Cancer Principles and Practice of Oncology

by DeVita, Jr., Vincent T.; Hellman, Samuel; Rosenberg, Steven A.

• ISBN13: 9780781722292
• ISBN10: 0781722292
• Edition: 6th
• Format: Hardcover
• Copyright: 2001-01-23
• Publisher: LWW

Summary

Acclaimed by the worldwide medical community as the standard-setting oncology reference, Cancer: Principles and Practice of Oncology is now in its Sixth Edition. This thoroughly revised and updated classic reflects the latest breakthroughs in every aspect of oncology, from molecular biology, to multimodality treatment, to new data on cancer prevention by drugs and diet. This edition places increased emphasis on the role of molecular biology in cancer diagnosis and treatment. In light of the growing clinical importance of biological therapy, a new section on Pharmacology of Cancer Biotherapeutics has been added. Chapters describe new radiotherapy techniques such as intensity-modulated radiation therapy and innovative surgical techniques such as radiofrequency ablation of tumors, isolation-perfusion for visceral cancers, and image-guided surgery. Rehabilitation is integrated into each of this edition's chapters on organ-specific cancers. Also included are new chapters on information systems in oncology, particularly on accessing information from the World Wide Web. This edition now includes a CD-ROM bound into the book. The CD-ROM has advanced search capabilities and gives you full text, high-quality video and color slides not found in the book, direct links to PubMed, and links to our new oncology portal, LWWoncology.com. The CD-ROM is also available separately.

Table of Contents

PART 1 ESSENTIALS OF MODERN ONCOLOGIC SCIENCE
Essentials of Molecular Biology: Basic Principles	3	(14)
Lance A. Liotta
Edison T. Liu
Storage and Transmission of Genetic Information	3	(4)
Reading the Genetic Code and Production of Encoded Proteins	7	(1)
Protein Structure and Function	8	(1)
Subcellular Molecular Structure	9	(3)
Different Pathways to Cancer	12	(3)
Suggested Readings	15	(2)
Essentials of Molecular Biology: Genomics and Cancer	17	(14)
Lance A. Liotta
Edison T. Liu
Understanding Cancer at the Molecular Level: The New Frontier	17	(1)
Genetic Mechanisms of Cancer Progression: Cancer Is a Genetic Disease	17	(1)
Cancer Genes: Models of Action	18	(2)
Molecular Profiling: Prognosis and Treatment Tailored to the Individual Patient	20	(1)
Postgenome Challenge for Molecular Medicine	21	(1)
cDNA Microarrays Are a New Tool to Analyze Gene Expression Patterns in Human Cancer	22	(2)
Technology for Tissue Microdissection Brings Molecular Analysis to the Tissue CellLevel	24	(1)
Tumor Tissue Arrays	25	(1)
Beyond Functional Genomics to Cancer Proteomics	25	(6)
Essentials of Signal Transduction	31	(12)
Christopher L. Carpenter
Lewis C. Cantley
The Sensory Machinery: Ligands and Receptors	31	(3)
Propagation of Signals to the Cell Interior	34	(4)
Efficiency and Specificity: Formation of Multiprotein Signaling Complexes	38	(1)
Regulation of Protein Levels: Transcription, Translation, and Proteolysis	39	(4)
Essentials of Immunology	43	(34)
Nicholas P. Restifo
John R. Wunderlich
T Cells and Cellular Immunity	43	(1)
Antigen Presentation to T Cells	44	(6)
Specialized Antigen-Presenting Cells	50	(1)
T-Cell Recognition of Antigens	51	(2)
T-Cell Maturation	53	(2)
Activation of Mature T Cells	55	(4)
States of Mature T Cells	59	(1)
Functions of Mature T Cells	60	(1)
Cytotoxic Effector Cell Mechanisms	61	(3)
B Cells and Humoral Immunity	64	(3)
Summary	67	(10)
PART 2 PRINCIPLES OF ONCOLOGY
Molecular Biology of Cancer: Cytogenetics	77	(14)
Mazin B. Qumsiyeh
Peining Li
History of Cancer Cytogenetics	77	(1)
Chromosome Structure and Function	77	(2)
Cytogenetic Methods	79	(3)
International System of Cytogenetic Nomenclature	82	(1)
Mechanisms and Implications of Chromosomal Abnormalities in Cancer	82	(4)
Cautions to Exercise in Interpreting Chromosomal Abnormalities Seen in Cancer Studies	86	(1)
Clonal Evolution and Chromosome Evolution	87	(1)
Constitutional Chromosomal Abnormalities Predisposing to Cancer Development	88	(1)
Data Mining in Cancer Cytogenetics	89	(1)
Glossary	89	(2)
Molecular Biology of Cancer: The Cell Cycle	91	(20)
Michael B. Kastan
Stephen X. Skapek
Mechanics of the Cell Division Cycle	91	(8)
Control of the Cell Division Cycle	99	(3)
Implications for Cancer	102	(9)
Molecular Biology of Cancer: Apoptosis	111	(12)
Stanley J. Korsmeyer
Sandra S. Zinkel
Apoptosis	111	(1)
Genetics of Cell Death	112	(1)
Death Receptors	113	(1)
Caspases	113	(1)
The Bcl-2 Family	114	(3)
Bcl-2 Family Members Play Critical Roles in Tissue Homeostasis	117	(1)
Role of Mitochondria	118	(1)
Cell Proliferation and Apoptosis	118	(1)
Possibilities for Therapeutic Intervention	118	(1)
Conclusions	119	(4)
Molecular Biology of Cancer: Invasion and Metastases	123	(14)
William G. Stetler-Stevenson
David E. Kleiner, Jr
The Metastatic Cascade	123	(2)
Oncogenesis: Metastasis and Tumorigenesis Are under Separate Genetic Control	125	(1)
Angiogenesis: Balance of Positive and Negative Effectors	126	(1)
Tumor Heterogeneity and Clonal Dominance	126	(1)
Defining the Invasive Phenotype	126	(1)
Cell-Cell Adhesion Suppresses or Facilitates Metastasis Formation	127	(2)
Cell-Extracellular Matrix Interactions in Tumor Progression	129	(5)
Intravasation, Extravasation, and Orthotopic Effect	134	(3)
Biology of Cancer: Angiogenesis	137	(12)
Isaiah J. Fidler
Robert S. Kerbel
Lee M. Ellis
Neoplastic Angiogenesis: The Balance of Proangiogenic and Antiangiogenic Molecules	137	(3)
Lymphoid Cell-Mediated Angiogenesis	140	(1)
Regulation of Angiogenic Factor Expression in Tumors	140	(1)
Endogenous Inhibitors of Angiogenesis	140	(1)
Clinical Utility of Angiogenesis	141	(2)
Antiangiogenic Therapy: Issues and Expectations	143	(1)
Antiangiogenic Therapy as a Component of Other Antineoplastic Regimens	144	(1)
Conclusions	144	(5)
Etiology of Cancer: Viruses	149	(30)
RNA Viruses	149	(1)
Eric M. Poeschla
Gary L. Buchschacher, Jr.
Flossie Wong-Staal
Retroviral Genetics: Selective Access to the Growth Control Genes of the Cell	149	(1)
Mechanisms of Retroviral Oncogenesis	150	(2)
Human T-Cell Leukemia Virus Type I	152	(2)
Human T-Cell Leukemia Virus Type II	154	(1)
Human Immunodeficiency Virus	154	(1)
Hepatitis C Virus	155	(3)
DNA Viruses	158	(1)
Peter M. Howley
Don Ganem
Elliott Kieff
Hepadnaviruses and Hepatocellular Carcinoma	158	(3)
Papillomaviruses and Human Cancer	161	(7)
Epstein-Barr Virus	168	(3)
Kaposi's Sarcoma-Associated Herpesvirus (Human Herpesvirus-8)	171	(8)
Etiology of Cancer: Chemical Factors	179	(16)
Stuart H. Yuspa
Peter G. Shields
The Nature of Chemical Carcinogens: Chemistry and Metabolism	180	(1)
Animal Model Systems and Multistage Carcinogenesis	181	(3)
Protection against Chemical Carcinogens: DNA Repair, Tumor Suppressor Genes, and Transforming Growth Factor-β	184	(1)
Genetic Susceptibility to Chemical Carcinogenesis in Experimental Models	184	(1)
Determination of Chemical Carcinogens for Humans and Population-Based Risk Assessment	185	(1)
Molecular Epidemiology of Cancer Risk from Chemicals	186	(4)
Mutational Spectrum of Human Cancers	190	(1)
Tobacco Smoking and Cancer Risk	190	(5)
Etiology of Cancer: Physical Factors	195	(12)
Robert L. Ullrich
Interactions of Radiation with Cells and Tissues	195	(2)
Ionizing Radiation and Cancer	197	(5)
Ultraviolet Light	202	(2)
Asbestos	204	(3)
Etiology of Cancer: Cancer Genetics	207	(12)
Allen E. Bale
Suzanne J. Brown
Cancer as a Genetic Disease	207	(1)
Mechanisms of Cancer Predisposition	207	(4)
Gatekeepers, Caretakers, and Landscapers	211	(1)
Clinical Characteristics of Cancer Families	211	(1)
Multisystem Genetic Syndromes with a High Risk of Cancer	212	(3)
Nonsyndromic Hereditary Cancer	215	(4)
Epidemiology of Cancer	219	(34)
Epidemiologic Methods	219	(1)
Margaret A. Tucker
Observational Studies	219	(2)
Descriptive Studies	221	(1)
Analytic Studies	221	(5)
Intervention Studies	226	(1)
Future Directions	227	(1)
Descriptive Epidemiology: Cancer Statistics	228	(1)
Philip Cole
Brad Rodu
Descriptive Epidemiology	228	(10)
Perspectives	238	(3)
Analytic Epidemiology: Cancer Causes	241	(1)
Philip Cole
Brad Rodu
Evaluating Carcinogenicity	241	(1)
Causes of Cancer	242	(7)
Perspectives	249	(4)
Principles of Cancer Management: Surgical Oncology	253	(12)
Steven A. Rosenberg
Historical Perspective	253	(1)
Anesthesia for Oncologic Surgery	254	(2)
Determination of Operative Risk	256	(3)
Roles for Surgery	259	(3)
The Surgical Oncologist	262	(3)
Principles of Cancer Management: Radiation Therapy	265	(24)
Samuel Hellman
Physical Considerations	265	(5)
Biologic Considerations	270	(12)
Clinical Considerations	282	(7)
Principles of Cancer Management: Chemotherapy	289	(18)
Edward Chu
Vincent T. Devita, Jr.
