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Colorectal Cancer

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  • Finally, Demonstrable Improvement in Remission Induction for Adult Acute Myelogenous Leukemia

    A multi-institutional study examined the addition of a purine analog, either cladribine or fludarabine, to the standard induction regimen ("7 & 3") in adult patients 60 years of age and younger with acute myelogenous leukemia, and found improved outcomes for those receiving cladribine. The added benefit from cladribine appears to be the result of a reduction in the incidence of resistant disease. The study arm containing cladribine, daunorubicin, and cytaribine yielded an overall survival at 3 years of 45% while conventional "7 & 3" therapy was only 33% at 3 years. Cladribine added to daunorubicin and cytarabine during remission induction improves leukemia control and patient survival for those 60 years of age and younger.
  • Pharmacology Watch: Does Finasteride Cause Permanent Sexual Side Effects?

    Side effects of finasteride; new ruling on pharmaceutical companies paying generic manufacturers; and FDA actions.
  • Adjuvant Chemotherapy for Older Patients

    Four large data sets were analyzed to evaluate the effect of adjuvant treatment on survival in patients with stage III colon cancer diagnosed after age 75. While adjuvant chemotherapy was associated with a survival benefit, oxaliplatin-based regimens offered no more than a small incremental benefit over non-oxaliplatin-containing regimens.
  • Dietary Lignan Intake and Breast Cancer Risk

    In this case-control study, dietary lignan intake was inversely associated with risk of breast cancer in both premenopausal and postmenopausal women. Also noted were more favorable prognostic characteristics associated with lignan intake, especially in premenopausal women.
  • Adjuvant Management of Uterine Leiomyosarcoma

    A 78-year-old female had been generally well with no known chronic medical conditions and was taking no medications when she presented to her primary care physician with lower abdominal pain and urinary frequency of one month's duration. Physical examination at the time revealed a well-appearing woman with normal vital signs and no abnormal physical findings except a palpably enlarged uterus by bimanual pelvic examination. CT scan confirmed the presence of a uterine mass suspicious for malignancy. She was referred to a gynecologic oncologist and had a total abdominal hysterectomy and salpingo-oophorectomy with partial infracolic omentectomy and pelvic debulking of what appeared to be a large (15 cm) tumor mass. Final pathology was high-grade leiomyosarcoma with microscopic invasion of the colon and bladder.
  • Postoperative Management of GIST

    A 61-year-old nuclear engineer with a past history of hypertension was admitted through the emergency department because of persistent lower abdominal pain. Clinical picture and imaging studies initially pointed to pelvic abscess.
  • Watchful Waiting for Patients with Follicular Lymphoma: Even in the Rituximab Era

    In an analysis of a well-characterized dataset capturing outcomes for patients with asymptomatic, low-burden follicular lymphoma, those managed by initial watchful waiting had outcomes similar to comparable patients who were treated at the time of diagnosis with regimens including rituximab. Thus, delayed initial therapy remains a reasonable approach for selected follicular lymphoma patients.
  • Clinical Briefs in Primary Care Supplement

  • Pharmacology Watch: Menopausal Hormone Therapy and the Risk for VTE, AD

    Menopausal hormone therapy and risk of VTE and AD; patients' understanding of chemotherapy benefits; and FDA actions.
  • Clinical Considerations for Uterine Serous Cancer

    Uterine (papillary) serous cancer is a genomically unstable cancer associated with poor survival even in stage i. it is also frequently associated with a secondary malignancy, particularly breast cancer. Comprehensive surgical staging is recommended since extrauterine disease can be present without other high-risk uterine features, like myometrial invasion. However, an optimal adjuvant treatment protocol remains to be defined.