Oncology NEWS International Vol 11 No 5

Prognosis Good for Local Recurrence After Lumpectomy

May 01, 2002

SAN ANTONIO-Patients who develop a local recurrence after conservative surgery and radiation therapy for early-stage breast cancer generally have a good long-term prognosis, particularly if treated with mastectomy, lead researcher Sharon Galper, MD, told ONI. In this study, 59% of patients with a local recurrence were alive at 10 years, said Dr. Galper, assistant professor of radiation oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, and Harvard Medical School.

Long-Term Use of Actiq Safe and Effective for Breakthrough Pain

May 01, 2002

BALTIMORE-For cancer patients with breakthrough pain, oral transmucosal fentanyl (Actiq) continues to provide good relief with long-term use, Richard Payne, MD, said at the 21st Annual Scientific Meeting of the American Pain Society (abstract 770).

Youth Exposed to Tobacco Promotions

May 01, 2002

WASHINGTON-Young people are frequently exposed to high levels of tobacco promotion despite current advertising restrictions, and a new report from the Centers for Disease Control and Prevention says such advertising exists in more than 90% of retail stores selling tobacco products.

Green Tea May Help Prevent Certain Gastrointestinal Cancers

May 01, 2002

SAN FRANCISCO-Retrospective and laboratory studies have suggested that green tea might be useful for both the prevention and treatment of cancer. Two presentations at the 93rd Annual Meeting of the American Association for Cancer Research, however, showed conflicting results on the effectiveness of this beverage as an anticarcinogenic agent.

EGFR Inhibitor Effective as Salvage Therapy for NSCLC

May 01, 2002

MIAMI BEACH-Drugs that block epidermal growth factor receptor (EGFR) tyrosine kinase activity may represent a new option for patients whose non-small-cell lung cancer (NSCLC) has progressed despite standard chemotherapy, Jose Baselga, MD, reported at the Molecular Targets and Cancer Therapeutics meeting (abstract 630A).

Targeted Filgrastim Support Allows Planned Chemotherapy Doses

May 01, 2002

SAN ANTONIO-Targeted support with G-CSF (filgrastim, Neupogen) based on cycle 1 ANC (absolute neutrophil count) nadirs improves the delivery of planned-dose-on-time chemotherapy and significantly reduces the incidence of febrile neutropenia and related hospitalizations, according to study from The University of Texas M.D. Anderson Cancer Center study using a prospective risk model. Edgardo Rivera, MD, assistant professor of breast medical oncology, presented the results at the 24th San Antonio Breast Cancer Symposium (abstract 3).

Low Risk of CHF With Paclitaxel/Trastuzumab Adjuvant Rx

May 01, 2002

SAN ANTONIO-In the treatment of breast cancer, cardiomyopathy has represented a possible barrier to the use of trastuzumab (Herceptin) in the adjuvant setting. But a study by the Eastern Cooperative Oncology Group (ECOG) now suggests the risk is small when trastuzumab is combined with paclitaxel (Taxol), and, for the most part, cardiac changes are reversible.

Anxiety, Depression in Women at High Risk for Breast Cancer

May 01, 2002

A substantial minority of the women who see themselves as being at high risk for breast cancer because of family history suffer noticeable depressive symptoms and anxiety, and the anxiety can interfere with compliance with recommendations on breast self-examination (BSE), according to studies at the UCLA Revlon Breast Center.

NCCN Updates its Treatment Guidelines for Breast Cancer

May 01, 2002

HOLLYWOOD, Florida-The 2002 National Comprehensive Cancer Network (NCCN) breast cancer treatment guidelines include a number of important updates regarding the use of aromatase inhibitors, leuteinizing hormone-releasing hormone (LHRH) agonists, and sentinel lymph node biopsy. Robert W. Carlson, MD, chair of the NCCN Breast Cancer Panel, presented the guidelines at the Seventh Annual NCCN Conference.

Danny Glover ‘Acting’ as Spokesman for Anemia LifeLine

May 01, 2002

NEW YORK-Actor Danny Glover is serving as spokesman for Anemia LifeLine, a new educational initiative. Mr. Glover’s father had anemia associated with chronic kidney disease. At a press conference to launch the initiative, Mr. Glover told how anemia had robbed his father James Glover of his desire to do the things he loved. He said his father was ready to give up, but treatment gave him back his energy and independence.

