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Recent Results In Cancer Research. Fortschritte Der Krebsforschung. Progres Dans Les Recherches Sur Le Cancer[JOURNAL]
Recent Results In Cancer Research. Fortschritte Der Krebsforschung. Progres Dans Les Recherches Sur Le Cancer[JOURNAL]
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200 papers
Introduction.
Khuntikeo N, Andrews RH, Petney TN … +1 more , Khan SA
Recent Results Cancer Res · 2023 · PMID 37660328 · Publisher ↗
Cholangiocarcinoma (CCA) is a lethal cancer arising in the bile ducts within and just outside the liver. It occurs worldwide and falls into two etiologically defined groups, one related to chronic liver fluke infection a...
Cholangiocarcinoma (CCA) is a lethal cancer arising in the bile ducts within and just outside the liver. It occurs worldwide and falls into two etiologically defined groups, one related to chronic liver fluke infection and the other not. Liver fluke-related CCA is found in continental Southeast Asia (caused by Opisthorchis viverrini with infection leading to opisthorchiasis), East Asia (Clonorchis sinensis), and Eastern Europe and Russia (Opisthorchis felineus). Both O. viverrini and C. sinensis are classified as group one carcinogens, while recent data from O. felineus suggest the same. In Southeast Asia, an estimated 67.3 million people are at risk of O. viverrini infection and subsequently developing CCA. When the three liver fluke species are considered, an estimated 700 million people are at risk of infection and developing CCA globally. The northeast of Thailand (Isan) is the world's hot spot of liver fluke infection and CCA. Early detection, diagnosis, and surgical intervention/curative treatment of CCA are critical to increase life expectancy and quality of life of people in the region and globally. Despite concentrated recent efforts focusing on a multidisciplinary approach to understand the ecology, epidemiology, biology, public health, and social significance of infection by cancer causing liver flukes, it remains an underestimated and under-resourced public health problem. In addition, it is still believed to be a regional problem without global significance-this is not the case. This book focuses on O. viverrini as the main causative agent of CCA in Southeast Asia, but many aspects detailed in the following chapters also relate to the two other liver fluke species. Our aim is to produce a holistic framework including the basic biology of O. viverrini and its relation to the epidemiology of the disease through diagnosis to treatment, including palliative methods, pathology, and control.
Cancer in Literature: Between Phenomenology and Symbolism.
von Engelhardt D
Recent Results Cancer Res · 2021 · PMID 34019175 · Publisher ↗
Cancer has been an important theme in literature, especially since the nineteenth century. Central dimensions of the frequent literary representations and interpretations of cancer are pathophenomenology, aetiology, diag...
Cancer has been an important theme in literature, especially since the nineteenth century. Central dimensions of the frequent literary representations and interpretations of cancer are pathophenomenology, aetiology, diagnosis and therapy, image of the physician, subjectivity of the patient, medical institutions, social reactions and symbolism. The relationship between literature and medicine is a complex and reciprocal one marked by ontological differences. The long tradition of 'medical humanities' dating from ancient to present times is essential as human and humane medicine for the benefit and dignity of the suffering, sick and dying.
Cancer and Life Beyond It: Patient Testimony as a Contribution to Subjective Evidence.
Gadebusch Bondio M, Herrmann IF
Recent Results Cancer Res · 2021 · PMID 34019174 · Publisher ↗
Patient narratives are a very valuable literary and medical resource. They transcribe the experience of illness into the life stories of the subject and the author. A serious case of cancer triggers the very individual e...
Patient narratives are a very valuable literary and medical resource. They transcribe the experience of illness into the life stories of the subject and the author. A serious case of cancer triggers the very individual experience of vulnerability, suffering, dependence, and even contingency in the no longer 'open' future. Even after overcoming cancer, life is never the same again. Writing about one's own experience of cancer is a hermeneutic feat of strength with ethical and aesthetic implications. In the age of personalized and evidence-based medicine, patient narratives offer a particular and necessary supplement to the objectifying medical perspective, since they constitute expressions of subjective evidence. This article is based on the direct experience of cancer by the co-author of the narrative. The long history of her illness is presented chronologically in her own words and has been translated from Italian to English. This is followed by an essay, published here for the first time, on "the life beyond cancer", on the patient's time without tumors and the consequences of therapies and mutilating operations. Our methodological approach is based on Havi Carel's Phenomenology of Illness. The close reading of this pathography focuses on three aspects: (1) the effect and power of words; (2) the passage from wariness to awareness; and (3) the maintenance of personal quality of life during and after cancer.
