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1

Ramaswamy, Govindan, ed. Locally advanced non-small-cell lung cancer. Manhasset, NY: CMP United Business Media, 2004.

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2

Wellner, Ulrich. Locally advanced pancreatic head cancer – margin-positive resection or bypass? Freiburg: Universität, 2012.

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3

Excellence, National Institute for Clinical. Guidance on the use of capecitabine for the treatment of locally advanced or metastatic breast cancer. London: National Institute for Clinical Excellence, 2003.

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4

Dee, Baldwin, ed. An Afrocentric approach to breast and cervical cancer early detection and screening: An educational program for undergraduate and advanced practice nursing students. Washington, DC: American Nurses Association, 1996.

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5

Dee, Baldwin, and American Nurses Association, eds. Faculty guidebook for an Afrocentric approach to breast and cervical cancer early detection and screening: An educational program for undergraduate and advanced practice nursing students. Washington, DC: American Nurses Association, 1996.

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6

Izumi, Kouji, ed. High-Risk Localized and Locally Advanced Prostate Cancer. MDPI, 2023. http://dx.doi.org/10.3390/books978-3-0365-8169-9.

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7

Recent advances in locally advanced non-small-cell lung cancer. Manhasset, N.Y: CMPMedica, 2006.

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8

Jocham, D. Therapeutic Options for Localized and Locally Advanced Prostate Cancer (Urologia Internationalis). S Karger Pub, 1998.

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9

Moyad, Mark. Promoting Wellness for Advanced Prostate Cancer, 5th Edition: Your Locally Advanced to CRPC Empowerment Guide. Spry Publishing LLC, 2023.

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10

Aigner, Karl Reinhard, and Frederick O. Stephens. Induction Chemotherapy: Integrated Treatment Programs for Locally Advanced Cancers. Springer, 2013.

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11

NCCN Guidelines for Patients® Early and Locally Advanced Non-Small Cell Lung Cancer. National Comprehensive Cancer Network® (NCCN®), 2023.

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12

National Comprehensive Cancer Network® (NCCN®). NCCN Guidelines for Patients® Non-Small Cell Lung Cancer Early and Locally Advanced. National Comprehensive Cancer Network® (NCCN®), 2022.

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13

National Comprehensive Cancer Network® (NCCN®). NCCN Guidelines for Patients® Non-Small Cell Lung Cancer Early and Locally Advanced. National Comprehensive Cancer Network® (NCCN®), 2022.

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14

O’Brien, Tim, and Amit Patel. Kidney cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0088.

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Despite advances in imaging techniques, many patients with renal cancer still present with locally advanced or metastatic disease. Surgical resection remains the main stay of treatment for locally advanced disease, but is technically challenging and survival remains limited. Progression free and overall survival following nephrectomy are dependent on many factors including pathological T-stage, lymph node status, and Fuhrman grade. Patients presenting with metastatic disease still have a poor prognosis and the use of multimodal therapy has yet to deliver dramatic improvements in outcomes, with just 15% of patients surviving in the long term. Understanding the potential but also the limitations of surgery is very important when the overall prognosis may be so limited in this challenging group of patients.
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15

(Editor), Dee Baldwin, ed. An Afrocentric Approach to Breast and Cervical Cancer Early Detection and Screening: An Educational Program for Undergraduate and Advanced Practice Nursing Students. American Nurses Association, 1996.

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16

Hematology/Oncology Clinics of North America - February 2004: Volume 18, Number 1: Lung Cancer, Part 1: Radiotherapy and Chemotherapy in Locally Advanced and Mestastic Non-Small Cell Lung Cancer. Saunders, 2005.

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17

Joniau, Steve, S. Van Bruwaene, J. Karnes, G. De Meerleer, P. Gontero, M. Spahn, and A. Briganti. High-risk prostate cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0066.

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In this chapter, patients with adverse tumour characteristics and a high risk of tumour progression are discussed. In the current era of PSA testing, the proportion of patients presenting with high-risk prostate cancer (PCa) is estimated between 10% and 20% with a 10-year cancer specific survival approaching 40% for those not receiving active local treatment. The prevalence of high-risk disease varies with community PSA use, and is higher in countries (e.g. 30% in the United Kingdom) with little PSA testing. Adequate staging with magnetic resonance imaging for tumour extension, computer tomography for visceral metastases, and bone scan for skeletal metastasis is advocated in this group. The treatment of locally advanced or high-risk prostate cancer is a contemporary challenge.
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18

Zehnder, Pascal, and George N. Thalmann. Muscle-invasive bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0078.

