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Effective Image Communication of Hormone Replacement Therapy Risks and Benefits 激素替代疗法的风险和益处的有效图像交流
The Cancer Journal Pub Date : 2022-05-01 DOI: 10.1097/PPO.0000000000000593
E. Rifkin
{"title":"Effective Image Communication of Hormone Replacement Therapy Risks and Benefits","authors":"E. Rifkin","doi":"10.1097/PPO.0000000000000593","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000593","url":null,"abstract":"Abstract This article focuses on the value of a unique graphic/image designed to communicate health risks and benefits related to the administration of hormone replacement therapy. It will demonstrate why equations, technical terms, and confusing rhetoric need not be used for communication to patients and others. The use of a “familiar” theater graphic (given the name Benefit/Risk Characterization Theater) will allow physicians and patients to share decision-making by visualizing tradeoffs through the use of a clearer format: example Benefit/Risk Characterization Theaters: breast cancer risks associated with hormone replacement therapy, effectiveness of estrogen in treating menopausal symptoms, and thromboembolic risk of taking estrogen for postmenopausal women. The article describes a practical, simple methodology that can be used in many countries to facilitate doctor-patient communication.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80218965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update on Pregnancy Following Breast Cancer Diagnosis and Treatment 乳腺癌诊断和治疗后妊娠的最新进展
The Cancer Journal Pub Date : 2022-01-01 DOI: 10.1097/PPO.0000000000000599
M. Perachino, F. Poggio, L. Arecco, E. Blondeaux, S. Spinaci, C. Marrocco, A. Levaggi, M. Lambertini
{"title":"Update on Pregnancy Following Breast Cancer Diagnosis and Treatment","authors":"M. Perachino, F. Poggio, L. Arecco, E. Blondeaux, S. Spinaci, C. Marrocco, A. Levaggi, M. Lambertini","doi":"10.1097/PPO.0000000000000599","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000599","url":null,"abstract":"Abstract Survivorship has become a crucial component in breast cancer care. For women who have not completed their family planning, conceiving at the end of anticancer treatments should not be discouraged but might be challenging. Oncofertility counseling should be offered at the time of diagnosis to all patients, in order to inform them about the potential treatment-induced gonadotoxicity as well as the available strategies for fertility preservation, thus allowing to increase the chances of a future pregnancy. This article reports an updated overview on the current state of the art on pregnancy in women with prior breast cancer diagnosis and treatment, with a main focus on the issues faced by patients with history of hormone receptor–positive disease and BRCA carriers.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77574434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concerns About Compounded Bioidentical Menopausal Hormone Therapy 对复合生物同质绝经期激素治疗的关注
The Cancer Journal Pub Date : 2022-01-01 DOI: 10.1097/PPO.0000000000000597
J. Pinkerton
{"title":"Concerns About Compounded Bioidentical Menopausal Hormone Therapy","authors":"J. Pinkerton","doi":"10.1097/PPO.0000000000000597","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000597","url":null,"abstract":"Abstract Following the release of the Women's Health Initiative data, women began to use compounded bioidentical hormone therapy (cBHT) in the misguided belief of greater safety and efficacy than traditional hormone therapy. New guidelines recommend government-approved hormone therapy for symptomatic healthy menopausal women younger than 60 years or within 10 years of menopause at the time of initiation. For women requesting bioidentical hormones, those similar to the hormones present before menopause, there are many government-approved hormone therapies with extensive pharmacokinetic, safety, and efficacy data provided with package inserts delineating efficacy, safety, and potential risks. For women requesting non–Food and Drug Administration–approved (cBHT), these cBHTs lack data on pharmacokinetics, safety, and efficacy and are not provided a label detailing risk. Their use should be restricted to women with allergies or dosing or formulations not available in government-approved therapies. Pellet therapy providing women with supraphysiologic hormone dosing raises even more safety concerns.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80925346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development 阴道内雌激素和全身睾酮在绝经期妇女管理中的个体益处和风险，并讨论任何与癌症发展相关的风险
The Cancer Journal Pub Date : 2022-01-01 DOI: 10.1097/PPO.0000000000000598
Abbie Laing, Louise R Newson, J. Simon