Health Care Spending Expected to Soar

May 01, 2002

WASHINGTON-Heath care spending is projected to more than double in the coming decade. The projected figure for 2011 is $2.8 trillion, up from $1.3 trillion in 2000, and the expected average annual growth rate is 7.3%, according to the Centers for Medicare and Medicaid Services.

Cancer Center Unit Redesigned to Create Healing Environment

May 01, 2002

SAN DIEGO--More than a year after the opening of the Barbara Ann Karmanos Cancer Institute, patients and staff alike are giving its design high marks. Dore Shepard, RN, MS, OCN, administrative manager for Cancer Patient Services at the Institute, said that the goal was to have a facility that creates a healing environment for patients.

Current Treatment Options for Aplastic Anemia and Myelodysplastic Syndrome

May 01, 2002

LOS ANGELES-Myelodysplastic syndrome and aplastic anemia are both diseases of bone marrow failure and are characterized by reticulocytopenic anemia, with variable neutropenia and thrombocytopenia. Other than that, the two diseases are substantially different from each other. Tools for diagnosing and managing these two complex diseases were updated by Ronald L. Paquette, MD, associate professor of medicine at the University of California Medical Center in Los Angeles

Study Shows That New State Regulations Encourage Appropriate Pain Management

May 01, 2002

NEW YORK-State regulators and medical boards are adopting new pain management policies favorable to physicians and patients even at a time when drug abuse issues are at the forefront of national attention, according to policy researcher Aaron M. Gilson, PhD.

Widespread Racial and Ethnic Disparities in US Health Care

May 01, 2002

WASHINGTON-Well-documented racial and ethnic disparities exist in health care even among individuals with the same income and health insurance, and a significant part of the problem lies with the health care system and its professionals, according to a report by the Institute of Medicine (IOM).

PET Scans Alter Management of Colorectal Cancer Recurrence

May 01, 2002

EAST MELBOURNE, Australia-A new prospective study has confirmed the usefulness of 18F-FDG PET in treatment planning for patients with confirmed or suspected colorectal cancer recurrence. In this study, 60% of planned surgeries were found to be unnecessary as the result of PET.

Total US AIDS Deaths Top 440,000, With Up to 950,000 HIV Infected

May 01, 2002

WASHINGTON-AIDS deaths in the United States total more than 440,000 since 1981, according to a new Department of Health and Human Services (HHS) fact sheet. The number of HIV-infected Americans now stands at an estimated 850,000 to 950,000, one quarter of whom do not know they carry the virus.

Before CNS Benefits of Erythropoietic Agents Can Be Realized, Transport Mechanisms Must Be Understood

May 01, 2002

THOUSAND OAKS, California-How do endogenous and exogenous erythropoietin (EPO) directly and indirectly affect the central nervous system (CNS)? How can erythropoietic agents penetrate the blood-brain/blood-cerebrospinal fluid (CSF) barrier so that their potential neuroprotective benefits can be realized?

The Ideal Blood Substitute: Probably Not in Our Lifetimes

May 01, 2002

BETHESDA, Maryland-The search for the ideal blood substitute continues, although with less urgency now that the nation’s blood supply is safer than it has ever been. None of the products currently being developed and nearing licensure can truly be considered substitutes for blood, according to Harvey Klein, MD.

Treating Anemia Can Reverse Declines It Causes in Physical Function and May Improve Clinical Outcomes

May 01, 2002

LONG BEACH, California-Treating anemia can reverse the declines it causes in physical function and quality of life for cancer patients and may have an impact on outcomes of cancer therapy, reported Simon Tchekmedyian, MD. Statistics suggest that anemia and its effects are under-recognized and undertreated, he noted, but barriers to treatment may fall as new therapeutic agents prove to be more effective and can be administered more easily and less frequently.

FDA Rejects Gliadel for New Glioma Patients

May 01, 2002

ROCKVILLE, Maryland-The FDA-going against a recommendation of its Oncologic Drugs Advisory Committee (ODAC)-has denied the supplemental new drug application for the use of Gliadel Wafer (polifeprosan 20 with carmustine implant, Guilford Pharmaceuticals) to treat newly diagnosed malignant glioma.