History	289	(1)
Chemotherapy as Part of the Initial Treatment of Cancer	290	(1)
Clinical End Points in Evaluating Response to Chemotherapy	291	(1)
Principles Governing the Use of Combination Chemotherapy	292	(2)
Effect of the Biology of Tumor Growth on Response to Chemotherapy	294	(1)
Apoptosis, Cell-Cycle Control, and Resistance to Chemotherapy	295	(5)
Concept of Dose Intensity	300	(2)
In Vitro Drug-Response Assays	302	(5)
Principles of Cancer Management: Biologic Therapy	307	(28)
Steven A. Rosenberg
Basic Principles of Tumor Immunology	307	(1)
Cells of the Immune System	308	(1)
Immune Effector Mechanisms Resulting in Cell Destruction	308	(1)
Cytokines	308	(12)
Tumor Antigens	320	(4)
Immunotherapy	324	(2)
Interferons	326	(9)
Pharmacology of Cancer Chemotherapy	335	(126)
Pharmacokinetics and Pharmacodynamics	335	(1)
Mark J. Ratain
Pharmacokinetics: Fundamental Principles	335	(3)
Pharmacokinetics: What's Important to the Clinician?	338	(1)
Basic Methodology of Pharmacokinetic Studies	339	(1)
Pharmacodynamics	340	(1)
Rational Use of Pharmacokinetic and Pharmacodynamic Data in Clinical Oncology	340	(5)
Cancer Drug Development	345	(1)
Identification and Screening of New Agents	345	(1)
Edward Chu
Michael R. Grever
Bruce A. Chabner
Drug Discovery	345	(7)
Drug Development	352	(2)
Conclusion	354	(2)
Combinatorial Chemistry	356	(1)
David J. Austin
Principles of Combinatorial Chemistry	356	(1)
The History of Combinatorial Chemistry	357	(2)
The Practice of Combinatorial Chemistry	359	(1)
Combinatorial Chemistry in Pharmaceutical Drug Development	360	(2)
The Future of Chemical Diversity in Drug Development	362	(1)
Antitumor Alkylating Agents	363	(1)
Oliver Michael Colvin
History of the Alkylating Agents	363	(1)
Chemistry and Cytotoxicity of Alkylating Agents	363	(1)
Classes of Alkylating Agents and Their Properties	363	(6)
Mechanisms of Toxicity and Drug Resistance	369	(2)
Common Toxicities	371	(5)
Cisplatin and Its Analogues	376	(1)
Steven W. Johnson
James P. Stevenson
Peter J. O'Dwyer
Platinum Chemistry	376	(1)
Evolution of Novel Platinum Complexes	377	(1)
Mechanism of Action	378	(2)
Mechanisms of Resistance	380	(3)
Clinical Pharmacology	383	(5)
Antimetabolites	388	(1)
Edward Chu
Augusto C. Mota
Miklos C. Fogarasi
Methotrexate	388	(5)
New Antifolates	393	(1)
Other Antifolates	393	(5)
Strategies to Permit Oral Administration of Fluoropyrimidines	398	(18)
Topoisomerase Interactive Agents	415	(1)
Clinton F. Stewart
Mark J. Ratain
Mechanism of Action of Topoisomerase Interactive Agents	416	(2)
Epipodophyllotoxins	418	(4)
Camptothecin Analogues	422	(3)
Anthracyclines and Related Compounds	425	(2)
Mitoxantrone and Losoxantrone	427	(1)
Dactinomycin (Actinomycin D)	428	(3)
Antimicrotubule Agents	431	(1)
Eric K. Rowinsky
Anthony W. Tolcher
Microtubules	431	(1)
Microtubule-Associated Proteins and Microtubule Motors	432	(1)
Vinca Alkaloids	432	(5)
The Taxanes	437	(8)
Estramustine Phosphate	445	(2)
Novel Compounds Targeting Microtubules	447	(5)
Miscellaneous Chemotherapeutic Agents	452	(1)
Bruce D. Cheson
Homoharringtonine	452	(1)
Suramin	453	(1)
Bleomycin	453	(1)
L-Asparaginase	454	(1)
Amifostine	455	(6)
Pharmacology of Cancer Biotherapeutics	461	(60)
Interferons	461	(1)
John M. Kirkwood
Rationale for Investigation of Interferons: Direct Regulation of Cell Growth, Differentiation, Antigen Expression; Indirect Effects Mediated through Modulation of the Host Immune Response	461	(3)
Clinical Evaluation	464	(7)
Interleukin-2	471	(1)
James W. Mier
Michael B. Atkins
Isolation, Characterization, and Cloning of Interleukin-2	471	(1)
Interleukin-2 Receptor	472	(1)
Interleukin-2-Activated Signaling Pathways	472	(1)
In Vitro Effects of Interleukin-2	473	(1)
Preclinical Studies with Interleukin-2 in Tumor-Bearing Mice	473	(1)
Clinical Applications of Interleukin-2	473	(2)
Biology and Pharmacokinetics of Interleukin-2	475	(1)
Attempts to Improve Activity of Interleukin-2-Based Therapy	476	(2)
Hormonal Therapies	478	(1)
Charles Erlichman
Charles L. Loprinzi
Selective Estrogen Receptor Modulators	478	(3)
Medroxyprogesterone and Megestrol	481	(1)
Aromatase Inhibitors	482	(1)
Gonadotropin-Releasing Hormone Analogues	483	(1)
Antiandrogens	484	(1)
Fluoxymesterone	485	(1)
Diethylstilbestrol and Estradiol (Estrace)	485	(1)
Octreotide	486	(3)
Differentiation Agents	489	(1)
Raymond P. Warrell, Jr.
Retinoids	489	(2)
Arsenic Trioxide	491	(1)
Histone Deacetylase Inhibitors	491	(2)
Vitamin D	493	(1)
Cytokines and Other Proteins	493	(2)
Therapeutic Monoclonal Antibodies: General Principles	495	(1)
Louis M. Weiner
Gregory P. Adams
Margaret von Mehren
Immunoglobulin Structure: Structural and Functional Domains	495	(1)
Factors Regulating Antibody-Based Tumor Targeting	495	(2)
Unconjugated Antibodies	497	(3)
Immunoconjugates	500	(1)
Therapeutic Applications	501	(4)
Future Directions	505	(4)
Antiangiogenesis Agents	509	(1)
Judah Folkman
Guidelines to the Biologic Basis of Antiangiogenic Therapy	509	(8)
Clinical Trials of Angiogenesis Inhibitors	517	(4)
Clinical Trials in Cancer	521	(28)
Design and Analysis of Clinical Trials	521	(1)
Richard Simon
Phase I Clinical Trials	521	(2)
Phase II Clinical Trials	523	(3)
Design of Phase III Clinical Trials	526	(5)
Analysis of Phase III Clinical Trials	531	(6)
Epidemiology of Clinical Trials	537	(1)
Metaanalysis	537	(2)
Research Data Management	539	(1)
Douglas Hageman
Dianne M. Reeves
Protocol Development	539	(1)
Protocol Implementation	540	(3)
Information Technology	543	(1)
Data Classification	544	(1)
U.S. Food and Drug Administration Recommendations	544	(1)
Data Validation	544	(1)
Direct Data Capture	545	(1)
Security	545	(1)
Summary	545	(4)
PART 3 PRACTICE OF ONCOLOGY
Cancer Prevention: Preventing Tobacco-Related Cancers	549	(12)
Howard K. Koh
Christine Kannler
Alan C. Geller
Tobacco and Nicotine Addiction	549	(1)
Health Effects	550	(1)
Smoking Rates and Trends	550	(2)
Cigarette Product Modification	552	(1)
Spit Tobacco	552	(1)
Cigars	552	(1)
Environmental Tobacco Smoke	552	(1)
Tobacco Industry Advertising Strategies	553	(1)
Strategies for Tobacco Control	553	(2)
Community Level and State Interventions	555	(1)
Tobacco Taxes That Fund Dedicated, Comprehensive Statewide Tobacco Control Programs	556	(1)
Mass Media and Counter-Advertising	557	(1)
Tobacco Litigation and Tobacco Settlement	557	(1)
Proposed U.S. Food and Drug Administration Regulation	558	(1)
Conclusion	558	(3)
Cancer Prevention: Diet and Chemopreventive Agents	561	(56)
Fat	561	(1)
Walter C. Willett
Fat and Breast Cancer	562	(2)
Fat and Colon Cancer	564	(1)
Fat and Prostate Cancer	565	(1)
Other Cancers	565	(1)
Summary	565	(3)
Dietary Fibers	568	(1)
Peter Greenwald
Sources and Types of Dietary Fiber	568	(1)
Dietary Fiber and Colorectal Cancer	568	(4)
Dietary Fiber and Breast Cancer	572	(1)
Dietary Fiber and Other Cancers	573	(1)
Public Health Implications	573	(2)
Retinoids, Carotenoids, and Micronutrients	575	(1)
Susan Taylor Mayne
Scott M. Lippman
Historical Perspective	575	(1)
Retinoid Biology and Pharmacology	576	(1)
Carotenoid Biology and Actions	577	(1)
Clinical Trials	577	(9)
Translational and Intermediate End Point Studies in Retinoid Chemoprevention	586	(1)
New Retinoids and Carotenoids	587	(1)
Conclusions	588	(2)
Naturally Occurring Dietary Anticarcinogens	590	(1)
Peter Greenwald
Carotenoids	590	(1)
Phytoestrogens	591	(1)
Organosulfur and Organoselenium Compounds	591	(1)
Phenolic Compounds	592	(1)
Monoterpenes	593	(1)
Isothiocyanates and Indoles	593	(1)
Protease Inhibitors	594	(1)
Implications for Cancer Prevention	594	(2)
Dietary Carcinogens	595	(1)
Peter Greenwald
Naturally Occurring Dietary Carcinogens	596	(1)
Products of Food Preparation and Processing	597	(2)
Synthetic Carcinogens in the Diet	599	(1)
Future Research Needs	599	(2)
Aspirin and Other Nonsteroidal Antiinflammatory Drugs and the Risk of Cancer Development	601	(1)
Michael J. Thun
Charles H. Hennekens
Pharmacology and Toxicity of Nonsteroidal Antiinflammatory Drugs	601	(1)
