Oncology

Stop the Distressing Nausea and Vomiting of Chemo or Surgery

Nausea and vomiting can be clinically significant and severely debilitating side effects of cytotoxic chemotherapy, radiation therapy, and certain types of surgery. These symptoms can represent a major therapeutic challenge and, if inadequately controlled by antiemetic treatment, will limit a patient’s ability or desire to eat and drink, significantly reduce quality of life, threaten the success of therapy and result in increased mortality, morbidity and also healthcare costs.

Modern Medicine – Issue 6 2022

Testicular Cancer: Key issues in diagnosis, treatment and follow up

Testicular cancer is the most commonly diagnosed malignancy in men aged under 40 years. Men presenting with a testicular lump and a solid intratesticular lesion on ultrasound need an urgent urology referral as most types of testicular cancer are rapidly progressing. Eliciting red flags for metastatic disease and discussing fertility are key issues in the early diagnostic process. Testicular cancer survivors should be monitored for relapse, cardiovascular disease, secondary malignancy and hypogonadism.

Modern Medicine – Issue 4 2022

Keratinocyte Skin Cancers: Diagnosis and current management

Keratinocyte cancers, formerly known as nonmelanoma skin cancers, are an important cause of morbidity and mortality in South Africa, which is second only after Australia for their prevalence. In 2019, Cancer Council Australia published updated guidelines on diagnosis and management of keratinocyte cancers. This summary for GPs incorporates the latest update.

Modern Medicine – Issue 3 2022

Neuroendocrine Tumours on the Rise, Eight-year Study Assesses GEP-NET Management Trends

An eight-year observational, multi-centre, registry study was undertaken to assess the incidence and regional trends in diagnosis, clinical management and outcome assessments of patients with gastroenteropancreatic neuroendocrine tumours (GEP-NET) in the Asia-Pacific region, the Middle East, Turkey and South Africa. The pancreas was the most commonly reported primary tumour site, with abdominal pain being the most commonly reported symptom. Surgery was the mostcommon initial treatment, followed by treatment with somatostatin analogues. This analysis highlighted the need for improvements in clinical practice to ensure better evaluation and treatment management.

Modern Medicine – Issue 2 2022

Early Diagnosis of Pituitary Adenoma Pays off

Acromegaly is a rare disease, caused largely by a growth hormone (GH ) pituitary adenoma. Incidence is higher than previously thought. Due to increased morbidity and mortality if not appropriately treated, early diagnosis efforts are essential. Treatment is multifactorial and personalised therapy is advised.

Modern Medicine – Issue 1 2022

Gastroenteropancreatic Neuroendocrine Neoplasms ESMO Clinical Practice Guideline summary

Neuroendocrine neoplasms (NEN s) arise from the diffuse neuroendocrine cell system and may occur at many different disease sites. Most frequently, these neoplasms occur in the digestive system, followed by the lung. The term NEN encompasses well-differentiated neuroendocrine tumours (NE Ts) and poorly differentiated neuroendocrine carcinomas (NECs). NECs represent only 10%–20% of all NEN s. The main focus of these guidelines is on sporadic small intestinal (SI)- NENs and pancreatic NENs (Pan-NENs) since these are the most prevalent NEN s at advanced disease stages. This is a shortened version of the original article.

Modern Medicine – Issue 5 2021

Chromogranin A, for Prostate Cancer Tracking

The lifetime risk for prostate cancer in men in South Africa is 1 in 19, according to the 2014 National Cancer Registry. Prostate cancer is the most common male cancer globally and locally, and is showing significant increases. A subset of advanced prostate cancer tumours are non-androgen axis signalling dependent, and harbour neuroendocrine features (including small-cell or large-cell subtypes) and are termed treatment-related neuroendocrine prostate cancer (tNEPC). Chromogranin A, due to its primary expression throughout the neuroendocrine system, is a widely accepted biomarker for the assessment of neuroendocrine tumours.

Modern Medicine – Issue 5 2020