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Living Beyond Breast Cancer Liver and Lung Metastases Workshop April 29, 2012 Paul B. Gilman, MDLankenau Medical Center
Recurrence Local Regional Distant LBBC/04.29.2012
Distant Metastasis Soft-tissue Bone Visceral LBBC/04.29.2012
Visceral Metastasis Liver Lung LBBC/04.29.2012
Presentation of Liver/Lung Metastases Symptomatic Incidental finding on physical exam Incidental finding on imaging Laboratory studies LBBC/04.29.2012
Liver Metastasis Symptoms Nausea, anorexia, weight loss Pain Jaundice Fever LBBC/04.29.2012
Liver Metastasis Laboratory Evaluation Liver function tests Blood counts Coagulation tests Tumor markers LBBC/04.29.2012
Liver Metastasis Imaging Evaluation Ultrasound CT Scan MRI PET-CT LBBC/04.29.2012
Lung Metastasis Symptoms Dyspnea Cough, hemoptysis Pain LBBC/04.29.2012
Lung Metastasis Laboratory Evaluations Sputum analysis Tumor markers Pulmonary Function Testing LBBC/04.29.2012
Lung Metastasis Imaging Evaluations Chest x-ray CT Scan PET-CT LBBC/04.29.2012
Diagnosis Clinical Laboratory Radiologic Pathologic LBBC/04.29.2012
Biopsy Tissue Diagnosis Needle Biopsy FNAFNA CoreCore Surgical Biopsy Endoscopic (ultrasound) US-guided CT-guided LBBC/04.29.2012
Biopsy Analysis Tissue of origin Hormone receptors HER-2 Biomarkers (investigational) LBBC/04.29.2012
Treatment Goals Palliation (Symptoms, QOL) Organ Function Improved Survival (chronic disease) LBBC/04.29.2012
Treatment Objectives Response vs. Stable (clinical benefits) Disease Free Survival vs. Overall Survival Toxicity LBBC/04.29.2012
Treatment Approaches Lines of Therapy (First-line, etc.) Sequential Combination “Maintenance” Investigational LBBC/04.29.2012
Treatment Local Ablation (cryo, radiofrequency)Ablation (cryo, radiofrequency) Radiation (external beam, brachytherapy)Radiation (external beam, brachytherapy) SurgerySurgery Systemic Hormonal therapyHormonal therapy ChemotherapyChemotherapy Targeted TherapiesTargeted Therapies LBBC/04.29.2012
Clinical Trials Response Time to Progression Progression-Free Survival Overall Survival Quality of Life LBBC/04.29.2012
Radiologic Imaging Defines the local extent of a tumor Can be used to stage malignant disease Aids in the diagnosis Monitoring tumor changes after treatment.
Oncology The study of cancer. What is cancer? Any malignant growth or tumor caused by abnormal and uncontrolled cell division May be a tumor but it doesn’t.
IMAGE CHALLENGE. A 51-year-old woman with a history of hypertension and chronic constipation presented with abdominal pain of 2 weeks' duration. The.
Martina Rastovac Mentor: A. Žmegač Horvat. Actor Patrick Swayze died after a 20-month battle with pancreatic cancer. He was 57.Patrick Swayze.
Julie R. Gralow, M.D. Director, Breast Medical Oncology, Seattle Cancer Care Alliance Professor, Medical Oncology, University of Washington School of Medicine.
First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait First HAYAT Annual Patients Forum 21 st March 2010 Al Hashimi II Ballroom – SAS Hotel.
Matthew Kilmurry, M.D. St. Mary’s General Hospital Grand River Hospital.
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62 years old man Main complaint: Back pain at night but not during the day Loss of appettite Weight loss.
Diseases of the Pancreas. 67 y old male with loss of appetite, gradual weight loss and dyspepsia. Recent onset of jaundice and dark urine.
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update in metastatic breast cancer
John Doyle, Jon Hood, Jimmy Svab. Lung Cancer is the uncontrolled growth of abnormal cells. Abnormal cells do not develop into healthy tissue. Instead.
DIFFUSE MALIGNANT MESOTHELIOMA GENERAL THORACIC SURGERY CHAPTER 65.
Taylor J Greenwood, MD, Adam Wallace, MD, Aseem Sharma, MD, Jack Jennings, MD, PhD.
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