Historical Evolution of the Hypothesis That Nonsteroidal Antiinflammatory Drugs Inhibit Cancer	602	(4)
Cellular Mediators of Tumor Inhibition	606	(1)
Nonsteroidal Antiinflammatory Drugs and Cancers Other Than Colorectal Cancer	607	(1)
Dose and Duration Issues in Chemoprevention	607	(3)
Physical Activity and Body Weight	610	(1)
Graham A. Colditz
Colon Cancer	610	(2)
Breast Cancer	612	(1)
Obesity	613	(1)
Relationship between Obesity and Carcinoma	614	(1)
Conclusions	614	(3)
Cancer Prevention: Role of Surgery in Cancer Prevention	617	(10)
Richard M. Sherry
Multiple Endocrine Neoplasia 2 and Familial Medullary Thyroid Carcinoma	617	(1)
Barrett's Esophagus and Esophageal Cancer	618	(2)
Breast Cancer	620	(1)
Ovarian Cancer	621	(1)
Colorectal Cancer	622	(2)
Testicular Cancer and Cryptorchidism	624	(3)
Cancer Screening	627	(14)
Barbara K. Rimer
Joellen Schildkraut
Robert A. Hiatt
What Is Cancer Screening?	627	(1)
Evaluation of a Screening Test	628	(1)
Breast Cancer Screening	629	(5)
Cervical Cancer Screening	634	(1)
Skin Cancer Screening	634	(1)
Prostate Cancer Screening	634	(1)
Colorectal Cancer Screening	635	(2)
Lung Cancer Screening	637	(1)
The Future of Screening	637	(4)
Cancer Diagnosis: Molecular Pathology	641	(18)
Jose Costa
Carlos Cordon-Cardo
Role of Molecular Pathology in Clinical Oncology and Translational Research	641	(1)
Use of Human Tissue Samples for Molecular Analyses	642	(1)
Overview of the Technological Approaches to Molecular Diagnostics	643	(8)
Applications of Molecular Markers: Diagnostic Molecular Pathology	651	(4)
Considerations for the Future	655	(4)
Cancer Diagnosis: Imaging	659	(62)
Computed Tomography	659	(1)
Elliot K. Fishman
Bruce A. Urban
Liver	659	(1)
Pancreas	660	(1)
Kidney	661	(1)
Adrenal Gland	662	(1)
Small Bowel and Colon	663	(2)
Esophagus and Stomach	665	(1)
Lungs and Mediastinum	665	(3)
Musculoskeletal System	668	(1)
Central Nervous System	668	(1)
Summary	668	(1)
Magnetic Resonance Imaging	669	(1)
Arthur E. Li
David A. Bluemke
Basic Principles	669	(2)
Brain	671	(1)
Spine	672	(1)
Head and Neck	672	(1)
Breast	673	(1)
Liver	673	(1)
Adrenal Glands	674	(1)
Kidney	675	(1)
Uterus	675	(1)
Cervix	675	(1)
Ovary	676	(1)
Prostate	676	(1)
Bladder	677	(1)
Musculoskeletal System	677	(2)
Functional and Metabolic Imaging	679	(1)
Martin G. Pomper
Techniques for Functional and Metabolic Imaging	679	(8)
New Functional and Metabolic Imaging Modalities	687	(1)
Summary	687	(3)
Interventional Radiology	690	(1)
Jean-Francois H. Geschwind
Diagnostic Procedures	690	(2)
Therapeutic Interventions	692	(16)
Ultrasound	708	(1)
Ulrike M. Hamper
Ultrasonography Applications	708	(1)
Urologic Oncology	708	(1)
Gynecologic Oncology	709	(1)
Medical Oncology	710	(2)
Ultrasonographically Guided Interventional Procedures	712	(1)
Summary	713	(1)
Radionuclide Imaging	714	(1)
E. Edmund Kim
Indirect Radionuclide Tumor Imaging	714	(2)
Direct Radionuclide Tumor Imaging	716	(5)
Cancer Diagnosis: Endoscopy	721	(18)
Robert C. Kurtz
Robert J. Ginsberg
Upper Gastrointestinal Endoscopy	721	(1)
Endoscopic Ultrasonography	722	(2)
Sigmoidoscopy	724	(1)
Colonoscopy	725	(1)
Laparoscopy	726	(1)
Endoscopic Retrograde Cholangiopancreatography	727	(2)
Small Intestinal Endoscopy: Enteroscopy	729	(1)
Percutaneous Endoscopic Gastrostomy	729	(1)
Bronchoscopy	729	(4)
Mediastinoscopy	733	(1)
Thoracoscopy	734	(5)
Specialized Techniques in Cancer Management	739	(50)
Laparoscopy	739	(1)
Alan T. Lefor
Laparoscopic Physiology	740	(1)
Port-Site Metastases	741	(1)
Laparoscopy in the Diagnosis of Malignancy	742	(1)
Laparoscopy in the Staging of Malignancy	743	(7)
Laparoscopy in the Treatment of Malignancy	750	(6)
Laparoscopy in the Palliation of Malignancy	756	(1)
The Future of Laparoscopy in the Care of the Patient with Cancer	757	(3)
Vascular Access and Specialized Techniques of Drug Delivery	760	(1)
Steven K. Libutti
McDonald K. Horne III
Catheter Types	760	(2)
Insertion Technique	762	(2)
Selecting the Appropriate Catheter	764	(1)
Catheter-Related Complications	765	(4)
Isolation Perfusion	769	(1)
H. Richard Alexander
Principles of Isolation Perfusion	769	(2)
Results of Isolation Perfusion	771	(4)
Conclusions	775	(2)
Intensity-Modulated Radiation Therapy	777	(1)
C. Clifton Ling
Chen Chui
Thomas Losasso
Chandra Burman
Margie Hunt
Gigas Mageras
Howard Ira Amols
Michael J. Zelefsky
Zvi Y. Fuks
Steven A. Leibel
Process of Intensity-Modulated Radiotherapy	777	(6)
Clinical Experience	783	(2)
Consideration of Treatment Uncertainties	785	(1)
Development and Research Issues	785	(4)
Cancer of the Head and Neck	789	(128)
Molecular Biology of Head and Neck Tumors	789	(1)
David Sidransky
Genetic Susceptibility	789	(1)
Cytogenetic Alterations	790	(1)
Protooncogenes	790	(1)
Suppressive Growth Regulation	790	(1)
Tumor Suppressor Genes	791	(1)
Field Cancerization	792	(1)
Molecular Epidemiology	793	(1)
Human Papillomavirus	793	(1)
Diagnostics	793	(4)
Tumors of the Nasal Cavity and Paranasal Sinuses, Nasopharynx, Oral Cavity, and Oropharynx	797	(1)
Stimson P. Schantz
Louis B. Harrison
Arlene A. Forastiere
Anatomy	797	(1)
Pathology	797	(1)
Staging and Screening	797	(3)
Treatment	800	(4)
Principles of Chemotherapy: Recurrent and Metastatic Disease	804	(7)
Biologic Targeted Therapies	811	(1)
Principles of Chemotherapy: Previously Untreated Disease	811	(2)
Postoperative Adjuvant Treatment	813	(4)
Principles of Chemoprevention	817	(2)
Posttreatment Rehabilitation	819	(1)
Nasal Cavity and Paranasal Sinuses	819	(5)
Nasopharynx	824	(8)
Oral Cavity	832	(1)
Lip	833	(1)
Alveolar Ridge and Retromolar Trigone	834	(2)
Floor of Mouth	836	(3)
Tongue	839	(2)
Hard Palate	841	(1)
Buccal Mucosa	841	(1)
Rehabilitation of the Oral Cancer Patient	842	(1)
Oropharynx	842	(1)
Base of Tongue	843	(3)
Tonsil, Tonsillar Pillar, and Soft Palate	846	(4)
Pharyngeal Wall	850	(11)
Tumors of the Larynx and Hypopharynx	861	(1)
Roy B. Sessions
Louis B. Harrison
Arlene A. Forastiere
Larynx	861	(17)
Hypopharynx	878	(8)
Tumors of the Salivary Glands and Paragangliomas	886	(1)
Roy B. Sessions
Louis B. Harrison
Arlene A. Forastiere
Major Salivary Gland Tumors	886	(11)
Minor Salivary Gland Tumors	897	(3)
Paragangliomas	900	(7)
Rehabilitation after Treatment for Head and Neck Cancer	907	(1)
Susan D. Miller
Roy B. Sessions
Pretreatment Assessment	907	(1)
Diagnostic Evaluation	907	(1)
Posttreatment Intervention	908	(6)
Volunteer and Support Organizations	914	(3)
Cancer of the Lung	917	(102)
Molecular Biology of Lung Cancer	917	(1)
Yoshitaka Sekido
Kwun M. Fong
John D. Minna
Genetic and Epigenetic Alterations in Lung Cancers	917	(1)
Protooncogenes and Growth Stimulation	918	(2)
Tumor Suppressor Genes and Growth Suppression	920	(2)
Other Biologic Abnormalities for Lung Cancer Development	922	(2)
Molecular Tools in the Lung Cancer Clinic	924	(1)
Non-Small Cell Lung Cancer	925	(1)
Robert J. Ginsberg
Everett E. Vokes
Kenneth Rosenzweig
Epidemiology	925	(2)
Pathology	927	(6)
Diagnosis and Staging	933	(6)
Pretreatment Prognostic Factors	939	(3)
Occult Disease	942	(1)
Chemoprevention	943	(1)
Overview of Invasive Lung Cancer Management: Treatment Modalities	943	(8)
Specifics of Lung Cancer Management	951	(32)
Small Cell Lung Cancer	983	(1)
John Murren
Eli Glatstein
Harvey I. Pass
Epidemiology and Etiology	983	(1)
Pathology	984	(1)
Clinical Presentation	985	(1)
Staging Evaluation and Prognostic Factors	986	(2)
Treatment	988	(2)
Combination Chemotherapy	990	(2)
Duration of Chemotherapy	992	(1)
General Approach to Patients with Limited Disease	992	(8)
General Approach to Patients with Extensive Disease	1000	(1)
Strategies to Optimize Chemotherapy Response	1001	(5)
Management of Small Cell Lung Cancer in the Elderly and Infirm	1006	(1)
Biologic Response Modifiers and Other Treatments	1007	(1)
Treatment at Relapse	1008	(1)
Treatment Outcome and Long-Term Survival	1009	(1)
Extrapulmonary Small Cell Carcinoma	1010	(9)
Neoplasms of the Mediastinum	1019	(18)
Robert B. Cameron
Patrick J. Loehrer
Charles R. Thomas, Jr.
