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Nutrients Sep 2021Nutrition and exercise interventions are strongly recommended for most cancer patients; however, much debate exists about the best prescription. Combining fasting with... (Review)
Review
Nutrition and exercise interventions are strongly recommended for most cancer patients; however, much debate exists about the best prescription. Combining fasting with exercise is relatively untouched within the oncology setting. Separately, fasting has demonstrated reductions in chemotherapy-related side effects and improved treatment tolerability and effectiveness. Emerging evidence suggests fasting may have a protective effect on healthy cells allowing chemotherapy to exclusively target cancer cells. Exercise is commonly recommended and attenuates treatment- and cancer-related adverse changes to body composition, quality of life, and physical function. Given their independent benefits, in combination, fasting and exercise may induce synergistic effects and further improve cancer-related outcomes. In this narrative review, we provide a critical appraisal of the current evidence of fasting and exercise as independent interventions in the cancer population and discuss the potential benefits and mechanisms of combined fasting and exercise on cardiometabolic, body composition, patient-reported outcomes, and cancer-related outcomes. Our findings suggest that within the non-cancer population combined fasting and exercise is a viable strategy to improve health-related outcomes, however, its safety and efficacy in the oncology setting remain unknown. Therefore, we also provide a discussion on potential safety issues and considerations for future research in the growing cancer population.
Topics: Biomarkers; Cancer Survivors; Clinical Decision-Making; Disease Management; Energy Metabolism; Exercise; Exercise Therapy; Fasting; Humans; Medical Oncology; Neoplasms; Quality of Life
PubMed: 34684421
DOI: 10.3390/nu13103421 -
Revue Medicale de Liege May 2024Clinical research is summarizing scientific trials performed in human aiming to improve biological and medical knowledges. The management of such an activity has to be... (Review)
Review
Clinical research is summarizing scientific trials performed in human aiming to improve biological and medical knowledges. The management of such an activity has to be conducted in a secured environment in terms of expertise, competency and professionalism of involved actors. In the field of cancer, multidisciplinarity is key in the treatment of malignant disease and plays a major role sequentially or concomitantly. In the 90s, clinical research in radiation oncology obtained historical successes, which remain validated guidelines for national societies in a significant number of clinical situations. They concern not only technological improvements but also combined modality treatments with chemotherapy, hormonal therapy and potentially new targeted agents. Radiotherapy, in a palliative or in a curative setting, benefited from dramatic technological improvements aiming to address patient quality of life after radiation therapy. Actually, the emergence of artificial intelligence is willing to modify our current practice historically based on old concepts of clinical evaluation.
Topics: Humans; Radiation Oncology; Biomedical Research; Neoplasms
PubMed: 38778642
DOI: No ID Found -
Tumori Aug 2022Clinical oncology is going through a period of profound change. Targeted therapy, and more recently immunotherapy, have revolutionized the natural history and outcomes...
Clinical oncology is going through a period of profound change. Targeted therapy, and more recently immunotherapy, have revolutionized the natural history and outcomes of many solid tumors. Clinical oncology is now indissoluble from molecular oncology, a rapidly evolving field. This profound transformation is the rationale for molecular tumor board (MTB) implementation. MTBs represent a resource for the development of precision oncology and clinical practice implementation is a complex and important challenge for the future of clinical and molecular oncology. Economic sustainability of genomic tests, access to drugs or clinical trials according to the MTB recommendation, and expanded use of existing anticancer drugs are required for MTBs to become a useful tool for the governance of precision oncology in the real world. This is an ongoing process, with establishment of MTBs the first step. Continuing to work in collaboration with scientific societies, MTBs are poised to become a homogeneous and well-structured reality that can make the care pathway of the patient with cancer more efficient, with the ultimate goal to offer personalized therapy based on the most advanced scientific knowledge.
