The Journal of community and supportive oncology最新文献

{"title":"Metastatic Kaposi sarcoma with osseous involvement in a patient with AIDS","authors":"Mariola Vazquez-Martinez, Erika Correa, B. Agarwal, Jingxu Zhou, S. Soundararajan, P. Lothe, M. Jain","doi":"10.12788/jcso.0343","DOIUrl":"https://doi.org/10.12788/jcso.0343","url":null,"abstract":"Kaposi sarcoma is an AIDS-defining illness associated with human herpes virus-8 (HHV-8) co-infection. It was described in 1872 by the Hungarian dermatologist Mortiz Kaposi, and was an isolated and sporadic occurrence before the emergence of HIV infection and AIDS.1 It was first affiliated as an AIDS-associated neoplasm in 1981.1 Kaposi sarcoma is a systemic disease that can present with cutaneous lesions with or without internal involvement. There are four subtypes: Classic, African endemic, AIDS-related (CD4 count, <200), and Kaposi sarcoma in iatrogenically immunosuppressed patients. The disease has the propensity to manifest in the skin and gastro-intestinal and respiratory tracts, and osseous involvement is rarely encountered. We present here the case of an AIDS-positive man with generalized bone pain as a result of metastasis from Kaposi sarcoma. Our discussion includes the epidemiological, clinical, pathological, and radiological facets of AIDS-related Kaposi sarcoma, and the anomaly of osseous involvement.","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42406866","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}

{"title":"Oncology and the heart","authors":"David H. Henry, J. Carver","doi":"10.12788/JCSO.0348","DOIUrl":"https://doi.org/10.12788/JCSO.0348","url":null,"abstract":"","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44436306","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}

{"title":"Improving cancer care through modern portfolio theory","authors":"K. Knopf","doi":"10.12788/JCSO.0328","DOIUrl":"https://doi.org/10.12788/JCSO.0328","url":null,"abstract":"We struggle daily to improve cancer care – to improve our therapeutic outcomes in cancer – as individual physicians and as researchers. We work collectively to disseminate information and collaborate, and there are welcome calls for open data sharing to accelerate progress.1 We enroll patients on clinical trials, or we work in a basic science lab to discover mechanisms of carcinogenesis and potential therapeutic targets. We discuss “n of 1” trials and the “paradigm shift of precision oncology,” and we are optimistic about the future of cancer care. Leaving the world of biology and clinical trials for a minute, we also can apply economic theory in our never-ending quest to improve cancer outcomes. One area of interest may be modern portfolio theory (MPT), which the economist Harry Markowitz introduced in an essay in 1952 and later won the Nobel Prize for his work. MPT is complex, but it states that one’s expected rate of financial return depends on how assets are allocated. There is even discussion of an “efficient frontier”: an optimal way to allocate assets for a given system. We can apply MPT to how we think about allocating economic assets in cancer care – with the goal of maximizing return for all cancer patients – by following the principal of distributive justice.2 At least 71 billionaires live in the San Francisco Bay Area, where I live, but 14,000 children (13%) in the area live below the poverty line.3 When there is a range of asset allocations in health care, results can vary not on the basis of the underlying disease state or the quality of the provider, but on access to care. As an example, most pediatric cancers are curable, yet a recent retrospective analysis of data in the SEER-Medicare registry showed that mortality within 1 month of diagnosis of childhood cancer related in part to socioeconomic factors – those patients with a lower socioeconomic status (which correlates with being an ethnic minority in the United States) were more likely to die within a month of diagnosis of their cancer than were patients with a higher socioeconomic status.3 Here is where MPT can transform the cancer outcomes landscape at no additional investment in basic science or costly precision medicine5: by triaging these patients according to their disease state rather than their ability to pay, they could be administered curative chemotherapy, placed on the appropriate clinical trial, and be cured of their cancer like other children of higher socioeconomic status. My colleagues and I observed a similar trend when we looked at treatment of diffuse large-cell non-Hodgkin lymphoma in Medicare recipients.6 Although the cure rate is as high as 60%-80% with the use of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) or R (rituxin)CHOP chemotherapy, we found that many patients had received suboptimal chemotherapy. Upon closer examination, we found that there were variations in care by socioeconomic status even in a single-payer system. Thus aspec","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47545716","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}