Experiencing Cancer. An Ethnographic Study on Illness and Disease.
Holmberg C
Recent Results Cancer Res · 2021 · PMID 34019173 · Publisher ↗
Cancer is seen as a 'dread disease' with a long and powerful history that remains resistant to defeat. It is a byword for suffering, pain and death. An unprecedented level of research spending and biomedical engagement o...
Cancer is seen as a 'dread disease' with a long and powerful history that remains resistant to defeat. It is a byword for suffering, pain and death. An unprecedented level of research spending and biomedical engagement offering new treatment options and hopes for a cure goes hand in hand with patient-led movements disseminating widespread public narratives of hope and survivorship. A key paradigm in these public narratives of hope and cure has been early detection of disease, with breast cancer, as the most frequent cancer among women, at the forefront of early detection campaigns. This chapter investigates the experiences behind the public face of breast cancer. It interrogates what it means to have breast cancer in the light of heroic stories of survivorship and fight using the theoretical concepts of illness-the subjective experience of feeling unwell-and disease-bodily pathologies that are identified through biomedical diagnostic technologies. With early detection becoming the primary mode of practice in breast cancer, illness has to be re-conceptualized. If a woman is to undergo treatment after a diagnosis of asymptomatic disease-without symptoms being present in her lifeworld-she has to cognitively understand the severity of the disease, and assume that she would die without treatment. The absence of bodily experiences of symptoms is irrelevant: it is the provision of information through which illness can manifest. The shock of diagnosis, as so often illustrated in cancer narratives, is therefore necessary in order to transform disease into an illness trajectory associated with biomedical treatment. The particular illness experiencehas profound and long-lasting consequences for a woman's life. Understanding the suffering associated with such disease conceptions as a necessary part of the illness experience could help us to improve health care services for those afflicted.
Routine Oncology Treatment and Its Human Deficits.
Hofheinz RD
Recent Results Cancer Res · 2021 · PMID 34019172 · Publisher ↗
Working with cancer patients is a highly demanding task. Both, caring for physical, social and spiritual needs of cancer patients as well as an overwhelming bureaucratisation, and technologisation challenge oncologists i...
Working with cancer patients is a highly demanding task. Both, caring for physical, social and spiritual needs of cancer patients as well as an overwhelming bureaucratisation, and technologisation challenge oncologists in a way that may cause mental and physical exhaustion, often-paradoxically-despite high job and specialty satisfaction. This article (i) summarises research findings with a special focus on oncologists' burnout (including factors associated with the phenomffenon), job satisfaction and physical health; (ii) describes potential consequences of burnout and distress, e.g., shortcomings in the physician-patient interaction in oncological treatment settings, financial implications on the health-care system, etc.; and (iii) reviews published data for interventions that may prevent or alleviate oncologists' burnout on an organisational and/or individual level.
Euthanasia and Assisted Suicide: Realization or Abandonment of Self-determination?
Bauer AW
Recent Results Cancer Res · 2021 · PMID 34019171 · Publisher ↗
There are undoubtedly sick people who suffer terribly, and of course this should not be. No patient with incurable cancer is to be so tortured for months or years that they want only to die and lack the means to do so. B...
There are undoubtedly sick people who suffer terribly, and of course this should not be. No patient with incurable cancer is to be so tortured for months or years that they want only to die and lack the means to do so. Being unable to die can be worse than death, one might say or think. But until we ourselves have crossed that frontier, we do not know this for certain. To die could be worse than not being able to die. One case is difficult to distinguish from the other. But we pretend we can distinguish them if we praise assisted suicide and euthanasia as solutions to a problem that we not only do not solve, but make worse. Do we need assisted suicide in the face of non-dying skills? The author's answer is no: we do not need euthanasia, neither in that nor in any other case. The logic of euthanasia itself decrees that it cannot be restricted to exceptional cases, based as it is on the idea that the patient's autonomy is to be valued more highly than their actual illness. But if autonomy were of absolute value, it could not be limited to cases of severe disease. The reasons which supporters of euthanasia cite for limiting assisted suicide to the most serious cases of illness, therefore, speak against euthanasia in general. Once the first step has been taken, the application can no longer be limited if, on the one hand, the 'autonomous' desire for death is superior to any counter-argument, and on the other hand, no state of illness is conceivable that could call into question the alleged autonomy.
