Moslem Hospital Goverment

Adjuvant Treatment of Colorectal Cancer

2007-08-09T03:36:00.000-07:00

Brian M. Wolpin, MD, Jeffrey A. Meyerhardt, MD, MPH, Harvey J. Mamon, MD, PhD and Robert J. Mayer, MD

Dr. Wolpin is Instructor in Medicine, Dana-Farber Cancer Institute, Department of Medical Oncology, Harvard Medical School, Boston, MA.
Dr. Meyerhardt is Assistant Professor of Medicine, Dana-Farber Cancer Institute, Department of Medical Oncology, Harvard Medical School, Boston, MA.
Dr. Mamon is Assistant Professor of Radiation Oncology and Clinical Director, Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Dr. Mayer is Professor of Medicine and Director, Center for Gastrointestinal Oncology, Dana-Farber Cancer Institute, Department of Medical Oncology, Harvard Medical School, Boston, MA.

This article is available online at http://CAonline.AmCancerSoc.org
To earn free CME credit for successfully completing the online quiz based on this article, go to http://CME.AmCancerSoc.org

ABSTRACT

Colorectal cancer is the fourth most common noncutaneous malignancyin the United States and the second most frequent cause of cancer-relateddeath. Approximately three quarters of patients are diagnosedwith disease limited to the bowel wall or surrounding lymphnodes. Over the past decade, significant progress has been madein the treatment of localized colorectal cancer due to advancesin surgery, radiotherapy, and chemotherapy. For patients withStage III colon cancer, an overall survival benefit for fluorouracil-basedchemotherapy has been firmly established, and recent data haveshown further efficacy through the inclusion of oxaliplatininto adjuvant treatment programs. For patients with Stage IIcolon cancer, the use of adjuvant chemotherapy remains controversial,but may be appropriate in a subset of individuals at high riskfor disease recurrence. In the treatment of patients with rectalcancer, improved outcomes have been noted with the use of totalmesorectal excision and preoperative concurrent chemoradiotherapy.Current randomized clinical trials in the adjuvant therapy ofcolorectal cancer are examining the value of adding agents knownto be active in metastatic disease, including those that modifyspecific molecular targets.

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Cancer Risk Elicitation and Communication

2007-08-09T03:34:00.000-07:00

Lessons from the Psychology of Risk Perception

William M. P. Klein, PhD and Michael E. Stefanek, PhD

Dr. Klein is Associate Professor, Department of Psychology, University of Pittsburgh, Pittsburgh, PA.
Dr. Stefanek is Vice President, Behavioral Research Center, American Cancer Society, Atlanta, GA.

This article is available online at http://CAonline.AmCancerSoc.org

ABSTRACT

Cancer risk perceptions are a key predictor of risk-reductionpractices, health behaviors, and processing of cancer information.Nevertheless, patients and the general public (as well as healthcare providers) exhibit a number of errors and biases in theway they think about risk, such that their risk perceptionsand decisions deviate greatly from those prescribed by normativedecision models and by experts in risk assessment. For example,people are more likely to engage in screening behaviors suchas mammography when faced with loss-based messages than gain-framedmessages, and they often ignore the base rate of a given diseasewhen assessing their own risk of obtaining this disease. Inthis article, we review many of the psychological processesthat underlie risk perception and discuss how these processeslead to such deviations. Among these processes are difficultieswith use of numerical information (innumeracy), cognitive processes(eg, use of time-saving heuristics), motivational factors (eg,loss and regret aversion), and emotion. We conclude with suggestionsfor future research in the area, as well as implications forimproving the elicitation and communication of personal cancerrisk.

