;In summary, the patient was &lt;i&gt;fit&lt;/i&gt; according to the CGA parameters used in the frailty index.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The Cancer and Aging Research Group Chemotherapy Toxicity Tool (CARG-TT), a calculated score that predicts for grade 3 or higher chemotherapy toxicity, indicated an intermediate risk for GB.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We discussed in detail that GB has incurable or ES-SCLC. The goal of treatment is to control the cancer with treatment and maintain her quality of life. Based on CGA assessment and an intermediate risk of grade 3 or higher toxicity, we recommended systemic, palliative chemotherapy with carboplatin, etoposide, and an immune checkpoint inhibitor with growth factor support. After a risk/benefit discussion, GB opted for the palliative treatment.&lt;/p&gt;&lt;p&gt;After visiting the GO-MDC, she began systemic therapy with carboplatin with an area under the curve of 5 on day 1, atezolizumab 1200 mg on day 1, and etoposide 80 mg/m&lt;sup&gt;2&lt;/sup&gt; on days 1–3 every 21 days. Apart from mild fatigue and grade 2 anemia, she did not have any significant toxicity. She received cycle 4 of induction chemoimmunotherapy without further dose reduction on October 30, 2024.&lt;/p&gt;&lt;p&gt;There was a significant reduction of the mass in the right upper lobe, mediastinal lymphadenopathy, and a liver lesion consistent with treatment response observed on a November 20, 2024, follow-up torso CT (Figure 2). The patient received maintenance atezolizumab, which is being administered every 21 days. Because of a lack of survival benefit f","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"475-484"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer acknowledgement 2025","authors":"","doi":"10.3322/caac.70033","DOIUrl":"10.3322/caac.70033","url":null,"abstract":"<p>In order to maintain the high standards of <i>CA</i>’s content, the Editors of <i>CA</i> rely on the knowledge and dedication of many experts in deciding which topics to pursue, which manuscripts to publish, and what modifications to make to ensure medical and scientific accuracy and suitability for our readers. We thank our Associate Editors and our Editorial Advisory Board, who continue to provide these services for us time and time again.</p><p>We are also greatly indebted to the effort and expertise of the following individuals for reviewing manuscripts for the journal from July 1, 2024, to June 30, 2025. These individuals go beyond expectations by consistently and expeditiously delivering comprehensive, discerning reviews.</p><p>Lauren Antrim</p><p>Pedro Barata</p><p>Nabila Bennani</p><p>Ari Birnbaum</p><p>Sue Bornstein</p><p>Donald Cannon</p><p>Michael Carney</p><p>Elizabeth Cathcart-Rake</p><p>Annie Chan</p><p>Huizi Chen</p><p>Carissa Chu</p><p>Sean David</p><p>Ruth Etzioni</p><p>Robert Ferris</p><p>Courtney Finlayson</p><p>Bryan Fuchs</p><p>Elizabeth Garrett-Mayer</p><p>William Hall</p><p>Michael Halpern</p><p>Ole-Petter Hamnvik</p><p>David Hui</p><p>Linda Jacobs</p><p>Salvador Jaime-Casas</p><p>Rebecca Johnson</p><p>Corinne Joshu</p><p>David Keefe</p><p>WonSeog Kim</p><p>Elise Kohn</p><p>Lindsay M. Kuroki</p><p>Rita Kuwahara</p><p>Richard Lee</p><p>Shing Lee</p><p>Phebe Lemert</p><p>Stanley Liauw</p><p>Stephen Liu</p><p>Shail Maingi</p><p>Sendurai Mani</p><p>Jonathan Marron</p><p>Brittany C. McGill</p><p>Jacob Miller</p><p>Paul Montgomery</p><p>Susan O'Brien</p><p>Krishnan Patel</p><p>Rodolfo Alberto Rey</p><p>Tina Rizack</p><p>Nabil Saba</p><p>Stephanie Smith</p><p>Umang Swami</p><p>Wade Swenson</p><p>Russell Taichman</p><p>Yungan Tao</p><p>Molly Taylor</p><p>Ayalew Tefferi</p><p>Sarah Temkin</p><p>William Tew</p><p>Premal Thaker</p><p>Jonathan Thompson</p><p>Michael Thun</p><p>Katherine Tossas</p><p>Zaza Tsitsishvili</p><p>Adam Wahida</p><p>Thomas Zilli</p><p>Miguel Zugman</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145078376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Cancer treatment and survivorship statistics, 2025”","authors":"","doi":"10.3322/caac.70036","DOIUrl":"10.3322/caac.70036","url":null,"abstract":"<p>Wagle NS, Nogueira L, Devasia TP, et al. Cancer treatment and survivorship statistics, 2025. <i>CA Cancer J Clin</i>. 