Multidisciplinary Cancer Care Model: A Positive Association Between Oncology Nurse Navigation and Improved Outcomes for Patients With Cancer.

Background: Patients with cancer often experience prominent deficiencies in cancer care in the immediate period following initial cancer diagnosis.

Objectives: This article aims to determine whether the inclusion of a gastrointestinal (GI) oncology nurse navigator (ONN) on the multidisciplinary cancer care team is associated with improved quality of care for patients.

Methods: This retrospective study compared randomly selected patients with GI cancer with and without an ONN.

Phase 2 trial of induction gemcitabine, oxaliplatin, and cetuximab followed by selective capecitabine-based chemoradiation in patients with borderline resectable or unresectable locally advanced pancreatic cancer.

Purpose: To evaluate, in a phase 2 study, the safety and efficacy of induction gemcitabine, oxaliplatin, and cetuximab followed by selective capecitabine-based chemoradiation in patients with borderline resectable or unresectable locally advanced pancreatic cancer (BRPC or LAPC, respectively).

Methods And Materials: Patients received gemcitabine and oxaliplatin chemotherapy repeated every 14 days for 6 cycles, combined with weekly cetuximab. Patients were then restaged; "downstaged" patients with resectable disease underwent attempted resection.

Chemotherapeutic and targeted biological agents for metastatic bladder cancer: a comprehensive review.

The American Cancer Society estimates that 73 510 new cases of bladder cancer will be diagnosed and 15 000 deaths will result this year. The paper summarizes the clinical evidence for the use of platinum-based, non-platinum-based and new targeted biological agents, while reporting the future directions in the treatment of metastatic bladder cancer. For cisplatin-base regimens, the combination of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) has been the mainstream treatment for both advanced and metastatic bladder cancers.

A phase II study of gemcitabine and irinotecan in patients with locally advanced or metastatic bladder cancer.

Background: The objectives of the current study were to evaluate the safety and efficacy of gemcitabine and irinotecan (Irinogem) in patients with metastatic bladder cancer. Irinotecan and gemcitabine are newer-generation chemotherapeutic agents with different mechanisms of action, nonoverlapping toxicity profiles, and synergistic activity in vitro.

Methods: Sixteen patients have been enrolled, of which 13 are evaluable for response.

Finasteride.

Importance Of The Field: Prostate cancer is the most common non-cutaneous malignancy in males in the US. Prostate cancer chemoprevention entails the use of agents which retard or inhibit the progression to invasive disease. Chemoprevention is an attractive option for patients with prostate cancer given the hormonally responsive nature of cancer, long latency period and high prevalence of the disease.

Primary testicular lymphoma and AIDS.

Immunosuppressed patients have an increased risk for developing extranodal lymphoma, including testicular lymphoma. In AIDS patients, primary testicular lymphoma has been reported as an initial manifestation of the disease. These patients typically present at an early age; their lymphomas usually have aggressive histologic appearance and are associated with poor prognosis.

Toxicity and survival outcomes of hyperfractionated split-course reirradiation and daily concurrent chemotherapy in locoregionally recurrent, previously irradiated head and neck cancers.

Background: : Reirradiation of locoregionally recurrent, previously irradiated head/neck cancer may be considered in situations of unresectability, medical inoperability, or adverse pathologic features found at salvage resection.

Methods: : Retrospective cohort analysis of toxicity and survival outcomes in locoregionally recurrent, previously irradiated patients with head/neck cancer treated with hyperfractionated split-course radiotherapy and concurrent chemotherapy.

Results: : Between March 1998 and September 2006, 39 patients initiated reirradiation at median of 2.

Testicular lymphoma: an update for clinicians.

Testicular lymphoma is a lethal disease with a median survival of approximately 12 to 24 months. It is the most common testicular malignancy in men older than 60 years of age. Testicular lymphoma has a predilection for widespread dissemination to unusual sites, including the central nervous system, contralateral testis, Waldeyer's ring, skin, and lung.

Localized palmar-plantar epidermal hyperplasia: a previously undefined dermatologic toxicity to sorafenib.

The development of multitargeted tyrosine kinase inhibitors has provided significant advances in the treatment of renal cell carcinoma. This case describes initial therapy for managing renal cell cancer with the administration of sorafenib, a multitargeted tyrosine kinase inhibitor. We report the development of localized palmar-plantar epidermal hyperplasia, a rare but significant cutaneous adverse event from sorafenib therapy.

Locally advanced leiomyosarcoma of the urinary bladder: near-complete pathologic response to neoadjuvant gemcitabine and docetaxel.

Leiomyosarcoma of the urinary bladder is a rare mesenchymal tumor with distinct pathologic features. Although radical cystectomy is the standard therapy for locally invasive disease, available literature appears to support the benefit of perioperative chemotherapy, similar to that seen with the more conventional urothelial malignancies. We report on a 77-year-old gentleman with locally advanced leiomyosarcoma of the bladder achieving a near-complete pathologic response to neoadjuvant chemotherapy with a unique regimen: gemcitabine and docetaxel.

Use of low molecular weight heparin and aminocaproic acid in chronic DIC associated with prostate cancer--a case report.

