Current Oncology

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Open AccessEditorial

Ode to My Oncologist

by C.A. Heykoop

Curr. Oncol. 2018, 25(3), 239; https://doi.org/10.3747/co.25.3979 - 1 Jun 2018

Viewed by 414

At the age of 34, I was diagnosed with follicular lymphoma. I had just finished my doctorate and was ready to launch into the world[...] Full article

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Open AccessMeeting Report

Canadian Lung Cancer Conference 2018

by S. Lau, Y. Wang, C. Ho and B. Melosky

Curr. Oncol. 2018, 25(3), 236-238; https://doi.org/10.3747/co.25.4100 - 1 Jun 2018

Viewed by 412

Abstract

The 2018 Canadian Lung Cancer Conference (CLCCO) took place 8–9 February in Vancouver, British Columbia. A highly anticipated event, the CLCCO attracts lung cancer professionals from across Canada to review the latest advances in lung cancer research in a multidisciplinary setting. It also [...] Read more.

The 2018 Canadian Lung Cancer Conference (CLCCO) took place 8–9 February in Vancouver, British Columbia. A highly anticipated event, the CLCCO attracts lung cancer professionals from across Canada to review the latest advances in lung cancer research in a multidisciplinary setting. It also brings world-renowned experts to share their knowledge. Some of the highlights this year included an overview of the remarkable advances in immuno-oncology, stereotactic radiotherapy, and navigational tools in bronchoscopy. Full article

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Open AccessCommunication

The North–South and East–West Gradient in Colorectal Cancer Risk: A Look at the Distribution of Modifiable Risk Factors and Incidence across Canada

by J. Tung, C. E. Politis, J. Chadder, J. Han, J. Niu, S. Fung, R. Rahal and C. C. Earle

Curr. Oncol. 2018, 25(3), 231-235; https://doi.org/10.3747/co.25.4071 - 1 Jun 2018

Cited by 6 | Viewed by 770

Abstract

Colorectal cancer (CRC) is the 2nd most common cancer in Canada and the 2nd leading cause of cancer death. That heavy burden can be mitigated given the preventability of crc through lifestyle changes and screening. Here, we describe the extent of the variation [...] Read more.

Colorectal cancer (CRC) is the 2nd most common cancer in Canada and the 2nd leading cause of cancer death. That heavy burden can be mitigated given the preventability of crc through lifestyle changes and screening. Here, we describe the extent of the variation in CRC incidence rates across Canada and the disparities, by jurisdiction, in the prevalence of modifiable risk factors known to contribute to the CRC burden. Findings suggest that there is a north–south and east–west gradient in CRC modifiable risk factors, including excess weight, physical inactivity, excessive alcohol consumption, and low fruit and vegetable consumption, with the highest prevalence of risk factors typically found in the territories and Atlantic provinces. In general, that pattern reflects the CRC incidence rates seen across Canada. Given the substantial interjurisdictional variation, more work is needed to increase prevention efforts, including promoting a healthier diet and lifestyle, especially in jurisdictions facing disproportionately higher burdens of CRC. Based on current knowledge, the most effective approaches to reduce the burden of CRC include adopting public policies that create healthier environments in which people live, work, learn, and play; making healthy choices easier; and continuing to emphasize screening and early detection. Strategic approaches to modifiable risk factors and mechanisms for early cancer detection have the potential to translate into positive effects for population health and fewer Canadians developing and dying from cancer. Full article

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Open AccessReview

How Can We Better Help Cancer Patients Quit Smoking? The London Regional Cancer Program Experience with Smoking Cessation

by S.M. Davidson, R.G. Boldt and A.V. Louie

Curr. Oncol. 2018, 25(3), 226-230; https://doi.org/10.3747/co.25.3921 - 1 Jun 2018

Cited by 22 | Viewed by 1594

Abstract

Background: Because continued cigarette smoking after a cancer diagnosis is associated with detrimental outcomes, supporting cancer patients with smoking cessation is imperative. We evaluated the effect of the Smoking Cessation Program at the London Regional Cancer Program (lrcp) over a 2-year period. Methods: [...] Read more.

