Guidelines for screening and management of late and long-term consequences of myeloma and its treatment

A growing population of long-term survivors of myeloma is now accumulating the ‘late effects’ not only of myeloma itself, but also of several lines of treatment given throughout the course of the disease. It is thus important to recognise the cumulative burden of the disease and treatment-related toxicity in both the stable and active phases of myeloma, some of which is unlikely to be detected by routine monitoring. We summarise here the evidence for the key late effects in long-term survivors of myeloma, including physical and psychosocial consequences (in Parts 1 and 2 respectively), and recommend the use of late-effects screening protocols in detection and intervention. The early recognition of late effects and effective management strategies should lead to an improvement in the management of myeloma patients, although evidence in this area is currently limited and further research is warranted

Survivorship care for people affected by advanced or metastatic cancer: MASCC-ASCO standards and practice recommendations

PURPOSE: People with advanced or metastatic cancer and their caregivers may have different care goals and face unique challenges compared to those with early-stage disease or those nearing the end-of-life. These MASCC-ASCO standards and practice recommendations seek to establish consistent provision of quality survivorship care for people affected by advanced or metastatic cancer. METHODS: An expert panel comprising MASCC and ASCO members was formed. Standards and recommendations relevant to the provision of quality survivorship care for people affected by advanced or metastatic cancer were developed through conducting: (1) a systematic review of unmet supportive care needs; (2) a scoping review of cancer survivorship, supportive care, and palliative care frameworks and guidelines; and (3) an international modified Delphi consensus process. RESULTS: A systematic review involving 81 studies and a scoping review of 17 guidelines and frameworks informed the initial standards and recommendations. Subsequently, 77 experts (including 8 people with lived experience) across 33 countries (33% were low-to-middle resource countries) participated in the Delphi study and achieved ≥ 94.8% agreement for seven standards (1. Person-Centred Care; 2. Coordinated and Integrated Care; 3. Evidence-Based and Comprehensive Care; 4. Evaluated and Communicated Care; 5. Accessible and Equitable Care; 6. Sustainable and Resourced Care; 7. Research and Data-Driven Care) and ≥ 84.2% agreement across 45 practice recommendations. CONCLUSION: Standards of survivorship care for people affected by advanced or metastatic cancer are provided. These MASCC-ASCO standards will support optimization of health outcomes and care experiences by providing guidance to stakeholders in cancer care (healthcare professionals, leaders, and administrators; governments and health ministries; policymakers; advocacy agencies; cancer survivors and caregivers. Practice recommendations may be used to facilitate future research, practice, policy, and advocacy efforts

Sustainable care for children with cancer: a Lancet Oncology Commission.

We estimate that there will be 13·7 million new cases of childhood cancer globally between 2020 and 2050. At current levels of health system performance (including access and referral), 6·1 million (44·9%) of these children will be undiagnosed. Between 2020 and 2050, 11·1 million children will die from cancer if no additional investments are made to improve access to health-care services or childhood cancer treatment. Of this total, 9·3 million children (84·1%) will be in low-income and lower-middle-income countries. This burden could be vastly reduced with new funding to scale up cost-effective interventions. Simultaneous comprehensive scale-up of interventions could avert 6·2 million deaths in children with cancer in this period, more than half (56·1%) of the total number of deaths otherwise projected. Taking excess mortality risk into consideration, this reduction in the number of deaths is projected to produce a gain of 318 million life-years. In addition, the global lifetime productivity gains of US$2580 billion in 2020-50 would be four times greater than the cumulative treatment costs of$594 billion, producing a net benefit of $1986 billion on the global investment: a net return of$3 for every $1 invested. In sum, the burden of childhood cancer, which has been grossly underestimated in the past, can be effectively diminished to realise massive health and economic benefits and to avert millions of needless deaths

Imaging assessment of haematopoietic and lymphoid tumours; advancing methodologies and applications