Advance Directives for Medical Decisions.
Beckmann R
Recent Results Cancer Res · 2021 · PMID 34019170 · Publisher ↗
Patients can determine in advance how they want to be treated in a certain situation, and in particular, situations in which they reject treatment. The provisions to be observed for the preparation and practical implemen...
Patients can determine in advance how they want to be treated in a certain situation, and in particular, situations in which they reject treatment. The provisions to be observed for the preparation and practical implementation of a living will under German law are presented and discussed. The chapter also describes the principles according to which a decision is to be made if no living will has been drafted. Additionally, it is recommended that a trusted person should be granted power of attorney, since the future course of an illness (including cancer) cannot be predicted in every detail.
Ethical Pain and Terminal Chaperonage.
Feldmann RE, Benrath J
Recent Results Cancer Res · 2021 · PMID 34019169 · Publisher ↗
Terminal chaperonage embedded in palliative care deeply resonates with human needs and has undergone significant advances in the past decades. At the same time, it is in jeopardy due to austerity measures in healthcare....
Terminal chaperonage embedded in palliative care deeply resonates with human needs and has undergone significant advances in the past decades. At the same time, it is in jeopardy due to austerity measures in healthcare. Its comprehensive translation in philanthropic end-of-life practice necessitates reflection on underlying ethical issues. This chapter addresses ethical aspects arising in pain and terminal chaperonage and deduces important ethical imperatives in the wake of the palliative mandate. The imperatives affect the deployment of resources necessary for a humane pain and terminal chaperonage, one that is to be comprehensive and flexible in design and implementation at the same time. Furthermore, they are concerned with critical implications for dying clients emerging from the idiosyncratic properties of opioids with respect to their potential to induce mental status alterations. Given that living and dying are profoundly mental by nature, the human mind plays a fundamental role in the command of both. Based on this, this chapter also outlines the essentials of terminal thought plasticity and affect catharsis en route to a mindful, decent death. It identifies and advocates eight most fundamental affective, respectively cognitive fields of the human mind, the "Ensemble of the essential eight iridescent fields of relinquishment", whose adaptable, culturally sensitive facilitation in mental management prior to death may have to be considered the core ethical imperative in terminal chaperonage - in true congruence with philanthropic end-of-life care.
Ethical Challenges in Pediatric Oncology Care and Clinical Trials.
Benedetti DJ, Marron JM
Recent Results Cancer Res · 2021 · PMID 34019168 · Publisher ↗
The care of pediatric cancer patients is a vast departure from cancer care of adults. While the available treatment modalities-chemotherapy, radiation, and surgery-are the same, the diseases, care-delivery, and outcomes...
The care of pediatric cancer patients is a vast departure from cancer care of adults. While the available treatment modalities-chemotherapy, radiation, and surgery-are the same, the diseases, care-delivery, and outcomes differ greatly. And just as 'children are not just little adults,' pediatric bioethics occupies a distinct place within the broader field of bioethics. In this chapter, we will begin with an introduction to fundamental principles and frameworks for understanding ethical issues in pediatrics, highlighting the triadic nature of medical decision-making between a physician, the child-patient, and the child's parent as the surrogate decision-maker. We will then delve into further details of how these principles and frameworks shape the care of children with cancer, examining specific ethical challenges commonly encountered by pediatric oncologists. We will traverse this landscape by examining issues involving (a) informed consent; (b) research involving children; (c) end of life; (d) genetic and genomic testing; and (e) professionalism. We also examine ethical challenges in clinical research, in children and more broadly. While not an exhaustive exploration of the myriad ethical issues one might encounter in pediatric cancer medicine and clinical trials, this chapter provides readers with a foundation for further reading.
Liver Living Donation for Cancer Patients: Benefits, Risks, Justification.
