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This volume of the CANCER TREATMENT AND RESEARCH series integrates articles that highlight some of the newest developments in the pathogenesis, diagnosis, and treatment of gynecologic malignancies, with chapters that provide an overview of selected areas of controversy. The volume is not an abbreviated textbook of gynecologic oncology, but rather a collection of selected works that can provide the reader with a better perspective on the areas of change or controversy within the field. The book is a resource to help elucidate the basis for the optimism and controversy associated with these selected topics in gynecologic oncology. With this perspective, the clinician will be in the best position to critically evaluate new data as it emerges, and recognize significant advances as they occur.
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Gynecologic Oncology: Controversies and New Developments

Pancreatic Tumors in Children

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Endocrine Neoplasia is a comprehensive, updated, and clearly-written text covering the diseases for which endocrine surgical expertise is often needed. We look towards advances in the science and the art of endocrine surgery to continuously improve outcomes for our patients. The goal of this text was to provide a detailed description of both the underlying science of disease as well as the art of clinical management.

The book is divided into five sections addressing neoplasms of the thyroid, parathyroid, adrenal gland, neuroendocrine pancreas, and multiple endocrine neoplasia. Experts from the United States, Canada, and Australia have contributed chapters addressing both the biology of endocrine tumors and the clinical management of disease. Recent discoveries regarding the genetic underpinnings of disease are highlighted. Updated consensus guidelines were used for clinical recommendations. The management of complex and often confusing clinical problems is discussed in detail.

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Endocrine Neoplasia

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Cancer Treatment and Research in Humanistic Perspective

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This volume is the third edited by Drs. Dickson and Lippman in the `Advances in Cellular and Molecular Biology of Breast Cancer’ series. It continues to explore the scientific thermes begun in the first two volumes: oncogenes and antioncogenes, growth factors, steriods, and stromalepithelial interactions. Rapid and important progress has continued to take place in all of these areas, especially the possibility that the new molecular understanding of regulation of growth, differentiation and metastases will lead to better tumor prognosis and treatment. For this reason this volume begins with two excellent chapters in this area.
Genes, Oncogenes, and Hormones is divided into five sections: (1) the progression of node negative to positive breast cancer, (2) suppressor genes and regulation growth factors, (3) oncogenes and stimulatory growth factors, (4) steroidal hormone receptors, (5) differentiation and function of breast cancer epithelium and stroma.
This volume will be useful to clinical researchers, basic researchers, and students in the breast cancer field. It complements and adds to the previous two volumes edited by Drs. Lippman and Dickson in this series.

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Genes, Oncogenes, and Hormones: Advances in Cellular and Molecular Biology of Breast Cancer

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Endocrine Therapies in Breast and Prostate Cancer

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Concepts, Mechanisms, and New Targets for Chemotherapy describes new interconnections between rationally designed and empirically discovered compounds. One route that has not been travelled previously is that of protein kinase C inhibition. This pathway may be exploited to give potent inhibitors, such as the bryostatins, now in clinical trial. A summary is given of the current status of topoisomerase, focusing on recent clinical advances with camptothecin analogs based on connecting empiricism with concepts of drug selectivity. Modification of existing therapies based on the pursuit of leads arising from mechanistic studies is also being applied clinically on a wide scale. Greater understanding should follow from the studies of reversal of the multidrug resistant phenotype, on the use of hydroxyurea to reverse resistance mediated by extrachromosomal DNA, and on various aspects of the fluoropyrimidine pathways. Successful applications of chemotherapy to the treatment of specific diseases include the growing applications of systemic therapy using various skin malignancies. In prostate cancer, estramustine phosphate will likely play an expanding role. Taxanes are restructuring treatment regimens in breast cancer, and high-dose strategies are described with peripheral blood progenitor autografting in the treatment of ovarian and breast cancers.
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Concepts, Mechanisms, and New Targets for Chemotherapy

