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PASADENA, California--The health care system in the United States has been developed along the lines of medical specialization, which can lead to the fragmentation of patient care. Specialties are created by artificial divisions such as organ systems (cardiology, neurology); age (pediatrics, geriatrics); sex (urology, gynecology); disease (oncology); and function (surgery, obstetrics).

RESEARCH TRIANGLE PARK, NC--The National Toxicology Program has requested public input on 11 chemicals recommended for absorption, toxicity, or carcinogenicity studies. It seeks information from completed or ongoing studies, and information on planned studies, as well as current production data, human exposure information, use patterns, and environmental occurrences.

WASHINGTON--Two pediatric oncologists brought a plea to Capitol Hill that Congress pay greater attention to childhood cancers, both in terms of research funding and guaranteeing access to quality care.

Cowen and colleagues provide a very good review of thymomas. Although thymomas are the most common of the anterior mediastinal tumors, these tumors as a group are relatively uncommon. The authors focus their discussion on the pathology, staging, and management of thymomas.

Health care providers and financing organizations have become more aware of the resource constraints on the provision of medical services, thus increasing the importance of economic evaluations within the health care industry.[1,2] This has carried over to the evaluation of new, therapeutic strategies for cancer, which have traditionally been evaluated exclusively for safety and clinical efficacy.

Dr. Aboulafia provides an accurate overview of the relationship between immunodeficiency and malignant lymphoma, the lymphoproliferative disorders that occur following solid organ transplantation, and the epidemiology and pathogenetic mechanisms possibly involved in acquired immunodeficiency syndrome (AIDS)-related lymphomagenesis.

Acquired immunodeficiency syndrome (AIDS)-related lymphoma is a complex disease process with a range of features that are distinct from both non-Hodgkin’s lymphoma (NHL) outside of the context of immunodeficiency and the lymphoproliferative disease seen in immunodeficiency unrelated to human immunodeficiency virus-1 (HIV-1). Dr. Aboulafia lucidly summarizes the issues contributing to the unique aspects of this disease.

As indicated in this review by Patt and Ellison, the literature pertaining to the association between transitory acute pains and chronic cancer-related pain is limited and plagued by nomenclatural problems. Nonetheless, the clinical relevance of these so-called breakthrough pains is apparent to those who treat cancer patients.

It is striking how often medical advances occur as a result of the recognition of something that, in retrospect, is obvious. Pain has always been a feared consequence of disease, particularly cancer. Only in the past decade, however, has the widespread undertreatment of pain and its impact on the quality of life of patient and family gained the attention of mainstream medical research. Rapid, simultaneous advances in basic neurobiology and clinical investigation have dramatically improved the clinician’s ability to diagnose and treat pain.

The curative management of primary and metastatic liver tumors has traditionally relied on surgical resection. Unfortunately, fewer than 10% of newly diagnosed patients have tumors that are considered to be surgically

Among patients with congenital and acquired immunodeficiencies, non-Hodgkin’s lymphomas (NHLs) are the most common tumors of the immune system. In the setting of human immunodeficiency virus (HIV) infection, as

Thymomas are rare, slow-growing neoplasms that are considered to be malignant because of their potential invasiveness. The most widely used staging system is that of Masaoka and colleagues, which takes into account

The majority of metastatic liver tumors cannot be resected because of bilobar involvement, location, size, and/or proximity to large vessels. Drs. McCarty and Kuhn succinctly summarize the existing literature on cryosurgery and its potential use in patients with unresectable liver tumors.

This review by Dr. Aboulafia presents aspects of the epidemiology of acquired immunodeficiency (AIDS)-related lymphomas and their pathogenesis. The author’s main focus is in the molecular area, and the summary of epidemiology is well known to those interested in this field.

NEW ORLEANS--Mutations in two types of genes, gatekeepers and caretakers, help explain both the progression of cells from normal to cancerous and the mechanism of actions of effective antitumor drugs, Bert Vogelstein, MD, of Johns Hopkins University School of Medicine, said at the plenary session of the 89th annual meeting of the American Association for Cancer Research.

