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(BQ) Part 2 book “Oncology in primary care” hass contents: Bone health, hepatocellular carcinoma, prostate cancer, bladder cancer, kidney cancer, breast cancer, gynecologic cancers, psychosocial sequelae of cancer, sexual dysfunction,… and other contents.
SECTION VI Cancer Survivorship (c) 2015 Wolters Kluwer All Rights Reserved CHAPTER 38 Cancer Survivors, Oncologists, and Primary Care Clinicians Kevin C Oeffinger, MD KEY POINTS • The population of cancer survivors is growing rapidly; many cancer survivors have complex health care needs • Risk-based health care of cancer survivors is lifelong care that integrates the cancer and survivorship experience in the overall health care needs of the individual and includes a systematic plan for surveillance and prevention that incorporates risks based on the previous cancer, cancer therapy, genetic factors, lifestyle behaviors, and comorbid health conditions • The survivorship care plan is a key component of risk-based health care • Many cancer survivors are lost in transition from active therapy to posttreatment health care and have many health care needs that are not addressed • The primary care clinician’s role in the care of cancer survivors is critically important strategies that incorporate prevention and early detection The Institute of Medicine (IOM) published two seminal reports on survivors of childhood and adult cancer.2,7 The latter report, subtitled Lost in Transition, highlighted the fact that the transition of patients from active cancer therapy to posttreatment care is often suboptimal.2 Through these reports, the concept of risk-based health care for cancer survivors was developed Risk-based health care (Table 38-1) is an approach to lifelong care that integrates the cancer and survivorship experience in the overall health care needs of the individual and includes a systematic plan for surveillance and prevention that incorporates risks based on the previous cancer, cancer therapy, genetic factors, lifestyle behaviors, and comorbid health conditions The document that is the cornerstone of this process is the survivorship care plan (SCP), which includes an individualized cancer treatment summary, information on potential late effects, and guidelines for follow-up care Figure 38-1 provides an example TABLE 38-1 Long-term cancer survivors represent a significant proportion of the US population Currently, there are more than 12 million cancer survivors; by 2020, it is estimated that this number will increase to 20 million.1 As the number of long-term survivors has increased, there has been a growing realization that many will develop health conditions as a direct or an indirect consequence of their cancer therapy.2–6 Although some of these conditions occur during therapy and persist well after the therapy has been completed (or become permanent), such as ifosfamide-induced renal dysfunction or steroidinduced osteonecrosis, many outcomes are not evident until 10 to 20 years later such as second cancers and therapy-related heart failure or ischemic coronary artery disease Collectively, these outcomes are referred to as “late effects.” Fortunately, the incidence and severity of many late effects of cancer therapy can be substantially reduced with Basic Tenets of Risk-Based Health Care of Cancer Survivors • Longitudinal care that is considered a continuum from cancer diagnosis to eventual death regardless of age • Continuity of care consisting of a partnership between the survivor and a health care provider who can coordinate necessary services • Comprehensive, anticipatory, personalized, and proactive care that includes a systematic plan of prevention and surveillance • Multidisciplinary team approach with communication between the primary health care provider, cancer specialists, and allied/ancillary service providers • Health care of the whole person, not a specific disease or organ system, which includes the individual’s family and his or her cultural and spiritual values • Sensitivity to the issues of the cancer experience, including expressed and unexpressed fears of the survivor and his or her family/spouse 238 (c) 2015 Wolters Kluwer All Rights Reserved Chapter 38 / Cancer Sur vivors, Oncologists, and Primar y Care Clinicians 239 CANCER TREATMENT SUMMARY / SURVIVORSHIP CARE PLAN Date of preparation: June 14, 2012 Name: Jane Doe Date of Birth: 7/1/1972 Cancer Diagnosis: Hodgkin lymphoma, nodular sclerosing, stage IV B Treatment center: Best Cancer Center, USA Date of diagnosis: 12/1/1998 Age at diagnosis: 26 y Date of completion of therapy: 7/29/1999 Surgery Date Procedure 12/1/1998 Left supraclavicular lymph node biopsy Radiation Therapy Date Start Date Stop Field 6/1/1999 6/24/1999 Modified mantle (cervical, supraclavicular, infraclavicular, mediastinal, and left axillary nodes) 7/12/1999 7/29/1999 Spleen and para-aortic lymph nodes Chemotherapy: Drug Name Dose (units or mg/m2) Doxorubicin 300 mg/m2 Bleomycin 100 U/m2 Vincristine Etoposide Prednisone Cyclophosphamide 4g Potential Late Effects Screening Recommendations** • • • • • • • Cardiovascular problems Lung problems Thyroid problems Fertility problems Second cancers Musculoskeletal problems Psychosocial problems including anxiety or depression • • • • • • • • • Dose (cGy) 2,100 2,100 Complete physical exam every year Echocardiogram annually EKG baseline and as clinically indicated Breast MRI/mammogram annually DXA baseline and as clinically indicated Pulmonary function test baseline and as clinically indicated Annual blood work: CBC, BUN, creatinine, fasting lipids, TSH, urinalysis Counseling as needed Yearly evaluation of skin in radiation field **Screening recommendations adapted from the Children’s Oncology Group Long-Term Follow-Up Guidelines http://www.survivorshipguidelines.org For any questions, please contact: Dr Mary Doe Best Cancer Center, Anywhere USA 1111 Main Street, USA Phone: 888-888-8888 FIGURE 38-1 Example of one-page cancer treatment summary/survivorship care plan EKG, electrocardiogram; MRI, magnetic resonance imaging; DXA, dual energy X-ray absorptiometry; CBC, complete blood count; BUN, blood urea nitrogen; TSH, thyroid-stimulating hormone (c) 2015 Wolters Kluwer All Rights Reserved 240 Oncology in Primar y Care Pre CA Low risk for future cancer-related health problems: All of the following: • Surgery only or chemotherapy that did not include alkylating agent, anthracycline, bleomycin, or epipodophyllotoxin • No radiation • Low risk of recurrence • Mild or no persistent toxicity of therapy PCC CA DX Off RX 2y Off RX a High risk: Any of the following: • High-dose radiation • High-dose alkylating agent, anthracycline, bleomycin, or epipodophyllotoxin • Allogeneic stem cell transplant • High risk of recurrence • Multi-organ persistent toxicity of therapy 10 y Off RX c c LTFU Onc Cancer center * PCC Moderate risk: Any of the following: • Low- or moderate-dose alkylating agent, anthracycline, bleomycin, or epipodophyllotoxin • Low-to-moderate dose radiation • Autologous stem cell transplant • Moderate risk of recurrence • Moderate persistent toxicity of therapy b 5y Off RX b c c c LTFU Onc Cancer center * PCC a b d d c LTFU Onc Cancer center * Communication points with PCC a CA DX and planned therapeutic approach, brief overview of chemotherapy, radiation therapy, and/or surgery b Survivorship care plan: CA DX, cancer therapy, surveillance recommendations, contact information c Periodic update with changes in surveillance recommendations and new information regarding potential late effects d Periodic update of survivor’s health for PCC record FIGURE 38-2 Risk-stratified shared care model for cancer survivors Solid line denotes primary responsibility for cancer-related care; PCC continues care to manage noncancer comorbidities and routine preventive health maintenance *Cancer center or oncologist/oncology group practice; if there is not an LTFU/survivor program available, care in the gray box is provided by the primary oncologist CA, cancer; DX, diagnosis; Off RX, completion of cancer therapy; PCC, primary care clinician; LTFU, long-term follow-up (survivor) program; Onc, oncologist (c) 2015 Wolters Kluwer All Rights Reserved Chapter 38 / Cancer Sur vivors, Oncologists, and Primar y Care Clinicians of a simple one-page SCP Despite recommendations from the IOM and numerous other national groups, studies indicate that most survivors not have an SCP; they are often unsure about the details of their cancer therapies; and most community physicians are unaware of their risks Thus, most survivors, including those at highest risk, are not engaged in risk-based follow-up care that is aimed on optimizing their health and quality of life 241 The following chapters highlight some of the more serious late effects and key aspects of integrating the health care needs of the cancer survivor with his or her routine health care needs The primary care clinician, with expertise in preventive care and the management of chronic conditions, is critically important in this process Figure 38-2 presents an approach, stratified by risk, for shared care between the primary care clinician and the cancer specialist(s) References Parry C, Kent EE, Mariotto AB, et al Cancer survivors: a booming population Cancer Epidemiol Biomarkers Prev 2011;20(10):1996–2005 Oeffinger KC, Robison LL Childhood cancer survivors, late effects, and a new model for understanding survivorship JAMA 2007;297(24):2762–2764 Hewitt M, Greenfield S, Stovall E, eds From Cancer Patient to Cancer Survivor: Lost in Transition Washington, DC: Committee on Cancer Survivorship: Improving Care and Quality of Life, National Cancer Policy Board, Institute of Medicine, and National Research Council, National Academies Press; 2006 Bhatia S, Robison LL Cancer survivorship research: opportunities and future needs for expanding the research base Cancer Epidemiol Biomarkers Prev 2008;17(7):1551–1557 Ganz PA Why and how to study the fate of cancer survivors: observations from the clinic and the research laboratory Eur J Cancer 2003;39(15): 2136–2141 Hewitt M, Weinger SL, Simone JV, eds Childhood Cancer Survivorship: Improving Care and Quality of Life Washington, DC: National Academies Press; 2003 Oeffinger KC, McCabe MS Models for delivering survivorship care J Clin Oncol 2006;24(32):5117–5124 (c) 2015 Wolters Kluwer All Rights Reserved CHAPTER 39 Cardiac and Pulmonary Sequelae of Cancer and Its Treatment Jennifer E Liu, MD, FACC • Kevin C Oeffinger, MD KEY POINTS • Cardiac and pulmonary sequelae are major contributing factors to serious morbidity and premature mortality among survivors of cancer • Chest (mediastinal) radiation frequently causes ischemic coronary artery disease Traditional risk factors increase this risk and therefore should be aggressively managed • Anthracycline therapy frequently causes asymptomatic left ventricular dysfunction, which occasionally can progress to overt heart failure • Pulmonary disease including pulmonary fibrosis and restrictive and obstructive lung disease can result from radiation to the chest and/or bleomycin and other pulmonary toxic chemotherapeutic agents Cardiac and pulmonary disease are the most common noncancer causes of serious morbidity and premature mortality among long-term survivors of cancer.1–8 Thus, preventive interventions and identification and management of earlystage disease are essential for the health and well-being of many survivors of cancer.9–11 The primary care clinician is integral in this process, particularly for cardiac sequelae, because most outcomes will not be clinically evident until 10 or 20 years after the cancer therapy CARDIAC SEQUELAE Depending on treatment exposures, there is an excess risk of ischemic coronary artery disease (CAD), heart failure (HF), valvular heart disease, arrhythmias, and pericardial disease (Table 39-1) As illustrated in Figure 39-1, CAD or HF can result from direct injury to the heart muscle and coronary arteries, respectively Comorbidities, unhealthy lifestyle behaviors, and genetic factors interact with treatment exposures and further increase risk Alternatively, indirect multifactorial pathways may lead to CAD Lastly, patients with cancer often are disconnected from their primary care provider as they are treated for their cancer and followed for recurrence This can result in suboptimal management of traditional cardiovascular risk factors, such as diabetes and hypertension, hastening the development of CAD Ischemic Coronary Artery Disease Radiation fields that include the mediastinum, often used in the therapy of Hodgkin and non-Hodgkin lymphoma, can cause direct injury to the proximal coronary arteries and accelerate atherosclerotic plaque formation leading to CAD (Fig 39-2) and myocardial infarction (MI) Following mediastinal radiation: • By 20 years, the cumulative incidence of symptomatic CAD is 21%.12 • By 30 years, the cumulative incidence of MI is 13%.1 • A survivor of cancer with an MI has a threefold increased risk of dying compared with a noncancer person with an MI.7 This is because the proximal coronary arteries, including the left main and left anterior descending arteries, are directly in the field of radiation Heart disease risk prediction models are often used in practice to estimate the 10-year risk of a serious cardiac event and then intervene with high-risk individuals by targeting risk factors.13,14 Unfortunately, traditional risk prediction models for cardiovascular disease fail to account for cancer treatment–related risk factors Take, for example, a 52-yearold female with a history of Hodgkin lymphoma diagnosed at the age of 22 years and treated with mediastinal radiation and chemotherapy, including cyclophosphamide, vincristine, procarbazine, and prednisone She is asymptomatic, does not smoke, has a total cholesterol of 210 mg per dL and a highdensity lipoprotein (HDL) of 44 mg per dL, and a systolic blood pressure of 138 mm Hg Using the cardiovascular risk calculator on the National Heart, Lung, and Blood Institute15 website based on the Framingham Study, her risk is Ͻ1% for having an MI or coronary death in the next 10 years However, 242 (c) 2015 Wolters Kluwer All Rights Reserved Chapter 39 / Cardiac and Pulmonar y Sequelae of Cancer and Its Treatment TABLE 39-1 243 Cancer Therapies Associated with Cardiac Sequelae Antitumor Class/Drug Most Frequent Toxicity Comments LV dysfunction/HF Toxicity can be acute (within 24 hr), chronic (within y) or late