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ORLANDO-The most important aspects in treating locally advanced breast cancer are thorough preoperative chemotherapy and a treatment team that combines chemotherapy, surgery, and radiation, two experts said at a special session of the Society of Surgical Oncology’s Annual Cancer Symposium. The presenters were Frederick C. Ames, MD, of the University of Texas M.D. Anderson Cancer Center, and A. Marilyn Leitch, MD, of the University of Texas Southwestern Medical Center, Dallas.

ATLANTA–Human immunodeficiency virus (HIV) infection is one of the leading causes of morbidity and mortality in the United States. Testing for HIV, in conjunction with counseling and other preventive services, can reduce the risk for HIV infection and appropriately link infected persons to treatment. To characterize HIV testing by region, state, and sex, the Centers for Disease Control (CDC) analyzed data from the 1996 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicate a high degree of variability in HIV testing throughout the United States.

BETHESDA, Md-Nine children’s cancer centers have joined together under the auspices of the National Cancer Institute (NCI) to form the Pediatric Brain Tumor Consortium. The NCI will provide the group $2 million a year for 5 years to fund collaborative efforts to develop and carry out pilot studies and early clinical trials of promising new therapies for children with brain malignancies.

ALEXANDRIA, Va-As cancer care increasingly shifts from inpatient to outpatient services and consumers use the Internet to educate themselves about their disease and their options, cancer programs must concentrate more carefully on marketing themselves as the answer to potential patients’ needs, said Patti Jamieson, MSSW, MBA, service line administrator for oncology, University of Illinois at Chicago Medical Center.

FORT LAUDERDALE, Fla-Time is running out for lobbying against the Health Care Finance Administration’s (HCFA) proposed Medicare hospital outpatient fee schedules, based on ambulatory payment classifications (APCs). The deadline for comments is June 30, 1999.

The Intercultural Cancer Council (ICC) is urging a 100%, or at least a $300 million, increase in federal funding for the

The article by Champlin and colleagues summarizes exciting recent clinical results in allogeneic bone marrow transplantation (BMT) for leukemia and lymphoma achieved by “reengineering” the process to take maximum advantage of the powerful

ORLANDO-Ten-year survival results from a major intergroup study support the use of elective (immediate) regional lymph node dissection (ELND) rather than watchful waiting for patients with intermediate-thickness melanomas (1 to 4 mm).

ALEXANDRIA, Va-“Organized opposition to the Health Care Finance Administration’s (HCFA) proposal to reimburse outpatient Medicare cancer services according to ambulatory payment classifications (APCs) now includes many of the major players in the oncology community,” reported Lee E. Mortenson, DPA, executive director of the Association of Community Cancer Centers (ACCC), Rockville, Maryland.

In the largest human study of its kind, researchers Renate D. Kimbrough, MD, and Martha L. Doemland,PhD, have found

Arsenic may be on the verge of overcoming its bad reputation. Two years ago, Chinese researchers reported that low doses

SAN FRANCISCO-Although there are many good metaanalyses, derived from combining the results of numerous solid clinical trials, there are also many “filled with garbage,” Deborah Grady, MD, said at the Seventh Symposium on Clinical Trials: Design, Methods and Controversies. It is incumbent on the physician to be able to distinguish the good from the bad, said Dr. Grady, associate professor of epidemiology, biostatistics and medicine, University of California, San Francisco (UCSF).

Developing and implementing cancer outreach programs for African-Americans takes planning and sensitivity, said Robin L.

Allen Lichter, MD, president of the American Society of Clinical Oncology (ASCO), stated at a meeting sponsored by the

COLUMBUS, Ohio-Hearing the words, “You have cancer,” is immediately upsetting. “That distress can echo through the years, negatively affecting a person’s quality of life [QOL] long after the initial diagnosis of cancer,” said Betty R. Ferrell, PhD, RN, research scientist, City of Hope National Medical Center. She spoke at a conference on cancer survi-vorship sponsored by the James Cancer Hospital and Solove Research Institute at Ohio State University. Indeed, she said, in a survey of cancer survivors, distress over initial diagnosis was ranked as the single most negative influence on quality of life, worse than fear of recurrent cancer, fear of cancer spreading, or physical symptoms like fatigue.