BALTIMORE--Patients choose genetic testing to help them make important life decisions, but often the risks and benefits are more complicated and less clear-cut than those of traditional medical tests, psychologist Ann-Marie Codori, PhD, of Johns Hopkins University, said at a seminar on genetic testing and counseling for adult onset disorders.

WASHINGTON--The government has upgraded its health information website, "healthfinder," adding two new sections: "Smart Choices," to tell people how to find reliable health information on the Internet, and "Just for You," to tailor information by age and ethnicity, with the aim of enabling consumers to seek information geared to children or aging parents, for example. The website can be reached at www.healthfinder.gov.

By transforming radio signals into a surgical laser, surgeons at the University of Pennsylvania Cancer Center are able to use high-energy radiofrequency sound waves to destroy inoperable primary and metastatic liver tumors.

The Oncology Nursing Society (ONS) recently received grants from Genentech, Inc., to fund two educational projects. A $96,000 grant will fund the ONS National Conference on Cancer Nursing Research to be held in 1999, and a $30,930 grant

NEW ORLEANS--The next decade will be a critical time for translating new cancer vaccine approaches into standard therapies, said Drew Pardoll, MD, PhD, of Johns Hopkins University School of Medicine. In a talk at the plenary session of the 89th annual meeting of the American Association for Cancer Research, Dr. Pardoll noted that antigen-based anticancer vaccines offer perhaps the most promising approach.

NEW ORLEANS--Ernst L. Wynder, MD, DSc, Dr.med.h.c., has received the seventh AACR American Cancer Society Award. Dr. Wynder is president and medical director of the American Health Foundation in New York.

SAN DIEGO--Women between the ages of 40 and 49 must still decide for themselves if undergoing a mammography is appropriate for them, according to a panel of experts at the American College of Physicians (ACP) Annual Session. The inability of key organizations to come to a decisive conclusion is the result of conflicting studies and the fact that "each organization espouses different rules of evidence," said Mary E. Costanza, MD, professor of medicine, University of Massachusetts Medical School.

NEW ORLEANS--"We can reduce the incidence of a cancer with preventive interventions without understanding their mechanism of action," said Ernst L. Wynder, MD, DSc, Dr.med.h.c., president and medical director of the American Health Foundation in New York. Dr. Wynder gave the Seventh AACR American Cancer Society Award Lecture on Cancer Epidemiology and Prevention at the American Association for Cancer Research meeting.

WASHINGTON--"The March . . . Coming Together to Conquer Cancer" rings of militancy. It has an American war hero, retired US Army General H. Norman Schwarzkopf, as its honorary chairman. Its monthly newsletter is subtitled "A Campaign Bulletin." And when leaders and supporters of The March held a press briefing to talk about the nationwide event scheduled for Sept. 26, the rhetoric matched.

BETHESDA, Md--Ending a clinical trial of a promising intervention may be just as difficult and delicate as starting one. The stopping point, Gilbert S. Omenn, MD, PhD, said at the American Society of Preventive Oncology meeting, applies to both the desired effect (or efficacy) and adverse effects (toxicity).

Women smokers who overestimate their body size may be more likely to continue smoking, said researchers at The Miriam Hospital in Providence. Results of a study led by Teresa K. King, PhD, of the hospital’s Center for Behavioral and

BETHESDA, Md--The National Cancer Institute has raised a red flag to the nation’s current "hot" smoking fad. It warns that daily cigar smoking can cause cancer of the lip, tongue, mouth, throat, larynx, esophagus, and lung. Cigar smoking is also responsible for chronic obstructive pulmonary disease and coronary heart disease.

The Charles E. Culpeper Foundation is currently accepting applications for its 1999 Scholarships in Medical Science Program, designed to support the career development of academic physicians

WASHINGTON--President Clinton is becoming increasingly ensnared in the tobacco wars on Capitol Hill, where partisan politics and philosophical differences threaten passage of national tobacco legislation. If no bill is passed before the November elections, many believe the issue could become even more politicized.

NEW YORK--People do not generally think about their civil rights when they get cancer, but they may need them at some point in the workplace, attorney L. Susan Scelzo Slavin, of Slavin Law Firm, Jericho, NY, said during a Cancer Care, Inc. teleconference for cancer survivors.