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Hypnosis for Symptom Management in Adult Cancer Patients: What is the Evidence?
Opinion StatementAs a palliative care specialist and a hypnotherapist, I use therapeutic communication and conversational hypnosis daily in my patient – doctor relationship. Formal hypnotherapy sessions are integrated in my practice whenever patients are open or wish for such an approach in relation to a specific symptom, for better overall management of their disease burden and/or enhanced well-being. Although hypnosis has been used for centuri es in medical practice and for thousands of years in healing practices in ancient cultures all over the world, the evidence remains scarce. Nevertheless, in the last 10 years se...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Therapeutic Management of Malignant Wounds: An Update
Opinion statementMalignant fungating wounds (MFW) are severe skin conditions generating tremendous distress in oncological patients with advanced cancer stages because of pain, malodor, exudation, pruritus, inflammation, edema, and bleeding. The classical therapeutic approaches such as surgery, opioids, antimicrobials, and application of different wound dressings are failing in handling pain, odor, and infection control, thus urgently requiring the development of alternative strategies. The aim of this review was to provide an update on the current therapeutic strategies and the perspectives on developing novel alternative...
Source: Current Treatment Options in Oncology - January 4, 2024 Category: Cancer & Oncology Source Type: research

Updates on Management of Biochemical Recurrent Prostate Cancer
Opinion StatementPatients with biochemical recurrent prostate cancer (BCR) are a heterogeneous group, whereby a personalized approach to management is critical. Patients with high-risk features such as PSA doubling time (PSADT)  ≤ 9–12 months warrant earlier imaging for metastasis detection and consideration for intensified therapy (beyond intermittent androgen deprivation alone) during this phase of BCR-only disease. The BCR phase represents a unique opportunity to impact disease survival and delay metastasis prog ression. There is compelling evidence from the EMBARK trial that ADT monotherapy is no longer the opt...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research

Steroid Premedication and Monoclonal Antibody Therapy: Should We Reconsider?
Opinion statementMonoclonal antibody (mAb) therapy is now considered a main component of cancer therapy in Australia. Although traditionally thought of as pure signalling inhibitors, a large proponent of these medications function through antibody-dependent cell-mediated cytotoxicity (ADCC). Currently, most protocols and institutional guidelines for ADCC-mediated mAbs promote the use of corticosteroids as premedication: this is implemented to reduce infusion-related reactions (IRRs) and antiemesis prophylaxis and combat concurrently administered chemotherapy-related syndromes. Concerningly, the inhibitory effects of ADCC b...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research

Surgical Management and Considerations for Patients with Localized High-Risk Prostate Cancer
Opinion statementLocalized high-risk (HR) prostate cancer (PCa) is a heterogenous disease state with a wide range of presentations and outcomes. Historically, non-surgical management with radiotherapy and androgen deprivation therapy was the treatment option of choice. However, surgical resection with radical prostatectomy (RP) and pelvic lymph node dissection (PLND) is increasingly utilized as a primary treatment modality for patients with HRPCa. Recent studies have demonstrated that surgery is an equivalent treatment option in select patients with the potential to avoid the side effects from androgen deprivation therapy ...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research

Strategies to Assess and Manage Frailty among Patients Diagnosed with Primary Malignant Brain Tumors
Opinion statementFrailty refers to a biologic process that results in reduced physiologic and functional reserve. Patients diagnosed with primary malignant brain tumors experience high symptom burden from tumor and tumor-directed treatments that, coupled with previous comorbidities, may contribute to frailty. Within the primary malignant brain tumor population, frailty is known to associate with mortality, higher healthcare utilization, and increased risk of postoperative complications. As such, methods to assess and manage frailty are paramount. However, there is currently no clear consensus on how to best assess and mana...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research

Antibody-Drug Conjugates in Gynecologic Cancers
Opinion StatementAntibody-drug conjugates (ADCs) are a novel class of targeted cancer therapies with the ability to selectively deliver a cytotoxic drug to a tumor cell using a monoclonal antibody linked to a cytotoxic payload. The technology of ADCs allows for tumor-specificity, improved efficacy, and decreased toxicity compared to standard chemotherapy. Common toxicities associated with ADC use include ocular, pulmonary, hematologic, and neurologic toxicities. Several ADCs have been approved by the United States Food and Drug Administration (FDA) for the management of patients with recurrent or metastatic gynecologic can...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research

Sentinel Lymph Node Evaluation in Early-Stage Vulvar Cancer
Opinion StatementSentinel lymph node mapping (SLNM) and dissection (SLND) should be used as an alternative to full inguinofemoral lymph node dissection (IFLND) in select patients with early-stage vulvar cancer. IFLND is associated with high postoperative complications such as wound breakdown, lymphedema, lymphocyst formation, and infection. SLND in select patients offers a safe, effective, and less morbid alternative. Candidates for SLND include patients with a unifocal vulvar tumor less than four centimeters, clinically negative lymph nodes, and no prior inguinofemoral surgeries. SLND should ideally be performed by a high...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research