Optimal Treatment of Anemia Requires Thorough Work-up of Patients

May 01, 2002

COLUMBIA, South Carolina-Anemia impairs quality of life and functional status, can interfere with cancer therapies, and now seems linked to poorer prognosis and shortened life span, at least in some cancer patients, according to Robert E. Smith, Jr., MD, president of South Carolina Oncology Associates and clinical associate professor at the University of South Carolina School of Medicine in Columbia. In his experience, and that of other oncologists, recombinant human erythropoietin (rHuEPO) and darbepoetin alfa (Aranesp) can increase hemoglobin levels, decrease fatigue, and improve quality of life for cancer patients. To get optimal treatment results with erythropoietic agents, however, requires understanding the full range of etiologies of anemia and its signs and symptoms, and a thorough work-up of patients.

HHS Promotes Colorectal Screening

May 01, 2002

WASHINGTON-The Department of Health and Human Services (HHS) is moving to cut colorectal cancer mortality by urging screenings for all Americans age 50 and older. In collaboration with the American Cancer Society, HHS will established a task force to increase public awareness of the causes, symptoms, treatment, and prevention of the disease. As part of its continuing "Screen for Life" campaign, HHS will release four new public service campaigns designed to educate American about the vital need for colorectal screening.

Aggressively Managing Anemia Can Significantly Improve Quality of Life

May 01, 2002

EVANSTON, Illinois-Anemia is the most treatable cause of fatigue in cancer patients and aggressively managing anemia could significantly improve the quality of life of cancer patients and may also impact survival, according to David Cella, PhD. Anemia has been associated with poor prognosis and increased mortality among cancer patients, although a causal relationship has not yet been established, he noted.

FK506 May Prevent Impotence After Nerve-Sparing Surgery

May 01, 2002

BALTIMORE-A single injection of FK506 (Prograf) or a similar immunophilin drug at the time of surgery might prevent impotence in men undergoing nerve-sparing prostatectomy for localized prostate cancer, according to preclinical work reported in Nature Medicine (7:1073-1074, 2001) by Sena F. Sezen, PhD, and colleagues at the Johns Hopkins Medical Institutions.

Erythropoietin Could Be Useful in Treating Neurologic Diseases/Trauma

May 01, 2002

KITCHAWAN, New York-Beyond its "classical" hormonal role signaling bone marrow to increase circulating red blood cells, erythropoietin (EPO) and its receptor (EPO-R) may have critical roles in the development, maintenance, protection, and repair of the brain. These roles rely on the status of the EPO and EPO-R molecules as cytokines and have been demonstrated by animal studies. Michael L. Brines, MD, PhD, senior member at the Kenneth S. Warren Institute in Kitchawan, New York, reported on these studies as well as "highly positive" results of the first human trial using recombinant human EPO to treat stroke.

Investigator Outlines Stumbling Blocks to Optimal Therapy for Anemia

May 01, 2002

LOS ANGELES-Many, if not most, oncologists agree that erythropoietic therapy can lower the need for transfusions and improve quality-of-life. This is especially true when cancer patients who suffer from fatigue have their hemoglobin levels raised from 10 g/dL or less to 12 g/dL or more. Why then are less than 30% of patients who should receive erythropoietic therapy being treated with it? (See Table 1.)

Improved QOL Considered To Be a Valid Clinical Endpoint in Itself

May 01, 2002

TAMPA, Florida-"Increasingly we have acknowledged that there is more to cancer treatment than the eradication of disease," stated Paul Jacobsen, PhD. "The treatment of anemia and its effects on quality of life have demonstrated that a treatment can be considered effective and clinically useful if it results in significant quality-of-life benefits, even in the absence of significant survival benefits."

Experts Show How to Combat Fatigue With Exercise, Nutrition

May 01, 2002

NEW YORK-Sipping smoothies, exercising, and keeping a journal are among the things cancer patients can do to combat fatigue and build energy, according to Eileen Donovan, PT, MEd, manager of rehabilitation services at The University of Texas M. D. Anderson Cancer Center, and Marilyn Joyce, RD, a Los Angeles-based nutritionist and author. Both women spoke at a Cancer Care teleconference about the role of exercise and nutrition in coping with fatigue.