Background: Because continued cigarette smoking after a cancer diagnosis is associated with detrimental outcomes, supporting cancer patients with smoking cessation is imperative. We evaluated the effect of the Smoking Cessation Program at the London Regional Cancer Program (lrcp) over a 2-year period. Methods: The Smoking Cessation Program at the lrcp began in March 2014. New patients are screened for tobacco use. Tobacco users are counselled about the benefits of cessation and are offered referral to the program. If a patient accepts, a smoking cessation champion offers additional counselling. Follow-up is provided by interactive voice response (ivr) telephone system. Accrual data were collected monthly from January 2015 to December 2016 and were evaluated. Results: During 2015–2016, 10,341 patients were screened for tobacco use, and 18% identified themselves as current or recent tobacco users. In 2015, 84% of tobacco users were offered referral, but only 13% accepted, and 3% enrolled in ivr follow-up. At the lrcp in 2016, 77% of tobacco users were offered referral to the program, but only 9% of smokers accepted, and only 2% enrolled in ivr follow-up. Conclusions: The Smoking Cessation Program at the lrcp has had modest success, because multiple factors influence a patient's success with cessation. Limitations of the program include challenges in referral and counselling, limited access to nicotine replacement therapy (nrt), and minimal follow-up. To mitigate some of those challenges, a pilot project was launched in January 2017 in which patients receive free nrt and referral to the local health unit. Full article

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Open AccessEditorial

Proffered Papers and Posters Presented at the Seventh International Symposium on Hereditary Breast and Ovarian Cancer—BrcA: From the Personal to the Population

by Stephen Lincoln, Eric Klee, Andrew Fellowes, Shimul Chowdhury, Shazia Mahamdallie, Justin Zook, Rebecca Truty, Russell Garlick, Marc Salit, Nazneen Rahman, Swaroop Aradhya, Stephen Kingsmore, Robert Nussbaum, Matthew Ferber and Brian Shirts

Curr. Oncol. 2018, 25(3), 224-262; https://doi.org/10.3747/co.25.4243 - 1 Jun 2018

Cited by 2 | Viewed by 731

Abstract

The comprehensive assessment of inherited mutations in cancer susceptibility genes helps to optimize clinical decision-making [...]
Full article

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Open AccessCase Report

Anastomosing Hemangioma of the Kidney: Radiologic and Pathologic Distinctions of a Kidney Cancer Mimic

by P.M. Cheon, R. Rebello, A. Naqvi, S. Popovic, M. Bonert and A. Kapoor

Curr. Oncol. 2018, 25(3), 220-223; https://doi.org/10.3747/co.25.3927 - 1 Jun 2018

Cited by 21 | Viewed by 900

Abstract

Anastomosing hemangioma (AH) is a rare subtype of primary vascular tumour that can, clinically and radiologically, present similarly to malignant renal tumours such as renal cell carcinoma (RCC) and angiosarcoma. Rarely seen in the genitourinary system, the ah we report here occurred in [...] Read more.

Anastomosing hemangioma (AH) is a rare subtype of primary vascular tumour that can, clinically and radiologically, present similarly to malignant renal tumours such as renal cell carcinoma (RCC) and angiosarcoma. Rarely seen in the genitourinary system, the ah we report here occurred in a 40-year-old male patient diagnosed initially with rcc based on imaging and successfully treated by laparoscopic left radical nephrectomy, with adrenal sparing and perihilar lymph node dissection. The pathologic diagnosis of ah can be challenging on small biopsy specimens; we therefore opine that it is appropriate to excise these lesions to facilitate diagnosis and definitively exclude common renal cancers. However, in this review, we describe some radiologic and pathologic distinctions between ah and malignant tumours. Full article

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Open AccessArticle

Rates of Cannabis Use in Patients with Cancer

by Kevin Martell, A. Fairchild, B. LeGerrier, R. Sinha, S. Baker, H. Liu, A. Ghose, I.A. Olivotto and M. Kerba

Curr. Oncol. 2018, 25(3), 219-225; https://doi.org/10.3747/co.25.3983 - 1 Jun 2018

Cited by 84 | Viewed by 2980

Abstract

Background: A comprehensive assessment of cannabis use by patients with cancer has not previously been reported. In this study, we aimed to characterize patient perspectives about cannabis and its use. Methods: An anonymous survey about cannabis use was offered to patients 18 years [...] Read more.

