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Abramson Cancer CenterNCI CANCERLIT® Search: Kidney (Renal Cell) Cancer - October 2002
National Cancer Institute®
Last Modified: October 1, 2002
- Induction and clonal expansion of tumor-specific cytotoxic T lymphocytes from renal cell carcinoma patients after stimulation with autologous
- Suicide gene therapy for urogenital cancer: current outcome and prospects.
- Alpha-interferon 2a and 1 3-cis-retinoic acid for the treatment of metastatic renal cell carcinoma.
- Expression of genes involved in chemoresistance, proliferation and apoptosis in clinical samples of renal cell carcinoma and correlation
- A phase II trial of oral temozolomide in patients with metastatic renal cell cancer.
- Prognostic significance of the mode of detection in renal tumours.
- Hand-assisted laparoscopic nephrectomy: complications related to the hand-port site.
- Prosthetic replacement of the inferior vena cava and the iliofemoral vein for urologically related malignancies.
- Renal masses: quantitative assessment of enhancement with dynamic MR imaging.
- Chromosome 14q LOH in localized clear cell renal cell carcinoma.
- The association of oral contraception with kidney cancer, colon cancer, gallbladder cancer (including extrahepatic bile duct cancer) and
- [the oral use of a progestational hormone (Provera 100) as an adjuvant in therapy of adenocarcinoma of the kidney. Preliminary report]
- [A "small" kidney tumor]
- [Ultrasonic methods in diagnosing renal growths]
- [Liver resection in locally-spread and metastatic kidney cancer]
- Partial nephrectomy: the rationale for expanding the indications.
- The possible role of postoperative azotemia in enhanced survival of patients with metastatic renal cancer after cytoreductive nephrectomy.
- Disease-associated bias in T helper type 1 (Th1)/Th2 CD4(+) T cell responses against MAGE-6 in HLA-DRB10401(+) patients with renal cell
- Reduced membrane major histocompatibility complex class I density and stability in a subset of human renal cell carcinomas with low TAP and
- Expression and function of the peptide transporters in escape variants of human renal cell carcinomas.
- IFN-gamma-mediated coordinated transcriptional regulation of the human TAP-1 and LMP-2 genes in human renal cell carcinoma.
- Induction of immunogenicity of a human renal-cell carcinoma cell line by TAP1-gene transfer.
- Gene transfer of human interferon gamma complementary DNA into a renal cell carcinoma line enhances MHC-restricted cytotoxic T lymphocyte
- Low-stage renal carcinoma of the native kidneys in renal transplant recipients.
- Laparoscopic and renal sparing approaches to tumours of the ureter and kidney.
- [New trends in the diagnosis and treatment of renal cell carcinoma]
- [Metastatic renal cell carcinoma]
- [The value of tumor nephrectomy in metastatic renal cell carcinoma]
- [Value of metastases surgery in metastatic renal cell carcinoma]
- [Systemic immunotherapy of metastatic renal cell carcinoma and long-term outcome]
- [Regional immunotherapy of metastatic renal cell carcinoma]
- [Specific cellular immunotherapy of renal cell carcinoma. Current status and prospects]
- [Immunotherapy of metastatic renal cell carcinoma in Germany. An assessment of the current status]
- [Diagnostic imaging before kidney tumor operations]
- Pegylated interferon alfa-2b treatment for patients with solid tumors: a phase I/II study.
- Gemcitabine plus epirubicin in patients with advanced urothelial carcinoma who are not eligible for platinum-based regimens.
- Renal angiomyolipoma: relationships between tumor size, aneurysm formation, and rupture.
- MN/CA IX/G250 as a potential target for immunotherapy of renal cell carcinomas.
- Molecular cloning and immunogenicity of renal cell carcinoma-associated antigen G250.
- Blood-based RT-PCR assays of MN/CA9 or PSMA: clinical application in renal cancer patients.
- The expression of G250/mn/CA9 antigen by flow cytometry: its possible implication for detection of micrometastatic renal cancer cells.
- [The role of MN/CA IX antigen in carcinogenesis and metastasis of renal cell carcinoma]
- [Apoptosis in renal adenocarcinoma. Expression of bcl-2 in locally confined tumors]
- HIF activation identifies early lesions in VHL kidneys: evidence for site-specific tumor suppressor function in the nephron.
- Renal angiomyolipoma: typical and atypical features.
- Immunotherapy of metastatic renal cell cancer.
- Positron emission tomography in urologic oncology.
- Contemporary diagnosis and management of renal angiomyolipoma.
- Outcome of laparoscopic radical and open partial nephrectomy for the sporadic 4 cm. or less renal tumor with a normal contralateral kidney.
- Management of renal cell carcinoma with level III thrombus in the inferior vena cava.
- Thrombocytosis is associated with a significant increase in the cancer specific death rate after radical nephrectomy.
- Long-term experience with bacillus Calmette-Guerin therapy of upper urinary tract transitional cell carcinoma in patients not eligible for
- Expression of the tumor-associated gene MN: a potential biomarker for human renal cell carcinoma.
- Identification of the MN/CA9 protein as a reliable diagnostic biomarker of clear cell carcinoma of the kidney.
- [Molecular detection of circulating cancer cells in patients with renal cell carcinoma]
- Immunohistochemical study of microphthalmia transcription factor and tyrosinase in angiomyolipoma of the kidney, renal cell carcinoma, and
- Immunohistochemical and reverse transcription-polymerase chain reaction expression analysis of tyrosinase and microphthalmia-associated
- Melanoma markers in angiomyolipoma of the liver and kidney: a comparative study.
- Prevalence of renal cell carcinoma in patients with ESRD pre-transplantation: a pathologic analysis.
- You've got to laugh.
- Surgery for solitary metastases of the spine: rationale and results of treatment.
- Single nucleotide polymorphisms of estrogen receptor alpha in human renal cell carcinoma.
- [Kidney tumors: clinical and pathological findings and detection]
- [Staging and follow-up of renal cell carcinoma]
- The differences in health outcomes between Web-based and paper-based implementation of a clinical pathway for radical nephrectomy.
- Prognostic implications of histological features in patients with chromophobe cell renal carcinoma.
