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Current Oncology
Volume 23
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..

Curr. Oncol., Volume 23, Issue 6 (December 2016) – 25 articles

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785 KiB  
Article
Treatment and Outcomes for Primary Cutaneous Extramedullary Plasmacytoma: A Case Series
by D.S. Tsang, L.W. Le, V. Kukreti and A. Sun
Curr. Oncol. 2016, 23(6), 630-646; https://doi.org/10.3747/co.23.3288 - 01 Dec 2016
Cited by 6 | Viewed by 647
Abstract
Background Primary cutaneous plasmacytoma (pcp) is a rare disease, with few studies to guide therapy. Our primary study objective was to define treatments used for pcp; a secondary objective was to describe outcomes of patients, including disease recurrence and death. Methods An institutional [...] Read more.
Background Primary cutaneous plasmacytoma (pcp) is a rare disease, with few studies to guide therapy. Our primary study objective was to define treatments used for pcp; a secondary objective was to describe outcomes of patients, including disease recurrence and death. Methods An institutional cancer registry was used to identify cases for retrospective chart review. In a systematic review, treatments for, and outcomes of, all known cases of pcp were described. Results Three eligible cases identified at our institution; each patient had a solitary pcp. The systematic review identified 66 patients. Radiotherapy was the most commonly used primary treatment modality (31% of all patients; 42% for patients with solitary lesions), followed by surgery (28% of all patients; 36% for patients with solitary lesions). Median survival for all patients was 10.4 years [95% CI: 4.3 years to not reached], with a trend toward a decreased risk of death with solitary lesions compared with multiple lesions (hazard ratio: 0.37; 95% CI: 0.13 to 1.08; p = 0.059). For patients with solitary lesions, the median and recurrence-free survivals were, respectively, 17.0 years (95% CI: 1.7 years to not reached) and 11.0 years (95% CI: 2 years to not reached); for patients with multiple lesions, they were 4.3 years (95% CI: 1.3 to not reached) and 1.4 years (95% CI: 0.6 years to not reached). Disease recurrence, including progression to multiple myeloma, was the most common cause of death. Conclusions Compared with patients having multiple pcp lesions, those presenting with a single pcp lesion might experience longer overall survival. Local therapy (radiation or surgery) is a reasonable curative treatment for a solitary pcp lesion. Full article
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Article
Cancer Referral and Treatment Activity 2010–2015: A Population-Based Study from Vancouver Island
by P. Savage, C. Holloway, G. Lindsay, K. Shubrook, C. Jones, M. Fung, K. Schaff, H. Anderson, K. Nystedt and J. Rauw
Curr. Oncol. 2016, 23(6), 626-629; https://doi.org/10.3747/co.23.3306 - 01 Dec 2016
Cited by 4 | Viewed by 463
Abstract
Introduction The years since 2005 have seen major changes in cancer treatment and significant increases in the number of anticancer drugs available. However, there are relatively few published data to reflect how those changes are affecting the activity and workload of oncology services. [...] Read more.
Introduction The years since 2005 have seen major changes in cancer treatment and significant increases in the number of anticancer drugs available. However, there are relatively few published data to reflect how those changes are affecting the activity and workload of oncology services. To explore the effects of those changes, we reviewed the population-based cancer treatment activity on Vancouver Island for the period 2010–2015. Methods Information about new patient referrals, radiation courses, new chemotherapy cycles commenced, total intravenous (IV) chemotherapy treatment visits, and pharmacy activity for oral anticancer drug prescriptions was obtained from BC Cancer Agency databases. Results During the 5-year study period, the Vancouver Island population increased by 2.8% and the number of new referrals to the BC Cancer Agency increased by 17.7%. The overall number of radiation courses increased by 6.1%. In contrast, IV chemotherapy activity increased by 52.1% for new courses commenced and by 62% for total IV chemotherapy attendances. Oral anticancer drug prescriptions rose by 22.9% during the 5-year period. Conclusions Our study documents substantial recent increases in cancer therapy activity in terms of patient referrals and particularly IV chemotherapy and oral anticancer therapy. The data reported here could be of value in planning for future care provision. Full article
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Guidelines
Recommendations on Breast Cancer Screening and Prevention in the Context of Implementing Risk Stratification: Impending Changes to Current Policies
by J. Gagnon, E. Lévesque, F. Borduas, J. Chiquette, C. Diorio, N. Duchesne, M. Dumais, L. Eloy, W. Foulkes, N. Gervais, L. Lalonde, B. L’Espérance, S. Meterissian, L. Provencher, J. Richard, C. Savard, I. Trop, N. Wong, The Clinical Advisory Committee on Breast Cancer Screening and Prevention, B.M. Knoppers and J. Simardadd Show full author list remove Hide full author list
Curr. Oncol. 2016, 23(6), 615-625; https://doi.org/10.3747/co.23.2961 - 01 Dec 2016
Cited by 33 | Viewed by 1276
Abstract
In recent years, risk stratification has sparked interest as an innovative approach to disease screening and prevention. The approach effectively personalizes individual risk, opening the way to screening and prevention interventions that are adapted to subpopulations. The international PERSPECTIVE project, which is developing [...] Read more.