Background: A comprehensive assessment of cannabis use by patients with cancer has not previously been reported. In this study, we aimed to characterize patient perspectives about cannabis and its use. Methods: An anonymous survey about cannabis use was offered to patients 18 years of age and older attending 2 comprehensive and 2 community cancer centres, comprising an entire provincial health care jurisdiction in Canada (ethics ID: HREBA-17011). Results: Of 3138 surveys distributed, 2040 surveys were returned (65%), with 1987 being sufficiently complete for analysis (response rate: 63%). Of the respondents, 812 (41%) were less than 60 years of age; 45% identified as male, and 55% as female; and 44% had completed college or higher education. Of respondents overall, 43% reported any lifetime cannabis use. That finding was independent of age, sex, education level, and cancer histology. Cannabis was acquired through friends (80%), regulated medical dispensaries (10%), and other means (6%). Of patients with any use, 81% had used dried leaves. Of the 356 patients who reported cannabis use within the 6 months preceding the survey (18% of respondents with sufficiently complete surveys), 36% were new users. Their reasons for use included cancer-related pain (46%), nausea (34%), other cancer symptoms (31%), and non-cancer-related reasons (56%). Conclusions:The survey demonstrated that prior cannabis use was widespread among patients with cancer (43%). One in eight respondents identified at least 1 cancer-related symptom for which they were using cannabis. Full article

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Open AccessCase Report

Overcoming Resistance in a BRAF V600e–Mutant Adenocarcinoma of the Lung

by T. Schmid and M. Buess

Curr. Oncol. 2018, 25(3), 217-219; https://doi.org/10.3747/co.25.3936 - 1 Jun 2018

Cited by 8 | Viewed by 508

Abstract

We report on a patient with an adenocarcinoma of the lung harbouring a BRAF V600E mutation who benefited from combination therapy with dabrafenib–trametinib after developing resistance to vemurafenib. To our knowledge, our report shows, for the first time, that combination therapy with dabrafenib–trametinib [...] Read more.

We report on a patient with an adenocarcinoma of the lung harbouring a BRAF V600E mutation who benefited from combination therapy with dabrafenib–trametinib after developing resistance to vemurafenib. To our knowledge, our report shows, for the first time, that combination therapy with dabrafenib–trametinib can overcome vemurafenib resistance in a BRAF V600E–mutated adenocarcinoma of the lung. Full article

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Open AccessArticle

Oncology Education for Canadian Internal Medicine Residents: The Value of Participating in a Medical Oncology Elective Rotation

by N.A. Nixon, H. Lim, C. Elser, Y.J. Ko, R. Lee-Ying and V.C. Tam

Curr. Oncol. 2018, 25(3), 213-218; https://doi.org/10.3747/co.25.3934 - 1 Jun 2018

Cited by 4 | Viewed by 567

Abstract

Background: Despite the high incidence and burden of cancer in Canadians, medical oncology (MO) rotations are not mandatory in most Canadian internal medicine (IM) residency training programs. Methods: All IM residents scheduled for a MO rotation at 4 Canadian teaching cancer centres between [...] Read more.

Background: Despite the high incidence and burden of cancer in Canadians, medical oncology (MO) rotations are not mandatory in most Canadian internal medicine (IM) residency training programs. Methods: All IM residents scheduled for a MO rotation at 4 Canadian teaching cancer centres between 1 January 2013 and 31 December 2015 were invited to complete an online survey before and after their rotation. The survey was designed to evaluate perceptions of oncology, comfort in managing cancer patients, and basic oncology knowledge. Results: The survey was completed by 68 IM residents pre-rotation and by 48 (71%) post-rotation. Cancer-related learning was acquired mostly from MO physicians in clinic (35%). Self-directed learning, didactic teaching, and resident or fellow teaching accounted for 31%, 26%, and 10% respectively of learning acquisition. Comfort level in dealing with cancer patients and patients at end of life improved to 4.0/5 from 3.2/5 (p < 0.001) and to 4.0/5 from 3.6/5 (p = 0.003) respectively. Mean knowledge assessment score improved to 83% post-rotation from 76% pre-rotation (p = 0.003), with the greatest increase observed in general knowledge of common malignancies. The 3 topics ranked as most important to learn during a MO rotation were oncologic emergencies, common complications of treatment, and approach to diagnosis of cancer. Conclusions: A rotation in MO improves the perceptions of IM residents about oncology and their comfort level in dealing with cancer patients and patients at end of life. Overall cancer knowledge is also improved. Given those benefits, IM residency programs should encourage most of their residents to complete a MO rotation. Full article

