Hematopoietic Growth Factors in Oncology

Progress in the treatment of cancer over the past two decades has been rapid with many new and novel therapeutic modalities arriving at an unprecedented pace. Overall cancer mortality rates have actually begun to fall in parallel with progress in the diagnosis and treatment of malignant disease. Despite our advances in the understanding of the biology and molecular genetics of cancer, as well as the availability of an increasing array of effective therapies, cancer treatment today and for the foreseeable future will include the traditional modalities of surgery, radiation therapy and chemotherapy. Myelosuppressive agents with their potential hematopoietic toxicities remain the mainstay of systemic treatment for both metastatic and early stage cancer. The complications of cancer chemotherapy have serious impact on a patient's well being and overall quality of life. Fortunately, advances in cancer treatment have been accompanied by equally impressive progress in the availability of a wide array of supportive care modalities which have greatly enhanced the ability of oncologists to minimize the impact of cancer and its treatment on patient quality of life as well improve delivery of potentially curative cancer treatment.

Despite the increasing complexity of modern cancer treatment, it is the obligation of the oncologist as well as the entire cancer care team to be certain that cancer patients receive the optimal supportive care available for their disease and its treatment. Among the most serious and potentially life threatening toxicities of cancer treatment are the hematologic toxicities accompanying myelosuppression including anemia and associated asthenia and fatigue, neutropenia and fever associated with infection in the immunocompromised patient and thrombocytopenia and accompanying risk of bleeding. Special supportive care needs arise in the very elderly care patient that may tax the ability of even the most skilled clinician. Despite theconsiderable