Nature reviews. Clinical oncology
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Access to pain relief is a crucial concern for patients with cancer, and remains so at all stages of the illness trajectory. This Review covers the scope of the problem and considers the optimal palliative strategy, mainly through the use of opioids. It also discusses various barriers to effective pain management around the world, including regulatory and attitudinal barriers towards opioids, and the unwillingness of national governments to integrate palliative care effectively in cancer control efforts.
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Patients with colorectal cancer with mutated PIK3CA, identified from two large observational cohorts, had increased cancer-specific and overall survival if they used aspirin regularly after diagnosis compared to non-users. No effect of aspirin was seen in patients with wild-type PIK3CA. Mutated PIK3CA might be a useful biomarker to select patients who would benefit from adjuvant aspirin therapy.
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The large randomized study by Crook et al. demonstrated that intermittent administration of androgen deprivation therapy should be considered the standard of care when patients with moderate and well-differentiated localized prostate cancer are treated for rising PSA levels after definitive radiotherapy.
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Review Case Reports
Geriatric oncology research to improve clinical care.
Cancer incidence increases with advanced age. The Cancer and Aging Research Group, in partnership with the National Institute on Aging and NCI, have summarized the gaps in knowledge in geriatric oncology and made recommendations to close these gaps. One recommendation was that the comprehensive geriatric assessment (CGA) should be incorporated within geriatric oncology research. ⋯ Other recommendations were to design trials for older adults with study end points that address the needs of the older and/or vulnerable adult with cancer and to build a better infrastructure to accommodate the needs of older adults to improve their representation in trials. We use a case-based approach to highlight gaps in knowledge regarding the care of older adults with cancer, discuss our current state of knowledge of best practice patterns, and identify opportunities for research in geriatric oncology. More evidence regarding the treatment of older patients with cancer is urgently needed.