Cancer Medicine 6 1

Holland-Frei Cancer Medicine, Ninth Edition, offers a balanced view of the most current knowledge of cancer science and clinical oncology practice. This all-new edition is the consummate reference source for medical oncologists, radiation oncologists, internists, surgical oncologists, and others who treat cancer patients. A translational perspective throughout, integrating cancer biology with cancer management providing an in depth understanding of the disease An emphasis on multidisciplinary, research-driven patient care to improve outcomes and optimal use of all appropriate therapies Cutting-edge coverage of personalized cancer care, including molecular diagnostics and therapeutics Concise, readable, clinically relevant text with algorithms, guidelines and insight into the use of both conventional and novel drugs Includes free access to the Wiley Digital Edition providing search across the book, the full reference list with web links, illustrations and photographs, and post-publication updates

An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.

This book is open access under a CC-BY licence. Cancer is perhaps the modern world's most feared disease. Yet, we know relatively little about this malady's history before the nineteenth century. This book provides the first in-depth examination of perceptions of cancerous disease in early modern England. Looking to drama, poetry and polemic as well as medical texts and personal accounts, it contends that early modern people possessed an understanding of cancer which remains recognizable to us today. Many of the ways in which medical practitioners and lay people imagined cancer – as a 'woman's disease' or a 'beast' inside the body – remain strikingly familiar, and they helped to make this disease a byword for treachery and cruelty in discussions of religion, culture and politics. Equally, cancer treatments were among the era's most radical medical and surgical procedures. From buttered frog ointments to agonizing and dangerous surgeries, they raised abiding questions about the nature of disease and the proper role of the medical practitioner.

In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.

This book describes recent advances in translational research in breast cancer and presents emerging applications of this research that promise to have meaningful impacts on diagnosis and treatment. It introduces ideas and materials derived from the clinic that have been brought to "the bench" for basic research, as well as findings that have been applied back to "the bedside". Detailed attention is devoted to breast cancer biology and cell signaling pathways and to cancer stem cell and tumor heterogeneity in breast cancer. Various patient-derived research models are discussed, and a further focus is the role of biomarkers in precision medicine for breast cancer patients. Next-generation clinical research receives detailed attention, addressing the increasingly important role of big data in breast cancer research and a wide range of other emerging developments. An entire section is also devoted to the management of women with high-risk breast cancer. Translational Research in Breast Cancer will help clinicians and scientists to optimize their collaboration in order to achieve the common goal of conquering breast cancer.

The American Joint Committee on Cancer's Cancer Staging Manual is used by physicians throughout the world to diagnose cancer and determine the extent to which cancer has progressed. All of the TNM staging information included in this Sixth Edition is uniform between the AJCC (American Joint Committee on Cancer) and the UICC (International Union Against Cancer). In addition to the information found in the Handbook, the Manual provides standardized data forms for each anatomic site, which can be utilized as permanent patient records, enabling clinicians and cancer research scientists to maintain consistency in evaluating the efficacy of diagnosis and treatment. The CD-ROM packaged with each Manual contains printable copies of each of the book’s 45 Staging Forms.