Embracing the role of real life studies in the management of rare cancers

For commonly occurring cancers, as well as situations or conditions that are frequently encountered in oncological setting, plenty of prospective data are available to oncologists or medical practitioners to facilitate the decision making process[1]. However, for rare cancers and atypical scenarios, there are limited references in the current literature. Understandably, this is attributed to the difficulty in recruiting enough patients to systematically study such rare manifestations. Under these circumstances, the importance of real life data that are collected via population-based studies, case series, and case reports is especially significant[2].In the current issue of AMOR, the journal features three case reports that describe distinctly uncommon oncological scenarios. In one report, Vafaii and Shao highlighted the stepwise development of classical Hodgkin lymphoma (cHL) from diffuse large B cell lymphoma (DLBCL) via precursor Reed-Sternberg/Hodgkin cells, as confirmed via multiple biopsies[3]. They suggested that cHL and DLBCL can be clonally related, even when developing metachronously in the same patient, based on the presence of a hybrid intermediate stage. Meanwhile, Xian and colleagues reported the surgical management of brachial plexus pain that is caused by Pancoast tumor[4]. According to them, the condition closely resembles the symptoms of brachial plexus injury and thus, the underlying cause is easily misdiagnosed. Finally, Coehlo and co-workers presented a report on the prolonged disease control of esthesioneuroblastoma using a multimodality approach, combining surgery, radiotherapy, and chemotherapy to derive an effective treatment strategy[5]. It is noteworthy that despite an initial distant metastasis setback, the patient responded positively to palliative chemotherapy, thus proving the value of the much debated approach[6].In short, these case reports are an invaluable addition to existing medical literature concerning the diagnoses and management of infrequently encountered malignancies and their associated conditions. Gaining a better understanding of these rare diseases will equip medical practitioners with the right information to devise an appropriate treatment strategy and thus, improve their patients’ long term prognosis.