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Melanoma is the cancer with the fastest incidence increase in Switzerland. 30% of the cases arise before the age of 50 years. Once metastatic, the median survival under current systemic therapies is about 8 months, with less than 5% of patients alive at 5 years. Many efforts in the understanding of cellular biology, intracellular signaling pathways, as well as the role of cellular immunity have been made in the recent years. This has resulted in the development of novel and very promising therapies. In this review, we will cover the results obtained with targeted therapies such as "tyrosin kinase inhibitors" (TKI), as well as those obtained with a monoclonal antibody directed against the CTLA-4 receptor of lymphocytes.

Anti-angiogenic therapies have recently enriched the therapeutic armentarium against the most common cancers. Among these, bevacizumab, a monoclonal antibody against vascular endothelial growth factor, is currently used most frequently. While the addition of bevacizumab to chemotherapy improves overall survival in first and second line treatment of metastatic colorectal cancer, its effect in metastatic breast cancer is limited to improvements in tumor response and progression-free-survival. In non-small-cell lung cancer, the positive results of a first American phase III study have not been confirmed by a second European study and are subject to controversies. A summary of the data concerning anti-angiogenic therapies in these three cancers is presented including safety information.

Diagnostic and treatment management of prostate cancer at its initial stage continues to raise important debates within the involved medical community. To establish a protocol for active surveillance, a validated option in specific conditions of localised prostate cancer management for eight years, is a unique opportunity to gather different specialists in this field. This paper presents this concept.

Colorectal cancer is the 2nd cause of cancer related death in industrialised countries. 20% of all patients present with metastatic disease at diagnosis and need systemic treatment. Since the introduction of irinotecan and oxaliplatin as part of standard chemotherapy, and recently the new targeted agents bevacizumab, cetuximab and panitumumab, the overall survival for patients suffering from metastatic colorectal cancer (mCRC) has increased significantly and nearly reaches 2 years nowadays. Surgery or radiofrequency ablation has become central in the care of metastatic disease. This article resumes recent therapeutic advances in the field and emphasizes the multidisciplinary concertation between specialists to obtain the best outcome.

Recent progress unveiling the cellular and molecular basis of the immune response allows nowadays the design of novel therapies for tumor immunotherapy. These recent approaches translate into response rates that often surpass what can be obtained by conventional chemotherapies or targeted therapies. Here we present the main current developments with an accent on the Lausanne experience in the treatment of melanoma. First, the new developments of peptide-based vaccination are presented. Second, approaches related to adoptive transfer are illustrated with a particular attention for the patient conditioning using lymphodepletion. Finally, the Lausanne project of rational lymphocyte TCR optimization is described.

To make a diagnostic of cancer in a young adult (15-30 years of age) has important physical, psychological and social implications. The most frequent cancers seen at this age are cancer of the thyroid, testicular germ cell tumours, 'melanoma, Hodgkin's lymphoma, non-Hodgkin lymphoma, leukaemia, cerebral tumours and sarcomas. Even if the prognostic of most of these cancers is excellent, treatments are difficult and often associated with long-term side effects. A multidisciplinary approach of these patients is essential. A long-term follow-up by a general practicioner or an oncologist is indispensable.

Breaking bad news is one of the most stressful duties of the physician in oncology. Among other issues, it includes discussion of cancer diagnosis or the failure of therapy. The oncologist is often puzzled by an apprehension regarding the delivery of bad news. The fear to be exposed to unexpected strong emotional reactions by the patient, such as aggression or despair, may cause the oncologist to adopt unproductive coping strategies such as discussion about technical details while avoiding to deliver the main message. However, good communication skills are the key for a satisfying conversation with the patient. The oncologists' discomfort induced by the above mentioned apprehension is one of the most important barriers for a successful conversation.

Advances in cancer biology have led to the development of screening tests that allow an early diagnosis. Cancer screening is not just the matter of a single individual patient, it is a matter of public health. Screening is commonly viewed as of no harm, when in fact harms are associated with the majority of cancer screening tests. A test should only be used when the potential of benefit clearly outweighs the risks for harm. The data in the literature are not always clear cut and in a lot of cases guidelines are somewhat controversial. What is known and what is unknown about screening tests is quite different from what is believed by the public. The aim of this work is to summarize the different methods and guidelines in cancer screening to help choosing the right test at the right time for the right person.

These last decades showed important progress in cancer systemic therapies. A better understanding of the differences between cancer cells and normal cells lead to the emergence of targeted therapies. These treatments interfere with different specific molecules playing a critical role in tumour growth or progression. On the other side, thanks to the development of new therapeutic substances, new modes of administration and to the improvement of supportive care, conventional chemotherapy is more effective and less toxic. The following review summarizes current progress with clinical impact observed these last years.

Due to the nature of the disease, patients often have a privileged and close relationship with their oncologist, and the oncologist also with their patients. This may in turn be detrimental to the relation between the general practitioner and the patient. Patients will not return to their general practitioner until end of life care or a consultation at the patient's home if necessary. In order to maintain a balance between the caretakers and assure appropriate involvement of the family physician, continuous communication and exchange of information are essential. This review identifies some of the problems and potential conflicts, which may arise, and discusses how the interaction could be improved.