Anatomy	1019	(1)
Incidence and Pathology	1019	(1)
Diagnostic Considerations	1020	(3)
Thymic Neoplasms	1023	(5)
Germ Cell Tumors	1028	(2)
Mesenchymal Tumors	1030	(1)
Neurogenic Tumors	1031	(2)
Primary Cardiac Malignancies	1033	(4)
Cancers of the Gastrointestinal Tract	1037	(306)
Molecular Biology of Gastrointestinal Cancers	1037	(1)
Eric R. Fearon
Colorectal Cancer as a Model System	1038	(1)
The Adenoma-Carcinoma Sequence in the Colon	1038	(1)
Inherited Colorectal Cancer Syndromes	1038	(5)
Oncogene and Tumor Suppressor Gene Mutations in Colorectal Tumor Progression	1043	(2)
Gene Defects in Pancreatic Carcinoma	1045	(1)
Gene Defects in Esophageal Adenocarcinoma	1046	(1)
Potential Clinical Applications of Molecular Advances	1047	(4)
Cancer of the Esophagus	1051	(1)
David S. Schrump
Nasser K. Altorki
Arlene A. Forastiere
Bruce D. Minsky
Epidemiology	1051	(1)
Anatomy	1052	(1)
Histology	1053	(1)
Predisposing Conditions	1054	(3)
Molecular Biology	1057	(1)
Clinical Presentation	1058	(2)
Treatment	1060	(32)
Cancer of the Stomach	1092	(1)
Martin S. Karpeh
David P. Kelsen
Joel E. Tepper
Epidemiology	1092	(1)
Etiology and Pathogenesis	1093	(2)
Pathology and Tumor Biology	1095	(2)
Clinical Presentation	1097	(1)
Pretreatment Staging	1098	(1)
Pathologic Staging and Prognosis	1099	(2)
Treatment of Localized Disease	1101	(5)
Adjuvant Therapy	1106	(10)
Palliative Treatment of Gastric Cancer	1116	(4)
Predicting Response	1120	(1)
Chemotherapy versus Best Supportive Care	1121	(1)
Surgery for Palliation	1121	(5)
Cancer of the Pancreas	1126	(1)
Douglas B. Evans
James L. Abbruzzese
Christopher G. Willett
Epidemiology	1126	(1)
Etiologic Factors	1126	(1)
Pathology and Molecular Pathogenesis	1127	(2)
Clinical Signs and Symptoms	1129	(1)
Natural History and Patterns of Treatment Failure	1129	(2)
Clinical and Pathologic (Surgical) Staging	1131	(1)
Pretreatment Diagnostic Studies	1132	(4)
Treatment of Potentially Resectable Disease	1136	(7)
Palliative Methods of Biliary and Gastric Decompression	1143	(2)
Treatment of Locally Advanced Disease	1145	(3)
Treatment of Metastatic and Recurrent Disease	1148	(14)
Cancer of the Liver and Biliary Tree	1162	(1)
Yuman Fong
Nancy Kemeny
Theodore S. Lawrence
Hepatocellular Carcinoma	1162	(15)
Other Primary Tumors of the Liver	1177	(1)
Cholangiocarcinoma	1178	(9)
Tumors of the Gallbladder	1187	(17)
Cancer of the Small Intestine	1204	(1)
Daniel G. Coit
History	1204	(1)
Incidence	1204	(1)
Etiology	1204	(1)
Anatomy	1205	(1)
Pathology	1205	(1)
Presentation	1205	(1)
Diagnosis	1206	(1)
Management	1207	(9)
Cancer of the Colon	1216	(1)
John M. Skibber
Bruce D. Minsky
Paulo M. Hoff
Anatomy	1216	(1)
Epidemiology	1217	(1)
Etiology	1218	(1)
Primary Prevention	1219	(1)
Secondary Prevention	1220	(1)
Clinical Risk Factor: Age	1220	(1)
Genetic Risk Factors	1221	(2)
Predisposing Medical Conditions	1223	(1)
Screening	1224	(3)
Diagnosis	1227	(2)
Spread of Colorectal Cancer	1229	(1)
Staging and Prognostic Features	1230	(8)
Treatment of Precancerous Conditions	1238	(2)
Management of Potentially Curable Colon Cancer	1240	(14)
Treatment of Initially Advanced Colon Cancer	1254	(1)
Follow-Up after Potentially Curative Treatment	1255	(1)
Chemotherapy for Metastatic Colorectal Cancer	1256	(6)
Miscellaneous Colorectal Tumors	1262	(9)
Cancer of the Rectum	1271	(1)
John M. Skibber
Paulo M. Hoff
Bruce D. Minsky
Anatomy	1271	(1)
Diagnosis	1271	(3)
Clinical Staging System	1274	(1)
Treatment of Resectable Rectal Cancer	1275	(4)
Treatment of Invasive Cancer by Nonradical Approaches	1279	(2)
Results of Treatment of Rectal Cancer	1281	(3)
Radiation Therapy Alone for Resectable Rectal Cancer	1284	(1)
Adjuvant Therapy and Sphincter-Saving Operations as an Alternative to Abdominoperineal Resection	1285	(1)
Local Excision and Postoperative Radiation Therapy	1285	(3)
Preoperative Radiation Therapy Followed by Surgery	1288	(1)
Low Anterior Resection and Coloanal Anastomosis	1289	(2)
Adjuvant Radiation Therapy for Resectable Rectal Cancer	1291	(4)
Preoperative and Postoperative Radiation Therapy	1295	(1)
Selected Controversies in the Role of Preoperative Therapy	1295	(1)
Radical Surgery and Adjuvant Postoperative Combined Modality Therapy for Resectable Rectal Cancer	1296	(2)
Future of Adjuvant Therapy	1298	(1)
Complications of Pelvic Radiation Therapy	1299	(2)
Minimizing Toxicity of Radiation Therapy	1301	(4)
Treatment of Locally Advanced and Unresectable Rectal Cancer	1305	(4)
Intraoperative or Postoperative Radiation Therapy for Residual Disease	1309	(2)
Investigational Radiation Therapy Approaches	1311	(1)
Treatment of Patients with Synchronous Metastatic Disease	1312	(1)
Follow-Up after Potentially Curative Treatment	1312	(1)
Treatment of Recurrence	1312	(7)
Cancer of the Anal Region	1319	(1)
Bruce D. Minsky
John P. Hoffman
David P. Kelsen
Epidemiology and Etiology	1319	(1)
Anal Cancer and Acquired Immunodeficiency Syndrome	1320	(1)
Molecular and Chromosomal Abnormalities	1320	(1)
Other Associations	1320	(1)
Animal Studies	1321	(1)
Anatomy	1321	(1)
Pathology	1322	(1)
Precancerous Changes	1322	(1)
Squamous Cell Cancer	1323	(11)
Radiation Therapy Treatment Techniques	1334	(2)
Inguinal Node Involvement	1336	(1)
Residual or Recurrent Cancer	1336	(1)
Metastatic Disease	1337	(1)
Follow-Up	1338	(1)
Anorectal Melanoma	1338	(1)
Adenocarcinoma	1339	(1)
Sarcoma	1339	(1)
Treatment of the Human Immunodeficiency Virus-Positive Patient	1339	(1)
Future Directions	1339	(4)
Cancers of the Genitourinary System	1343	(148)
Molecular Biology of Genitourinary Cancers	1343	(1)
W. Marston Linehan
Berton Zbar
Fredrick Leach
Carlos Cordon-Cardo
William Isaacs
Kidney Cancer	1343	(5)
Prostate Cancer	1348	(4)
Bladder Cancer	1352	(10)
Cancer of the Kidney and Ureter	1362	(1)
W. Marston Linehan
Berton Zbar
Susan E. Bates
Michael J. Zelefsky
James C. Yang
Renal Carcinoma	1362	(22)
Carcinoma of the Renal Pelvis and Ureter	1384	(12)
Cancer of the Bladder	1396	(1)
Harry W. Herr
William U. Shipley
Dean F. Bajorin
Epidemiology	1396	(1)
Clinical Presentation and Diagnosis	1397	(2)
Pathogenesis	1399	(1)
Treatment	1400	(14)
Summary	1414	(4)
Cancer of the Prostate	1418	(1)
Peter R. Carroll
Keith L. Lee
Zvi Y. Fuks
Philip W. Kantoff
Normal Prostate Anatomy and Histology	1418	(2)
Pathology and Patterns of Progression of Prostate Cancer	1420	(2)
Premalignant Lesions (Prostatic Intraepithelial Neoplasia)	1422	(1)
Staging	1423	(1)
Epidemiology	1424	(1)
Chemoprevention and Diet	1425	(2)
Prostate Cancer Early Detection	1427	(4)
Initial Cancer Staging and Risk Assessment	1431	(4)
Treatment Selection for Nonmetastatic (T1-T3N0M0) Disease	1435	(24)
Treatment Selection for Advanced Disease: Metastatic and Local Regional Disease	1459	(8)
Future Therapies: Novel Targets	1467	(13)
Cancer of the Urethra and Penis	1480	(1)
Harry W. Herr
Guido Dalbagni
Dean F. Bajorin
William U. Shipley
Carcinoma of the Male Urethra	1480	(3)
Carcinoma of the Female Urethra	1483	(1)
Cancer of the Penis	1484	(7)
Cancer of the Testis	1491	(28)
George J. Bosl
Dean F. Bajorin
Joel Sheinfeld
Robert J. Motzer
R. S. K. Chaganti
Background: Incidence	1491	(1)
Epidemiology	1491	(1)
Initial Presentation and Management	1492	(1)
Histology	1492	(4)
Staging	1496	(4)
Management of Clinical Stage I Disease	1500	(4)
Management of Clinical Stage II (Low Tumor Burden)	1504	(1)
Management of Stage II and Stage III Disease (High Tumor Burden)	1505	(5)
Management of Relapse after Chemotherapy	1510	(1)
Treatment Sequelae	1511	(1)
Midline Tumors of Uncertain Histogenesis	1512	(1)
Other Testicular Tumors	1513	(6)
Gynecologic Cancers	1519	(114)
Molecular Biology of Gynecologic Cancers	1519	(1)
Setsuko Kuki Chambers
Endometrial Cancer	1519	(1)
Ovarian Cancer	1520	(2)
Cervical and Vulvar Cancer	1522	(4)
Cancer of the Cervix, Vagina, and Vulva	1526	(1)
Patricia J. Eifel
Jonathan S. Berek
James T. Thigpen
Carcinoma of the Cervix	1526	(23)
Carcinoma of the Cervical Stump	1549	(1)
Carcinoma of the Vagina	1550	(6)
Carcinoma of the Vulva	1556	(17)
Cancers of the Uterine Body	1573	(1)
Thomas W. Burke
Patricia J. Eifel
Franco M. Muggia
Endometrial Carcinoma	1573	(13)
Uterine Sarcomas	1586	(8)
Gestational Trophoblastic Diseases	1594	(1)
Franco M. Muggia
Patricia J. Eifel
Thomas W. Burke
Epidemiology	1594	(1)
Pathology and Biology	1594	(1)
Clinical Diagnosis and Human Chorionic Gonadotropin	1594	(1)
Choriocarcinoma	1595	(2)
Ovarian Cancer, Fallopian Tube Carcinoma, and Peritoneal Carcinoma	1597	(1)
Robert F. Ozols
Peter E. Schwartz
Patricia J. Eifel
Ovarian Cancer	1597	(27)
Borderline Tumors	1624	(1)
Sex Cord-Stromal Tumors	1624	(1)
Extraovarian Peritoneal Carcinoma	1625	(1)
Germ Cell Tumors of the Ovary	1626	(1)
Nondysgerminomatous Germ Cell Tumors	1627	(1)
Fallopian Tube Cancer	1628	(5)
Cancer of the Breast	1633	(94)
Molecular Biology of Breast Cancer	1633	(1)
Robert B. Dickson
Marc E. Lippman
Genetics	1633	(2)
Steroid and Growth Factor Pathways of Cellular Regulation	1635	(6)
The Cell Cycle and Cell Death	1641	(2)
Process of Malignant Progression	1643	(2)
Implications of Molecular Biology for Tumor Prevention, Early Detection, Prognosis, and Response to Therapy	1645	(7)
Malignant Tumors of the Breast	1651	(1)
Eric P. Winer
Monica Morrow
C. Kent Osborne
Jay R. Harris
Risk Factors for Breast Cancer	1652	(3)
Management of the High-Risk Patient	1655	(1)
Breast Cancer Prevention	1656	(1)
Biopsy Techniques for Suspicious Breast Lesions	1657	(2)
Ductal Carcinoma In Situ	1659	(4)
Lobular Carcinoma In Situ	1663	(1)
Staging of Breast Cancer	1664	(3)
Local Management of Invasive Breast Cancer	1667	(13)
Local Recurrence	1680	(2)
Breast Reconstruction	1682	(1)
Special Therapeutic Problems	1683	(4)
Prognostic and Predictive Factors	1687	(1)
Adjuvant Drug (Systemic) Therapy	1688	(4)
Adjuvant Chemotherapy	1692	(5)
Therapy of Locally Advanced and Inflammatory Breast Cancer	1697	(1)
Follow-Up after Primary Treatment	1698	(1)
Management of Patients with Metastatic Breast Cancer	1699	(18)
Rehabilitation after Treatment for Cancer of the Breast	1717	(1)
Joseph J. Disa
Jeanne A. Petrek
Delayed versus Immediate Reconstruction	1717	(1)
Prosthetic Reconstruction	1718	(1)
Autologous Tissue Reconstruction	1719	(2)
Postmastectomy after Breast Irradiation	1721	(1)
Skin-Sparing Mastectomy with Immediate Reconstruction	1721	(1)
Lymphedema	1722	(5)
Cancer of the Endocrine System	1727	(114)
Molecular Biology of Endocrine Tumors	1727	(1)
Terry C. Lairmore
Samuel A. Wells, Jr.
