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1.
Cancer ; 123(13): 2404-2412, 2017 Jul 01.
Article in English | MEDLINE | ID: mdl-28464289

ABSTRACT

Cervical cancer is the fourth most common malignancy diagnosed in women worldwide. Nearly all cases of cervical cancer result from infection with the human papillomavirus, and the prevention of cervical cancer includes screening and vaccination. Primary treatment options for patients with cervical cancer may include surgery or a concurrent chemoradiotherapy regimen consisting of cisplatin-based chemotherapy with external beam radiotherapy and brachytherapy. Cervical cancer causes more than one quarter of a million deaths per year as a result of grossly deficient treatments in many developing countries. This warrants a concerted global effort to counter the shocking loss of life and suffering that largely goes unreported. This article provides a review of the biology, prevention, and treatment of cervical cancer, and discusses the global cervical cancer crisis and efforts to improve the prevention and treatment of the disease in underdeveloped countries. Cancer 2017;123:2404-12. © 2017 American Cancer Society.


Subject(s)
Antineoplastic Agents/therapeutic use , Brachytherapy , Carcinoma, Squamous Cell/therapy , Cisplatin/therapeutic use , Hysterectomy , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/therapeutic use , Uterine Cervical Neoplasms/therapy , Adenocarcinoma, Clear Cell/pathology , Adenocarcinoma, Clear Cell/therapy , Carcinoma, Adenosquamous/pathology , Carcinoma, Adenosquamous/therapy , Carcinoma, Neuroendocrine/pathology , Carcinoma, Neuroendocrine/therapy , Carcinoma, Small Cell/pathology , Carcinoma, Small Cell/therapy , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/prevention & control , Carcinoma, Squamous Cell/virology , Chemoradiotherapy, Adjuvant , Early Detection of Cancer , Early Medical Intervention , Female , Fertility Preservation , Global Health , Humans , Neoplasms, Cystic, Mucinous, and Serous/pathology , Neoplasms, Cystic, Mucinous, and Serous/therapy , Radiotherapy, Adjuvant , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/virology
2.
Int J Radiat Oncol Biol Phys ; 89(3): 476-80, 2014 Jul 01.
Article in English | MEDLINE | ID: mdl-24929157

ABSTRACT

The international growth of cancer and lack of available treatment is en route to become a global crisis. With >60% of cancer patients needing radiation therapy at some point during their treatment course, the lack of available facilities and treatment programs worldwide is extremely problematic. The number of deaths from treatable cancers is projected to increase to 11.5 million deaths in 2030 because the international population is aging and growing. In this review, we present how best to answer the need for radiation therapy facilities from a technical standpoint. Specifically, we examine whether cobalt teletherapy machines or megavoltage linear accelerator machines are best equipped to handle the multitudes in need of radiation therapy treatment in the developing world.


Subject(s)
Cobalt Radioisotopes/therapeutic use , Developing Countries , Neoplasms/radiotherapy , Particle Accelerators , Cancer Care Facilities , Developing Countries/statistics & numerical data , Equipment Reuse/standards , Equipment Reuse/statistics & numerical data , Forecasting , Health Services Accessibility , Health Services Needs and Demand , Humans , Particle Accelerators/standards , Particle Accelerators/supply & distribution , Quality Improvement , Radiotherapy/instrumentation
4.
Int J Radiat Oncol Biol Phys ; 89(3): 462-7, 2014 Jul 01.
Article in English | MEDLINE | ID: mdl-24929155

ABSTRACT

West Africa has one of the highest incidence rates of carcinoma of the cervix in the world. The vast majority of women do not have access to screening or disease treatment, leading to presentation at advanced stages and to high mortality rates. Compounding this problem is the lack of radiation treatment facilities in Senegal and many other parts of the African continent. Senegal, a country of 13 million people, had a single (60)Co teletherapy unit before our involvement and no brachytherapy capabilities. Radiating Hope, a nonprofit organization whose mission is to provide radiation therapy equipment to countries in the developing world, provided a high-dose-rate afterloading unit to the cancer center for curative cervical cancer treatment. Here we describe the implementation of high-dose-rate brachytherapy in Senegal requiring a nonstandard fractionation schedule and a novel treatment planning approach as a possible blueprint to providing this technology to other developing countries.


Subject(s)
Brachytherapy/methods , Developing Countries , Dose Fractionation, Radiation , Health Plan Implementation , Uterine Cervical Neoplasms/radiotherapy , Brachytherapy/instrumentation , Cancer Care Facilities/statistics & numerical data , Female , Humans , Organizations, Nonprofit , Program Development , Radiography , Radiotherapy Planning, Computer-Assisted , Senegal , Uterine Cervical Neoplasms/diagnostic imaging , Uterine Cervical Neoplasms/drug therapy , Workforce
5.
Ear Nose Throat J ; 92(6): E38, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23780603

ABSTRACT

A 52-year old man was referred to our service for evaluation after being diagnosed with oropharyngeal squamous cell carcinoma. Contrast-enhanced computed tomography (CT) revealed a mass in the left tonsillar pillar, as well as submental lymphadenopathy. The extent of tumor infiltration was assessed by fluoro-2-deoxyglucose positron emission tomography scans, which showed increased uptake in the tumor bed and a suspicious-looking lymph node near the right hilum. No other signs or symptoms of distant metastasis were evident at that time, and the patient was treated with induction chemotherapy followed by chemoradiation. Several weeks after treatment completion, the patient returned, complaining of right medial foot edema. CT of the right lower extremity revealed multiple high-attenuation masses in the soft tissues of the right leg and foot, including a mass in the medial plantar region of the foot. Approximately 15 to 20% of patients with oropharyngeal squamous cell carcinoma develop distant metastasis throughout the course of the disease. Soft-tissue metastases from oropharyngeal cancers are rare, however, particularly when they present in the absence of widespread metastasis. A review of the current head and neck tumor literature describes soft-tissue metastases in less than 10% of patients with known distant metastases. Metastasis to distal regions such as the lower extremities has rarely been observed but should be included in the differential diagnosis for patients presenting with lower-extremity pain or edema.


Subject(s)
Carcinoma, Squamous Cell/secondary , Foot , Leg , Oropharyngeal Neoplasms/pathology , Soft Tissue Neoplasms/secondary , Carcinoma, Squamous Cell/therapy , Chemoradiotherapy , Humans , Male , Middle Aged , Oropharyngeal Neoplasms/therapy , Positron-Emission Tomography , Tomography, X-Ray Computed
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