Disseminated Intravascular Coagulopathy (DIC) is the most common coagulopathy in patients with prostate cancer. Though rare, it could be fatal without treatment. Literature suggests that there is significant activation of fibrinolytic pathway.

Cold agglutinin induced autoimmune hemolytic anemia and NK-cell leukemia: a new association.

Cold agglutinin induced autoimmune hemolytic anemia is uncommonly associated with leukemia and lymphomas. We present a case of a young Mexican female presenting with a cold agglutinin hemolytic anemia with expression of a rare Pr antigen specificity and an aggressive NK-cell leukemia. Our patient had a rapid fatal course.

A rare case of clear cell adenocarcinoma of the bladder with unique pathological features.

Clear cell adenocarcinomas of the urinary bladder are rare tumors with an unknown histogenesis. Since these tumors appear histologically similar to clear cell tumors of the female genital tract, a mullerian histogenesis has been proposed. Several publications have examined the immunohistochemical properties of clear cell adenocarcinomas to improve understanding of the cause and pathogenesis of this tumor.

Sacral epithelioid angiosarcoma associated with a bleeding diathesis and spinal epidural hematoma: case report.

Epithelioid angiosarcoma of bone is a rare, high-grade lesion that is highly vascular and can be associated with a bleeding diathesis. An association has been reported in angiosarcomas in other locations with coagulopathy from tumor-related disseminated intravascular coagulopathy and fibrinolysis. The authors report the case of a rare occurrence of a primary sacral epithelioid angiosarcoma associated with a large epidural hematoma and a severe bleeding diathesis.

Secondary hormonal manipulations in the management of advanced prostate cancer.

Prostate cancer is a heterogeneous disease and clinical outcomes vary considerably after failure of primary androgen ablation. With the development of new therapeutics the management of patients with androgen independent prostate cancer has changed considerably over the last few years. Multiple secondary hormonal manipulations are available and may lead to prolonged periods of clinical response.

High-dose etoposide, thiotepa, and dose-adjusted carboplatin (TVCa) with autologous hematopoietic stem cell rescue as treatment of relapsed or refractory germ cell cancer.

A phase I/II trial with high-dose etoposide, thiotepa, and dose-adjusted carboplatin (TVCa) with autologous hematopoietic stem cell rescue (AHSCT) as treatment for patients with relapsed or refractory germ cell cancer was investigated. The phase I portion involved a dose escalation schema for carboplatin and thiotepa while keeping the dose of etoposide constant. The intended carboplatin dose was adjusted for renal function based on the glomerular filtration rate.

Primary mediastinal large B-cell lymphoma in an HIV-infected patient.

HIV-related non-Hodgkin lymphoma is well documented in the literature. We report a case of an HIV-infected patient who presents with primary mediastinal large B-cell lymphoma. On review of the literature, this appears to be the first documented case of this subtype of large B-cell non-Hodgkin lymphoma seen in an HIV-infected patient.

Complete response to adriamycin and ifosfamide in a patient with sarcomatoid renal cell carcinoma.

Sarcomatoid renal cell carcinoma (SRCC) is a heterogeneous disease with generally unreliable response to various therapies in clinical studies. We illustrate a case report in which a woman with metastatic SRCC had a complete and durable response to adriamycin and ifosfamide chemotherapy. We find this to be incongruous with expectations from some recently published data.

Isolated late recurrence of renal cell carcinoma in the inferior vena cava.

The occurrence of an isolated late recurrence of renal cell carcinoma within the inferior vena cava (IVC) is a rare event. We present a case of a 55-year-old patient with recurrence in the IVC more than 3 years following her initial nephrectomy. The asymptomatic presentation of this patient with recurrent disease emphasizes the importance of close, long-term surveillance.

Intermittent androgen deprivation therapy for prostate cancer.

Androgen deprivation therapy for prostate cancer is associated with several complications, including loss of libido, hot flashes, night sweats, psychological stress, osteoporosis, anemia, fatigue, loss of muscle mass, glucose intolerance, and changes in lipid profile. The natural history of prostate cancer while on such therapy is the attainment of an incurable androgen-independent state. Early diagnosis by prostate-specific antigen screening, longer life expectancies, and a penchant for immediate therapy pose a problem where clinicians have to balance the potential benefits of early hormonal therapy with the risks of development of these metabolic and psychological complications.

Transitional cell carcinoma of the bladder producing parathyroid hormone-related protein (PTHrP).

Hypercalcemia associated with transitional cell carcinoma (TCC) is rarely encountered. We report a case of TCC of bladder with documented production of parathyroid hormone related protein (PTHrP). Our patient had a rapidly progressive course and died 2 months after radical cystectomy.

Acquired amegakaryocytic thrombocytopenia purpura and eosinophilic fasciitis: a long relapsing and remitting course.

Acquired amegakaryocytic thrombocytopenia purpura (AATP) is a rare disorder of unclear etiology characterized by severe thrombocytopenia, preservation of erythroid and myeloid cell lines, and absence of megakaryocytes in the bone marrow. We report herein a patient who developed eosinophilic fasciitis preceding a diagnosis of AATP. Longitudinal follow-up and treatment of this individual show a relapsing and remitting disease course which appears closely related to the dosing of cyclosporine.