2025;75(4):308-340. doi:10.3322/caac.70011</p><p>In the “Cancers in children and adolescents” section, the first sentence currently reads: “As of January 1, 2025, it is estimated that 40,260 children (<i>aged 14 years and older</i>) and 44,290 adolescents (aged 15–19 years) are living in the United States with a previous cancer diagnosis.” The correct age category for children is “0–14 years” and should read: “As of January 1, 2025, it is estimated that 40,260 children (<i>aged 0–14 years</i>) and 44,290 adolescents (aged 15–19 years) are living in the United States with a previous cancer diagnosis.”</p><p>The authors apologize for this oversight.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study assesses normal tissue effects after axillary radiotherapy for early breast cancer","authors":"Carrie Printz","doi":"10.3322/caac.70039","DOIUrl":"10.3322/caac.70039","url":null,"abstract":"&lt;p&gt;In 2020, the multicenter, randomized, phase 3 FAST-Forward trial reported 5-year results showing that delivery of whole breast or chest wall adjuvant radiotherapy was a safe and effective alternative to the 3-week regimen. Current UK and European guidelines support 26 Gy in 5 daily fractions (Fr) as a standard of care for early breast cancer.&lt;/p&gt;&lt;p&gt;In a FAST-Forward substudy published in Radiotherapy &amp; Oncology (doi:10.1016/j.radonc.2025.110915), researchers sought to assess normal tissue effects on the axilla after the same 1- and 3-week radiotherapy dose schedules. Findings showed no patient-reported differences between the two protocols after 5 years and thus indicated that 26-Gy/5-Fr/1-week hypofractionation radiotherapy is safe for patients with breast cancer who need it.&lt;/p&gt;&lt;p&gt;This substudy followed the same design as the randomized, noninferiority, nonblinded FAST-Forward trial. The ongoing trial compares two 5-Fr schedules of adjuvant radiotherapy to the whole breast or chest wall delivered in 1 week with the 15-Fr/3-week schedule. A total of 469 patients with invasive breast cancer from 50 UK centers were included in the substudy. Participants had surgery (either lumpectomy or mastectomy) and required axillary radiotherapy (any or all levels [1–4]). The analysis compared 40 Gy and 5 Fr (3 weeks, control) to 26 Gy and 5 Fr (1 week). The primary endpoint was 5-year patient-reported moderate or marked arm or hand swelling. The median age was 61 years.&lt;/p&gt;&lt;p&gt;In the group, 54% and 39% of the patients had grade 2 and 3 tumors, respectively, and 56% of the patients had axillary dissection. Patients were randomized to either the 3-week control group (&lt;i&gt;n&lt;/i&gt; = 182) or the 1-week treatment group (&lt;i&gt;n&lt;/i&gt; = 183). A third arm (27 Gy and 5 Fr) that enrolled 104 patients was stopped early because increased toxicity was detected.&lt;/p&gt;&lt;p&gt;Participants completed questionnaires at the baseline and 3, 6, 12, 24, and 60 months after randomization. These included the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life tool, a breast cancer module, a body image scale, and fatigue questionnaires. In addition, patients were asked protocol-specific questions about the adverse effects of radiotherapy and were clinically assessed.&lt;/p&gt;&lt;p&gt;The primary endpoint was 5-year patient-reported moderate or marked arm or hand swelling reported via the EORTC Quality of Life questionnaire. Secondary endpoints included patient- and clinician-reported outcomes for late radiotherapy adverse effects. A composite endpoint consisted of the worst grade for problems and other adverse effects such as breast distortion, shrinkage, induration, and lymphedema.&lt;/p&gt;&lt;p&gt;The 5-year questionnaires were returned by 307 patients, with 300 including data on the primary endpoint. Clinicians provided 5-year assessments for 376 patients. At 5 years, moderate or marked hand or arm swelling was reported by 11 of 107 patients (10%) in the 3-week radiotherapy group ","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"466-468"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145449814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urothelial carcinoma: Perioperative considerations from top to bottom","authors":"Wesley Yip MD,&nbsp;Salvador Jaime-Casas MD,&nbsp;Anjaney Kothari PhD,&nbsp;Mary Sullivan MA,&nbsp;Leslie K. Ballas MD,&nbsp;Domenique Escobar MD,&nbsp;Anne K. Schuckman MD,&nbsp;Jonathan E. Rosenberg MD,&nbsp;Jonathan A. Coleman MD","doi":"10.3322/caac.70019","DOIUrl":"10.3322/caac.70019","url":null,"abstract":"<p>Urothelial carcinoma is an aggressive entity that is associated with significant morbidity, but there have been major advances in both our understanding of and treatment options for patients with this disease. In this review, the authors focus on novel therapeutic and diagnostic approaches in