onset (after y) Antitumor antibiotic Anthracycline Doxorubicin Daunorubicin Idarubicin Monoclonal antibodies/small molecule inhibitors Trastuzumab LV dysfunction/HF Increased incidence when combined with anthracyclines Toxicity is not dose dependent and usually reversible Bevacizumab MI, CVA, HF Increased toxicity in age Ͼ65 y and preexisting CVD Hypertension Sunitinib Hypertension, HF Tyrosine kinase inhibitor that targets the vascular endothelial growth factor pathway; potential for LV dysfunction recovery with interruption of drug and initiation of cardiac treatment Acute ischemic events, CAD, MI Increased risk of CAD in male germ cell tumor survivors treated with cisplatin Platinum agents Cisplatin Arrhythmia, hypertension, HF Antimicrotubules Paclitaxel Bradyarrhythmia, HF, ischemia Increased risk of LV dysfunction when combined with anthracycline Fluorouracil Myocardial ischemia/MI Possibly secondary to vasospasm; risk increased with co-existing CAD and concomitant cisplatin therapy Capecitabine Same as mentioned previously Radiotherapy Myocardial fibrosis with restrictive heart disease, valvular disease, accelerated atherosclerosis, pericardial disease Antimetabolites Atrial or ventricular arrhythmia Cardiac effects worsen over time with long latency between exposure and onset of symptoms LV, left ventricular; HF, heart failure; MI, myocardial infarction; CVA, cerebrovascular accident; CVD, cardiovascular disease; CAD, coronary artery disease because of her mediastinal radiation, we know that her 10-year risk of MI or coronary death has been substantially underestimated—based on available evidence, her risk is 10% to 15%.16 Despite an apparently low-risk profile based on a traditional risk calculator, this patient’s cancer treatment history necessitates aggressive risk-reducing measures to prevent a serious coronary event This vignette illustrates the lack of appropriate tools available to clinicians when managing longterm survivors of cancer Current studies are in progress to develop risk prediction models for survivors of cancer Ischemic CAD can result from indirect pathways For example, therapy for childhood acute lymphoblastic leukemia Lifestyle: tobacco, alcohol, diet, physical activity results in obesity, insulin resistance, decreased levels of physical activity, and ultimately to increased rates of CAD.17 Cisplatin-based chemotherapy used in the treatment of men with testicular cancer has been associated with an increased risk of CAD and MI This may be the result of direct endothelial damage caused by cisplatin and/or increasing the risk of developing hypertension and lipid abnormalities.18–24 To date, studies of the use of stress exercise testing, echocardiography, and radionucleotide imaging to screen for obstructive CAD in asymptomatic survivors have been inconclusive.8 Stress echocardiography appears to be more sensitive and specific than other methods.25 However, this area of Therapy: mediastinal/neck radiation, anthracyclines, alkylating agents, stem cell transplantation Cardiovascular Outcomes: coronary artery disease/ myocardial infarction, cardiomyopathy, heart failure, stroke Biology/Genetics Comorbidities: diabetes, hypertension, dyslipidemia, renal disease FIGURE 39-1 Factors associated with cardiac sequelae in survivors of cancer (c) 2015 Wolters Kluwer All Rights Reserved 244 Oncology in Primar y Care FIGURE 39-2 A 39-year-old man who was treated for Hodgkin lymphoma 25 years ago with 45 Gy mantle field radiation The curved reconstruction of coronary computed tomography (CT) angiogram shows two areas of severe stenosis (straight arrows) in left anterior descending coronary artery (LAD) and multiple plaques (arrowhead) More distal LAD has relatively wide diameter and might represent normal vessel or region of ectasia (curved arrow) (From Rademaker J, Schoder H, Ariaratnam NS, et al Coronary artery disease after radiation therapy for Hodgkin lymphoma: coronary CT angiography findings and calcium scores in nine asymptomatic patients AJR Am J Roentgenol 2008;191:32–37, with permission.) research is limited because of the relatively small number of survivors available for study Because of the substantially heightened risk of CAD and elevated risk of death from an MI among pediatric and young adult survivors of cancer treated with high-dose mediastinal radiation (Ն40 Gy), the Children’s Oncology Group recommends consideration of cardiology consultation to 10 years after radiation.26 Regardless, studies consistently emphasize the importance of modifiable traditional cardiovascular risk factors.1,2,7,8 Smoking and comorbid hypertension, dyslipidemia, and diabetes mellitus substantially increase the risk of ischemic CAD in individuals treated with mediastinal radiation Thus, the primary care clinician’s role in the care of survivors of cancer is critically important As with other high-risk populations (i.e., patients with type diabetes), it is essential that the clinician screen for and manage hypertension, lipid disorders, and diabetes and implement strategies for smoking cessation or increasing level of physical activity as necessary Left Ventricular Dysfunction and Heart Failure Anthracycline chemotherapy (e.g., doxorubicin, daunorubicin, epirubicin) is an important component in the treatment of several types of cancer including breast, lung, endometrial, and ovarian cancer; lymphoma; leukemia; and sarcoma In a seminal study, von Hoff et al.27 reported that anthracyclineinduced cardiac injury is characterized by dose-dependent and progressive left ventricular (LV) dysfunction, which can lead to HF, developing within year of treatment in 3% of patients treated with a cumulative dose of 400 mg per m2 of doxorubicin, 7% at 550 mg per m2, and 18% at 700 mg per m2 Subsequent studies have established that anthracycline-induced LV dysfunction is common, risk increases with increasing interval from therapy, and can occur even with low cumulative doses.28–35 Although the incidence of overt HF is low with conventional regimens, subclinical echocardiographic abnormalities of LV structure and function has been reported in more than half of patients in the first few years after anthracycline exposure and the abnormalities worsened over time Importantly, HF can develop a decade or two after completion of the anthracycline therapy Risk factors for anthracyclineinduced HF include young age at therapy, cumulative doxorubicin dose, rate of administration, concurrent mediastinal or chest radiation, female gender, preexisting heart disease, and hypertension Recent studies have identified modifying genetic factors associated with anthracycline-related cardiomyopathy.36–38 The primary care clinician is an important member of the team for patients who may be treated with anthracycline chemotherapy as well as those who have completed their therapy Before a patient starts on potentially LV cardiotoxic therapy, risk stratification should be formulated based on treatmentrelated factors (type of drug, cumulative dose, combination of potentially cardiotoxic treatment) and patient-specific risk factors (age, coexisting cardiovascular conditions, and prior history of cardiotoxic treatment) In high-risk patients, there should be a discussion between the oncologist, the primary care clinician, and a cardiologist assessing the oncologic benefit of treatment and possible adverse cardiac risk, with consideration of cardioprotective measures or alteration of the treatment Optimization of the cardiovascular status (e.g., management of hypertension) prior to initiation of chemotherapy is recommended with close cardiac monitoring during treatment so that an intervention can be initiated as soon as signs of cardiotoxicity are detected The American College of Cardiology (ACC)/American Heart Association (AHA) recommend echocardiographic monitoring in patients who are at risk for HF (class I indication).39 For children, adolescents, and young adults who have completed anthracycline-based chemotherapy, the Children’s Oncology Group has developed evidence-informed recommendations for screening.26 The frequency of monitoring is based on cumulative anthracycline dose, age at exposure, and whether or not the patient was treated with chest radiation Guidelines for posttherapy cardiac screening and follow-up in asymptomatic survivors of adult cancer have not been established.8 The most common method for monitoring LV function during or after cancer therapy is measurement of LV ejection fraction (LVEF) either by echocardiography or multigated acquisition (MUGA) scan Other newer methods include cardiac magnetic resonance imaging (MRI) and 3-D echocardiography (Table 39-2) Because a broad range LVEF can be seen in healthy individuals, changes in LVEF indicative of cardiac damage can be identified only when comparison between serial studies and pretreatment study are made Cardiotoxicity in recent major clinical trials has been defined as reduction of LVEF Ͼ5% to Ͻ55% with symptoms of HF or an asymptomatic reduction of LVEF of Ͼ10% to Ͻ55% The natural history of anthracycline-induced LV dysfunction and its response to modern HF therapy has not been well established Mortality rates up to 50% within years of diagnosis have been reported in the past, which is worse than many other forms of cardiomyopathy.40 Although ACC/AHA has published evidence-based treatment guidelines (c) 2015 Wolters Kluwer All Rights Reserved Chapter 39 / Cardiac and Pulmonar y Sequelae of Cancer and Its Treatment TABLE 39-2 245 Assesment of Cardiac Function Methods Advantages Disadvantages MUGA scan Reproducible LVEF measurement with low interobserver and intraobserver variability Radiation exposure; limited information on cardiac structure and diastolic function 2-D echocardiography Low cost, easy to perform and widely available; no radiation exposure; comprehensive evaluation of cardiac structure and function High intraobserver and interobserver variability of LVEF calculation because of dependency on image quality, geometric assumption, and operator expertise May fail to detect subtle changes in LVEF 3-D echocardiography Same as 2-D echo; highly reliable LVEF calculation Limited data on its use in monitoring cardiotoxicity; not yet incorporated into routine clinical practice MRI Accurate and reliable assessment of LVEF; gold standard in the measurement of LV volume, structure, and systolic function; can detect myocardial fibrosis and scarring when combined with late gadolinium contrast enhancement High cost and not widely available MUGA, multigated acquisition scan; LVEF, left ventricular ejection fraction; MRI, magnetic resonance imaging; LV, left ventricular for HF in general,41,42 the effectiveness of therapy in anthracycline-related HF has not been well established Given the well-established final common pathway of remodeling and compensation in systolic HF, treatment for chemotherapyrelated LV dysfunction based on current HF management guideline is recommended Valvular Heart Disease and Arrhythmias Mediastinal (chest radiation) occasionally causes valvular heart disease, predominantly involving the aortic and mitral valves.43 About 6% of survivors treated with moderate- to high-dose mediastinal radiation develop clinically significant valvular disease and have an eightfold higher likelihood of valve surgery.44 Evaluation for and monitoring of valvular heart disease in survivors treated with mediastinal radiation can be accomplished with periodic echocardiography.8,26 Importantly, survivors of cancer with valvular heart disease following mediastinal radiation have a higher incidence of perioperative morbidity.45 Life-threatening arrhythmias, including complete heart block, are rare outcomes following cancer therapy and are generally attributable to mediastinal radiation Prolongation of QTc infrequently occurs following anthracycline therapy.46 As in the general population, the patient should be counseled about the use of medications that may prolong the QT interval such as antifungal agents and metronidazole PULMONARY SEQUELAE Cancer therapy–related pulmonary sequelae include restrictive and obstructive lung disease and pulmonary fibrosis In addition, patients with cancer treated with a hematopoietic stem cell transplant may develop an array of pulmonary problems, as described in Chapter 46 In contrast to cardiac outcomes, most pulmonary sequelae develop either during therapy or soon thereafter Dose-related bleomycin-induced pneumonitis has long been recognized With contemporary therapy for germ cell tumors in men, this outcome is very uncommon because of limits in the total dose of bleomycin.47–49 Other chemotherapeutic agents that are associated with pulmonary disease include busulfan, carmustine, and lomustine Combination of pulmonary toxic chemotherapy with chest radiation increases the risk of pulmonary disease Survivors of Hodgkin lymphoma treated with chest radiation in combination with bleomycin frequently have pulmonary problems; fortunately, these are generally mild to moderate in severity.50,51 The natural history of treatment-related pulmonary disease, particularly 10 years or more after therapy, is not well described Thus, the optimum frequency and duration of monitoring pulmonary function is not known.8 As previously mentioned, it is imperative that survivors of cancer treated with potentially pulmonary toxic therapy avoid or stop smoking References Aleman BM, van den Belt-Dusebout AW, De Bruin ML, et al Late cardiotoxicity after treatment for Hodgkin lymphoma Blood 2007;109: 1878–1886 Chapman JA, Meng D, Shepherd L, et al Competing causes of death from a randomized trial of extended adjuvant endocrine therapy for breast cancer J Natl Cancer Inst 2008;100:252–260 Aleman BM, van den Belt-Dusebout AW, Klokman WJ, et al Long-term cause-specific mortality of patients treated for Hodgkin’s disease J Clin Oncol 2003;21:3431–3439 Hooning MJ, Aleman BM, van Rosmalen AJ, et al Cause-specific mortality in long-term survivors of breast cancer: a 25-year follow-up study Int J Radiat Oncol Biol Phys 2006;64:1081–1091 (c) 2015 Wolters Kluwer All Rights Reserved 246 Oncology in Primar y Care Mertens AC, Liu Q, Neglia JP, et al Cause-specific late mortality among 5-year survivors of childhood cancer: the Childhood Cancer Survivor Study J Natl Cancer Inst 2008;100:1368–1379 Ng AK, Bernardo MP, Weller E, et al Long-term survival and competing causes of death in patients with early-stage Hodgkin’s disease treated at age 50 or younger J Clin Oncol 