Jeffrey F. Moley
Multiple Endocrine Neoplasia Syndromes	1727	(6)
Molecular Pathogenesis of Sporadic Thyroid Neoplasms	1733	(2)
Genetic Abnormalities in Parathyroid Neoplasms	1735	(1)
Other Genetic Loci Implicated in Familial Hypercalcemic Syndromes	1736	(1)
Parathyroid Carcinoma	1737	(1)
Genetic Abnormalities in Adrenal Neoplasms	1737	(1)
Summary	1737	(4)
Thyroid Tumors	1740	(1)
Douglas L. Fraker
Monica Skarulis
Virginia Livolsi
Thyroid Nodules	1741	(1)
Well-Differentiated Thyroid Carcinoma	1742	(13)
Anaplastic Thyroid Cancer	1755	(1)
Medullary Thyroid Cancer	1756	(3)
Thyroid Lymphoma	1759	(1)
Secondary Thyroid Malignancy	1759	(4)
Parathyroid Tumors	1763	(1)
Douglas L. Fraker
Primary Hyperparathyroidism	1763	(7)
Adrenal Tumors	1770	(1)
Jeffrey A. Norton
Hop N. Le
Pathology of the Adrenal Cortex	1770	(1)
Adrenal Cortical Adenoma	1770	(1)
Adrenal Cortical Carcinoma	1770	(1)
Clinical Presentations of Adrenal Cortical Neoplasms	1771	(6)
Treatment of Adrenal Cortical Neoplasms	1777	(3)
Ectopic Adrenocorticotropic Hormone Syndrome	1780	(1)
Pheochromocytoma	1780	(8)
Pancreatic Endocrine Tumors	1788	(1)
H. Richard Alexander
Robert T. Jensen
Introduction	1788	(1)
Pathogenesis, Pathologic Features, and Tumor Biology	1788	(4)
Clinical Presentation and Diagnosis	1792	(4)
Imaging and Localization of Pancreatic Endocrine Tumors	1796	(2)
Treatment of Resectable Disease	1798	(8)
Treatment of Metastatic Disease	1806	(7)
Carcinoid Tumors and the Carcinoid Syndrome	1813	(1)
Robert T. Jensen
Gerard M. Doherty
Pathology and Tumor Histology	1813	(3)
Molecular Pathogenesis	1816	(1)
Clinical Features	1816	(1)
Carcinoid Syndrome	1817	(9)
Treatment of the Carcinoid Tumor	1826	(8)
Multiple Endocrine Neoplasias	1834	(1)
Gerard M. Doherty
Robert T. Jensen
Multiple Endocrine Neoplasia Type 1	1834	(2)
Familial Medullary Thyroid Carcinoma and Multiple Endocrine Neoplasia Types 2A and 2B	1836	(5)
Sarcomas of the Soft Tissue and Bone	1841	(96)
Soft Tissue Sarcoma	1841	(1)
Murray F. Brennan
Kaled M. Alektiar
Robert G. Maki
Incidence	1841	(1)
Etiology and Genetics	1841	(2)
Distribution	1843	(1)
Pathologic Classification	1844	(3)
Grading of Sarcoma	1847	(1)
Differential Diagnosis	1848	(1)
Clinicopathologic Features of Specific Types of Benign and Malignant Soft Tissue Tumors	1848	(7)
Clinical Presentation	1855	(1)
Differential Diagnosis	1856	(4)
Management of Extremity and Superficial Truncal Soft Tissue Sarcoma	1860	(1)
Radiation Therapy	1861	(3)
Special Considerations	1864	(1)
Definitive Radiation	1865	(1)
Adjuvant Chemotherapy	1865	(5)
Preoperative Chemotherapy	1870	(1)
Intraarterial Chemotherapy	1870	(1)
Hyperthermia and Limb Perfusion	1871	(1)
Special Features of the Management of Sarcomas of Nonextremity Sites	1871	(2)
Management of Head and Neck Sarcoma	1873	(1)
Management of Breast Sarcoma	1873	(1)
Serious Complications of Primary Treatment	1874	(1)
Prognostic Factors for Outcome	1874	(1)
Quality of Life and Functional Outcome	1875	(1)
Treatment of Local Recurrence	1875	(1)
Management of Advanced Disease	1876	(1)
Systemic Therapy for Advanced Disease	1876	(4)
Response by Histologic Subtype and Site	1880	(3)
Recommendations for Patients with Advanced Disease	1883	(1)
Future Directions	1883	(8)
Sarcomas of Bone	1891	(1)
Martin M. Malawer
Michael P. Link
Sarah S. Donaldson
Classification and Types of Bone Tumors	1891	(1)
Radiographic Evaluation and Diagnosis	1892	(1)
Natural History	1893	(1)
Staging Bone Tumors	1894	(1)
Preoperative Evaluation	1895	(1)
Biopsy Technique and Timing	1896	(1)
Restaging after Preoperative Chemotherapy	1896	(2)
Surgical Management of Skeletal Tumors	1898	(1)
Principles and Techniques of Limb-Sparing Surgery	1898	(2)
Amputations	1900	(1)
Cryosurgery	1901	(1)
Chemotherapy for Bone Sarcomas	1901	(6)
Radiotherapy for Bone Tumors	1907	(1)
Benign Bone Tumors	1908	(2)
Malignant Bone Tumors	1910	(27)
Benign and Malignant Mesothelioma	1937	(34)
Molecular Biology of Mesothelioma	1937	(1)
Joseph R. Testa
Harvey I. Pass
Michele Carbone
Mechanism of Asbestos-Induced Oncogenesis	1937	(1)
Cytogenetic Assessment of Malignant Mesotheliomas	1938	(1)
Deletion Mapping	1938	(1)
Alterations of Tumor Suppressor Genes in Mesothelioma	1939	(1)
Simian Virus 40	1939	(2)
Conclusions	1941	(1)
Summary	1942	(1)
Management of Mesothelioma	1943	(1)
Karen H. Antman
Harvey I. Pass
Peter B. Schiff
Epidemiology	1943	(2)
Biology of Mesothelioma: Ploidy Studies	1945	(1)
Diagnosis of Mesothelioma	1945	(2)
Malignant Pleural Mesothelioma	1947	(12)
Multimodality Treatment	1959	(2)
Malignant Peritoneal Mesothelioma	1961	(2)
Malignant Mesothelioma of the Tunica Vaginalis Testis	1963	(1)
Malignant Mesothelioma of the Pericardium	1964	(1)
Benign Mesothelioma	1964	(7)
Cancer of the Skin	1971	(32)
Molecular Biology of Skin Cancer	1971	(1)
Douglas E. Brash
Allen E. Bale
Skin Carcinogens	1971	(1)
Genetic Events	1972	(1)
Cellular Events	1973	(1)
Therapeutics	1974	(2)
Management of Skin Cancer	1976	(1)
David J. Leffell
John A. Carucci
Diagnosis	1976	(1)
General Approach to Management of Skin Cancer	1976	(3)
Nonmelanoma Skin Cancer and Precancerous Lesions	1979	(19)
Carcinoma Metastatic to Skin	1998	(1)
Conclusion	1998	(5)
Melanoma	2003	(88)
Molecular Biology of Cutaneous Melanoma	2003	(1)
Meenhard Herlyn
Kapaettu Satyamoorthy
Etiology of Melanoma	2003	(1)
Genetics of Melanoma	2004	(1)
Functional Significance of Specific Gene Mutations in Melanoma	2005	(2)
Biology of Melanoma Development and Progression	2007	(1)
Biologic Basis of Melanoma Progression	2008	(4)
Cutaneous Melanoma	2012	(1)
Michael T. Lotze
Ramsey M. Dallal
John M. Kirkwood
John C. Flickinger
Epidemiology	2012	(3)
Risk Factors, Prevention, and Screening	2015	(7)
Staging of Melanoma	2022	(6)
Imaging of Malignant Melanoma	2028	(1)
Radiobiology of Melanoma	2028	(1)
Stage I and II Disease: Management of Primary Melanoma	2029	(3)
Stage I and II Disease: Examination of the Lymph Node Basin	2032	(5)
Stage III Disease: Management of the Clinically Positive Nodal Basin	2037	(2)
Stage III Disease: Management of In-Transit Disease	2039	(5)
Adjuvant Medical Therapy	2044	(4)
Treatment of Stage IV Disease	2048	(3)
Cytotoxic Chemotherapy	2051	(2)
Immunotherapy of Metastatic Disease	2053	(3)
Management of Melanoma in the Pregnant Patient	2056	(1)
Future Prospects for the Biologic Therapy of Patients with Melanoma	2056	(14)
Intraocular Melanoma	2070	(1)
Jose A. Sahel
Arthur S. Polans
Minesh P. Mehta
Richard M. Auchter
Daniel M. Albert
Epidemiology	2070	(1)
Etiology and Histogenesis of Ocular Melanomas	2071	(1)
Histopathology, Prognostic parameters, and Natural History	2072	(3)
Diagnosis of Uveal Melanomas: Choroidal and Ciliary Body Melanomas	2075	(3)
Management	2078	(7)
Future Directions for Research	2085	(6)
Neoplasms of the Central Nervous System	2091
Molecular Biology of Central Nervous System Neoplasms	2091	(1)
David N. Louis
Webster K. Cavenee
Diffuse, Fibrillary Astrocytomas	2091	(2)
Other Gliomas	2093	(3)
Medulloblastomas	2096	(1)
Meningiomas	2096	(1)
Peripheral Nerve Tumors	2097	(1)
Miscellaneous Tumors	2097	(1)
Neurologic Tumor Syndromes	2098	(1)
Summary	2098	(2)
Neoplasms of the Central Nervous System	2100	(1)
Victor A. Levin
Steven A. Leibel
Philip H. Gutin
Incidence and Classification	2100	(1)
