Oncology is a medical branch devoted to the study, diagnosis, treatment, and prevention of cancer. Cancer prevalence is increasing. By 2030, the global cancer burden is expected to grow to 21.7 million new cases and 13 million deaths. Developing as well as developed nations have cancer burden, but there is a gap. Ideally, cancer management involves a multidisciplinary team composed of qualified individuals from different specialties collaborating to optimize the care. This team must follow evidence-based medicine principles, considering three questions: What is the problem? How can we manage it? And why are we selecting this pathway? To fill the gaps in care, we present 10 questions that can help those who are managing patients with cancer globally. We concluded that although there is no “one-size-fits-all” approach, adhering to basic principles can help guide provision of evidence-based patient-centered care and fill some of the gaps in oncology.
Stereotactic body radiotherapy (SBRT) has not been widely employed in the treatment of limited-stage (LS) small-cell lung cancer (SCLC), although SBRT finds particular utility in patients medically unfit to undergo surgical resection or radiotherapy with conventional fields. The authors present the case of a 61-year-old female smoker with severe chronic obstructive pulmonary disease (COPD), diagnosed incidentally with LS-SCLC. Concurrent chemoradiotherapy was contraindicated by her poor pulmonary function, and she was treated radically with four cycles of cisplatin and etoposide chemotherapy. This was followed by prophylactic cranial irradiation and consolidative SBRT (48 Gy in 4 fractions) to the residual tumour, which achieved a complete clinical response. Fifteen months following the patient’s initial diagnosis, a metachronous Stage IA contralateral non-small cell lung cancer (NSCLC) was incidentally diagnosed and was treated with SBRT (48 Gy in 4 fractions). Although studies have established that the incidence of a second lung cancer is higher in patients with previous SCLC, this case is unique in that both primaries were treated with SBRT.
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