Nadalin S, Genedy L, Königsrainer A
Recent Results Cancer Res · 2021 · PMID 34019167 · Publisher ↗
LDLT covers all standard indications for liver transplantation, and the results are similar or even better than for standard DDLT. Due to the donor shortage and long waiting time, LDLT has become a relevant option for pa...
LDLT covers all standard indications for liver transplantation, and the results are similar or even better than for standard DDLT. Due to the donor shortage and long waiting time, LDLT has become a relevant option for patients with liver tumors, provided the expected five-year survival rate is comparable to that of patients receiving a DDLT. Nowadays, LDLT offers the possibility to extend the standard morphometric selection by considering the biological parameters. In the setting of LDLT, we are not only faced with surgical morbidity in the donor, but long-term non-medical problems like psychological complications and financial burden also have to be considered. On the other hand, the benefits to the donor are mainly social and psychological. In LDLT, the donor's altruism is the fundamental ethical principle and it is based on the principles of (1) beneficence (doing good), (2) non-maleficence (avoiding harm), (3) respect for autonomy, and (4) respect for justice (promoting fairness). On top of that, the concept of double equipoise of living organ donation evaluates the relationship between the recipient's need, the donor's risk, and the recipient's outcome. It considers each donor-recipient pair as a unit, analyzing whether the specific recipient's benefit justifies the specific donor's risk in particular oncologic indications. In this light, it is essential to seek adequate informed consent focused on risk, benefits and outcome benefits of both donor and recipient supported by an independent living donor advocate. Finally, the transplant team must protect donors from donation if harm does not justify the expected benefit to the recipient.
Ethical Aspects of Regulating Oncology Products.
Guizzaro L, Drosos S, Kihlbom U … +1 more , Pignatti F
Recent Results Cancer Res · 2021 · PMID 34019166 · Publisher ↗
Medicines, including those intended for the treatment of cancer, are tightly regulated. Such regulation, historically linked to disasters due to unsafe medicines, evolved to cover all aspects of research around the quali...
Medicines, including those intended for the treatment of cancer, are tightly regulated. Such regulation, historically linked to disasters due to unsafe medicines, evolved to cover all aspects of research around the quality, safety and efficacy of candidate medicines. This chapter intends to give an introduction on what regulators do and where the ethical foundations for regulating medicines might be searched. Some specific dilemmas will be explored, such as (i) whether at all, and if so subject to which conditions, research on animals is justified; (ii) what to do when potentially useful data on a medicine were collected unethically; (iii) which additional ethical challenges are posed by the fact that regulators have to make decisions on a medicine under uncertainty; and (iv) how to account for patients' preferences (and their heterogeneity) in regulatory decision-making. An overview of emerging topics such as use of healthcare data and open science is also proposed. While not intending to cover all arguments in the complex conversation around the regulation of medicines for cancer (let alone, around the regulation of medicines in general), this chapter aims to give a basis for further reading.
Cancer, the Media and Dealing with Knowledge.
Steger F, Schochow M
Recent Results Cancer Res · 2021 · PMID 34019165 · Publisher ↗
Among the primary function of the media are conveying personal understanding and expanding the subjective knowledge of the recipient citizen. A particular challenge arising during this process is the mediation of medical...
Among the primary function of the media are conveying personal understanding and expanding the subjective knowledge of the recipient citizen. A particular challenge arising during this process is the mediation of medical knowledge. In addition to pure factual knowledge, it often involves subjective experiences, hopes and wishes. One example of this is media reports about cancer therapies. As a result of widespread media coverage since 2017, the public is under the impression that methadone is a promising treatment for cancer. This chapter analyzes the part played by the media and the ethical debate. The ethical issues that arise concern good scientific practice, patient autonomy and the media coverage of methadone. We conclude that, according to the current state of research, the promotion of methadone as a cure for cancer is ethically unacceptable. In this case the media are not fulfilling their task of imparting knowledge, because they are not communicating the current state of research or the associated ethical questions.
Harms and Benefits of Cancer Screening.
Robra BP
Recent Results Cancer Res · 2021 · PMID 34019164 · Publisher ↗
In recommending and offering screening, health services make a health claim ('it's good for you'). This article considers ethical aspects of establishing the case for cancer screening, building a service programme, monit...