In recent years, risk stratification has sparked interest as an innovative approach to disease screening and prevention. The approach effectively personalizes individual risk, opening the way to screening and prevention interventions that are adapted to subpopulations. The international PERSPECTIVE project, which is developing risk stratification for breast cancer, aims to support the integration of its screening approach into clinical practice through comprehensive tool-building. Policies and guidelines for risk stratification—unlike those for population screening programs, which are currently well regulated—are still under development. Indeed, the development of guidelines for risk stratification reflects the translational aspects of PERSPECTIVE. Here, we describe the risk stratification process that was devised in the context of PERSPECTIVE, and we then explain the consensus-based method used to develop recommendations for breast cancer screening and prevention in a risk-stratification approach. Lastly, we discuss how the recommendations might affect current screening policies. Full article
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Article
Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016
by D. Bossé, T. Ng, C. Ahmad, A. Alfakeeh, I. Alruzug, J. Biagi, J. Brierley, P. Chaudhury, S. Cleary, B. Colwell, C. Cripps, L.A. Dawson, M. Dorreen, E. Ferland, P. Galiatsatos, S. Girard, S. Gray, F. Halwani, N. Kopek, A. Mahmud, G. Martel, L. Robillard, B. Samson, M. Seal, J. Siddiqui, L. Sideris, S. Snow, M. Thirwell, M. Vickers, R. Goodwin, R. Goel, T. Hsu, E. Tsvetkova, B. Ward and T. Asmisadd Show full author list remove Hide full author list
Curr. Oncol. 2016, 23(6), 605-614; https://doi.org/10.3747/co.23.3394 - 01 Dec 2016
Cited by 6 | Viewed by 589
Abstract
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5–7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for [...] Read more.
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5–7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: (1) Follow-up and survivorship of patients with resected colorectal cancer; (2) Indications for liver metastasectomy; (3) Treatment of oligometastases by stereotactic body radiation therapy; (4) Treatment of borderline resectable and unresectable pancreatic cancer; (5) Transarterial chemoembolization in hepatocellular carcinoma; (6) Infectious complications of antineoplastic agents. Full article
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Article
Risk Stratification, Treatment Selection, and Transplant Eligibility in Multiple Myeloma: A Qualitative Study of the Perspectives and Self-Reported Practices of Oncologists
by T.W. LeBlanc, A. Howson, W. Turell, P. Sheldon, S.C. Locke, S.A. Tuchman, C. Gasparetto, S. Kaura, Z.M. Khan and A.P. Abernethy
Curr. Oncol. 2016, 23(6), 598-604; https://doi.org/10.3747/co.23.3298 - 01 Dec 2016
Cited by 3 | Viewed by 522
Abstract
Background Since the early 2000s, treatment options for multiple myeloma have rapidly expanded, adding significant complexity to the management of this disease. To our knowledge, no systematic qualitative research on clinical decision-making in multiple myeloma has been published. We sought to characterize how [...] Read more.
Background Since the early 2000s, treatment options for multiple myeloma have rapidly expanded, adding significant complexity to the management of this disease. To our knowledge, no systematic qualitative research on clinical decision-making in multiple myeloma has been published. We sought to characterize how physicians view and implement guidelines and incorporate novel approaches into patient care. Methods We designed a semi-structured qualitative interview guide informed by literature review and an expert advisory panel. We conducted 60-minute interviews with a diverse sample of oncology physicians in the southeast United States. We used a constant comparative method to code and analyze interview transcripts. The research team and advisory panel discussed and validated emergent themes. Results Participants were 13 oncologists representing 5 academic and 4 community practices. Academic physicians reported using formal risk-stratification schemas; community physicians typically did not. Physicians also described differences in eligibility criteria for transplantation; community physicians emphasized distance, social support, and psychosocial capacity in making decisions about transplantation referral; the academic physicians reported using more specific clinical criteria. All physicians reported using a maintenance strategy both for post-transplant and for transplant-ineligible patients; however, determining the timing of maintenance therapy initiation and the response were reported as challenging, as was recognition or definition of relapse, especially in terms of when treatment re-initiation is indicated. Conclusions Practices reported by both academic and community physicians suggest opportunities for interventions to improve patient care and outcomes through optimal multiple myeloma management and therapy selection. Community physicians in particular might benefit from targeted education interventions about risk stratification, transplant eligibility, and novel therapies. Full article
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Article
Treatment Patterns and Survival in Patients with ALK-Positive Non-small-Cell Lung Cancer: A Canadian Retrospective Study
by S. Kayaniyil, M. Hurry, J. Wilson, P. Wheatley-Price, B. Melosky, J. Rothenstein, V. Cohen, C. Koch, J. Zhang, K. Osenenko and G. Liu
Curr. Oncol. 2016, 23(6), 589-597; https://doi.org/10.3747/co.23.3273 - 01 Dec 2016
Cited by 17 | Viewed by 1014
Abstract
Background Crizotinib was the first agent approved for the treatment of anaplastic lymphoma kinase (ALK)– positive (+) non-small-cell lung cancer (NSCLC), followed by ceritinib. However, patients eventually progress or develop resistance to crizotinib. With limited real-world data available, the [...] Read more.
