CA: A Cancer Journal for Clinicians最新文献

Adolescent and young adult (AYA) cancer survivors represent a vulnerable population in cancer care and survivorship. AYA survivors are a heterogeneous group that includes people between the ages of 15 and 39 years who were treated for cancer during their childhood or AYA years, at which time they had variable agency and may have received cancer care in pediatric or adult settings. AYA survivors experience one or multiple health care transitions, moving from active oncology to posttreatment survivorship and/or from pediatric to adult care. Clinician communication that centers the needs and preferences of the AYA and their family (parent, partner, other support person) is a therapeutic tool that can support AYAs in these health care transitions and promote AYA engagement in their care. In this article, the authors review clinician communication practices through the lens of AYAs' and families' lived experiences with a focus on the initial diagnosis and treatment phase, completion of treatment, and throughout posttreatment survivorship care. Specific communication topics relevant to survivorship encompass managing uncertainty and fear of cancer recurrence, discussing treatment-related future health risks, and supporting self-management and engagement in care. Best practices for clinician communication include maintaining openness, compassion, and flexibility to re-assess and adapt communication styles as an AYA cancer survivors' needs, concerns, and preferences change over time.

Prostate cancer is the most common cancer among men in the United States, and the incidence of advanced disease is increasing rapidly. This article provides an overview of prostate cancer occurrence using population-based incidence and mortality data from the National Cancer Institute and the Centers for Disease Control and Prevention. Prostate cancer incidence trends have reversed from a decline of 6.4% per year during 2007 through 2014 to an increase of 3.0% annually during 2014 through 2021. The increasing trend is confined to distant-stage disease in men younger than 55 years and to regional/distant-stage disease in men aged 55–69 years but includes early stage disease in men aged 70 years and older. Over the past decade of data, distant-stage disease has increased by 2.6% annually in men younger than 55 years, 6.0% annually in men aged 55–69 years, and 6.2% annually in men aged 70 years and older. American Indian/Alaska Native, Asian American/Pacific Islander, and Hispanic men are less likely than Black and White men to be diagnosed with localized disease (64%–67% vs. 71%–72%). Compared with White men, American Indian/Alaska Native men have 12% higher prostate cancer mortality despite 13% lower incidence, whereas Black men have double the prostate cancer mortality, with 67% higher incidence. In summary, continued increases in the diagnosis of advanced prostate cancer and persistent racial disparities underscore the need for redoubled efforts to optimize early detection while limiting overdiagnosis and to understand and address barriers to equitable outcomes.

Adolescents and young adults with a cancer diagnosis face unique challenges during treatment and into survivorship related to fertility and family building. This review provides an updated overview of the impact of cancer and its associated treatments, including novel treatments in male and female fertility. An overview of fertility preservation and family building options, including experimental options, is also provided.

The discovery of activating mutations in the epidermal growth factor receptor (EGFR) gene has revolutionized the management of lung cancer, enabling the development of targeted tyrosine kinase inhibitors (TKIs). These therapies offer improved survival and reduced side effects compared with conventional treatments. Recent advancements have significantly reshaped the treatment paradigm for EGFR-mutant non-small cell lung cancer. TKIs are now incorporated into the management of early stage and locally advanced disease, and phase 3 trials have explored combination strategies in metastatic settings. Although these intensified approaches improve progression-free survival, they come with increased toxicity and higher costs, underscoring the need for precise patient selection to maximize benefit. Emerging data on biomarkers, such as co-mutations and circulating tumor DNA, show promise for refining treatment decisions. In addition, significant progress in understanding resistance mechanisms to EGFR TKIs has broadened therapeutic options. This review provides a comprehensive overview of the current landscape of EGFR-mutant nonsmall cell lung cancer, highlighting recent breakthroughs and discussing strategies to optimize treatment based on the latest evidence.