Reviews

Fatigue is an exceedingly common often treatable problem in cancer patients that profoundly affects all aspects of quality of life. Prevalence estimates have ranged from 50% to 90% of cancer patients overall. After addressing reversible or treatable contributing factors, such as hypothyroidism, anemia, sleep disturbance, pain, emotional distress, climacterium, medication adverse events, metabolic disturbances, or organ dysfunction such as heart failure, myopathy, and pulmonary fibrosis, patients may be screened with a brief fatigue self-assessment tool. All cancer patients should be screened regularly for fatigue. Those with moderate or severe fatigue may benefit from both pharmacologic and nonpharmacologic interventions, while mild fatigue that does not interfere with quality of life can be treated with nonpharmacologic measures alone. Physicians often have insufficient knowledge about fatigue and its treatments or underestimate the impact of fatigue on quality of life...

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Molecular Oncology

The promise of personalised medicine is now a clinical reality, with colorectal cancer genetics at the forefront of this next major advance in clinical medicine. This is no more evident than in the testing of colorectal cancers for specific molecular alterations in order to guide treatment with the monoclonal antibody therapies cetuximab and panitumumab, which target the epidermal growth factor receptor (EGFR).Indeed, the discovery that acquired KRAS mutations are a robust predictive marker of resistance to cetuximab and panitumumab has led to clinically validated and cost-effective testing strategies to direct these drugs to appropriate patients. This discovery resulted from a detailed understanding of colorectal cancer genetics, including the role of KRAS mutations in colorectal carcinogenesis, as well as knowledge of the EGFR signalling pathways.The success of KRAS mutation testing in predicting treatment response is just the beginning of the use of genetic markers for directing the care of patients with colorectal cancer. Many other genetic markers in colorectal cancer....
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Retinoblastoma (RB) is the most common malignant ocular tumour in childhood. In the United States the incidence is 11 new cases of RB per million population under 5 years of age. In developing countries, most of the cases are detected at advanced stages. At the present time, nearly all patients diagnosed during the early stages can achieve a prolonged disease free survival, and at least 50% of the affected eyes can be preserved. In Mexico, RB may represent the second most frequent malignant ....

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Over the past decades, clinical, pathological or epidemiological investigations into the large bowel have semi-automatically divided the colorectum into three compartments, namely, the rectum, distal colon and proximal colon.In 1990, Bufill proposed the existence of two distinct genetic categories of colorectal cancers according to tumour location in the proximal or distal segment of the large bowel, divided at splenic flexure. This concept of distinct molecular features of proximal ....
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Lung cancer is probably the most substantial cancer problem faced by public and private health-care systems in the developed world, in terms of its human impact on lives lost and morbidity burden and in terms of its budget impact on those health-care systems....
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Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and ....
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Oncologists are asked with increasing frequency to counsel their patients with respect to the medical, psychological and social repercussions of genetic testing for cancer susceptibility that may have been prescribed by physicians or carried out through direct-to-consumer tests. This article critically reviews the main ethical and social implications of BRCA testing, focusing on genetic responsibility and genetic discrimination. Genetic responsibility toward oneself and others is a highly debated implication of genetic testing for cancer predisposition that requires broad....
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