- Kidney cancer in the Swedish Family Cancer Database: familial risks and second primary malignancies.
- Detection and characterization of renal masses and staging of renal cancers: new considerations in the era of helical computed tomography.
- Imaging for nephron-sparing surgery.
- A high rate of venous thromboembolism in a multi-institutional phase II trial of weekly intravenous gemcitabine with continuous infusion
- Prospective analysis of circulating endostatin levels in patients with renal cell carcinoma.
- Interleukin-2, interferon-alpha, 5-fluorouracil, and vinblastine in the treatment of metastatic renal cell carcinoma: a prospective phase II
- Posterior retroperitoneoscopic partial nephrectomy using microwave tissue coagulator for small renal tumors.
- Vinblastine and interferon-gamma combination with and without 13-cis retinoic acid for patients with advanced renal cell carcinoma. Results
Table of Contents
1
UI - 11275975
AU - Kurokawa T; Oelke M; Mackensen A
TI -
Induction and clonal expansion of tumor-specific cytotoxic T lymphocytes
from renal cell carcinoma patients after stimulation with autologous
dendritic cells loaded with tumor cells.
SO - Int J Cancer 2001 Mar 15;91(6):749-56
AD - Department of Hematology/Oncology, Freiburg University Medical Center,
Freiburg, Germany.
Melanoma and renal cell carcinoma (RCC) are considered to be the most
immunogenic tumors in humans. To generate conditions to induce primary
T-cell responses against RCC and to allow further expansion of
tumor-specific cytotoxic T lymphocytes (CTL) for adoptive transfer,
peripheral blood mononuclear cells from RCC patients were stimulated
with primary autologous tumor cells or monocyte-derived dendritic cells
(DC) loaded with either tumor lysate (TU-LY) or apoptotic tumor cells
(TU-AP). Whereas repetitive stimulation (4x) with tumor cells alone
induced a predominant population of CD3(-) natural killer cells, 4 weeks
of stimulation with tumor-loaded DC favored induction and expansion of
CD4+ T cells (>80%). However, 2 weekly stimulation cycles with
tumor-loaded DC followed by restimulation with autologous irradiated
tumor cells alone were optimal for induction of tumor-specific CTL
responses in vitro. Using these culture conditions a marked increase of
CD4+ T cells was observed during the first 2 weeks of stimulation with
tumor-loaded DC. Subsequent restimulation with autologous tumor cells
alone gave rise to 500-fold expansion of CD8+ T cells. These CD8+ T
cells were shown to exhibit strong major histocompatibility complex
class I-restricted cytotoxic activity against the autologous tumor.
Comparison of TU-LY and TU-AP as a source of tumor antigen for loading
DC did not show any difference in stimulating tumor-specific CTL. Length
pattern analysis of the complementary determining region 3 (CDR3) of the
T-cell receptor Vbeta chain revealed expansion of oligoclonal CTL
populations with outgrowth of 1 or 2 clones after prolonged stimulation
with autologous tumor cells. Our study demonstrated an efficient method
for generating tumor-specific CTL in vitro that may be used to identify
tumor cell antigens or that can be expanded for adoptive T-cell transfer
in tumor immunotherapy. Copyright 2001 Wiley-Liss, Inc.
2
UI - 12006245
AU - Nasu Y; Kusaka N; Saika T; Tsushima T; Kumon H
TI -
Suicide gene therapy for urogenital cancer: current outcome and
prospects.
SO - Mol Urol 2000 Summer;4(2):67-71
AD - Department of Urology, Okayama University Medical School, Shikata,
Okayama, Japan. ynasu@med.okayama-u.ac.jp
Viral-mediated transfer of the herpes simplex virus thymidine kinase
(HSV-tk) gene has been demonstrated by several investigators to confer
sensitivity to nucleoside analogs such as ganciclovir (GCV) in a variety
of tumor cells including brain, prostate, bladder, kidney, ovary, head
and neck, lung, pancreas, and liver cancers. Fourteen suicide gene
clinical protocols using adenovirus vectors have been conducted,
including four in prostate cancer. Two additional protocols for prostate
cancer are in preparation in Japan and the Netherlands. A study
conducted at Baylor College of Medicine was the first to demonstrate the
safety of HSV-tk plus GCV therapy for human prostate cancer and the
anticancer activity of gene therapy in this disease. However, it is
still in the early stage of its development, with a number of problems
to be overcome. Systemic delivery, specific introduction, and specific
expression of the target gene are the major issues to be managed in
order to establish a clinically relevant treatment strategy.
3
UI - 11951927
AU - Wong M; Goldstein D; Woo H; Testa G; Gurney H
TI -
Alpha-interferon 2a and 1 3-cis-retinoic acid for the treatment of
metastatic renal cell carcinoma.
SO - Intern Med J 2002 Apr;32(4):158-62
AD - Department of Medical Oncology, Westmead Hospital, Sydney, New South
Wales, Australia. markwong@westgate.wh.usyd.edu.au
BACKGROUND: It is suggested that immunotherapy may have a better role
than cytotoxic chemotherapy in the treatment of metastatic renal cell
carcinoma. AIMS: A phase II study of alpha-interferon 2a (IFN2a) and
13-cis-retinoic acid (CRA) in the treatment of metastatic renal cell
carcinoma. METHODS: Twenty-two patients with no previous systemic
therapy were treated with IFN2a daily at 3 million units (MU) and
escalated to 6 and 9 MU if tolerated, together with CRA given orally at
1 mg/kg per day in two divided doses. Changes in quality of life were
also assessed. RESULTS: Twenty patients were available for assessment.
Three patients (14%) achieved a partial response and five patients (23%)
had stable disease. No patient achieved a complete response. A durable
response was observed in partial responders with median length of
response of 44 weeks (range 32-59 weeks). Therapy was stopped in seven
(35%) patients due to treatment-related toxicities, and quality of life
was worsened in the majority of patients. CONCLUSION: IFN2a and CRA has
a low response rate and significant toxicity, and the combination as
standard treatment of metastatic renal cell carcinoma is not
recommended, despite the suggestion that CRA may lengthen the response
to IFN2a.