{"title":"Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development","authors":"Abbie Laing, Louise R Newson, J. Simon","doi":"10.1097/PPO.0000000000000598","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000598","url":null,"abstract":"Abstract Several formulations of intravaginal oestrogen are available for the treatment of genitourinary syndrome of menopause (GSM). These are safe and effective treatments for the symptoms of GSM. Licensed doses of intravaginal oestrogen do not elevate systemic estradiol levels above the normal postmenopausal range with long term use and there is no evidence of an increased risk of coronary heart disease, stroke, thromboembolism, colorectal cancer, endometrial cancer, breast cancer or breast cancer recurrence with their use. This should reassure both women and their healthcare professionals and should lead to more women receiving these localised, vaginally administered hormonal treatments. Available evidence also suggests a positive safety profile for transdermal testosterone treatment when delivered at physiological concentrations.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87931467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Mechanistic Effects of Estrogens on Breast Cancer 雌激素对乳腺癌的机制作用
The Cancer Journal Pub Date : 2022-01-01 DOI: 10.1097/PPO.0000000000000596
R. Santen, C. Stuenkel, W. Yue
{"title":"Mechanistic Effects of Estrogens on Breast Cancer","authors":"R. Santen, C. Stuenkel, W. Yue","doi":"10.1097/PPO.0000000000000596","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000596","url":null,"abstract":"Purpose Current concepts regarding estrogen and its mechanistic effects on breast cancer in women are evolving. This article reviews studies that address estrogen-mediated breast cancer development, the prevalence of occult tumors at autopsy, and the natural history of breast cancer as predicted by a newly developed tumor kinetic model. Methods This article reviews previously published studies from the authors and articles pertinent to the data presented. Results We discuss the concepts of adaptive hypersensitivity that develops in response to long-term deprivation of estrogen and results in both increased cell proliferation and apoptosis. The effects of menopausal hormonal therapy on breast cancer in postmenopausal women are interpreted based on the tumor kinetic model. Studies of the administration of a tissue selective estrogen complex in vitro, in vivo, and in patients are described. We review the various clinical studies of breast cancer prevention with selective estrogen receptor modulators and aromatase inhibitors. Finally, the effects of the underlying risk of breast cancer on the effects of menopausal hormone therapy are outlined. Discussion The overall intent of this review is to present data supporting recent concepts, discuss pertinent literature, and critically examine areas of controversy.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87785482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Menopausal Hormone Therapy and Breast Cancer 绝经期激素治疗和乳腺癌
The Cancer Journal Pub Date : 2022-01-01 DOI: 10.1097/PPO.0000000000000601
R. Chlebowski, J. Manson
{"title":"Menopausal Hormone Therapy and Breast Cancer","authors":"R. Chlebowski, J. Manson","doi":"10.1097/PPO.0000000000000601","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000601","url":null,"abstract":"Abstract Associations of estrogen-alone and estrogen plus progestin with breast cancer incidence and related mortality are reviewed from observational studies (The Collaborative Group on Hormonal Factors in Breast Cancer and The Million Women Study, 2019) and the Women’s Health Initiative’s (2020) two randomized trials evaluating conjugated equine estrogen alone, for women with prior hysterectomy or with medroxyprogesterone acetate. Findings are generally concordant for estrogen plus progestin use with both observational and randomized studies reporting higher breast cancer incidence. Findings are discordant for estrogen-alone use where, in the WHI randomized trial, a lower incidence and lower breast cancer mortality was seen. In contrast, in the observational studies, estrogen-alone use was associated with higher breast cancer incidence and higher breast cancer mortality. Although these discordant findings are difficult to fully reconcile, we conclude with a discussion of public health implications of the available evidence on menopausal hormone therapy and breast cancer.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81791431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Menopause Hormone Therapy in the Management of Postmenopausal Osteoporosis 绝经期激素治疗绝经后骨质疏松症
The Cancer Journal Pub Date : 2022-01-01 DOI: 10.1097/PPO.0000000000000592
S. Rozenberg, J. Vandromme, Perrine Revercez, Mathilde Valcarenghi, Aurélie Joris