In recommending and offering screening, health services make a health claim ('it's good for you'). This article considers ethical aspects of establishing the case for cancer screening, building a service programme, monitoring its operation, improving its quality and integrating it with medical progress. The value of (first) screening is derived as a function of key parameters: prevalence of the target lesion in the detectable pre-clinical phase, the validity of the test and the respective net utilities or values attributed to four health states-true positives, false positives, false negatives and true negatives. Decision makers as diverse as public regulatory agencies, medical associations, health insurance funds or individual screenees can legitimately come up with different values even when presented with the same evidence base. The main intended benefit of screening is the reduction of cause-specific mortality. All-cause mortality is not measurably affected. Overdiagnosis and false-positive tests with their sequelae are the main harms. Harms and benefits accrue to distinct individuals. Hence the health claim is an invitation to a lottery with benefits for few and harms to many, a violation of the non-maleficence principle. While a public decision maker may still propose a justified screening programme, respect for individual rights and values requires preference-sensitive, autonomy-enhancing educational materials-even at the expense of programme effectiveness. Opt-in recommendations and more 'consumer-oriented' qualitative research are needed.
The Right to Know and not to Know: Predictive Genetic Diagnosis and Non-diagnosis.
Duttge G
Recent Results Cancer Res · 2021 · PMID 34019163 · Publisher ↗
The expansion of genetic diagnostic potential in the direction of future contingencies (risks) creates temptations and compulsions for timely knowledge and responsible-sometimes radical-prevention. In the area of mamma c...
The expansion of genetic diagnostic potential in the direction of future contingencies (risks) creates temptations and compulsions for timely knowledge and responsible-sometimes radical-prevention. In the area of mamma carcinoma, the 'Angelina Jolie effect' has not only been a media topic but has had real consequences. The undisputed right to knowledge is increasingly taking on the character of a general recommendation or even norm for society as a whole, regardless of the possibly toxic consequences of discovering a predisposition. In an "enlightened knowledge society" in which health and illness increasingly "appear as products of our own actions" (Giovanni Maio), not wanting to know is difficult; thus, it is all the more significant that this concept has found widespread recognition in current law. Its legal practical implementation, however, presents several questions that have not yet been fully clarified, for example in connection with incidental medical findings or family members affected as third parties. It is also unclear how, in the age of next-generation sequencing and the standardizing digitalization of medicine and society, it will be possible to counteract the cultural bias in favour of knowledge, even outside the law.
Risk-Adjusted Prevention. Perspectives on the Governance of Entitlements to Benefits in the Case of Genetic (Breast Cancer) Risks.
Meier F, Harney A, Rhiem K … +7 more , Neusser S, Neumann A, Braun M, Wasem J, Huster S, Dabrock P, Schmutzler RK
Recent Results Cancer Res · 2021 · PMID 34019162 · Publisher ↗
This article is a revised version of our proposal for the establishment of the legal concept of risk-adjusted prevention in the German healthcare system to regulate access to risk-reduction measures for persons at high a...
This article is a revised version of our proposal for the establishment of the legal concept of risk-adjusted prevention in the German healthcare system to regulate access to risk-reduction measures for persons at high and moderate genetic cancer risk (Meier et al. Risikoadaptierte Prävention'. Governance Perspective für Leistungsansprüche bei genetischen (Brustkrebs-)Risiken, Springer, Wiesbaden, 2018). The German context specifics are summarized to enable the source text to be used for other country-specific healthcare systems. Establishing such a legal concept is relevant to all universal and free healthcare systems similar to Germany's. Disease risks can be determined with increasing precision using bioinformatics and biostatistical innovations ('big data'), due to the identification of pathogenic germ line mutations in cancer risk genes as well as non-genetic factors and their interactions. These new technologies open up opportunities to adapt therapeutic and preventive measures to the individual risk profile of complex diseases in a way that was previously unknown, enabling not only adequate treatment but in the best case, prevention. Access to risk-reduction measures for carriers of genetic risks is generally not regulated in healthcare systems that guarantee universal and equal access to healthcare benefits. In many countries, including Austria, Denmark, the UK and the US, entitlement to benefits is essentially linked to the treatment of already manifest disease. Issues around claiming benefits for prophylactic measures involve not only evaluation of clinical options (genetic diagnostics, chemoprevention, risk-reduction surgery), but the financial cost and-from a social ethics perspective-the relationship between them. Section 1 of this chapter uses the specific example of hereditary breast cancer to show why from a medical, social-legal, health-economic and socio-ethical perspective, regulated entitlement to benefits is necessary for persons at high and moderate risk of cancer. Section 2 discusses the medical needs of persons with genetic cancer risks and goes on to develop the healthy sick model which is able to integrate the problems of the different disciplines into one scheme and to establish criteria for the legal acknowledgement of persons at high and moderate (breast cancer) risks. In the German context, the social-legal categories of classical therapeutic medicine do not adequately represent preventive measures as a regular service within the healthcare system. We propose risk-adjusted prevention as a new legal concept based on the heuristic healthy sick model. This category can serve as a legal framework for social law regulation in the case of persons with genetic cancer risks. Risk-adjusted prevention can be established in principle in any healthcare system. Criteria are also developed in relation to risk collectives and allocation (Sects. 3, 4, 5).
