bluuebunny/crossref_metadata_2025_split huggingface dataset:
Culture, Black Men, and Prostate Cancer: What is Reality?
Authors: Woods V. Diane , Montgomery Susanne B. , Belliard Juan Carlos , Ramírez-Johnson Johnny , Wilson Colwick M. 
Published: August 2017

Background The worldwide incidence of prostate cancer is higher among American black men than any other male group. In the United States, lack of participation in screening for prostate cancer by black men is influenced by several cultural factors, including knowledge, health beliefs, barriers, and relationships with primary healthcare providers. Methods We used the qualitative and paralleling descriptive quantitative findings of a mixed-method longitudinal study exploring prostate cancer screening behaviors among 277 black men. Results Five themes were identified as critical elements affecting men's screening for prostate cancer: lack of knowledge, communication, social support, quality of care, and sexuality. These themes were associated with a sense of disconnectedness by black men from the healthcare system and contributed to nonparticipation in prostate cancer early detection activities. Conclusions Lack of discussion about the decision to screen for prostate cancer and general lack of culturally appropriate communication with healthcare providers has engendered distrust, created fear, fostered disconnect, and increased the likelihood of nonparticipation in prostate cancer screening among black men.
Targeted Therapy for Hematologic Malignancies
Authors: Kuriakose Philip 
Published: August 2017

Background: The introduction of monoclonal antibodies, either as native molecules or conjugated to radioisotopes or other toxins, has led to new therapeutic options for patients with hematologic malignancies. In addition, the use of small molecules against specific cell surface receptors, enzymes, and proteins has become an important strategy in the treatment of such disorders. Methods: The author reviewed the published clinical trials of monoclonal antibody and other targeted therapies in hematologic malignancies. Results: Results from several trials demonstrate a therapeutic benefit for the use of monoclonal antibodies (either native or conjugated) and other targeted therapies, used alone or in combination with standard cytotoxic chemotherapy. Conclusions: Targeted therapy of hematologic malignancies seems to be an effective and less toxic approach to the treatment of such disorders. Nevertheless, additional studies are needed to determine where and when such management fits into a therapeutic regimen for any given disorder, whether upfront or as salvage therapy, alone or in combination with chemotherapy (concurrent or sequential).
The Role of External-Beam Radiation Therapy in the Treatment of Clinically Localized Prostate Cancer
Authors: Torres-Roca Javier F. 
Published: August 2017

Background The treatment of clinically localized prostate cancer is controversial. Options include radical prostatectomy, external-beam radiation therapy (EBRT), brachytherapy, cryotherapy, and watchful waiting. Methods The author reviews EBRT as treatment for clinically localized prostate cancer, with particular emphasis on the technological advances that have allowed dose escalation and fewer therapy-related side effects. Results Technological advances in the last two decades have significantly improved the delivery of EBRT to the prostate. This has resulted in an overall increase in the total dose that can be safely delivered to the prostate, which has led to modest improvements in biochemical outcome. An alternative approach of combining androgen suppression therapy and EBRT has also been successful in improving clinical outcomes. However, establishing the optimal therapy for prostate cancer remains controversial. Conclusions Recent progress has led to improvements in clinical outcomes in patients treated with EBRT for prostate cancer. It is hoped that the next decades will bring continued advances in the development of biologicals that will further improve current clinical outcomes.
Survival after Surgical Resection of Isolated Pulmonary Metastases from Malignant Melanoma
Authors: Andrews Stephanie , Robinson Lary , Cantor Alan , Deconti Ronald C. 
Published: August 2017

