Esophageal cancer is a highly aggressive cancer with limited treatment options. In the United States, cancers of the lower esophagus and gastroesophageal junction are some of the fastest-growing malignancies. Treatment is tailored to the stage of the cancer and involves various modalities, including radiation, surgical resection and chemotherapy. Integration of targeted therapies into the therapeutic algorithms for esophageal adenocarcinoma is an area of active investigation.
Esophageal cancer is best treated by a multidisciplinary team. The surgical pathologist contributes by making the pathological diagnosis and presenting the pathological findings at the multidisciplinary esophageal tumor board. This face-to-face communication is essential for ensuring clear communication among team members and identifying individualized treatment options for our patients.
There are predictive factors (both host and environmental) that correlate with increased risk of developing such inflammatory conditions as Barrett's esophagus with dysplasia, which may also predispose patients to esophageal cancer . In these patients, who may already be undergoing endoscopic evaluation, early superficial cancers can be identified, treated, and cured.
Esophageal cancer (EC) is the eighth-most-common cancer worldwide, with two common sub-types — squamous cell carcinoma (SCC) and adenocarcinoma (AC). Several risk factors have been associated with this cancer, including smoking, alcohol consumption, gastroesophageal reflux disease (GERD) and Barrett’s esophagus. Many studies have implicated diet and nutrition in risk of these cancers.
Sorafenib is the only approved drug for patients with advanced liver cancer. Unfortunately, it is not curative and is also associated with side effects that impact quality of life. At Roswell Park, we are investigating a novel anti-angiogenic agent called tivozanib that is similar to sorafenib but with greater potency and a more favorable toxicity profile.
The two most common malignancies originating within the liver are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). HCCs are one of the most common solid tumors seen worldwide, typically arising in the setting of hepatitis B and C. In the United States, 33,000 new cases of HCC and ICC were estimated for 2014.
Between February 6, 2014 and March 15, 2014 a total of 529 physicians, nurse practitioners, physician assistants, nurses, pharmacists and medical students participated in the online CME activity “Optimizing Dose Intensity for Patients with Metastatic Renal Cell Carcinoma.”
The traditional algorithm of management for metastatic prostate cancer involves androgen deprivation therapy (ADT) as first-line treatment with reservation of chemotherapy for second-line setting after disease progression.
The management of hepatocellular carcinoma (HCC) requires a careful multidisciplinary approach utilizing medical oncologists, surgeons and interventional radiologists. Treatment options require assessment of tumor stage, liver function and performance status.
Patients with localized (stages I and II) pancreatic adenocarcinoma are typically offered surgical removal to give the best chance for long-term survival. Unfortunately, only about 20% of patients fall within these stage categories, and some of these are probably better characterized as "borderline resectable."