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Open AccessReview

Harmonization of PD-L1 Testing in Oncology: A Canadian Pathology Perspective

by Diana N. Ionescu, M. R. Downes, A. Christofides and M. S. Tsao

Curr. Oncol. 2018, 25(3), 209-216; https://doi.org/10.3747/co.25.4031 - 1 Jun 2018

Cited by 34 | Viewed by 903

Abstract

Checkpoint inhibitors targeting the programmed cell death 1 protein (PD-1) and programmed cell death ligand 1 (PD-L1) are demonstrating promising efficacy and appear to be well tolerated in a number of tumour types. In non-small-cell lung cancer, head-and-neck squamous cell carcinoma, and urothelial [...] Read more.

Checkpoint inhibitors targeting the programmed cell death 1 protein (PD-1) and programmed cell death ligand 1 (PD-L1) are demonstrating promising efficacy and appear to be well tolerated in a number of tumour types. In non-small-cell lung cancer, head-and-neck squamous cell carcinoma, and urothelial carcinoma, outcomes appear particularly favourable in patients with high PD-L1 expression. However, assays for PD-L1 have been developed for individual agents, and they use different antibody clones, immunohistochemistry staining protocols, scoring algorithms, and cut-offs. Given that laboratories are unlikely to use multiple testing platforms, use of one PD-L1 assay in conjunction with a specific therapy will become impractical and could compromise treatment options. Methods to harmonize testing methods are therefore crucial to ensuring appropriate treatment selection. This paper focuses on lung, bladder, and head-and-neck cancer. It reviews and compares available PD-L1 testing methodologies, summarizes the literature about comparability studies to date, discusses future directions in personalized diagnostics, and provides a pathologist’s perspective on PD-L1 testing in the Canadian laboratory setting. Full article

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Open AccessArticle

Medical Oncology Workload in Canada: Infrastructure, Supports, and Delivery of Clinical Care

by A. Fundytus, W.M. Hopman, N. Hammad, J.J. Biagi, R. Sullivan, V. Vanderpuye, B. Seruga, G. Lopes, M. Sengar, M.D. Brundage and C.M. Booth

Curr. Oncol. 2018, 25(3), 206-212; https://doi.org/10.3747/co.25.3999 - 1 Jun 2018

Cited by 14 | Viewed by 656

Abstract

Background: In 2000, a Canadian task force recommended that medical oncologists (MOS) meet a target of 160–175 new patient consultations per year. Here, we report the Canadian results of a global survey of mo workload compared with mo workload in other [...] Read more.

Background: In 2000, a Canadian task force recommended that medical oncologists (MOS) meet a target of 160–175 new patient consultations per year. Here, we report the Canadian results of a global survey of mo workload compared with mo workload in other high-income countries (HICS). Methods: Using a snowball method, an online survey was distributed by national oncology societies to chemotherapy-prescribing physicians in 22 HICS (World Bank criteria). The survey was distributed within Canada to all members of the Canadian Association of Medical Oncologists. Workload was measured as the annual number of new cancer patient consults per oncologist. Results: The survey was completed by 782 oncologists from HICS, including 58 from Canada. Median annual consults per mo were 175 in Canada compared with 125 in other HICS. The proportions of MOS having 100 or fewer consults or more than 300 consults per year were 3% (2/58) and 5% (3/58) in Canada compared with 31% (222/724) and 16% (116/724) in other HICS (p < 0.001 and p = 0.023 respectively). The median number of patients seen in a full-day clinic was 15 in Canada and 25 in other HICS (p = 0.220). Canadian MOS reported spending a median of 55 minutes per new consultation; new consultations of 35 minutes were reported in other HICS (p < 0.001). Median hours worked per week was 55 in Canada and 45 in other HICS (p = 0.200). Conclusions: Although the median annual clinical volume for Canadian MOS aligns with recommended targets, half the respondents exceeded that level of activity. Health policymakers and educators have to consider mo workforce supply and alternative models of care in preparation for the anticipated surge in cancer incidence in the coming decade. Full article

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Open AccessArticle

Glove and Instrument Changing to Prevent Tumour Seeding in Cancer Surgery: A Survey of Surgeons’ Beliefs and Practices

by D. Berger-Richardson, R.S. Xu, R.A. Gladdy, J.A. McCart, A. Govindarajan and C.J. Swallow

Curr. Oncol. 2018, 25(3), 200-208; https://doi.org/10.3747/co.25.3924 - 1 Jun 2018

Cited by 9 | Viewed by 768

Abstract

Background: Some surgeons change gloves and instruments after the extirpative phase of cancer surgery with the intent of reducing the risk of local and wound recurrence. Although this practice is conceptually appealing, the evidence that gloves or instruments act as vectors of cancer-cell [...] Read more.