Background The overall prognosis for patients with metastatic malignant melanoma remains poor. However, careful staging and identification of patients with limited metastatic disease offers the opportunity for surgical salvage and improved survival for selected patients. Methods We reviewed the experience over the last 17 years at our institute with isolated pulmonary metastasectomy in 86 patients with advanced malignant melanoma. Results Our data demonstrate an overall median time to relapse of approximately 8.4 months and a median survival of 35 months. The 5-year survival rate is estimated at 33%, and 16% remain continuously free of disease after a median follow-up of 35 months. Resection of properly staged and evaluated patients with limited pulmonary metastases appears to convey a significant survival benefit. Patients with a single metastasis fare best. Conclusions These encouraging results offer a rationale for the careful follow-up of resected patients. One third of all relapses will be limited and additional surgery contributes to their overall survival.
Aging, Frailty, and Chemotherapy
Authors: Balducci Lodovico 
Published: August 2017

Background In many cases, elderly individuals have not been offered life-saving interventions due to the assumption that these treatments would be too toxic to tolerate. Methods This article offers an overview of the biology of aging, reviews the assessment of an individual's physiologic age, and explores the medical definition of frailty and its implications in cancer treatment. Results The definition of frailty is controversial. Rather than chronologic age, a more accurate assessment relies on individual estimates of life expectancy and functional reserve, including serum levels of interleukin 6 and D-dimer, the levels of a number of inflammatory cytokines, and the circulating level of C-reacting protein. Decision making for optimal cancer treatment in the older-aged patient benefits from a comprehensive geriatric assessment, a functional test, and a laboratory evaluation to determine a patient's life expectancy and functional reserve. Conclusions Most older patients appear to benefit from cancer treatment to an extent comparable to that of younger individuals, and only a minority of these patients should be excluded from treatment due to reducedtolerance.
Tolerance to Chemotherapy in Elderly Patients with Cancer
Authors: Wedding Ulrich , Honecker Friedemann , Bokemeyer Carsten , Pientka Ludger , Höffken Klaus 
Published: August 2017

Background Due to demographic changes, the number of elderly people with cancer will increase in the next decades. In the past, elderly patients with cancer were often excluded from clinical trials. Chronological age has been considered a risk factor for increased toxicity and reduced tolerance to chemotherapy. Methods We present a review on toxicity of chemotherapy and factors associated with toxicity in elderly patients with cancer, and we discuss chemotherapeutic agents and treatment options in treating this patient population. Results Age is a risk factor for increased toxicity to chemotherapy and decreased tolerance. However, few trials have been reported with adjustment for age-associated changes such as impairment of functional status and increased comorbidity, which also show an independent association with increased toxicity. Published data may include several biases, such as referral and publication bias. Conclusions Decision making in elderly cancer patients should be based on the results of a geriatric assessment. Patients with few or no limitations should be treated as younger patients are treated. Data with a high level of evidence are unavailable for patients showing moderate or severe limitations in a geriatric assessment.
Current and Future Directions of Clinical Trials for Ovarian Cancer
Authors: Gardner Ginger J. , Jewell Elizabeth L. 
Published: August 2017

Background The management of ovarian cancer includes a combination of surgery and chemotherapy. The majority of clinical trials have historically addressed questions pertaining to the selection, dosing, and schedule of chemotherapy agents. Methods In this report, a comprehensive review of the major clinical trials in ovarian cancer is performed. The increasing data and clinical experience in the management of ovarian cancer, as it sets the stage for currently active protocols and future clinical trial design, are emphasized. Results Paclitaxel plus carboplatin is the primary intravenous treatment strategy in the front-line setting. Recent data show an improvement in overall survival for intravenous dose-dense treatment. Multiple randomized controlled trials support the use of intraperitoneal treatment. For recurrent disease, a growing number of new agents including targeted therapeutics are now available. Increasingly, surgical approach, biologic targets, and quality of life endpoints are included in clinical trial design. Conclusions Over the last several decades, clinical trials have defined the current therapeutic approach for ovarian cancer. Paclitaxel with a platinum-based agent is currently the preferred front-line therapy, with encouraging data to support either dose-dense or intraperitoneal drug delivery. Future trials will determine the role of biologic agents and vaccine therapies, as well as their impact on quality of life.
Cancer Incidence among Korean-American Immigrants in the United States and Native Koreans in South Korea
Authors: Lee Joanne , Demissie Kitaw , Lu Shou-En , Rhoads George G. 
Published: August 2017

