Jahodové blues

Jana Kučerová

Onkologie. 2015:9(2)  

Karcinom prsu - slovo úvodem

Tomáš Svoboda

Onkologie. 2015:9(2):57  

Options and consequences of genetic testing in patients with high risk of breast and ovarian cancer due to

Ivan Šubrt, Jiří Presl, Tomáš Svoboda

Onkologie. 2015:9(2):58-63  

BRCA1 and BRCA2 mutations Although incidence of BRCA positivity in population seems to be long-term stable this finding is especialy in women discussed more and more often. The reason is extremely high lifelong risk of breast and ovarian cancer development. Affected patients have to be precisely followed by oncologists and gynecologists and on the contrary it is necesary to provide genetic testing for BRCA mutation positivity if some posibility of hereditary conditioned tumor exists. However, it is important not to reduce this problem on the question of prophylactic bilateral mastectomy only. Even in this situation we can use some modified...

Core cut biopsy in diagnosis of breast lesions: advantages and pitfalls

Alena Skálová, Alena Skálová, jr., Jindřich Fínek

Onkologie. 2015:9(2):64-66  

Core cut biopsies are now widely used for non-operative diagnosis of breast lesions. In contrast to fine needle aspiration cytology, core cut biopsy provides sufficient amount of tissue for reliable diagnosis. Histologic structure, classification of carcinoma, grading and markers of predictive oncology can be assesed. The review article deals with some commonly encountered diagnostic problems.

Change of the view of repeated surgeries in breast cancer aiming at positive surgical margins

Ilona Zedníková, Monika Černá, Andrea Ňaršanská, Tomáš Svoboda, Ondřej Hes

Onkologie. 2015:9(2):67-69  

Introduction: Most carcinomas can be removed by performing breast conserving surgery – partial resection. This operation supplemented with adjuvant therapy is as oncologically efficient as mastectomy, the number of local recurrences is similar, too. Due to acceptable cosmetic effects, there is an effort to remove the tumor only with a small amount of circumjacent gland. Material and methodology: The aim of our report was to find out the influence of positive resection margins on local recurrence of breast cancer and overall survival. In the group, there were 183 patients breast conserving surgery had been performed for carcinoma in...

Question marks in neoadjuvant systemic treatment of breast cancer

Renata Neumanová

Onkologie. 2015:9(2):70-73  

Being both morphologically and genetically very heterogenous disease, breast cancer requires strictly individulal treatment approach. One of possible treatment strategies is to start the therapy with neoadjuvant systemic treatment. This was originally designated only for locally advanced disease, in which primary surgery was excluded, it has been possible to use it also in high risk patients with early stage disease recently. The goal of this treatment was to turn inoperable tumors into operable or convert radical operation into breast saving surgery, to eliminate micrometastases and also to achieve longer survival in women with more advanced...

Eribulin mesylate (Halaven®): a new hope for pretreated patients with advanced and metastatic breast cancer

Jitka Abrahámová, Zuzana Donátová

Onkologie. 2015:9(2):74-80  

Eribulin is a non-taxane microtubule dynamics inhibitor. It is a synthetic analogue of halichondrin B. By acting on microtubules, eribulin has an antimitotic effect in the G2/M phase of cell cycle, disrupting the mitotic spindle and inducing apoptosis. It specifically inhibits the growth phase of microtubules and sequesters tubulin in non-productive aggregates. Recently, the results of preclinical research of “non-mitotic” mechanism of action of eribulin (particularly the effect on tumour vascularization, epithelial-mesenchymal transition, invasiveness, and migration ability) have been published.

Liver metastases, the role of interventional radiology

Vlastimil Válek, Tomáš Andrašina, Igor Kiss, Lenka Ostřížková

Onkologie. 2015:9(2):82-84  

Unresectable colorectal liver metastases have a 1- and 2-year survival of 55 % and 33 % with current systemic therapies. Currently image- -guided liver-directed therapy like trans-arterial chemoembolization (TACE), hepatic arterial infusion (HAI) and termoablation (RFA) has a growing role in the therapy of patients with liver metastases. Endovascular and percutaneous hepatic-directed therapy offers the dual benefit of true local neoplastic control and reduction of sideeffects. The development of new embolizing agents, such as DC beads (DEB) loaded with doxorubicin and irinotecan, permits better standardization and definition of protocols, making...

Prophylaxis and treatment of infections in patients with solid tumours treated with targeted therapies

Tomáš Büchler

Onkologie. 2015:9(2):85-87  

Targeted therapy is indicated for many types of solid malignancies, either in monotherapy or in combination with chemotherapy, hormonal therapy, or radiotherapy. The incorporation of targeted drugs into clinical algorithms has improved the prognosis of many cancers but also increased the risk of some less common adverse effects. Targeted therapy may increase haematological toxicity of chemotherapy and cause disruption of protective barriers or directly inhibit the function of immune cells. Routine prophylactic anti-infective therapy in patients treated with current targeted therapies for solid tumors is not recommended. Some targeted drugs,...

Targeted therapy based treatment of gastrointestinal stromal tumors

Beatrix Bencsiková

Onkologie. 2015:9(2):88-92  

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of gastrointestinal tract. Oncogenic activating mutations in the receptor tyrosine kinases, KIT (75–80 %) and platelet- derived growth factor receptor alpha (PDGFRA, 10 %) play a crucial role in the molecular pathogenesis of GIST. Complete surgical resection is the standard treatment for localized GISTs, however, recurrence is observed in approximately a third of patients 2 years following resection. Better treatment strategies and targeted therapies have improved survival rates for patients with GIST significantly. Imatinib, the receptor tyrosine kinase inhibitor,...

Position of sublingual fentanyl (Lunaldin®) in oncological clinical practice

Luboš Holubec, Ondřej Fiala, Vít Martin Matějka, Jindřich Fínek

Onkologie. 2015:9(2):93-95  

The present article accompanied by a clinical case report highlights the pitfalls frequently encountered in the common practice of a clinical oncologist. In the introduction, the management of tumour pain is characterized with a focus on errors that can occur in everyday practice. Next, the algorithm of diagnosing and treating breakthrough pain is analyzed in detail. The present case report emphasizes the importance of a good-quality combination therapy for chronic and breakthrough pain that can substantially contribute to improving the quality of life of a patient with multiple generalized tumour disease.

The Meaning of Illness, Dying and Death for the Life of Contemporary Roma People: Perspective of Social Anthropology

Irena Kašparová

Onkologie. 2015:9(2):96-98  

This paper aims to describe the ways Roma people deal with illness and death from the perspective of social anthropology. Social science defines illness primarily as an opposite to the state of health. As such, it sees it to large extend as a subjective and relative phenomenon, seriously determined by ones native culture. To illustrate the context, the author uses Explanatory model of Arthur Kleinman (1980) and sets it against the primary data, observed during the interaction between the Roma and the majority medical staff in the current Czech Republic. Paper does not offer practical solutions. Rather, it points to differences and similarities...