4
UI - 12017273
AU - Oudard S; Levalois C; Andrieu JM; Bougaran J; Validire P; Thiounn N;
TI -
Poupon MF; Fourme E; Chevillard S
Expression of genes involved in chemoresistance, proliferation and
apoptosis in clinical samples of renal cell carcinoma and correlation
with clinical outcome.
SO - Anticancer Res 2002 Jan-Feb;22(1A):121-8
AD - Hopital Europeen Georges Pompidou, Division of Oncology, Paris, France.
stephane.oudard@hop.egp.ap-hop-paris.fr
This study investigated the multidrug resistance, proliferation and
apoptosis expression in renal cell carcinomas compared to adjacent
normal kidney (ANK) tissues. Multidrug resistance (MDR1), multidrug
resistance-associated protein (MRP), glutathione-S-transferase-pi
(GST-pi), Topoisomerase-II alpha (TOPO-IIalpha), thymidylate synthase
(TS), thymidine kinase (TK), Ki67, BAX and BCL-2 genes were analysed in
a series of 30 renal cell carcinomas (RCC) and 16 biopsies from adjacent
normal kidney (ANK) tissue using reverse-transcription-PCR (rt-PCR). The
mean MDR1 expression was significantly lower in RCC than that of ANK
(0.4 +/- 0.2 sd versus 0.75 +/- 0.19, p = 0.0008). The expression of
MRP, GST-pi and TOPO-IIalpha was not significantly different in RCC as
compared with ANK. The mean TK expression in RCC was significantly
higher than in ANK (0.31 +/- 0.15 versus 0.09 +/- 0.08, p = 0.002). The
TS and Ki67 expression in RCC was significantly higher than in ANK
(87.5%, IC95% 71-100% versus 0%, p = 0.001; 56% IC95% 32-81% versus 0%,
p = 0.004, respectively). BAX and BCL-2 expression in RCC was
significantly higher than that of ANK (0.51 +/- 0.08 versus 0.18 +/-
0.12, p = 0.0001; 0.73 +/- 0.16 versus 0.5 +/- 0.22, p = 0.01,
respectively). No significant correlation was found between MDR1, MRP,
GST-pi, TOPO-IIalpha, TS, TK and BAX expression with the grade and the
clinical stage in RCC.
5
UI - 12172983
AU - Park DK; Ryan CW; Dolan ME; Vogelzang NJ; Stadler WM
TI -
A phase II trial of oral temozolomide in patients with metastatic renal
cell cancer.
SO - Cancer Chemother Pharmacol 2002 Aug;50(2):160-2
AD - Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
PURPOSE: To determine the activity of temozolomide, an oral
imidazotetrazine alkylating agent that has exhibited broad antitumor
activity in preclinical studies, in renal cell cancer (RCC) patients.
METHODS. Metastatic RCC patients were treated with temozolomide, 200
mg/m(2) per day orally, and traditional radiologic response endpoints
were assessed. O(6)-Alkylguanine-DNA alkyltransferase (AGT) activity was
measured in four pretreatment biopsies. RESULTS: Among 12 patients,
there were no responses. High AGT activity was observed in all four
biopsies analyzed. CONCLUSIONS: Temozolomide is not active against RCC
and this clinical observation may be due to high levels of AGT in this
tumor.
6
UI - 12175389
AU - Patard JJ; Rodriguez A; Rioux-Leclercq N; Guille F; Lobel B
TI -
Prognostic significance of the mode of detection in renal tumours.
SO - BJU Int 2002 Sep;90(4):358-63
AD - Department of Urology and Pathology, CHU Rennes, France.
jean-jacques.patard@chu-rennes.fr
OBJECTIVE: To evaluate the mode of detection of 400 renal tumours as a
prognostic factor compared with the usual clinical and pathological
prognostic variables. PATIENTS AND METHODS: The data were reviewed for
400 patients operated for a renal tumour at our institution between 1984
and 1999, analysing the prognostic value of age, sex, tumour size,
stage, grade, vein invasion, adrenal gland invasion, lymph node
invasion, metastasis, and mode of detection (incidental or not). The
survival rates were assessed using the Kaplan-Meier method and log-rank
test, and the data evaluated using multivariate analysis with the Cox
proportional-hazard model. RESULTS: In all, 151 (38%) renal tumours were
discovered incidentally. There was no significant difference in the
percentage of renal cell carcinoma found between the groups of patients
discovered incidentally or not (94.4% vs 93.9%). Tumours were smaller in
the incidental group (5.7 cm vs 8.7 cm, P < 0.001). In the incidental
group, 15.2% of the tumours were treated with partial nephrectomy,
against 1.2% in the symptomatic group (P < 0.001). The specific survival
was significantly better in patients with renal tumours discovered
incidentally (log-rank test, P < 0.001). The multivariate analysis
showed that the mode of detection, stage, grade, metastasis (all P <
0.001), and lymphatic extension (P = 0.005) were independent prognostic
factors. CONCLUSION: The incidental discovery of renal tumours gives a
supplementary benefit to patients in terms of survival, and should be
considered as a prognostic factor in addition to stage and grade.
7
UI - 12175390
AU - Okeke AA; Timoney AG; Keeley FX
TI -
Hand-assisted laparoscopic nephrectomy: complications related to the
hand-port site.
SO - BJU Int 2002 Sep;90(4):364-7
AD - Bristol Urological Institute, Southmead Hospital, Bristol, UK.
frank_keeley@bui.ac.uk
OBJECTIVE: To evaluate the early results of hand-assisted radical
nephrectomy and nephroureterectomy in our institution. PATIENTS AND
METHODS: The records of 13 patients with malignant disease of the kidney
who underwent hand-assisted laparoscopic radical nephrectomy and
nephroureterectomy were reviewed retrospectively. Clinical outcomes were
compared with a series of 16 patients who underwent similar procedures
via a standard laparoscopic approach. RESULTS: There were three major
hand-port wound complications in those who underwent hand-assisted
procedures, while one other patient required conversion because of
technical failure of the device. The operative duration, length of
hospital stay, estimated blood loss, transfusion rate, analgesic
requirement, conversion rates, and minor complications were similar
between the hand-assisted and standard laparoscopy groups. CONCLUSION:
There was little difference between hand-assisted and standard
laparoscopy in operative duration or recovery, but there were problems
with wound complications which may be related to the hand-assisted
approach. We have consequently abandoned the technique in favour of a
standard laparoscopic approach.