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In the United Kingdom, >4,000 people die of bladder cancer every year. This reflects around one-third of affected patients and occurs in those with primary metastatic disease, with invasion at presentation, and in persons whose tumour progresses to invasion from non-invasive disease. The outcome from invasive cancers has not dramatically altered over the last 30 years, due to a lack of screening programmes, a lack of advances in treatment, and the fact that many patients present with tumours at an advanced stage. Around 50% of patients with invasive disease die from bladder cancer despite radical treatment, suggesting the disease is metastatic at presentation. Cure is rarely possible in patients with locally advanced tumours and lymph node metastases. Therapeutic options include systemic chemotherapy and salvage radical treatment for responders or palliation. Following radical cystectomy for cancer, patients require lifelong follow-up for both oncologic and functional reasons.
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19

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Madhumita Bhattacharyya. Breast cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0014_update_001.

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Thoracic cancer examines the epidemiology, aetiology, and role of screening and prevention in the reduction of deaths from lung cancer, the majority caused by cigarette smoking. The pathology and genetics of lung cancer, with particular note of the driver mutations, are followed by the symptoms and signs of the disease. Appropriate investigations are described to stage the tumour. The optimum treatment for localised non-small cell lung cancer (NSCLC) is surgical resection, followed in some cases by adjuvant chemotherapy. However, most cases present with disease too advanced for surgery, and for these chemotherapy and radiotherapy are appropriate. Metastatic NSCLC can be treated with platinum based doublet chemotherapy with modest palliative benefits. Metastatic NSCLC with specific driver mutations are amenable to control by targeted therapy. Locally advanced NSCLC is often treated with similar chemotherapy and radiotherapy, ideally administered concurrently, to achieve symptom relief but also improved survival rates. Short course simple radiotherapy offers symptom relief in patients not fit for chemotherapy. Patients with localised NSCLC who are not fit for surgery, may benefit from radical radiotherapy, particularly stereotactic radiotherapy. Small cell lung cancer (SCLC) is characterised by almost universal systemic spread, so that surgery is rarely appropriate. Staging is similar to NSCLC, and chemotherapy is the mainstay of treatment, usually cisplatin or carboplatin combined with etoposide. When possible, this is combined with concurrent thoracic irradiation covering all radiological sites of disease. Prophylactic cranial irradiation reduces the risk of CNS disease. Malignant pleural mesothelioma is caused by occupational asbestos exposure. Symptoms and signs, investigation and staging, and management are discussed. Thymic tumours, their pathology, presenting symptoms including paraneoplastic syndromes, investigation, staging and treatment are reviewed.
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20

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Amen Sibtain. Colorectal cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0015_update_001.

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Breast cancer reviews the epidemiology and aetiology of this malignancy, with particular attention to the genetics underlying familial breast cancer, its pathology along with its receptors, oestrogen receptor (ER), the growth factor receptor HER2, and epidermal growth factor receptor (EGFR), and the bearing these have on treatment and prognosis. The benefits of breast cancer screening in the population and families at higher risk are discussed. Presenting symptoms and signs are followed by investigation including examination, bilateral mammography, and core biopsy of suspicious lesions. Management of non-invasive in situ disease is considered. Invasive breast cancer is staged according to TNM guidelines. Early breast cancer is defined, managed frequently by breast conserving surgery and sentinel node biopsy from the axilla. A positive sentinel node biopsy requires clearance of the axilla. Larger lesions may require mastectomy. Breast radiotherapy is indicated after breast conserving surgery. Following surgery, the risk of systemic micrometastatic disease is estimated from the primary size, lymph node spread, and tumour grade. Adjuvant chemotherapy improves treatment outcome in all but very good prognosis premenopausal breast cancer, and intermediate or poor prognosis postmenopausal breast cancer. This is combined with trastuzumab in HER2 positive disease. Adjuvant endocrine therapy is recommended for all ER positive breast cancer, tamoxifen in premenopausal, aromatase inhibitors in postmenopausal women. Neoadjuvant chemotherapy may be used in large operable breast cancers to facilitate breast conserving surgery. Locally advanced breast cancer is defined, its high risk of metastatic disease requiring full staging before treatment. Systemic therapy is often best first treatment, according to receptor profile. Metastatic breast cancer although incurable can be controlled for years using endocrine therapy, chemotherapy, trastuzumab, palliative radiotherapy, and bisphosphonates as appropriate. Male breast cancer is uncommon, but management similar.
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21

Bjartell, Anders, and David Ulmert. Clinical features, assessment, and imaging of prostate cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0063.

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In contemporary practice, most patients with prostate cancer are diagnosed following a prostate-specific antigen (PSA) test and are asymptomatic at the time of diagnosis. Although serum PSA has a low specificity for prostate cancer, it can be used to single out patients with advanced disease. While most men do not have a palpable tumour at digital rectal examination (DRE), those with palpable or an elevated PSA test require transrectal ultrasonography-guided prostate biopsy in order to make a diagnosis of cancer. Tumours are staged clinically as localized, locally advanced, or metastatic. The urologist and the patient need the correct staging information for decision-making. A combination of several parameters (PSA value, Gleason grade and tumour extent on biopsy, and DRE findings) can be used in a variety of tools to predict the extent of the disease and treatment outcomes.
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22

Freer, Phoebe E. Skin Lesions. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0050.