2002;20:2101–2108 26 Shankar SM, Marina N, Hudson MM, et al Monitoring for cardiovascular disease in survivors of childhood cancer: report from the Cardiovascular Disease Task Force of the Children’s Oncology Group Pediatrics 2008;121:e387–e396 27 Von Hoff DD, Layard MW, Basa P, et al Risk factors for doxorubicininduced congestive heart failure Ann Intern Med 1979;91:710–717 Swerdlow AJ, Higgins CD, Smith P, et al Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study J Natl Cancer Inst 2007;99:206–214 28 Du XL, Xia R, Burau K, et al Cardiac risk associated with the receipt of anthracycline and trastuzumab in a large nationwide cohort of older women with breast cancer Med Oncol 2010:1998–2005 Carver JR, Shapiro CL, Ng A, et al American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects J Clin Oncol 2007;25: 3991–4008 29 Du XL, Xia R, Liu C, et al Cardiac toxicity associated with anthracyclinecontaining chemotherapy in older women with breast cancer Cancer 2009;115:5296–5308 Hewitt M, Greenfield S, Stovall E, eds From Cancer Patient to Cancer Survivor: Lost in Transition Washington, DC: Committee on Cancer Survivorship: Improving Care and Quality of Life, National Cancer Policy Board, Institute of Medicine, and National Research Council, National Academies Press; 2005 10 Oeffinger KC, Hudson MM, Landier W Survivorship: childhood cancer survivors Prim Care 2009;36:743–780 11 Oeffinger KC, McCabe MS Models for delivering survivorship care J Clin Oncol 2006;24:5117–5124 12 Reinders JG, Heijmen BJ, Olofsen-van Acht MJ, et al Ischemic heart disease after mantlefield irradiation for Hodgkin’s disease in long-term follow-up Radiother Oncol 1999;51:35–42 13 Mosca L, Benjamin EJ, Berra K, et al Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: a guideline from the American Heart Association Circulation 2011;123:1243–1262 14 U.S Preventive Services Task Force Aspirin for the prevention of cardiovascular disease: U.S Preventive Services Task Force recommendation statement Ann Intern Med 2009;150:396–404 15 National Heart Lung and Blood Institute http://www.nhlbi.nih.gov/ Accessed April 10, 2012 16 Aleman BMP, van den Belt-Dusebout AW, De Bruin ML, et al Late cardiotoxicity after treatment for Hodgkin lymphoma Blood 2007;109:1878–1886 17 Oeffinger KC Are survivors of acute lymphoblastic leukemia (ALL) at increased risk of cardiovascular disease? Pediatr Blood Cancer 2008;50:462–467; discussion 468 18 Feldman DR, Bosl GJ, Sheinfeld J, et al Medical treatment of advanced testicular cancer JAMA 2008;299:672–684 19 Haugnes HS, Aass N, Fossa SD, et al Components of the metabolic syndrome in long-term survivors of testicular cancer Ann Oncol 2007;18:241–248 20 Haugnes HS, Aass N, Fossa SD, et al Predicted cardiovascular mortality and reported cardiovascular morbidity in testicular cancer survivors J Cancer Surviv 2008;2:128–137 21 Haugnes HS, Wethal T, Aass N, et al Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study J Clin Oncol 2010;28:4649–4657 22 van den Belt-Dusebout AW, Nuver J, de Wit R, et al Long-term risk of cardiovascular disease in 5-year survivors of testicular cancer J Clin Oncol 2006;24:467–475 30 Lipshultz SE, Colan SD, Gelber RD, et al Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood N Engl J Med 1991;324:808–815 31 Lipshultz SE, Lipsitz SR, Sallan SE, et al Chronic progressive cardiac dysfunction years after doxorubicin therapy for childhood acute lymphoblastic leukemia J Clin Oncol 2005;23:2629–2636 32 Pinder MC, Duan Z, Goodwin JS, et al Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer J Clin Oncol 2007;25:3808–3815 33 Sawaya H, Sebag IA, Plana JC, et al Early detection and prediction of cardiotoxicity in chemotherapy-treated patients Am J Cardiol 2011;107: 1375–1380 34 Swain SM, Whaley FS, Ewer MS Congestive heart failure in patients treated with doxorubicin: a retrospective analysis of three trials Cancer 2003;97:2869–2879 35 van Dalen EC, van der Pal HJ, Kok WE, et al Clinical heart failure in a cohort of children treated with anthracyclines: a long-term follow-up study Eur J Cancer 2006;42:3191–3198 36 Blanco JG, Sun CL, Landier W, et al Anthracycline-related cardiomyopathy after childhood cancer: role of polymorphisms in carbonyl reductase genes—A report from the Children’s Oncology Group J Clin Oncol 2011 37 Visscher H, Ross CJ, Rassekh SR, et al Pharmacogenomic prediction of anthracycline-induced cardiotoxicity in children J Clin Oncol 2011 38 Wojnowski L, Kulle B, Schirmer M, et al NAD(P)H oxidase and multidrug resistance protein genetic polymorphisms are associated with doxorubicin-induced cardiotoxicity Circulation 2005;112:3754–3762 39 Cheitlin MD, Armstrong WF, Aurigemma GP, et al Guideline update for the clinical application of echocardiography—summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography) J Am Coll Cardiol 2003;42:954–970 40 Felker GM, Thompson RE, Hare JM, et al Underlying causes and longterm survival in patients with initially unexplained cardiomyopathy N Engl J Med 2000;342:1077–1084 41 Hunt SA, Abraham WT, Chin MH, et al 2009 Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines developed in collaboration with the International Society for Heart and Lung Transplantation J Am Coll Cardiol 2009;53:e1–e90 24 Vaughn DJ, Palmer SC, Carver JR, et al Cardiovascular risk in long-term survivors of testicular cancer Cancer 2008;112:1949–1953 42 Hunt SA, Baker DW, Chin MH, et al ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee to revise the 1995 guidelines for the evaluation and management of heart failure) J Am Coll Cardiol 2001;38:2101–2113 25 Heidenreich PA, Schnittger I, Strauss HW, et al Screening for coronary artery disease after mediastinal irradiation for Hodgkin’s disease J Clin Oncol 2007;25:43–49 43 Adams MJ, Lipsitz SR, Colan SD, et al Cardiovascular status in longterm survivors of Hodgkin’s disease treated with chest radiotherapy J Clin Oncol 2004;22:3139–3148 23 Feldman DR, Schaffer WL, Steingart RM Late cardiovascular toxicity following chemotherapy for germ cell tumors J Natl Compr Canc Netw 2012;10:537–544 (c) 2015 Wolters Kluwer All Rights Reserved Appendix Useful Internet and Community Resources for Cancer Care Bonnie Indeck, MSW, LCSW • Nora Rightmer, LCSW GENERAL American Cancer Society www.cancer.org American Institute for Cancer Research www.aicr.org Association of Cancer Online Resources www.acor.org Cancer Care Inc www.cancercare.org Cancer Hope Network www.cancerhopenetwork.org Cancer Support Community www.cancersupportcommunity.org ChemoCare www.chemocare.com Gilda’s Club/The Wellness Community www.gildasclub.org Imerman Angels www.imermanangels.org Info Line www.211.org Lance Armstrong Foundation www.livestrong.org Cancer and Careers www.cancerandcareers.org Lotsa Helping Hands www.lotsahelpinghands.com National Cancer Institute www.cancer.gov National LGBT Cancer Project www.lgbtcancer.com National Lymphedema Network www.lymphnet.org People Living with Cancer www.cancer.net A Physician’s Guide to Social Security Disability Determinations www.virtualmentor.ama-assn.org/2011/12/hlaw1-1112.html Social Security Disability Information www.ssa.gov CATEGORIZED BY TOPIC CAREGIVERS— addresses the needs of the well spouse/partner Well Spouse Association www.wellspouse.org COMPLEMENTARY THERAPY—sites that provide information and education about complementary and alternative medicine MedlinePlus: Complementary and Alternative Medicine www.nlm.nih.gov/medlineplus/complementaryand alternativemedicine.html Memorial Sloan-Kettering Cancer Center: About Herbs, Botanicals, and Other Products www.mskcc.org/mskcc/html /11570.cfm?herbsaccept=yes National Cancer Institute Office of Complementary and Alternative Medicine: CAM Therapies A-Z www.cancer.gov/cam /health_camaz.html National Cancer Institute Office of Complementary and Alternative Medicine: Health Information www.cancer.gov/cam /health_index.html National Institutes of Health National Center for Complementary and Alternative Medicine www.nccam.nih.gov Society for Integrative Oncology www.integrativeonc.org EMPLOYMENT—websites that provide information, resources, and guidance regarding the legal aspects of employment during cancer treatment Cancer and Careers www.cancerandcareers.org Job Accommodation Network www.askjan.org U.S Department of Labor www.dol.gov U.S Equal Employment Opportunity Commission www.eeoc.gov Workplace Fairness www.workplacefairness.org END-OF-LIFE/PALIATIVE CARE—information and guidance regarding palliative care, pain issues, hospice resources, and general end-of-life concerns The Children’s Treehouse Foundation www.childrenstreehousefdn.org Jack & Jill Late Stage Cancer Foundation www.jajf.org Kids Konnected www.kidskonnected.org Parenting at a Challenging Time (PACT)— Massachusetts General Hospital www.mghpact.org/home.php Parenting at a Challenging Time (PACT)—Smilow Cancer Hospital at Yale-New Haven www.ynhh.org/smilow-cancer-hospital /patient-information/sm_pact_main.aspx American Pain Foundation www.painfoundation.org American Pain Society www.ampainsoc.org Center to Advance Palliative Care www.capc.org Growth House www.growthhouse.org Hospice Education Institute www.hospiceworld.org Hospice Foundation of America www.hospicefoundation.org Hospice Patients Alliance www.hospicepatients.org National Association for Home Care & Hospice www.nahc.org National Hospice and Palliative Care Organization www.nhpco.org Promoting Excellence in End-of-Life Care www.promotingexcellence.org CLINICAL TRIALS—information about clinical trials and how to access them FERTILITY—resources about pregnancy and fertility for women with cancer Clinical Trials Information Coalition of Cancer Cooperative Groups American Society for Reproductive Medicine www.asrm.org Cancer in Pregnancy www.motherisk.org/women/cancer.jsp CHILDREN WHOSE PARENTS HAVE CANCER— information and resources for children and for parents to assist children www.centerwatch.com www.cancertrialshelp.org 411 (c) 2015 Wolters Kluwer All Rights Reserved 412 Oncology in Primar y Care Consortium of Cancer in Pregnancy www.motherisk.org/women/cancer.jsp Fertile Hope www.fertilehope.org Hope for Two www.pregnantwithcancer.org FINANCIAL AND PHARMACEUTICAL ASSISTANCE— provides patients with connections to financial assistance for pharmaceuticals Cancer Co-Payment Assistance Foundation www.cancercopay.org Cancer Financial Assistance Coalition www.cancerfac.org Chronic Disease Fund www.cdfund.org HealthWell Foundation www.healthwellfoundation.org Leukemia & Lymphoma Society www.lls.org//diseaseinformation/getinformationsupport /financialmatters/patientfinancialaid/ Medicare Prescription Plan Assistance www.socialsecurity.gov/prescriptionhelp NeedyMeds www.needymeds.org Partnership for Prescription Assistance www.pparx.org Patient Access Network Foundation www.panfoundation.org Patient Advocate Foundation www.patientadvocate.org Patient Advocate Foundation Co-Pay Relief www.copays.org Patient Services, Inc www.uneedpsi.org Patient Assistance Program Center www.rxassist.org HOUSING— temporary housing resources near treatment centers American Cancer Society (ACS): Hope Lodge www.cancer.org/Treatment/SupportProgramsServices/ HopeLodge/index Joe’s House www.joeshouse.org National Association of Hospital Hospitality Houses www.nahhh.org Ronald McDonald House Charities www.rmhc.com LEGAL RESOURCES— resources detailing legal rights for people with cancer American Bar Association www.findlegalhelp.org Cancer Legal Resource Center www.cancerlegalresourcecenter.org LawHelp www.lawhelp.org PERSONAL COMMUNICATION WEBSITES— free private blogs that connect patients with family and friends during a health crisis CarePages CaringBridge MyHopeSpace MyLifeLine www.carepages.com www.caringbridge.org www.myhopespace.com www.mylifeline.org SURVIVORSHIP American Society of Clinical Oncology (ASCO): Survivorship www.cancer.net/patient/Survivorship Beyond the Cure www.beyondthecure.org Journey Forward www.journeyforward.org Lance Armstrong Foundation www.livestrong.org National Coalition for Cancer Survivorship www.canceradvocacy.org TRANSPORTATION Air Charity Network Angel Flight America Central Northeast Southeast West Corporate Angel Network Miracle Flights for Kids National Patient Travel Center Operation Liftoff Patient AirLift Services www.aircharitynetwork.org www.angelflightcentral.org www.angelflightne.org www.angelflightse.org www.angelflight.org www.corpangelnetwork.org www.miracleflights.org www.patienttravel.org www.operationliftoff.com www.palservices.org WISH FOUNDATIONS— agencies that provide “wishes” for people with cancer Dream Foundation Make-A-Wish Foundation Sunshine Foundation A Wish with Wings www.dreamfoundation.com www.makeawish.org www.sunshinefoundation.org www.awishwithwings.com YOUNG ADULTS WITH CANCER— specific resources for young adults with cancer I’m Too Young for This (i2y) www.imtooyoungforthis.org Planet Cancer www.planetcancer.org Surviving and Moving Forward: The SAMFund www.thesamfund.org The Ulman Cancer Fund for Young Adults www.ulmanfund.org CATEGORIZED BY DISEASE BLADDER CANCER American Urological Association www.urologyhealth.org/urology/index.cfm?article=100 Bladder Cancer Advocacy Network www.bcan.org Bladder Cancer WebCafé http://blcwebcafe.org BRAIN CANCER American Brain Tumor Association www.abta.org Brain Tumor Foundation www.braintumorfoundation.org Financial Assistance for the Treatment of Brain Cancer www.mission4maureen.org/ Musella Foundation for Brain Tumor Research and Information www.virtualtrials.com National Brain Tumor Society www.braintumor.org BREAST CANCER Breast Cancer Information and Awareness www.breastcancer.org Breast Cancer Information/Jewish Backgrounds www.sharsheret.org Breast Cancer Network of Strength www.networkofstrength.org Facing Our Risk of Cancer Empowered (FORCE) www.facingourrisk.org Inflammatory Breast Cancer Research Foundation www.ibcresearch.org Living Beyond Breast Cancer www.lbbc.org Men Against Breast Cancer (MABC) www.menagainstbreastcancer.org Mothers Supporting Daughters with Breast Cancer (MSDBC) www.mothersdaughters.org (c) 2015 Wolters Kluwer All Rights Reserved Appendix—Useful Inter net and Community Resources for Cancer Care National Alliance of Breast Cancer Organizations www.nabco.org National Breast Cancer Coalition www.stopbreastcancer.org Reconstruction Financial Assistance www.myhopechest.org Sisters Network, Inc www.sistersnetworkinc.org Susan G Komen for the Cure ww5.komen.org Y-ME National Breast Cancer Organization