Approach to Patients with High-Risk Localized Prostate Cancer: Radiation Oncology Perspective
Opinion statementHigh-risk localized prostate cancer is a challenging clinical entity to treat, with heterogeneous responses to an evolving array of multidisciplinary treatment approaches. In addition, this disease state is growing in incidence due to a variety of factors, including shifting recommendations that discouraged routine prostate cancer screening. Current guidelines now incorporate an informed decision-making process for prostate cancer screening and evaluation. More work is underway to improve targeted screening for certain at-risk populations and to implement greater personalization in the use of diagnostic to...
Source: Current Treatment Options in Oncology - January 3, 2024 Category: Cancer & Oncology Source Type: research

Systemic Therapy for Melanoma Brain and Leptomeningeal Metastases
Opinion statementMelanoma has a high propensity to metastasize to the brain which portends a poorer prognosis. With advanced radiation techniques and targeted therapies, outcomes however are improving. Melanoma brain metastases are best managed in a multi-disciplinary approach, including medical oncologists, neuro-oncologists, radiation oncologists, and neurosurgeons. The sequence of therapies is dependent on the number and size of brain metastases, status of systemic disease control, prior therapies, performance status, and neurological symptoms. The goal of treatment is to minimize neurologic morbidity and prolong both p...
Source: Current Treatment Options in Oncology - December 30, 2023 Category: Cancer & Oncology Source Type: research

Treatment Landscape of Renal Cell Carcinoma
Opinion StatementThe treatment landscape of renal cell carcinoma (RCC) has evolved significantly over the past three decades. Active surveillance and tumor ablation are alternatives to extirpative therapy in appropriately selected patients. Stereotactic body radiation therapy (SBRT) is an emerging noninvasive alternative to treat primary RCC tumors. The advent of immune checkpoint inhibitors (ICIs) has greatly improved the overall survival of advanced RCC, and now the ICI-based doublet (dual ICI-ICI doublet; or ICI in combination with a vascular endothelial growth factor tyrosine kinase inhibitor, ICI-TKI doublet) has beco...
Source: Current Treatment Options in Oncology - December 28, 2023 Category: Cancer & Oncology Source Type: research

Research Progress on the Cardiotoxicity of EGFR-TKIs in Non-Small Cell Lung Cancer
Opinion statementWith the development of molecular biology and histology techniques, targeted therapy for non-small cell lung cancer (NSCLC) has emerged, which is highly effective and has marginal side effects. Epidermal growth factor receptor (EGFR) was the first driver gene discovered, whose three generations of therapeutic use have its characteristics and benefits in clinical practice. However, cardiovascular complications by EGFR-tyrosine kinase inhibitors (EGFR-TKIs) in preclinical studies have been increasingly reported, including heart failure, cardiomyopathy, and QT prolongation, among others. Cardiotoxicity of tar...
Source: Current Treatment Options in Oncology - December 28, 2023 Category: Cancer & Oncology Source Type: research

Liver-Directed Therapy for Neuroendocrine Tumor Metastases in the Era of Peptide Receptor Radionuclide Therapy
Opinion statementThe treatment of neuroendocrine neoplasm (NEN) liver metastases involves a multidisciplinary approach that includes liver-directed therapies (LDT) and systemic treatments, such as peptide receptor radionuclide therapy (PRRT). LDT has demonstrated efficacy in rapidly reducing tumor bulk, improving symptoms, and delaying disease progression. Interventional radiologists should be consulted prior to switching therapy for patients with progressive or symptomatic neuroendocrine tumor liver metastases. Long-term follow-up data on the safety of Yttrium-90 radioembolization before and after PRRT remain limited. The...
Source: Current Treatment Options in Oncology - December 15, 2023 Category: Cancer & Oncology Source Type: research

Treatment of Non-Small Cell Lung Cancer with Atypical EGFR Mutations
Opinion statementEGFR tyrosine kinase inhibitors (TKI) should always be considered when treating advanced/metastatic non-small cell lung cancer (NSCLC) with atypical EGFR mutations. The first choice of TKI depends on the specific mutation(s) present and its effect on structure and function of the EGFR protein. Afatinib is the only EGFR TKI currently FDA approved for atypical EGFR mutations and has the strongest data to support its use in PACC mutations, a subgroup of atypical EGFR mutations which includes G719X and S7681. Dacomitinib may also be an option for these mutations given similar efficacy to afatinib. In contrast,...
Source: Current Treatment Options in Oncology - December 14, 2023 Category: Cancer & Oncology Source Type: research

Non-Surgical Therapeutic Strategies for Non-Melanoma Skin Cancers
Opinion statementNon-melanoma skin cancer (NMSC) is a globally prevalent skin disease, with basal cell carcinoma and squamous cell carcinoma accounting for 99% of NMSC cases. While surgical excision is the most common approach, numerous non-surgical therapies have rapidly advanced in recent years. In cases of low-risk NMSC, alongside surgical excision, priority should be given to physical therapy and photodynamic therapy. Physical therapy modalities, exemplified by electrodessication and curettage, emerge as safe and efficacious alternatives. In juxtaposition, photodynamic therapy, albeit relatively more costly, assumes pr...
Source: Current Treatment Options in Oncology - December 14, 2023 Category: Cancer & Oncology Source Type: research