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The diagnosis rate of prostate cancer is higher in the developed world following the increased usage of PSA screening,¹ resulting in the diagnosis of many asymptomatic tumours. This is combined with other detection methods for a diagnosis to be achieved.

Age, family history and ethnicity are all well established risk factors of prostate cancer.² However many risk factors usually associated with the development of other types of cancer, such as smoking, alcohol and a sedentary lifestyle, are not thought to be associated with prostate cancer.³

Following screening the majority of men are diagnosed with a low gleason-grade, hormone-sensitive prostate cancer,² which is managed through watchful waiting and active surveillance. This is later treated with radiotherapy, radical prostatectomy and hormonal therapies. Disease progression will lead to patients being diagnosed with castrate-resistant prostate cancer. These patients will require chemotherapy treatment according to the current guidelines.²

The Prostate Cancer Knowledge Centre brings together current and detailed information relating to:

• Epidemiology
• Disease classification
• Methods of detection
• Hormone-sensitive prostate cancer
• Castration-resistant prostate cancer
• Treatment and management guidelines

The diagnosis of GIST relies on standard histologic examination and immunohistochemical analysis of several markers, including KIT. Equivocal cases should be submitted to a central review by an expert in sarcoma pathology, experienced in the diagnosis of GIST.

Before the availability of Glivec, the only treatments for GIST other than surgery were conventional chemotherapy and radiation therapy.^5,6 The role of chemotherapy and radiation therapy has been limited by a lack of efficacy and intolerable toxicity, currently surgery is Standard of Care for Resectable Primary GIST.

GIST is now recognised as having a much higher incidence than previously thought. Under the current, widely accepted definition of GIST as a distinct molecular and pathologic entity, the incidence of GIST is in the range of 10-20 cases per million persons per year ^7-11. The prevalence of GIST in a population-based study was estimated to be 129 cases per million persons.¹¹ GIST tumours occur at a median age of 60 years and are slightly more predominant in men than women.⁹ 

Enter the Gastrointestinal Stromal Tumours (GIST) Knowledge Centre

References

1. Fletcher CDM, Berman JJ, Gorstein F, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol. 2002;33:459-465.
2. Connolly EM, Gaffney E, Reynolds JV. Gastrointestinal stromal tumours,Br J Surg. 2003;90:1178-1186.
3. Kindblom LG. Gastrointestinal stromal tumors: diagnosis, epidemiology, prognosis. Available at: www.asco.org. Accessed July 13, 2007.
4. Joensuu H, Fletcher C, Dimitrijevic S, Silberman S, Roberts P, Demetri G. Management of malignant gastrointestinal stromal tumours. Lancet Oncol. 2002;3:655-664.
5. Eisenberg BL, Judson I. Surgery and imatinib in the management of GIST: emerging approaches to adjuvant and neoadjuvant therapy. Ann Surg Oncol. 2004;11:464-475.
6. Dematteo RP, Heinrich MC, El-Rifai WM, Demetri G. Clinical management of gastrointestinal stromal tumors: before and after STI-571. Hum Pathol. 2002;33:466-477.
7. Goettsch WG, Bos SD, Breekveldt-Postma N, Casparie M, Herings RM, Hogendoorn PC. Incidence of gastrointestinal stromal tumours is underestimated: results of a nation-wide study. Eur J Cancer. 2005;41:2868-2872.
8. Joensuu H. Current perspectives on the epidemiology of gastrointestinal stromal tumours. Eur J Cancer. 2006;4(suppl 1):4-9.
9.  Blay JY, Bonvalot S, Casali P, et al. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of European Society for Medical Oncology. Ann Oncol. 2005;16:566-578.
10. Miettinen M, Lasota J. Gastrointestinal stromal tumors--definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch. 2001;438:1-12.
11. Nilsson B, Bumming P, Meis-Kindblom JM, et al. Gastrointestinal stromal tumors: The incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era. Cancer. 2005;103:821-829

Accurate diagnosis of NPC requires awareness of many clinical phenotypes, narrowing of differential diagnosis by ancillary testing and final confirmation by biochemical testing – the current mainstay of primary diagnosis in NPC.

The prevalence of NPC has undoubtedly been underestimated in the past due to a mixture of factors including confusing terminology, prior lack of specific biochemical or genetic tests, varied pathology, and the many variant clinical manifestations of the disease.

Current, non-specific treatments for NPC focus mainly on supportive care, aimed toward managing the symptoms of the disease. As such, these treatments have no effect on disease progression or long-term outcomes.

Specific therapies for the intended treatment of NPC are based on targeting known pathophysiological and/or biochemical defects involved in the pathogenesis of the disease. While earlier attempts proved largely ineffective, more recent efforts indicate possible hope for the future. 

Enter the Niemann-Pick Type C Knowledge Centre

In 2006, there were estimated to be 63,300 new cases of kidney cancer (tenth most common cancer in the European Union [EU]¹) and 26,400 kidney cancer-related deaths in the EU. The Czech Republic, Estonia and Iceland have the highest RCC rates in Europe. Although the worldwide incidence of RCC is thought to be increasing,² data from a recent European study, which analysed kidney cancer incidence in 1980– 2004, indicate a shift towards stabilization or a decrease in incidence in recent years in both sexes. Recently, kidney cancer incidence rates also have decreased or stabilized in some countries in Northern Europe, except for England, Scotland and Ireland, whereas incidence in Eastern Europe has generally increased (except for women in the early 2000s). The highest sustained decreases in incidence rates were seen in Sweden; declines were observed in both sexes throughout the 25-year study period.

Enter the Renal Cell Carcinoma Knowledge Centre

References

1.Ferlay J, Autier P, Boniol M et al. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 2007; 18:581-592.
2. Matthew A, Devesa SS, Fraumeni JF, Jr.., Chow WH. Global Increases in kidney cancer incidence, 1973-1992. Eur J Cancer Prev. 2002;11:171-178.

Every year approximately 13,000 new cases of soft tissue sarcomas are diagnosed in adults and children in Europe. The 5-year survival rate for patients with soft tissue sarcoma is around 90% if the cancer is detected in early phases and before it has spread. However, the 5-year survival rate is 10% to 15% for sarcomas with metastasis.

Management of STS depends on the stage of disease and histological subtype.² Surgery is the mainstay of treatment for patients with localised disease and is often curative. However, as recurrence is likely to occur when tumour cells remain after surgery, adjuvant radiotherapy is often also considered, especially for patients with intermediate or high-grade tumours. Radiotherapy is also often administered for patients in whom surgery is inappropriate or who decline surgery.²

There are a number of Associations and Organisations across Europe who strive to inform others of this disease as well as offer help and support to those affected or to those who know and want to help those suffering.

Enter the Soft Tissue Sarcoma Knowledge Centre

References

1. Cormier JN, Pollock RE. Soft tissue sarcomas. CA: A Cancer Journal for Clinicians 2004; 54(2):94–109.
2. Clark MA, Fisher C et al. (2005) “Soft-tissue sarcomas in adults.” N Engl JMed 353(7): 701–11.