{"title":"Menopause Hormone Therapy in the Management of Postmenopausal Osteoporosis","authors":"S. Rozenberg, J. Vandromme, Perrine Revercez, Mathilde Valcarenghi, Aurélie Joris","doi":"10.1097/PPO.0000000000000592","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000592","url":null,"abstract":"Abstract This narrative review analyzes the customization of menopause hormone therapy (MHT) for osteoporosis prevention and treatment in the context of the patients' age and menopausal age. In short, MHT is indicated in most women suffering from menopause before the age of 45 years except for breast cancer survivors. These women should be treated with MHT until the age of 50 years. For women who have entered menopause at around the age of 50 years, risks associated with MHT are low, and MHT is a safe option, provided there is an indication for it. We suggest that pursuing MHT entails different risks than initiating it, after the age of 60 years. In both cases, advantages and risks should be evaluated. We suggest using risk calculators to assess the magnitude of these risks and choosing regimens that entail the lowest breast and thrombosis risks.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87079916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Introduction by the Guest Editor 特邀编辑介绍
The Cancer Journal Pub Date : 2019-11-01 DOI: 10.1097/PPO.0000000000000415
B. Cheson
{"title":"Introduction by the Guest Editor","authors":"B. Cheson","doi":"10.1097/PPO.0000000000000415","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000415","url":null,"abstract":"","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80378425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chimeric Antigen Receptor T Cells in Chronic Lymphocytic Leukemia 嵌合抗原受体T细胞在慢性淋巴细胞白血病中的作用
The Cancer Journal Pub Date : 2019-11-01 DOI: 10.1097/PPO.0000000000000409
J. Rhodes, S. Schuster
{"title":"Chimeric Antigen Receptor T Cells in Chronic Lymphocytic Leukemia","authors":"J. Rhodes, S. Schuster","doi":"10.1097/PPO.0000000000000409","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000409","url":null,"abstract":"Abstract Recent advances in the treatment of chronic lymphocytic leukemia (CLL) have dramatically changed outcomes for patients. Despite these improvements, CLL is still considered incurable. Chimeric antigen receptor–modified T cells have demonstrated the ability to produce long-term remissions in subsets of heavily pretreated patients with B-cell malignancies, including CLL. Unfortunately, the majority of patients with CLL do not attain durable responses. Recent studies have focused on understanding the mechanisms and predictors of response in these patients. In this review, we will discuss the literature for chimeric antigen receptor–modified T-cell therapy in CLL and highlight mechanisms of response and resistance as currently understood.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83790712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BCL-2 Inhibitors, Present and Future BCL-2抑制剂的现状和未来
The Cancer Journal Pub Date : 2019-11-01 DOI: 10.1097/PPO.0000000000000408
C. Ryan, M. Davids
{"title":"BCL-2 Inhibitors, Present and Future","authors":"C. Ryan, M. Davids","doi":"10.1097/PPO.0000000000000408","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000408","url":null,"abstract":"Abstract The members of the B-cell leukemia/lymphoma-2 (BCL-2) family of proteins are key regulators of the intrinsic apoptotic pathway; dysregulation of this pathway leads to pathologic survival of cancer cells. B-cell leukemia/lymphoma-2 had long been viewed as a promising target for the treatment of several hematologic malignancies, specifically chronic lymphocytic leukemia (CLL), yet for many years the development of a drug to successfully target this protein remained elusive. The approval of the BCL-2 inhibitor venetoclax for relapsed/refractory del(17p) CLL in 2016 represented the culmination of decades of molecular and clinical research and has paved the way for new combination therapy regimens in CLL, including the venetoclax + rituximab regimen approved for relapsed/refractory CLL in 2018 and the venetoclax + obinutuzumab regimen approved for frontline CLL treatment in 2019. Here, we provide an overview of the mechanism of action of BCL-2 inhibition, the role of this approach in the current treatment paradigm of CLL, and an in-depth focus on the clinical trials in CLL involving venetoclax. Additionally, we review key areas of active research including the integration of minimal residual disease as a marker of clinical efficacy in current clinical trials as well as the emergence of venetoclax resistance mechanisms and potential strategies to overcome this resistance. Given the success of venetoclax in the clinical setting thus far, it is likely that BCL-2 inhibition will take on an increasingly important role in the treatment of CLL going forward.","PeriodicalId":22430,"journal":{"name":"The Cancer Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83025509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
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