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BETHESDA, Md--The President's Cancer Panel, after nearly a year of study, has concluded that managed care overall has adversely affected clinical cancer research, patient access to clinical trials, and physicians who participate in studies.

Roswell Park Cancer Institute is currently recruiting patients for the first phase I study to test a novel method of delivering cisplatin (Platinol) to tumors. The new treatment, called SPI-77, carries cisplatin via a special vehicle called a STEALTH

HMO abuses are the single largest health problem in America today," said New York State's Lieutenant Governor Betsy McCaughy Ross. New York recently became the first state in the nation to ban "drive-through mastectomies," when it

BUFFALO, NY--Researchers at Roswell Park Cancer Institute are recruiting patients for enrollment in 19 different protocols testing unique treatments for HIV-infected individuals. The goal of these protocols is to preserve or enhance the fragile immune system while treating and preventing malignancy.

Scientists have developed a drug and radiation regimen for reducing locally advanced and inoperable tumors in the pancreas and stomach.

Culture appears to influence people's perceptions of narcotic pain relief after surgery, say researchers who have surveyed fracture patients in Northern California and in Vietnam.

Scientists at Stanford University have done the next best thing to packaging living cells in individual boxes for study.

NOTTINGHAM, UK--Some researchers have hypothesized that tamox-ifen resistance occurs because tumor cells lose estrogen receptors over time. But new data suggest that this is not the case.

BETHESDA, Md--Ending what began as a year's evaluation of scientific evidence and became an emotionally charged public debate, the National Cancer Institute has recommended that women between ages 40 and 49 get a screening mammogram every one or two years.

A newly synthesized vitamin D5 compound designated 1-alpha-(OH)D5, unlike the natural active metabolite [1-alpha,25(OH)2D3] of vitamin D3, strongly inhibited the development of precancerous cells in animal breast organ culture studies but did not

Ferrell and Hassey Dow summarize research on the domains of quality of life (QOL) most important to the adaptation of survivors, and offer insights about possible interventions to support and promote this adaptation. In addition, they note that the field is poised to make great progress in understanding the concerns and needs of survivors, due, in part, to the establishment of the Office of Cancer Survivorship, an institutional home at the National Cancer Institute (NCI) that will coordinate and promote research on this critical topic.

Small intestinal epithelial cells are remarkably resistant to the development of benign or malignant neoplasms. Why small-bowel adenocarcinomas are so rare compared to colorectal adenocarcinomas is unknown. Thus, the work of Neugut et al is important, as they provide an excellent overview of the current knowledge of this unique tumor, and the problems and limitations encountered in such research.

Thanks to advances in cancer diagnosis and treatment, there are now more than 10 million cancer survivors in the United States. Successful treatment of cancer has resulted in increased demands on survivors and has had diverse effects on the quality of life (QOL) of patients and their families. A model of QOL encompassing dimensions of physical, psychological, social, and spiritual well-being has been applied to illustrate the multidimensional needs of cancer survivors and the necessity of comprehensive care extending over the long term. Data from a recent survey of members of the National Coalition of Cancer Survivorship (NCCS) is presented, along with a summary of issues compiled by the NCCS that merit future attention. [ONCOLOGY 11(4):565-571, 1997]

For the sake of the 7.4 million Americans alive today who have a history of cancer, Ferrell and Hassey Dow's paper is important. Understanding more about the problems and issues faced by these individuals and their families, as well as identifying effective ways to ensure that they experience a high quality of survival, are significant issues for cancer care and research.

Of all the digestive tract tumors, small-bowel cancers are the least common. Why should we study these rare tumors, and what, if anything, can we learn from them? Sometimes the absence of an important event can provide the answer to a difficult problem. For example, consider the famous Sherlock Holmes mystery story, "Silver Blaze," in which the master sleuth solved a challenging case, simply because the watchdog didn't bark when he should have, implying that the murderer was well known to the dog.[1]