Ethical Challenges Using Human Tumor Cell Lines in Cancer Research.
Dirks WG
Recent Results Cancer Res · 2021 · PMID 34019161 · Publisher ↗
Human and animal cell cultures are indispensable model systems for the biomedical research and pharmaceutical industry and already represent one of the most important alternatives to animal experiments. The development o...
Human and animal cell cultures are indispensable model systems for the biomedical research and pharmaceutical industry and already represent one of the most important alternatives to animal experiments. The development of mammalian cell culture started in the first half of the last century when fundamental questions of genetics were unresolved and the pioneers of cell culture did not care about individual personality rights of donors of biomaterials. However, cultivation of primary and continuous cell cultures was and still is usually associated with the use of FBS, which-almost universally applicable-is questionable in terms of extraction and quality variations measurably affecting reproducibility of results. The history of the cell line HeLa is a prime example for the development of biomedical research with its great successes in the fight against cancer and development of Polio Virus vaccinia, but also for limitations in the public and scientific applications of cell lines in the age of digitization and bioinformatics. HeLa leads from the establishment of the first human continuous cell line to initial cancer research using tumor cells, from disastrous cross-contaminations by HeLa cell cultures to legal and ethical controversy by reading out the individual genome and the commercial use that continues to this day.
HPV Vaccination in Bangladesh: Ethical Views.
Salwa M, Al-Munim TA
Recent Results Cancer Res · 2021 · PMID 34019160 · Publisher ↗
Human papillomavirus (HPV) vaccination of young adolescent girls as a part of primary prevention of cervical cancer is now a routine practice in many countries. Bangladesh, a lower-middle income country, observed a succe...
Human papillomavirus (HPV) vaccination of young adolescent girls as a part of primary prevention of cervical cancer is now a routine practice in many countries. Bangladesh, a lower-middle income country, observed a successful HPV vaccination demonstration program recently. As much as the benefits of the vaccination programs are well-recorded, the ethics of administration of it is not focused highly; rather the focus tends to be on the most efficient method to get it done. In countries like Bangladesh, vaccination-related ethical issues are often overlooked. Thus, addition of HPV vaccination to the existing immunization programs calls for logical discussion and consideration to preserve the highest ethical standard in administering this vaccine to a sensitive age group of adolescence. This chapter summarizes some ethical concerns related to the HPV vaccination implementation in Bangladesh.
One in Four Dies of Cancer. Questions About the Epidemiology of Malignant Tumours.
Weiss C
Recent Results Cancer Res · 2021 · PMID 34019159 · Publisher ↗
Cancer is the second leading cause of death globally. Malignant tumours are responsible for about 9.6 million deaths in 2018 (Ritchie H (2019) How many people in the world die from cancer? https://ourworldindata.org/how-...