NCCN Outcomes Databases Track Guidelines Compliance

May 01, 2002

HOLLYWOOD, Florida-An important part of the cancer guidelines effort by the National Comprehensive Cancer Network (NCCN), a coalition of 19 major US cancer centers, is to monitor concordance with the guidelines through the use of outcomes databases. Results from the breast cancer and non-Hodgkin’s lymphoma databases were presented during the NCCN’s Seventh Annual Conference.

Normalizing Hemoglobin Predicted to Slow Progression of Chronic Inflammatory Diseases

May 01, 2002

LOS ANGELES-Progress in treating cancer-related anemia has accelerated in the almost 20 years since the human erythropoietin gene was cloned. That was in 1983. Ten years later, the Food and Drug Administration approved epoetin alfa (Epogen, Procrit) for transfusion-preventing treatment of patients with anemia-complicating therapy.

Helping Cancer Patients Get the Information They Need to Manage Fatigue

May 01, 2002

LOS ANGELES-To better manage fatigue, cancer patients need clear, concise information about what to expect and how to deal with reduced energy, memory, and other cognitive functions. The challenge for oncology nurses and physicians, noted Patricia Jakel, RN, MN, AOCN, is to provide this information in a manner that is sensitive to the individual patient’s changing attitudes toward treatment and need for information at each visit. "We need to know what the patients feel and what the patients want us to communicate to them," Ms. Jakel said. She is a clinical nurse specialist at University of California Medical Center, and associate professor, University of California School of Nursing, Los Angeles.

Church Programs Motivate Black Men to Get Prostate Cancer Screening

May 01, 2002

WASHINGTON-Twice as many black as white men prefer not to know that they have prostate cancer, and two thirds believe that it is a "death sentence" with a treatment "worse than the disease," according to a study reported by Allyson Schifano, MPH, CHES, at the 8th Biennial Symposium on Minorities, the Medically Underserved, and Cancer.

Strong Support for Medicare Coverage of Oral Cancer Drugs

May 01, 2002

WASHINGTON-Nearly 9 out of 10 American adults favor changing Medicare rules to cover all approved cancer drugs for its beneficiaries, including oral medications, according to a poll commissioned by the National Coalition for Cancer Survivorship (NCCS). Further, 83% said they would support increasing Medicare’s cancer budget by 1% to pay the additional costs, and 83% said that Congress should pass legislation this year requiring coverage of oral cancer agents.

Patients’ Subjective Fatigue Assessments Help Guide Anemia Management

May 01, 2002

HOUSTON-Using subjective complaints reported by patients as a basis for treatment is new, "in a sense revolutionary," said Charles S. Cleeland, PhD, and worth pursuing. Well-established pain measurement scales can be used as a model to assess multiple symptoms, including fatigue, among cancer patients and identify moderate to severe levels of symptoms that might warrant intervention, he explained. Dr. Cleeland is McCullough Professor of Cancer Research at the University of Texas M.D. Anderson Cancer Center in Houston.

InnerviewGI Workstation for Virtual Colonoscopy

May 01, 2002

WESTBURY, New York-E-Z-Em, Inc. has begun marketing its InnerviewGI workstation for virtual colonoscopy procedures. The product is able to render three-dimensional (3D) images in just seconds and provides imaging professionals with multiple 3D view options (see figures below), as well as synchronized 2D and 3D views of the colon, the company said in a news release. InnerviewGI is powered by Vital Images’ Vitrea 2 software and features real-time navigation of 3D volume data.

Cancer Signatures Promise Better Detection, Staging, Treatment

May 01, 2002

BETHESDA, Maryland-As researchers probe the complex nature of individual cancer cells, unique molecular patterns, or signatures, have emerged. Several drugs based on early findings in the field have already earned US Food and Drug Administration approval. A goal set by the National Cancer Institute (NCI) is to "catalog distinguishing molecular signatures of cancer cells to develop new diagnostic and therapeutic approaches and predict response."

Evidence Suggests That Correcting Anemia May Prolong Survival in Cancer Patients

May 01, 2002

LOS ANGELES-Preclinical and early clinical evidence indicates that correcting anemia might prolong survival in cancer patients, reported John Glaspy, MD, MPH, at the Fifth Quality of Life in Oncology Symposium in Pasadena, California. He called for more prospective randomized trials specifically designed to investigate the effect of anemia on survival.

