ONCOLOGY Vol 13 No 1

Varian has created a new patient education Internet web site containing information on cancer radiotherapy treatments.

Researchers at The University of Texas M. D. Anderson Cancer Center have received funding to investigate the long-term effects of chemotherapy on men surviving testicular cancer.

Human immunodeficiency virus (HIV) tests that can be taken at home are good options for individuals who want to know whether they have been infected with the acquired immune deficiency (AIDS) virus but shy away from clinics and doctors’

The FDA uses a complex series of procedures to get needed drugs to patients as quickly as possible while ensuring safety. Patricia Keegan, md, oncology staff director in the FDA’s Clinical Trial Design and Analysis Division, walked the audience

Hormone replacement therapy may reduce the risk of colorectal cancer in women, according to new results of a meta-analysis presented at the North American Menopause Society meeting.

Sentinel lymph node biopsy, a minimally invasive procedure for staging patients with breast cancer, is a rapidly evolving technique in breast surgery. In response, a task force convened by the American Society of Breast Surgeons has issued a

As Dr. Cody points out, sentinel lymph node mapping of axillary nodes in patients with invasive breast cancer will probably become the standard of care for patients with early breast cancer, and will replace standard axillary dissection for many of these patients. With mammography increasing the detection of small, nonpalpable breast cancers, which pose a very low risk of axillary metastases, it is difficult to justify the continued use of standard axillary dissection. To my mind, it is also difficult to justify omitting axillary dissection of any type in these settings.

The Susan G. Komen Breast Cancer Foundation, a pioneer in the funding of research for breast cancer, announced at its 1998 National Grant Conference that the Joseph Drown Foundation has awarded the Komen Foundation a matching grant

A pharmaceutical now being considered for approval by the FDA for the diagnosis of certain lung tumors may also aid in the detection of primary and metastatic breast cancer tumors, according to a preliminary clinical study presented at the annual

The National Cancer Institute (NCI) will sponsor phase III trials to test the efficacy of AE-941/Neovastat, an angiogenesis inhibitor developed by AEterna Laboratories Inc., a Canadian biotechnology corporation, in the treatment of cancer.

Scientists at Jefferson Medical College believe they’ve uncovered a molecular mechanism by which aspirin interferes with colorectal cancer development in individuals who carry particular gene mutations that make them very likely to get the

Surgical excision not only is the most accurate method of evaluating a solitary pulmonary nodule, it is also the most cost effective, said Stephen C. Yang, md, Johns Hopkins assistant professor of surgery at the 1998 meeting of The American

Dr. Cody presents a very thorough review of the use of sentinel lymphadenectomy in breast cancer. The article raises key issues related to a procedure that is becoming more widespread and may indeed replace axillary dissection for the staging of breast cancer.

Colorectal cancer is one of the most commonly occurring cancers in the United States. In an effort to prevent the occurrence of colorectal cancer, agents identified as reducing risk of the disease are being targeted as potential chemoprevention tools. However, complex associations exist among diet, lifestyle factors, and genetic susceptibility and the eventual development of colon cancer, sometimes making the transition from associations identified in epidemiologic studies to the clinical use of chemoprevention agents difficult. Environmental factors that may serve as chemoprevention agents are addressed in the article by Garay and Engstrom. Does our current knowledge allow us to embrace these agents as tools for chemoprevention?

An important, though as yet elusive, goal of cancer chemotherapy is the development of agents that are selectively toxic to tumor cells and, thus, permit effective cancer treatment to be administered without severe, often life-threatening toxicity to normal tissues. Until such agents are available, an alternative strategy to improve the therapeutic index of cancer chemotherapy is the administration of cytoprotective agents to selectively protect normal tissues from injury by cytotoxic drugs.

Remarkable progress has been made in recent years in our understanding of colorectal cancer etiology. The various hypotheses of causality continue to be tested in human observational and intervention studies, as well as experimental models. Drs. Garay and Engstrom provide a comprehensive review of the dietary and chemopreventive factors for colorectal cancer. While their conclusions are noteworthy, those related to dietary factors are debatable.

Sentinel node surgery for breast cancer has generated considerable interest, and the timely article by Dr. Cody provides a concise, well-written review of the topic. This commentary will add a few relatively minor points and will offer some alternative viewpoints to the author’s conclusions.

Sentinel lymph node (SLN) biopsy is a rapidly emerging treatment option for patients with early-stage invasive breast cancer and a clinically negative axilla. In the era of mammographic detection, SLN biopsy has the potential to eliminate axillary dissection for the enlarging cohort of breast cancer patients who are node-negative. Using radioisotope, blue dye, or both methods, experienced surgeons can successfully localize SLNs in more than 90% of cases. The effects of isotope and blue dye may be additive. Sentinel lymph node biopsy reliably predicts axillary node status in 98% of all patients and 95% of those who are node-positive. The operation is best learned under a formalized protocol in which a backup axillary dissection is performed to validate the technique during the surgeon’s early experience. Enhanced pathologic analysis, including serial sections and immunohistochemical (IHC) staining, is an essential element of the procedure. In experienced hands, SLN biopsy has less morbidity and greater accuracy than conventional axillary dissection. [ONCOLOGY 1(13):25-34, 1999]

Colorectal cancer is a major cause of death in the United States, where it accounts for approximately 57,000 deaths per year. Thus, the prevention of this disease would have a significant impact on public health. Chemoprevention is defined as the use of natural or pharmacologic agents to disrupt the process of carcinogenesis. Substances explored as chemopreventive agents in colorectal cancer include: (1) the nonsteroidal anti-inflamma-tory drugs (NSAIDS), which may inhibit the evolution and formation of adenomas by their inhibition of cyclooxygenase and decrease of prostaglandin synthesis; (2) antioxidants, such as vitamin E or C, which may modulate carcinogenic substances; and (3) folate and calcium, which may interfere with tumor cell growth and replication. Dietary intervention can be accomplished by decreasing fat intake and increasing fiber consumption, both of which have been linked to a lower incidence of colon cancer in multiple epidemiologic studies. This field is continuing to evolve. Hopefully, ongoing research efforts will offer a better understanding of the role of these and other substances in chemoprevention. This article summarizes the available data regarding dietary and pharmacologic approaches to colorectal cancer chemoprevention. [ONCOLOGY 1(13):89-98, 1999]

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 47 breast cancer experts and 13 patient advocates participated. The proceedings of the conference will be published in six installments in successive issues of oncology. This first part defines the problem and explores its magnitude and ramifications for patient management. [ONCOLOGY 1(13):109-136, 1999]

Researchers have concluded that shark cartilage powder does not demonstrate antitumor properties and is not an effective treatment for patients with advanced cancer, according to the first scientific review of the substance published in a major

Amifostine (Ethyol) is an analog of cysteamine that selectively protects normal tissues in multiple organ systems against the toxic effects of radiation and various cytotoxic drugs while preserving the antitumor effects of these