Background Crizotinib was the first agent approved for the treatment of anaplastic lymphoma kinase (ALK)– positive (+) non-small-cell lung cancer (NSCLC), followed by ceritinib. However, patients eventually progress or develop resistance to crizotinib. With limited real-world data available, the objective of the present work was to evaluate treatment patterns and survival after crizotinib in patients with locally advanced or metastatic ALK+ NSCLC in Canada. Methods In this retrospective study at 6 oncology centres across Canada, medical records of patients with locally advanced or metastatic ALK+ NSCLC were reviewed. Demographic and clinical characteristics, treatments, and outcomes data were abstracted. Analyses focused on patients who discontinued crizotinib treatment. Results Of the 97 patients included, 9 were crizotinib-naïve, and 39 were still receiving crizotinib at study end. The 49 patients who discontinued crizotinib treatment were included in the analysis. Of those 49 patients, 43% received ceritinib at any time, 20% subsequently received systemic chemotherapy only (but never ceritinib), and 37% received no further treatment or died before receiving additional treatment. Median overall survival from crizotinib discontinuation was shorter in patients who did not receive ceritinib than in those who received ceritinib (1.7 months vs. 20.4 months, p < 0.001). In a multivariable analysis, factors associated with poorer survival included lack of additional therapies (particularly ceritinib), male sex, and younger age, but not smoking status; patients of Asian ethnicity showed a nonsignificant trend toward improved survival. Conclusions A substantial proportion of patients with ALK+ NSCLC received no further treatment or died before receiving additional treatment after crizotinib. Treatment with systemic agents was associated with improved survival, with ceritinib use being associated with the longest survival. Full article
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Article
A Retrospective Analysis of the Role of Proton Pump Inhibitors in Colorectal Cancer Disease Survival
by C. Graham, C. Orr, C.S. Bricks, W.M. Hopman, N. Hammad and R. Ramjeesingh
Curr. Oncol. 2016, 23(6), 583-588; https://doi.org/10.3747/co.23.3204 - 01 Dec 2016
Cited by 12 | Viewed by 532
Abstract
Background: Proton pump inhibitors (PPIS) are a commonly used medication. A limited number of studies have identified a weak-to-moderate association between PPI use and colorectal cancer (CRC) risk, but none to date have identified an effect of PPI use [...] Read more.
Background: Proton pump inhibitors (PPIS) are a commonly used medication. A limited number of studies have identified a weak-to-moderate association between PPI use and colorectal cancer (CRC) risk, but none to date have identified an effect of PPI use on CRC survival. We therefore postulated that an association between PPI use and CRC survival might potentially exist. Methods: We performed a retrospective chart review of 1304 CRC patients diagnosed from January 2005 to December 2011 and treated at the Cancer Centre of Southeastern Ontario. Kaplan–Meier analysis and Cox proportional hazards regression models were used to evaluate overall survival (OS). Results: We identified 117 patients (9.0%) who were taking PPIS at the time of oncology consult. Those taking a PPI were also more often taking ASA or statins (or both) and had a statistically significantly increased rate of cardiac disease. No identifiable difference in tumour characteristics was evident in the two groups, including tumour location, differentiation, lymph node status, and stage. Univariate analysis identified a statistically nonsignificant difference in survival, with those taking a PPI experiencing lesser 1-year (82.1% vs. 86.7%, p = 0.161), 2-year (70.1% vs. 76.8%, p = 0.111), and 5-year os (55.2% vs. 62.9%, p = 0.165). When controlling for patient demographics and tumour characteristics, multivariate Cox regression analysis identified a statistically significant effect of PPI in our patient population (hazard ratio: 1.343; 95% confidence interval: 1.011 to 1.785; p = 0.042). Conclusions: Our results suggest a potential adverse effect of PPI use on OS in CRC patients. These results need further evaluation in prospective analyses. Full article
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Article
Sensor-Controlled Scalp Cooling to Prevent Chemotherapy-Induced Alopecia in Female Cancer Patients
by M.K. Fehr, J. Welter, W. Sell, R. Jung and R. Felberbaum
Curr. Oncol. 2016, 23(6), 576-582; https://doi.org/10.3747/co.23.3200 - 01 Dec 2016
Cited by 13 | Viewed by 976
Abstract
Background: Scalp cooling has been used since the 1970s to prevent chemotherapy-induced alopecia, one of the most common and psychologically troubling side effects of chemotherapy. Currently available scalp cOf the 55 patients, 78% underwent scalp cooling untilooling systems demonstrate varying results in terms [...] Read more.
