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16.1 Teenage and young adult malignancies 16.1 Teenage and young adult malignancies
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Introduction Introduction
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Incidence/epidemiology Incidence/epidemiology
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Aetiology Aetiology
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Clinical features Clinical features
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Diagnosis and delays Diagnosis and delays
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Clinical trials Clinical trials
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Place of care Place of care
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Psychological support Psychological support
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Body image and fertility Body image and fertility
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Education Education
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Late effects Late effects
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Clinical outcome Clinical outcome
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Transition Transition
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Terminal care and bereavement Terminal care and bereavement
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Further reading Further reading
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16.2 Cancer in older people 16.2 Cancer in older people
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Epidemiology Epidemiology
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Factors affecting access to treatment Factors affecting access to treatment
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Decision making in the elderly Decision making in the elderly
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Factors affecting choice of treatment Factors affecting choice of treatment
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Comorbidities Comorbidities
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Patient selection Patient selection
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Management of older oncology patients Management of older oncology patients
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Chemotherapy Chemotherapy
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Targeted agents Targeted agents
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Immunotherapy Immunotherapy
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Surgery Surgery
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Radiotherapy Radiotherapy
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Management of common cancers in the elderly Management of common cancers in the elderly
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Prostate cancer Prostate cancer
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General principles of management General principles of management
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Management of localized (T1–3N0M0) disease Management of localized (T1–3N0M0) disease
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Management of advanced disease Management of advanced disease
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Colorectal cancer Colorectal cancer
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Management of early disease Management of early disease
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Management of metastatic disease Management of metastatic disease
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Breast cancer Breast cancer
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Non-small cell lung cancer (NSCLC) Non-small cell lung cancer (NSCLC)
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Early stage disease Early stage disease
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Locally advanced disease Locally advanced disease
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Advanced/metastatic disease Advanced/metastatic disease
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Conclusion Conclusion
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Further reading Further reading
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Internet resources Internet resources
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16.3 Cancer in pregnant women 16.3 Cancer in pregnant women
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Epidemiology Epidemiology
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Interaction of pregnancy with cancer Interaction of pregnancy with cancer
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Modifications of investigations and treatment Modifications of investigations and treatment
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Specific cancer management Specific cancer management
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Cervical cancer Cervical cancer
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Breast cancer Breast cancer
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Melanoma Melanoma
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Lymphomas Lymphomas
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Further reading Further reading
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Internet resources Internet resources
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16.4 Cancer of unknown primary site 16.4 Cancer of unknown primary site
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Introduction Introduction
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Definition Definition
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Pathology Pathology
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Clinical presentation and management Clinical presentation and management
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Favourable subsets Favourable subsets
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Women with adenocarcinoma involving only axillary lymph nodes Women with adenocarcinoma involving only axillary lymph nodes
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Women with papillary adenocarcinoma of the peritoneal cavity Women with papillary adenocarcinoma of the peritoneal cavity
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Squamous cell carcinoma involving cervical or supraclavicular lymph nodes Squamous cell carcinoma involving cervical or supraclavicular lymph nodes
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Poorly differentiated neuroendocrine carcinomas Poorly differentiated neuroendocrine carcinomas
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Men with osteoblastic bone metastases and elevated PSA with adenocarcinoma histology Men with osteoblastic bone metastases and elevated PSA with adenocarcinoma histology
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Isolated inguinal lymphadenopathy from squamous cell carcinoma Isolated inguinal lymphadenopathy from squamous cell carcinoma
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Patients with a single metastatic site Patients with a single metastatic site
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Adenocarcinoma with a colon-cancer profile (CK20+, CK7–, CDX2+) Adenocarcinoma with a colon-cancer profile (CK20+, CK7–, CDX2+)
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Squamous cell CUP of the pelvis, abdomen, and retroperitoneum Squamous cell CUP of the pelvis, abdomen, and retroperitoneum
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Renal cell CUP Renal cell CUP
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Unfavourable subsets Unfavourable subsets
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Advances in the management of CUP Advances in the management of CUP
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Further reading Further reading
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16.5 Fertility and cancer 16.5 Fertility and cancer
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Introduction Introduction
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Significance Significance
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Male infertility Male infertility
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Female infertility Female infertility
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Female fertility strategies Female fertility strategies
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Risks for the offspring of survivors Risks for the offspring of survivors
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Timing of future pregnancy Timing of future pregnancy
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Monitoring in future pregnancy Monitoring in future pregnancy
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Internet resources Internet resources
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16.6 Late effects 16.6 Late effects
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Introduction Introduction
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Medical late effects Medical late effects
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Lessons learned from paediatrics Lessons learned from paediatrics
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Second malignancy Second malignancy
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Infertility Infertility
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Osteoporosis and osteonecrosis Osteoporosis and osteonecrosis
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Neurological Neurological
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Cardiological Cardiological
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Pulmonary Pulmonary
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Endocrine Endocrine
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Chronic health conditions Chronic health conditions
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Follow-up Follow-up
