Introduction Non-spine bone metastases are a common source of pain and morbidity among patients with metastatic cancer. Although their true incidence is unknown, estimates ranging as high as 30% to 70% have been reported during the course of their malignancies…
Introduction Hematologic malignancies arising from bone marrow cell populations classically include leukemias, either of lymphocytic or myelogenous origin, and multiple myeloma (MM), of plasma cell origin. The mainstay of definitive therapy for these malignancies is high-dose chemotherapy with local therapy,…
Introduction Radiotherapeutic palliation of lymphoma is unique among cancers for several reasons. First, unlike most cancers, even patients with disseminated “stage IV” disease can be routinely cured or put into a lasting remission with systemic therapies alone. Even in the…
Background An estimated 11,060 new cases of pediatric cancer will be diagnosed in the United States in 2019. In children ages 0 to 14, the most common diagnoses are leukemia (28%), central nervous tumors (21%), and neuroblastoma (7%) ( Fig.…
Introduction The five primary gynecologic malignancies (vulvar, vaginal, cervical, uterine, and ovarian) accounted for 12.2% ( n = 109,000) of new cancer diagnoses and 11.6% ( n = 33,100) of cancer deaths in American women in 2019. Uterine cancers are…
Pancreatic cancer Indications for palliative radiotherapy A diagnosis of pancreatic cancer is devastating; the 5-year overall survival for patients with locally-advanced unresectable disease is less than 5%, and for patients with metastatic disease is worse. At least 50% of patients…
Introduction The definition of palliative care by the World Health Organization (WHO) is centered around “an approach that improves the quality of life of patients … through the prevention and relief of suffering ….” One of the most important and…
Introduction Patients with advanced lung cancer may experience a variety of symptoms that can cause suffering, including (but not limited to) anxiety, dyspnea, fatigue, nausea, and pain. Palliative radiation to the thorax can ameliorate these symptoms in an attempt to…
Introduction Head and neck cancers represent the sixth most common cancer worldwide, with approximately 630,000 new patients diagnosed annually. While many advances within the field of head and neck cancer have focused on the improvement of curative-intent treatment, there remains…
Principles of reirradiation The guiding principle of “Do No Harm” lies at the heart of reirradiation, as the limits of radiation therapy are bounded by the potential for morbidity. Patients are commonly referred for reirradiation in two distinct clinical settings.…