Background: Scalp cooling has been used since the 1970s to prevent chemotherapy-induced alopecia, one of the most common and psychologically troubling side effects of chemotherapy. Currently available scalp cOf the 55 patients, 78% underwent scalp cooling untilooling systems demonstrate varying results in terms of effectiveness and tolerability. Methods: For the present prospective study, 55 women receiving neoadjuvant, adjuvant, or palliative chemotherapy were enrolled. The aim was to assess the effectiveness of a sensor-controlled scalp cooling system (DigniCap: Sysmex Europe GmbH, Norderstedt, Germany) to prevent chemotherapy-induced alopecia in breast or gynecologic cancer patients receiving 1 of 7 regimens. Clinical assessments, satisfaction questionnaires, and alopecia evaluations [World Health Organization (WHO) grading for toxicity] were completed at baseline, at each cycle, and at completion of chemotherapy. Results: Of the 55 patients, 78% underwent scalp cooling until completion of chemotherapy. In multivariate analysis, younger women and those receiving paclitaxel weekly or paclitaxel–carboplatin experienced less alopecia. The compound successful outcome (“no head covering” plus “WHO grade 0/1”) was observed in all patients 50 years of age and younger receiving 4 cycles of docetaxel–cyclophosphamide or 6 cycles of paclitaxel–carboplatin. Conversely, alopecia was experienced by all women receiving triplet polychemotherapy (6 cycles of docetaxel–doxorubicin–cyclophosphamide). For women receiving sequential polychemotherapy regimens (3 cycles of fluorouracil–epirubicin–cyclophosphamide followed by 3 cycles of docetaxel or 4 cycles of doxorubicin–cyclophosphamide followed by 4 cycles of docetaxel), the subgroup 50 years of age and younger experienced a 43% success rate compared with a 10% rate for the subgroup pf older women receiving the same regimens. Conclusions: The ability of scalp cooling to prevent chemotherapy-induced alopecia varies with the chemotherapy regimen and the age of the patient. Use of a compound endpoint with subjective and objective measures provides insightful and practical information when counselling patients. Full article
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Article
Personalized Oncogenomics in the Management of Gastrointestinal Carcinomas—Early Experiences from a Pilot Study
by B.S. Sheffield, B. Tessier-Cloutier, H. Li-Chang, Y. Shen, E. Pleasance, K. Kasaian, Y. Li, S.J.M. Jones, H.J. Lim, D.J. Renouf, D.G. Huntsman, S. Yip, J. Laskin, M. Marra and D.F. Schaeffer
Curr. Oncol. 2016, 23(6), 571-575; https://doi.org/10.3747/co.23.3165 - 01 Dec 2016
Cited by 8 | Viewed by 785
Abstract
Background: Gastrointestinal carcinomas are genomically complex cancers that are lethal in the metastatic setting. Whole-genome and transcriptome sequencing allow for the simultaneous characterization of multiple oncogenic pathways. Methods: We report 3 cases of metastatic gastrointestinal carcinoma in patients enrolled in the Personalized Onco-Genomics [...] Read more.
Background: Gastrointestinal carcinomas are genomically complex cancers that are lethal in the metastatic setting. Whole-genome and transcriptome sequencing allow for the simultaneous characterization of multiple oncogenic pathways. Methods: We report 3 cases of metastatic gastrointestinal carcinoma in patients enrolled in the Personalized Onco-Genomics program at the BC Cancer Agency. Real-time genomic profiling was combined with clinical expertise to diagnose a carcinoma of unknown primary, to explore treatment response to bevacizumab in a colorectal cancer, and to characterize an appendiceal adenocarcinoma. Results: In the first case, genomic profiling revealed an IDH1 somatic mutation, supporting the diagnosis of cholangiocarcinoma in a malignancy of unknown origin, and further guided therapy by identifying epidermal growth factor receptor amplification. In the second case, a BRAF V600E mutation and wild-type KRAS profile justified the use of targeted therapies to treat a colonic adenocarcinoma. The third case was an appendiceal adenocarcinoma defined by a p53 inactivation; Ras/RAF/MEK, Akt/mTOR, Wnt, and NOTCH pathway activation; and overexpression of RET, ERBB2 (HER2), ERBB3, MET, and cell cycle regulators. We show that whole-genome and transcriptome sequencing can be achieved within clinically effective timelines, yielding clinically useful and actionable information. Full article
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Article
Burden of Illness for Metastatic Melanoma in Canada, 2011–2013
by D.S. Ernst, T. Petrella, A.M. Joshua, A. Hamou, M. Thabane, S. Vantyghem and F. Gwadry-Sridhar
Curr. Oncol. 2016, 23(6), 563-570; https://doi.org/10.3747/co.23.3161 - 01 Dec 2016
Cited by 15 | Viewed by 1060
Abstract
Background: Detailed epidemiology for patients with advanced metastatic melanoma in Canada is not well characterized. We conducted an analysis of patients with this disease in the province of Ontario, with the aim being to study the presentation, disease characteristics and course, and treatment [...] Read more.
Background: Detailed epidemiology for patients with advanced metastatic melanoma in Canada is not well characterized. We conducted an analysis of patients with this disease in the province of Ontario, with the aim being to study the presentation, disease characteristics and course, and treatment patterns for malignant melanoma. Methods: In this Canadian observational prospective and retrospective study of patients with malignant melanoma, we used data collected in the Canadian Melanoma Research Network (CMRN) Patient Registry. We identified patients who were seen at 1 of 3 cancer treatment centres between April 2011 and 30 April 2013. Patient data from 2011 and 2012 were collected retrospectively using chart records and existing registry data. Starting January 2013, data were collected prospectively. Variables investigated included age, sex, initial stage, histology, mutation type, time to recurrence, sites of metastases, resectability, and previous therapies. Results: A cohort of 810 patients with melanoma was identified from the cmrn registry. Mean age was 58.7 years, and most patients were men (60% vs. 40%). Factors affecting survival included unresectable or metastatic melanoma, initial stage at diagnosis, presence of brain metastasis, and BRAF mutation status. The proportion of surviving patients decreased with higher initial disease stages. Conclusions: Using registry data, we were able to determine the detailed epidemiology of patients with melanoma in the Canadian province of Ontario, validating the comprehensive and detailed information that can be obtained from registry data. Full article
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Article
Effect of Chemotherapy on Health-Related Quality of Life among Early-Stage Ovarian Cancer Survivors: A Study from the Population-Based Profiles Registry
by C.S. Bhugwandass, J.M.A. Pijnenborg, B. Pijlman and N.P.M. Ezendam
Curr. Oncol. 2016, 23(6), 556-562; https://doi.org/10.3747/co.23.3243 - 01 Dec 2016
Cited by 17 | Viewed by 625
Abstract
Background: There is wide variation in the application of adjuvant chemotherapy in early-stage epithelial ovarian cancer. Our aim was to assess differences in health-related quality of life (HRQOL) between patients with early-stage ovarian cancer who did or did not receive chemotherapy [...] Read more.