8
UI - 12175391
AU - Caldarelli G; Minervini A; Guerra M; Bonari G; Caldarelli C; Minervini R
TI -
Prosthetic replacement of the inferior vena cava and the iliofemoral
vein for urologically related malignancies.
SO - BJU Int 2002 Sep;90(4):368-74
AD - Urology Unit and Vascular Surgery Unit, Department of Surgery,
University of Pisa, Pisa, Italy.
OBJECTIVE: To evaluate the feasibility and results of prosthetic venous
replacement, as inferior vena cava (IVC) and iliofemoral vein resection
and replacement are sometimes necessary when they are extensively
involved by a large and fixed tumour thrombus from renal cell carcinoma
(RCC) or other urological malignancies. PATIENTS AND METHODS: Five men
and two women (age range 41-75 years) were treated over a 10-year period
(1991-2001) by aggressive venous surgery to achieve complete tumour
resection, with prosthetic graft replacement to re-establish venous
flow. The tumours included RCC of the right kidney (two),
retroperitoneal liposarcoma (two), bladder cancer (one), retroperitoneal
fibrosarcoma (one) and inguino-pelvic lymphoma (one). Two patients had a
vena caval replacement, of whom one had a circular reinforced PTFE and
one a Dacron silver graft; five patients had either an iliofemoral or an
ilio-iliac circular reinforced PTFE graft. The prosthetic diameter was
18-20 mm for the IVC grafts and 8-10 mm for the iliac grafts. In all the
patients, graft patency was evaluated during the follow-up by colour
flow duplex imaging, and in one it was determined by angio-computed
tomography scan and venography. RESULTS: One patient died 30 days after
surgery; of the remaining six patients one had no evidence of regional
recurrence or metastatic disease at 12 months, and five died from
recurrent tumour 8-30 months after surgery. The mean time to death was
23 months. At 3 months all six prosthesis were patent; at 6 months four
were patent and at 12 months three of five prostheses were patent.
CONCLUSION: Resecting and replacing the IVC allows complete tumour
resection and avoids renal failure, providing durable relief from the
symptoms of venous obstruction. Iliofemoral prosthetic reconstruction
for urological-related malignancies represents a viable option to avoid
venous engorgement and lower extremity swelling, at least in the early
postoperative period. The mean time to death for the present patients
must be considered the limit for these aggressive operations.
9
UI - 12202701
AU - Ho VB; Allen SF; Hood MN; Choyke PL
TI -
Renal masses: quantitative assessment of enhancement with dynamic MR
imaging.
SO - Radiology 2002 Sep;224(3):695-700
AD - MR Research Division, Department of Radiology and Radiological Sciences,
Uniformed Services University of the Health Sciences, 4301 Jones Bridge
Rd, Bethesda, MD 20814-4799, USA. vho@usuhs.mil
PURPOSE: To establish a quantitative magnetic resonance (MR) imaging
contrast enhancement criterion for distinguishing cysts from solid renal
lesions. MATERIALS AND METHODS: Regions of interest were measured in 74
patients with renal lesions evaluated by means of dynamic contrast
material-enhanced MR imaging with serial breath-hold spoiled
gradient-echo acquisitions. Sensitivity for renal tumors and specificity
for renal cysts were established by using percentage of enhancement
thresholds that varied between 5% and 35%. RESULTS: The mean percentage
of enhancement at MR imaging for the 50 renal cysts was less than 5%;
for the 50 renal tumors, it was 97% or higher. With use of a threshold
percentage of enhancement of 15% and results obtained between 2 and 4
minutes after administration of contrast material, all malignancies
(sensitivity for tumor, 100%) were diagnosed, and there were 6% or fewer
false-positive tumor diagnoses. Lower thresholds resulted in
unacceptably high false-positive rates (ie, cysts that appeared to
enhance-pseudoenhancement), whereas higher threshold values (>20%)
resulted in an unacceptably lower sensitivity for tumors. CONCLUSION:
The optimal percentage of enhancement threshold for distinguishing cysts
from malignancies with the imaging technique prescribed was 15%, and the
optimal timing for measurement was 2-4 minutes after administration of
contrast material. Copyright RSNA, 2002
10
UI - 12210070
AU - Mitsumori K; Kittleson JM; Itoh N; Delahunt B; Heathcott RW; Stewart JH;
TI -
McCredie MR; Reeve AE
Chromosome 14q LOH in localized clear cell renal cell carcinoma.
SO - J Pathol 2002 Sep;198(1):110-4
AD - Department of Biochemistry, University of Otago, Dunedin, New Zealand.
The progression of a malignant tumour is understood to be the result of
the accumulation of multiple genetic aberrations. As up to 14% of
organ-confined renal cell carcinomas will recur after surgery, tumour
clones with metastatic potential must already be present in some of
these localized tumours. The association of 14q LOH with high-grade
tumours and advanced tumour stage suggests an important role for the
gene in tumour progression. Chromosome 14q LOH has been analysed in
microdissected specimens from 130 organ-confined (UICC TNM stage 1 and
2) clear cell renal cell carcinomas using three microsatellite markers
(D14S588, D14S617, GATA136B01). Tumours were classified as 14q LOH or
not on the basis of LOH at one or more of the markers. The allelic
imbalance ratio was used to determine both LOH and LOH proportion and
the association between LOH and mortality, tumour size, histological
grade and growth kinetics, measured by quantification of nucleolar
organizer regions, was analysed. 14q LOH was present in 35.4% of
informative cases at marker D14S588, 24.4% at D14S617, 36.4% at
GATA136B01 and 39.5% for any one of the three markers. The mean 14q LOH
proportion was 0.24 (range 0.009-0.80). LOH proportion correlated
significantly with tumour size, AgNOR score and histological grade. It
was also significantly associated with disease-specific mortality;
(hazard ratio 1.22; 95% CI 1.02-1.45; p = 0.039). LOH proportion did not
remain significant after adjusting for tumour size (hazard ratio 0.98;
95% CI 0.76-1.27; p = 0.90). These results indicate that the proportion
of cells with 14q LOH in the tumour is associated with tumour
aggressiveness; while this is not an independent predictor of survival,
it may have some utility as a marker of latent metastatic potential.
