Recent Results in Cancer Research

Cholangiocarcinoma (CCA) is the second most common primary liver cancer worldwide. Despite the severity of the disease and its impact on individuals, families, and communities, there remains an overall lack of awareness and interest in this disease. The information contained in the chapters of this book shows that this is indeed a significant public health and socioeconomic problem with varying levels of country-specific awareness. In Southeast Asia liver fluke, O. viverrini related CCA is endemic with the highest incidence worldwide in northeast Thailand, yet it is treatable and preventable...

Although cholangiocarcinoma (CCA) or bile duct cancer is considered rare, worldwide it is the second most common primary liver cancer. The incidence is increasing globally, and mortality is high owing to its aggressiveness, late diagnosis, and refractory nature. In this chapter, the awareness of cholangiocarcinoma in the West and in Southeast Asia, particularly Thailand, is explored. The background to this cancer in each region is described, and the challenges faced by both by healthcare professionals and patients are uncovered...

Raw attitudes relate to the food cultures, eating habits, and behaviours of people in relation to the consumption of raw, partially cooked, and fermented freshwater fish dishes, which puts people at risk of Ophistochis viverrini and other parasitic infections. The chapter reviews raw attitudes within the countries and across the borders of the greater Mekong region, particularly northeast Thailand, Lao PDR, Vietnam, and Cambodia. Rather than treat each nation-state as an isolated epidemiological box, the chapter explores transborder complexity in relation to multiple anthropogenic transformations to the landscapes of the region and developmental impacts upon ecosystems and life cycles...

Innovations in digital procedures are discussed and highlighted in this chapter providing a comprehensive background and an overview of the Cholangiocarcinoma Screening and Care Program (CASCAP), and the innovative data base known as the Isan cohort, including the O. viverrini - CCA module, tele-radiology, databases for pathology, surgery, palliative care, and a randomized controlled trial database.

This chapter details all aspects of the general principles of palliative care for advanced stage cholangiocarcinoma patients. These include symptoms management, communication guide, advance care planning, and management for bereavement. Surgical and intervention techniques of palliative biliary drainage are described in detail for patients with obstructive jaundice with advanced stage CCA. Additionally, details are provided regarding the establishment of a multidisciplinary palliative care team which is critical to provide the most appropriate multimodal treatment for good quality of life and survival of patients...

Cholangiocarcinoma (CCA) is a diverse group of epithelial cancers that affect the biliary tree. The incidence of CCA is low in Western countries but significantly higher in endemic regions such as China and Thailand. Various risk factors contribute to the development of CCA. Recent studies have revealed molecular alterations in biliary tract cancers, providing insights into cholangiocarcinogenesis and potential targeted therapies. Surgical resection is the primary curative treatment for CCA. Adjuvant chemotherapy has been extensively studied, and some regimens have proven to be beneficial...

This chapter provides a comprehensive background from basic to applied knowledge of surgical anatomy which is necessary for the surgical treatment of cholangiocarcinoma (CCA) patients. Significant advances that have been made in the surgical treatment of CCA were examined. For instance, in-depth details are provided for appropriate preoperative assessment and treatment to optimize patient status and to improve the outcome of surgical treatment(s). Comprehensive details are provided for the surgical techniques and outcomes of treatments for each type of CCA with clear illustrations and images...

The chapter discusses the advancement of new imaging techniques, the role of imaging in CCA diagnosis, anatomical and morphological classification, ultrasound screening of CCA, ultrasound findings of MF-CCA, PI-CCA, ID-CCA, the use of CT in CCA diagnosis, staging and treatment planning, CT volumetry and estimation of future liver remnant, post-treatment follow-up and surveillance, MRI imaging, Positron Emission Tomography (PET)/CT, limitations to contrast studies and resolution, internal receivers for CCA imaging, and in vitro imaging of CCA...

The liver excretes bile through the biliary system, which has a complicated anatomical structure. Cholangiocarcinoma, a malignant bile duct epithelial tumor, is separated into intrahepatic and extrahepatic portions depending on the structure of the bile duct and exhibits both similarities and varieties in patient presentations and staging. The three main macroscopic characteristics of cholangiocarcinoma-mass formating, intraductal growth, and periductal infiltrating types-allow pathologists and surgeons to see and analyze the cancerous tissue...

Cholangiocarcinoma (CCA) is a malignant tumor of the biliary tree that is classified into three groups based on its anatomic location: intrahepatic (iCCA), perihilar (pCCA), and distal (dCCA). Perihilar CCA is the most common type and accounts for 50-60% of CCA cases. It is followed by distal CCA and then intrahepatic CCA that account for 20-30% and 10-20% of cases, respectively. This chapter discusses the hallmarks of liver fluke related CCA and explores insights into drug target possibilities.

