ABSTRACT
The NCCN Guidelines for Prostate Cancer include recommendations for staging and risk assessment after a prostate cancer diagnosis and for the care of patients with localized, regional, recurrent, and metastatic disease. These NCCN Guidelines Insights summarize the panel's discussions for the 2024 update to the guidelines with regard to initial risk stratification, initial management of very-low-risk disease, and the treatment of nonmetastatic recurrence.
Subject(s)
Neoplasms, Second Primary , Prostatic Neoplasms , Male , Humans , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Risk AssessmentABSTRACT
The NCCN Guidelines for Prostate Cancer provide a framework on which to base decisions regarding the workup of patients with prostate cancer, risk stratification and management of localized disease, post-treatment monitoring, and treatment of recurrence and advanced disease. The Guidelines sections included in this article focus on the management of metastatic castration-sensitive disease, nonmetastatic castration-resistant prostate cancer (CRPC), and metastatic CRPC (mCRPC). Androgen deprivation therapy (ADT) with treatment intensification is strongly recommended for patients with metastatic castration-sensitive prostate cancer. For patients with nonmetastatic CRPC, ADT is continued with or without the addition of certain secondary hormone therapies depending on prostate-specific antigen doubling time. In the mCRPC setting, ADT is continued with the sequential addition of certain secondary hormone therapies, chemotherapies, immunotherapies, radiopharmaceuticals, and/or targeted therapies. The NCCN Prostate Cancer Panel emphasizes a shared decision-making approach in all disease settings based on patient preferences, prior treatment exposures, the presence or absence of visceral disease, symptoms, and potential side effects.
Subject(s)
Prostatic Neoplasms, Castration-Resistant , Prostatic Neoplasms , Humans , Male , Androgen Antagonists/therapeutic use , Hormones/therapeutic use , Prostatic Neoplasms/therapy , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms, Castration-Resistant/therapy , Prostatic Neoplasms, Castration-Resistant/drug therapyABSTRACT
The NCCN Guidelines for Survivorship are intended to help healthcare professionals address the complex and varied needs of cancer survivors. The NCCN Guidelines provide screening, evaluation, and treatment recommendations for psychosocial and physical problems resulting from adult-onset cancer and its treatment; recommendations to help promote healthy behaviors and immunizations in survivors; and a framework for care coordination. These NCCN Guidelines Insights summarize recent guideline updates and panel discussions pertaining to sleep disorders, fatigue, and cognitive function in cancer survivors.
Subject(s)
Cancer Survivors , Neoplasms , Adult , Humans , Survivorship , Neoplasms/diagnosis , Neoplasms/therapy , Neoplasms/psychology , Survivors , Cancer Survivors/psychology , ImmunizationABSTRACT
Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by the clonal expansion of myeloid blasts in the peripheral blood, bone marrow, and/or other tissues. It is the most common form of acute leukemia among adults and accounts for the largest number of annual deaths from leukemias in the United States. Like AML, blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a myeloid malignancy. It is a rare malignancy characterized by the aggressive proliferation of precursors of plasmacytoid dendritic cells that frequently involves the bone marrow, skin, central nervous system, and other organs and tissues. This discussion section focuses on the diagnosis and management of BPDCN as outlined in the NCCN Guidelines for AML.
Subject(s)
Hematologic Neoplasms , Leukemia, Myeloid, Acute , Skin Neoplasms , Adult , Humans , Dendritic Cells/pathology , Hematologic Neoplasms/diagnosis , Leukemia, Myeloid, Acute/diagnosis , Leukemia, Myeloid, Acute/therapy , Leukemia, Myeloid, Acute/pathology , Medical Oncology , Skin Neoplasms/diagnosisABSTRACT
A core component of NCCN's mission is to improve and facilitate equitable cancer care. Inclusion and representation of diverse populations are essential toward this goal of equity. Within NCCN's professional content, inclusivity increases the likelihood that clinicians are prepared to provide optimal oncology care to all patients; within NCCN's patient-facing content, it helps ensure that cancer information is relevant and accessible for all individuals. This article describes changes that have been made in the language and images used in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) and the NCCN Guidelines for Patients to promote justice, respect, and inclusion for all patients with cancer. The goals are to use language that is person-first, nonstigmatizing, inclusive of individuals of all sexual orientations and gender identities, and anti-racist, anti-classist, anti-misogynist, anti-ageist, anti-ableist, and anti-fat-biased. NCCN also seeks to incorporate multifaceted diversity in images and illustrations. NCCN is committed to continued and expanding efforts to ensure its publications are inclusive, respectful, and trustworthy, and that they advance just, equitable, high-quality, and effective cancer care for all.