Copyright 2002 John Wiley & Sons, Ltd.
11
UI - 1868737
AU - Milne R; Vessey M
TI -
The association of oral contraception with kidney cancer, colon cancer,
gallbladder cancer (including extrahepatic bile duct cancer) and
pituitary tumours.
SO - Contraception 1991 Jun;43(6):667-93
AD - Department of Public Health and Primary Care, Radcliffe Infirmary,
Oxford, England.
This paper reviews the evidence for a relationship between oral
contraceptive use and certain neoplasms: cancers of the kidney, colon
and gallbladder (including the extrahepatic bile ducts) and tumours
(benign or malignant) of the pituitary. Special reference is made to
controlled epidemiological studies, both case-control and cohort. There
is no convincing evidence that oral contraceptive use is causally
related, either negatively or positively, to any of the tumours studied.
12
UI - 7432332
AU - Liberti M; Di Silverio F; Concolino G; Tenaglia R; Marocchi A
TI -
[the oral use of a progestational hormone (Provera 100) as an adjuvant
in therapy of adenocarcinoma of the kidney. Preliminary report]
SO - Minerva Urol 1980 Jul-Sep;32(3):175-8
13
UI - 12077818
AU - Aliaev IuG; Krapivin AA; Al' Agbar NI
TI -
[A "small" kidney tumor]
SO - Urologiia 2002 Mar-Apr;(2):3-7
The authors think it necessary to distinguish small tumors of the
kidney--a neoplasm 4 cm in size maximum. The number of such small tumors
account for 1/3 of all renal newgrowths. An important role in detection
of small tumors belongs to ultrasonography. Ultrasonic finding of the
tumor should be followed by spiral computer tomography with
3-dimensional reconstruction of the image of the tumor, calyceal-pelvic
system and renal vessels. Small tumors are asymptomatic in 71.4 cases,
in many cases benign, in renal cell carcinoma their cells are well
differentiated, they do not invade paranephral fat. Morphological
verification is effective and safe in puncture biopsy of the tumor under
ultrasound control. Adequate treatment depends on correct diagnosis of
the tumor nature. Surgery of choice in small tumor of the kidney is
resection.
14
UI - 12077824
AU - Ignashin NS; Vinogradov EV; Safarov RM
TI -
[Ultrasonic methods in diagnosing renal growths]
SO - Urologiia 2002 Mar-Apr;(2):43-50
15
UI - 12077826
AU - Patiutko IuI; Matveev VB; Matveev BP; Podluzhnyi DV
TI -
[Liver resection in locally-spread and metastatic kidney cancer]
SO - Urologiia 2002 Mar-Apr;(2):7-11
The postoperative outcome and survival were studied in patients operated
for renal cancer with involvement of the liver. 9 patients have
undergone radical nephrectomy and 12 patients--hepatic resections for
direct hepatic involvement (2), synchronous (2) and metachronous (8)
metastases of renal cell carcinoma. Right hemihepatectomy was performed
in 2 and wedge resection in 10 cases. A complete resection was performed
in 8 of 9 patients while one patient with direct hepatic invasion was
found to have positive surgical margins. Postoperative lethality was
absent but complications occurred in 6 patients: pancreatitis (1),
pneumonia (3), hepatic abscess (1), hepatic and renal failure followed
by GI bleeding (1). At follow-up, two patients died of progressive
disease 4 and 68 months after the surgery and one was lost for
follow-up. One patient with positive surgical margins is alive with
pulmonary and liver metastases 16 months after surgery. Five patients
are alive with no evidence of relapse 6, 10, 12, 19 and 56 months after
the operation. Thus, the aggressive surgical approach is justified and
should be considered in patients with renal cancer and hepatic
involvement.
16
UI - 12167583
AU - Russo P; Goetzl M; Simmons R; Katz J; Motzer R; Reuter V
TI -
Partial nephrectomy: the rationale for expanding the indications.
SO - Ann Surg Oncol 2002 Aug;9(7):680-7
AD - Department of Urology, Memorial Sloan-Kettering Cancer Center, 1275 York
Avenue, New York, NY 10021, USA. russop@mskcc.org
BACKGROUND: We report preliminary results of partial nephrectomy for
renal tumors of > or =4 cm in 39 patients with the intent of extending
cortical tumors >4 cm in maximum diameter. Fourteen (36%) had the
procedure performed for essential reasons, and 25 (64%) had an elective
kidney-sparing operation. We evaluated tumor location and histology,
perioperative renal function, and postoperative complications. RESULTS:
There were 20 conventional clear-cell (51%), 13 papillary (33%), 4
chromophobe (10%), and 3 oncocytomas (8%) with a median tumor size of 5
cm. After a median follow-up of 13 months, 36 patients had no evidence
of disease, 1 patient had died as a result of other causes, and 2
patients who had essential operations were alive with disease.
Twenty-three patients (70%) maintained normal postoperative renal
function. Of six patients with moderate preoperative renal dysfunction,
five (83%) had no change in postoperative renal function and only one
patient required short-term dialysis. CONCLUSIONS: With careful patient
selection, partial nephrectomy can be effectively used to treat patients
with renal cortical tumors >4 cm in diameter. The benefits of this
approach include the effective local tumor control while at the same
time preserving maximum renal function.
17
UI - 12234987
AU - Gatenby RA; Gawlinski ET; Tangen CM; Flanigan RC; Crawford ED
TI -
The possible role of postoperative azotemia in enhanced survival of
patients with metastatic renal cancer after cytoreductive nephrectomy.
