Cancer as a Chronic Disease

Cancers which were once fatal are increasingly able to be managed as chronic diseases. While most metastatic cancers in adults may not be curable, they often can be controlled for long periods of time with a succession of treatments. In this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist, we will examine those cancers with longer natural histories and those with extended survivals due to therapeutic advances. Finally, several cases will be presented that exemplify this new paradigm of cancer as a chronic disease.https://escholarship.umassmed.edu/cancer_concepts/1028/thumbnail.jp

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Treatment Toxicity: Radiation

Radiation exposures, both intentional and unintentional, have influence on normal tissue function. Short-term and long-term injuries can occur to all cell systems of both limited and rapid self-renewal potential. Radiation effects can last a lifetime for a patient and can produce complications for all organs and systems. Often invisible at the time of exposure, the fingerprints for cell damage can appear at any timepoint after. Health-care providers will need comprehensive knowledge and understanding of the acute and late effects of radiation exposure and how these interrelate with immediate and long-term care

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Proton Therapy Center Layout and Interface

Due to space requirements and a substantial financial burden, the feasibility of health systems adopting proton therapy has been called into question. However, advances in facility design and treatment delivery have allowed institutions offering proton therapy to reduce footprint while incorporating technological improvements at reduced costs. As the number of centers and patients treated continue to increase, this chapter will review the layout and interface of proton therapy facilities providing a detailed overview of the design, costs and faculty and staff considerations

Enhancing wind erosion monitoring and assessment for U.S. rangelands

Wind erosion is a major resource concern for rangeland managers because it can impact soil health, ecosystem structure and function, hydrologic processes, agricultural production, and air quality. Despite its significance, little is known about which landscapes are eroding, by how much, and when. The National Wind Erosion Research Network was established in 2014 to develop tools for monitoring and assessing wind erosion and dust emissions across the United States. The Network, currently consisting of 13 sites, creates opportunities to enhance existing rangeland soil, vegetation, and air quality monitoring programs. Decision-support tools developed by the Network will improve the prediction and management of wind erosion across rangeland ecosystems. © 2017 The Author(s)The Rangelands archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information

Elevating your career and making a difference: The SIGUCCS mentoring program

Need help defining your goals, identifying strengths or just need a sounding board for new ideas? Are you a seasoned member who can share resources and experience? Come to this session to learn about SIGUCCS\u27 newest membership benefit: a formal mentoring program. Established in fall 2012, this program gives SIGUCCS members the opportunity to define and achieve their personal and/or professional development goals in a safe partnership. This presentation will discuss the first year program guidelines, outcomes and implementation strategies such as: forming an advisory committee and pairing interested mentees and mentors. These outcomes include success stories and lessons learned, as well as how to get involved in 2014. Copyright 2013 ACM

Western population-based study of oncologic surgical quality and outcomes of laparoscopic versus open gastrectomy for gastric adenocarcinoma

Background While studies have reported improved morbidity of laparoscopic (LG) compared with open gastrectomy (OG), it remains unclear whether comparable oncologic outcomes can be achieved. This study aims at comparing not only short-term outcomes, including 30- and 90-day mortality, but also survival of LG vs OG. Methods The National Cancer Database was searched for adult patients with histologically proven gastric cancer and complete information regarding M0 disease, tumor size, differentiation grade, T stage, nodal status, comorbidities, type of hospital, hospital stay, type of surgery, oncological treatment and survival data were included. Logistic regression analyses were performed to analyze margin status, 30- and 90-day mortality, and 30-day re-admission rate. Linear regression was performed for length of hospital stay and lymph node yield. Kaplan-Meier survival analyses were performed to evaluate median survival. Cox multivariable regression models were created to correct for confounders and identify factors affecting survival. Results A query of the National Cancer Database identified 13,538 patients with complete dataset. A significant regression equation favoring LG for lymph node yield, hospital stay, and unplanned re-admission rate was identified. There was no significant effect of surgical approach on R1 margin rate, 30-day mortality, or 90-day mortality. Median survival was comparable between LG and OG (44.8 vs 40.2 months,p = 0.804). Conclusion LG offers a safe surgical approach to gastric cancer with shorter hospital stay and lower re-admission rates than OG, and also similar and sometimes improved operative oncologic quality parameters (margin, lymph node yield). More importantly, this Western series demonstrates that equivalent long-term outcomes of LG vs. OG are being achieved

Sage-Grouse Habitat Monitoring: Daubenmire versus Line-Point Intercept

On the Ground • Evaluation of range/habitat projects for sage-grouse require careful monitoring to measure their impact. • Daubenmire canopy cover and line-point intercept did not yield similar results. • As herbaceous canopy cover increased, the differences between the cover estimates increased. • Adoption of both techniques by both groups may be the only feasible solution since institutional constraints limit either group from changing monitoring techniques.The Rangelands archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform March 202

Preoperative Chemotherapy for Pancreatic Cancer Improves Survival and R0 Rate Even in Early Stage I

While preoperative chemotherapy for patients with stage II-III pancreatic adenocarcinoma (PDAC) is frequently practiced, its impact on very early PDAC (stage I) remains unclear today. Patients undergoing pancreatectomy for PDAC between 2010 and 2016 were identified in the National Cancer Database. Early-stage patients (IA-IB) with complete oncologic and clinical information and more than 30-day survival were included. The effect of preoperative chemotherapy on margin status was assessed with binary logistic regression. Following correction for confounders, the effect of therapy sequencing was assessed via comparison of preoperative, postoperative, perioperative (pre- and post-operative) chemotherapy, and surgery only using Cox regression. Of 4785 patients, 688 (14.4%) were stage IA, and 4197 (87.7%) IB. The rate of preoperative chemotherapy was only 8.8%. Rate of margin positivity was lower for preoperative chemotherapy (12.3% vs 19.7%). After correcting for confounders, the risk of a positive margin was lower in preoperative chemotherapy (odd ratio [OR] 0.703, p = 0.042). Cox regression showed a significant overall survival advantage for preoperative (hazard ratio [HR] 0.784, p = 0.002), postoperative (HR 0.618, p < 0.001), and perioperative (HR 0.601, p < 0.001) chemotherapy compared with surgery alone. There was no significant difference in survival between chemotherapy groups but a trend towards optimal survival for preoperative chemotherapy. Despite preoperative chemotherapy vs surgery alone resulting in improved R0 rates and overall survival even in stage I PDAC, it is rarely practiced. The results presented here suggest that preoperative chemotherapy should be strongly considered in all patients with resectable PDAC, including very early PDAC