Subject(s)
Neoplasms , Respect , Humans , Neoplasms/diagnosis , Neoplasms/therapy , Medical Oncology , Language , Surveys and QuestionnairesABSTRACT
The NCCN Guidelines for Prostate Cancer Early Detection provide recommendations for individuals with a prostate who opt to participate in an early detection program after receiving the appropriate counseling on the pros and cons. These NCCN Guidelines Insights provide a summary of recent updates to the NCCN Guidelines with regard to the testing protocol, use of multiparametric MRI, and management of negative biopsy results to optimize the detection of clinically significant prostate cancer and minimize the detection of indolent disease.
Subject(s)
Early Detection of Cancer , Prostatic Neoplasms , Male , Humans , Early Detection of Cancer/methods , Prostate , Prostatic Neoplasms/diagnosis , BiopsyABSTRACT
The NCCN Guidelines for Prostate Cancer address staging and risk assessment after a prostate cancer diagnosis and include management options for localized, regional, recurrent, and metastatic disease. The NCCN Prostate Cancer Panel meets annually to reevaluate and update their recommendations based on new clinical data and input from within NCCN Member Institutions and from external entities. These NCCN Guidelines Insights summarizes much of the panel's discussions for the 4.2022 and 1.2023 updates to the guidelines regarding systemic therapy for metastatic prostate cancer.
Subject(s)
Prostatic Neoplasms , Male , Humans , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Risk AssessmentABSTRACT
The NCCN Guidelines for Survivorship are intended to help healthcare professionals who work with survivors to ensure that the survivors' complex and varied needs are addressed. The NCCN Guidelines provide screening, evaluation, and treatment recommendations for the consequences of adult-onset cancer and its treatment; recommendations to help promote physical activity, weight management, and immunizations in survivors; and a framework for care coordination. This article summarizes updates to the NCCN Guidelines pertaining to preventive health for cancer survivors, including recommendations about alcohol consumption and vaccinations.
Subject(s)
Cancer Survivors , Neoplasms , Adult , Humans , Immunization , Neoplasms/diagnosis , Neoplasms/therapy , Survivors , SurvivorshipABSTRACT
The NCCN Guidelines for Acute Lymphoblastic Leukemia (ALL) focus on the classification of ALL subtypes based on immunophenotype and cytogenetic/molecular markers; risk assessment and stratification for risk-adapted therapy; treatment strategies for Philadelphia chromosome (Ph)-positive and Ph-negative ALL for both adolescent and young adult and adult patients; and supportive care considerations. Given the complexity of ALL treatment regimens and the required supportive care measures, the NCCN ALL Panel recommends that patients be treated at a specialized cancer center with expertise in the management of ALL This portion of the Guidelines focuses on the management of Ph-positive and Ph-negative ALL in adolescents and young adults, and management in relapsed settings.
Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma , Adolescent , Humans , Immunophenotyping , Medical Oncology , Philadelphia Chromosome , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Young AdultABSTRACT
The NCCN Guidelines for Survivorship are intended to help healthcare professionals working with cancer survivors to ensure that each survivor's complex and varied needs are addressed. The Guidelines provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment; recommendations to help promote healthful lifestyle behaviors, weight management, and immunizations in survivors; and a framework for care coordination. This article summarizes the recommendations regarding employment and return to work for cancer survivors that were added in the 2021 version of the NCCN Guidelines.
Subject(s)
Cancer Survivors , Neoplasms , Adult , Humans , Mass Screening , Neoplasms/diagnosis , Neoplasms/therapy , Survivors , SurvivorshipABSTRACT
The NCCN Guidelines for Prostate Cancer address staging and risk assessment after a prostate cancer diagnosis and include management options for localized, regional, and metastatic disease. Recommendations for disease monitoring and treatment of recurrent disease are also included. The NCCN Prostate Cancer Panel meets annually to reevaluate and update their recommendations based on new clinical data and input from within NCCN Member Institutions and from external entities. This article summarizes the panel's discussions for the 2021 update of the guidelines with regard to systemic therapy for metastatic castration-resistant prostate cancer.