www.y-me.org Young Survival Coalition www.youngsurvival.org 413 HEAD AND NECK CANCERS American Head & Neck Society www.headandneckcancer.org Courage Unmasked: Help for Head and Neck Cancer http://9114hnc.org International Association of Laryngectomees www.larynxlink.com Oral Cancer Foundation www.oralcancerfoundation.org Support for People with Oral and Head and Neck Cancer www.spohnc.org CARCINOID CANCER Carcinoid Cancer Foundation www.carcinoid.org KIDNEY CANCER Kidney Cancer Association www.curekidneycancer.org COLON CANCER Colon Cancer Alliance www.ccalliance.org Colorectal CareLine www.colorectalcareline.org Fight Colorectal Cancer www.fightcolorectalcancer.org United Ostomy Associations of America, Inc www.uoa.org LIVER CANCER American Liver Foundation YES! Beat Liver Tumors www.liverfoundation.org www.beatlivertumors.org LUNG CANCER GASTROINTESTINAL STROMAL TUMOR (GIST) GIST Support International Life Raft Group www.gistsupport.org www.liferaftgroup.org ESOPHAGEAL CANCER Esophageal Cancer Awareness Association www.ecaware.org LYMPHEDEMA EYE CANCER The Eye Cancer Foundation Alliance for Lung Cancer Advocacy, Support and Education www.alcase.org American Lung Association www.lungusa.org Lung Cancer Alliance www.lungcanceralliance.org Lung Cancer Online www.lungcanceronline.org www.eyecancerfoundation.net Lymphedema Research Foundation National Lymphedema Network www.lymphaticresearch.org www.lymphnet.org GYNECOLOGIC CANCER Alliance for Cervical Cancer Prevention (ACCP) www.alliance-cxca.org CONVERSATIONS: The International Ovarian Cancer Connection www.ovarian-news.org Facing Our Risk of Cancer Empowered (FORCE) www.facingourrisk.org Foundation for Women’s Cancer www.thegcf.org National Cervical Cancer Coalition www.nccc-online.org National Ovarian Cancer Coalition www.ovarian.org Ovarian Cancer National Alliance www.ovariancancer.org Ovarian Cancer Research Fund (OCRF) www.ocrf.org Society of Gynecologic Oncologists www.sgo.org HEMATOLOGIC CANCER Hairy Cell Leukemia Research Foundation http://hairycellleukemia.org Leukemia & Lymphoma Society www.lls.org Patients Against Lymphoma www.lymphomation.org Lymphoma Information Network www.lymphomainfo.net Lymphoma Research Foundation www.lymphoma.org Myelodysplastic Syndromes Foundation, Inc (MDS) www.mds-foundation.org MELANOMA Aim at Melanoma www.aimatmelanoma.org Melanoma Foundation of New England www.melanomafoundationne.org Melanoma International Foundation www.melanomaintl.org Melanoma Research Foundation www.melanoma.org Melanoma Resources www.melanomaresources.info Skin Cancer Foundation www.skincancer.org MESOTHELIOMA Asbestos Disease Awareness Organization www.asbestosdiseaseawareness.org Mesothelioma Applied Research Foundation www.curemeso.org Mesothelioma: Overview of Malignant Mesothelioma Cancer www.researchmesotheliomacancer.com MULTIPLE MYELOMA International Myeloma Foundation www.myeloma.org Institute for Myeloma & Bone Cancer Research www.imbcr.org Leukemia & Lymphoma Society: Myeloma www.lls.org/diseaseinformation/myeloma Multiple Myeloma Research Foundation www.themmrf.org TRANSPLANT Blood & Marrow Transplantation Information Network www.bmtinfonet.org Blood and Marrow Transplant Newsletter bmtnews.org National Bone Marrow Transplant Link www.nbmtlink.org National Marrow Donor Program www.marrow.org PANCREATIC CANCER Lustgarten Foundation for Pancreatic Cancer Research www.lustgarten.org Pancreatica: Confronting Pancreatic Cancer www.pancreatica.org Pancreatic Cancer Action Network www.pancan.org (c) 2015 Wolters Kluwer All Rights Reserved 414 Oncology in Primar y Care PROSTATE CANCER SARCOMA Urology Care Foundation www.urologyhealth.org Center for Prostate Disease Research www.cpdr.org Malecare www.malecare.org Patient Advocates for Advanced Cancer Treatments www.paactusa.org Prostate Cancer Foundation www.prostatecancerfoundation.org Prostate Cancer Research Institute www.pcri.org Us TOO International Prostate Cancer Education & Support Network www.ustoo.com Sarcoma Alliance Sarcoma Foundation of America www.sarcomaalliance.org www.curesarcoma.org TESTICULAR CANCER Lance Armstrong Foundation Testicular Cancer Resource Center www.livestrong.org tcrc.acor.org THYROID CANCER American Thyroid Association www.thyroid.org ThyCA: Thyroid Cancer Survivors’ Association, Inc www.thyca.org (c) 2015 Wolters Kluwer All Rights Reserved Index Page numbers followed by f denote figures; those followed by t denote tables A Abdominal symptoms, 97–98 Absolute neutrophil count (ANC), 134, 135, 158, 180, 185, 186t, 372 Acanthosis nigricans, 100, 100f, 106t, 110 ACCs See Adrenocortical carcinomas Acid reflux See Gastroesophageal reflux disease Acneiform rash, 219t, 220t, 221t Acquired ichthyosis, 102, 106t, 357 Acrokeratosis, 106t, 110, 357 ACTH See Adrenocorticotrophic hormone Acupuncture, 148, 152, 230, 231, 232 Acute leukemias, 369–374 See also Leukemias; Myelodysplastic syndromes hyperleukocytosis, 370, 376t presenting symptoms, 369–370, 370t surveillance, 373–374, 373t workup, 372t Acute lymphoblastic leukemia (ALL) chemotherapy, 373 childhood therapy, 249t ischemic coronary artery disease, 243 nilotinib, 219t Philadelphia chromosome positive acute lymphoblastic leukemia, 369, 371, 371f survivorship, 269 Acute myeloid leukemia (AML) blasts, 369 chemotherapy, 372–373 HIV and, 400 hypokalemia, 370 subclasses and prognosis, 372t t-AML, 268t, 272 Acute promyelocytic leukemia (APL) ATRA, 369 chemotherapy, 369, 372 described, 373 DIC, 191 features, 372t leukostasis, 370 pediatric, 405 Acute respiratory distress syndrome, 163, 268t Acute stress disorder, 166 Acyclovir, 180, 181t, 187t, 272 Adaptive coping, 166 Addiction, 147 Addison syndrome, 110 Adenocarcinoma, 409 Adenosine diphosphate phosphorylation, 175 Adenosine triphosphate, 410 ADH See Antidiuretic hormone; Atypical ductal hyperplasia Adipose tissue loss, 175 Adjuvant therapy, 409 Adnexal masses, incidental, 120–122, 122f, 122t Adoption resources, 255t Adrenal masses, incidental, 117–118, 118f Adrenergic agonists, 146t Adrenocortical carcinomas (ACCs), 110, 117, 118f, 389, 391–392, 391t, 392t Adrenocorticotrophic hormone (ACTH), 100, 105, 106t, 107t, 108, 260, 261t Aflatoxins, 44t AFP (alpha-fetoprotein), 76, 313t, 330, 331t, 395t, 406 Aggravating/Alleviating factors See WILDA approach AIDS-defining malignancies, 397–399 See also Immunosuppression-related malignancies Alarm symptoms, 94, 96t, 97, 98 ALCL See Anaplastic large cell lymphoma Alcohol consumption, PCC’s role, 3t Alemtuzumab, 187t, 220, 220t Alkylating agents, 218t, 228, 268t, 403 ALL See Acute lymphoblastic leukemia Alleviating factors See WILDA approach All-trans-retinoic acid (ATRA), 369, 372t, 373 Alpha-fetoprotein See AFP Altretamine, 218t Aluminum production, 45t Amantadine, 146t American Association for the Study of Liver Diseases, 76, 312 American Urological Association, 88, 89, 323 Amifostine, 180 Aminobiphenyl, 44t Aminoglycosides, 136f, 186t, 269 Amitriptyline, 146t, 170t AML See Acute myeloid leukemia Amoxicillin-clavulanate, 186t Amphetamine, 169 Amputation/limb-sparing strategies, 267–268 Amyloidosis, 363, 364t, 366t, 367 Anal cancer, 308–310, 309f, 400 Analgesics, 146t Anaplastic large cell lymphoma (ALCL), 220t, 355t, 356, 360, 405 Anaplastic thyroid cancer, 389, 391 Anastrozole, 24, 27, 223t, 224 ANC See Absolute neutrophil count Androgen, 223t Anemia, 183–184, 184t, 185f Fanconi anemia, 18t, 227t hematologic disorders, 100 Aneuploidy, 409 ANNA-1, ANNA-2, ANNA-3, 108t Ann Arbor staging system, 357t, 359, 359t Anorexia, 174 Anorexia-cachexia syndrome, cancer-related, 174–177, 175t, 176t Anthracyclines, 4, 194, 218t, 229, 240, 242, 243t, 244, 253t, 268t, 270, 274t, 337t, 340, 357t, 359, 361, 372, 373, 374, 399, 405 Anti-AChR, 108t Anti-amphiphysin, 108t Antianxiety agents, 171 Antibiotics, neutropenic fever, 136–137 See also specific antibiotics Antibipolar cells of retina, 108t, 111 Anticholinergics, 155t, 159t, 170t Anticonvulsants, 146t Anti-CV2, 108t Antidepressants, 170t–171t See also specific antidepressants Antidiarrheal agents, 159t Antidiuretic hormone, 138, 260 See also SIADH Antiemetic drug therapies, 151–152, 152t Antihistamines, 151 Anti-Hu syndrome, 106, 108t, 111 Anti-Ma2, 108t, 111 Antimetabolites, 218t Antimicrobial regimens, neutropenia and, 187, 187t Antimicrotubule agents, 218t, 243t Anti-nAChR, 108t, 111 Antineoplastic therapy, 217–234 See also Chemotherapy; Radiation therapy biotherapy, 221–222, 233 clinical trials, 232–234 hormonal therapy, 222–224, 223t immune therapy, 221–222 integrative oncology, 230–232 PCC’s role, 3t, 5t stem cell transplantation, 227–229, 227t, 229t Antipseudomonal -lactam agent, 134, 136, 186t Antipsychotics, 171 Antirecoverin, 108t, 111 Anti-Ri, 108t Anti-Tr, 108t Antitumor antibiotics, 243t Anti-VGCC, 108t, 111 Anti-VGKC, 108t Antivoltage-gated calcium channel, 108t, 111 Anti-Yo, 108t, 111 Anti-Zic 4, 108t Anxiety, 166–171 See also Antidepressants APC See Argon plasma coagulation APL See Acute promyelocytic leukemia Aplenzin See Bupropion Apoptosis, 409 Argon plasma coagulation (APC), 19, 79 Aromatase inhibitors, 24, 27, 213, 222, 223t See also Anastrozole; Exemestane Arrhythmias, 245 Arsenic, 44t Asbestos, 44t Aspiration, 125 Aspirin, 24, 26t, 27–28, 305 Asymptomatic (smoldering) myeloma, 364t, 365, 365f, 368 Ataxia telangiectasia, 18t, 43, 356, 403, 404t Athena Breast Health Network, 63–64 ATRA See All-trans-retinoic acid Atypical ductal hyperplasia, 24, 25t, 27t, 28f Auramine, 44t 415 (c) 2015 Wolters Kluwer All Rights Reserved 416 Oncology in Primar y Care Autoantibodies, neurologic paraneoplastic syndromes, 105–106, 108t Axitinib, 219t, 221t, 328t B B12 deficiency, 183, 184t, 187t, 295, 374 Back pain, as presenting symptom, 95–96, 96t Bacteremia, 95, 135, 136, 136f, 180 Bacteria, 37t–38t See also specific bacteria Bacterial infections, HCT, 272 Barrett’s esophagus, 78–80 Barriers, between PCCs and cancer specialists, 4–5, 5t BARRX, 79 Basal cell carcinoma (BCC), 348–349, 349f, 349t, 353, 353t Basophilia, 105, 107t, 109, 376 BCC See Basal cell carcinoma Behavioral interventions, 34, 48, 148, 278 See also Cognitive behavioral therapy Belgian Euromelanoma campaign, 84f Benzene, 44t Benzo[a]pyrene, 44t Benzodiazepines, 151, 162t, 164, 171 Beryllium, 44t Bevacizumab, 187t, 190t, 191, 194, 220t, 221, 243t, 290, 306, 328t, 386, 410 Bifidobacterium sp., 159t Bile duct cancers, 301, 301t Biofeedback, 148, 231, 310 Biopsies, 124, 125, 126t Biotherapy, 221–222, 233 Birt-Hogg-Dubé syndrome, 18t, 326t Bisacodyl, 154, 156t Bis(chloromethyl) ether, 44t Bismuth, 128t, 159t Bladder cancer, 322–325, 323t, 324t, 325t hematuria presentation, 98 presenting symptoms, 101t, 322 Schistosoma haematobium, 13, 38, 38t, 322 survival rates, Blast cell, 369, 409 Bleomycin, 163t, 179, 219, 239f, 240f, 245 Blood transfusions See Transfusions BMD See Bone mineral density BMI See Body mass index Body fatness, 48f Body mass index (BMI), 47, 48, 48f Bone and soft tissue sarcomas, 380–383, 381f, 382f, 383t, 406 Bone health, 248–251, 249t, 250t, 251t Bone marrow transplantation, 157t, 179 Bone mineral density (BMD), 248, 249t, 250t Bone pain, 146t Bone remodeling, 248 Bone scan, 128t Bortezomib, 218t, 219, 366, 367, 367t Bosniak classification, renal cysts, 118, 119f, 119t Bosutinib, 219t BRAC Analysis Rearrangement Test, 19 Brachytherapy, 409 Brain function impairment, 212 Brain metastases, 132t, 190, 387 Brain tumors, 384–387, 387t See also Nervous system cancers childhood, 407 headache presentation, 96 BRCA mutations See also Breast cancer; Ovarian cancer breast cancer and, 20t, 334, 335, 336, 336t, 340t cancer history checklist, 17t carriers, 20t ethnic backgrounds and, 21t genetic counseling evaluation, 18t management, 19 ovarian cancer and, 12, 20t, 70, 343, 345 pancreatic cancer and, 299 prevention opportunities, 63–64 risk assessment, 17 risk reduction options, 20t, 27 screening, 20t testing, 19 Breaking bad news, 197–199, 206–208 Breast cancer, 334–340 See also BRCA mutations; Raloxifene; Tamoxifen adjuvant systemic therapy, 339t AJCC-UICC TNM classification, 338, 338t atypical ductal hyperplasia, 24, 25t, 27t, 28f cancer history checklist, 17t chemopreventive agents, 24, 25t, 27, 335, 336t cognitive impairments, 263 DCIS, 24, 25t, 27t, 62–63, 223, 337, 338 diagnosis and evaluation, 336–337, 337t endocrine therapy, 222–224 exemestane, 2, 24, 25t, 27, 223t, 224, 335, 339 genetic testing, 19 hormonal therapy, 222–224, 223t hormone replacement therapy, 11, 63, 334, 335t incidence and mortality rates, 8t, 9, 9f, 10, 10f, 11, 11f invasive ductal carcinoma, 62 LCIS, 24, 25t, 27t, 335, 336t, 337, 338 neurologic paraneoplastic syndromes, 108t physical activity and, 40t, 47, 49, 49f presenting symptoms, 98–99, 99t, 101t probability model, 63 risk factors, 334–335, 335t screening, 61–64, 335–336 surveillance, 340, 340t survival rates, Breast Cancer Surveillance Consortium, 63 Brentuximab vedotin, 220t, 360 Bronchiolitis obliterans, 229, 229t, 270, 271 Bronchiolitis obliterans with organizing pneumonia, 271 Budeprion See Bupropion Bupropion (Zyban, Aplenzin, Budeprion, Wellbutrin), 32, 33t, 169, 171t Burkitt lymphoma, 13 Busulfan, 218t, 219, 245, 249t, 253t, 271 Butadiene, 44t C Cabazitaxel, 218t, 319t, 320 Cachexia, 174 See also Anorexia-cachexia syndrome Cadmium, 44t Calcitonin, 107t, 109, 139, 146t, 390, 391, 391t Calorie counter, exercise, 49t CANBESURE study, 194 Cancers See also specific cancers cancer history checklist, genetic risk, 17t complications, 211–213 metachronous, 409 resources, 8, 8t, 169 synchronous, 410 as trauma, 166 Cancer-associated anorexia-cachexia syndrome See Anorexia-cachexia syndrome Cancer-induced nausea and vomiting, 150, 151 See also Nausea; Vomiting Cancer-related emergencies See Emergencies Candida albicans, 180 Cannabinoids, 151, 176t, 177 Cannabis, 176, 177 Capecitabine, 157t, 191, 218t, 219, 243t, 306 Capsaicin cream, 146t Carbamazepine, 146t, 155t Carboplatin, 212, 218t, 250t, 253t, 291, 324t, 332t, 344, 346 Carcinoid disease, hormonal therapy, 224 Carcinomas, 409 See also specific carcinomas Cardiac complications, HCT, 270 Cardiac evaluation, 194–196, 195f, 245t Cardiac sequelae of cancer, 242–245, 243f, 243t Cardiac-type epithelium, 78 Care, 4, 4t See also Hospice care; Palliative care; Survivorship care; specific cancers Carfilzomib, 218t Carmustine, 218t, 219, 245, 253t, 274t, 386 Carotenoids, 52–53 Cataracts, HCT and, 272 CBT See Cognitive behavioral therapy Cefepime, 136, 136f, 186t Ceftazidime, 136, 136f, 186t Celecoxib, 26t, 28 Centers for Disease