SO - Cancer Res 2002 Sep 15;62(18):5218-22
AD - Departments of Radiology and Applied Mathematics, University of Arizona,
Tucson, AZ 85721, USA. rgatenby@radiology.arizona.edu
Cytoreductive nephrectomy prior to systemic therapy significantly
increases survival in patients with metastatic renal cancer. This result
is generally ascribed to the benefits of resection of the primary tumor
including reduction of tumor burden, removal of a source for growth
factors and metastases, and enhanced immune response. On the basis of
mathematical models of tumor invasion, we propose that the observed
effects of cytoreductive nephrectomy may be caused by resection of the
kidney rather than the cancer. The models predict that the graded
metabolic acidosis associated with mild renal failure after unilateral
nephrectomy may alter the dynamics of the tumor-host interface
sufficiently to reduce and even reverse the rate of invasion. A review
of patient data from the surgical arm of the Southwest Oncology Group
(SWOG) 8949(2) trial demonstrates significantly improved survival in
patients who experienced postoperative increase in blood urea nitrogen
(BUN) and creatinine compared with those who did not (17-month survival
versus 4-month survival; P = 0.0007). This is generally consistent with
the predictions of the mathematical models. If confirmed, these results
suggest novel and broadly applicable tumor therapies.
18
UI - 12208877
AU - Tatsumi T; Kierstead LS; Ranieri E; Gesualdo L; Schena FP; Finke JH;
TI -
Bukowski RM; Mueller-Berghaus J; Kirkwood JM; Kwok WW; Storkus WJ
Disease-associated bias in T helper type 1 (Th1)/Th2 CD4(+) T cell
responses against MAGE-6 in HLA-DRB10401(+) patients with renal cell
carcinoma or melanoma.
SO - J Exp Med 2002 Sep 2;196(5):619-28
AD - Department of Surgery, University of Pittsburgh School of Medicine,
Pittsburgh, PA 15261, USA.
T helper type 1 (Th1)-type CD4(+) antitumor T cell help appears critical
to the induction and maintenance of antitumor cytotoxic T lymphocyte
(CTL) responses in vivo. In contrast, Th2- or Th3/Tr-type CD4(+) T cell
responses may subvert Th1-type cell-mediated immunity, providing a
microenvironment conducive to disease progression. We have recently
identified helper T cell epitopes derived from the MAGE-6 gene product;
a tumor-associated antigen expressed by most melanomas and renal cell
carcinomas. In this study, we have assessed whether peripheral blood
CD4(+) T cells from human histocompatibility leukocyte antigens
(HLA)-DRbeta1*0401(+) patients are Th1- or Th2-biased to MAGE-6 epitopes
using interferon (IFN)-gamma and interleukin (IL)-5 enzyme-linked
immunospot assays, respectively. Strikingly, the vast majority of
patients with active disease were highly-skewed toward Th2-type
responses against MAGE-6-derived epitopes, regardless of their stage
(stage I versus IV) of disease, but retained Th1-type responses against
Epstein-Barr virus- or influenza-derived epitopes. In marked contrast,
normal donors and cancer patients with no current evidence of disease
tended to exhibit either mixed Th1/Th2 or strongly Th1-polarized
responses to MAGE-6 peptides, respectively. CD4(+) T cell secretion of
IL-10 and transforming growth factor (TGF)-beta1 against MAGE-6 peptides
was not observed, suggesting that specific Th3/Tr-type CD4(+) subsets
were not common events in these patients. Our data suggest that
immunotherapeutic approaches will likely have to overcome or complement
systemic Th2-dominated, tumor-reactive CD4(+) T cell responses to
provide optimal clinical benefit.
19
UI - 9816317
AU - Seliger B; Hohne A; Knuth A; Bernhard H; Ehring B; Tampe R; Huber C
TI -
Reduced membrane major histocompatibility complex class I density and
stability in a subset of human renal cell carcinomas with low TAP and
LMP expression.
SO - Clin Cancer Res 1996 Aug;2(8):1427-33
AD - The Johannes Gutenberg University, Third Department of Internal
Medicine, Division of Hematology/Oncology, Langenbeckstr. 1, 55131
Mainz, Germany.
Suppression of MHC class I expression is thought to allow tumor cells to
escape immune surveillance mediated by CD8(+) CTLs. For stable MHC class
I surface expression, multiple protein interactions are required for
efficient assembly of MHC class I heavy chain and beta 2-microglobulin
with endogenous peptides. Peptide processing and transport into the
endoplasmic reticulum involves the genes of the transporters associated
with antigen processing, TAP-1 and TAP-2, and the two components of the
proteasome complex, the low molecular weight proteins LMP-2 and LMP-7.
We selected human renal cell carcinoma (RCC) cells derived from a tumor
that is thought to be controlled by host immunity to study the MHC class
I antigen presentation machinery. Eleven RCC lines established from
primary tumors were investigated for the mRNA and protein expression of
MHC class I, TAP, and LMP genes. In addition, membrane stability of MHC
class I was determined by incubation of the RCC cell lines at low
temperature and in the presence of exogenous HLA-binding peptides. Our
results revealed the existence of two different phenotypes of RCC cell
lines. Group I displayed temperature-stable MHC class I surface
expression associated with high, and in most cases coordinated,
expression of MHC class I heavy and light chain, TAP and LMP
transcripts, and proteins. Group II demonstrated a marked MHC class I
instability at 37 degreesC associated with low but coordinated
expression of the respective transcripts and proteins. MHC class I
membrane expression of group II, but not of group I RCC cells, could be
stabilized by incubation with specific MHC class I binding peptides.
These results suggest an important role of the genes of the antigen
presentation machinery in stable and efficient MHC class I surface
expression of RCC cells. However, it has still to be defined whether
deficient antigen processing is one of the mechanisms of RCC cells to
escape the surveillance of the immune system.
20
UI - 9216736
AU - Seliger B; Hohne A; Jung D; Kallfelz M; Knuth A; Jaeger E; Bernhard H;
TI -
Momburg F; Tampe R; Huber C
Expression and function of the peptide transporters in escape variants
of human renal cell carcinomas.
SO - Exp Hematol 1997 Jul;25(7):608-14
AD - Johannes Gutenberg-Universitat, Abteilung fur Hamatologie/Onkologie,
Mainz, Germany.