the perioperative setting, with an emphasis on patient-centered and individualized care. For urothelial carcinoma of the bladder (UCB), advances in nonplatinum-based therapies, specifically immunotherapy and antibody–drug conjugates, have expanded the therapeutic arsenal for patients with muscle-invasive UCB in both the neoadjuvant and adjuvant settings to improve survival outcomes. Given the significant morbidity of extirpative surgery (radical cystectomy and urinary diversion), there have also been greater efforts to evaluate bladder-sparing protocols and improve the selection of patients for surgery and their postoperative recovery. The authors review special considerations for organ-sparing surgery in females, geriatric co-management, and enhanced recovery after surgery protocols. For upper tract urothelial carcinoma, there has been increasing recognition of its unique diagnostic and therapeutic challenges, including risks of renal functional loss. There have been advances in molecular profiling that have demonstrated various genomic differences between upper tract urothelial carcinoma and UCB, with treatment implications. This article reviews studies evaluating perioperative care that focused on optimizing therapeutic approaches, including neoadjuvant/adjuvant chemotherapy and immunotherapy, as well as nephron-sparing strategies in carefully selected cases.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"528-551"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Talking with adolescent and young adult cancer survivors about health after cancer: A review and communication guide for clinicians","authors":"Stephanie M. Smith MD, MPH,&nbsp;Lauren C. Heathcote PhD,&nbsp;Jennifer N. John BA,&nbsp;Jasan Zimmerman MNA, CFRE,&nbsp;Catherine Benedict PhD,&nbsp;Abby R. Rosenberg MD, MA, MS,&nbsp;Lidia Schapira MD","doi":"10.3322/caac.70030","DOIUrl":"10.3322/caac.70030","url":null,"abstract":"<p>Adolescent and young adult (AYA) cancer survivors represent a vulnerable population in cancer care and survivorship. AYA survivors are a heterogeneous group that includes people between the ages of 15 and 39 years who were treated for cancer during their childhood or AYA years, at which time they had variable agency and may have received cancer care in pediatric or adult settings. AYA survivors experience one or multiple health care transitions, moving from active oncology to posttreatment survivorship and/or from pediatric to adult care. Clinician communication that centers the needs and preferences of the AYA and their family (parent, partner, other support person) is a therapeutic tool that can support AYAs in these health care transitions and promote AYA engagement in their care. In this article, the authors review clinician communication practices through the lens of AYAs' and families' lived experiences with a focus on the initial diagnosis and treatment phase, completion of treatment, and throughout posttreatment survivorship care. Specific communication topics relevant to survivorship encompass managing uncertainty and fear of cancer recurrence, discussing treatment-related future health risks, and supporting self-management and engagement in care. Best practices for clinician communication include maintaining openness, compassion, and flexibility to re-assess and adapt communication styles as an AYA cancer survivors' needs, concerns, and preferences change over time.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"667-681"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update and new advances in fertility preservation and cancer","authors":"Gwendolyn P. Quinn PhD,&nbsp;Michelle Bayefsky MD,&nbsp;Brooke Cherven PhD, MPH,&nbsp;Lauren V. Ghazal PhD, FNP-BC,&nbsp;Kara N. Goldman MD,&nbsp;Nina Francis Levin PhD,&nbsp;Leena Nahata MD,&nbsp;Bobby Najari MD,&nbsp;Sameer Thakker MD,&nbsp;Daniel R. Greenberg MD,&nbsp;Joshua A. Halpern MD, MS,&nbsp;Susan T. Vadaparampil PhD","doi":"10.3322/caac.70029","DOIUrl":"10.3322/caac.70029","url":null,"abstract":"<p>Adolescents and young adults with a cancer diagnosis face unique challenges during treatment and into survivorship related to fertility and family building. This review provides an updated overview of the impact of cancer and its associated treatments, including novel treatments in male and female fertility. An overview of fertility preservation and family building options, including experimental options, is also provided.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"602-629"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}