Comment

Editor's Picks

Elevated breast cancer risk among mothers of a population-based series of 2668 children with cancer

“The editor’s pick is the paper by Dong Pang of the University of Manchester.

It represents more bad news for mothers of children with cancer, as if the social consequences weren’t enough. Discovering a child with cancer causes serious strains in the family as well as the child, ranging from acute denial in the parents, dreadful sibling rivalry and, worst of all, breaking of the family. A recent survey by the UK based children’s cancer charity CLIC Sargent revealed a 75% divorce rate amongst parents of these children.

The findings in this paper of an increased breast cancer risk in mothers of children with cancer follows hard on the heels of a cluster of reports of late second tumours in children who survive cancer. The late sequelae of treatment, especially radio chemotherapy, are not insignificant, and these have driven the design of new trials of milder chemotherapy, with less mutagenic drugs and avoidance where possible of radiotherapy.

But none of this will alter the risk described in this paper. Only the unravelling of this genetic basis for the increased risk will offer possible preventative strategies. Knowledge of the role of P53 in the Li-Fraumeni syndrome has not, however, yet lead to an effective management.”

abstract | full article | PDF

Does LigaSure(TM) Reduce Fluid Drainage in Axillary Dissection? A Randomised Prospective Clinical Trial.

“There are two reasons to commend this paper:

First it is a randomised trial of a new device, which is extremely unusual in the world of Health Service evaluation. Whereas drugs are endlessly tested in large Phase 3 trials prior to acceptance, technologies all too often sneak into clinical practice without more than a consecutive series from a couple of hospitals who claim that the new contraption is better than any previous device used in their clinic. That is called "historical control" and is insufficient in critical evidence-based evaluation.

The second reason to applaud the trial is that it was published despite being a negative trial. Frequently much extra expense is thrown away on literature reviews of novel techniques or molecules, which are flawed due to a publication bias. In other words only positive trials tend to be accepted by journals.

Negative results can be just as important as positive ones.”

abstract | full article | PDF

[18F] FDG uptake: pay attention to candies

“Laura L. Travanini’s Article on FDG uptake has been chosen as our first ecancermedicalscience, “Editors’ Pick”.

We have chosen this article for several reasons:

Firstly, because the article is the first in the history of a totally new online cancer journal.

Secondly, due to its importance as a clinical story regarding high tech imaging. It demonstrates that this high technology can be fooled by different artefacts. So despite the considerable amount of money invested in a CT/PET scan, a simple thing like a dietary sugar renders it null and void.

Thirdly, it is especially appropriate as, like ecancermedicalscience it emanates from the European Institute of Oncology.”

abstract | full article | PDF