The transporter associated with antigen processing (TAP) complex is a
heterodimeric transmembrane pump consisting of the TAP-1 and TAP-2
subunits; these subunits translocate peptides from the cytoplasm into
the lumen of the endoplasmic reticulum, where they bind nascent major
histocompatibility complex (MHC) class I molecules. Loss or reduced
expression of the TAP genes results in the synthesis of unstable peptide
free MHC class I molecules that are only weakly expressed on the cell
surface. In a number of human tumor cell lines, downregulation of MHC
class I expression has been found to be associated with reduced or
absent TAP expression. To investigate whether alterations in MHC class I
expression occur during transformation and subsequent progression and
whether MHC class I suppression is caused by impaired TAP function, we
analyzed the protein expression of MHC class I heavy and light chain and
TAP-1 in three renal cell carcinoma (RCC) cell lines and short-term
cultures from corresponding normal kidney tissue. In one case a cell
line established from a metastatic lesion was also available. Compared
with normal epithelial cells, suppression of TAP-1 and MHC class I
molecules was detected in all three primary RCC cells and was even more
pronounced in the metastatic cell line. In contrast to normal epithelial
cells, MHC class I membrane expression of two RCC lines was enhanced by
culture in the presence of MHC class I binding peptides or at low
temperature (26 degrees C) instead of 37 degrees C. Unstable MHC class I
surface expression is caused by dissociation of the MHC class I heavy
and light chain molecules as a result of functional defects in the
antigen processing machinery, e.g., impaired peptide transport. Attempts
to counteract the reduced immunogenicity by transferring the TAP genes
into these cells demonstrated that TAP-1-modified RCC cells expressed
higher levels of MHC class I molecules. These data indicate that
downregulation and instability of MHC class I surface expression in RCC
cells is at least partially caused by deficient loading with endogenous
peptides and can be restored by TAP gene transfer.
21
UI - 9815722
AU - Seliger B; Hammers S; Hohne A; Zeidler R; Knuth A; Gerharz CD; Huber C
TI -
IFN-gamma-mediated coordinated transcriptional regulation of the human
TAP-1 and LMP-2 genes in human renal cell carcinoma.
SO - Clin Cancer Res 1997 Apr;3(4):573-8
AD - III. Medical Clinic, Department of Hematology/Oncology, Johannes
Gutenberg-University, 55101 Mainz, Germany.
Some human tumor cells exhibit deficient expression of the peptide
transporters TAP1 and TAP2 and of the proteasome subunits low molecular
weight protein (LMP)-2 and LMP-7, which could be partially restored by
cytokine treatment. Here, we show that IFN-gamma stimulation of human
renal cell carcinoma lines increased the MHC class I, transporter
associated with antigen processing (TAP), and LMP transcript and protein
levels, but TAP and LMP expression are more rapidly induced by IFN-gamma
than MHC class I molecules. No correlation between the level of
induction of the MHC class I antigen presentation genes and IFN
sensitivity/resistance was detected. The IFN-gamma-mediated increase of
MHC class I, TAP-1, and LMP-2 expression was independent of de novo
protein synthesis. Analysis of the dual TAP-1/LMP-2 promoter activity
revealed that TAP-1 and LMP-2 expression are controlled by IFN-gamma at
the transcriptional level. Site-specific mutations in the
IFN-gamma-responsive element of the TAP-1/LMP-2 promoter blocked
induction by IFN-gamma. Thus, the IFN-gamma-mediated coordinated
transcriptional up-regulation of TAP-1 and LMP-2 expression occurs
through the use of a common regulatory element, which might result in
enhanced recognition of renal cell carcinoma cells by the immune system.
22
UI - 10077163
AU - Kallfelz M; Jung D; Hilmes C; Knuth A; Jaeger E; Huber C; Seliger B
TI -
Induction of immunogenicity of a human renal-cell carcinoma cell line by
TAP1-gene transfer.
SO - Int J Cancer 1999 Mar 31;81(1):125-33
AD - Johannes Gutenberg-Universitat, III, Medizinische Klinik, Mainz,
Germany.
Reduced expression of the major-histocompatibility-complex(MHC)-class-I
antigens has been demonstrated in renal-cell carcinoma (RCC), and
appeared to be associated with deficiencies in the expression and
function of different components of the MHC-class-I-antigen-processing
pathway and poor recognition by cytotoxic T-lymphocytes (CTL). In order
to investigate the role of peptide transporters for the immunogenic
phenotype of RCC, tumor cells were stably transfected with the human
TAP1A gene. While the TAP1 transfectants showed heterogeneous
TAP1-transgene expression pattern of mRNA and protein, high TAP1
expression and a TAP-controlled increase in MHC-class-I surface
expression could be achieved in selected transfectants. IFN-gamma
up-regulates the expression of MHC-class-I antigens and TAP1 both in
control and in TAP1-transfected RCC cells to a similar level. No
additive effect of TAP1 over-expression was observed in TAP1
transfectants. Although no enhanced CTL-mediated lysis was obtained,
cytokine release was substantially increased in response to
TAP1-transfected RCC cells, but not to control cells. Furthermore, TAP1
transfectants were able to stimulate the proliferation of allogeneic T
cells. These studies suggest that abnormalities of MHC-class-I surface
expression due to dysfunctional peptide transporters contribute to the
immune escape phenotype of RCC cells and that the immune tolerance of
RCC could be altered by TAP1-gene transfer.
23
UI - 10849555
AU - Schendel DJ; Falk CS; Nossner E; Maget B; Kressenstein S; Urlinger S;
TI -
Tampe R; Gansbacher B
Gene transfer of human interferon gamma complementary DNA into a renal
cell carcinoma line enhances MHC-restricted cytotoxic T lymphocyte
recognition but suppresses non-MHC-restricted effector cell activity.
SO - Gene Ther 2000 Jun;7(11):950-9
AD - Institute of Molecular Immunology, GSF National Research Center for the
Environment and Health, Munich, Germany.
Even though renal cell carcinomas (RCC) are thought to be immunogenic,
many tumors express variations in surface molecules and intracellular
proteins that hinder induction of optimal antitumor responses.