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The purpose of this book is to contribute to the further development of the multidisciplinary approach to the treatment of soft tissue sarcomas. A proper diagnosis and staging remains the cornerstone of the treatment strategy. Sophisticated histopathology techniques and growing consensus on grading systems have further increased the importance of the histopathologist in providing estimates of the prognosis of the patient as well as providing data for the planning of treatment strategy. The use of cytogenetics is relatively new in this field. This might enable distinction of subgroups in specific histological tumor types. Further to this, molecular biological studies not only help to reveal inherited predispositions and details in oncogenesis in tumor development, but they may also provide additional predictive factors for tumor behaviour. Further data for the treament strategy will be provided by diagnostic imaging, in which field the role of magnetic resonance imaging is rapidly developing. As far as actual treatment is concerned, surgery still provides the major chance for cure. In view of the endeavour to be as sparing as possible, the addition of radiotherapy to surgery is of utmost importance. Usually radiotherapy is given after surgery, but the optimal sequence of the two modalities yet needs to be defined. The combined use of surgery with radiotherapy and/or chemotherapy does have an impact on wound healing. A review on recent data concerning wound healing in these situations has thus been added. There appears to be growing consensus about the role of chemotherapy in metastatic disease, where only doxorubicin, ifosfamide and DTIC are known to be active. Although it may be different for subsets, in general, single-agent chemotherapy appears to be as effecive as standard doses of combination chemotherapy. The lack of efficacy of adjuvant chemotherapy with standard doses of the drugs presently available has been shown. Just as for radiotherapy, chemotherapy may have an important role in the preoperative treatment of advanced soft tissue sarcomas, where intravenous drug administration appears to be as effective as the more complicated intraarterial administration. Thermochemotherapy, another and still investigational approach to advanced local disease, also yields interesting preliminary results. Finally, clinical behaviour, treatment strategy and the outcome of treatment in childhood soft tissue sarcomas are quite different from those in adult soft tissue sarcomas.
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Multidisciplinary Treatment of Soft Tissue Sarcomas

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This digital document is an article from NWHRC Health Center – Breast Cancer, published by Thomson Gale on March 14, 2007. The length of the article is 3027 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.

Citation Details
Title: Breast Cancer; Treatment.
Author: Gale Reference Team
Publication: NWHRC Health Center – Breast Cancer (Pamphlet)
Date: March 14, 2007
Publisher: Thomson Gale
Page: NA

Distributed by Thomson Gale
$9.95

Breast Cancer; Treatment.: An article from: NWHRC Health Center – Breast Cancer

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In human solid cancer, the lymph node (LN) status is the most important prognostic indicator for the clinical outcome of patients. Recent developments in the sentinel lymph node (SLN) concept and technology have resulted in the application of this revolutionary approach to define the first draining or SLN to which the cancer may have metastasized. The underlying thesis in solid cancer biology is that metastasis generally starts in an orderly progression, spreading through the lymphatic channels to the SLN in the nearest LN basin. Thus, the logical approach is to harvest that specific SLN for thorough analysis. Because a tumorfree SLN is usually associated with a negative residual LN basin, a negative SLN is an excellent indication that micrometastasis has not occurred in the regional LNs. When the SLN is involved, it is unknown whether or not metastasis is limited only to the SLN or if the disease has spread to the remainder of the nodal basin. For this reason, if a SLN is positive, a complete lymph node dissection is recommended. Therefore, selective sentinel lymphadenectomy (SSL) should be considered as a staging procedure so that patients with negative SLNs (about 80%) may be spared an extensive LN dissection. Malignant melanoma has been proven to be the most ideal tumor model to study the role of SLN. Subsequently, SSL has been applied to breast cancer, colon cancer and other types of solid cancer. The multidisciplinary approach encompassing the surgeon, nuclear medicine physician, and pathologist is the key to such a successful procedure. Such a team can be formed readily with appropriate training. Beyond the technical aspects of harvesting the SLN, the implication of micrometastasis remains to be defined. Because the follow-up of melanoma and breast cancer patients after SSL is crucial, ongoing clinical trials are in progress to determine the biological and clinical significance of SLNs. Although the concept of SLN is viable in other types of cancer, such as gynecological and gastrointestinal, the technical aspects of the procedure need to be perfected and verified. The most exciting possibility of SSL is that it will lead to early diagnosis of micrometastasis in regional LNs. Early diagnosis makes it useful as a clinical staging procedure, and opens up new opportunities to study micrometastasis and its evolution within the SLNs. Examining the multifaceted aspects of micrometastasis, such as differentiation of different clones with respect to the primary tumor, acquisition of adhesion molecules, and host interaction with the microscopic tumor, will shed new light on the biology of early metastasis. New molecular and genetic tools may be used to dissect the mechanisms of lymphatic and hemo togenous routes of metastasis. If such mechanisms can be understood, new therapeutic advances may be developed to prevent the process of micrometastasis. Rather than targeting larger tumor burdens such as Stage IV disease, targeted adjuvant clinical trials can be developed for high risk patients following definit ive surgical resection. SSL is a standard staging procedure for patients with melanoma and is rapidly evolving into a standard procedure for breast cancer as well.
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Selective Sentinel Lymphadenectomy for Human Solid Cancer

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