Cancer Treatment

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired clonal disorder in which patients experience complement-mediated hemolytic anemia, with or withotu hemogobinuria. It is often associated with Venous Thrombosis and cytopenias. The lack of CD55 (decay accelerating factor) and CD59 (membrane inhibitor of reactive lysis) in RBC membranes is responsible for unchecked complement activation and subsequent [...]

Local control of osteosarcoma primarily is a surgical problem, but histologic response to neoadjuvant therapy is the single most important prognostic factor for long-term survival in nonmetastatic osteosarcoma of the extremity.IA therapy might be able to provide better guidance but this is not proven. Currently, doxorubicin, cisplatin, high-dose methotrexate with leucovorin rescue and ifosfamide are [...]

Multiple plexiform fibromas, Schwannomas and accoustic neuromas are a hallmark neurofibromatosis, which condition also presents with other findings and symptoms. It can appear as cafe-au-lait spots and bumps under the skin, or it can lead to complications that include blindness, scoliosis and disfigurement. Fibromas can cause pain and compromise other organs. Few treatments are available, [...]

Erlotinib has shown activity individually, as single drugs, or in combination with chemotherapy in upper gastro-intestinal cancers, including esophageal and gastro-esophageal adenocarcinomas, gastric cancer and pancreatic cancer.  In several recent phase 2 trials,erlotinib appears to be somewhat active in esophageal cancer and not very active in gastric cancer. The authors conclude that additional studies with [...]

Obstructive sleep apnea (OSA) is a prevalent disorder, which consists of recurring partial or complete occlusion of the upper airway during sleep, resulting in oxyhemoglobin desaturation and arousal. The associated excessive daytime sleepiness (EDS) and nocturnal symptoms such as snoring, witnessed apneas, and sleep disruption can lead to emotional, marital, social, occupational, and road safety [...]

Patients with acute myeloid leukemia (AML) are often neutropenic becasue of leukemia and they also experience profound neutropenia following induction and/or consolidation chemotherapy, which may result in serious, potentially life-threatening, infection. Prophylactic use of myeloid growth factors reduces the severity and duration of neutropenia. Pegylated filgrastim (pegfilgrastim), or Neulasta, has the same mechanism of action [...]

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by gait disturbance, dementia, and/or urinary incontinence without causative disorders, and ventricular enlargement due to disturbance of the cerebrospinal fluid (SF) circulation. Surgical CSF shunting remains the main treatment modality. Prior to embarking upon surgical therapy, knowing which patients may benefit from surgery. Several different tests [...]

The widely used PSA blood marker is well established. However, the poor specificity of the PSA test for detecting cancer, or for differentiating indolent cancers from clinically significant ones, tends to lead to many negative biopsies and overtreatment of men with prostatic adenocarcinoma. More specific markers are being sought.PCA3 (formerly known as DD3) is one [...]

NCCN, ASCO and ASH guidelines recommend routine use of Neulasta® or Neupogen (filgrastim) for patients with an overall risk of FN of 20% or greater. Previous studies have suggested that these drugs can reduce the incidence of hospitalizations, decrease Febrile Neutropenia and allow better delivery of protocol doses of chemotherapy. The supportive data was generated [...]

Interim PET may provide important prognostic information and guide therapy. My reading of the evidence is that NCCN does recommend interim PET. NCCN for Hodgkin's does recommend a PET after two cycles fo ABVD, which is similar and not substantively different fomr this patients ABVD based regimen,  on p. HODG-4. For this reason I disagree [...]