Prevention and Control, 38 Central appetite control, 174 Central nervous system tumors, 193, 384–385, 404, 407 See also Nervous system cancers Cerebrospinal fluid examination, 106, 398, 404, 405, 407 Cervarix, 37t, 66, 68, 70, 346 Cervical cancer, 345t, 346–347, 347t AIDS-defining malignancies, 399 Chlamydia trachomatis and, 37t, 38, 67 HPV and, 4t, 12 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 12 key points, 343 presenting symptoms, 344t, 346 screening, 66–69, 346 Cervical cytology (Pap smears), 12–13, 38, 58, 66, 345, 346, 399 Cervical intraepithelial neoplasia (CIN), 38t, 62, 66, 67t, 343 Cetuximab, 220, 220t, 221, 221t, 233, 306, 409 Chantix (varenicline), 33t CHEK2, 19 Chemicals, workplace, 42, 43–45, 44t–45t Chemo brain, 263, 265t Chemoprevention, 24–28 Barrett’s esophagus, 79 breast cancer, 24, 25t, 27, 335, 336t colorectal cancer, 26t, 27–28 prostate cancer, 25t–26t, 27 skin cancers, 83 Chemoreceptors, 161, 162f Chemoreceptor trigger zone, 151 Chemotherapeutic agents, 218t Chemotherapy, 217–221 agents (list), 218t ALL, 373 AML, 372–373 APL, 369, 372 cardiac evaluation, 194 chemotherapy-induced nausea and vomiting, 231 childhood cancer survivors, 267, 268t diarrhea, 157t, 158 effects, 212 endocrinopathies, 260–262 fertility issues, 252–255, 253t, 254t, 255t key points, 217 monoclonal antibodies, 217, 220, 220t, 243t, 358 mucositis, 179 periodontal disease, 180 peripheral nervous system dysfunction, 212–213 side effects, 217, 219 small molecule inhibitors, 217, 219t, 220 unknown primary cancers, 396 VEGF, 138, 193, 231, 328t, 386, 410 Childhood cancers, 402–407 adult cancers versus, 402–403 BMD and, 249t bone health, 248 distribution of, 403f genetic syndromes, 403, 404t leukemia, 403–405 lymphoma, 405 nervous system, 407 neuroblastoma, 405–406 renal tumors, 406 (c) 2015 Wolters Kluwer All Rights Reserved Index solid tumors, 406 survivors, 267–269, 267f, 268t Children’s Oncology Group, 248, 260, 267 Chlamydia pneumoniae, 38, 38t Chlamydia trachomatis, 37t, 38, 67 Chlorambucil, 218t, 253t, 372t Chloroaniline, 44t Cholangiocarcinomas, 120, 299, 300–301 See also Gall bladder cancer Cholestyramine, 159t, 310 Choline magnesium trisalicylate, 146t Chromium, 44t Chromosomal translocation, 409 Chromosomes, 409 Chronic health conditions, childhood cancer survivors, 267, 268f Chronic myelogenous leukemia (CML), 376–377, 377t Chronic obstructive pulmonary disease (COPD), 31t, 162t, 163, 164, 195 Cigarette consumption See Smoking CIN See Cervical intraepithelial neoplasia Ciprofloxacin, 136, 136f, 186t, 187t Cisplatin, 155t, 157t, 212, 218t, 219, 243, 243t, 250t, 253t, 261t, 268t, 284, 287 Citalopram, 169, 170t Cladribine, 218t Clearview Ultra FOB, 74t Clinical trials, 232–234 Clofarabine, 218t Clomipramine, 146t, 170t Clonidine, 32, 33t, 146t, 147 Clonorchis sinensis, 38, 38t Clostridium difficile, 136f, 155t, 156t, 157t, 159t Clotrimazole troches, 181, 181t CML See Chronic myelogenous leukemia Coal tars, 45t Codeine, 145, 145t Cognitive behavioral therapy (CBT), 148, 168 Cognitive effects of cancer See Neurocognitive effects of cancer Colonoscopy, 20t, 39, 73–74, 304 Colorectal cancer (CRC), 303–306, 306t alarm symptoms, 98 aspirin usage, 24, 26t, 27–28, 305 chemopreventive agents, 26t, 27–28 genetic testing, 19 gFOBTs, 73–74, 75 hereditary, cancer history checklist, 17t hormone replacement therapy, 11 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 11 inflammation and, 39 Lynch syndrome, 18t, 19, 20t, 27, 70, 74, 299, 304, 343, 345, 346 metastatic, 158, 306, 396t PCC’s role, 303 physical activity and, 40t, 49, 49f PLCO Cancer Screening Trial, 70, 88 presenting symptoms, 98, 101t, 305, 305t primary rectal cancer treatment, 305–306 rectal examinations, 73 screening, 73–75, 303, 304f sigmoidoscopy, 73, 304 Streptococcus bovis and, 38, 38t Columnar epithelium, 78, 346 Common Terminology Criteria for Adverse Events (CTCAE), 158t, 179, 180t Communication with patients, 197–200 See also Hospice care; Palliative care breaking bad news, 197–199, 206–208 hope and, 199, 199t prognostication, 199 transitioning to hospice care, 199–200 Complaints, cognitive See Neurocognitive effects of cancer Complex decongestive therapy, 215 Congress model, palliative care delivery, 204 Constipation, 148, 154–155, 155t, 156t, 157t Constitutional symptoms, 95 COPD See Chronic obstructive pulmonary disease Coping challenges, 166, 168t Coping skills training, 168 Corticosteroids, 133–134, 146t, 151, 176t, 249t Cough, as presenting symptom, 97 Covidien California, 79 Cowden syndrome, 18t, 110, 113 Cranial radiation, cognitive change and, 263 CRC See Colorectal cancer C-reactive protein, 39, 405 Crizotinib, 219t, 290 Cryopreservation, 254t See also Fertility Cryotherapy, 180, 181, 351 CSFs See Granulocyte colony-stimulating factors CTCAE See Common Terminology Criteria for Adverse Events CT scans incidentally found cancers, 116f, 117f, 118f, 119f, 120f, 121f staging evaluation, 127, 128–129, 128t Cutaneous cancers See Skin cancers Cyclooxygenase-2 inhibitor, 27–28, 83 Cyclophosphamide, 108, 157t, 180, 196, 218t, 219, 239f, 242, 249t, 250t, 253t, 261t, 268t, 271, 322, 360, 366, 367t, 372t, 373, 395, 399, 400 CYP2D6 genes, 169 CYP17 gene, 222, 320 Cytarabine, 179, 218t, 253t, 360, 372, 373 Cytochrome P450 enzymes, 169, 231 Cytogenetic analysis, 409 Cytokine, 409 Cytology screening, cervix, 66–68 Cytomegalovirus, 184, 272, 273 D Dacarbazine, 218t, 253t, 353, 360, 400 Daily oral morphine equivalents (DOME), 146, 146t Dairy products, milk and, 52 Darbepoetin, 184, 374 Dasatinib, 219t, 369, 371, 373, 377, 377t Daunorubicin, 157t, 218t, 219, 243t, 244, 372, 373 DCIS See Ductal carcinoma in situ De Haene, Jean-Luc, 84f Delirium, 148, 166, 170t, 171, 205 Denosumab, 138, 139, 220t, 248, 319, 319t, 340 Deodorized tincture of opium, 159t Dependence, 147 Depression, 166–171 See also Antidepressants Dermatitis, 106t, 220, 283 Dermatologic toxicities, of anticancer agents, 221t Dermatomyositis, 96, 100, 111, 213 Desipramine, 146t, 169 Desvenlafaxine, 170t Developing countries, incidence and mortality rates, 7, 8–13, 8t, 9f, 10f Dexamethasone, 131, 133–134, 146t, 152t, 176t, 229t, 253t, 392t Dextromethorphan, 146t Diabetes mellitus, 261t Diagnosis, 124–129 See also specific cancers challenges, 94 overdiagnosis, 9, 124 PCC’s role, 3, 3t, 124–125, 129 underdiagnosis, 124 Diarrhea, 155–159, 157t, 158t, 159t DIC See Disseminated intravascular coagulation Diclofenac, 26t Diet See Nutrition Dietary fats, 52 Digital rectal examination (DRE), 87, 88, 89, 316 Dilator therapy, 258t Dioxin, 44t Diphenoxylate (Lomotil), 159t (c) 2015 Wolters Kluwer All Rights Reserved 417 Disseminated intravascular coagulation (DIC), 99, 109, 191 Distress thermometer, 166, 167f, 277t Docetaxel, 157t, 196, 212, 218t, 219, 319t DOME See Daily oral morphine equivalents Donor embryos or oocytes, 255t Donor sperm, 255t Dopamine agonists, 261 Dopamine receptor antagonists, 150, 151, 152t Dopamine treatment, 169 Doxepin, 181, 181t Doxorubicin, 218t, 239t, 243t, 244, 250t, 253t, 268t, 314t, 324t, 337t, 346, 372t, 373, 395, 400 DRE See Digital rectal examination Dronabinol, 176, 176t Drugs See Pharmacologic management; specific drugs Ductal carcinoma in situ (DCIS), 24, 25t, 27t, 62–63, 223, 337, 338 Duloxetine, 146t, 169, 170t, 215 Duration See WILDA approach Dutasteride, 26t, 27, 27t Dynasplint Trismus System, 214, 215f Dysplasias See specific dysplasias Dyspnea, 161–164, 162t, 163t E Eastern Cooperative Oncology Group (ECOG) Performance Status, 175, 175t Economic impacts, of smoking, 30–31 Edmonton Symptom Assessment System, 161 EGFR See Epidermal growth factor receptor Eicosapentaenoic acid, 177 Elderly, leukemia in, 373 Electroejaculation, 254t Electromyography, needle, 213 Electronic technology-assisted interventions, 168–169 Embryo cryopreservation, 254t Emergencies, oncologic, 131–140 See also Acute leukemias; Venous thromboembolism ESCC, 131–134, 134f HCM, 137–139 list, 132t lymphomas (non-Hodgkin lymphomas), 358 SVCS, 139–140 Emotion focused adaptive coping, 166 Emotions, SPIKES tool, 198, 207t Empathy, SPIKES tool, 198, 207t Endocrine cancers, 389–392 See also Thyroid cancers adrenocortical carcinomas, 110, 117, 118f, 389, 391–392, 391t, 392t multiple endocrine neoplasia, 18t, 390 pheochromocytomas, 392 Endocrine complications, HCT, 271 Endocrine therapy See Hormonal therapy Endocrinologic paraneoplastic cancer manifestations, 105, 107t, 108–109 Endocrinopathies, 260–262 See also POEMS syndrome gonadal dysfunction, 260, 261t hypothalamic–pituitary disorders, 260–261 late effects of cancer therapies, 261t metabolic syndrome, 261–262 thyroid gland disorders, 260, 261f End-of-life issues, 206–208, 207t See also Hospice care Endometrial cancer See also Uterine cancer Lynch syndrome, 20t megestrol treatment, 224 physical activity and, 40t, 47, 49, 49f presenting symptoms, 99, 101t screening, 20t, 70 survival rates, tamoxifen toxicities, 24, 25t, 222, 223 vaginal bleeding, 70, 99 variations, 12 418 Oncology in Primar y Care Endometriosis, 39t, 223 Endoscopic ablation therapies, 79 Endoscopic mucosal resection, 79 Endoscopic surveillance, 79, 80 Endoxifen, 169 Enemas, laxatives and, 156t Energy balance, obesity and, 47–48 ENOXACAN study, 194 Enteral feeding, diarrhea and, 158 Enterobacter, 135 Eosinophilia, 107t, 110, 229t, 358, 372t, 376 EpCAM, 19 Epidermal growth factor receptor (EGFR), 409 Epidermal suprabasal keratinocytes, 350 Epidural spinal cord compression (ESCC), 131–134, 134f Epipodophyllotoxin, 240f, 268t See also Etoposide Epirubicin, 218t, 219, 244, 253t Epithelium, columnar, 78, 346 Epoetin alfa, 184 Epstein-Barr virus, 36, 37t, 38t, 272, 284t, 355, 356, 400 Equianalgesic dosing, 146, 146t Erectile dysfunction, 31, 88, 98, 228, 257, 318 Erionite, 44t Erlotinib, 219t, 221, 221t, 232, 290, 409 Erythema gyratum repens, 106t, 110 Erythromycin, 155, 156t, 273t Erythropoiesis-stimulating agents (ESAs), 184, 189 ESAs See Erythropoiesis-stimulating agents ESCC See Epidural spinal cord compression Escherichia coli, 135 Esophageal cancers, 295–297 acid reflux and, 12 causes of, 12 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 12, 295–296 key points, 294 postesophagectomy care, 297 presenting symptoms, 101t, 295t, 296, 296t surveillance, 296t survival, 296, 297t Esophageal dysplasia, 78–80 Esophagectomy, 79–80, 294, 296, 297 Essential thrombocythemia (ET), 376, 378, 378t Estradiol, 223t, 250t, 258t, 274t, 392t Estramustine, 218t Estrogen, 12, 223t, 258t See also Hormone replacement therapy ET See Essential thrombocythemia Ethylenediaminetetraacetic acid, 187 Ethylene oxide, 44t Etoposide, 179, 180, 218t, 219, 239f, 253t, 268t, 272, 291, 332t, 372t, 396t, 399 European Randomized Study of Prostate Cancer, 88 Evaluation See specific cancers Everolimus, 219t, 221, 328t, 409 Excess weight See Obesity; Overweight Excisional biopsies, 125 Exemestane, 2, 24, 25t, 27, 223t, 224, 335, 339 Exercise See also Physical activity calorie counter, 49t cancer risk, 49, 49f Exon, 409 Extramedullary plasmacytomas, 364t F Fallopian tube cancer cancer history checklist, 17t postmenopausal bleeding, 99 screening, 70 sexual dysfunction, 258 Famciclovir, 187t Familial adenomatous polyposis (FAP), 18t, 26t, 27t, 28, 74, 294 Familial melanoma, 18t, 351 Familial paraganglioma syndrome, 18t Family history, genetic risk, 16–17, 17t Fanconi anemia, 18t, 227t Fanconi syndrome, 268t FAP See Familial adenomatous polyposis Fatigue, 95, 166–171 Fats, dietary, 52 Febrile neutropenia, 185–187, 186t, 187t Fecal immunochemical test, 73, 74t, 75, 304 Fecal occult blood testing (FOBT), 303–304 Ferritin, 183, 184, 184t, 269 Fertility, 252–255 chemotherapy, 253t preservation options, 254t resources, 253, 255t Fever neutropenic, 134–137, 136f presenting symptom, 95 Filgrastim, 186 Finasteride, 25t, 27, 27t FISH See Fluorescence in situ hybridization FIT-CHEK, 74t 5As, smoking cessation, 34 Fleischner Society recommendations, 115, 116f, 116t Flow cytometry, 358t, 371, 372t, 404, 409 Fluconazole, 181, 187t Fludarabine, 135, 184t, 187, 187t, 218t Fluorescence in situ hybridization (FISH), 409 Fluoroquinolones, 38t, 135, 136, 186t Fluorouracil, 179, 180, 181, 218t, 243t, 253t, 300, 305, 310, 347, 400 Fluoxetine, 169, 170t Flushing, 100, 110, 258 FOBT See Fecal occult blood testing Folate, 52 Folic acid, 51, 52, 159, 183, 374 Follicular thyroid carcinoma, 389, 390 Food and food components, 51–53 Foot/hand rash, 221t Formaldehyde, 44t Fractures, pathologic, 213, 213t From Cancer Patient to Cancer Survivor: Lost in Transition, Frozen embryos or oocytes, 255t Frozen sperm, 255t Fruits, vegetables and, 51 Fulvestrant, 223, 223t Fungal pathogens, 135, 137, 155t, 187, 187t, 245, 273, 373 G Gabapentin, 146t, 169, 215, 340 Gall bladder cancer cholangiocarcinomas, 120, 299, 300–301 incidence, 13 Salmonella typhi and, 38, 38t, 157t Gamma-aminobutyric acid, 32f Gardasil, 37t, 66, 68, 68f, 69, 69f, 70f, 346 Gardner syndrome, 110 Garlic, 52 Gastric cancer, 294–295, 295t, 296t, 297t hereditary diffuse, 18t presenting symptoms, 101t Gastric fundic-type epithelium, 78 Gastric reflux See Gastroesophageal reflux disease Gastroesophageal junction cancer, 294, 295 Gastroesophageal reflux disease (GERD), 12, 39t, 78, 79, 296, 297 Gastrointestinal stromal tumors (GIST), 107t, 219t, 233, 294, 383 Gefitinib, 219t, 221t Gelclair, 181, 181t Gemcitabine, 184t, 187t, 191, 218t, 219, 299, 300, 301, 324t, 347 Genes See specific genes GeneTests, 18t Genetic cancer syndromes, 16, 18t, 19–20, 403, 404t Genetic counseling, 18–21, 18t, 21t Genetic Information Nondiscrimination Act, 21 Genetic risk, 16–22, 17t, 63 Genetics Services Directory website, 18t Genetic testing, 18–22 copies of results, 17 endometrial cancer and, 346 ovarian cancer and, 19, 345 for RET mutations, 391, 391t sales representatives and, 16, 18 screening, breast cancer treatment, 340t Genitourinary symptoms, 98 Genome project, human, GERD See Gastroesophageal reflux disease Germ cell tumors, 406 Germline mutations, 409 See also BRCA mutations; RET mutations Gestational carrier, 255t gFOBTs See Guaiac fecal occult blood tests GHD See Growth hormone deficiency GIST See Gastrointestinal stromal tumors Gliomas, nervous system cancers and, 386 Global hot spots, 8, 8t, 9, 10, 12 See also Incidence; Mortality rates GLOBOCAN 2008, Glutamine, 180 GnRH See Gonadotropin-releasing hormone Gonadal dysfunction, 260, 261t Gonadal failure, HCT, 271 Gonadotropin, human chorionic, 330, 331t, 395t, 406 Gonadotropin deficiency, 249t, 260, 261, 268t Gonadotropin-releasing hormone (GnRH), 222, 250t, 254t, 319, 319t Gorlin syndrome, 18t Goserelin, 222, 223, 250t Göteborg trial, 88 Governmental interventions, smoking cessation, 34 Graft-versus-host disease (GVHD), 158, 184, 227, 228, 229 Gram-negative bacilli, 135 Gram-positive bacilli, 135 Granulocyte colony-stimulating factors (CSFs), 186–187 Granulocytopenia, 105, 107t Granulocytosis, 105, 107t, 171t Group psychotherapy, 168 Growth factor, 409 Growth hormone deficiency (GHD), 260–261, 261t Growth hormones, 177, 248, 249t, 250t Growth impairment, HCT, 271 Guaiac fecal occult blood tests (gFOBTs), 73–74, 75 GVHD See Graft-versus-host disease Gynecologic cancer, 343–347 See also Cervical cancer; Endometrial cancer; Ovarian cancer; Uterine cancer Lynch syndrome, 20t neurologic paraneoplastic syndromes, 108t presenting symptoms, 99 screening, 66–70 H Hair loss, 110 Haloperidol, 148, 150, 151, 152t, 171 Hand/foot rash, 221t HCC See Hepatocellular carcinoma HCM See Hypercalcemia of malignancy HCT See Hematopoietic cell transplantation HDAC See Histone deacetylase Headache presentations, 96 Head and neck cancers, 281–285, 282t, 284t, 285t non–AIDS-defining malignancies, 400 presenting symptoms, 96–97, 281–282, 283t RFS, 213 (c) 2015 Wolters Kluwer All Rights Reserved Index Health, Eating, Activity, and Lifestyle (HEAL) study, 39 Health care, risk-based, 238, 238t, 239f, 240f, 241 See also Survivorship Health conditions, childhood cancer survivors, 267, 268f Health Insurance Portability and Accountability Act See HIPAA The Health Consequences of Smoking, 30 Heart failure, 244–245 Heavy chain disease, 364t Heavy metal, 268t See also Cisplatin Helicobacter pylori, 2, 3t, 9, 12 See also Stomach cancer Hematologic disorders See also Myelodysplastic syndromes; Myeloproliferative neoplasms anemia, 100 causes of, 13 childhood cancers, 403–405 presenting symptoms, 99–100 upper airway bleeding presentation, 97, 99 variation across regions, 13 weight loss, 95 Hematologic paraneoplastic syndromes, 105, 107t, 109 Hematopoietic cell transplantation (HCT) complications, 270–271 evaluation of survivors, 274t late infections, 272–274 subsequent malignant neoplasms, 272 vaccinations, 273–274, 273t visual impairments, 272 Hematuria, 98 Hemoccult ICT, 74t Hemoccult II, 303–304 Hemoccult SENSA, 303–304 Hemoptysis, 97, 101t, 132t, 283t, 286, 287t Hemosure One Step, 74t Hepatic lesions, incidental, 120, 121f Hepatitis B, 2, 3t, 4t, 13, 37t, 76 Hepatitis C virus, 36, 37t, 38t, 76 Hepatobiliary cancer, 95, 120, 190, 194 See also Gall bladder cancer; Pancreatic cancer Hepatoblastoma, 313, 403f, 404t, 406, 407 Hepatocellular carcinoma (HCC), 312–314 cause of, 12 hepatitis B, 2, 3t, 4t, 13, 76 HIV, 400 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 12 key points, 312 presenting symptoms, 101t, 312–313, 313t screening, 76 treatment, 313, 314t Hepatosplenomegaly, 366, 374 HER2/neu (human epidermal growth factor receptor 2), 409 Hereditary cancer syndromes See Genetic cancer syndromes Hereditary diffuse gastric cancer, 18t Hereditary leiomyomatosis and RCC, 18t, 326t Hereditary nonpolyposis colorectal cancer See Lynch syndrome Hereditary papillary renal cell carcinoma, 326t Herpes simplex virus, 135, 180, 181t HGD See High-grade dysplasia HHM See Humoral hypercalcemia of malignancy High-grade dysplasia (HGD), 78–80 HIPAA (Health Insurance Portability and Accountability Act), 20, 21 Hirsutism, 105, 110, 310 Histone deacetylase (HDAC), 409 Histone deacetylase inhibitors, 218t HIV (human immunodeficiency virus) See also Immunosuppression-related malignancies; Kaposi sarcoma HCC, 400 key points, 397 419 PCC’s role, 3t testicular seminomas, 400 HLA See Human leukocyte antigen Hodgkin lymphoma See also Lymphomas Ann Arbor staging system, 357t, 359, 359t back pain presentation, 96 incidence and mortality rates, 8t neurologic paraneoplastic syndromes, 108t non–AIDS-defining malignancies, 400 presenting symptoms, 101t RFS, 213 splenectomy, 269 stem cell transplantation, 227t survival rates, Hope, patient communication and, 199, 199t Hormonal therapy (endocrine therapy) breast cancer, 222–224, 223t carcinoid disease, 224 prostate cancer, 222 Hormone deficiencies, 260–261 Hormone replacement therapy, 11, 12, 19, 63, 229, 261, 334, 335t Hospice care, 205–208 key points, 202 Medicare benefits, 204–205, 205t palliative care versus, 203t PCC’s role, 3t transitioning to, 199–200 Hospital-based palliative care programs, 204–205 Hot spot regions, 8, 8t, 9, 10, 12 See also Incidence; Mortality rates HPV See Human papillomavirus HTLV See Human T-cell leukemia virus Human chorionic gonadotropin, 330, 331t, 395t, 406 Human epidermal growth factor receptor See HER2/neu Human genome project, Human immunodeficiency virus See HIV Human leukocyte antigen (HLA), 409 Human papillomavirus (HPV), 4t, 12, 37t, 66 Human papillomavirus vaccine, 12, 37t, 38, 66, 67t, 68–69 Human T-cell leukemia virus (HTLV), 36, 37t, 38t, 356 Humoral hypercalcemia of malignancy (HHM), 138 Humoral immunosuppression, 106 Hürthle cell carcinomas, 389, 390 Hydrazine sulfate, 177 Hydrocodone, 145t Hypercalcemia, 105, 107t, 109 Hypercalcemia of malignancy (HCM), 137–139 Hypercoagulable states DIC, 99, 109, 191 nonbacterial thrombotic endocarditis, 99, 189, 191 presenting symptoms, 99, 99t thrombotic microangiopathy, 187t, 189, 191 VTE, 189–191, 193–194 Hyperleukocytosis, 370, 376t Hyperparathyroidism, 18t, 138, 390, 391 Hyperprolactinemia, 260, 261, 261t Hypertrophic osteoarthropathy, 96, 105, 287t Hypnosis, 148, 167, 231 Hypoglycemia, 105, 107t, 109, 132t, 219t, 370 Hypogonadotropic hypogonadism, 261 Hypokalemia, 105, 155t, 222, 320, 370, 391t Hypothalamic–pituitary axis, 260, 261 Hypothalamic–pituitary disorders, 260–261 Icterus, 110 Idarubicin, 218t, 219, 243t, 372, 373 Ifosfamide, 218t, 219, 238, 249t, 250t, 253t, 380, 382 Imatinib, 219t, 220, 232, 369, 371, 373, 376, 377, 377t, 383 Imipenem, 136, 186t Imipramine, 170t Imiquimod, 26t, 349, 351, 400 Immigrants, 7, 8, 11, 12, 13 Immune therapy, 221–222 Immunomodulatory drugs, 218t Immunosuppression-related malignancies, 397–401 See also HIV Incidence, U.S., developing countries, hot spot regions, 7, 8–13, 8t, 9f, 10f See also specific cancers Incidentally found cancers, 115–122 adnexal masses, 120–122, 122f, 122t adrenal masses, 117–118, 118f hepatic lesions, 120, 121f mediastinal masses, 117, 117f pancreatic cysts, 118–120, 120f pulmonary nodules, 115–116, 116f, 116t, 117f renal malignancies, 118, 119f, 119t Incisional biopsies, 125 Infections, 36–38, 37t–38t See also specific infections Inflammations, 36, 39–40, 39t, 40t See also specific inflammations Information, SPIKES tool, 198, 207t Information focused adaptive coping, 166 Information sources, cancer, 8, 8t, 169 Informed medical decisions website, 18t Inhaler, nicotine, 33t Instant-View, 74t Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition, InSure, 74t Integrative oncology, 230–232 Intensity See WILDA approach Interdisciplinary approach, rehabilitation, 211 Interferons, 221–222 Interleukins, 221–222, 409 International Agency for Research on Cancer (IARC), 8, INTERSUN, 82 Interval, screening See Screening Interval cancers, 62 See also Breast cancer Intestinal epithelium, 78 Intraductal papillary mucinous neoplasms, 119, 120f Intravaginal estrogens, 258t Intron, 409 Invasive ductal carcinoma, 62 Invitation, SPIKES tool, 198, 207t Ipilimumab, 220t, 353 Irinotecan, 157t, 158, 218t, 219, 300, 306 Iron and steel founding, 45t Iron supplements, 155t Ischemic coronary artery disease, 242–244 Isopropyl alcohol manufacture, 45t I-SPY TRIAL, 62 I K IARC See International Agency for Research on Cancer Ibritumomab tiuxetan, 220t, 360 Ibuprofen, 146t Ichthyosis, 102, 106t, 357 Kaopectate, 159t Kaposi sarcoma, 10f, 36, 37t, 38t, 106t, 110, 221, 356, 397–398, 398f, 401t Kaposi sarcoma-associated herpesvirus, 36, 38t, 356 (c) 2015 Wolters Kluwer All Rights Reserved J Jaw tumor syndrome, 18t See also Hyperparathyroidism Jewish ancestry, 17, 17t, 18t, 335t, 340t Jewish panel, 19 Juvenile polyposis syndrome, 18t 420 Oncology in Primar y Care Keratinocyte growth factor, recombinant, 180 Ketamine, 146t Kidney cancer See Renal cancer; Renal cell carcinoma Kinase, 409 Klebsiella, 135 Knowledge, SPIKES tool, 198, 207t KRAS, 409 L Lactobacillus sp., 159t Lactulose, 156t, 157t Lamotrigine, 146t Lapatinib, 157t, 219t, 221t, 409 Larynx cancer, 10–11, 225t, 281 Late effects See Childhood cancers Late infections, HCT, 272–274 Laxatives, enemas and, 156t LCIS See Lobular carcinoma in situ Leather dust, 45t Left ventricular dysfunction, 244–245 Leiomyomatosis, hereditary, 18t, 326t Lenalidomide, 190t, 218t, 366, 367t, 374 Leser-Trélat, 100, 110, 344 Letrozole, 223t, 224, 339 Leukemias See also Acute leukemias; Myelodysplastic syndromes childhood, 403–405 CML, 376–377, 377t defined, 409 human T-cell leukemia virus, 36, 37t, 38t, 356 incidence and mortality, 8t, 9, 9t presenting symptoms, 101t Leukopenia, 184–187 Leukostasis, 110, 132t, 370 Leuprolide, 222, 223t, 250t Levofloxacin, 187t Leydig cell dysfunction, 260 LGD See Low-grade dysplasia Libman-Sacks endocarditis, 99, 189, 191 Lidocaine, 146t, 181, 221t Lifestyle interventions, 40t, 63, 248 Lifetime periodic follow-up, Li-Fraumeni syndrome, 18t, 294, 369, 380, 391, 403, 404t Light chain amyloidosis, 367 Limb-sparing/amputation strategies, 267–268 Lipolysis, 175, 177 Liver cancer See Hepatocellular carcinoma Lobular carcinoma in situ (LCIS), 24, 25t, 27t, 335, 336t, 337, 338 Location See WILDA approach Lomotil See Diphenoxylate Loperamide, 154, 159t Lorcet, 145t Lortab, 145t Lost in Transition, 238 Low-dose computed tomography, 57, 90 Low-grade dysplasia (LGD), 78–79 Lubricant enemas, 156t Lung cancer (non–small cell lung cancer, NSCLC), 286–291 See also Small cell lung cancer Chlamydia pneumoniae and, 38, 38t incidence and mortality rates, 8t, 9, 9f, 10–11, 10f neurologic paraneoplastic syndromes, 108t NLST study, 90–91 non–AIDS-defining malignancies, 399 oligometastatic disease, 289f, 290–291 physical activity and, 40t, 49, 49f PLCO Cancer Screening Trial, 70, 88 presenting symptoms, 97, 101t, 286–287, 287t respiratory presentation, 97 screening, 90–91 smoking lung cancer lag, 30 staging, 287–291, 288t, 289f, 289t Luteinizing hormone, 223t, 250t, 260, 261t, 273 Lymphadenopathy, 100, 389 Lymphangiogram, 128t Lymphedema, 215 Lymphoblastic leukemia See Acute lymphoblastic leukemia Lymphomas (non-Hodgkin lymphomas, NHLs), 355–361 See also Hodgkin lymphoma AIDS-defining malignancies, 398–399 anaplastic, 220t, 355t, 356, 360, 405 Ann Arbor staging system, 357t, 359, 359t back pain presentation, 96 Burkitt lymphoma, 13 childhood, 405 classifications, 355, 356f clinical aggressiveness groups, 355, 355t defined, 409 emergencies, 358 frequency, by type, 356f incidence and mortality rates, 8t key points, 355 laboratory abnormalities, 357–358 neurologic paraneoplastic syndromes, 108t PCNSLs, 357, 384, 386, 387 presenting symptoms, 101t, 356–357, 357t prognosis, 357, 357t, 358–359, 359t staging, 357t, 359, 359t stem cell transplantation, 227t subtypes, 359–360 workup, 358, 358t Lynch syndrome (hereditary nonpolyposis colorectal cancer), 18t, 19, 20t, 27, 70, 74, 299, 304, 343, 345, 346 M Magenta, 44t Magnesium citrate, 155t, 156t Magstream HemSp, 74t Malignant melanoma See Melanoma Malignant pheochromocytomas, 392 Malignant pleural effusion (MPE), 163–164, 196 Mammalian target of rapamycin (mTOR), 409 Mammary Prevention, 3, 25t, 27, 27t, 28f Mammogram, 128t Mammography Quality Standards Act accreditation, 63 Management See also Pain management; Pharmacologic management; specific cancers PCC’s role, 3, 3t perioperative, 193–196 Marantic endocarditis, 99, 189, 191 MDS See Myelodysplastic syndromes Meat intake, 52 Mediastinal masses, incidental, 117, 117f Medical approaches to cancer prevention See Chemoprevention Medical cannabis, 176, 177 Medicare hospice benefits, 204–205, 205t Medications See Pharmacologic management; specific medications Meditation techniques, 148, 168 Medroxyprogesterone acetate, 223t Medullary thyroid cancer, 219t, 390–391, 391t Megestrol acetate, 176, 176t, 177, 223t, 224 Melanoma (malignant melanoma) BRCA carriers, 20t key points, 348 neurologic paraneoplastic syndromes, 108t presenting symptoms, 101t, 349t, 351, 351f staging, 351–352, 352t, 353t surveillance, 353, 353t survival rates, Melanosis, 106t, 110 Melphalan, 180, 218t, 219, 253t, 261t, 366, 367t, 372t Memantine, 146t Meningiomas, nervous system cancers and, 386–387 Menopause issues, 258 See also Sexual dysfunction Mercaptopurine, 218t, 373 Meropenem, 136, 186t Mesothelioma, 291–292 Metabolic abnormalities, acute leukemia, 370 Metabolic syndrome, 261–262, 271 Metachronous cancers, 409 Metastatic breast cancer, 339–340 Metastatic colorectal cancer, 158, 306, 396t Metastatic kidney cancer, 221, 328, 328t Methadone, 146t, 147, 148, 155 Methicillin-resistant Staphylococcus aureus, 136 Methotrexate, 157t, 163t, 179, 218t, 219, 249t, 250t, 253t, 261t, 268t, 324t, 351, 360, 373, 387 Methylenebis(2-chloroaniline), 44t Methylnaltrexone, 155, 157t Methylphenidate, 169, 265, 265t Methylprednisolone, 163, 176t Metoclopramide, 148, 150, 151, 152t, 155, 156t, 157t, 176t, 177 Mexiletine, 146t mGluR1, 108t MGUS See Monoclonal gammopathy of uncertain significance Microsatellite instability, 17, 18t, 304 Milk, dairy products and, 52 Mindfulness training, 168 Mineral oils, 45t MiraLAX See Polyethylene glycol Mirels’ Scoring System, 213, 213t Mirtazapine, 169, 171t, 177 Mitoxantrone, 218t, 219, 372t MLH1, 17t, 19, 304, 343 Modafinil, 169, 265, 265t Monoclonal antibodies, 217, 220, 220t, 243t, 358 Monoclonal gammopathy of uncertain significance (MGUS), 111, 363, 364, 364t, 365f, 365t, 366t See also Plasma cell disorders Monoclonal immunoglobulin proteins, 364, 364f, 365, 365f Monoclonal light and heavy chain deposition disease, 364t, 367 MonoHaem, 74t Morphine, 146, 146t, 159t Mortality rates breast cancer screening and, 61–62 smoking, 2, 30, 31f, 31t U.S., developing countries, hot spot regions, 7, 8–13, 8t, 9f, 10f Motivational interviewing, 277–278, 277t Mouth sores, 221t MPE See Malignant pleural effusion MPNs See Myeloproliferative neoplasms MRI, staging evaluation, 127, 128–129, 128t See also Incidentally found cancers MSH2, 17, 19, 304 MSH6, 19 M staging parameter, 125 mTOR See Mammalian target of rapamycin Mucinous cystic neoplasms, 119 Mucosal barrier agents, 181 Mucositis, 179–181, 180t, 181t MuGard, 181, 181t Muir–Torre syndrome, 110 Multimedia, cancer survivors, 278 Multiple endocrine neoplasia, 18t, 390 