Last Days of Life (PDQ®): Supportive care - Health Professional Information [NCI] - Ethical Issues
Nutritional SupplementationProviding nutrition to patients at the end of life is a very complex and individualized decision. Ideally, the options for nutrition support for end-of-life care should be discussed in advance, and information on all nutritional choices and their consequences should be provided to the patient and family. Patients are best able to make decisions if they are well informed about the possible risks and benefits of artificial nutrition. Considerations of financial cost, burden to patient and family of additional hospitalizations and medical procedures, and all potential complications must be weighed against any potential benefit derived from artificial nutrition support. Supplemental nutrition may be beneficial in the treatment of advanced cancer, where quality of life would otherwise suffer and death would be caused by malnutrition rather than the underlying disease, such as in mechanical obstruction or malabsorption resulting in intolerance of oral
Intraocular (Uveal) Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Iris Melanoma
Melanocytic stromal proliferations and nevi of the iris are the most common tumors of the iris, but melanoma is rare.[1,2] Clinical differentiation between an iris nevus and a melanoma might sometimes be difficult and at times may be impossible. Melanomas of the iris are usually small discrete lesions, though they may occasionally be diffuse, infiltrative, or multiple, and they may result in heterochromia, chronic uveitis, or spontaneous hemorrhage into the anterior chamber of the eye (hyphema). Iris melanomas that involve more than 66% of the angle circumference are associated with secondary glaucoma.Routine evaluation of iris melanomas includes gonioscopy, transillumination of the globe, and indirect ophthalmoscopy with 360° of scleral depression. Photographic documentation is essential to document progression in size or growth of the tumor. Anterior segment fluorescein angiography may be helpful to demonstrate the vascularity of the lesion but is not diagnostic.
Metastatic Squamous Neck Cancer with Occult Primary Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (07 / 31 / 2014)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Neuroblastoma Treatment (PDQ®): Treatment - Patient Information [NCI] - nci_ncicdr0000258023-nci-header
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Neuroblastoma Treatment
Intraocular (Uveal) Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Extraocular Extension and Metastatic Intraocular Melanoma
Extrascleral extension confers a poor prognosis. For patients with gross tumor involvement of the orbit, treatment requires orbital exenteration. However, there is no evidence that such radical surgery will prolong life. Most patients with localized or encapsulated extraocular extension are not exenterated. This subject is controversial.[1,2,3,4,5]No effective method of systemic treatment has been identified for patients with metastatic ocular melanoma. Available clinical trials should be considered as an option for these patients.Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with extraocular extension melanoma and metastatic intraocular melanoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.General information about clinical trials is also available from the NCI Web site.References: Shammas HF, Blodi FC: Prognostic factors in choroidal and
Adult Brain Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Adult Brain Tumors
SurgeryRe-resection of recurrent brain tumors is used in some patients. However, the majority of patients do not qualify because of a deteriorating condition or technically inoperable tumors. The evidence is limited to noncontrolled studies and case series on patients who are healthy enough and have small enough tumors to technically debulk. The impact of reoperation versus patient selection on survival is not known.Localized ChemotherapyCarmustine wafers have been investigated in the setting of recurrent malignant gliomas, but the impact on survival is less clear than at the time of initial diagnosis and resection. In a multicenter randomized, placebo-controlled trial, 222 patients with recurrent malignant primary brain tumors requiring reoperation were randomly assigned to receive implanted carmustine wafers or placebo biodegradable wafers. Approximately half of the patients had received prior systemic chemotherapy. The two treatment groups were well balanced at baseline.
Nasopharyngeal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Nasopharyngeal Cancer
Standard treatment options:Selected patients with local recurrence may be retreated with moderate-dose external-beam radiation therapy using intensity-modulated radiation therapy, stereotactic radiation therapy, or intracavitary or interstitial radiation to the site of recurrence.[1,2,3]In highly selected patients, surgical resection of locally recurrent lesions may be considered.If a patient has metastatic disease or local recurrence that is no longer amenable to surgery or radiation therapy, chemotherapy should be considered.[4,5,6]Treatment options under clinical evaluation:Clinical trials evaluating chemotherapy should be considered.Stereotactic radiation for locally recurrent disease or persistence.[7,8,9][Level of evidence: 3iiiDiv]Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent nasopharyngeal cancer. The list of clinical trials can be further narrowed by location, drug, intervention,
Carcinoma, Squamous Cell
Important It is possible that the main title of the report Carcinoma, Squamous Cell is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report. ...
Nutrition in Cancer Care (PDQ®): Supportive care - Health Professional Information [NCI] - Tumor-Induced Effects on Nutritional Status
Nutritional status can be compromised in direct response to tumor-induced alterations in metabolism. Also known as cachexia, this condition is one of advanced protein-calorie malnutrition and is characterized by involuntary weight loss, muscle wasting, and decreased quality of life.[1,2] Tumor-induced weight loss occurs frequently in patients with solid tumors of the lung, pancreas, and upper gastrointestinal tract and less often in patients with breast cancer or lower gastrointestinal cancer. Although anorexia may also be present, the energy deficit alone does not explain the pathogenesis of cachexia. Several factors have been proposed. Mediators including cytokines, neuropeptides, neurotransmitters, and tumor-derived factors are postulated to contribute to this syndrome. Products of host tissues, such as tumor necrosis factor-α, interleukin-1, interleukin-6, interferon-γ, and leukemia inhibitor factor, as well as tumor products that have a direct catabolic effect on host
Adult Brain Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview
Primary Brain TumorsRadiation therapy and chemotherapy options vary according to histology and anatomic site of the brain tumor. For high-grade malignant gliomas—glioblastoma, anaplastic astrocytoma, anaplastic oligodendroglioma, and anaplastic oligoastrocytoma—combined modality therapy with resection, radiation, and chemotherapy is standard. Since anaplastic astrocytomas, anaplastic oligodendrogliomas, and anaplastic oligoastrocytomas represent only a small proportion of central nervous system gliomas, phase III randomized trials restricted to them are not generally practical. However, since they are aggressive and are often included in studies along with glioblastomas, they are generally managed in a fashion similar to glioblastoma. Therapy involving surgically implanted carmustine-impregnated polymer wafers combined with postoperative external-beam radiation therapy (EBRT) has a role in the treatment of high-grade gliomas regardless of