Management of Breast Cancer in Older Women

Editat de Malcolm Reed, Riccardo A. Audisio
Notă GoodReads:
en Limba Engleză Carte Hardback – 15 May 2019
I was looking at Mrs T – all 45 kilos of her – with somewhat puzzled thoughts. I had prescribed her capecitabine at very prudent doses, in view of her 91-year-old kidneys and physiology. She had reduced my treatment even further, “because it was making her tired.” As a result, she was taking a grand total of 500 mg of capecitabine a day. Yet, her metastatic, ER/PR-negative, Her2-positive breast cancer was undoubtedly responding. Her pain was improving and her chest mass was shrinking, as were her lung metastases… What was the secret of that response? Were Mrs T’s kidneys eli- nating even less drug than predicted by her creatinine clearance? Was her sarcopenia altering drug distribution? Was she absorbing more drug than average? Or was her tumor exquisitely sensitive to fluoropyrimidines? “Physicians,” said Voltaire, “pour drugs they know little for diseases they know even less into patients they know no- ing about.” Medicine has made tremendous progress since the eighteenth century. Yet, there are fields where quite a lot remains to be learned. In developed countries, 25% of breast cancers occur in patients aged 75 years and older. Yet, these patients represent only 4% of the population of traditional clinical trials. That ought to let us wonder how relevant data acquired in patients in their 60s are to a nonagenarian. Fortunately, geriatric oncologists have been stepping up to the task and have gen- ated data to help us to treat such patients.
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ISBN-13: 9783030118747
ISBN-10: 3030118746
Pagini: 279
Dimensiuni: 155 x 235 mm
Greutate: 0.64 kg
Ediția: 2nd ed. 2019
Editura: Springer
Colecția Springer
Locul publicării: Cham, Switzerland


Basic Science: Tumor Biology and Pathology.- Epidemiology of Breast Cancer in Older Women.- Comprehensive Geriatric Assessment .- Experiences of a Multidisciplinary Elderly Breast Cancer Clinic: Using the Right Specialists, in the Same Place, with Time.- Mammographic Breast Screening in Elderly Women.- Primary Endocrine Therapy for the Treatment of Early Breast Cancer in Older Women.- Anesthesia and Pain Relief.- The Surgical Management of Breast Cancer in Elderly Women.- Breast Reconstruction.- Adjuvant Endocrine Therapy.- Adjuvant Chemotherapy.- Adjuvant Radiotherapy.- Prevention and Treatment of Skeletal Complications .- Medical Treatment of Advanced Disease.- Polypharmacy in Older Cancer Patient.- Assisting Patients in making the Right Decision.- Supportive, Palliative and End-of-Life Care for Older Breast Cancer Patients.- Nursing.-  The Patient’s Perception.-  Managing Patients with Cognitive Impairment.- Research and Clinical Trials for Older Patients.

Notă biografică

Riccardo A. Audisio was born in Milan, Italy, where he completed his High School at the Istituto Leone XIII (Maturità Scientifica) in 1975. He graduated in Padua in Medicine & Surgery (1980) and specialised in General Surgery at the University of Verona (1985) as well as in Diagnostic Radiology at the University of Milan (1994).
Trained at the National Cancer Institute of Milan (1980-94) he was appointed deputy director at the Department of General Surgery, European Institute of Oncology, Milan (1994-8).
He moved to the United Kingdom in 1999 to become Consultant Surgical Oncologist and Honorary Professor at the University of Liverpool, UK.
Past Editor of Surgical Oncology, Elsevier Publisher (2007-13) he is Editor-in-Chief of the European Journal of Surgical Oncology. Author of 240 peer-reviewed publications and 36 book chapters, Professor Audisio edited 20 book projects and is guest reviewer to 39 international scientific journals.
Professor Audisio is past-president of BASO (British Association of Surgical Oncologists) and of ESSO (European Society of Surgical Oncology). He is serving as an advisor to the Department of Health and to the All Party Parliamentary Group on Breast Cancer in Older Women. Professor Audisio sits on the Board of Directors of ECCO, the European CanCer Organisation. He is member of several international scientific societies including BASO, ESSO, SSO, ASGBI, ASCRS, AAA, SIOG and EUSOMA. He is past-chair of the Education & Training Committee of ESSO. His clinical research focuses on Breast Cancer and Geriatric Oncology. Past-President of SIOG (International Society of Geriatric Oncology) and past-chair the Surgical Task Force, Professor Audisio has organised several international advanced courses/meeting on cancer surgery, breast cancer and geriatric-oncology. Professor Malcolm Reed
Dean of Brighton and Sussex Medical School.
Malcolm Reed qualified in medicine from the University of Sheffield in 1981. Following postgraduate surgical training in the UK and a period of research at the University of Louisville in Kentucky, he returned to the UK for Higher Surgical Training.
He became Senior Lecturer and Honorary Consultant in 1992 and was appointed to the Foundation Chair in Surgical Oncology at the University of Sheffield in 1999.
In 2003 he became Head of Academic General Surgery and subsequently was appointed Head of the University's Department of Oncology. He was appointed as Dean of Brighton and Sussex Medical School in December 2014 and in 2016, Professor Reed became the Chair of the Medical Schools Council Education sub-committee.
He has a long-standing track record in cancer research, with more than 200 publications. His main current areas of clinical research relate to the surgical management of breast cancer, with particular emphasis on breast cancer in older women. His research also covers other important aspects of breast cancer diagnosis and treatment including projects evaluating the variation in the treatment of breast cancer. He is an active clinical trialist with several roles in major RCT’s as Chair or member of Trial Management and Data Monitoring Groups as well as Co-Investigator in a large UK Cohort Study (Bridging the Gap, Chief Investigator Professor Lynda Wyld).
A Fellow of the Royal College of Surgeons (FRCS), Professor Reed runs a joint surgery/geriatric breast cancer clinic.

Textul de pe ultima copertă

The second, updated edition of Management of Breast Cancer in Older Women offers the reader evidence-based knowledge to support the care of older patients with breast cancer. It presents the most up-to-date research and clinical practice from  leading specialists across a range of fields that come into contact with older breast cancer patients.
With new chapters on nursing and clinical trials in older women, as well as patient perspectives and the issues of managing patients with cognitive impairment, the book offers a new focus on this increasingly common and important group of patients. Multidisciplinary in its approach, this book covers all the bases for managing breast cancer in older women. The full range of therapeutic options is presented, as well as the epidemiology and specific psychosocial considerations for older patients.
Medical, surgical and radiation oncologists, breast nurses, gerontologists and all healthcare professionals involved in the management of older breast cancer patients will benefit from this unique and important work.


Written by opinion leaders in oncology in their relevant fields
Comprehensively discusses therapeutic approaches as well as issues and challenges specific to this special population
Offers oncological, nursing and psychotherapy perspectives