Background: There is wide variation in the application of adjuvant chemotherapy in early-stage epithelial ovarian cancer. Our aim was to assess differences in health-related quality of life (HRQOL) between patients with early-stage ovarian cancer who did or did not receive chemotherapy as adjuvant treatment. Methods: All patients diagnosed with early-stage ovarian cancer between 2000 and 2010 within the population-based Eindhoven Cancer Registry (n = 191) were enrolled in this study. Patients were requested to complete questionnaires, including the cancer-specific (QLQ-C30) and ovarian cancer-specific (QLQ-OV28) quality of life measures from the European Organisation for Research and Treatment of Cancer. Primary outcome measures were the generic-and cancer-specific domain scores for HRQOL in ovarian cancer survivors. Results: Of the 107 patients (56%) who returned the questionnaires, 57 (53.3%) had received adjuvant chemotherapy and 50 (46.7%) had been treated with surgery alone. Significant differences in HRQOL between those groups were found in the symptom scales for peripheral neuropathy, attitude toward sickness, and financial situation, with worse scores in the chemotherapy group. Conclusions: Results of our study show that patients who receive adjuvant chemotherapy have a significantly worse score for 3 aspects of HRQOL. Efforts should be made to reduce use of adjuvant chemotherapy in early-stage ovarian cancer. Moreover, preventive strategies to improve long-term quality of life for those who need adjuvant chemotherapy should be explored. Full article
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Article
Socioeconomic Status and Lifestyle Behaviours in Cancer Survivors: Smoking and Physical Activity
by H. Naik, X. Qiu, M.C. Brown, L. Eng, D. Pringle, M. Mahler, H. Hon, K. Tiessen, H. Thai, V. Ho, C. Gonos, R. Charow, V. Pat, M. Irwin, L. Herzog, A. Ho, W. Xu, J.M. Jones, D. Howell and G. Liu
Curr. Oncol. 2016, 23(6), 546-555; https://doi.org/10.3747/co.23.3166 - 01 Dec 2016
Cited by 33 | Viewed by 865
Abstract
Purpose: Smoking cessation and increased physical activity (PA) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis. Methods: As part of a cross-sectional study, a diverse group [...] Read more.
Purpose: Smoking cessation and increased physical activity (PA) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis. Methods: As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors. Results: Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering PA questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that PA had no effect or could worsen fatigue and quality of life (p ≤ 0.0001). Conclusions: In cancer survivors, education level was a major modifier of smoking and PA behaviours. Lower socioeconomic status was associated with incorrect perceptions about PA. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs. Full article
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Article
Annual Surveillance Mammography After Early-Stage Breast Cancer and Breast Cancer Mortality
by L.F. Paszat, R. Sutradhar, S. Gu and E. Rakovitch
Curr. Oncol. 2016, 23(6), 538-545; https://doi.org/10.3747/co.23.3399 - 01 Dec 2016
Cited by 8 | Viewed by 618
Abstract
Background: After treatment for early-stage breast cancer (bca), annual surveillance mammography (asm) is recommended based on the assumption that early detection of an invasive ipsilateral breast tumour recurrence or subsequent invasive contralateral primary bca reduces bca mortality. Methods: We studied women with unilateral [...] Read more.
Background: After treatment for early-stage breast cancer (bca), annual surveillance mammography (asm) is recommended based on the assumption that early detection of an invasive ipsilateral breast tumour recurrence or subsequent invasive contralateral primary bca reduces bca mortality. Methods: We studied women with unilateral early-stage bca treated by breast-conserving surgery from 1994 to 1997 who subsequently developed an ipsilateral recurrence or contralateral primary more than 24 months after initial diagnosis, without prior regional or distant metastases. Annual surveillance mammography was defined as 2 episodes of bilateral mammography 11–18 months apart during the 2 years preceding the ipsilateral recurrence or contralateral primary. The association between asm and bca death was evaluated using a Cox proportional hazards model. Results: We identified 669 women who experienced invasive ipsilateral recurrence (n = 455) or a contralateral primary (n = 214) at a median interval of 53 months [interquartile range (iqr): 37–72 months] after initial diagnosis, 64.7% of whom had received asm during the preceding 2 years. The median interval between the 2 bilateral mammograms was 12.3 months (iqr: 11.9–13.0 months), and the median interval between the 2nd mammogram and histopathologic confirmation of ipsilateral recurrence or contralateral primary was 1.5 months (iqr: 0.8–3.9 months). Median followup after ipsilateral recurrence or contralateral primary was 7.76 years (iqr: 3.68–9.81 years). The adjusted hazard ratio for bca death associated with asm was 0.86 (95% confidence limits: 0.63, 1.16). Conclusions: Annual surveillance mammography was associated with a modestly lowered hazard ratio for bca death. Full article
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Article
Stakeholder Views on Participant Selection for First-in-Human Trials in Cancer Nanomedicine
by P. Satalkar, B.S. Elger and D.M. Shaw
Curr. Oncol. 2016, 23(6), 530-537; https://doi.org/10.3747/co.23.3214 - 01 Dec 2016
Cited by 5 | Viewed by 527
Abstract
Background: Participant selection for first-in-human (FIH) trials involves complex decisions. The trial design makes it unlikely that participants will receive clinically relevant therapeutic benefit, but they are likely to experience risks of various magnitudes and types. The aim of the present [...] Read more.