Multiple myeloma See Myeloma Musculoskeletal complications, 213, 271 Musculoskeletal paraneoplastic syndromes, 96 Mutations, 409 See also BRCA mutations; specific mutations (c) 2015 Wolters Kluwer All Rights Reserved Index MUTYH-associated polyposis, 18t Myelodysplastic syndromes (MDS) See also Acute leukemias alkylating agents and, 218t, 403 AML with MDS-related features, 372t antimetabolites and, 218t chemotherapy and, 340, 361 classification and prognosis, 374, 374t ESAs and, 184 fever symptom and, 95 HCT and, 272, 274t HSCT and, 227, 227t, 228, 229 key points, 369 neutropenia and, 185 pre-AML state, 369 prognosis of, 374 stem cell transplantation, 227t Sweet syndrome, 107t therapy-related, 272 therapy-related AML and, 372t thrombocytopenia and, 187, 187t topoisomerase inhibitors and, 403 Myelofibrosis, 227t, 376, 378–379 Myeloid leukemia See Acute myeloid leukemia Myeloma, 365–367 back pain presentation, 96 features, 365, 365f incidence and mortality rates, 8t nonsecretory, 364, 364f, 364t, 365t osteosclerotic, 364t plasmacytomas, 364t, 365, 365t, 366t prognostic scoring system, 367t smoldering (asymptomatic), 364t, 365, 365f, 368 stem cell transplantation, 227t symptomatic, 365–366, 366t treatment agents, 367t Myeloproliferative neoplasms (MPNs), 376–379 arterial thromboembolic events and, 191 basophilia, 107t, 109 Budd-Chiari syndrome and, 190 CML, 376–377, 377t ET, 376, 378, 378t HSCT and, 227t key points, 376 myelofibrosis, 227t, 376, 378–379 polycythemia vera, 110, 191, 376, 377–378 pre-AML state, 369 presenting symptoms, 376, 376t splenomegaly and, 374 stem cell transplantation, 227t Sweet syndrome, 107t thrombocytosis, 107t, 109 MYH, 19 Myths, genetic counseling, 21t N Naltrexone, 155, 157t Naphthylamine, 44t Naproxen, 146t Nasal spray, nicotine, 33t Nasopharyngeal cancers (NPC), 8t, 13 National Cancer Institute website, 27 National Comprehensive Cancer Network, 43, 63, 76 National Health and Nutrition Examination Survey, 47 National Lung Screening Trial (NLST), 90–91 National Society of Genetic Counselors, 18t Nausea, 150–152, 152t chemotherapy-induced nausea and vomiting, 231 opioid usage, 148 Neck cancers See Head and neck cancers Neck extensor weakness, 213–214 Needle electromyography, 213 Nephrectomy, 268–269 Nervous system cancers, 384–387, 385t See also Brain tumors central nervous system tumors, 193, 384, 385, 404, 407 childhood, 407 gliomas, 386 key points, 384 meningiomas, 386–387 PCNSLs, 357, 384, 386, 387 Neuroblastoma childhood, 405–406 neurologic paraneoplastic syndromes, 108t Neurocognitive effects of cancer, 263–265 evaluation of cognitive complaints, 264, 264t, 265f management, 265, 265t Neurofibromatosis, 18t, 380, 384, 403, 404t, 407 Neuroleptics, 171 Neurologic paraneoplastic syndromes, 105–106, 108t, 110–111 NEUROMetrix, 213 Neuromuscular complications, of cancer, 212–213 Neuropathic pain, 144 Neutropenia febrile, 185–187, 186t, 187t risk factors, 135 Neutropenic enterocolitis, 132t, 158 Neutropenic fever, 134–137, 136f Neutrophilic dermatosis, paraneoplastic, 105, 107t Nevoid basal cell carcinoma syndrome, 18t New frontiers, cancer, 2–3 NHLs See Lymphomas Nickel compounds, 44t Nicotine, 31, 32f, 33t See also Smoking Nicotine replacement therapy, 32–33 Nicotine vaccines, 33–34 Nilotinib, 219t, 369, 371, 373, 377, 377t NLST See National Lung Screening Trial NMDA See N-methyl-d-aspartate receptor antagonists N-methyl-d-aspartate (NMDA) receptor antagonists, 146t Nodular panniculitis, 110 Non–AIDS-defining malignancies, 399–400 Nonbacterial thrombotic endocarditis, 99, 189, 191 non-Hodgkin lymphomas See Lymphomas Nonsecretory myeloma, 364, 364f, 364t, 365t Nonseminomas, 330, 331, 331t, 332t See also Testicular cancer Non–small cell lung cancer See Lung cancer Nonsteroidal anti-inflammatory drugs (NSAIDs), 27–28, 39, 79, 146t, 155t Norepinephrine, 33t, 391t, 392 See also Serotonin norepinephrine reuptake inhibitors Nortriptyline, 32, 33t, 146t NPC See Nasopharyngeal cancers NSAIDs See Nonsteroidal anti-inflammatory drugs NSCLC See Lung cancer N staging parameter, 125 Nutrition, 51–53 anemia, 183 CRC risk, 305 diarrhea and, 157t inflammation-associated cancers and, 40t integrative oncology, 230–231 lymphomas, 356 PCC’s role, 3, 51, 53 O Obesity, 47–49 See also Overweight; Physical activity lymphedema, 215 measurement, 48, 48f uterine cancer and, 12 Observational studies, screening and, 58–59 (c) 2015 Wolters Kluwer All Rights Reserved 421 Octreotide, 108, 109, 151, 152t, 159t, 224 Ofatumumab, 220t Olanzapine, 151, 177 Oligometastatic disease, 289f, 290–291 Oncogenes, 409 Oncogenic osteomalacia, 105, 107t Oncologic emergencies See Emergencies Ondansetron, 148, 151, 152t Oocytes, cryopreservation, 254t, 255t Opioids antagonists, 157t constipation, 154–155 dyspnea, 164 pain management, 145–148, 145f, 145t Opisthorchis viverrini, 38, 38t Opium, deodorized tincture of, 159t Oral candidiasis, 102, 180, 181 Oral contraceptives, 20t, 27t, 28, 70, 343 Oral cryotherapy, 180, 181 Oral thrush, 174, 176, 181, 221t, 370t Ortho-toluidine, 44t Osmotic enemas, 156t Osmotic laxatives, 156t Osteoarthropathy, hypertrophic, 96, 105, 287t Osteolytic bone metastases, 138 Osteonecrosis, HCT and, 271 Osteopenia, 271 Osteoporosis, 248, 261t, 271 Osteosclerotic myeloma, 364t See also POEMS syndrome Ovarian cancer, 343–345, 344t, 345t See also BRCA mutations cancer history checklist, 17t genetic testing, 19, 345 hormone replacement therapy, 12 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 12 Lynch syndrome, 20t oral contraceptives, 20t, 27t, 28, 70, 343 physical activity and, 40t PLCO Cancer Screening Trial, 70, 88 presenting symptoms, 101t, 343–344, 344t screening, 70 urinary symptoms, 98 Ovarian stimulation, 255t Ovarian suppression, 254t Ovarian tissue cryopreservation, 254t Ovarian transposition, 254t Ovaries, incidental adnexal masses, 120–122, 122f, 122t Overdiagnosis, 9, 124 Overweight See also Obesity cancer risk factor, defined, 47 measurement, 48, 48f PCC’s role, 3t Oxaliplatin, 157t, 218t, 219, 253t, 300, 305, 306 Oxcarbazepine, 146t Oxycodone, 145, 145t, 146t, 148 Oxygen, dyspnea and, 164 P p53, 19, 281, 350, 351, 369, 380 Pachydermoperiostosis, 106t Packed red blood cells (PRBCs), 183, 184, 193 Paclitaxel, 157t, 196, 212, 218t, 219, 243t, 324t, 344, 346 Paget disease, 106t, 380 Pain, as presenting symptom, 95–100 Pain management, 144–148 DOME, 146, 146t musculoskeletal complications of cancer, 213 opioids, 145–148, 145f, 145t PCC’s role, 3t Painters, workplace chemicals and, 45t PALB2, 19 422 Oncology in Primar y Care Palifermin, 180, 181, 181t Palliative care, 202–208 See also Hospice care definitions, 202–204, 203f hospice care versus, 203t nausea and vomiting, 150–152 principles, 204t skill sets, 204t transitioning to hospice care, 199–200 Palmer hyperkeratosis, 106t Pamidronate, 139, 146t, 367, 367t Pancreatic cancer, 299–301, 300t causes of, 12 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 12 physical activity and, 49, 49f presenting symptoms, 101t, 299 screening and, 12 Pancreatic cysts, incidental, 118–120, 120f Panitumumab, 220t, 221, 221t, 409 Papanicolaou, George, 66 Papillary thyroid carcinoma (PTC), 389–390, 390t Pap smears See Cervical cytology Paraneoplastic parkinsonian syndromes, 111 Paraneoplastic pemphigus, 110 Paraneoplastic syndromes, 105–111 endocrinologic, 105, 107t, 108–109 hematologic, 105, 107t, 109 hypercalcemia, 105, 107t, 109 hypertrophic osteoarthropathy, 96, 105, 287t kidney cancer, 326, 327t musculoskeletal, 96 neurologic, 105–106, 108t, 110–111 neutrophilic dermatosis, 105, 107t pain, 96 renal, 109–110 skin, 105, 106t, 107t, 110 Parasites, 36, 38, 38t Parathyroid hormone-related protein, 109, 138, 287t See also Hyperparathyroidism Parathyroid recombinant human hormone, 248 Parkinson disease, 151, 155t Paroxetine, 169, 170t Passive smoking, 45t Pathologic fractures, 213, 213t Patient-controlled analgesia, 145, 181 Pazopanib, 219t, 221t, 328t PCA2, 108t PCCs See Primary care clinicians PCNSLs See Primary central nervous system lymphomas PCR See Polymerase chain reaction Pediatric cancers See Childhood cancers Pegfilgrastim, 186 Pelvic floor health, 258t Pemetrexed, 218t, 290, 292 Penicillin allergy, 136, 273t Penile cancer, 332–333 Pentachlorobenzofuran, 44t Pentachlorobiphenyl, 44t Pepto-Bismol, 128t, 159t Perception, SPIKES tool, 197–198, 207t Percocet, 145t Periodontal disease, 179, 180 Perioperative management cardiac evaluation, 194–196, 195f VTE, 193–194 Peripheral appetite stimulation, 174 Peripheral nervous system dysfunction, 212–213 Pertuzumab, 220t PET scan, staging evaluation, 127, 128–129, 128t Peutz-Jeghers syndrome, 18t, 299 Pharmacologic management cancer-associated anorexia-cachexia syndrome, 176–177, 176t constipation, 154–155, 156t, 157t dyspnea, 164 neurocognitive dysfunction, 265, 265t pain, 145–147 smoking cessation, 33t Pheochromocytomas, 392 Philadelphia chromosome positive acute lymphoblastic leukemia, 369, 371, 371f Phosphate enemas, 156t Phosphorus-32, 146t Physical activity, 47–49, 49f, 49t, 230 See also Obesity Physical dependence, 147 Physical modalities, pain management, 148 Physiology, of dyspnea, 161 Piperacillin/tazobactam, 136, 136f, 186t Plasma cell disorders, 363–368 See also Myeloma amyloidosis, 363, 364t, 366t, 367 heavy chain disease, 364t HIV and, 400 light chain amyloidosis, 367 MGUS, 111, 363, 364, 364t, 365f, 365t, 366t monoclonal immunoglobulin proteins, 364, 364f, 365, 365f monoclonal light and heavy chain deposition disease, 364t, 367 POEMS syndrome, 111, 364t, 366t precursor, 364t presenting symptoms, 366t Plasmacytomas, 364t, 365, 365t, 366t Platinum analogues, 218t, 243t PLCO See Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Pleural effusion, 132t, 162, 162t, 163–164, 196 See also Dyspnea PMF See Primary myelofibrosis PMS2, 19 Pneumocystis carinii pneumonia, 373 Pneumocystis jiroveci infection, 187, 187t, 272 Pneumonia, bronchiolitis obliterans and, 271 POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes), 111, 364t, 366t Polacrilex gum, nicotine, 33t Polycythemia vera (PV), 110, 191, 376, 377–378 Polyethylene glycol (MiraLAX), 154, 156t Polymerase chain reaction (PCR), 409 Polymyositis, 96, 213 Polyneuropathy See POEMS syndrome Polyposis, MUTYH-associated, 18t See also Familial adenomatous polyposis Pomalidomide, 218t Posaconazole, 187t Positive predictive value (PPV), 94, 95, 95t, 97, 98 Post–stem cell transplant management, 229t Posttraumatic stress disorder (PTSD), 166, 269, 361 PPV See Positive predictive value Pralatrexate, 218t Praziquantel, 38t PRBCs See Packed red blood cells Precocious puberty, 261, 261t Prednisone, 146t, 176t, 187t, 222 Pregabalin, 146t, 214, 215 Presenting symptoms, 94–102 See also Paraneoplastic syndromes; specific cancers abdominal symptoms, 97–98 alarm symptoms, 94, 96t, 97, 98 cancer list, 101t, 102 constitutional symptoms, 95 pain, 95–100 Prevention See also Chemoprevention; Screening breast cancer screening, 63–64 cancer risk factor modification and, future of, 4, 4t medical approaches, 24–29 PCC’s role, 3, 3t, 4, 4t skin cancers, 81–84 Primary care clinicians (PCCs) barriers between PCCs and specialists, 4–5, 5t roles, 2–5 care, 4, 4t clinical trials, 234 diagnosis, 3, 3t, 124–125, 129 future, 4, 4t with immigrants, 7, 8, 11, 12, 13 integrative oncology, 232 management phase, 3, 3t nutrition, 3, 51, 53 physical activity guidelines, 49, 49t presenting symptoms, 94 prevention, 3, 3t, 4, 4t screening, 3, 3t smoking cessation, 3, 34 staging, 124–125, 129 survivorship care, 3–4, 4t, 43 treatment phase, 3, 3t Primary central nervous system lymphomas (PCNSLs), 357, 384, 386, 387 Primary light chain amyloidosis, 367 Primary myelofibrosis (PMF), 378–379 Probiotics, 159t Problem focused adaptive coping, 166 Problem solving, psychosocial sequelae management, 277t, 278 Progestational agents, 223t Progesterone analogues, 174, 176, 176t Prognostication, patient communication and, 199 Prokinetic agents, 150, 151, 152t Promethazine, 152t Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, 70, 88 Prostate cancer, 316–320 back pain presentation, 96 BRCA carriers, 20t chemopreventive agents, 25t–26t, 27 erectile dysfunction, 98, 257 hematuria presentation, 98 hormonal treatment, 222 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 12 management, 317–320, 317t, 319t physical activity and, 40t presenting symptoms, 101t, 316, 316t PSA testing, 12, 87 screening, 87–89 sexual dysfunction, 257 staging and prognosis, 317, 317t survival rates, Prostatectomy, 88, 318 Prostate-specific antigen See PSA testing Proteasome inhibitors, 218t Proton pump inhibitor, 28, 38, 38t, 78, 79 PSA (prostate-specific antigen) testing, 12, 87 Pseudomonas, 135 Pseudomonas aeruginosa, 186 Psychiatric disorders, 166 Psychoeducational interventions, 167 Psychosocial interventions, 148, 167 Psychosocial problems, 166–171, 167f cancer as trauma, 166 childhood cancer survivors, 269 coping challenges, 166, 168t Psychosocial sequelae of cancer, 276–278, 277t Psychotropic medication, 169–171 See also Antidepressants PTC See Papillary thyroid carcinoma PTEN, 19 PTSD See Posttraumatic stress disorder Public awareness campaigns, skin cancer, 82 Pulmonary complications, HCT, 270–271 Pulmonary evaluation, 195–196 Pulmonary nodules, incidental, 115–116, 116f, 116t, 117f Pulmonary sequelae of cancer, 245 (c) 2015 Wolters Kluwer All Rights Reserved Index Purine analogs, 187t PV See Polycythemia vera Pyoderma gangrenosum, 107t Q Qi gong, 230, 231 Quick Reference Guide for Clinicians on Treating Tobacco Use and Dependence, 34 Quinolones, 38t, 135, 136, 186t R Radiation fibrosis syndrome (RFS), 211, 213–215 Radiation-induced trismus, 214–215 Radiation therapy, 42–43 cardiac sequelae, 243t childhood cancer survivors, 267, 268t clinical uses, 225t cranial, cognitive change and, 263 diarrhea, 157t effects, 212 endocrinopathies, 260–262 ESCC, 134 fertility issues, 252–255, 253t, 254t, 255t mucositis, 179 principles, 224–226 radiation-induced nausea and vomiting, 150 toxicity, 226t Radiofrequency thermal energy, 79 Radiopharmaceuticals, 146t, 319t Raloxifene breast cancer, 2, 20t, 24 STAR trial, 24, 25t, 27t, 223, 335 Randomized control trials, screening, 58 Randomized phase trials, 233 RANKL (receptor activator of nuclear factor-B ligand), 138, 220t, 319 RCC See Renal cell carcinoma Reactive thrombocytosis, 378t See also Essential thrombocythemia Receptor activator of nuclear factor-B ligand See RANKL Recombinant growth hormones, 177 Recombinant human parathyroid hormone, 248 Recombinant keratinocyte