Genetic, Molecular, Environmental, Viral, and Other Factors Associated with Central Nervous System Neoplasia	2101	(1)
Anatomic and Clinical Considerations	2102	(6)
Neurodiagnostic Tests	2108	(4)
Surgery	2112	(2)
Radiation Therapy	2114	(5)
Chemotherapy	2119	(1)
Cerebral Astrocytomas	2120	(7)
Brain Stem Gliomas	2127	(2)
Cerebellar Astrocytomas	2129	(1)
Optic, Chiasmal, and Hypothalamic Gliomas	2130	(1)
Oligodendrogliomas	2131	(2)
Ependymoma	2133	(2)
Meningiomas	2135	(3)
Primitive Neuroepithelial Tumors	2138	(1)
Medulloblastoma	2139	(3)
Pineal Region Tumors	2142	(3)
Pituitary Adenomas	2145	(1)
Craniopharyngiomas	2146	(1)
Cerebellopontine Vestibular Schwannomas	2147	(1)
Glomus Jugulare Tumors	2148	(1)
Chordomas	2149	(1)
Hemangioblastomas and Hemangiomas	2150	(1)
Choroid Plexus Papilloma and Carcinoma	2151	(1)
Spinal Axis Tumors	2152
Cancers of Childhood	2161	(1)
Molecular Biology of Childhood Cancers	2161	(1)
Lee J. Helman
David Malkin
Tumor Suppressor Genes	2162	(1)
Retinoblastoma: The Paradigm	2162	(1)
Wilms' Tumor: Three Distinct Loci	2163	(1)
Neurofibromatoses	2164	(1)
Neuroblastoma	2164	(1)
Ewing's Sarcoma Family of Tumors	2165	(1)
Rhabdomyosarcoma	2165	(1)
Hereditary Syndromes Associated with Tumors of Childhood	2166	(1)
Predictive Testing for Germline Mutations and Childhood Cancers	2167	(2)
Solid Tumors of Childhood	2169	(1)
David H. Ebb
Daniel M. Green
Robert C. Shamberger
Nancy J. Tarbell
Epidemiology	2169	(1)
Management of Childhood Cancer	2170	(1)
Wilm's Tumor	2171	(5)
Favorable Histology Wilms' Tumor	2176	(1)
Neuroblastoma	2177	(5)
Retinoblastoma	2182	(1)
Treatment	2183	(1)
Advanced Unilateral Disease	2184	(1)
Limited Unilateral or Limited Bilateral Disease	2184	(1)
Bilateral Disease	2184	(1)
Chemotherapy	2185	(1)
Rhabdomyosarcoma	2185	(8)
Ewing's Sarcoma and Peripheral Primitive Neuroectodermal Tumor	2193	(4)
Primary Hepatic Tumors	2197	(3)
Germ Cell Tumors	2200	(2)
Clinical Presentation and Treatment by Anatomic Site	2202	(13)
Lymphomas	2215	(174)
Molecular Biology of Lymphomas	2215	(1)
Riccardo Dalla-Favera
Gianluca Gaidano
Histogenetic Pathways of Lymphoma	2215	(2)
General Mechanisms of Genetic Lesions in Lymphoma	2217	(3)
Molecular Pathogenesis of B-Cell Non-Hodgkin's Lymphoma	2220	(8)
Molecular Pathogenesis of T-Cell Non-Hodgkin's Lymphoma	2228	(2)
Molecular Pathogenesis of Hodgkin's Lymphoma	2230	(1)
Genetic Lesions as Clinical Tools in the Management of Lymphoma	2230	(5)
Leukemias and Lymphomas of Childhood	2235	(1)
Howard J. Weinstein
Nancy J. Tarbell
Leukemias	2235	(10)
Non-Hodgkin's Lymphoma	2245	(5)
Hodgkin's Disease	2250	(6)
Non-Hodgkin's Lymphomas	2256	(1)
James O. Armitage
Peter M. Mauch
Nancy Lee Harris
Philip Bierman
Epidemiology	2256	(2)
Etiology	2258	(15)
Principles of Management of Non-Hodgkin's Lymphoma	2273	(3)
Specific Disease Entities	2276	(22)
Special Clinical Situations	2298	(18)
Cutaneous T-Cell Lymphomas	2316	(1)
Lynn D. Wilson
Glenn W. Jones
Barry M. Kacinski
Richard L. Edelson
Peter W. Heald
Pathobiology	2316	(1)
Epidemiology	2317	(1)
Etiology	2317	(1)
Clinical Presentation	2317	(1)
Approach to Patients with Mycosis Fungoides	2318	(2)
Patient Evaluation	2320	(1)
Principles of Therapy	2321	(9)
Primary Central Nervous System Lymphoma	2330	(1)
Lisa M. Deangelis
Joachim Yahalom
Clinical Features	2330	(1)
Diagnostic Tests	2331	(1)
Pathology	2332	(1)
Management	2332	(7)
Hodgkin's Disease	2339	(1)
Volker Diehl
Peter M. Mauch
Nancy Lee Harris
History	2339	(1)
Etiology and Epidemiology	2339	(2)
Biology and Cell of Origin	2341	(3)
Pathology	2344	(6)
Diagnosis and Staging	2350	(2)
Clinical Presentation	2352	(1)
Treatment Methods	2353	(2)
Choice of Treatment	2355	(19)
Clinical Features	2374	(1)
Treatment Results	2375	(1)
Transformation to Non-Hodgkin's Lymphoma	2375	(1)
Consequences for Future Treatment	2375	(1)
Hodgkin's Disease in the Elderly Patient	2375	(1)
Hodgkin's Disease During Pregnancy	2376	(1)
Hodgkin's Disease in Human Immunodeficiency Virus-Positive Patients	2376	(1)
Sequelae	2377	(2)
Quality of Life	2379	(1)
New Drugs in Hodgkin's Disease	2379	(1)
Immunotherapy	2380	(9)
Leukemias	2389	(122)
Molecular Biology of Leukemias	2389	(3)
Clara D. Bloomfield
Michael A. Caligiuri
Gene Fusions in Leukemia	2392	(7)
Gene Activation in Leukemia	2399	(1)
Tumor Suppressor Genes in Leukemia	2400	(1)
Molecular Monitoring of Leukemia	2401	(4)
Acute Leukemias	2404	(1)
David A. Scheinberg
Peter Maslak
Mark Weiss
Epidemiology and Etiology	2405	(2)
Biology of Acute Leukemias	2407	(1)
Diagnosis and Classification of Acute Leukemias	2408	(12)
Treatment of Relapsed Acute Myelogenous Leukemias	2420	(2)
Acute Promyelocytic Leukemia	2422	(6)
Conclusions	2428	(5)
Chronic Leukemias	2433	(1)
Chronic Myelogenous Leukemia	2433	(1)
Hagop M. Kantarjian
Stefan Faderl
Moshe Talpaz
Epidemiology	2433	(1)
Etiology and Pathogenesis	2434	(1)
Diagnosis and Clinical Course	2435	(1)
Treatment	2436	(9)
Conclusions	2445	(2)
The Chronic Lymphocytic Leukemias	2447	(1)
Bruce D. Cheson
Cell of Origin	2447	(1)
Immune Function and Autoimmunity in Chronic Lymphocytic Leukemia	2448	(1)
Cytogenetics	2448	(1)
Molecular Biology and Genetics	2448	(1)
Diagnosis	2448	(3)
Clinical Features	2451	(1)
Staging and Prognostic Factors	2452	(1)
Therapy	2453	(5)
Related B-Cell Leukemias	2458	(8)
Plasma Cell Neoplasms	2465	(1)
Nikhil C. Munshi
Guido Tricot
Bart Barlogie
History	2466	(1)
Epidemiology	2466	(1)
Etiology	2467	(1)
Pathogenesis	2467	(4)
Clinical Manifestations	2471	(2)
Diagnosis	2473	(6)
Differential Diagnosis	2479	(1)
Prognostic Variables	2480	(2)
Treatment	2482	(9)
Waldenstrom's Macroglobulinemia	2491	(2)
Perspective	2493	(6)
Myelodysplastic Syndromes	2499	(1)
Hagop M. Kantarjian
Elihu Estey
Incidence	2499	(1)
Etiology	2499	(1)
Classification and Risk Groups	2500	(1)
Biology and Pathophysiology	2501	(1)
Clinical Manifestations	2502	(1)
Laboratory Features	2502	(1)
Differential Diagnosis	2503	(1)
Significance of the 30% Blast Cutoff to Distinguish High-Risk Myelodysplastic Syndromes from Acute Myeloid Leukemia	2503	(1)
Specific Subtypes of Myelodysplastic Syndromes	2503	(1)
Therapy	2504	(3)
Summary	2507	(4)
Paraneoplastic Syndromes	2511	(26)
Susanne M. Arnold
Roy Patchell
Andrew M. Lowy
Kenneth A. Foon
Endocrinologic Manifestations of Cancer	2511	(5)
Hematologic Manifestations of Cancer	2516	(2)
Gastrointestinal Manifestations of Cancer	2518	(2)
Renal Manifestations of Nonrenal Cancer	2520	(1)
Cutaneous Paraneoplastic Syndromes	2521	(4)
Neurologic Manifestations of Cancer	2525	(6)
Miscellaneous Paraneoplastic Syndromes	2531	(6)
Cancer of Unknown Primary Site	2537	(24)
Frank A. Greco
John D. Hainsworth
Poorly Differentiated Neoplasms of Unknown Primary Site	2538	(2)
Adenocarcinoma of Unknown Primary Site	2540	(5)
Squamous Carcinoma of Unknown Primary Site	2545	(1)
Poorly Differentiated Carcinoma (with or without Features of Adenocarcinoma) of Unknown Primary Site	2546	(6)
Neuroendocrine Carcinoma of Unknown Primary Site	2552	(2)
Special Issues	2554	(2)
Conclusion: Future Trends	2556	(5)
Peritoneal Carcinomatosis	2561	(14)
David L. Bartlett
Pathophysiology	2561	(1)
Diagnosis	2562	(1)
Histologic Subtypes	2563	(4)
Treatment	2567	(8)
Immunosuppression-Related Malignancies	2575	(34)
AIDS-Related Malignancies	2575	(1)
Robert Yarchoan
Richard F. Little
Kaposi's Sarcoma	2576	(5)
Acquired Immunodeficiency Syndrome-Associated Lymphomas	2581	(6)