Background While previous studies demonstrated contrasting patterns of cancer risk among migrant populations from different ethnic groups in the United States, few studies have focused on the Korean-American population. This study compares cancer incidence rates between Korean-Americans, whites, and blacks in the United States and native Koreans. Methods Data from the Surveillance, Epidemiology, and End Results (SEER) program and International Association for Research on Cancer were used to calculate age-standardized incidence rates among whites, blacks, and Korean Americans in the United States and native Koreans. Results The risk of stomach, liver, gallbladder, larynx, and esophageal cancer has sharply declined in Korean-American men compared with their native counterparts while prostate, colon, and rectum cancer risk has increased. In women, stomach, liver, gallbladder, and cervical cancers have declined, and breast, lung, colon, rectum, and endometrial cancers have increased. Cancer rates for stomach, liver, gallbladder, and esophagus are higher in native Koreans compared to US whites. Recently, cancer rates for Korean-American immigrants have increased for prostate, breast, colon, and rectal cancers. Conclusions The study provides evidence that the risk of cancers common in Western countries is higher for Korean Americans than for their native counterparts. Recent trends among Korean Americans also revealed a stronger Western profile.
Need for an Improved Molecular/Genetic Classification for CD30+ Lymphomas Involving the Skin
Authors: Droc Claudia , Cualing Hernani D. , Kadin Marshall E. 
Published: August 2017

BackgroundThe spectrum of diseases that constitute the CD30+ lymphomas, with lymphomatoid papulosis (LyP) at one end, and anaplastic large-cell lymphoma (ALCL) at the other end, shows variable morphology, immunophenotype, and clinical behavior. The border between these diseases is sometimes difficult to establish and there are many grey zones in their classification.MethodsWe reviewed the clinical and research literature and guided by our experiences attempted to discern molecular and phenotypic criteria to improve the classification and identify molecular targets for therapy of CD30-positive cutaneous lymphomas.ResultsFunctional studies of ALCL cell lines clonally derived from LyP have revealed loss of growth inhibition by transforming growth factor beta (TGF-β), due to TGF-β receptor mutations. Studies of genetic variants of the CD30 promoter showed distinct microsatellite alleles associated with development of LyP and lymphoma progression. Studies of LyP and cutaneous ALCL tissues and cell lines suggest a dual role for CD30/CD30 ligand interactions in regression of LyP and progression to lymphoma. CD30 signaling activates NF-κB in cell lines derived from cutaneous ALCL but not anaplastic lymphoma kinase (ALK)-positive systemic ALCL in which growth arrest occurs through cell cycle inhibitor p21WAF1/Cip1. Other likely biomarkers of disease progression include differential expression of Bcl-2, fascin, cutaneous lymphocyte antigen, and T-cell receptor clonality. These may lead to improved classification, diagnoses, and therapeutic targets.ConclusionsThe current clinicopathologic classification of CD30+ cutaneous lymphoproliferative disorders is insufficient. Incorporating genetic and molecular criteria would better define the borders between benign/malignant and aggressive/nonaggressive disorders.
Evidence-Based Medicine for Rare Diseases: Implications for Data Interpretation and Clinical Trial Design
Authors: Behera Madhusmita , Kumar Ambuj , Soares Heloisa P. , Sokol Lubomir , Djulbegovic Benjamin 
Published: August 2017

BackgroundThe randomized, controlled trial (RCT) is the “gold standard” for establishing the effect of any intervention. This approach, however, is often not feasible with rare diseases such as cutaneous T-cell lymphoma.MethodsWe review the principles of evidence-based medicine to see which are particularly pertinent to the study of rare diseases.ResultsWhen an RCT is not feasible, attention is given to determining all the available prior data. Evaluation of the new data and the historic base requires attention to biases, but can allow estimation of a “true” study result.ConclusionsEven when an RCT cannot be performed because of insufficient cases, utilization of evidence-based methodology can help minimize bias and maximize the truth of observed new data.
High-Risk Benign Breast Lesions: Current Strategies in Management
Authors: Kiluk John V. , Acs Geza , Hoover Susan J. 
Published: August 2017