Haematological malignancies are a burden being the fifth most common cancer and the second leading cause of cancer mortality on a global scale. Their presentation is complex due to disparate patterns of biological behaviour and anatomical involvement. Accurate detection of disease and precise assessment of treatment response is critical for optimal patient management. However, the appropriate use of imaging tests requires awareness of their strengths and limitations and appreciation of the myriad biological behaviours of haematological malignancies. This thesis presents research undertaken to enhance the imaging assessment of haematological malignancies. Four key themes of concern were identified and addressed. Firstly, general reporting of haematological malignancies lacked standardisation in staging, response, and prognostication assessment across all imaging studies: computed tomography (CT), positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI). A multimodality imaging report with a multidisciplinary team meeting (MDTM) style conclusion needs to be issued at each relevant timepoint in the patient pathway. The aim was to reduce imaging ‘error’ rates by using template reports, produce comparative datasets from different centres, and improve patient outcomes. Analogous to UK developments in pathology reporting, a robust and adaptable methodology, termed ‘Specialist Integrated Haematological Malignancy Imaging Reporting’ (SIHMIR), was formulated. Secondly, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) imaging guidance varied widely. There was no detailed analysis of the strengths and weaknesses of the numerous imaging tests used, and patient data was prone to misinterpretation. No comprehensive imaging guidance was available for the distinct types of BIA-ALCL, a ‘cascade’ of investigations being performed. An assessment of the strengths and limitations of all anatomical and functional imaging investigations in BIA-ALCL was undertaken, and patient imaging pathways were developed. Thirdly, a prompt diagnosis of Richter’s transformation (RT) from chronic lymphocytic leukaemia (CLL) was needed. The selection of a biopsy target to diagnose RT was a particular challenge in clinical practice. A PET-CT driven decision-making pathway to decide whether biopsy was required and, if so, to select a representative biopsy site in the era of novel therapies was developed. Lastly, MRI, used for central nervous system lymphoma (CNSL) imaging, was unable to differentiate disease activity from benign post-biopsy and inflammatory change and did not provide prognostic information. Two imaging applications for this purpose were developed: (i) the theoretical concept and clinical use of contrast clearance analysis (CCA), with its ability to differentiate viable CNSL from benign enhancement, and (ii) 18F-choline radiotracer (FCH) cranial PET-CT for staging, response-assessment, and prognostication. This thesis advances the imaging assessment in haematopoietic and lymphoid tumours, most notably with a standardised reporting framework (SIHMIR), guidance in both BIA-ALCL and CLL RT, and two CNSL imaging applications. The disease-histology specific approach to the use of imaging tests has been endorsed by the UK National Institute of Health and Care Excellence (NICE) Guidelines and UK Medicines and Healthcare products Regulatory Agency (MHRA) Guidelines. The new methodologies and tools described, particularly the two new tools for CNSL assessment, have the capacity to change global clinical and research trial practice

Catalan Cancer Plan 2022-2026

Càncer; Planificació sanitària; CatalunyaCancer; Health planning; CataloniaCáncer; Planificación sanitaria; CataluñaEn aquest document es presenta una avaluació de l’impacte del càncer a Catalunya fins al 2025 (any triat per seguir la metodologia i els períodes temporals de l’Agència Internacional de Recerca sobre el Càncer, IARC). Tot seguit, es presenta una avaluació dels avenços introduïts en el període 2015-2020, així com dels reptes pendents, sobretot considerant els objectius introduïts pel Pla Europeu contra el Càncer (Europe’s Beating Cancer Plan), publicat el febrer del 2021 amb motiu del Dia Mundial del Càncer. Finalment, es presenten els objectius per al proper període de forma sintètica

Central Nervous System Tumors

Though the treatment of central nervous system (CNS) tumors has been challenging, new advances have helped us better understand the molecular and genetic makeup of many tumor types, and new chemotherapies and immunotherapies have extended survival in patients with aggressive primary CNS tumors. This book discusses pediatric and adult tumors of the CNS, the classification schemes used to categorize them, advances in surgical techniques, and several important genetic alterations found in these tumors. We hope this book contributes to the reader’s understanding of these tumors and provides the most up-to-date and cutting-edge discoveries in this exciting field

Recent advances in the biology and treatment of brain metastases of non-small cell lung cancer: summary of a multidisciplinary roundtable discussion

This article is the result of a round table discussion held at the European Lung Cancer Conference (ELCC) in Geneva in May 2017. Its purpose is to explore and discuss the advances in the knowledge about the biology and treatment of brain metastases originating from non-small cell lung cancer. The authors propose a series of recommendations for research and treatment within the discussed context

Cancer in the Arab World

This is an Open Access book. This book is a must-have for healthcare providers and researchers, public health specialists and policy makers who are interested and involved in cancer care in the Arab world. The Arab world consists of 22 countries, which are members of the Arab League and spanning over 13,132,327 km2 with over 423,000,000 population. Over the past few decades, the Arab world has witnessed a swift evolution in healthcare provision. Nonetheless, Arab countries have considerable variability in economic capabilities, resource allocation, and intellectual talent that inevitably reflect on access to modern cancer care and prevention. This book is authored by experts from the Arab world who provide vital information on cancer statistics and risk factors, available clinical care pathways and infrastructure, and prevention programs in their individual countries. The chapters also address specific challenges in each country and insights into future directions to achieve optimal care with conventional and novel diagnostics and therapies to keep up with the era of precision medicine. Special topics of interest and unique to the Arab world are also discussed, such as out of the country’s medical tourism for cancer care and cancer care during war and conflict. Other special chapters include: Cancer research in the Arab world, Radiation therapy in Arab World and Pediatric Oncology in the Arab World Cancer in the Arab World is the first comprehensive book that addresses cancer care in depth in all Arab countries and it is endorsed by the prestigious Emirates Oncology Society

DoR Communicator - January 2014

The January 2014 issue of the Division of Research newsletter.https://digitalcommons.fiu.edu/research_newsletter/1007/thumbnail.jp