Nutrition support for treating cancer-associated weight loss: an update
Purpose of review Patients with cancer present high risk for involuntary body weight loss and reduced food intake, which, contributing to progressive tissue wasting and affecting the nutritional status, are often under-estimated in the clinical practice. In this article, we aimed at focusing on cancer-associated weight loss and investigating recent evidences on the indications of nutritional interventions to treat this condition. Recent findings During the last few years, increased emphasis has been addressed on the mechanisms underlying body weight loss in cancer that can be induced by either cancer metabolism and inflammation, either several side-effects of the anticancer treatments. This led to consider clinical parameters, such as BMI, body weight change and food intake, and their modification overtime, in predicting patient's overall survival. In this light, nutritional support has to be considered to maintain or restore nutritional status, improve tolerance to oncological therapies, and ameliorate physical performance and quality of life. Summary Increased awareness on weight loss in cancer patients and on cancer cachexia is needed to carry out a nutritional assessment at an early stage of cancer journey and to establish its management and nutritional support to obtain advantages in terms of treatment tolerance and clinical outcomes.
ConclusionsBevacizumab was the only prescribed targeted therapy in first-line treatment. Considering the limited number of patients receiving first-line bevacizumab and the unknown reasons to prescribe additional targeted therapy, the corresponding survival rates of patients treated with and without additional bevacizumab in first-line treatment might suggest a limited clinical effect of bevacizumab in addition to first-line palliative chemotherapy on OS. Future research should focus on identifying the subgroup of patients who might benefit OR benefiting from anti-VEGF therapy in metastatic SBA.
AbstractLocal excision following chemoradiotherapy in rectal cancer is an organ-preserving procedure which aims at reducing morbidity and functional disorders associated with total mesorectal excision (TME) in selected patients. Although TME after chemoradiotherapy remains the gold standard for locally advanced mid and low rectal cancer, in the last years multicenter research trials have offered encouraging oncologic results which have allowed to preserve the rectum in patients with a pathologic complete response after chemoradiotherapy. A review of the available literature on this topic was conducted to define the state o...
Publication date: November–December 2019Source: Journal of Minimally Invasive Gynecology, Volume 26, Issue 7, SupplementAuthor(s): SR Pena, J Brown, M Wally, R Seymour, JR Hsu, RW NaumannStudy ObjectiveTo determine opioid and benzodiazepine prescribing practices in the gynecologic oncology population and determine if this patient population is at risk for narcotic abuse.DesignThis was an IRB-approved, retrospective study of opioid and benzodiazepine prescriptions for cervical, ovarian (including fallopian tube and primary peritoneal), and uterine cancer patients within a single healthcare system from January 2016 to ...
Journal of Palliative Medicine, Ahead of Print.
Journal of Palliative Medicine, Ahead of Print.
This study aimed to evaluate the value of palliative resection or radiation of primary tumor for metastatic esophageal cancer using the Surveillance, Epidemiology, and End Results database. Additionally, we constructed prognostic nomograms for both preoperative and postoperative risk factors. We found that palliative resection or radiation could improve the survival of such patients, across both squamous cell carcinoma and adenocarcinoma. AbstractPurposeWe aimed to explore the value of palliative resection or radiation of primary tumor for metastatic esophageal cancer (EC) patients.MethodsSurveillance, Epidemiology, and En...
A phase II trial was proposed to define the efficacy of a short-course radiotherapy for symptomatic palliation of metastatic or locally advanced oesophageal cancer in a low resourced setting where only a 2D-radiotherapy technique was available. Results showed that the delivery of a total dose of 12 Gy in 4 fractions, twice-a-day, over 2 days, ≥ 8 hours apart, was tolerated and effective for the symptomatic palliation of metastatic or locally advanced oesophageal malignancies.
Large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC) are aggressive neuroendocrine tumors with poor survival rates [1 –3]. For stage IV SCLC, treatment has not advanced significantly over the last decades and consists of palliative chemotherapy. The same applies to stage IV LCNEC, were no standard treatment exists and palliative chemotherapy with SCLC and non-small cell lung cancer (NSCLC) regimens are both deeme d appropriate . Recently, targeted therapy focusing on delta like protein 3 (DLL3) has received attention to improve outcomes for SCLC and LCNEC .
CONCLUSION: Indian patients with colon cancer, at a tertiary referral center, tend to present at more advanced stages of the disease as compared to the West. However, curative treatment with surgery and chemotherapy offers similar survival outcomes when compared stage for stage.
This article gives an outline of the history, existing radiotherapy facilities and future trends related to radiotherapy practice in India.