BackgroundHigh-risk benign breast lesions can create confusion for both the patient and the clinician. This paper reviews the characteristics of these lesions to help direct appropriate management.MethodsThe authors reviewed the literature regarding high-risk breast lesions and include management guidelines that we employ at our institute.ResultsHigh-risk breast lesions offer varying degrees of increased risk for the future development of breast cancer. Chemoprevention may be used to help decrease the risks from some lesions.ConclusionsThe management of high-risk benign breast lesions can be confusing. Clinicians should assess the risk of future breast cancer and develop a proper screening and prevention strategy for each individual patient.
Recent Advances in Breast-Specific Imaging
Authors: Berman Claudia G. 
Published: August 2017

BackgroundImaging the breast is a vital component not only for breast cancer screening, but also for diagnosis, evaluation, treatment, and follow-up of patients with breast cancer.MethodsThe author reviews recent advances and also provides her personal experience in describing the status of digital mammography, computer-aided detection, dedicated magnetic resonance imaging (MRI), and positron-emission mammography for evaluating the breast.ResultsFull-field digital mammography is superior to standard mammography in women under 50 years of age and in those with dense breasts. Computer-aided detection assists inexperienced mammographers and enhances detection of microcalcifications in dense breasts. Breast MRI is useful in preoperative evaluation, clarification of indeterminate mammograms, and follow-up of BRCA mutation carriers. The specificity of MRI remains problematic, however. Positron-emission mammography promises enhanced detection of ductal carcinoma in situ (DCIS), even when not associated with microcalcifications, and should aid surgical planning.ConclusionsThese four significant advances in breast imaging have all improved the sensitivity of detecting breast abnormalities. Cost issues, however, may limit the widespread application of these advances.
Proteomic Approach to Breast Cancer
Authors: Laronga Christine , Drake Richard R. 
Published: August 2017

Background Breast cancer is the most common cancer affecting women worldwide. Despite tremendous advances in screening, diagnosis, and treatment, the causes of this disease remain elusive and complex. Proteomics is a rapidly developing field that can explore the heterogeneity of breast cancer and supplement the wealth of information gained from genomics. Methods This article serves as an overview of the application of matrix-assisted laser desorption/ionization source with a time-of-flight (MALDI-TOF) proteomic techniques as applied to breast cancer. Examples of the clinical applicability of MALDI-TOF mass spectrometry are provided but represent only a fraction of the potential uses yet to be discovered. In addition, a brief summary of the bioinformatics issues that surround proteomics is included. Results Mass spectrometry has provided new proteomic approaches to unravel the complexities of clinical specimens relevant to breast cancer diagnostics. In particular, MALDI-TOF mass spectrometry analysis has been used to differentiate cancer profiles from benign profiles in samples from sera, plasma, tissue, nipple fluid, and ductal lavage. Some discriminating proteins have subsequently been identified. Conclusions Mass spectrometry applications to breast cancer diagnostics continue to be developed but are evolving faster than bioinformatics/statistical analysis can adapt. The future of these techniques in terms of clinical investigation is limitless, but in terms of general applicability, these applications are currently cost-prohibitive.
Orthopedic Surgery Options for the Treatment of Primary Osteosarcoma
Authors: Marulanda German A. , Henderson Eric R. , Johnson David A. , Letson G. Douglas , Cheong David 
Published: August 2017

