Maria Giulia Cicchetti, James Liebmann, Andrew Chen, Carolynn DeBenedectis, and Elizabeth Kurian
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an overview of breast cancer, including etiology, screening, pathology, staging, and treatment.
Bruce A. Woda, James Liebmann, and Elizabeth Kurian
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist focuses on DNA mutations that cause cancer, abnormal regulation of cell growth and death, and metastasis.
Updated March 2016 version posted March 28, 2017.
Current treatments of cancer are imperfect and entail risks. For many malignancies, the best “treatment” is to prevent the cancer from ever appearing in the first place. Cancer prevention refers to interventions that reduce the incidence of cancer. Such interventions can include reduction of exposure to known carcinogens (e.g., tobacco), treatment with drugs that lower cancer risk (chemoprevention), vaccination against infectious agents that cause cancer, surgery to remove organs at high risk of developing cancer in individuals with familial cancer syndromes, or the adoption of a “healthy lifestyle” that modifies cancer risk. Cancer screening shares some concepts with cancer prevention. A screening test like colonoscopy that results in the removal of polyps that have the potential of progressing to cancer can be a form of cancer prevention. Cancer screening is also utilized to find an established cancer at an early, treatable stage. Cancer screening tests are employed in healthy, asymptomatic patients so it is imperative that these tests are safe and effective. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will provide a brief review of cancer prevention and screening.
Amanpreet Buttar, Laura A. Lambert, James Liebmann, and Richard S. Pieters
Cancers of unknown primary (CUP) are a heterogeneous group of histologically proven metastatic tumors whose primary site can't be determined after a standard diagnostic and pathologic work-up. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents provides an overview of cancers of unknown primary, including initial evaluation and principles of treatment.
Richard J. Horner
Over eighty different compounds have been approved to treat cancer. Their mechanisms of action, effectiveness against specific cancers, and potential toxicity vary greatly. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will describe, in terms of mechanism of action, the most important classes of cytotoxic and targeted therapies as well as their most characteristic side effects and clinical uses. A table summarizing the classes of drugs and representative members of those classes is included at the end of the chapter. Rather than an encyclopedia, this will be a schematic diagram or roadmap to more detailed knowledge that you will acquire during your clinical training and subsequent experience.
Anne Garrison, Andrew H. Fischer, Adib R. Karam, Antonella Leary, and Richard S. Pieters
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents provides an overview of cervical cancer. The etiology, pathology, staging, and principles of treatment will be reviewed.
Ronald N. Bogdasarian, Andrew Chen, Richard S. Pieters, and Thomas J. Fitzgerald
This chapter in The Interactive Atlas of CT-Based Human Anatomy is designed to assist students, physicians and other clinical professionals to learn or review the interpretation of computed tomography (CT) images and therefore, cross-sectional anatomy of the head and neck. The atlas also provides a strong anatomical reference for clinical practitioners.
Contents: Three Dimensional: Skeletal System, Muscular System, Vascular System, Digestive and Respiratory Systems, Nervous System, Lymphatic. Two Dimensional: Frontal, Sagittal, Axial (All Structures), Axial (Lymphatic System).
Age of Subject: 17
Reviewed by: Richard Gacek, MD, David Goff, MD, Alan Stark, MD, of the University of Massachusetts Medical School; Ozan Toy, BA
Ronald N. Bogdasarian, Adam J. Fusick, Andrew Chen, Richard S. Pieters, and Thomas J. Fitzgerald
This chapter in the Radiology-Based USMLE Board Prepbook provides medical students with an efficient, interactive resource to enhance USMLE National Board Step1 and 2 preparation and mastery. The workbook also aids students in learning clinical interpretation of computed tomography (CT) images of the head and neck. The atlas portion is also published separately as an anatomical reference for students and clinical practitioners.
Contents: Three Dimensional: Skeletal System, Muscular System, Vascular System, Digestive and Respiratory Systems, Nervous System, Lymphatic. Two Dimensional: Frontal, Sagittal, Axial (All Structures), Axial (Lymphatic System). Images of Pathology: USMLE Style Questions.
