The Science of Prevention: Novel Strategies for and New Insights Into Central Nervous System Prophylaxis in Patients With Cancer
Guest Editors: Michael Glantz, MD and Lawrence Recht, MD
Volume 36, Supplement 2 (August 2009)
Publication of this supplement and video presentation are supported by Enzon Pharmaceuticals. Editorial support provided by Phase V Communications, New York, NY.
FAQ #1.
Neoplastic meningitis is rare in my experience, how commonly and in whom does it occur?
FAQ #2.
How does neoplastic meningitis present and how is it diagnosed?
FAQ #3.
Aren’t most patients with neoplastic meningitis too sick to treat for their disease?
FAQ #4.
Which patients, then, are most likely to benefit from treatment?
FAQ #5.
You’ve mentioned “CSF flow status” as a prognostic factor. I never examine that. Is it important?
FAQ #6.
Given the overall poor prognosis for patients once they develop neoplastic meningitis, what is the standard of care and are there any patient populations for whom prophylactic intra-CSF hemotherapy is appropriate?
FAQ #7.
Even more commonly than neoplastic meningitis, I see patients who develop brain metastases. How reliably can I predict which of these patients is at risk and are there reliable ways to prevent this nervous system complication of cancer?
FAQ #8.
My biggest concern about CSF prophylaxis of any type is the risk of causing major side effects in patients who might never have suffered a CNS metastasis. How do I weigh the risks and benefits of prophylaxis?