Topics: Humans; Immunotherapy; Medical Oncology; Neoplasms; Precision Medicine
PubMed: 34918610
DOI: 10.1177/03008916211062266 -
Seminars in Thrombosis and Hemostasis Nov 2021Progress in the treatment of cancer has significantly improved survival of oncologic patients in recent decades. However, anticancer therapies, particularly some new,... (Review)
Review
Progress in the treatment of cancer has significantly improved survival of oncologic patients in recent decades. However, anticancer therapies, particularly some new, more potent and targeted agents, are potentially cardiotoxic. As a consequence, cardiovascular complications, including heart failure, arterial hypertension, coronary artery disease, venous thromboembolism, peripheral vascular disease, arrhythmias, pericardial disease, and pulmonary hypertension, as related to cancer itself or to anticancer treatments, are increasingly observed and may adversely affect prognosis in oncologic patients. Cardiovascular oncology is an emerging field in cardiology and internal medicine, which is rapidly growing, dealing with the prevention, the early detection, and the management of cardiovascular disease, in all stages of anticancer therapy and during the survivorship period, now crucial for reducing cardiovascular morbidity and mortality in cancer patients. In this narrative review, the existing literature regarding the epidemiology of cardiovascular oncology, the mechanisms of cardiovascular complications in cancer, and the pathophysiology of cardiotoxicity related to chemotherapeutic agents, targeted therapies, immunotherapies, and radiotherapy will be analyzed and summarized.
Topics: Antineoplastic Agents; Cardiotoxicity; Cardiovascular Diseases; Cardiovascular System; Humans; Medical Oncology; Neoplasms
PubMed: 34255338
DOI: 10.1055/s-0041-1729885 -
Der Radiologe Jan 2021Modern oncology has implemented several novel modalities, which increasingly warrant interdisciplinarity, dedicated imaging methods as well as intensive communication... (Review)
Review
CLINICAL ISSUE
Modern oncology has implemented several novel modalities, which increasingly warrant interdisciplinarity, dedicated imaging methods as well as intensive communication between imager and oncologists.
STANDARD TREATMENT
The classical pillars of cancer treatment are surgery, radiotherapy, and chemotherapy.
TREATMENT INNOVATIONS
Evidence-based oncology, radio-oncology, and surgery, individualized precision oncology, novel drug classes, immuno-oncology, minimally invasive diagnostic and treatment methods.
DIAGNOSTIC WORK-UP
Standard imaging methods are undergoing constant innovation and are being supplemented by specific radiotracers that can be used for radionuclide therapy. Adapted response criteria are to be used in the context of targeted therapy or checkpoint inhibitors.
PERFORMANCE AND ACHIEVEMENT
Modern cancer treatment enables improved tumor control. Due to its complexity, however, it increasingly warrants structured reporting and intense communication between imager and oncologists, to make best use of its potential.
Topics: Humans; Medical Oncology; Neoplasms; Oncologists; Precision Medicine; Radiation Oncology
PubMed: 33340067
DOI: 10.1007/s00117-020-00790-3 -
Current Opinion in Oncology Jul 2022Cancer-related fatigue (CRF) and sleep disturbances are common symptoms among patients with cancer. They are often conceptualized as a part of a larger symptom cluster,... (Review)
Review
PURPOSE OF REVIEW
Cancer-related fatigue (CRF) and sleep disturbances are common symptoms among patients with cancer. They are often conceptualized as a part of a larger symptom cluster, also comprising pain and emotional distress. Despite their prevalence and long-lasting effects, CRF and sleep disturbances are still poorly addressed in clinical settings. Specific interventions are needed to manage these symptoms.
RECENT FINDINGS
In addition to conventional pharmacological therapies, other kinds of interventions are increasingly being developed in oncology. This review will discuss three categories of interventions for patients with cancer and their interest in alleviating CRF and sleep disturbances: physical exercises (e.g., aerobic, resistance training, running, free weights), psychological interventions (e.g., cognitive-behavioural therapy, psychoeducational interventions), and mind-body interventions (e.g., yoga, mindfulness, hypnosis). The multicomponent aspect of these interventions seems particularly important to address these symptoms.
SUMMARY
The findings detailed in this review will allow the scientific community, as well as health professionals working in oncology settings, to be informed about new nonpharmacological therapeutic options to help patients to manage their symptoms. It could eventually help to improve existing interventions for these patients.