Age of Subject: 17
Reviewed by: Richard Gacek, MD, David Goff, MD, Alan Stark, MD, of the University of Massachusetts Medical School; Ozan Toy, BA
Paul R. Sturrock, James Liebmann, Adib R. Karam, Richard S. Pieters, and Elizabeth Kurian
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an overview of colorectal cancer, including etiology, screening, pathology, staging, and treatment.
Richard S. Pieters, Maryanne Bombaugh, Yuxin Liu, Gina Cunto-Amesty, Adib R. Karam, Elizabeth Kurian, and Sarah Huges
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist is about cancers of the endometrium and uterus, including the epidemiology, risk factors, diagnosis, genetic risk, histology, grading and type categorization, management, and prognosis.
Mary Linton Peters, Richard S. Pieters, and James Liebmann
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a summary of the most relevant causative agents of cancer. Exposure to many environmental agents is associated with an increased incidence of certain malignancies, although causation is usually difficult to prove. Certain chemicals, infections (parasitic, viral, and bacterial) and ionizing radiation are known carcinogens. Variable genetic susceptibility to carcinogenesis is apparent. Up to 2/3 of human cancers are believed to have an environmental component.
Epidemiology is the study of populations using defined research methods to confirm the patterns and causes of disease and applying this information to improve the health of the populations. This branch of science is the basis for understanding the spread of diseases in a defined area or group of people. Epidemiologic studies have been instrumental in improving outcomes by establishing preventive and therapeutic measures for the incidence, prevalence and mortality from cancers. The incidence of malignancy in a country or in our world defines the magnitude of the cancer problem. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will introduce the role of epidemiology in the diagnosis and treatment of cancer.
Beverly N. Hay
While the majority of cancers are not inherited, there are a number of well described collections of cancers that occur within families. These cancer syndromes were initially identified based on observation of the family history and subsequently the molecular mechanisms have been elucidated. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist is intended to allow the reader to recognize when a pattern of cancers occurs in an individual or their family, and to generate an investigation into potential cancer syndromes. With the rapidly expanding understanding of the molecular basis of cancers at the cellular and constitutional levels, appropriate preventive care may be offered and tailored treatment holds great promise.
Richard S. Pieters, Maryann Bishop-Jodoin, and James Liebmann
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an introduction to the Guidebook, which developed from the Cancer Concepts course at the University of Massachusetts Medical School.
Jeffrey A. Gordon, Elizabeth Kurian, Arash Bedayat, Ali Akalin, Karl Uy, and Richard S. Pieters
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an overview of lung cancer and mesothelioma, including epidemiology, etiology, screening, pathology, staging, and treatment.
Angela Beeler, Katherine Saunders, Alexis Penney, James Liebmann, and Richard S. Pieters
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a summary of the nutritional concerns in oncology patients. Nutritional intake is frequently deficient in patients undergoing cancer treatment and should be assessed and treated. There are unique nutritional needs of the patient based on their site of cancer and effects of their particular treatment. There is little evidence that dietary manipulation or supplementation can produce a significant decrease in cancer risk.
Richard S. Pieters, Joyce Rosenfeld, Andrew Chen, and James Liebmann
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents a discussion of the risks to cancer patients for oncologic and metabolic crises. These effects may be caused by the cancer, the treatment provided to cure or palliate the cancer, and/or other medical conditions. They may occur at initial presentation, as a first sign of disease or during the disease course. Oncologists divide these crises into emergencies and urgencies, depending on the severity of the consequences of delay in treatment. Every health care provider should be aware of the signs and symptoms of oncologic urgencies and emergencies and initial management.
John J. Shim and Andrew Chen
Imaging is an integral part of the multidisciplinary management of cancer. Radiographic techniques are indispensable for proper staging of cancers and evaluation of the response of tumors to treatment. A wide variety of imaging modalities is available to clinicians. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will introduce the role of radiology in the diagnosis and treatment of cancer.
Christopher P. Keuker
This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist presents an overview of childhood cancer, including the incidence, distribution, diagnosis, treatment, and survivorship.
James Liebmann and Richard S. Pieters
Medical oncologists are internists specializing in the care of the adult cancer patient. They frequently function as a primary care physician for patients with cancer. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will review the practice of medical oncology and some general principles followed in the use of chemotherapy. Concepts including goals of chemotherapy treatment, evaluation of the effects of chemotherapy, integration of chemotherapy with other cancer treatments, and use of combinations of chemotherapy drugs will be covered.