Continue Paclitaxel After Complete Response in Ovarian Cancer

May 01, 2002

MIAMI, Florida-In women with advanced ovarian cancer who achieved a complete response (CR) with a platinum/paclitaxel (Taxol)-based chemotherapy regimen, continuing single-agent paclitaxel for 12 cycles prolonged the duration of progression-free survival, compared with a 3-cycle continuation, Maurie Markman, MD, of the Cleveland Clinic Foundation, said at the 33rd Annual Meeting of the Society of Gynecologic Oncologists (abstract 1).

AACR Urges Development of Drugs for High-Risk Intraepithelial Neoplasia

May 01, 2002

SAN FRANCISCO-Drug therapies aimed at reducing or eradicating intraepithelial neoplasia (IEN) could reduce the burden of IEN and the incidence of malignancies, according to the American Association for Cancer Research (AACR) Task Force on the Treatment and Prevention of Intraepithelial Neoplasia. Three of the co-chairs of this Task Force reviewed key recommendations at a news briefing at the 93rd Annual Meeting of the AACR.

Effective Fatigue Management Begins With Good Communication

May 01, 2002

NEW YORK-Management of anemia-related fatigue begins with good communication, said Patricia Ann Kramer, RN, MSN, AOCN, a San Francisco-based oncology nurse educator and consultant. Speaking at a Cancer Care teleconference, she urged patients to report their fatigue to doctors, describe it on a scale of 0 to 10, and not to feel they are taking up their doctor’s valuable time talking about it. "The squeaky wheel," Ms. Kramer observed, "gets the grease."

Breast Cancer Risk Assessment Guidelines Outlined

May 01, 2002

MIAMI BEACH, Florida-The Breast Cancer Risk Assessment Working Group is completing work on its consensus guidelines for stratifying patients into risk categories for breast cancer and managing their care accordingly. The model was outlined at the 19th Annual Miami Breast Cancer Conference.

Campath Active in Refractory B-CLL With p53 Mutation

May 01, 2002

ORLANDO-Alemtuzumab (Campath-1H) can induce responses in patients with refractory B-cell chronic lymphocytic leukemia (B-CLL) who have the 17p-/p53 genetic mutation, which is usually characterized by a dismal outcome, Stephan Stilgenbauer, MD, of the Department of Internal Medicine III, University of Ulm, Germany, reported at the 43rd Annual Meeting of the American Society of Hematology (abstract 3211). The researchers used alemtuzumab to treat 11 patients with B-CLL, as well as 4 with T-prolymphocytic leukemia (T-PLL) and 1 with Sézary syndrome.

Gene Chip Identifies Risk of Relapse in Children With ALL

May 01, 2002

ORLANDO-A gene-profiling chip might help identify children with acute lymphoblastic leukemia (ALL) who are at low risk of relapse and could be spared intensive therapy, or who are at high risk for treatment-induced acute myeloid leukemia (AML) and should not be treated with topoisomerase II inhibitors.

Nominees for NIH Director, Surgeon General Announced

May 01, 2002

WASHINGTON-In selecting the new director of the National Institutes of Health (NIH) and the new surgeon general, President Bush steered a middle course through political thickets and chose two men whose views on stem cell research, human cloning, and other moral and ethical issues confronting biomedical research dovetail with his own.

New Cyclin Dependent Kinase Inhibitors May Help Overcome Chemotherapy Resistance

May 01, 2002

NEW YORK-Agents classified as cyclin dependent kinase (CDK) inhibitors show promise in overcoming chemotherapy resistance, Gary K. Schwartz, MD, said at a media briefing on new pathways to targeted treatments sponsored by the American Society of Clinical Oncology (ASCO).

Cytarabine Can Be Added Safely to Imatinib

May 01, 2002

ORLANDO-Low-dose cytarabine can be safely administered in combination with imatinib mesylate (Gleevec, also known as STI-571) to chronic myelogenous leukemia (CML) patients in blast crisis, but is unlikely to provide substantial benefit or salvage relapses.