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Causes of death after cancer treatment Causes of death after cancer treatment
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Health behaviours Health behaviours
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Treatment summaries and care plans Treatment summaries and care plans
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Further reading Further reading
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Internet resources Internet resources
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16.7 Cancer survivorship 16.7 Cancer survivorship
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Introduction Introduction
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Prevalence Prevalence
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Lessons learned from paediatrics Lessons learned from paediatrics
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Psychological Psychological
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Relationships Relationships
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Social consequences Social consequences
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Treatment summaries and care plans Treatment summaries and care plans
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Further reading Further reading
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Internet resources Internet resources
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16.8 Travel 16.8 Travel
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Introduction Introduction
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Pre-travel preparation Pre-travel preparation
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Issues associated with mode of travel Issues associated with mode of travel
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Air travel Air travel
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Fitness to air travel Fitness to air travel
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Deep vein thrombosis Deep vein thrombosis
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Travel by sea Travel by sea
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Medical kit for a traveller Medical kit for a traveller
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Disability and travel Disability and travel
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Internet resources Internet resources
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16.9 Insurance 16.9 Insurance
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Travel insurance Travel insurance
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Reciprocal arrangements between countries Reciprocal arrangements between countries
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Life insurance and mortgages Life insurance and mortgages
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Driving and car insurance Driving and car insurance
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Car and motor cycle Car and motor cycle
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Large goods vehicle and passenger carrying vehicle Large goods vehicle and passenger carrying vehicle
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Motor insurance Motor insurance
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Internet resources Internet resources
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16.10 Vaccination 16.10 Vaccination
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Introduction Introduction
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Vaccines Vaccines
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Killed vaccines Killed vaccines
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Live vaccines Live vaccines
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Vaccination of family members Vaccination of family members
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Travel vaccination Travel vaccination
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Principles of travel vaccination in cancer patients Principles of travel vaccination in cancer patients
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Revaccination Revaccination
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Passive immunization Passive immunization
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Timing and administration of vaccines Timing and administration of vaccines
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Assessment of success of vaccination Assessment of success of vaccination
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Malaria chemoprophylaxis Malaria chemoprophylaxis
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Enteric infections Enteric infections
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Further reading Further reading
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Internet resources Internet resources
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16.11 Lifestyle choices after cancer 16.11 Lifestyle choices after cancer
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Introduction Introduction
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Adiposity and weight gain Adiposity and weight gain
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Diet Diet
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Food supplements Food supplements
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Alcohol Alcohol
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Smoking Smoking
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Physical activity after cancer Physical activity after cancer
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Evidence that physical activity improves survival and reduces relapse rates Evidence that physical activity improves survival and reduces relapse rates
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Mechanisms of the potential anticancer effects of exercise Mechanisms of the potential anticancer effects of exercise
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Incorporating healthy living and exercise programmes into mainstream cancer management Incorporating healthy living and exercise programmes into mainstream cancer management
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Summary Summary
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Further reading Further reading
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Internet resources Internet resources
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16.12 Complementary therapies 16.12 Complementary therapies
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Introduction Introduction
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Curative treatments Curative treatments
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Preventative measures Preventative measures
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Supportive and palliative care during chemotherapy Supportive and palliative care during chemotherapy
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Integrative medicine Integrative medicine
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Conclusion Conclusion
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Further reading Further reading
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Internet resources Internet resources
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16.13 Supportive care during chemotherapy 16.13 Supportive care during chemotherapy
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Nausea and vomiting Nausea and vomiting
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Myelosuppression Myelosuppression
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Colony stimulating factors Colony stimulating factors
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Erythropoietin Erythropoietin
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Mouth care Mouth care
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Preventing hair loss Preventing hair loss
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Preservation of fertility during chemotherapy Preservation of fertility during chemotherapy
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Bone modifying agents in the supportive care of cancer patients Bone modifying agents in the supportive care of cancer patients
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The role of bone modifying agents in the treatment of bone metastases The role of bone modifying agents in the treatment of bone metastases
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The role of bone modifying agents in bone health The role of bone modifying agents in bone health
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Further reading Further reading
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Internet resources Internet resources
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Cite
Abstract
This chapter covers a range of special situations in oncology, from demographic age groups, lifestyle, and social and non-medical care to the practicalities of and resources for travelling and insurance. The median age of diagnosis of cancer in the general population is 70 years. The majority of those cancers are related to specific risk factors such as smoking. At the other end of the scale, the majority of paediatric malignancies are thought to be developmental in origin with teenager and young adult malignancies falling in between these two extremes and may represent a late developmental malignancy or an early adult malignancy due to other factors such as genetic and environmental factors. Topics covered in this chapter include teenage and young adult malignancies, cancer in older people, cancer in pregnant women, cancer of unknown primary site, fertility and cancer, late effects, cancer survivorship, travel, insurance, vaccination, lifestyle choices after cancer, complementary therapies, and supportive care during chemotherapy.
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