Richard S. Pieters and James Liebmann
This chapter in Cancer Concepts: a Guidebook for the Non-Oncologist describes the principles of multi-disciplinary management, meaning multi-specialty physician management of malignancies. Tumor Boards are the model for multi-disciplinary management. They may be site specific or include the entire spectrum of malignancy. At Tumor Boards, staging workup and treatment recommendations are made collectively, and then the treatments are delivered by the respective modality specialists and their individual teams. Improved clinical decision making leading to superior survival for patients with some diseases and better quality of life has been documented with multi-disciplinary management. Just like curative patients, palliative patients require multi-disciplinary management.
Richard S. Pieters, Linda Ding, Harry Bushe, and Jesse N. Aronowitz
This chapter in Cancer Concepts: a Guidebook for the Non-Oncologist describes the principles of Radiation Oncology. Radiation Oncology utilizes ionizing radiation to treat cancer (and occasionally a few benign conditions). Radiotherapy or radiation therapy (RT) was initially developed in conjunction with diagnostic radiology, but has evolved into a separate specialty. Currently, more than fifty percent of cancer patients undergo RT at some point during the course of their cancer. Most receive treatment with curative intent (radical therapy); however, patients with incurable disease receive shorter, gentler courses of therapy to relieve cancer-induced symptoms.
Giles F. Whalen
Surgery is a branch of medicine that developed primarily around the management of wounds, infections, and bladder stones. Along the way, it also became the primary treatment modality for malignant solid tumors. For many cancers, surgical resection remains the foundation of curative treatment. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist aims to introduce the history of cancer surgery, to answer the question of “What is a surgical oncologist?”, and to discuss the different categories of cancer surgery.
Mary Linton Peters, Richard S. Pieters, James Liebmann, and Geoffrey Graeber
The “stage” of a cancer is a short-hand way of describing the extent of cancer in a patient. Stage is based on macroscopic involvement of tissues by cancer. Staging of cancer occurs prior to the beginning of treatment, or at the first definitive surgery. Clinical staging, which includes radiography and exam findings, takes place initially. Pathologic staging, which is obtained from surgical specimens, can be acquired during the course of surgical treatment. Patients then carry either the clinical stage or the pathologic stage for the duration of their illness. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will describe principles of cancer staging.
The University of Massachusetts Medical School, A History: Integrating Primary Care and Biomedical Research
Ellen S. More
The University of Massachusetts Medical School was chartered in 1962 and opened in 1970, one of the cohort of medical schools founded in response to fears of a physician shortage. In Massachusetts, this translated into a call for more opportunities for the state’s students to attend an affordable school where, it was hoped, they would deliver primary care to the people of their home state. Yet, the original dean and faculty, most of whom were recruited from Boston medical schools, were equally devoted to basic research and tertiary care medicine.
This book tells the story of the school’s successful efforts to reconcile the demands of primary care education with world-class research. Part 1 tells the sometimes raucous story of the politics attendant on bringing the school from legislative enactment to actual groundbreaking, a process lasting more than 20 years. Part 2 describes the school’s development over a 45-year period, from a fledgling endeavor to a successful academic health science center.
Corrected version posted March 9, 2017.
Ellen S. More, Ph.D. is Professor Emeritus of psychiatry at the University of Massachusetts Medical School. A medical historian specializing in the history of the American medical profession, the history of women physicians, and the history of medical education, she was the founding head of the Office of Medical History and Archives, Lamar Soutter Library, at UMass Medical School and a professor in the Department of Psychiatry. She is the author or editor of three previous books, including Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (Harvard), winner of the Rossiter Prize from the History of Science Society, Women Physicians and the Cultures of Medicine (Johns Hopkins), co-edited with Elizabeth Fee and Manon Parry, winner of the Best Publication award from the Archivists and Librarians of the History of the Health Sciences, and The Empathic Practitioner: Empathy, Gender, and Medicine (Rutgers), co-edited with Maureen Milligan. She was the Visiting Curator for the National Library of Medicine’s exhibition, “Changing the Face of Medicine,” and a Fellow of the Radcliffe Institute for Advanced Study, Harvard University.