{"title":"Comprehensive assessment of cancer survivors' concerns to inform program development","authors":"Susan R. Mazanec, P. Gallagher, W. Miano, A. Sattar, B. Daly","doi":"10.12788/JCSO.0338","DOIUrl":"https://doi.org/10.12788/JCSO.0338","url":null,"abstract":"Complex cancer treatments, limited personnel resources, and a growing number of cancer survivors are challenging cancer health care professionals’ abilities to provide comprehensive care. Cancer survivors have a range of needs that extend over the cancer care trajectory and that represent physical, psychological, social, and spiritual domains. Numerous studies have explored supportive care needs and recent systematic reviews have highlighted the supportive care needs related to cancer1 and to specific cancer types, including prostate cancer,2 breast cancer,3 gynecologic cancer,4 hematological cancer,5 and lung cancer.6 However, reviews are limited in that they do not always assess needs across the cancer trajectory or identify demographic or clinical variables that are associated with needs. These data are needed to focus survivorship program development in cancer centers in order to target populations most likely at risk for unmet needs, identify what salient concerns to address, and to appropriately schedule supportive care programs. The importance of assessing the patient’s subjective view of his/her needs or concerns is well acknowledged as being fundamental to patientcentered care.7 Clinicians routinely assess needs in practice using a variety of screening tools. However, there needs to be a broader assessment of concerns and needs in a population of survivors with mixed cancer diagnoses, along with their appraisal of how well their needs were addressed by their health care team, to provide an overall identification of gaps in supportive care. The primary purpose of the present study was to prioritize survivors’ most salient physical, social, emotional, and spiritual concerns or needs; ascertain survivors’ perceived importance of those needs and the extent to which our institution, the University Hospitals Seidman Cancer Center, was attentive to those needs; and to identify who","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41541976","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}

{"title":"Prescriber adherence to antiemetic guidelines with the new agent trifluridine-tipiracil","authors":"Daniel S. Childs, Alison Jacobson, J. Mitchell, J. Hubbard, H. Yoon, H. Finnes, A. Grothey, A. Jatoi","doi":"10.12788/JCSO.0314","DOIUrl":"https://doi.org/10.12788/JCSO.0314","url":null,"abstract":"Cancer drugs are becoming available at an unprecedented rate. In 2015 alone, the US Food and Drug Administration (FDA) approved 18 new agents.1 Although many of those agents have adverse event profiles that are more favorable than those seen with conventional chemotherapy, nausea and vomiting still occur. In fact, nausea and vomiting continue to be ranked as among the most common and distressing of cancer symptoms.2,3 In a 2004 study, Grunberg and colleagues reported that as many as 75% of health care providers misjudge the risk for chemotherapy-induced nausea and vomiting (CINV), even when prescribing cancer drugs that have been available for years,4 thus amplifying concerns that such risk assessment might be even worse when new cancer agents are prescribed for the first time. In this study, we hypothesized that patients prescribed a new cancer drug, trifluridine-tipiracil, would be at risk for CINV because of poor guideline adherence on the part of health care providers. The correct matching of antiemetics to chemotherapy is important. Inadequate antiemetic prophylaxis predisposes to nausea and vomiting with dehydration and met-","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45376417","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}

{"title":"Toxic abandonment: A case for nonparticipation in physician-Assisted suicide","authors":"A. Weir","doi":"10.12788/JCSO.0339","DOIUrl":"https://doi.org/10.12788/JCSO.0339","url":null,"abstract":"","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":"15 1","pages":"122-123"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43047092","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}

{"title":"Patterns of care with regard to whole-brain radiotherapy technique and delivery among academic centers in the United States","authors":"P. Barry, M. Amsbaugh, C. Ziegler, A. Dragun","doi":"10.12788/JCSO.0305","DOIUrl":"https://doi.org/10.12788/JCSO.0305","url":null,"abstract":"Despite the recent advances in systemic therapy, metastatic spread to the brain continues to be the most common neurologic complication of many cancers. The clinical incidence of brain metastases varies with primary cancer diagnosis, with estimates ranging from 1.2%-19.8%.1,2 Metastatic spread to the brain is even more prevalent at autopsy, with evidence of intracranial tumor being found in 26% of patients in some series.3 It is possible that the clinical incidence of metastatic disease to the brain will continue to increase as newer therapeutic agents improve survival and imaging techniques continue to improve. The management of brain metastases has changed rapidly as technological improvements have made treatment increasingly safe and efficacious. Traditionally, treatment consisted of radiotherapy to the whole brain, with or without surgical resection.4,5 More recently, stereotactic radiosurgery (SRS) has been adopted on the basis of evidence that it is safe and efficacious alone or in combination with radiotherapy to the whole brain.6 Further evidence is emerging that neurocognitive outcomes are improved when whole-brain radiotherapy (WBRT) is omitted, which possibly contributes to improved patient quality of life.7 Taking into account this and other data, the American Society for Radiation Oncology’s Choosing Wisely campaign now recommends not routinely adding WBRT to radiosurgery in patients with limited brain metastases.8 Despite this recommendation, many patients continue to benefit from WBRT, and it remains a common treatment in radiation oncology clinics across the US for several reasons. Many patients present with multiple brain metastases and are ineligible for radiosurgery. Even for technically eligible patients, WBRT has been shown to improve local control and decrease the rate of distant brain failure over radiosurgery alone.6 With higher rates of subsequent failures, patients receiving radiosurgery alone must adhere to more rigorous follow-up and imaging schedules, which can be difficult for many rural patients who have to travel long distances to centers.","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":"15 1","pages":"89-94"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44053438","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}

