RESUMO
Prostate cancer is the most frequently diagnosed cancer among elderly men in the United States. Skeletal architecture is affected by metastasis and androgen deprivation therapy (ADT), which is considered a gold standard treatment in prostate cancer. Osteoporosis and skeletal effects are reported among most patients on ADT. To counter these effects and to reduce bone turnover, antiresorptive drugs such as bisphosphonates and denosumab are commonly prescribed in prostate cancer. These drugs increase the prevalence of osteonecrosis of the jaw in a subset of patients. The future should hold promise for new drugs that could have a positive impact on bone metabolism without jeopardizing bone integrity.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Neoplasias da Próstata , Idoso , Antagonistas de Androgênios/efeitos adversos , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Conservadores da Densidade Óssea/efeitos adversos , Denosumab/efeitos adversos , Difosfonatos , Humanos , Arcada Osseodentária , Masculino , Neoplasias da Próstata/tratamento farmacológicoRESUMO
The practice of dentistry has been dramatically altered by the coronavirus disease 2019 (COVID-19) pandemic. Given the close person-to-person contact involved in delivering dental care and treatment procedures that produce aerosols, dental healthcare professionals including dentists, dental assistants and dental hygienists are at high risk of exposure. As a dental clinic in a comprehensive cancer center, we have continued to safely provide medically necessary and urgent/emergent dental care to ensure that patients can adhere to their planned cancer treatment. This was accomplished through timely adaptation of clinical workflows and implementation of practice modification measures in compliance with state, national and federal guidelines to ensure that risk of transmission remained low and the health of both immunocompromised cancer patients and clinical staff remained protected. In this narrative review, we share our experience and measures that were implemented in our clinic to ensure that the oral health needs of cancer patients were met in a timely manner and in a safe environment. Given that the pandemic is still on-going, the impact of our modified oral healthcare delivery model in cancer patients warrants continued monitoring and assessment.
RESUMO
It has become increasingly clear that we live in a symbiotic relationship with microbes within us. We are just beginning to unravel the nature and strength of this relationship and its impact on both physiology and by extension, pathology. While microorganisms have long been known to have carcinogenic potential, their role may have been underestimated. The knowledge of the role of the microbiome in carcinogenesis is rapidly evolving. This evolution has reached a tipping point with current omics technologies used for cataloguing the microbiome. The lung is an organ constantly exposed to the environment. It is now clear that the lung has a distinct microbiome and that this may influence the development of lung cancer. In addition, evidence suggests that this microbiome originates from the oral microbiome. This review summarizes current knowledge about the role of microbiome, especially the oral and lung microbiome in human lung cancer. The goal of the manuscript is to provide a summary of this rapidly evolving field while providing a context of the general role of the microbiome in carcinogenesis. In addition, a primer of the current technology used in evaluating the microbiome is provided to familiarize the practicing clinician with the experimental methods used to generate the information that will likely impact the field of lung cancer.
RESUMO
Accurate mediastinal staging is the hallmark of a good thoracic oncology program. Despite advancements in imaging, surgical staging remains the gold standard of mediastinal staging for lung cancer. This review article summarizes the technique of transcervical mediastinal lymph node dissection and its role in the staging of non-small cell lung cancer (NSCLC).