Review of adherence to medications for the treatment of osteoporosis

One of the major challenges of successful osteoporosis management is poor patient adherence to current therapies. Individuals who are nonadherent have significant consequences of reduced bone mineral density response, reduced bone marker suppression, and increased risk for fracture compared with individuals who are adherent. Although reducing the dosing interval from daily to weekly oral bisphosphonates has improved adherence, adherence with weekly bisphosphonates remains suboptimal. Barriers to adherence include patient health beliefs, inadequate patient education and age. Potential solutions include increased health care provider-patient interaction, and longer times between doses of medications.     

Nonmammographic Evaluation of the Extent of Breast Carcinoma

The role of the breast imager has evolved beyond detecting breast cancer. With emphasis on management with breast conservation therapy, it has become imperative to image the patient preoperatively to adequately determine tumor size and to establish the presence or absence of multifocal, multicentric, or contralateral malignancy. The focus of this article was to provide a review of the current literature examining nonmammographic modalities available to the radiologist to thoroughly evaluate the newly diagnosed breast cancer patient. Our emphasis will be on breast ultrasound and magnetic resonance imaging (MRI). Specific topics discussed include the role, efficacy, and availability of these modalities in the assessment of ductal carcinoma in situ (DCIS) and invasive carcinoma. Mammography remains the standard for the evaluation of the extent of DCIS. However, ultrasound and MRI have been shown to be invaluable adjuncts in the evaluation of the patient with invasive carcinoma, especially those who are considering breast conservation therapy.     

Prostate cancer – major changes in the American Joint Committee on Cancer eighth edition cancer staging manual

Answer questions and earn CME/CNE The eighth edition of the American Joint Committee on Cancer (AJCC) tumor‐node‐metastasis (TNM) Staging Manual has been updated and improved to ensure the highest degree of clinical relevance and to improve its utility for patient evaluation and clinical research. Major changes include: 1) pathologically organ‐confined disease is now considered pT2 and is no longer subclassified by extent of involvement or laterality, 2) tumor grading now includes both the Gleason score (as in the seventh edition criteria) and the grade group (introduced in the eighth edition criteria), 3) prognostic stage group III includes select, organ‐confined disease based on prostate‐specific antigen and Gleason/grade group status, and 4) 2 statistical prediction models are included in the staging manual. The AJCC will continue to critically analyze emerging prostate cancer biomarkers and tools for their ability to prognosticate and guide treatment decision making with the highest level of accuracy and confidence for patients and physicians. CA Cancer J Clin 2017;67:245–253 . © 2017 American Cancer Society .     

Mechanisms of Action for Acupuncture in the Oncology Setting

A growing body of literature supports the use of acupuncture in the oncology clinic for the relief of symptoms caused by cancer treatments. Several clinical trials are currently supported by the National Institutes of Health to assess the efficacy of such treatments, as evidenced by the listings in the National Institutes of Health Computer Retrieval of Information on Scientific Projects (CRISP) database. However, little is known about the mechanisms of action behind the effects of acupuncture. A biomedical database search for articles in the English-language literature revealed studies examining the effect of acupuncture on fibroblast cells, a decrease of inflammatory cytokines, an increase of T-lymphocytes, and increasing adenosine, neuropeptides, opioid peptides, peptide hormones, and stem cells. This limited review attempts to reveal some possible mechanisms of action for the effects of acupuncture for symptom relief in the oncology setting.