{"title":"Pulmonary sarcomatoid carcinoma presenting as a necrotizing cavitary lung lesion: diagnostic dilemma","authors":"G. Vaidya, R. Shah, A. Dhamoon","doi":"10.12788/JCSO.0259","DOIUrl":"https://doi.org/10.12788/JCSO.0259","url":null,"abstract":"Pulmonary sarcomatoid carcinoma (PSC) is a rare histological subtype that has an aggressive course with average survival of 11-13 months.1 In clinical practice, the possible presentations of this rare cancer are not widely known, resulting in a misdiagnosis. That is what happened with our patient, who presented with necrotizing cavitary lung lesion and soft tissue necrotizing lymphadenitis. The clinical picture was reminiscent of tuberculosis or granulomatosis with polyangiitis and was further confounded by negative computed-tomography (CT)-guided biopsy and bronchoscopy findings, which added to the delay in diagnosis. With the currently available knowledge, the diagnosis of PSC depends largely on evaluation of the surgically resected specimen, which in most cases is avoided until there is a high suspicion of PSC. Biopsy is not useful due to extensive necrosis, as will be seen in our case. Consequently, most of the data in the literature is based on case series of autopsy specimen, and the clinical characteristics of PSC remain unclear. The rarity of PSC has prevented its characterization in literature. We report here a rare presentation of PSC with necrotizing lung lesion, to add to the paucity of the current data.","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":"15 1","pages":"103-105"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45995642","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}

{"title":"APF530 for nausea and vomiting prevention following cisplatin: phase 3 MAGIC trial analysis","authors":"L. Schwartzberg, Michael C. Mosier, R. Geller, M. Klepper, I. Schnadig, N. Vogelzang","doi":"10.12788/JCSO.0331","DOIUrl":"https://doi.org/10.12788/JCSO.0331","url":null,"abstract":"Despite available antiemetic therapies, chemotherapy-induced nausea and vomiting (CINV) following highly emetogenic chemotherapy (HEC), particularly in the delayed phase (>24-120 h after chemotherapy), continues to impair patient quality of life and chemotherapy compliance.1 Cisplatin-based chemotherapy, classified as HEC at any dose,2 is widely used to treat cancers such as non–small-cell and small-cell lung cancer, sarcomas, germ-cell tumors, lymphoma, and ovarian cancer. Cisplatin is associated with a biphasic pattern of CINV and may induce delayedonset nausea and vomiting, reaching maximum intensity of 48-72 hours after administration and lasting 6-7 days.2 CINV after cisplatin-based therapy may be severe enough to cause chemotherapy discontinuation or dose reductions.3 Being female is a known risk factor for CINV, and because cisplatin-based regimens are often used to treat women with gynecologic cancers, this patient population is at even higher risk for CINV.4,5 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists (RAs; eg, granisetron, ondansetron, dolasetron, and palonosetron) have been the cornerstone of CINV therapy for decades and remain an integral part of contemporary antiemetic treatment regimens. Most current antiemetic guidelines for HEC recommend a 3-drug regimen, comprising a 5-HT3","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":"15 1","pages":"82-88"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46391845","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}

{"title":"Palmoplantar exacerbation of psoriasis after nivolumab for lung cancer","authors":"T. Liebman, L. Adams, U. Alapati","doi":"10.12788/JCSO.0262","DOIUrl":"https://doi.org/10.12788/JCSO.0262","url":null,"abstract":"Nivolumab is a full human immunoglobulin antibody to the programmed cell death 1 (PD-1) immune checkpoint receptor on T cells. This programmed cell death inhibitor is a targeted immunotherapy used to treat patients with melanoma, among other malignancies.1 More recently, nivolumab has been used for advanced non-small-cell lung cancer (NSCLC) after failure of previous chemotherapeutic agents. It was approved by the US Food and Drug Administration for the NSCLC indication in 2015.2 PD-1 inhibitors are efficacious in treating advanced malignancies, although their immunemediated functions can lead to undesirable side effects. Patients treated with nivolumab have been reported to develop thyroid disease,1,3,4 diabetes,3 hypophysitis,1,3 hypopituitarism,3 and pneumonitis,4,2 as well as other autoimmune conditions.3 Although nivolumab is often used to treat skin diseases such as melanoma, it can have many cutaneous side effects including pruritus,1,3-6 rash,1,3,4,6,7 vitiligo,1,3,7,6 mouth sores,3 injection site reactions,3,6 and alopecia.5 Herein, we describe a patient who was treated with nivolumab and developed an exacerbation of pre-existing psoriasis.","PeriodicalId":75058,"journal":{"name":"The Journal of community and supportive oncology","volume":"15 1","pages":"106-108"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49018982","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}