Primary Central Nervous System Lymphoma in Acquired Immunodeficiency Syndrome	2587	(1)
Effect of Antiretroviral Therapy on Primary Central Nervous System Lymphoma Incidence	2588	(1)
Hodgkin's Disease	2588	(1)
Anogenital Cancers in Human Immunodeficiency Virus Infection	2589	(2)
Future Directions	2591	(6)
Transplantation-Related Malignancies	2597	(1)
Stanley R. Riddell
Immune Surveillance and Tumor Development	2597	(1)
Hematopoietic Stem Cell Transplant Recipients	2597	(5)
Organ Transplant Recipients	2602	(7)
Oncologic Emergencies	2609	(46)
Superior Vena Cava Syndrome	2609	(1)
Joachim Yahalom
Anatomy and Pathophysiology	2609	(1)
Etiology and Natural History	2609	(2)
Diagnostic Procedures	2611	(1)
Management	2612	(1)
Treatment	2613	(2)
Recommendations	2615	(2)
Spinal Cord Compression	2617	(1)
Brian G. Fuller
John D. Heiss
Edward H. Oldfield
Epidemiology	2617	(1)
Pathophysiology	2617	(5)
Clinical Presentation	2622	(1)
Diagnostic Evaluation	2623	(1)
Treatment	2624	(6)
Pediatric Spinal Cord Compression	2630	(1)
Conclusion	2630	(3)
Metabolic Emergencies	2633	(1)
Raymond P. Warrell, Jr.
Hypercalcemia	2633	(2)
Treatment of Cancer-Related Hypercalcemia	2635	(3)
General Approach to Treatment of Hypercalcemia	2638	(1)
Hyperuricemia	2639	(1)
Tumor Lysis Syndrome	2640	(1)
Lactic Acidosis	2640	(1)
Hypoglycemia	2641	(1)
Adrenal Failure	2642	(3)
Urologic Emergencies	2645	(1)
McClellan M. Walther
Urinary Tract Infection	2645	(1)
Cystitis	2645	(3)
Bladder Hemorrhage	2648	(1)
Urinary Obstruction	2649	(1)
Priapism	2650	(1)
Paraphimosis	2651	(4)
Treatment of Metastatic Cancer	2655	(98)
Metastatic Brain Cancer	2655	(1)
Patrick Y. Wen
Peter Mclaren Black
Jay S. Loeffler
Incidence and Epidemiology	2655	(1)
Method of Spread and Distribution	2655	(1)
Clinical Manifestations	2656	(1)
Diagnosis	2656	(1)
Brain Metastases without a Known Primary Tumor	2657	(1)
Management	2657	(10)
Prognosis	2667	(3)
Metastatic Cancer to the Lung	2670	(1)
Joe B. Putnam, Jr.
Historical Perspective	2670	(1)
Identification of Pulmonary Metastases	2670	(2)
Selection of Patients for Surgery	2672	(1)
Preparation of the Patient for Metastasectomy	2673	(1)
Surgical Incisions	2673	(1)
Resection of Pulmonary Metastases	2674	(1)
Survival Analysis	2674	(1)
Results of Resection of Sarcomatous Pulmonary Metastases	2675	(2)
Colorectal Neoplasms	2677	(1)
Breast Carcinoma	2678	(1)
Testicular Neoplasms	2679	(1)
Gynecologic Neoplasms	2679	(1)
Renal Cell Carcinoma	2680	(1)
Melanoma	2680	(1)
Squamous Cell Carcinoma	2680	(1)
Wilms' Tumor	2680	(1)
Metastasis or Primary Bronchogenic Carcinoma?	2681	(1)
Recurrent Pulmonary Metastases	2681	(1)
Extended Resection of Pulmonary Metastases	2681	(2)
Prognostic Indicators	2683	(2)
Resectability	2685	(1)
Multivariate Analysis of Prognostic Indicators	2686	(1)
Novel Treatment Strategies	2686	(4)
Metastatic Cancer to the Liver	2690	(1)
H. Richard Alexander
Carmen J. Allegra
Theodore S. Lawrence
Natural History of Liver Metastases	2690	(1)
Imaging of Hepatic Metastases	2691	(1)
Resection of Hepatic Metastases	2692	(5)
Infusional Therapy for Hepatic Metastases	2697	(5)
Local Ablative Therapy	2702	(7)
Conclusions	2709	(4)
Metastatic Cancer to the Bone	2713	(1)
Holly K. Brown
John H. Healey
Presentation	2713	(1)
Pathogenesis	2714	(1)
Diagnostic Evaluation	2714	(1)
Treatment Goals	2715	(1)
Imaging of Bone Lesions	2716	(1)
Therapeutic Modalities	2717	(7)
Specific Anatomic Sites	2724	(5)
Malignant Pleural and Pericardial Effusions	2729	(1)
David S. Schrump
Dao M. Nguyen
Malignant Pleural Effusion	2729	(7)
Malignant Pericardial Effusion	2736	(9)
Malignant Ascites	2745	(1)
Francesco M. Marincola
Douglas J. Schwartzentruber
Diagnosis and Workup	2745	(1)
Treatment of Malignant Ascites	2746	(7)
Hematopoietic Therapy	2753	(62)
Transfusion Therapy	2753	(1)
Peter L. Perrotta
Edward L. Snyder
Blood Component Therapy	2754	(5)
Transfusion Reactions and Complications	2759	(3)
Transfusion-Transmitted Disease	2762	(1)
Use of Special Blood Products in Oncology Patients	2763	(1)
Apheresis	2764	(1)
Conclusions	2765	(2)
Autologous Stem Cell Transplantation	2767	(1)
Dennis L. Cooper
Stuart Seropian
History	2767	(1)
Stem Cell Mobilization	2768	(2)
Inadequate Mobilization of Stem Cells	2770	(1)
Tumor Contamination	2771	(1)
Practical Considerations for the Potential High-Dose Therapy and Autologous Stem Cell Rescue Patient	2772	(1)
High-Dose Therapy Regimens: New Directions	2773	(2)
Late Toxicity: Myelodysplasia	2775	(1)
Future Directions	2775	(4)
Allogeneic Stem Cell Transplantation	2779	(1)
Richard W. Childs
Historical Perspective	2779	(1)
Allogeneic Hematopoietic Stem Cell Transplantation for Hematologic Malignancies	2779	(1)
Allogeneic Hematopoietic Stem Cell Transplantation for Nonmalignant Disorders	2779	(1)
Preparative Regimens	2780	(1)
Graft-versus-Leukemia Effect	2780	(2)
Mechanisms	2782	(1)
Complications of Allogeneic Hematopoietic Stem Cell Transplantation	2782	(4)
Sources of Allogeneic Hematopoietic Stem Cells	2786	(2)
Nonmyeloablative Allogeneic Stem Cell Transplantation	2788	(3)
Results of Conventional Allogeneic Transplantation for Hematologic Malignancies	2791	(1)
Future Prospects	2792	(6)
Hematopoietic Growth Factors	2798	(1)
James D. Griffin
Overview of Hematopoietic Growth Factors	2798	(2)
Biologic Features of the Major Hematopoietic Growth Factors in Clinical Use	2800	(2)
Clinical Applications of Hematopoietic Growth Factors in Cancer Therapy	2802	(7)
Long-Term Effects of Growth Factor Administration	2809	(1)
Conclusions	2809	(6)
Infections in the Cancer Patient	2815	(54)
Brahm H. Segal
Thomas J. Walsh
Steven M. Holland
Factors Predisposing to Infection in Patients with Cancer	2815	(5)
Bacterial Pathogens in Cancer Patients	2820	(5)
Fungal Infections	2825	(8)
Viral Infections	2833	(6)
Parasitic Infections	2839	(2)
Evaluation and Management of Febrile Neutropenia	2841	(7)
Manifestations and Therapy of Infections	2848	(10)
Immune Augmentation Strategies	2858	(11)
Adverse Effects of Treatment	2869	(108)
Nausea and Vomiting	2869	(1)
Ann M. Berger
Rebecca A. Clark-Snow
Nature of the Problem	2869	(1)
Pathophysiology of Nausea and Vomiting	2869	(2)
Emetic Syndromes	2871	(1)
Control of Emesis and Patient Characteristics	2872	(1)
Antiemetic Agents	2873	(2)
Delayed Emesis	2875	(1)
Anticipatory Nausea and Vomiting	2875	(1)
Radiation-Induced Nausea and Vomiting	2876	(1)
Nausea and Vomiting Secondary to Comorbid Conditions	2877	(1)
Cost and Benefit of Antiemetic Therapy	2877	(4)
Oral Complications	2881	(1)
Ann M. Berger
Thomas J. Kilroy
Direct Stomatotoxicity	2881	(1)
Pathophysiology of Mucositis	2882	(1)
Risk Factors	2882	(1)
Assessment of the Oral Mucosa	2883	(1)
Remedies for the Prevention and Treatment of Mucositis	2883	(6)
Oral Complications in Radiotherapy	2889	(3)
Conclusion	2892	(2)
Pulmonary Toxicity	2894	(1)
Diane E. Stover
Robert J. Kaner
Radiation-Induced Pulmonary Toxicity	2894	(2)
Radiation-Related Bronchiolitis Obliterans with Organizing Pneumonia	2896	(1)
Chemotherapy-Induced Pulmonary Toxicity	2897	(7)
Cardiac Toxicity	2904	(1)
Laurel J. Steinherz
Joachim Yahalom
Chemotherapy	2904	(8)
Radiation-Induced Heart Disease	2912	(4)
Conclusion	2916	(6)
Hair Loss	2922	(1)
Claudia A. Seipp
Head Covering	2922	(1)
Prevention of Alopecia	2923	(1)
Gonadal Dysfunction	2923	(1)
