Current oncology reports
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Endoscopic and minimally invasive techniques represent a natural evolution for the discipline of head and neck surgery. Endoscopic head and neck surgery (eHNS) encompasses transoral laser microsurgery, transoral robotic surgery, as well as video-assisted and robotic surgery of the neck and thyroid. In the next 5 years, with robotic surgery and laser technology as a common platform, we foresee the development and widespread use of eHNS procedures, via transoral and transaxillary approaches.
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Malignant pleural effusion (MPE) often presents in patients with cancer at an advanced stage and thus carries a poor prognosis. This review updates the current knowledge on the management of MPE, focusing on recent literature about the efficacy and safety of the most common methods, including pleurodesis by either thoracoscopy with talc insufflation or thoracostomy with talc slurry, use of an indwelling pleural catheter, and intrapleural chemotherapy. ⋯ Talc pleuro-desis is relatively well tolerated and safe, as is an indwelling pleural catheter, in an appropriate patient population. Because MPE is a common problem in cancer patients, future research with more randomized, prospective designs and innovative interventions is needed.
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During the past decade, the critical role of sleep in health and disease has been underscored by research that further defines the relationship between sleep and myriad physiologic and psychological functions as well as quality of life. For many years, there was little exploration of the significance of sleep and sleep disorders in cancer patients; however, the past decade has seen a steady growth of inquiry in this area. These investigations have demonstrated the high frequency and significance of sleep disturbance as a symptom in cancer patients. ⋯ Although treatment studies lag behind, reports of effective psychological and behavioral interventions for insomnia in cancer patients are increasing. Several studies are addressing pharmacotherapeutic intervention for hot flashes as a potential source of sleep disturbance. Other sleep disorders, most notably obstructive sleep apnea, also occur with some regularity in cancer patients.
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Current oncology reports · Jul 2008
ReviewNovel targets with potential therapeutic applications in osteosarcoma.
For patients with osteosarcoma, the development of metastases, often to the lungs, is the most common cause of death. Long-term outcomes for patients who present with localized or disseminated disease have largely remained unchanged over the past 20 years. Further improvements in outcome are not likely to come from intensification of cytotoxic chemotherapy; as such, new targets for treatment are needed. ⋯ These include the origin of osteosarcoma in the bone or primitive mesenchymal cells, the predictable process of metastatic progression characterized by this disease, and the development of metastatic lesions almost exclusively in the lung. It is likely and potentially favorable for some targets to be relevant for more than one process. This review summarizes novel targets under evaluation for the treatment of osteosarcoma based on these three features of the disease.
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Dyspnea is a common symptom that causes considerable suffering in cancer patients. Although some knowledge of the sensory information that is transduced to the brain during dyspnea exists, we still have only a rudimentary understanding of the subjective perception of this symptom. ⋯ In addition to opioids, there are other important pharmacologic and nonpharmacologic tools with varying degrees of support that can be considered for symptomatic relief. Importantly, because dyspnea is a subjective symptom that occurs in a unique individual, the optimal treatment of dyspnea will always entail an understanding of, and support for, a patient's other sources of psychosocial, spiritual, and/or existential suffering.