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Minimal Access Cancer Management

2007-08-09T03:33:00.000-07:00

Frederick L. Greene, MD, Kent W. Kercher, MD, Heidi Nelson, MD, Chris M. Teigland, MD and Anne-Marie Boller, MD

Dr. Greene is Chairman, Department of General Surgery, Carolinas Medical Center, Charlotte, NC.
Dr. Kercher is Chief of Minimal Access Surgery; and Co-director of the Carolinas Laparoscopic and Advanced Surgery Program, Department of General Surgery, Carolinas Medical Center, Charlotte, NC.
Dr. Nelson is Professor of Surgery; and Division Chief, Department of Surgery and Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN.
Dr. Teigland is Chairman, McKay Department of Urology, Carolinas Medical Center, Charlotte, NC.
Dr. Boller is Fellow, Department of Surgery and Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN.

This article is available online at http://CAonline.AmCancerSoc.org
To earn free CME credit for successfully completing the online quiz based on this article, go to http://CME.AmCancerSoc.org.
Disclosures: The authors have no financial support or financial interest in products or manufacturers of products mentioned in the manuscript

ABSTRACT

Minimal access approaches in the treatment of a variety of solidtumors of the stomach, large bowel, and genitourinary systemare now being advocated in several surgical specialty areas.The laparoscope has evolved from a diagnostic tool to a modalitythat allows for removal of tumors using small incisions andthe application of pneumoperitoneum with carbon dioxide. Throughstudies using animal models and patient investigation, the immunologicbenefits of laparoscopic cancer procedures appear to be beneficialwhen compared with conventional laparotomy. Overall benefitsof analgesic reduction, more rapid postoperative recovery, andpatient satisfaction are the byproducts of minimal access approaches.Patients with cancers of the stomach, colon, and kidney showsimilar long-term outcomes when compared with conventional opentechniques. Caution, however, should be exercised in recommendinglaparoscopic approaches for routine management of primary tumorsof the rectum and adrenal gland.

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Young Adult Oncology

2007-08-09T03:30:00.000-07:00

The Patients and Their Survival Challenges

Archie Bleyer, MD

Dr. Bleyer is Adolescent and Young Adult Oncologist and Medical Advisor, Cancer Treatment Center, St. Charles Medical Center, Bend, OR; Adolescent and Young Adult Oncologist, Oregon Health and Sciences University, Portland, OR; and Director, CureSearch/National Childhood Cancer Foundation, Bethesda, MD, and Arcadia, CA.

ABSTRACT

One in every 168 Americans develops invasive cancer betweenage 15 to 30 years. During this age interval, cancer is uniquein the distribution of types that occur and rarely related toeither environmental carcinogens, a recognizable inherited predisposition,or a family cancer syndrome. Patients in this age group havethe lowest rate of health insurance coverage, frequent delaysin diagnosis, and the lowest accrual to clinical trials. Theirpsychosocial needs are unique and generally less well attendedto than in any other age group. Despite an intrinsically equalability to tolerate chemotherapy, older adolescents and youngadults frequently receive lower dose intensities than do youngerpatients, and at times less than in older patients. Whereasthe 15- to 29-year age group once had a better overall survivalrate than either younger or older patients, a relative lackof progress has resulted in the majority of cancers in the agegroup having a worse overall survival rate than in younger patients,and several of these having a worse prognosis than in olderpatients. Against this background, young adults with cancerhave unique survival challenges—medically, psychosocially,and economically—that are now beginning to be appreciatedand addressed with a national initiative.

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The Lethal Phenotype of Cancer

2007-08-09T03:28:00.000-07:00

The Molecular Basis of Death Due to Malignancy

Robert D. Loberg, PhD, Deborah A. Bradley, MD, Scott A. Tomlins, Arul M. Chinnaiyan, MD, PhD and Kenneth J. Pienta, MD

Dr. Loberg is Research Assistant Professor, Internal Medicine and Urology, University of Michigan, Ann Arbor, MI.
Dr. Bradley is Fellow, Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI.
Mr. Tomlins is Graduate Student, Department of Pathology, University of Michigan, Ann Arbor, MI.
Dr. Chinnaiyan is S. P. Hicks Endowed Professorship; Professor of Pathology and Urology; Director of Pathology Research Informatics; and Director of Cancer Bioinformatics, University of Michigan, Ann Arbor, MI.
Dr. Pienta is Professor, Internal Medicine and Urology; and American Cancer Society Clinical Research Professor, University of Michigan, Ann Arbor, MI.