Marvin L. Meistrich
Rena Vassilopoulou-Sellin
Larry I. Lipshultz
Effects of Cytotoxic Agents on Adult Men	2924	(2)
Effects of Cytotoxic Agents on Adult Women	2926	(4)
Effects of Cytotoxic Agents on Children	2930	(1)
Gonadal Dysfunction after Cranial Irradiation	2930	(1)
Preservation of Fertility, Hormone Levels, and Sexual Function	2931	(3)
Genetic Concerns	2934	(1)
Counseling	2935	(5)
Second Cancers	2939	(1)
Flora E. Van Leeuwen
Lois B. Travis
Methods to Assess Second Cancer Risk	2940	(1)
Carcinogenicity of Individual Treatment Modalities	2941	(3)
Risk of Second Malignancy in Patients with Selected Primary Cancers	2944	(16)
Conclusion	2960	(4)
Miscellaneous Toxicities	2964	(1)
Raymond B. Weiss
Neurotoxicity	2964	(4)
Nephrotoxicity	2968	(2)
Hepatotoxicity	2970	(2)
Hypersensitivity Reactions	2972	(1)
Vascular Toxicity	2973	(4)
Supportive Care and Quality of Life	2977	(112)
Management of Cancer Pain	2977	(1)
Kathleen M. Foley
Epidemiology	2977	(2)
Definition and Types of Cancer Pain	2979	(1)
Types of Pain	2980	(1)
Temporal Aspects of Pain	2980	(1)
Intensity of Pain	2981	(1)
Measurement of Pain	2981	(3)
Classification of Patients with Cancer Pain	2984	(1)
Acute Cancer-Related Pain	2984	(1)
Chronic Cancer-Related Pain	2984	(1)
Preexisting Chronic Pain and Cancer-Related Pain	2985	(1)
Patients with a History of Drug Addiction and Pain	2985	(1)
Dying Patients with Pain	2986	(1)
Common Pain Syndromes	2986	(1)
Clinical Assessment of Pain	2986	(3)
Management of Cancer Pain	2989	(1)
Analgesic Drug Therapy	2990	(1)
Classes of Drugs	2991	(3)
Principles of Opioid Drug Therapy	2994	(7)
Psychological Approaches	3001	(1)
Anesthetic and Neurosurgical Approaches	3002	(2)
Neurosurgical Approaches	3004	(3)
Physiatric Approaches	3007	(1)
Sedation in the Imminently Dying	3007	(2)
Algorithm for Cancer Pain Management	3009	(1)
Future Directions	3009	(3)
Nutritional Support	3012	(1)
J. Stanley Smith
Wiley W. Souba
Clinical Manifestations of Cancer Cachexia	3012	(1)
Causes and Consequences of Cancer Cachexia	3013	(4)
Nutritional Support of the Cancer Patient	3017	(11)
Techniques of Providing Nutritional Support	3028	(2)
Nutrition Support for Cancer Patients and Health Care Reform	3030	(2)
Sexual Problems	3032	(1)
Patricia A. Ganz
Mark S. Litwin
Beth E. Meyerowitz
Sexual Health and Physiology	3032	(2)
Sexual Problems and Their Prevalence among the General Population	3034	(1)
Impact of Cancer and Its Treatment on Sexual Health	3035	(5)
Sexual Problems Associated with Specific Cancers	3040	(4)
Strategies for Assessment and Intervention	3044	(2)
Conclusions	3046	(4)
Genetic Counseling	3049	(1)
Ellen T. Matloff
Allen E. Bale
Who Is a Candidate for Cancer Genetic Counseling?	3050	(1)
Components of the Cancer Genetic Counseling Session	3051	(3)
Issues in Cancer Genetic Counseling	3054	(2)
Future Directions	3056	(2)
Psychological Issues	3058	(1)
Mary Jane Massie
Lisa Chertkov
Andrew J. Roth
Psychiatric Disorders in Cancer Patients	3058	(5)
Psychiatric Symptoms in Cancer Patients with Pain	3063	(1)
Unconventional Cancer Treatments	3063	(1)
Psychotherapeutic Interventions with Cancer Patients	3064	(1)
Survivor Issues	3064	(2)
Community Resources	3066	(1)
Bonnie A. Indeck
Phyllis M. Smith
Initial Diagnosis of Cancer	3066	(1)
Social Support Network	3066	(1)
Emotional Support	3066	(2)
Informational Support	3068	(1)
Internet	3068	(1)
Computer Groups	3069	(1)
Instrumental Support	3069	(2)
Trends Affecting Demand for Community Services	3071	(1)
Survivorship	3072	(1)
Appendix: Common Resources	3072	(5)
Emotional Support	3074	(1)
Financial Assistance	3074	(1)
Home Health Care	3075	(2)
Specialized Care of the Terminally III	3077	(1)
Frederick A. Flatow
Scott Long
Overview of Hospice Care	3077	(2)
Symptom Management	3079	(7)
Conclusion	3086	(3)
Rehabilitation of the Cancer Patient	3089	(22)
Lynn Gerber
Jeanne Hicks
Jay Shah
Cancer Rehabilitation Team	3090	(1)
Functional Assessment	3091	(1)
Common Functional Impairments in Oncology	3091	(2)
Tumor-Associated Myopathy	3093	(1)
Bone Replacement by Tumor	3094	(3)
Neuropathies and Plexopathies	3097	(1)
Lymphedema and Deep Venous Thrombosis	3098	(1)
Bowel and Bladder Disorders	3099	(1)
Psychosocial Aspects of Cancer Rehabilitation	3100	(1)
Rehabilitation and Management of Specific Tumors	3100	(9)
Conclusion	3109	(2)
Advanced Practice Nurses and Physician Assistants in Oncology Care	3111	(8)
M. Tish Knobf
Susan Anderson
Physician Assistants	3111	(1)
Advanced Practice in Oncology Nursing	3112	(7)
Ethical Issues in Oncology and Clinical Trials	3119	(16)
Christopher Daugherty
Mark Siegler
Ethical Issues in Cancer Clinical Care	3119	(7)
Ethical Issues in Cancer Clinical Trials	3126	(5)
Conclusions	3131	(4)
Information Systems in Oncology	3135	(12)
Susan Molloy Hubbard
National Cancer Institute's Information Services	3140	(6)
Conclusion	3146	(1)
Complementary, Alternative, and Unproven Methods of Cancer Treatment	3147	(14)
Jeffrey D. White
Definitions	3147	(1)
Phenomenology of Complementary and Alternative Medicine in Cancer	3147	(1)
Reasons for Cancer Patient Use of Complementary and Alternative Medicine Modalities	3148	(2)
Complementary and Alternative Medicine Therapies	3150	(3)
Supportive Care (Complementary Medicine)	3153	(1)
Complementary and Alternative Medicine Cancer Research	3154	(1)
Practical Issues in the Interface of Oncology and Complementary and Alternative Medicine	3154	(7)
PART 4 NEWER APPROACHES IN CANCER TREATMENT
Genetic Therapy	3161	(28)
Gene Therapy	3161	(1)
Patrick HWU
Methods of Gene Transfer	3161	(6)
Gene Marking Studies	3167	(1)
Genetic Modification of the Immune Response	3168	(5)
Modification of Tumors with Genes That Have Direct Antitumor Effects	3173	(2)
Selective Replication of Virus in Tumors	3175	(1)
Introduction of Genes into Hematopoietic Stem Cells to Decrease Toxicity from Chemotherapy	3175	(1)
Antiangiogenic Gene Therapy	3176	(5)
Molecular Therapy	3180	(1)
Albert B. Deisseroth
Amanda Psyrri
David J. Austin
Strategies of New Drug Design	3181	(1)
Approaches to Drug Design	3182	(5)
Summary and Future Directions	3187	(2)
Cancer Vaccines	3189	(30)
Preventive Cancer Vaccines	3189	(1)
Douglas R. Lowy
John T. Schiller
Infectious Agents and Cancer	3189	(2)
Prophylactic Versus Therapeutic Vaccination	3191	(1)
Hepatitis B Virus	3192	(1)
Human Papillomavirus	3193	(3)
Therapeutic Cancer Vaccines	3195	(1)
Nicholas P. Restifo
Mario Sznol
Willem W. Overwijk
Immune Mechanisms Underlying Vaccine Function	3196	(2)
Monitoring of Cancer Vaccine Trials	3198	(1)
Anticancer Vaccine Approaches Derived from Autologous and Allogeneic Tumor Cells	3199	(2)
Approaches Using Recombinant and Synthetic Anticancer Vaccines	3201	(9)
Enhancing Vaccine-Induced Immune Responses	3210	(1)
Future Challenges: Tumor Escape from Immune Recognition	3211	(1)
Conclusion	3212	(7)
Image-Guided Surgery	3219	(10)
Nick Bryan
Steven K. Libutti
Medical Imaging Techniques	3219	(2)
Image Guidance	3221	(1)
Specific Applications of Image-Guided Surgery	3222	(4)
Conclusions	3226	(3)
Proton Beam Radiation Therapy	3229	(5)
Ira J. Spiro
Alfred R. Smith
Anthony Lomax
Jay S. Loeffler
Physical Aspects of Protons	3229	(1)
Proton Beam Radiation Treatment: Historical Note	3230	(1)
Clinical Results	3230	(3)
Design of Clinical Trials Using Proton Beams	3233	(1)
Conclusions and Future Directions	3234