VariSeed 7.0 Treatment Planning Tool for Permanent Seed Implant Brachytherapy

May 01, 2002

PALO ALTO, California-Varian Medical Systems has released VariSeed 7.0, the company’s newest treatment planning software for permanent seed implant brachytherapy used in treating prostate cancer. VariSeed 7.0 gives physicians the ability to use real-time images generated during the implant procedure to deliver precise accurate doses, the company said in a news release.

Bioluminescent Imaging Tracks Responses

May 01, 2002

ORLANDO-Bioluminescent imaging may provide a noninvasive method to monitor the effect of new biologic and immunomodulatory treatments for cancer, Matthias G. Edinger, MD, said at the 43rd Annual Meeting of the American Society of Hematology (abstract 1817). Dr. Edinger is in the Division of Bone Marrow Transplantation at Stanford University School of Medicine.

Improving Quality of Life, Not Transfusion Avoidance, Drives Clinical Use of Erythropoietin

May 01, 2002

DURHAM, North Carolina-Improving quality of life for cancer patients is the driving force behind clinical patterns of use of erythropoietin (EPO) therapy, at least in this country, according to Jeffrey Crawford, MD. Although the Food and Drug Administration approved epoetin alfa (Epogen, Procrit) based on evidence that it reduced the need for transfusions in cancer patients with chemotherapy-related anemia, most current clinical use of epoetin alfa is not to decrease transfusion needs. "I think we’re convinced now that there is a quality-of-life benefit," Dr. Crawford said (Figure 1), and epoetin alfa is now primarily directed at helping cancer patients realize that benefit

Physician Style Crucial in Enrolling Black Men in Clinical Trials

May 01, 2002

WASHINGTON-Despite the high rate of cancer among black men in the United States, their participation in clinical trials is low. The interaction between these patients and their physicians affects willingness to enroll in trials, Dawn L. Riddle, PhD, of the H. Lee Moffitt Cancer Center, reported at the 8th Biennial Symposium on Minorities, the Medically Underserved, and Cancer. She described pilot data indicating that when physicians go beyond simply imparting legal and medical information about the trial and make a strategic effort to answer the patient’s concerns, discover any barriers that impede his participation, and remove those barriers, black men are more likely to consent to participate.

Diagnostic Dilemma

May 01, 2002

A 72-year-old woman with chronic obstructive pulmonary disease (COPD) presents with abnormal liver chemistries. She denies recent abdominal pain but recalls "gallbladder problems" after childbirth approximately 40 years ago. She has not lost any weight and denies fever. There is no history of nausea or vomiting.

As Hemoglobin Levels Rise, So Do Patients’ Assessments of Well-Being

May 01, 2002

THOUSAND OAKS, California-Increases in hemoglobin levels appear to improve the physical, functional, emotional, and psychological well-being of cancer patients with anemia. Based on the combined results of two randomized, controlled clinical trials, data supporting this statement were presented by Joel D. Kallich, PhD, associate director, health economics and epidemiology, at Amgen, Thousand Oaks, California.

Working Group Seeks to Increase Cancer Prevention Awareness

May 01, 2002

WASHINGTON-The Cancer Prevention Working Group (CPWG), a consortium of leading oncologists, researchers, and patient advocates, has proposed the development of a National Cancer Prevention Education Program to increase professional and public education on the need for screening and risk assessment and to communicate cancer prevention models that incorporate appropriate use of chemopreventive agents.

Exercise Is an Important Ingredient in Ameliorating Anemia-Related Fatigue

May 01, 2002

LITTLE ROCK-For patients with cancer-related fatigue, "the first line of treatment, in my opinion, is to increase their hemoglobin levels so that they can begin an exercise program," noted William Evans, PhD. "Cancer patients suffering from primary fatigue should not be advised to increase the amount of daily rest. Rather, they should be counseled to carry out aerobic exercise," he explained. Dr. Evans serves as director, nutrition, metabolism, and exercise, and professor of geriatrics, physiology, and nutrition at the University of Arkansas for Medical Sciences in Little Rock.

Hairy Cell Leukemia Diagnosis Affects Finances, Lifestyle

May 01, 2002

While patients who are cured from cancer can expect to lead long and productive lives, we do not know the extent to which a diagnosis of cancer affects employability, insurability, and lifestyle of individuals with long-term survival.