This article is available online at http://CAonline.AmCancerSoc.org
To earn free CME credit for successfully completing the online quiz based on this article, go to http://CME.AmCancerSoc.org
Disclosures: K.J.P. is supported by an American Cancer Society Clinical Research Professorship. A.M.C. is supported by a Burroughs Welcome Foundation Award in Clinical Translational Research. S.A.T. is supported by the Medical Scientist Training Program and a Rackham Predoctoral Award. This research was supported in part by National Institutes of Health Grant RO1 CA102872 (to K.J.P.); RO1 CA97063 (to A.M.C.); U01 CA111275 (to A.M.C.); P50 CA69568 (to K.J.P., A.M.C.); Department of Defense Grant PC051081 (to A.M.C.); Ralph Wilson Medical Research Foundation Award (K.J.P.); and a Prostate Cancer Foundation Research Award (R.D.L.)

ABSTRACT

The last decade has seen an explosion in knowledge of the molecularbasis and treatment of cancer. The molecular events that definethe lethal phenotype of various cancers—the genetic andcellular alterations that lead to a cancer with a poor or incurableprognosis—are being defined. While these studies describethe cellular events of the lethal phenotype of cancer in detail,how these events result in the common clinical syndromes thatkill the majority of cancer patients is not well understood.It is clear that the central step that makes most cancers incurableis metastasis. Understanding the traits that a cancer acquiresto successfully grow and metastasize to distant sites givesinsight into how tumors produce multiple factors that resultin multiple different clinical syndromes that are lethal forthe patient.

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Functional Imaging of Cancer with Emphasis on Molecular Techniques

2007-08-09T03:25:00.000-07:00

Drew A. Torigian, MD, MA^*, Steve S. Huang, MD, PhD^*, Mohamed Houseni, MD and Abass Alavi, MD

Dr. Torigian is Assistant Professor of Radiology, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
Dr. Huang is Nuclear Medicine Resident, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
Dr. Houseni is Visiting Scholar in Nuclear Medicine, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
Dr. Alavi is Professor of Radiology; and Director of Research Education, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.

This article is available online at http://CAonline.AmCancerSoc.org
To earn free CME credit for successfully completing the online quiz based on this article, go to http://CME.AmCancerSoc.org
Disclosures: Dr. Huang was supported by a training grant through the National Institutes of Health (NIH) (T32-CA093258–03). Dr. Houseni was supported as a visiting scholar by the Ministry of Higher Education of Egypt.
^*Please note that these authors have contributed equally to this manuscript.

ABSTRACT

A multitude of noninvasive, quantitative, functional imagingtechniques are currently in use to study tumor physiology, toprobe tumor molecular processes, and to study tumor moleculesand metabolites in vitro and in vivo using computed tomography(CT), magnetic resonance imaging (MRI), ultrasonography (US),positron emission tomography (PET), single-photon emission computedtomography (SPECT), and optical imaging (OI). Such techniquescan be used in conjunction with structural imaging techniquesto detect, diagnose, characterize, or monitor tumors beforeand after therapeutic intervention. These can also be used tostudy tumor gene expression, to track cells and therapeuticdrugs, to optimize individualized treatment planning for patientswith tumors, and to foster new oncologic drug development. Inthis article, we review the rich variety of functional imagingtechniques that are available for these purposes, which arebecoming increasingly important for optimal individualized patienttreatment in this day and age of "personalized medicine."