Cancer is the second leading cause of death globally. Malignant tumours are responsible for about 9.6 million deaths in 2018 (Ritchie H (2019) How many people in the world die from cancer? https://ourworldindata.org/how-many-people-in-the-world-die-from-cancer ). Worldwide, about 1 in 6 deaths is due to cancer. This confronts researches with the question of their origin and doctors with treatment options. It is common sense that great efforts should be done in order to reduce the number of cancer-specific deaths. In recent years, in lots of countries a variety of cancer screening programs have been developed, investigated and improved. The basic idea of this approach seems to be quite simple: Tumours will be detected at a very early stage when patients do not yet feel clinical symptoms. Thus, using an appropriate therapy, progression of the disease can be prevented and, concerning a whole population, disease-specific mortality should be reduced. Actually, after the introduction of screening programs, an increasing number of new cancer cases can be observed associated with an apparent reduction of the case fatality rate (i.e. the proportion of deaths due to cancer). Partly, the increasing number of cancers may be explained by the fact that people have a higher life expectancy. Under this aspect, the decreased case fatality rate could be considered as a success which may be attributed to screening efforts. However, there is still insufficient evidence affirming benefits of screening programs for crucial outcomes, i.e. all-cause mortality. In this narrative review, the phenomenon that probabilities and risks are rather often interpreted in an inadmissible way will be described. Furthermore, conceptual issues and inconsistencies between evidence and opinion about screening will be explored.
'The King of Diseases': An Essay on the Special Attention Paid to Cancer Patients and How It Came About.
Eckart WU
Recent Results Cancer Res · 2021 · PMID 34019158 · Publisher ↗
The history of cancer during the twentieth century demonstrates that various factors have contributed to the perception of cancer as the 'Emperor of All Maladies', although this has never been true from an epidemiologica...
The history of cancer during the twentieth century demonstrates that various factors have contributed to the perception of cancer as the 'Emperor of All Maladies', although this has never been true from an epidemiological perspective. Depending on the geographical area, infectious diseases such as tuberculosis, malaria or cardiovascular disease still head the list of the most common illnesses. Within the group of chronic-degenerative diseases, however, cancer has outdistanced the widespread classic infectious diseases as a result of the epidemiologic transition around 1900, at least in the more developed countries. Under the Nazi dictatorship from 1933 to 1945, the perception of cancer in Germany was particularly promoted for propaganda purposes. In the atomic era, cancer began to attract strong public interest as a worthwhile object of research in radiation therapies using large-scale facilities (electron accelerators, 'electron guns'). A further upsurge of interest in cancer was then registered in the context of the debate about the pathogenic role of environmental factors. The remarkable thing is that this increased perception of cancer has not yet been significantly associated with any overarching success in cancer treatment, but it has been associated with ideologies, hopes and advances in technology.
Chapter XX Antiviral Treatment and Cancer Control.
Shih WL, Fang CT, Chen PJ
Recent Results Cancer Res · 2021 · PMID 33200371 · Publisher ↗
Hepatitis B virus (HBV), hepatitis C virus (HCV), human papilloma virus (HPV), Epstein-Barr virus (EBV), human T-cell lymphotropic virus type 1 (HTLV-1), Kaposi's sarcoma-associated herpesvirus (KSHV), and Merkel cell po...
Hepatitis B virus (HBV), hepatitis C virus (HCV), human papilloma virus (HPV), Epstein-Barr virus (EBV), human T-cell lymphotropic virus type 1 (HTLV-1), Kaposi's sarcoma-associated herpesvirus (KSHV), and Merkel cell polyomavirus (MCV) contribute to about 10-15% global burden of human cancers. Conventional chemotherapy or molecular target therapies have been used to treat virus-associated cancers. However, a more proactive approach would be the use of antiviral treatment to suppress or eliminate viral infections to prevent the occurrence of cancer in the first place. Antiviral treatments against chronic HBV and HCV infection have achieved this goal, with significant reduction in the incidence of hepatocellular carcinoma in treated patients. Antiviral treatments for EBV, KSHV, and HTLV-1 had limited success in treating refractory EBV-associated lymphoma and post-transplant lymphoproliferative disorder, KSHV-associated Kaposi's sarcoma in AIDS patients, and HTLV-1-associated acute, chronic, and smoldering subtypes of adult T-cell lymphoma, respectively. Therapeutic HPV vaccine and RNA interference-based therapies for treating HPV-associated infection or cervical cancers also showed some encouraging results. Taken together, antiviral therapies have yielded promising results in cancer prevention and treatment. More large-scale studies in a real-world setting are necessary to confirm the efficacy of antiviral therapy. Further investigation for more effective and convenient antiviral regimens warrants more attention.
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