Background: Some surgeons change gloves and instruments after the extirpative phase of cancer surgery with the intent of reducing the risk of local and wound recurrence. Although this practice is conceptually appealing, the evidence that gloves or instruments act as vectors of cancer-cell seeding in the clinical setting is weak. To determine the potential effect of further investigation of this question, we surveyed the practices and beliefs of a broad spectrum of surgeons who operate on cancer patients. Methods: Using a modified Dillman approach, a survey was mailed to all 945 general surgeons listed in the College of Physicians and Surgeons of Ontario public registry. The survey consisted of multiple-choice and free-text response questions. Responses were tabulated and grouped into themes, including specific intraoperative events and surgeon training. Predictive variables were analyzed by chi-square test. Results: Of 459 surveys returned (adjusted response rate: 46%), 351 met the inclusion criteria for retention. Of those respondents, 52% reported that they change gloves during cancer resections with the intent of decreasing the risk of tumour seeding, and 40%, that they change instruments for that purpose. The proportion of respondents indicating that they take measures to protect the wound was 73% for laparoscopic cancer resections and 31% for open resections. Training and years in practice predicted some of the foregoing behaviours. The most commonly cited basis for adopting specific strategies to prevent tumour seeding was “gut feeling,” followed by clinical training. Most respondents believe that it is possible or probable that surgical gloves or instruments harbour malignant cells, but that a cancer recurrence proceeding from that situation is unlikely. Conclusions: There is no consensus on how gloves and instruments should be handled in cancer operations. Further investigation is warranted. Full article

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Open AccessArticle

What Do Primary Care Providers Think About Implementing Breast Cancer Survivorship Care?

by M. Luctkar-Flude, A. Aiken, M.A. McColl and J. Tranmer

Curr. Oncol. 2018, 25(3), 196-205; https://doi.org/10.3747/co.25.3826 - 1 Jun 2018

Cited by 9 | Viewed by 807

Abstract

Purpose: As cancer centres move forward with earlier discharge of stable survivors of early-stage breast cancer (BCA) to primary care follow-up, it is important to address known knowledge and practice gaps among primary care providers (PCPS). In the present [...] Read more.

Purpose: As cancer centres move forward with earlier discharge of stable survivors of early-stage breast cancer (BCA) to primary care follow-up, it is important to address known knowledge and practice gaps among primary care providers (PCPS). In the present qualitative descriptive study, we examined the practice context that influences implementation of existing clinical practice guidelines for providing such care. The purpose was to determine the challenges, strengths, and opportunities related to implementing comprehensive evidence-based BCA survivorship care guidelines by PCPS in southeastern Ontario. Methods: Semi-structured interviews were conducted with 19 PCPS: 10 physicians and 9 nurse practitioners. Results: Thematic analysis revealed 6 themes within the broad categories of knowledge, attitudes, and resources. Participants highlighted 3 major challenges related to providing BCA survivorship care: inconsistent educational preparation, provider anxieties, and primary care burden. They also described 3 major strengths or opportunities to facilitate implementation of survivorship care guidelines: tools and technology, empowering survivors, and optimizing nursing roles. Conclusions: We identified several important challenges to implementation of comprehensive evidence-based survivorship care for bca survivors, as well as several strengths and opportunities that could be built upon to address those challenges. Findings from our research could inform targeted knowledge translation interventions to provide support and education for PCPS and bca survivors. Full article

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Open AccessCommentary

The Survivorship Care Plan: A Valuable Tool for Primary Care Providers?

by G. Chaput

Curr. Oncol. 2018, 25(3), 194-195; https://doi.org/10.3747/co.25.4156 - 1 Jun 2018

Cited by 3 | Viewed by 363

Abstract

The era of immunotherapy and improved cancer treatments has led to current trends in health care [...]
Full article

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Open AccessArticle

A Bioimpedance Analysis of Head-and-neck Cancer Patients Undergoing Radiotherapy

by K. Kohli, R. Corns, K. Vinnakota, P. Steiner, C. Elith, D. Schellenberg, W. Kwan and A. Karvat

Curr. Oncol. 2018, 25(3), 193-199; https://doi.org/10.3747/co.25.3920 - 1 Jun 2018

Cited by 10 | Viewed by 658

Abstract

Malnutrition is a frequent manifestation in patients with head-and-neck cancer undergoing radiation therapy and a major contributor to morbidity and mortality. Thus, body composition is an important component of an overall evaluation of nutrition in cancer patients. Malnutrition is characterized by weight loss, [...] Read more.