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Cancer Incidence, Mortality, and Associated Risk Factors Among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese Ethnicities

2007-08-09T01:42:00.000-07:00

Melissa McCracken, MPH, Miho Olsen, MPH, Moon S. Chen, Jr., PhD, MPH, Ahmedin Jemal, DVM, PhD, Michael Thun, MD, MS, Vilma Cokkinides, PhD, MSPH, Dennis Deapen, DrPH and Elizabeth Ward, PhD

Ms. McCracken is Epidemiologist, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Ms. Olsen is Epidemiologist, Rollins School of Public Health, Emory University; and Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Dr. Chen is Professor and Principal Investigator, Asian American Network for Cancer Awareness Research and Training; and Associate Director, Population Research and Cancer Disparities, University of California-Davis, Cancer Center, Sacramento, CA.
Dr. Jemal is Strategic Director, Cancer Occurrence, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Dr. Thun is Vice President, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Dr. Cokkinides is Strategic Director, Risk Factor Surveillance, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Dr. Deapen is Professor, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Dr. Ward is Managing Director, Surveillance Research, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.

This article is available online at http://CAonline.AmCancerSoc.org
Disclosures: The collection of cancer incidence data used in this study was supported by the California Department of Health Services as part of the statewide cancer-reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute's Surveillance, Epidemiology, and End Results Program (SEER Program) under contract N01-PC-35136 awarded to the Northern California Cancer Center, contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention's National Program of Cancer Registries under agreement #U55/CCR921930–02 awarded to the Public Health Institute.
Funding for M.S.C.'s role is attributable to Grant Number U01 CA114640 from the National Cancer Institute and P01 CA109091–01A, funded both by the National Cancer Institute and the National Center on Minority Health and Health Disparities.
The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California, Department of Health Services, the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended, nor should it be inferred.

ABSTRACT

Many studies demonstrate that cancer incidence and mortalitypatterns among Asian Americans are heterogeneous, but nationalstatistics on cancer for Asian ethnic groups are not routinelyavailable. This article summarizes data on cancer incidence,mortality, risk factors, and screening for 5 of the largestAsian American ethnic groups in California. California has thelargest Asian American population of any state and makes specialefforts to collect health information for ethnic minority populations.We restricted our analysis to the 4 most common cancers (prostate,breast, lung, colon/rectum) and for the 3 sites known to bemore common in Asian Americans (stomach, liver, cervix). Cancerincidence and mortality were summarized for 5 Asian Americanethnic groups in California in order of population size (Chinese,Filipino, Vietnamese, Korean, and Japanese). Chinese Americanshad among the lowest incidence and death rate from all cancercombined; however, Chinese women had the highest lung cancerdeath rate. Filipinos had the highest incidence and death ratefrom prostate cancer and the highest death rate from femalebreast cancer. Vietnamese had among the highest incidence anddeath rates from liver, lung, and cervical cancer. Korean menand women had by far the highest incidence and mortality ratesfrom stomach cancer. Japanese experienced the highest incidenceand death rates from colorectal cancer and among the highestdeath rates from breast and prostate cancer. Variations in cancerrisk factors were also observed and were for the most part consistentwith variations in cancer incidence and mortality. Differencesin cancer burden among Asian American ethnic groups should beconsidered in the clinical setting and in cancer control planning.

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2007-08-06T22:53:00.001-07:00

First Day in blog

2007-07-29T17:51:00.000-07:00

Versi Indonesia:

Ini adalah blog Rumah Sakit Haji Surabaya. Rumah Sakit Haji Surabaya adalah rumah sakit pemerintah di bawah kendali pemerintah propinsi Jawa Timur. Rumah sakit Tipe B yang terus berkembang dan mengarah ke Tipe B pendidikan ini berdiri tahun 1993. Rumah Sakit ini adalah rumah sakit satu-satunya yang memiliki jam kunjung bebas.
Dengan Blog ini mungkin pasien atau keluarga pasien bisa mendapatkan informasi penting yang dibutuhkan.