ALEXANDRIA, Va-Treating a patient in a clinical trial-nearly always a cancer patient’s best treatment option-is no more costly and far more effective than giving supposedly less expensive “established” care, reported William P.Peters, MD, PhD, president, director, and chief executive officer of the Barbara Ann Karmanos Cancer Institute, Detroit. Dr. Peters discussed a series of cost and outcome studies that reached this conclusion at the Annual Meeting of the Association of Community Cancer Centers.

MIAMI BEACH, Fla-The development of chemotherapy agents peaked between 1985 and 1990, Dr. Eric Rowinsky said at the annual meeting of the Network of Oncology Communication and Research (NOCR). “However, we saw the same types of drugs being developed (analogs of the platinums and anthracyclines) because we were using the same old screening system,” he said.

Viruses, such as the human immunodeficiency virus (HIV), are parasites: to reproduce, they need to appropriate their host’s

ALEXANDRIA, Va-Although physicians and other health professionals are not taught how to create or pass legislation, it is vital “for each of us to be involved in the legislative process,” Edward L. Braud, MD, said at the 25th Annual Meeting of the Association of Community Cancer Centers (ACCC).

ALEXANDRIA, Virginia-Genetic alterations very early in the disease process lie at the root of every cancer. Functional genomics, the study of which genes are actually functioning at a given time or stage, affords a “new approach” to fighting cancer, reported Kristina Cole, MD, PhD, a cancer research training fellow at the National Cancer Institute, Bethesda, Maryland.

ALEXANDRIA, Va-With 56% of cancer patients now receiving off-label therapies and “more than 50%” of physicians reporting problems getting reimbursement for these treatments, assuring coverage for such medications is a major focus of the Association of Community Cancer Centers’ legislative efforts at the state level, said Christian Downs, MHA, director of Provider Economics and Public Policy for the ACCC.

ALEXANDRIA, Va-Although nurses traditionally have not been sued individually for malpractice, changes in technology, medical practice, and medical economics have made them increasingly vulnerable to being named in litigation, according to Susan B. Fink, RN, JD, an attorney with Koskoff, Koskoff & Bieder, PC, of Bridgeport, Conn.

COLUMBUS, Ohio-Many aspects of cancer patient care can be improved or enhanced with the use of music therapy, said Deforia Lane, PhD, resident director of music therapy, University Hospitals of Cleveland-Ireland Cancer Center/Rainbow Babies & Children’s Hospital, and assistant clinical professor of medicine, Case Western Reserve University. Dr. Lane, a board-certified music therapist, spoke at a conference on cancer survivorship sponsored by the Ohio State University’s James Cancer Center and Solove Research Institute.

ORLANDO-The new frontiers in colorectal cancer include multimodality treatment used preoperatively and a new group of oral fluoropyramidine drugs, according to presentations at the Society of Surgical Oncology’s 52nd Annual Cancer Symposium.

COLUMBUS, Ohio-“Fatigue in the cancer patient has multiple causes and must be treated with a variety of strategies,” said Lois Almadrones, MSN, clinical research associate at Memorial Sloan-Kettering Cancer Center.

NEW YORK-In recent years, the practicing anesthesiologist has become more involved in the management of pain and has to be aware of the increasing number of treatments available, said Carol A. Warfield, MD, chief, Division of Pain Services, Beth Israel Deaconess Hospital, Boston.

ALEXANDRIA, Virginia-Drinking grapefruit juice with certain medications, including at least one widely used in cancer treatment, may inhibit their absorption, according to an in vitro study in the April 1999 issue of Pharmaceutical Research, a publication of the American Association of Pharmaceutical Scientists (AAPS).

ORLANDO-Both dye and radioactive tracer are required for finding sentinel lymph nodes most accurately in patients with operable breast cancer, but small intradermal injections of the tracer can be used instead of intraparenchymal tracer injections, researchers from Memorial Sloan-Kettering Cancer Center reported at the Society of Surgical Oncology’s Annual Cancer Symposium.

FORT LAUDERDALE, Fla-Before talking about the various “patients’ bill of rights” legislation before the US Congress, Harry D. Holmes, PhD, played the theme from the movie Back to the Future. “That’s what it seems like in managed care reform, since all of these bills were filed last year and here they are again, both in the House and the Senate.”

WASHINGTON-Overall cancer incidence and mortality have continued to decline in the United States, but incidences of some cancers continue to rise, and significant differences in both incidence and mortality persist among different racial and ethnic groups.