Subject(s)
Prostatic Neoplasms , Humans , Male , Neoplasm Metastasis , Neoplasm Staging , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Prostatic Neoplasms, Castration-Resistant , Risk AssessmentABSTRACT
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment, with the goal of helping healthcare professionals who work with survivors, including those in primary care. The guidelines also provide recommendations to help clinicians promote physical activity, weight management, and proper immunizations in survivors and facilitate care coordination to ensure that all of the survivors' needs are addressed. These NCCN Guidelines Insights summarize additions and changes made to the guidelines in 2020 regarding cardiovascular disease risk assessment and screening for subsequent primary malignancies.
Subject(s)
Neoplasms , Survivorship , Adult , Body Weight Maintenance , Exercise , Humans , Immunization , Mass Screening , Neoplasms/diagnosis , Neoplasms/therapy , Practice Guidelines as Topic , SurvivorsABSTRACT
Pediatric aggressive mature B-cell lymphomas are the most common types of non-Hodgkin lymphoma in children, and they include Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). These diseases are highly aggressive but curable, the treatment is complex, and patients may have many complicated supportive care issues. The NCCN Guidelines for Pediatric Aggressive Mature B-Cell Lymphomas provide guidance regarding pathology and diagnosis, staging, initial treatment, disease reassessment, surveillance, therapy for relapsed/refractory disease, and supportive care for clinicians who treat sporadic pediatric BL and DLBCL.
Subject(s)
Burkitt Lymphoma , Lymphoma, Large B-Cell, Diffuse , Burkitt Lymphoma/diagnosis , Burkitt Lymphoma/epidemiology , Burkitt Lymphoma/therapy , Child , Humans , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/therapy , Medical OncologyABSTRACT
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of cancer and cancer treatment to aid healthcare professionals who work with survivors of adult-onset cancer. Guidance is also provided to help promote physical activity, weight management, and proper immunizations in survivors and to facilitate care coordination to ensure that all needs are addressed. These NCCN Insights summarize some of the topics discussed by the NCCN Survivorship Panel during the 2019 update of the guidelines, including the survivorship population addressed, ways to improve care coordination, and pain management.
Subject(s)
Guidelines as Topic , Neoplasms/therapy , Survivorship , Body Weight Maintenance/physiology , Exercise/physiology , Humans , Neoplasms/pathologyABSTRACT
The NCCN Guidelines for Prostate Cancer include recommendations regarding diagnosis, risk stratification and workup, treatment options for localized disease, and management of recurrent and advanced disease for clinicians who treat patients with prostate cancer. The portions of the guidelines included herein focus on the roles of germline and somatic genetic testing, risk stratification with nomograms and tumor multigene molecular testing, androgen deprivation therapy, secondary hormonal therapy, chemotherapy, and immunotherapy in patients with prostate cancer.
Subject(s)
Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Disease Management , Disease Susceptibility , Humans , Male , Prostatic Neoplasms/etiologyABSTRACT
As treatment of HIV has improved, people living with HIV (PLWH) have experienced a decreased risk of AIDS and AIDS-defining cancers (non-Hodgkin's lymphoma, Kaposi sarcoma, and cervical cancer), but the risk of Kaposi sarcoma in PLWH is still elevated about 500-fold compared with the general population in the United States. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for AIDS-Related Kaposi Sarcoma provide diagnosis, treatment, and surveillance recommendations for PLWH who develop limited cutaneous Kaposi sarcoma and for those with advanced cutaneous, oral, visceral, or nodal disease.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/therapy , Sarcoma, Kaposi/diagnosis , Sarcoma, Kaposi/therapy , AIDS-Related Opportunistic Infections/epidemiology , AIDS-Related Opportunistic Infections/etiology , Humans , Sarcoma, Kaposi/epidemiology , Sarcoma, Kaposi/etiologyABSTRACT
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for common physical and psychosocial consequences of cancer and cancer treatment to help healthcare professionals who work with survivors of adult-onset cancer in the posttreatment period. This portion of the guidelines describes recommendations regarding the management of anthracycline-induced cardiotoxicity and lymphedema. In addition, recommendations regarding immunizations and the prevention of infections in cancer survivors are included.
