Colonoscopy examination requires a longer time in patients with acromegaly than in other individuals.
In conclusion, although cecal intubation during colonoscopy was successful in all participants, it required a longer time in patients with acromegaly. Our results underscore the importance of and certain technical difficulties involved in colonoscopy procedures in patients with acromegaly, especially in older patients. PMID: 29081443 [PubMed - as supplied by publisher]
During the production of this paper, an error appeared in the title. The title should be, “Immune Checkpoint Inhibition Combined With Intracranial Stereotactic Radiation Therapy in Non-Small Cell Lung Cancer: Is There an Increasing Rate of Radionecrosis or Not? In Regards to Schapira et al, Huppeling et al and Colaco et al.”
Prostate cancer is the leading cause of cancer treatment –related years lived with disability for men worldwide.1 This has driven a disruptive change in management of favorable-risk prostate cancer such that nearly all National Comprehensive Cancer Network (NCCN) very low-risk patients are recommended conservative management rather than radical therapy. 2 Simultaneously, at the other end of the risk spectrum, treatment intensification with more potent systemic therapies has been the subject of recent trials for men with higher-risk disease (eg, NCT02772588).
In the above referenced article, portions of the text and table reading “CALGB 80801” should have read “CALGB 80101,” to correctly reflect the referenced Fuchs CS et al. publication and CALGB study. The authors regret the error.
The authors' letter and translational research work support the question posed in the review1,2: Are we at the tipping point for the era of real-time radiation therapy? The research by Dahele and Verbakel adds additional clinical evidence that real-time 3-dimensional image guided radiation therapy (3D IGRT) can be performed on standard-equipped cancer radiation therapy (RT) systems. Indeed, had it been published or known to us before we wrote the review, their clinical translation of markerless spine tracking3 would have been included as a fourth real-time 3D IGRT implementation on standard-equipped systems.
Multiple randomized studies have demonstrated that breast-conserving therapy (partial mastectomy plus whole breast radiation) can yield survival outcomes equivalent to those of mastectomy (1). However, newer population-based data suggest that breast cancer –specific survival and overall survival with breast-conserving therapy may actually be better than those with mastectomy (2-8). How is this possible? How can removal of the breast yield outcomes inferior to those of a therapy that leaves most of the breast intact and where in-breast failures are r eported to occur in approximately 5% to 10% of patients at 10 y...
In the world of cancer care, Halstedian paradigms for radical surgery have evolved toward organ preservation strategies without compromising the probability of cure. As such, clinicians have increasingly turned their focus toward minimizing the stigmata of treatment, with patient-centered outcomes having greater influence on decision making. Today, patients are typically able to preserve much of their functional anatomy and cosmesis. For example, selected patients with head and neck cancers are routinely offered a strategy of larynx preservation with upfront radiation therapy and chemotherapy, reserving a more morbid total...
A 66-year-old ex-smoker presented with metastatic renal cell cancer with lytic lesions in the left femur, T8, and a 1.5-cm lesion in the right lung. A biopsy from the femur confirmed clear cell renal cell cancer; the lung lesion could not be biopsied safely. The patient underwent a radical nephrectomy (pathologically staged as pT3a). He commenced sunitinib, which was stopped owing to severe hypertension, followed by everolimus, stopped after 8 cycles owing to muscle cramping. Repeat imaging demonstrated resolution of the lung nodule but progression in the left femur, T8, and new disease in the anterior right 10th rib and left humerus.
CONCLUSIONS: Benign neoplasms were found in majority of patients with acromegaly (71.6%) most notably: nodular goiter and colon polyps; malignant lesions were rare (4.5%). Only every fifth patient suffered from no neoplastic proliferations. No correlations between the studied parameters and the incidence of neoplasms were found, most likely due to the small number of patients. This is the reason for proposing the creating of the first national register of incidences of neoplasms among acromegalic patients. PMID: 30260174 [PubMed - in process]
ConclusionThyroid micro-carcinomas are probably over-diagnosed among acromegalic patients. In regard to colon cancer, there is no sufficient data to suggest that colon cancer risk is higher in acromegaly compared to the general population.
Growth hormone (GH) excess in acromegaly is associated with increased precancerous colon polyps and soft tissue adenomas, whereas short-stature humans harboring an inactivating GH receptor mutation do not develop cancer. We show that locally expressed colon GH is abundant in conditions predisposing to colon cancer and in colon adenocarcinoma-associated stromal...