Volume 2, Number 2

Robert Thomas FRCP MD FRCR Consultant Oncologist, Addenbrooke’s and Bedford Hospitals; Sanjay Raj MRCP Specialist Registrar, Oncology, Addenbrooke’s Hospital; Ahmed Eldin FRCS Consultant Surgeon, Bedford Hospital, Cambridge University NHS Foundation Trust

Bevacizumab (Avastin®, Roche, UK) is one of a new breed of exciting therapeutic monoclonal antibodies, which are forging a new era of oncology practice. Although bevacizumab is now given routinely in the USA as firstline therapy for patients with metastatic colorectal carcinoma, financial pressures in the UK are constraining its use to anecdotal cases, such as that presented here. The case report highlights the human side of its therapeutic potential as, despite a long road of extensive previous chemotherapy regimens, a dramatic response was achieved.

Janet Richardson BSc PhD RN CPsychol PGCE RNT Reader in Nursing and Health Studies, Faculty of Health and Social Work, University of Plymouth; Karen Pilkington BPharm(Hons) DipInfSci MSc PCME MRPharmS Project Manager/Senior Research Fellow, School of Integrated Health, University of Westminster, London; Robert Thomas FRCP MD FRCR Consultant Oncologist, Addenbrooke’s and Bedford Hospitals, Cambridge University NHS Foundation Trust

In 1995, 70% of oncology centres in England and Wales were providing some form of complementary therapy.1 A postal survey sampling over 1,000 women with breast cancer found that more than 22% had consulted a complementary practitioner in the previous 12 months.2 The most commonly received therapies were massage, aromatherapy, osteopathy, relaxation, yoga, meditation and healing.

Wendy Rees BSc SRD Senior Dietitian, Gloucestershire Royal Hospital, Gloucester

Low bacteria diets are known as ‘neutropenic diets’, ‘clean diets’, ‘low microbial diets’ and ‘reduced bacteria diets’. By reducing the introduction of potentially pathogenic micro-organisms into the gastrointestinal (GI) tract, it is assumed that the risk of bacterial and fungal infections will be reduced in the neutropenic haemato-oncology patient.1

Graham H Jackson, Editor

Welcome to issue 2.2. As we prepare to bring you the next issue of the journal, controversy and confusion reign about trastuzumab (Herceptin®, Roche, UK) and the treatment of early-stage human epidermal growth factor receptor 2 (HER2) positive breast cancer.

Simon Rule MPhil FRCP FRCPA Consultant Haematologist and Honorary Senior Lecturer, Derriford Hospital, Plymouth

The management of mantle cell lymphoma (MCL) presents some particular difficulties to the clinician. It is now clear that as a distinct entity within the non-Hodgkin’s lymphomas (NHL), MCL has the worst prognosis of all subtypes, with a five-year survival rate of around 27%.1 While many patients will respond to firstline therapy, this response is rarely complete and a large proportion of patients will relapse within 18 months,2 at which point further treatment is often inadequate.

Rakesh Popat MRCP Clinical Research Fellow; Heather Oakervee MRCPath Senior Lecturer and Honorary Consultant; Jamie Cavenagh MD FRCP FRCPath Senior Lecturer and Honorary Consultant, Department of Haematology, St Bartholomew’s Hospital, London

Multiple myeloma (MM) treated by conventional therapies is currently an incurable disease with a median survival of three to four years.1 Recently, the increased understanding of the pathogenesis of MM has led to the introduction of novel agents such as lenalidomide (Revlimid®, Celgene Corporation, USA) and the proteasome inhibitor, bortezomib (Velcade®, Ortho Biotech, UK).

Catherine Burton MB BChir MA MRCP Clinical Research Fellow; David Linch MB BChir FRCP FRCPath FMedSci Professor of Haematology, Department of Haematology, University College London

Following on from our article in issue 2.1 of the British Journal of Cancer Management,1 we look at alternative treatment options for non-Hodgkin’s lymphoma (NHL). Early studies of high-dose therapy (HDT) and autologous haemopoietic stem cell transplantation have clearly established that only patients with chemosensitive disease at the time of transplant have a satisfactory long-term outcome2,3 and few centres would now consider such a procedure in a patient with chemorefractory disease.