Even though the small intestine contains 90% of the gastrointestinal tract mucosa and is located between the stomach and large intestine, two organs with a high cancer incidence, adenocarcinoma of the small intestine is 1/50th as common as adenocarcinoma of the large bowel. In several other respects, small-intestinal adenocarcinoma resembles large bowel adenocarcinoma; eg, it arises from adenomatous polyps, co-occurs in the same individuals, and has a similar pattern of incidence rates by country. Small-intestinal adenocarcinoma is diagnosed prior to surgery in only about 50% of cases and often occurs in conjunction with small bowel obstruction. The mainstay of treatment is surgery; prognosis depends on stage at presentation. Little is known about the use of radiotherapy and chemotherapy in this malignancy, but most physicians utilize therapeutic strategies modeled on the management of large-intestinal adenocarcinoma. Clarification of the reason for the low incidence of small-intestinal adenocarcinoma could lead to new interventions for the prevention of colorectal cancer. [ONCOLOGY 11(4):529-536, 1997]

This special series on cancer and genetics is compiled and edited by Henry T. Lynch, MD, director of the Hereditary Cancer Institute and professor of medicine and chairman of the Department of Preventive Medicine and Public

Our phase II study results demonstrating high efficacy and low toxicity for a weekly schedule of high-dose, 24-hour infusional 5-fluorouracil(5-FU)/folinic acid (HD5-FU/FA) in intensively pretreated patients with metastatic

FORT LAUDERDALE, Fla--The new NCCN practice guidelines on antiemesis in patients receiving chemotherapy are divided into four categories based on the emetogenic potential of the chemotherapy regimen, ie, high, moderate, low, and unlikely, and further divided into primary treatment, breakthrough treatment, and use in subsequent chemotherapy cycles. The guidelines also cover antiemesis for radiation-induced nausea and vomiting.

WASHINGTON--Cancer ranked high among a package of seven Senate bills introduced by Sen. Olympia Snowe (R-Maine), all of them intended to address women's health issues.

Researchers at Duke University Medical Center and the Durham V. A. Medical Center say the psychological impact of taking even a single puff of a cigarette on a preset "quit day" means a smoker will probably go back to smoking within 6 months.

An expert panel of 10 international cancer researchers and practicing oncologists met in Boston to discuss the past, present, and future uses of antiestrogens in the treatment of breast cancer. The first four articles in this series, based on the symposium presentations, appeared in Oncology News International in Oct 1996 , Nov 1996, Dec 1996 , and Jan 1997 . The symposium was sponsored by Zeneca Pharmaceuticals.

In late January, the Agency for Health Care Policy and Research (AHCPR) released the first evidence report under its new evidence-based practice initiative. The report indicates that screening has been shown to be effective in detecting early-stage

CHICAGO--Although digital whole breast mammography has a number of possible advantages over conventional mammography, including enhanced image contrast and better exposure of dense tissues, it is not yet known whether the technology will be equal to or better than conventional film screen mammography in detecting breast cancer, Stephen A. Feig, MD, said at the Radiological Society of North America (RSNA) annual meeting.

PITTSBURGH--Nearly three years after it began its investigation, the federal Office of Research Integrity (ORI) has cleared Dr. Bernard Fisher of any scientific misconduct, stating that he did not include false data in his NSABP reports.

BETHESDA, Md--After considering the politically charged and complex issue of mammography screening for women between ages 40 and 49, the National Cancer Advisory Board (NCAB) created a special working group to craft a recommendation for the National Cancer Institute on what it might advise doctors to tell these women.

NEW YORK--Fatigue is a significant problem experienced by the vast majority of cancer patients--and also the most under-recognized and under-treated symptom, Barbara F. Piper, DNsc, RN, OCN, told Oncology News International in a telephone interview.

The autosomal, dominantly inherited multiple endocrine neoplasia (MEN) syndromes provide some of the best examples of the practical application of advancing technology, not only in the detection and treatment of neoplastic disease but also in the understanding of the mechanisms involved in the initiation and progression of malignancies.

WASHINGTON--President Clinton has asked Congress to approve $2.217 billion in funding for the National Cancer Institute (NCI) in fiscal year 1998, which begins next Oct. 1.

Ann Kelsall is a medical writer who reported on the NIH Consensus Development Panel meeting for Oncology News International. Here she considers, from the woman's perspective, the panel's arguments against mammography screening for women ages 40 to 49.