Malnutrition is a frequent manifestation in patients with head-and-neck cancer undergoing radiation therapy and a major contributor to morbidity and mortality. Thus, body composition is an important component of an overall evaluation of nutrition in cancer patients. Malnutrition is characterized by weight loss, loss of muscle mass, changes in cell membrane integrity, and alterations in fluid balance. Bioelectrical impedance analysis is a method to analyze body composition and includes parameters such as intracellular water content, extracellular water content, and cell membrane integrity in the form of a phase angle (Φ). Bioelectrical impedance analysis has consistently been shown to have prognostic value with respect to mortality and morbidity in patients undergoing chemotherapy. The goal of the present study was to evaluate the relationship between Φ, time, intracellular water content, and weight for head-and-neck cancer patients undergoing radiotherapy. The results demonstrate that Φ decreases with time and increases with intracellular water content and weight. Full article

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Open AccessCommentary

Comprehensive Metastatic Lung Cancer Care Must Include Palliative Care

by A. M. Rosenblum and M. Chasen

Curr. Oncol. 2018, 25(3), 192-193; https://doi.org/10.3747/co.25.4104 - 1 Jun 2018

Cited by 3 | Viewed by 436

Abstract

The Canadian Lung Cancer Conference, held in Vancouver, 8–9 February 2018, was a successful, informative, and well-organized meeting. [...]
Full article

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Open AccessEditorial

Oncology Education for Internal Medicine Residents: A Call for Action!

by T. Younis and B. Colwell

Curr. Oncol. 2018, 25(3), 189-190; https://doi.org/10.3747/co.25.4046 - 1 Jun 2018

Cited by 3 | Viewed by 434

Abstract

Cancer is a prevalent health condition that all physicians will frequently encounter during their clinical practice. [...]
Full article

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Open AccessArticle

Comparing Enrolees with Non-Enrolees of Cancer-Patient Navigation at End of Life

by G. Park, G.M. Johnston, R. Urquhart, G. Walsh and M. McCallum

Curr. Oncol. 2018, 25(3), 184-192; https://doi.org/10.3747/co.25.3902 - 1 Jun 2018

Cited by 2 | Viewed by 741

Abstract

Background: Cancer-patient navigators who are oncology nurses support and connect patients to resources throughout the cancer care trajectory, including end of life. Although qualitative and cohort studies of navigated patients have been reported, no population-based studies were found. The present population-based study compared [...] Read more.

Background: Cancer-patient navigators who are oncology nurses support and connect patients to resources throughout the cancer care trajectory, including end of life. Although qualitative and cohort studies of navigated patients have been reported, no population-based studies were found. The present population-based study compared demographic, disease, and outcome characteristics for decedents who had been diagnosed with cancer by whether they did or did not see a navigator. Methods: This retrospective study used patient-based administrative data in Nova Scotia (cancer registry, death certificates, navigation visits) to generate descriptive statistics. The study population included all adults diagnosed with cancer who died during 2011–2014 of a cancer or non-cancer cause of death. Results: Of the 7694 study decedents, 74.9% had died of cancer. Of those individuals, 40% had seen a navigator at some point in their disease trajectory. The comparable percentage for those who did not die of cancer was 11.9%. Decedents at the oldest ages had the lowest navigation rates. Navigation rates, time from diagnosis to death, and time from last navigation visit to death varied by disease site. Conclusions: This population-based study of cancer-patient navigation enrolees compared with non-enrolees is the first of its kind. Most findings were consistent with expectations. However, we do not know whether the rates of navigation are consistent with the navigation needs of the population diagnosed with cancer. Because more people are living longer with cancer and because the population is aging, ongoing surveillance of who requires and who is using navigation services is warranted. Full article

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Curr. Oncol., Volume 25, Issue 3 (June 2018) – 18 articles

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