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Erectile dysfunction is a common occurrence as men age. Approximately 20% of men over the age of 50 years report difficulty in achieving or maintaining an erection, and as many as 60% of men age 70 and older suffer from erectile dysfunction.[1]

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients

Laheru and Jaffee review the potential role of tumor vaccines in the management of gastrointestinal (GI) malignancies, which represent the leading cause of cancer death and are believed to be poorly immunogenic. The authors carefully review the questions and controversies surrounding currently available immunotherapeutic strategies and describe ongoing clinical protocols using tumor vaccine therapy, a few of which deserve special comment.

Primary central nervous system (CNS) lymphoma is a non-Hodgkin’s lymphoma restricted to the nervous system. The incidence of this lymphoma is rising in the immunocompetent population but may be decreasing in patients

Intensive outpatient care is rapidly becoming the primary mode of care for selected patients undergoing high-dose chemotherapy with autologous peripheral blood stem cell (PBSC) transplantation. Although the traditional inpatient model of care may still be necessary for high-risk patients, published data suggest that outpatient care is safe and feasible during or after administration of high-dose chemotherapy and autologous PBSC transplant. Blood and marrow transplant (BMT) centers have developed programs to provide more outpatient care under three basic models: an early discharge model, a delayed admission model, and a comprehensive, or total, outpatient model. This review will describe these models of care and address the elements necessary for the development of an outpatient BMT program, including patient selection, staff development, and patient and caregiver education. Available supportive care strategies to facilitate outpatient care will also be highlighted.

NEW ORLEANS-Prolonged hospitalization and toxic effects have limited the use of peripheral blood stem cell transplants for hematologic malignancies to younger, fitter patients. But a new nonmyeloablative approach may allow otherwise-excluded patients to also benefit, according to two studies presented at the American Society of Hematology meeting.

NEW YORK—Ezra Greenspan, MD, has been at the helm of the Chemotherapy Foundation since its founding in 1968. At its 17th annual symposium, in what he termed an “op-ed” piece, Dr. Greenspan, clinical professor of medicine, Mt. Sinai School of Medicine, highlighted what he considers the “blind spots and halos” in adult solid tumor chemotherapy.”

WASHINGTON—Three cancer specialists offered a more optimistic view for the future of lung cancer patients during a congressional briefing. Despite the disease’s “dismal” 5-year survival statistics, advances in genetics, a new screening technique, and treatment improvements promise earlier diagnosis and prolonged life for some patients, they said.

WASHINGTON-The Cancer Research Foundation of America (CRFA) honored a member of Congress, a journalist, and an antitobacco crusader with its 1999 FrontLine Awards.

Patients with chronic myelogenous leukemia (CML) are finding new hope in an experimental oral agent developed by Oregon Health Sciences University researcher Brian Druker, MD, in collaboration with scientists at Novartis Pharmaceuticals. Early clinical trials are producing dramatic results with minimal side effects.

CLEVELAND-Communicating bad news is an essential part of end-of-life care as well as an important skill in all areas of medicine. Although many physicians feel unprepared to deliver bad news, it is a skill that can be learned and improved, said Donna S. Zhukovsky, MD, director of the Cancer Pain Clinic in the Palliative Medicine Program, Cleveland Clinic Foundation.

CHICAGO-A new ultrasound technology that amasses as much as nine times more information than conventional ultrasound provides greater detail in characterizing breast lesions and also allows real-time tracking of the entire path of the breast biopsy needle, Jacques Souquet, PhD, senior vice president and chief technology officer at ATL Ultrasound (Bothell, Washington), said in an interview with ONI.

 RESEARCH TRIANGLE PARK, NC—The National Toxicology Program is considering an NCI request that it do toxicity studies of four herbal products and a substance found in vegetables: aloe vera, used in cosmetics and as a dietary supplement; ginseng, promoted to increase vigor; kava kava, sold as a mood elevator; milk thistle, believed by some to prevent cancer and protect the liver; and indole-3-carbinol, which occurs in cruciferous

Despite recent decreases in sexual risk behaviors among high school students nationwide, human immunodeficiency virus (HIV) infection was the seventh leading cause of death for persons ages 15 to 24 years in the United States during 1997. To determine whether the prevalence of HIV-related sexual risk behaviors among high school students also has decreased in certain urban areas heavily affected by the epidemic, the Centers for Disease Control (CDC) analyzed data from the Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997 in eight large-city school districts: Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Fort Lauderdale, Florida; Jersey City, New Jersey; Miami, Florida; Philadelphia, Pennsylvania; and San Diego, California. This report summarizes the results of this analysis, which indicate that, from 1991 to 1997, the percentage of high school students engaging in HIV-related sexual risk behaviors decreased in some US cities.

Each year, cigarette smoking causes an estimated 430,000 deaths in the United States. In addition, the health risks for smoking cigars, which include mouth, throat, and lung cancers, are well documented. This report summarizes the findings from the 1998 Behavioral Risk Factor Surveillance System (BRFSS) on the prevalence of current cigarette and cigar smoking in the 50 states and the District of Columbia. The findings indicate that state-specific cigarette smoking prevalence among adults ³ 18 years old varied twofold and having ever smoked a cigar (ie, ever cigar smoking) varied nearly fourfold.