Interferon gamma (IFNgamma) stimulation can correct some of these
deficiencies. Therefore, we introduced the complementary DNA (cDNA)
encoding human IFNgamma into a well-characterized RCC line that has been
selected for development of an allogeneic tumor cell vaccine for
treatment of patients with metastatic disease. Studies were performed to
determine how endogenous IFNgamma expression influences tumor cell
immunogenicity. IFNgamma transductants showed minimal increases in
surface expression of MHC class I and adhesion molecules but expression
of class II molecules was induced. Proteins of the transporter
associated with antigen processing (TAP) and low molecular weight
polypeptide (LMP) were constitutively expressed at high levels. The
transductants stimulated allospecific cytotoxic T lymphocytes (CTL);
however, they were not better than unmodified tumor cells in this
capacity. Endogenous IFNgamma expression enhanced tumor cell recognition
by MHC-restricted, tumor antigen-specific CTL but suppressed recognition
by non-MHC-restricted cytotoxic cells. Thus, the functional consequences
of IFNgamma expression varied with respect to the type of effector cell
and were not always beneficial for tumor cell recognition.
24
UI - 12009631
AU - Szmidt J; Durlik M; Galazka Z; Nazarewski S; Gornicka B;
TI -
Ziarkiewicz-Wroblewska B; Bojakowski K; Nowacka-Cieciura E; Lao M
Low-stage renal carcinoma of the native kidneys in renal transplant
recipients.
SO - Transplant Proc 2002 Mar;34(2):583-4
AD - Department of General, Vascular and Transplant Surgery, Medical
University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.
25
UI - 12031867
AU - Tolley DA; Esposito MP
TI -
Laparoscopic and renal sparing approaches to tumours of the ureter and
kidney.
SO - Surg Oncol 2002 Jun;11(1-2):47-54
AD - Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, UK.
datollet@baus.org.uk
Until recently, malignancies of the kidney and ureter were managed with
open radical surgery. Over the last decade the urologic community has
adopted the skill of laparoscopic surgery for the treatment of these
tumours. Parenchymal sparing procedures have become the standard of care
in the treatment of selected patients with renal and ureteral tumours
and many of these surgical procedures can be performed laparoscopically
or ureteroscopically. Due partly to necessity and partly to the
advancement of technology, renal and ureteral sparing procedures have
become commonplace for definitive treatment and palliation of these
tumours. The morbidity of such procedures is significantly less than for
open surgery and the future of urologic minimally invasive surgery
appears secure. This review article is aimed at updating the reader in
the most recent advances in these techniques.
26
UI - 12222136
AU - Zisman A
TI -
[New trends in the diagnosis and treatment of renal cell carcinoma]
SO - Harefuah 2002 Aug;141(8):713-7, 761
AD - Urology Department, Assaf-Harofeh Medical Center, Zerifin.
In the last decade the treatment of renal cell carcinoma (RCC) have
changed dramatically. Currently, laparoscopic radical nephrectomy,
partial nephrectomy in the presence of normal contralateral kidney as
well as ablative surgery for small renal masses, are vivid options for
the treatment of localized RCC. For metastatic RCC, cytoreductive
nephrectomy is the standard of care prior to immunotherapy or combined
treatment with tumor vaccines. On the horizon are: laparoscopic partial
nephrectomy for localized disease and allogenic dendritic
cell--autologous tumor cell hybrid vaccines as a non-toxic tumor
vaccine. More experimental therapies involving targeting RCC cells using
specific markers such as G250 are under investigation. In addition,
changes in the 1997 TNM classification of RCC are anticipated.
Retiring--routine adrenalectomy during radical nephrectomy and
immunotherapy using tumor infiltrating lymphocytes (TIL).
27
UI - 12132269
AU - Gschwend JE; Huland E
TI -
[Metastatic renal cell carcinoma]
SO - Urologe A 2002 May;41(3):219-20
28
UI - 12132270
AU - Scheepe JR; Mickisch GH
TI -
[The value of tumor nephrectomy in metastatic renal cell carcinoma]
SO - Urologe A 2002 May;41(3):221-4
AD - Urologische Universitatsklinik, Erasmus Medical Center und Academic
Hospital, Rotterdam, Niederlande.
In the case of an organ-confined RCC, tumor nephrectomy is the
undisputed therapy of choice even though overall 5-year survival has not
surpassed the 60% threshold. Further improvement will most likely have
to await the development of more effective systemic treatment
strategies. For an exclusively surgical therapy of metastatic RCC, tumor
nephrectomy, sometimes in combination with metastasectomy, can be
applied. However, more commonly used is a multimodality approach
consisting of a cytoreductive operation followed by immunotherapy.
Alternatively, one may select immunotherapy first followed by adjuvant
nephrectomy in the case of a response, or one may proceed directly to
immunotherapy only. Long-term survival does not exceed 5-10%, and
patient selection appears to have a higher prognostic impact than any
treatment strategy available. Concepts and progress in the field clearly
are of increasing value for modern oncologic urologists. The current
standard, a multimodality treatment of metastatic RCC, in which an
operation becomes necessary at a certain point in time, easily justifies
a central role for the urologic surgeon.
29
UI - 12132271
AU - Volkmer BG; Gschwend JE
TI -
[Value of metastases surgery in metastatic renal cell carcinoma]
SO - Urologe A 2002 May;41(3):225-30
AD - Klinik fur Urologie und Kinderurologie, Urologischen Universitatsklinik
Ulm, Prittwitzstr. 43, 89075 Ulm. bjoern.volkmer@medizin.uni-ulm.de
Metastasectomy in patients with renal cell carcinoma has to be
considered as a palliative approach for symptomatic metastases (e.g.,
pathologic fracture) or as a curative approach in patients with the
option for radical resection of all metastases. By modern perioperative
management, even extended resections can be performed with limited
morbidity and mortality. The survival rate is significantly higher after
resection of pulmonary metastases than after resection of extrapulmonary
metastases. Solitary metastases show a better prognosis than multiple
metastases. Metachronous metastases that develop after a tumor-free
interval of at least 12 months after tumor nephrectomy have a better
prognosis than earlier metastases. For metastases that are resected with
a curative intent, the best long-term results can be achieved after
complete or radical resection.
30
UI - 12132272
AU - Brinkmann OA; Roigas J; Hertle L
TI -
[Systemic immunotherapy of metastatic renal cell carcinoma and long-term
outcome]
SO - Urologe A 2002 May;41(3):231-8
AD - Klinik und Poliklinik fur Urologie, Universitatsklinikum Munster,
Albert-Schweitzer-Strasse 33, 48129 Munster. brinkmo@uni-muenster.de
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