growth factor, 180 Recombinant TSH, 390 Recombinant urate oxidase, 358 Recombivax HB, 37t Rectal cancer, 305 See also Colorectal cancer Rectal examinations, 73 See also Colorectal cancer Red blood cell transfusions, anemia and, 184, 185f Regulatory issues, opioids, 148 Rehabilitation, 211–215 cancer complications, 211–213 interdisciplinary approach, 211 RFS, 211, 213–215 Religion, integrative oncology, 231–232 Renal cancer, 326–329 childhood, 406 familial syndromes, 326, 326t fever presentation, 95 hematuria presentation, 98 hereditary leiomyomatosis and, 18t, 326t incidence and mortality rates, 8t, 9, 9f, 13 metastatic kidney cancer treatment, 221, 328, 328t nephrectomy, 268–269 neurologic paraneoplastic syndromes, 108t paraneoplastic syndromes, 326, 327t presenting symptoms, 101t, 326 urothelial carcinoma, 322, 326 Renal malignancies, incidental, 118, 119f, 119t Renal paraneoplastic syndromes, 109–110 Respiratory suppression, opioids and, 147 Respiratory symptoms, 97 Retina, antibipolar cells of, 108t, 111 Retinoblastoma, 18t, 217, 380, 403f, 404t, 406 RET mutations, 17t, 219t, 290, 390, 391 Revised Cardiac Risk Index, 194 RFS See Radiation fibrosis syndrome Rhabdomyosarcoma, 249t, 322, 403f, 404t, 406 Risk, 7–13 See also specific cancers cancer information sources, 8, 8t, 169 genetic, 16–22, 17t, 63 hot spot regions, 8, 8t, 9, 10, 12 incidence and mortality rates, 7, 8–13, 8t, 9f, 10f Risk-based health care, 238, 238t, 239f, 240f, 241 See also Survivorship Rituximab, 108, 188, 220t, 253t, 355, 357t, 358, 359, 360, 395, 399 Rofecoxib, 28 Romidepsin, 218t Roxicodone, 145t Rubber manufacture, 45t S Saccharomyces boulardii, 159t Saforis, 180 Salmonella typhi, 38, 38t, 157t Samarium-153, 146t, 319t Sarcomas, 380–383 See also specific sarcomas defined, 409 presenting symptoms, 101t Sargramostim, 186 Saunders, Cicely, 205 SCC See Squamous cell carcinoma Schistosoma haematobium, 13, 38, 38t, 322 Schistosomiasis, 13, 38 SCLC See Small cell lung cancer Screening, 55–60 See also specific cancers burden of cancers and, 56–57, 56t colonoscopy, 20t, 39, 73–74, 304 evaluation, 57–58, 58f harms, 59 interval cytology screening programs, 67, 68 defined, 56t, 57 prostate screening, 87, 88 NLST, 90–91 observational studies and, 58–59 pancreatic cancer and, 12 PCC’s role, 3, 3t PSA testing, 12 psychological problems, 166, 167f sensitivity and, 57 sigmoidoscopy, 73, 304 specificity and, 57 SEER See Surveillance Epidemiology and End Results Selective estrogen receptor modulators (SERMs), 24, 169, 223, 335 See also Raloxifene; Tamoxifen Selective serotonin reuptake inhibitors (SSRIs), 169, 170t, 257, 259t Senna, 154, 156t Sensitivity, screening and, 57 Sentinel lymph node, 409–410 SERMs See Selective estrogen receptor modulators Serotonin norepinephrine reuptake inhibitors (SNRIs), 146t, 169, 170t Serratia, 135 Sertraline, 169, 170t Setting up, SPIKES tool, 197, 207t Sexual dysfunction, 257–259 erectile dysfunction, 31, 88, 98, 228, 257, 318 male treatment options, 259t pelvic floor health, 258t vaginal health products, 258t Sexual health strategies, 258t Shale oil extraction and refining, 45t Shortness of breath See Dyspnea (c) 2015 Wolters Kluwer All Rights Reserved 423 SIADH (syndrome of inappropriate secretion of antidiuretic hormone), 96, 105, 106, 107t, 108, 131, 132t, 261t, 287t, 291 Side effects See specific medications Sigmoidoscopy, 73, 304 Silica dust, 44t Sipuleucel-T, 221, 222, 319 Skeletal dysplasia, 261t Skeletal muscle loss, 175 Skin cancers, 348–353 See also Melanoma BCC, 348–349, 349f, 349t, 353, 353t chemoprevention, 83 key points, 81, 348 non–AIDS-defining malignancies, 400 nondermatologist’s role, 81, 84 presenting symptoms, 100, 102, 349t primary prevention, 81–83 public awareness campaigns, 82 risk factors, 81–82 SCC, 348, 349t, 350–351, 350f, 353, 353t screening, 83 secondary prevention, 83–84 sunscreen, 82–83, 83f surveillance, 353, 353t topical medicines, 24, 26t, 28, 28f Skin care, diarrhea and, 158 Skin changes See POEMS syndrome Skin paraneoplastic syndromes, 105, 106t, 107t, 110 Skin toxicities, of anticancer agents, 221t SMAD4, 19 Small cell lung cancer (SCLC) See also Lung cancer described, 291 ectopic hormone production, 105 key points, 286 neurologic paraneoplastic syndromes, 108t presenting symptoms, 97, 101t, 286–287, 287t Small molecule inhibitors, 217, 219t, 220 Smoking, 30–35 behavioral interventions, 34 drugs for cessation, 33t esophageal cancers and, 12 governmental interventions, 34 inflammation and, 39t, 40t mortality rates, 2, 30, 31f, 31t nicotine addiction and mechanisms, 31, 32f PCC counseling, 3, 34 smoking lung cancer lag, 30 societal interventions, 34 tobacco control, 30–35 Smoldering (asymptomatic) myeloma, 364t, 365, 365f, 368 SNRIs See Serotonin norepinephrine reuptake inhibitors Societal interventions, smoking cessation, 34 Soft tissue sarcomas See Bone and soft tissue sarcomas; Sarcomas Solitary plasmacytomas, 364t, 365, 365t, 366t Solo practice model, palliative care delivery, 204 Somatic mutations, 410 Somatic pain, 144 Soot, 45t Sorafenib, 190t, 219t, 221, 221t, 260, 314t, 328t, 410 Soy, 52 Specialists barriers between PCCs and specialists, 4–5, 5t predicted shortage, 4t Specificity, screening and, 57 Sperm banks, 252, 253, 254t, 255t cryopreservation, 254t testicular sperm extraction, 254t, 255t SPIKES tool, 197–199, 207t Spinal cord compression, 96 See also Epidural spinal cord compression 424 Oncology in Primar y Care Spinal cord dysfunction, 212 Spinal cord lesions, 133f Spinal Instability Neoplastic Score, 214t Spine Oncology Study Group, 213 Spirituality, integrative oncology, 231–232 Splenectomy, 269 Spurious lab abnormalities, 370 Squamous cell carcinoma (SCC), 348, 349t, 350–351, 350f, 353, 353t SSRIs See Selective serotonin reuptake inhibitors Stage-specific coping challenges, 168t Staging, 124–129 See also specific cancers Ann Arbor staging system, 357t, 359, 359t annotation, 126t classification system, 125–126 evaluation, 126–129, 128t resources for, 126 Staphylococcus aureus, 135, 136, 186 Staphylococcus epidermidis, 135 Staphylococcus species, 272 STAR trial (Study of Tamoxifen and Raloxifene), 24, 25t, 27t, 223, 335 Steel and iron founding, 45t Stem cells, 410 Stem cell transplantation, 227–229, 227t, 229t Stimulant laxatives, 156t Stomach cancer See also Gastric cancer; Esophageal cancers Helicobacter pylori, 2, 3t, 9, 12 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 11–12 Strategize, SPIKES tool, 198, 207t Streptococci, 135 Streptococcus bovis, 38, 38t Streptozotocin, 218t Stress distress thermometer, 166, 167f, 277t integrative oncology, 231 posttraumatic stress disorder, 166, 269, 361 Strontium-89, 146t, 319t Study of Tamoxifen and Raloxifene See STAR trial Subsequent malignant neoplasms, HCT, 272 Sulfuric acid, 45t Sulfur mustard, 44t Sulindac, 26t, 27t, 28 Summarize, SPIKES tool, 198, 207t Sunitinib, 187t, 190t, 191, 219t, 221, 243t, 260, 328t, 383, 410 Sunscreen, 82–83, 83f Superior vena cava syndrome (SVCS), 139–140 Support groups, 278 Surgery effects, 212, 267–269 See also Childhood cancers; Rehabilitation; specific cancers Surveillance See specific cancers Surveillance Epidemiology and End Results (SEER), Survivorship, 238–241 ALL, 269 bone health, 248–251, 249t, 250t, 251t breast cancer, 340, 340t From Cancer Patient to Cancer Survivor: Lost in Transition, childhood cancer, 267–269 CRC, 305, 305t esophageal cancer, 296, 297t gastric cancer, 294, 297t HCT, 270–274, 274t head and neck cancer, 282t increases in, 2, 4t kidney cancer, 327, 327t melanoma, 353t opioid usage, 147 psychosocial sequelae of cancer, 276–278, 277t radiation therapy, 43 research statistics, risk-based health care, 238, 238t, 239f, 240f, 241 survivor numbers, 166–167 Survivorship care described, 166–167 PCC’s role, 3–4, 4t, 43 SVCS See Superior vena cava syndrome Sweet syndrome, 107t Symptoms See Presenting symptoms Synchronous cancers, 410 T Tai chi, 230, 231 t-AML See Therapy-related acute myeloid leukemia Tamoxifen antidepressants and, 166, 169, 170t, 171t breast cancer reduction, 2, 20t, 24, 25t, 28, 63 CYP2D6 genotype and, 169 endometrial cancer, 24, 25t, 222, 223 paroxetine and, 169 side effects, 339t STAR trial, 24, 25t, 27t, 223, 335 Target Heart Rate Calculator, 49t TCAs See Tricyclic antidepressants Tea, 52 Technology-assisted interventions, 168–169 Teledermatology, 84 Telemedicine, 84 Temozolomide, 187t, 218t, 353, 386 Temsirolimus, 219t, 221, 328t, 409 Teniposide, 218t Teriparatide, 248 Testicular cancer, 330–332, 332t erectile dysfunction, 257 HIV and, 400 neurologic paraneoplastic syndromes, 108t nonseminomas, 330, 331, 331t, 332t presenting symptoms, 101t, 330 survival rates, Testicular shielding, 254t Testicular sperm extraction, 254t, 255t Testicular tissue cryopreservation, 254t Tetracycline antidepressants, 169, 177 Thalidomide, 155t, 177, 190t, 218t, 219, 366, 367t TheraBite Jaw Motion Rehabilitation System, 214, 214f Therapy-related acute myeloid leukemia (t-AML), 268t, 272 See also Acute myeloid leukemia Thioguanine, 218t Thiotepa, 218t, 324t Thoracoscopy, video-assisted, 140, 163, 287, 291 Thrombocythemia See Essential thrombocythemia Thrombocytopenia, 187–188, 187t, 188t Thrombocytosis, 106, 107t, 109, 287t, 358, 376, 377, 378, 378t Thromboembolism complications, 212 Thrombotic microangiopathy, 187t, 189, 191 Thrush, oral, 174, 176, 181, 221t, 370t Thymic carcinoma, 292 Thymoma described, 286, 292 hematologic paraneoplastic syndromes, 109 neurologic paraneoplastic syndromes, 108t staging, 292t SVCS and, 139 Thyroid abnormalities, HCT, 271 Thyroid cancers anaplastic, 389, 391 follicular thyroid carcinoma, 389, 390 Hürthle cell carcinomas, 389, 390 key points, 389 medullary, 219t, 390–391, 391t neurologic paraneoplastic syndromes, 108t PTC, 389–390, 390t survival rates, Thyroid dysfunction, 260, 261f, 261t Thyroid-stimulating hormone (TSH), 390 Thyrotropin deficiency, 261 Tizanidine, 146t TNM staging variables, 125–126 Tobacco control See Smoking Tolerance, 147 Topical medicines, 24, 26t, 28, 28f See also Skin cancers Topiramate, 146t Topoisomerase interacting agents, 218t Topotecan, 157t, 218t, 219, 291 Toremifene, 223, 223t Tositumomab, 220, 220t, 360 Toxicities See specific toxicities Tramadol, 145t Transcription, 410 Transcription factor, 410 Transcutaneous nerve stimulation, 148 Transdermal fentanyl, 146, 146t, 155 Transdermal nicotine patch, 33t Transfusions anemia and, 184, 185f childhood cancer survivors, 269 therapy, 183 transfusion-associated graft-versus-host disease, 184 Translation, 410 Trastuzumab, 219, 220, 220t, 243t, 337t, 338, 339, 339t, 340, 409 Trauma, cancer as, 166 Trazodone, 169, 171t Treatment See also Pharmacologic management; specific cancers improvements in, interventions, psychological issues, 167–169 PCC’s role, 3, 3t resources for, 126 Trematode liver fluke, 38t Tricyclic antidepressants (TCAs), 32, 33t, 146t, 155t, 169, 170t Tripe palms, 100, 106t Trismus, radiation-induced, 214–215 Trisomy, 410 TSH See Thyroid-stimulating hormone Tumors See also specific tumors childhood, 405–406 HCT, 272 Tumor lysis syndrome, 131, 132t, 357, 358t, 370, 371, 372, 372t, 404, 405 Tumor necrosis factor, 138, 175, 177 Tylenol, 145t Tyrosine kinase, 410 Tyrosine kinase inhibitors, 220, 243t, 260, 261t, 376 See also Dasatinib; Imatinib; Nilotinib; Sorafenib; Sunitinib U Ultrasound, staging evaluation, 127–129, 128t See also Incidentally found cancers Underdiagnosis, 124 Underweight, 48t See also Anorexia-cachexia syndrome Unintentional weight loss, 174 United States, incidence and mortality rates, 7, 8–13, 8t, 9f, 10f Unknown primary site, cancers of, 394–396, 395t, 396t Upper gastrointestinal symptoms, 97–98 Urethral cancer, 330, 332 Urinary symptoms, 98 Urothelial carcinoma, 322, 326 U.S Preventive Services Task Force (USPSTF), 26t, 27t, 63, 81, 83, 89, 303, 304 (c) 2015 Wolters Kluwer All Rights Reserved Index Uterine cancer, 344t, 345–346, 345t See also Endometrial cancer cancer history checklist, 17t hormone replacement therapy, 12 incidence and mortality rates, 8t, 9, 9f, 10, 10f, 12 V Vaccinations, 2, 3t, 4t HCT, 273–274, 273t HPV, 12, 37t, 38, 66, 67t, 68–69 infectious agents and cancer, 37t, 38t nicotine, 33–34 sipuleucel-T, 221, 222, 319 Vaginal bleeding, 70, 99 Vaginal cancers, 36, 69–70 Vaginal health products, 258t Valacyclovir, 180, 181t, 187t Valvular heart disease, 245 Vancomycin, 136, 137, 186, 186t Vandetanib, 219t Varenicline See Chantix Vascular endothelial growth factor (VEGF), 138, 193, 231, 328t, 386, 410 Vasculitis, 96, 110, 374 Vegetables, fruits and, 51 VEGF See Vascular endothelial growth factor Venlafaxine, 146t, 169, 170t, 340 Venous thromboembolism (VTE), 189–191, 193–194 Vicodin, 145t Video-assisted thoracoscopy, 140, 163, 287, 291 Vinblastine, 218t, 253t, 324t, 360, 400 Vinca alkaloids, 155t, 219, 261t Vincristine, 155t, 218t, 219, 242, 253t, 360, 373, 395, 399 Vinorelbine, 218t Vinyl chloride, 44t Viral infections, HCT, 272–273 Viruses, 37t See also Hepatitis B; HIV; Human papillomavirus; specific viruses Visceral pain, 144 Visual impairments, HCT, 272 Voltage-gated calcium channel, 108t, 111 Vomiting, 150–152, 152t chemotherapy-induced nausea and vomiting, 231 opioid usage, 148 Vomiting center, 151 von Hippel-Lindau, 18t, 326t Voriconazole, 187t Vorinostat, 218t, 409 VTE See Venous thromboembolism Vulvar cancers, 36, 68, 69–70 (c) 2015 Wolters Kluwer All Rights Reserved 425 W Weight loss, 95 See also Anorexia-cachexia syndrome Wellbutrin See Bupropion Whole grains, 51–52 WHO pain ladder, 144, 145, 145f WILDA approach (Words, Intensity, Location, Duration, Aggravating/Alleviating factors), 144–145 Window of opportunity studies, 232–233 Wood dust, 45t Words See WILDA approach Workplace chemicals, 42, 43–45, 44t–45t Workup See specific cancers X Xerostomia, 180, 226t, 229t, 231, 283 Y Yoga, 230, 231 Z Zen Buddhism meditation techniques, 168 Zoledronic acid, 139, 146t, 319, 319t, 367, 367t Zyban See Bupropion Zydone, 145t ... Clin Oncol 20 05 ;23 :26 29 26 36 32 Pinder MC, Duan Z, Goodwin JS, et al Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer J Clin Oncol 20 07 ;25 :3808–3815... Improving Care and Quality of Life Washington, DC: National Academies Press; 20 03 Oeffinger KC, McCabe MS Models for delivering survivorship care J Clin Oncol 20 06 ;24 ( 32) :5117–5 124 (c) 20 15 Wolters... DXA baseline and as clinically indicated Pulmonary function test baseline and as clinically indicated Annual blood work: CBC, BUN, creatinine, fasting lipids, TSH, urinalysis Counseling as needed