CLEVELAND-Primary care physicians and their patients should make advance care planning part of their routine office visits. This is the message of the Education of Physicians in End-of-Life Care (EPEC) program, developed by the American Medical Association in conjunction with the Robert Wood Johnson Foundation.

WASHINGTON—The federal government has created an internet source that allows access to more than 27 million pages of tobacco industry papers, one that allows full-text searches of these key documents for the first time. The website, http://www.cdc.gov/tobacco, has four parts: citations from 4 million tobacco industry documents; a database for the Minnesota Select Set, which holds about 350,000 pages of documents used by attorneys in the state’s successful suit against the tobacco companies; a similar database containing nearly 7,000 documents from the British American Tobacco Co.;

NEW YORK-Marrow hypoplasia was achieved within 28 days in 14 of 41 patients with refractory leukemia after a first cycle of a new nucleoside analog, troxacitabine, Francis J. Giles, MD, associate professor of medicine, M.D. Anderson Cancer Center, reported at the Chemotherapy Foundation Symposium XVII.

CLEVELAND-While the majority of Americans wish to die in the comfort of their homes, most are actually dying in institutions, often with pain and other symptoms poorly controlled.

CHICAGO-V. Craig Jordan, PhD, has been named Diana, Princess of Wales, Professor of Cancer Research at Northwestern University. Dr. Jordan, a native of the United Kingdom, is professor of cancer pharmacology at Northwestern University Medical School and director of the Lynn Sage Breast Cancer Research program affiliated with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

NEW YORK-A simplified version of the Brief Symptom Inventory (BSI) that can be completed by patients in less than 2 minutes is speeding screening and referral for psychosocial problems at Johns Hopkins University cancer clinics.

The interim results of an ongoing phase II trial of IntraDose (cisplatin [Platinol]/epinephrine) were presented at the 17th Annual Chemotherapy Foundation Symposium in New York City. Of 29 evaluable patients with liver cancer, 12 (41%) responded to treatment. Of the 12 responders, 6 achieved a complete response (100% reduction in viable tumor volume), while the other 6 showed a more than 50% reduction in viable tumor. To date, 10 of the 12 responders remain in remission, while the 2 other patients maintained remissions for 200+ days. Median survival time from the date of diagnosis for all patients has not yet been reached and is currently in excess of 15 months.

WASHINGTON-An Institute of Medicine (IOM) committee has urged instituting a comprehensive strategy to sharply reduce medical errors that result in needless death and injury. According to an IOM report, one study put the annual number of deaths in the United States from medical mistakes at 44,000 and a second study concluded the toll reached 98,000.

SAN FRANCISCO-The Cancer Survival Toolbox is a set of self-learning audiotapes available in English and Spanish, designed for persons with cancer to help them develop skills needed to manage their cancer experience.

ROCKVILLE, Md—Evidence supporting the use of garlic in cancer prevention and the efficacy of preventive behavioral dietary interventions to reduce cancer risk will be assessed in studies ordered by the Agency for Health Care Policy and Research. The agency assigned the studies to two of its Evidence-based Practice Centers—the Research Triangle Institute and the University of North Carolina at Chapel Hill, and the University of Texas Health Sciences Center, San Antonio.

BETHESDA, Md-A new report from the California state government links secondhand smoke to a number of diseases, including lung and nasal-sinus cancers, heart disease, and sudden infant death syndrome (SIDS). The National Cancer Institute has taken the lead in distributing the 430-page document nationwide.

The Institute of Medicine (IOM) committee that released a report on medical errors in December recommended that physicians demonstrate “competence and knowledge of safety practices” through periodic reexamination and relicensing. The report, entitled “To Err is Human: Building a Safer Health System,” was written by a committee chaired by William Richardson, chief executive officer of the W. K. Kellogg Foundation. Most members of the 19-person committee were doctors.

BETHESDA, Md-G.D. Searle & Co. has won FDA approval for its COX-2 inhibitor Celebrex (celecoxib) as an oral adjunct to usual care (endoscopic surveillance and surgery) to reduce the number of adenomatous colorectal polyps in patients with familial adenomatous polyposis (FAP). The FDA initially approved Celebrex for treating osteoarthritis and rheumatoid arthritis in April 1998.

NEW ORLEANS-The use of highly active antiretroviral therapy (HAART) in HIV-infected individuals with lymphoma may make it possible for them to receive high-dose chemotherapy with autologous stem cell transplantation (ASCT), according to a study conducted at City of Hope National Medical Center, Los Angeles.

ATLANTA-Smoking rates among adults in the United States have dropped dramatically over the past 30 years, from 44% in 1965 to 25.5% in 1990, but now the rate seems to have leveled off, the Centers for Disease Control and Prevention (CDC) said in a report.