Background: Participant selection for first-in-human (FIH) trials involves complex decisions. The trial design makes it unlikely that participants will receive clinically relevant therapeutic benefit, but they are likely to experience risks of various magnitudes and types. The aim of the present paper was to describe and discuss the views of investigators and ethics committee members about the choice of trial participants for FIH trials in cancer nanomedicine. Methods: We drew insights from an exploratory qualitative study involving thematic analysis of 46 in-depth interviews with key stakeholders in Europe and North America involved in FIH nanomedicine trials. The present work draws on subset of 21 interviews with investigators and ethics committee members who have either conducted or reviewed a FIH cancer nanomedicine trial or are planning one. Results: Investigators and ethics committee members are aware of the ethics standards for recruiting patients with end-stage cancer into FIH trials, but they nonetheless question the practice and provide reasons against it. Conclusions: Although it is a standard and ethically accepted practice to enrol patients with end-stage cancer and no treatment options into FIH trials of investigational chemotherapeutic molecules, doing so can threaten the validity and generalizability of the trials, thereby weakening translational research. Another possibility is to stratify and include patients with less advanced disease who demonstrate certain biomarkers or cancer genotypes and who have a disease profile similar to that tested in preclinical studies. The latter approach could be a step toward personalized medical research and targeted drug development. Such a patient selection approach requires multi-stakeholder discussion to reach scientific and ethics consensus. Full article
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Editorial
Cancer Care in South India: Perspectives from Visiting Canadian Oncologists
by S. Karim, J.C. Del Paggio, S.R. Berry and C.M. Booth
Curr. Oncol. 2016, 23(6), 527-529; https://doi.org/10.3747/co.23.3411 - 01 Dec 2016
Cited by 3 | Viewed by 811
Abstract
Cancer is recognized as an increasing threat to public health in low- and middle-income countries (lMICS).[...] Full article
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Article
Report from the 17th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Edmonton, Alberta; 11–12 September 2015
by K.E. Mulder, S. Ahmed, J.D. Davies, C.M. Doll, S. Dowden, S. Gill, V. Gordon, P. Hebbard, H. Lim, A. McFadden, J.P. McGhie, J. Park and R. Wong
Curr. Oncol. 2016, 23(6), 425-434; https://doi.org/10.3747/co.23.3384 - 01 Dec 2016
Cited by 3 | Viewed by 470
Abstract
The 17th annual Western Canadian Gastrointestinal Cancer Consensus Conference (wcgccc) was held in Edmonton, Alberta, 11–12 September 2015. The wcgccc is an interactive multidisciplinary conference attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved [...] Read more.
The 17th annual Western Canadian Gastrointestinal Cancer Consensus Conference (wcgccc) was held in Edmonton, Alberta, 11–12 September 2015. The wcgccc is an interactive multidisciplinary conference attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management of gastric cancer. Full article
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Article
Adjuvant Systemic Chemotherapy for Stages II and III Colon Cancer after Complete Resection: A Clinical Practice Guideline
by B.M. Meyers, R. Cosby, F. Quereshy and D. Jonker
Curr. Oncol. 2016, 23(6), 418-424; https://doi.org/10.3747/co.23.3330 - 01 Dec 2016
Cited by 28 | Viewed by 601
Abstract
Background Updated practice guidelines on adjuvant chemotherapy for completely resected colon cancer are lacking. In 2008, Cancer Care Ontario’s Program in Evidence-Based Care developed a guideline on adjuvant therapy for stages ii and iii colon cancer. With newer regimens being assessed in this [...] Read more.