Topics: Fatigue; Humans; Mind-Body Therapies; Neoplasms; Psycho-Oncology; Sleep
PubMed: 35730502
DOI: 10.1097/CCO.0000000000000847 -
Seminars in Cancer Biology Feb 2020Molecular diagnostics is becoming one of the major drivers of personalized oncology. With hundreds of different approved anticancer drugs and regimens of their... (Review)
Review
Molecular diagnostics is becoming one of the major drivers of personalized oncology. With hundreds of different approved anticancer drugs and regimens of their administration, selecting the proper treatment for a patient is at least nontrivial task. This is especially sound for the cases of recurrent and metastatic cancers where the standard lines of therapy failed. Recent trials demonstrated that mutation assays have a strong limitation in personalized selection of therapeutics, consequently, most of the drugs cannot be ranked and only a small percentage of patients can benefit from the screening. Other approaches are, therefore, needed to address a problem of finding proper targeted therapies. The analysis of RNA expression (transcriptomic) profiles presents a reasonable solution because transcriptomics stands a few steps closer to tumor phenotype than the genome analysis. Several recent studies pioneered using transcriptomics for practical oncology and showed truly encouraging clinical results. The possibility of directly measuring of expression levels of molecular drugs' targets and profiling activation of the relevant molecular pathways enables personalized prioritizing for all types of molecular-targeted therapies. RNA sequencing is the most robust tool for the high throughput quantitative transcriptomics. Its use, potentials, and limitations for the clinical oncology will be reviewed here along with the technical aspects such as optimal types of biosamples, RNA sequencing profile normalization, quality controls and several levels of data analysis.
Topics: Biomarkers, Tumor; Computational Biology; Gene Expression Profiling; Genomics; Humans; Medical Oncology; Neoplasms; Prognosis; Proteomics; Sequence Analysis, RNA
PubMed: 31412295
DOI: 10.1016/j.semcancer.2019.07.010 -
Surgical Oncology Clinics of North... Apr 2024Pediatric precision oncology has provided a greater understanding of the wide range of molecular alterations in difficult-to-treat or rare tumors with the aims of... (Review)
Review
Pediatric precision oncology has provided a greater understanding of the wide range of molecular alterations in difficult-to-treat or rare tumors with the aims of increasing survival as well as decreasing toxicity and morbidity from current cytotoxic therapies. In this article, the authors discuss the current state of pediatric precision oncology which has increased access to novel targeted therapies while also providing a framework for clinical implementation in this unique population. The authors evaluate the targetable mutations currently under investigation-with a focus on pediatric solid tumors-and discuss the key surgical implications associated with novel targeted therapies.
Topics: Child; Humans; Neoplasms; Precision Medicine; Medical Oncology; Antineoplastic Agents; Mutation; Molecular Targeted Therapy
PubMed: 38401917
DOI: 10.1016/j.soc.2023.12.008 -
Bulletin Du Cancer Sep 2020
Topics: Humans; Medical Oncology; Neoplasms; Professional-Patient Relations
PubMed: 32951685
DOI: 10.1016/j.bulcan.2020.09.001 -
Psycho-oncology Dec 2021People with severe mental illness (SMI) are at extreme risk of being stigmatized and to receive poor quality physical care. It has been demonstrated that they have...
OBJECTIVES
People with severe mental illness (SMI) are at extreme risk of being stigmatized and to receive poor quality physical care. It has been demonstrated that they have higher morbidity and poorer prognosis of several medical diseases than the general population, with an at least 10-20-year reduction in life expectancy.
METHODS
A special issue of Psycho-Oncology focusing on cancer care among patients affected by SMI was called by the Editorial Board of the journal, with the aim to explore cancer health disparities and inequalities among people with SMI, mortality from cancer, problems of communication between multidisciplinary oncology and psychiatric teams and need for more structured intervention (i.e., screening, prevention, treatment).
RESULTS
Authors from eight countries contributed. The problem of stigma and barriers to cancer care provision for patients with SMI were studied (e.g., the complex nature of SMI and healthcare providers' misunderstanding of SMI). Key barriers were related to both patients, clinicians and institutional problems, such as fragmentation of care. A higher mortality from cancer and poor knowledge about cancer risk-factors was shown in patients with SMI. Models of intervention were also proposed.
CONCLUSIONS
Several conclusions have been recommended by the authors, such as the need for guidelines and clinical procedures specific for cancer care in mental health settings; large-scale studies to address the disparities of care in people with SMI; a larger vision of psychosocial oncology as the facilitator of the liaison between oncology and psychiatry.
Topics: Humans; Mental Disorders; Mental Health; Neoplasms; Quality of Health Care; Social Stigma
PubMed: 34874094
DOI: 10.1002/pon.5853