Description

In this issue of Focus on Cancer Medicine we present several articles and
case histories in patients undergoing treatment for cancer. As we become
more successful in long term cure of patients with malignant disease, we
also encounter more and more long term consequences of the therapies we give.
We have in the past usually thought of long term consequences in patients who
are survivors and free of disease and two articles in the issue address this, namely
radiation induced verbetral fractures following radiotherapy and an unusual site
for venous thrombosis related to tamoxifen. However, in patients with
metastatic disease we are seeing long term survivors with the use of newer
biological agents, and we report how this can change the patterns of relapse that
we see. For example in Human epidermal growth factor receptor 2 (HER-2)
positive disease we are aware of the relatively high risk of CMS relapse with up
to 50% of patients with metastatic HER-2 positive disease experiencing cerebral
metastases in some reported series, but here we present a patient with an unusual
lymph node relapse leading to lower limb lymphoedema whilst receiving
trastuzumab, for breast cancer.

Finally we revisit themes from earlier issues with a focus in supportive care
with a very useful update and audit for scalp cooling in patients receiving
chemotherapy for breast cancer in the modern era, and also a new role for the
antidepressant mirtazapine in controlling multiple symptoms in patients with
advanced cancer.