Background Updated practice guidelines on adjuvant chemotherapy for completely resected colon cancer are lacking. In 2008, Cancer Care Ontario’s Program in Evidence-Based Care developed a guideline on adjuvant therapy for stages ii and iii colon cancer. With newer regimens being assessed in this patient population and older agents being either abandoned because of non-effectiveness or replaced by agents that are more efficacious, a full update of the original guideline was undertaken. Methods Literature searches (January 1987 to August 2015) of MEDLINE, EMBASE, and the Cochrane Library were conducted; in addition, abstracts from the American Society of Clinical Oncology, the European Society for Medical Oncology, and the European Cancer Congress were reviewed (the latter for January 2007 to August 2015). A practice guideline was drafted that was then scrutinized by internal and external reviewers whose comments were incorporated into the final guideline. Results Twenty-six unique reports of eighteen randomized controlled trials and thirteen unique reports of twelve meta-analyses or pooled analyses were included in the evidence base. The 5 recommendations developed included 3 for stage ii colon cancer and 2 for stage iii colon cancer. Conclusions Patients with completely resected stage iii colon cancer should be offered adjuvant 5-fluorouracil (5FU)–based chemotherapy with or without oxaliplatin (based on definitive data for improvements in survival and disease-free survival). Patients with resected stage ii colon cancer without “high-risk” features should not receive adjuvant chemotherapy. For patients with “high-risk” features, 5FU-based chemotherapy with or without oxaliplatin should be offered, although no clinical trials have been conducted to conclusively demonstrate the same benefits seen in stage iii colon cancer. Full article
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Review
Emerging Therapies for the Treatment of Relapsed or Refractory Follicular Lymphoma
by D. MacDonald, A. Prica, S. Assouline, A. Christofides, T. Lawrence and L.H. Sehn
Curr. Oncol. 2016, 23(6), 407-417; https://doi.org/10.3747/co.23.3405 - 01 Dec 2016
Cited by 11 | Viewed by 629
Abstract
With no treatment standard having been established for relapsed and refractory follicular lymphoma, a number of therapeutic approaches are used in Canada. In patients who relapse early or who eventually become resistant to subsequent treatment, prognosis is poor, and new approaches are needed. [...] Read more.
With no treatment standard having been established for relapsed and refractory follicular lymphoma, a number of therapeutic approaches are used in Canada. In patients who relapse early or who eventually become resistant to subsequent treatment, prognosis is poor, and new approaches are needed. A number of novel therapies are being examined in this setting, including monoclonal antibodies, immunoconjugates, immunomodulatory agents, and signal transduction inhibitors. With the body of evidence for those emerging therapies accumulating and the standard upfront treatment changing from rituximab and chop (cyclophosphamide–doxorubicin–vincristine–prednisone) or rituximab and cvp (cyclophosphamide–vincristine–prednisone) to bendamustine and rituximab, treatment decisions in the relapsed and refractory setting have become more complex. The choice of subsequent treatment must consider type of upfront treatment; duration of remission; and patient-related factors such as age, comorbidities, and treatment preferences. This paper summarizes the evidence for novel therapies and proposes recommendations for subsequent treatment options by remission duration after induction and maintenance. Full article
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Review
A User’s Guide to Cannabinoid Therapies in Oncology
by V. Maida and P.J. Daeninck
Curr. Oncol. 2016, 23(6), 398-406; https://doi.org/10.3747/co.23.3487 - 01 Dec 2016
Cited by 60 | Viewed by 2914
Abstract
“Cannabinoid” is the collective term for a group of chemical compounds that either are derived from the Cannabis plant, are synthetic analogues, or occur endogenously. Although cannabinoids interact mostly at the level of the currently recognized cannabinoid receptors, they might have cross reactivity, [...] Read more.
“Cannabinoid” is the collective term for a group of chemical compounds that either are derived from the Cannabis plant, are synthetic analogues, or occur endogenously. Although cannabinoids interact mostly at the level of the currently recognized cannabinoid receptors, they might have cross reactivity, such as at opioid receptors. Full article
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Article
The Risk of Colorectal Cancer Is Not Increased after a Diagnosis of Urothelial Cancer: A Population-Based Study
by C.H. Harlos, H. Singh, Z. Nugent, A. Demers, S.M. Mahmud and P.M. Czaykowski
Curr. Oncol. 2016, 23(6), 391-397; https://doi.org/10.3747/co.23.3304 - 01 Dec 2016
Viewed by 570
Abstract
Background The data about whether patients with a prior urothelial cancer (UCa) are at increased risk of colorectal cancer (CRC) are conflicting. We used a competing risks analysis to determine the risk of CRC after UCa. Methods Historical [...] Read more.
Background The data about whether patients with a prior urothelial cancer (UCa) are at increased risk of colorectal cancer (CRC) are conflicting. We used a competing risks analysis to determine the risk of CRC after UCa. Methods Historical cohorts were assembled by record linkage of Manitoba Cancer Registry and Manitoba Health databases. The incidence of CRC for individuals with UCa as their first cancer between 1987 and 2009 was compared with the incidence for randomly selected age- and sex-matched individuals without a cancer diagnosis at the index date (UCa diagnosis date). Three competing outcomes (CRC, another primary cancer, and death) were evaluated by competing risks proportional hazards models with adjustment for relevant confounders. Results The cohorts of 4591 patients with UCa and 22,312 without UCa were followed for a total of 179,287 person– years (py). After UCa, the rate of subsequent colon cancer in UCa patients was 4.5 per 1000 py compared with 3.6 per 1000 py in the non-cancer cohort. In the multivariable analysis, no overall increase in CRC risk was observed for patients first diagnosed with UCa (hazard ratio: 0.88; 95% confidence interval: 0.70 to 1.1; p = 0.26). Conclusions Because of similar CRC risk, a similar CRC screening strategy should be applied for individuals with and without UCa. Full article
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Article
Chemotherapy in Recurrent Advanced Non-Small-Cell Lung Cancer After Adjuvant Chemotherapy
by M. Valdes, G. Nicholas, G.D. Goss and P. Wheatley-Price
Curr. Oncol. 2016, 23(6), 386-390; https://doi.org/10.3747/co.23.3191 - 01 Dec 2016
Cited by 22 | Viewed by 675
Abstract
Introduction: Despite adjuvant systemic therapy in patients with completely resected non-small-cell lung cancer (NSCLC), many will subsequently relapse. We investigated treatment choices at relapse and assessed the effect of palliative platinum doublet systemic therapy in this population. Methods: With research ethics [...] Read more.