BackgroundOsteosarcoma is the most common malignant primary neoplasm of bone. Orthopedic procedures are essential components in the multidisciplinary treatment of osteosarcoma. Limb-salvaging procedures offer adequate disease control comparable to the results obtained by amputations. This review discusses the advantages and disadvantages of the various types of amputations and the limb-salvaging techniques for the treatment of osteosarcoma.MethodsThe authors analyzed the characteristics of limb-salvaging procedures and amputations for osteosarcoma. Qualitative and quantitative studies published in the English language that are listed in the National Library of Medicine were used as the basis for this review. In addition, a review of an expandable prosthesis is included.ResultsLimb-salvaging techniques have acceptable rates of disease control. However, amputation remains a valid procedure in selected cases of osteosarcoma in most parts of the world. Orthopedic oncology surgeons have various materials, procedures, and techniques available to achieve disease control and improve function in patients with osteosarcoma.ConclusionsThe surgical management of patients with osteosarcoma is challenging. No difference in survival has been shown between amputations and adequately performed limb-salvaging procedures. Optimal tumor resection and a functional residual limb with increased patient survival are the goals of modern orthopedic oncology.
Outpatient Chemotherapy plus Radiotherapy in Sarcomas: Improving Cancer Control with Radiosensitizing Agents
Authors: Anderson Pete , Aguilera Dolly , Pearson Margaret , Woo Shaio 
Published: August 2017

BackgroundCancer control by radiotherapy (RT) can be improved with concurrent chemotherapy. Outpatient strategies for sarcomas that combine chemotherapy and RT are possible since supportive care and RT techniques have improved.MethodsThe current status of non-anthracycline chemotherapy in combination with radiation for high-risk sarcoma is reviewed.ResultsIfosfamide with mesna and newer activated ifosfamide agents (ZIO-201 and glufosfamide) have high potential to improve sarcoma cancer control. In Ewing's sarcoma and osteosarcoma, high-dose ifosfamide with mesna (2.8 g/m2/day of each x 5 days; mesna day 6) can be safely given to outpatients using continuous infusion. Reducing ifosfamide nephrotoxicity and central nervous system side effects are discussed. Other outpatient radiosensitization regimens include gemcitabine (600–1000 mg/m2/dose IV over 1 hour weekly x 2–3 doses), temozolomide (75 mg/m2/daily x 3–6 weeks), or temozolomide (100 mg/m2/dose daily x 5) + irinotecan (10 mg/m2/dose daily x 5 x 2 weeks). In osteosarcoma with osteoblastic metastases on bone scan, samarium (1 mCi/kg; day 3 of RT) and gemcitabine (600 mg/m2IV over 1 hour day 9 of RT) is a radiosensitization strategy. Future drugs for radiosensitization include beta-D-glucose targeted activated ifosfamide (glufosfamide) and sapacitabine, an oral nucleoside with in vitro activity against solid tumors including sarcomas.ConclusionsThe potential to treat major causes of sarcoma treatment failure (local recurrence and distant metastases) with concurrent chemotherapy during radiation should be considered in high-grade sarcomas.
Current Issues in Adolescent and Young Adult Cancer Survivorship
Authors: Soliman Hatem , Agresta Samuel V. 
Published: August 2017

Background Overall, the survival rate for cancer patients has continued to improve over the past several decades. However, those aged 15 to 29 years have not experienced the same improvements in survival. This review explores some of the challenges faced by adolescent and young adult (AYA) cancer patients and their survivorship needs. Methods Using the OVID Medline database from 1966 to present, a variety of search terms including “adolescent,” “young adult,” and “cancer survivorship” were entered. Articles related to those obtained by the search were also collected. Additional data were obtained from the SEER database AYA monograph, the Childhood Cancer Survivorship Study, the Report of the Adolescent and Young Adult Oncology Progress Review Group, and the Long-Term Follow-Up Recommendations of the Children's Oncology Group. Results Cancer patients in this age-group are at increased risk for second malignancies, cardiotoxicity, and reproductive difficulties. Few data exist concerning intellectual and other psychosocial issues for this specific patient population. Conclusions More research is needed to develop accurate data on treatment and survivorship for AYA patients. A separate cancer discipline focusing on improving outcomes in treatment and survivorship among AYA patients should be developed in major academic cancer centers.