It is known that Opisthorchis viverrini (OV) is the most significant risk factor for the development of cholangiocarcinoma (CCA); hence, it is also known as carcinogenic parasite. Effective control and elimination of OV infection should significantly reduce O. viverrini-related CCA. This chapter includes details of the three recently developed innovative tools, namely the Isan cohort database software, an OV-RDT for screening of O. viverrini, and an ultrasound telecommunication system. Past and current control programs, i...

Opisthorchis viverrini plays a key role as the carcinogenic liver fluke causing bile duct cancer in Southeast Asia. A comprehensive understanding of its life cycle, distribution, systematics, and population genetics is critically important as they underpin the effective development and establishment of future prevention and control programs that center on opisthorchiasis and cholangiocarcinoma. This chapter provides detailed information concerning the basic biology and updated information of O. viverrini related to its host life cycle, transmission route via raw, partially cooked or fermented freshwater cyprinid fish, endemic areas, and the discovery of new foci...

Cholangiocarcinoma (CCA) is a lethal cancer arising in the bile ducts within and just outside the liver. It occurs worldwide and falls into two etiologically defined groups, one related to chronic liver fluke infection and the other not. Liver fluke-related CCA is found in continental Southeast Asia (caused by Opisthorchis viverrini with infection leading to opisthorchiasis), East Asia (Clonorchis sinensis), and Eastern Europe and Russia (Opisthorchis felineus). Both O. viverrini and C. sinensis are classified as group one carcinogens, while recent data from O...

Cancer has been an important theme in literature, especially since the nineteenth century. Central dimensions of the frequent literary representations and interpretations of cancer are pathophenomenology, aetiology, diagnosis and therapy, image of the physician, subjectivity of the patient, medical institutions, social reactions and symbolism. The relationship between literature and medicine is a complex and reciprocal one marked by ontological differences. The long tradition of 'medical humanities' dating from ancient to present times is essential as human and humane medicine for the benefit and dignity of the suffering, sick and dying...

Patient narratives are a very valuable literary and medical resource. They transcribe the experience of illness into the life stories of the subject and the author. A serious case of cancer triggers the very individual experience of vulnerability, suffering, dependence, and even contingency in the no longer 'open' future. Even after overcoming cancer, life is never the same again. Writing about one's own experience of cancer is a hermeneutic feat of strength with ethical and aesthetic implications. In the age of personalized and evidence-based medicine, patient narratives offer a particular and necessary supplement to the objectifying medical perspective, since they constitute expressions of subjective evidence...

Cancer is seen as a 'dread disease' with a long and powerful history that remains resistant to defeat. It is a byword for suffering, pain and death. An unprecedented level of research spending and biomedical engagement offering new treatment options and hopes for a cure goes hand in hand with patient-led movements disseminating widespread public narratives of hope and survivorship. A key paradigm in these public narratives of hope and cure has been early detection of disease, with breast cancer, as the most frequent cancer among women, at the forefront of early detection campaigns...

Working with cancer patients is a highly demanding task. Both, caring for physical, social and spiritual needs of cancer patients as well as an overwhelming bureaucratisation, and technologisation challenge oncologists in a way that may cause mental and physical exhaustion, often-paradoxically-despite high job and specialty satisfaction. This article (i) summarises research findings with a special focus on oncologists' burnout (including factors associated with the phenomffenon), job satisfaction and physical health; (ii) describes potential consequences of burnout and distress, e...

There are undoubtedly sick people who suffer terribly, and of course this should not be. No patient with incurable cancer is to be so tortured for months or years that they want only to die and lack the means to do so. Being unable to die can be worse than death, one might say or think. But until we ourselves have crossed that frontier, we do not know this for certain. To die could be worse than not being able to die. One case is difficult to distinguish from the other. But we pretend we can distinguish them if we praise assisted suicide and euthanasia as solutions to a problem that we not only do not solve, but make worse...

Patients can determine in advance how they want to be treated in a certain situation, and in particular, situations in which they reject treatment. The provisions to be observed for the preparation and practical implementation of a living will under German law are presented and discussed. The chapter also describes the principles according to which a decision is to be made if no living will has been drafted. Additionally, it is recommended that a trusted person should be granted power of attorney, since the future course of an illness (including cancer) cannot be predicted in every detail...

Terminal chaperonage embedded in palliative care deeply resonates with human needs and has undergone significant advances in the past decades. At the same time, it is in jeopardy due to austerity measures in healthcare. Its comprehensive translation in philanthropic end-of-life practice necessitates reflection on underlying ethical issues. This chapter addresses ethical aspects arising in pain and terminal chaperonage and deduces important ethical imperatives in the wake of the palliative mandate. The imperatives affect the deployment of resources necessary for a humane pain and terminal chaperonage, one that is to be comprehensive and flexible in design and implementation at the same time...