Nihon rinsho. Japanese journal of clinical medicine
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A team approach is efficient in palliative care for cancer patients. People suffered from cancer have a right to receive high-quality palliative care earlier in cancer treatment. In Japan the National Act for Strategy against Cancer was enacted in 2007. ⋯ Recently various types of opioids can be used routinely in daily clinical setting for Japanese cancer patients. Complementary and alternative medicine (CAM) may also effective in some patients but further study for proving scientific evidence in CAM should be warranted. Tailor-maid pain control will be established in the near future with molecular based pharmacogenomics.
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Active clinical researches for breast cancer advance the therapeutic strategies remarkably, however, it seems to be more difficult to choose the appropriate treatment based on the evidence for each patient due to its diversification. Moreover, the striking achievements of various molecular targeting drugs established by basic researches make it complex, since the biological feature of tumor cell must be considered carefully for drug selection. To make it straight, the latest strategies for breast cancer treatment based on both basic and clinical evidences are summarized, especially about surgical and medical treatments of primary therapy for breast cancer.
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Mammalian target of rapamycin (mTOR) protein complex functions as an integration center for various intracellular signaling pathways involving proliferation, cell survival, and angiogenesis. These pathways are frequently abnormally regulated in cancer. Notably, Akt is an upstream molecule which is over-expressed and/or activated in several cancers. ⋯ Temsirolimus is indicated as the first line therapy for RCC patients with poor prognosis, whereas everolimus as the second line for those refractory to sorafenib or sunitinib. Interstitial pneumonia is the most serious adverse event for both agents. Clinical trials are under way to explore indications for various cancers.