Subject(s)
Cancer Survivors , Medical Oncology/standards , Neoplasms/therapy , Survivorship , Anthracyclines/adverse effects , Antibiotics, Antineoplastic/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Bacterial Infections/immunology , Bacterial Infections/prevention & control , Cardiotoxicity/diagnosis , Cardiotoxicity/etiology , Cardiotoxicity/therapy , Humans , Immunocompromised Host/drug effects , Immunocompromised Host/immunology , Immunocompromised Host/radiation effects , Lymphedema/chemically induced , Lymphedema/diagnosis , Lymphedema/therapy , Mass Screening/methods , Mass Screening/standards , Medical Oncology/methods , Neoplasms/complications , Neoplasms/immunology , Neoplasms/psychology , Risk Assessment/methods , Risk Assessment/standards , Societies, Medical/standards , United States , Vaccination/methods , Vaccination/standards , Virus Diseases/immunology , Virus Diseases/prevention & controlABSTRACT
People living with HIV (PLWH) are diagnosed with cancer at an increased rate over the general population and generally have a higher mortality due to delayed diagnoses, advanced cancer stage, comorbidities, immunosuppression, and cancer treatment disparities. Lack of guidelines and provider education has led to substandard cancer care being offered to PLWH. To fill that gap, the NCCN Guidelines for Cancer in PLWH were developed; they provide treatment recommendations for PLWH who develop non-small cell lung cancer, anal cancer, Hodgkin lymphoma, and cervical cancer. In addition, the NCCN Guidelines outline advice regarding HIV management during cancer therapy; drug-drug interactions between antiretroviral treatments and cancer therapies; and workup, radiation therapy, surgical management, and supportive care in PLWH who have cancer.
Subject(s)
HIV Infections/drug therapy , Medical Oncology/standards , Neoplasms/drug therapy , Opportunistic Infections/prevention & control , Anti-HIV Agents/pharmacology , Anti-HIV Agents/therapeutic use , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Comorbidity , Drug Interactions , Evidence-Based Medicine/methods , Evidence-Based Medicine/standards , HIV/drug effects , HIV/isolation & purification , HIV Infections/epidemiology , HIV Infections/immunology , HIV Infections/virology , Healthcare Disparities/standards , Humans , Immunocompromised Host/drug effects , Immunocompromised Host/immunology , Immunocompromised Host/radiation effects , Medical Oncology/methods , Neoplasms/epidemiology , Neoplasms/immunology , Neoplasms/virology , Opportunistic Infections/immunology , Opportunistic Infections/virology , Palliative Care/methods , Palliative Care/standards , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Randomized Controlled Trials as Topic , Societies, Medical/standards , Surgical Procedures, Operative/adverse effects , Surgical Procedures, Operative/methods , Surgical Procedures, Operative/standards , United StatesABSTRACT
The NCCN Guidelines for Anal Carcinoma provide recommendations for the management of patients with squamous cell carcinoma of the anal canal or perianal region. Primary treatment of anal cancer usually includes chemoradiation, although certain lesions can be treated with margin-negative local excision alone. Disease surveillance is recommended for all patients with anal carcinoma because additional curative-intent treatment is possible. A multidisciplinary approach including physicians from gastroenterology, medical oncology, surgical oncology, radiation oncology, and radiology is essential for optimal patient care.
Subject(s)
Anus Neoplasms/therapy , Carcinoma, Squamous Cell/therapy , Medical Oncology/standards , Neoplasm Recurrence, Local/therapy , Societies, Medical/standards , Anal Canal/pathology , Anal Canal/surgery , Antineoplastic Combined Chemotherapy Protocols/standards , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Anus Neoplasms/diagnosis , Anus Neoplasms/epidemiology , Anus Neoplasms/pathology , Biopsy , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/pathology , Chemoradiotherapy/methods , Chemoradiotherapy/standards , Colostomy/standards , Disease-Free Survival , Humans , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/pathology , Patient Care Team/standards , Randomized Controlled Trials as Topic , United States/epidemiologyABSTRACT
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Rectal Cancer address diagnosis, staging, surgical management, perioperative treatment, management of recurrent and metastatic disease, disease surveillance, and survivorship in patients with rectal cancer. This portion of the guidelines focuses on the management of localized disease, which involves careful patient selection for curative-intent treatment options that sequence multimodality therapy usually comprised of chemotherapy, radiation, and surgical resection.