Introduction: Despite adjuvant systemic therapy in patients with completely resected non-small-cell lung cancer (NSCLC), many will subsequently relapse. We investigated treatment choices at relapse and assessed the effect of palliative platinum doublet systemic therapy in this population. Methods: With research ethics board approval, we performed a retrospective chart review of all patients with resected NSCLC who received adjuvant systemic therapy from January 2002 until December 2008 at our institution. The primary outcome was the response rate to first-line palliative systemic therapy among patients who relapsed. Results: We identified 176 patients who received adjuvant platinum doublet systemic therapy (82% received cisplatin–vinorelbine). In the 85 patients who relapsed (48%), median time to relapse was 18.5 months (95% confidence interval: 15 months to 21.3 months). Palliative systemic therapy was given in 43 patients. Of those 43 patients, 25 (58%) were re-challenged with platinum doublet systemic therapy, with a response rate of 29% compared with 18% in 18 patients who received other systemic therapy (p = 0.48). We observed a trend toward an increased clinical benefit rate (complete response + partial response + stable disease) in patients who were treated with a platinum doublet (67% vs. 41%, p = 0.12). Median overall survival (OS) from relapse was 15.3 months in patients receiving palliative systemic therapy and 7.8 months in those receiving best supportive care alone. Compared with patients treated with non-platinum regimens, the platinum-treated group experienced longer survival after relapse (18.4 months vs. 9.7 months, p = 0.041). Conclusions: In patients previously treated with adjuvant systemic therapy, re-treatment with platinum doublet chemotherapy upon relapse is feasible. Moreover, compared with patients receiving other first-line systemic therapy, patients receiving platinum doublets experienced higher response rates and significantly longer survival. Full article
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Article
The Experiences of Cancer Survivors While Transitioning from Tertiary to Primary Care
by B.B. Franco, L. Dharmakulaseelan, A. McAndrew, S. Bae, M.C. Cheung and S. Singh
Curr. Oncol. 2016, 23(6), 378-385; https://doi.org/10.3747/co.23.3140 - 01 Dec 2016
Cited by 14 | Viewed by 588
Abstract
Purpose: In current fiscally constrained health care systems, the transition of cancer survivors to primary care from tertiary care settings is becoming more common and necessary. The purpose of our study was to explore the experiences of survivors who are transitioning from tertiary [...] Read more.
Purpose: In current fiscally constrained health care systems, the transition of cancer survivors to primary care from tertiary care settings is becoming more common and necessary. The purpose of our study was to explore the experiences of survivors who are transitioning from tertiary to primary care. Methods: One focus group and ten individual telephone interviews were conducted. Data saturation was reached with 13 participants. All sessions were audio-recorded, transcribed verbatim, and analyzed using a qualitative descriptive approach. Results: Eight categories relating to the main content category of transition readiness were identified in the analysis. Several factors affected participant transition readiness: how the transition was introduced, perceived continuity of care, support from health care providers, clarity of the timeline throughout the transition, and desire for a “roadmap.” Although all participants spoke about the effect of their relationships with health care providers (tertiary, transition, and primary care), their relationship with the primary care provider had the most influence on their transition readiness. Conclusions: Our study provided insights into survivor experiences during the transition to primary care. Transition readiness of survivors is affected by many factors, with their relationship with the primary care provider being particularly influential. Understanding transition readiness from the survivor perspective could prove useful in ensuring patient-centred care as transitions from tertiary to primary care become commonplace. Full article
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Editorial
Early Integration of Palliative Care into Standard Oncology Care: Evidence and Overcoming Barriers to Implementation
by D.A. Kain and E.A. Eisenhauer
Curr. Oncol. 2016, 23(6), 374-377; https://doi.org/10.3747/co.23.3404 - 01 Dec 2016
Cited by 27 | Viewed by 683
Abstract
In Canada, widespread discussion of medical aid in dying (http://www.parl.gc.ca/HousePublications/Publication.[...] Full article
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Editorial
Controlled Settings for Lung Cancer Screening: Why Do They Matter? Considerations for Referring Clinicians
by A. Bharmal, A. Crosskill, S. Lam and H. Bryant
Curr. Oncol. 2016, 23(6), 371-373; https://doi.org/10.3747/co.23.3430 - 01 Dec 2016
Viewed by 372
Abstract
The updated guideline on lung cancer screening released in March 2016 by the Canadian Task Force on Preventive Health Care recommends screening for people at high risk for lung cancer.[...] Full article
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Editorial
Early Palliative Care: Taking Ownership and Creating the Conditions
by J. Pereira and M.R. Chasen
Curr. Oncol. 2016, 23(6), 367-370; https://doi.org/10.3747/co.23.3461 - 01 Dec 2016
Cited by 16 | Viewed by 415
Abstract
The evidence for early integration of palliative care into standard oncology care is growing.[...] Full article
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