European Journal of Cancer: Highlights of Issue 40:11

Imaging to detect recurrent cancer

Imaging to detect recurrent cancer-how far should we go?

That is the question posed by Dr. Gwyther in an Editorial published in this issue. His reply? "For the most part, the asymptomatic patient with early stage disease still deserves to be investigated to a lesser rather than greater degree, unless there are specific concerns or that patient is at a high risk of recurrence". He also discusses a related article in this issue by Jarvenpaa and colleagues who prospectively studied whether the detection of recurrence or patient outcome is affected by who reads the plain radiographs - the oncologist or the radiologist. Patients were randomised to either a double-reading (oncologist and radiologist independently reading radiographs) or a single-reading arm (oncologist's reading only). 55 of 227 (24%) recurrences diagnosed were detected on plain radiographs. No survival differences were seen between the 2 arms. Jarvenpaa's study suggests that a radiological opinion on plain radiographs is not that important in patients attending the follow-up clinic for various cancers, Dr. Gwyther said.

Management of the axilla in breast cancer

Routine use of axillary clearance is increasingly difficult to justify and should be restricted to those patients with involved nodes, according to authors reporting in this issue. Drs. Gaston and Dixon sent a questionnaire to 439 specialist breast surgeons to survey their views with regard to the management of the axilla. 371 returned the questionnaire. "There is no consistent practice of managing the axilla in the United Kingdom and standardisation is required. Sentinel Lymph Node (SLN) biopsy is performed both within and outside of trials and a variety of techniques are used", they said. "A consensus of when and how SLN biopsy can be introduced for clinical node-negative patients is urgently required."

Spouses of testicular cancer survivors have a better physical quality of life

Spouses of testicular cancer survivors had a better physical quality of life (QoL) than a reference group of 'average' women, authors report in this issue. Tuinman and colleagues received 259 questionnaires assessing both QoL and stress responses from spouses of testicular cancer survivors in the Netherlands: 219 were from spouses who had been present at the diagnosis of cancer and throughout the treatment, whereas the other 40 responses were from women who became spouses after treatment for cancer. Interestingly, the spouses who had been present at the cancer diagnosis and treatment not only had better physical QoL scores than the reference population, but also showed significant differences in the QoL measures from the spouses who met their partners later. The latter group reported a poorer psychological QoL, both in comparison with the other spousal group and the reference population. Research into the processes of building a relationship after surviving cancer might provide more insight into these results, they said.

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