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Skin lesions are commonly seen on breast imaging. Often, a raised skin lesion is encountered incidentally during screening mammography and can be mistaken for a mass within the breast parenchyma. In most cases, lesions confined within the dermis are benign. Occasionally, focal skin involvement may be the presenting sign of a breast cancer that is either locally extensive to the skin or has an inflammatory component. This chapter reviews the key imaging and clinical features of skin lesions that may be encountered either incidentally on breast imaging or on diagnostic imaging as an area of patient concern. Imaging features of skin lesions, the differential diagnoses, and further management will be reviewed. Topics discussed include benign epithelial cysts (i.e., sebaceous cyst and epidermal inclusion cysts), seborrheic keratosis, keloid and dermal nevi, cellulitis, and inflammatory and locally advanced breast cancers.
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23

Lewis, Keir. Smoking. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0338.

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The UK government, in its White Paper in 1998, declared that ‘smoking is the greatest single cause of preventable illness and premature death in the UK’. Cigarette smoke is inhaled because it contains nicotine, which is highly addictive. Nicotine itself has some adverse physiological effects but it is mainly the 4000+ chemicals (including acetone, arsenic, paint stripper, pesticides, and over 60 known carcinogens), added to make the cigarette such an extremely potent nicotine delivery device, that cause so much damage.A smoker dies on average 8–10 years before a non-smoker does. The commonest causes of premature death in smokers are cardiovascular disease, lung cancer, and COPD. However, smoking also leads to much morbidity, causing or worsening many illnesses and affecting every system of the body. In addition, it is associated with a number of cancers, including lung cancer, nasopharyngeal cancer, laryngeal cancer, oesophageal cancer, stomach cancer, pancreatic cancer, colonic cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukaemia. Stopping smoking at any age has been shown to improve health and increase life expectancy. Even with advanced smoking-related diseases, observational studies show clinically meaningful benefits in stopping smoking.
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24

GonzÁlez, Amy Berrington de, André Bouville, Preetha Rajaraman, and Mary Schubauer-Berigan. Ionizing Radiation. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0013.

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Ionizing radiation is a universal carcinogen due to its ability to induce cancer in most organs following exposure at any age, including in utero. Several organs are especially radiosensitive, particularly when exposure occurs in childhood. These include the female breast, thyroid, brain, and red bone marrow. Very few cancers, notably cervical and Hodgkin lymphoma, do not seem to be related to ionizing radiation, for unknown reasons. For most cancers (lung may be the exception) the relative risk decreases with attained age and time since exposure. Currently the main sources of radiation exposure to the general population involve very low-dose (<50 mGy) natural background exposure (including residential radon) and medical exposures, such as computed tomography (CT) scans. Natural background exposure varies by location but is generally stable over time. Medical exposure has been increasing in many countries due to the expanded use of advanced imaging technologies.
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25

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Madhumita Bhattacharyya. Gynaecological cancers. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0020_update_001.

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Genitourinary cancers examines the malignancies arising in the kidney, ureter, bladder, prostate, testis, and penis. Renal cancer has high propensity for systemic spread, largely mediated by overexpression of vascular endothelial growth factor (VEGF). Treatments include surgery, immunotherapy, and targeted therapy. Wilms tumour, a childhood malignancy of the kidney, warrants specialist paediatric oncology management to provide expertise in its unique pathology, staging, and treatment, often with surgery and chemotherapy. Cancer of the bladder and ureters, another tobacco related cancer, may present as either superficial or invasive disease. The former is managed by transurethral resection and intravesical therapy. The latter may require radical surgery, preoperative chemotherapy, or radiotherapy. Prostate cancer, the commonest male cancer, is an androgen dependent malignancy. It has attracted controversy with regards to PSA screening, and potential over treatment with radical prostatectomy. Division into low, intermediate, and high risk disease according to tumour grade, stage, and PSA helps in deciding best treatment, antiandrogen therapy for metastatic disease, radiotherapy and adjuvant hormone therapy for locally advanced disease, either surgery or radiotherapy for early intermediate risk disease, and active monitoring for low risk cases. Testicular cancer divides according to pathology into seminoma, nonseminomatous germ cell tumours (NSGCT), and mixed tumours, the latter two frequently producing tumour markers, alpha-fetoprotein (AFP) and/or human chorionic gonadotrophin (HCG). Stage I disease is managed by inguinal orchidectomy and surveillance or adjuvant chemotherapy. More advanced disease is managed by chemotherapy, with high probability of cure in the majority. Penile cancer, often HPV related, can be excised when it presents early, but delay in presentation may lead to regional and systemic spread with poor prognosis.
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