Oncology NEWS International Vol 5 No 10

Anesthetic Interventions Rise When Anesthesiologists Join the Pain Team

December 01, 1999

HOUSTON--Development of a specialized anesthesiology pain team led to a jump in pain consultations by anesthesiologists and in the number of anesthetic procedures performed for pain control at The University of Texas M.D. Anderson Cancer Center

Worldwide UN Survey Shows Many Impediments to Morphine Availability

December 01, 1999

MADISON, Wis-In attempting to increase availability of opiates for pain, "we are really up against the war on drugs," David E. Joranson, MSSW, said, "because it is the same laws aimed at preventing illicit narcotic trafficking that also control medical availability of opioid analgesics, and some governments may be reluctant to relinquish that control."

Case-Based Pain Curriculum Used in Canadian Schools

December 01, 1999

MONTREAL--A recent survey of the 16 Canadian medical schools showed that only one, McGill Uni-versity, recorded more than 20 formal teaching hours in palliative care, and five schools had less than 5 hours, Neil MacDonald, MD, said at the congress.

Withdrawal Syndrome After Stopping Opioids Is Not Evidence of Drug Dependence, WHO Committee Says

December 01, 1999

VANCOUVER, BC-Drug dependence is not physical dependence alone, nor is it the same as drug tolerance. "Drug dependence is primarily psychological dependence, or compulsive use of drugs for their mood-altering effects and continued use despite harm," David E. Joranson, MSSW, said at the WHO workshop on cancer pain.

Brief Pain Inventory and Faces Scale Perform Well in a Group of Low-Income, Primarily Black Cancer Patients

December 01, 1999

ATLANTA, Ga-A group of mainly low-income African-American cancer patients had no difficulty completing a multidimensional pain measure, and among the unidimensional measures tested, preferred a faces scale, Deborah B. McGuire, PhD, RN, told Oncology News International at her poster presentation at the 8th World Congress on Pain

Whole-Body Vibration Within Specified Frequency Range May Provide Pain Relief

December 01, 1999

DENTON, Tex-Music has long been used, albeit unscientifically, to relax patients in an effort to relieve pain. Now, a researcher from the University of North Texas College of Music is attempting an approach to music therapy that involves vibration and appears to have a neurophysiologic mechanism of action.

Pain Descriptions May Predict Presence of Neuropathic Pain

December 01, 1999

BUFFALO, NY-Just by looking at the words cancer pain patients used to describe their pain, researchers were able to correctly predict in 66% of cases which patients had neuropathic pain, Dr. Thomas Sist, of the Roswell Park Cancer Institute, said in his poster presentation at the 8th World Congress on Pain.

Neurotoxicity Related to High-Dose Opioid Therapy Can Be Managed

December 01, 1999

EDMONTON, Alberta-Vigorous worldwide pain education efforts emphasizing undertreatment have resulted in a "very healthy increase" in the use of opioids around the world, including increases in dose and length of exposure, Eduardo Bruera, MD, of the University of Alberta and Edmonton General Hospital, said at a plenary session of the 8th World Congress on Pain.

Epidural Morphine Relieves Pain in Advanced Cancer, But May Not Influence Quality of Life

December 01, 1999

OXFORD, UK-Epidural delivery of opioids effectively relieves pain in patients with advanced cancer who are intolerant of or insensitive to high-dose oral morphine, but improvement in quality of life may be more difficult to achieve, Christopher Glynn, MB, said at a workshop on pain management in palliative care, held at the Vancouver meeting.

Dr. Payne Urges Strategies to Overcome Barriers to Use of Cancer Pain Guidelines

December 01, 1999

VANCOUVER, BC-The US Agency for Health Care Policy and Research (AHCPR) cancer pain practice guidelines, like the World Health Organization (WHO) 3-step ladder, emphasize a hierarchical pain management strategy, Richard Payne, MD, said at a symposium held in conjunction with the 8th World Congress on Pain of the International Association for the Study of Pain (IASP).

Program Trains Community Opinion Leaders in Principles of Pain Control

December 01, 1999

DULUTH, Minn-Effective strategies to improve cancer pain management in the community may be elusive, but researchers from the Minnesota Cancer Pain Project, led by Thomas E. Elliott, MD, believe they are on the right track with an intervention program that combines education of community opinion leaders with community outreach programs.

Postmarketing Surveillance for Drug Abuse Supports Nonscheduled Status of Tramadol

December 01, 1999

ST. LOUIS--When tramadol (Ultram) received FDA approval last year for use in moderate to moderately severe pain, its abuse potential was felt to be low (1.5 cases of abuse per 100,000 patients in the European experience).

Consider Quality of Life and Patient Preference When Choosing Pain Relief

December 01, 1999

SHEFFIELD, UK-What should the research question be when investigating a new approach to cancer pain? The most obvious answer is, Does it relieve pain? But David Brooks, MB, of the University of Sheffield, argues that this is not enough. Researchers must also ask about side effects, quality of life, and patient preference.

Patients' Pain Anxiety Levels Vary Depending on the Type of Pain, the Patient's Gender, and Pain Duration

December 01, 1999

Although patients with cancer pain reported lower levels of current pain than did patients with benign or treatmentrelated pain, their pain anxiety levels were higher, Mikki Miner, RN, MS, said in a poster presentation at the 8th World Congress on Pain.

More than 4,000 Attend World Congress

December 01, 1999

VANCOUVER, BC-More than 4,000 pain experts from all over the world attended the International Association for the Study of Pain (IASP) 8th World Congress on Pain, at the Vancouver Trade and Convention Centre.

Outcomes Data Are Essential for Pharmacoeconomic Evaluations

December 01, 1999

VANCOUVER, BC-The use of pharmacoeconomics in cancer pain management is not about "decreasing the drug budget," but rather about evaluating the cost and outcomes of drug therapy, Stephen L. Huber, MS, RPh, said at a symposium held in conjunction with the 8th World Congress on Pain.

Why Don't Patients With Pain Become Addicted to Morphine?

December 01, 1999

GLASGOW-Pain specialists continually stress the message that clinicians should not fear prescribing adequate doses of opioids for pain patients, since such patients are not at risk of becoming "addicted."

WHO Guidelines for Pediatric Cancer Pain Focus on Drug, Nondrug Strategies

December 01, 1999

LONDON, Ontario-For a child with cancer, the pain related to the disease, its therapy, and required procedures is quite often the worst pain that the child has ever encountered, said Patricia A. McGrath, PhD, in her presentation at the World Health Organization workshop session on cancer pain.

Laptop Computer Allows Bedside Assessment of Pain and Automated Tracking of Medications

December 01, 1999

HOUSTON-A male cancer patient receiving opioids for pain is reluctant to tell the female pain specialist at the clinic about his constipation until she hands him a small computer and shows him how to use a pen device to indicate his side effects from a list on the screen

Use of Implanted Epidural Catheter for Opioid Delivery Appears Safe, Effective in Home Setting

December 01, 1999

NEW YORK-An implanted epidural catheter can be a safe and effective means of providing analgesia in the home setting for patients with advanced cancer, Memorial Sloan-Kettering Cancer Center researchers found in a retrospective review.

WHO Adds More Opioids to its Analgesic Ladder for the Treatment of Cancer Pain

December 01, 1999

MADISON, Wis--The World Health Organization (WHO), which first published its analgesic ladder in the original 1986 version of Cancer Pain Relief, has now issued an updated 2nd edition of the book that includes additional alternative opioids such as hydromorphone, oxycodone, and transdermal fentanyl, David E. Joranson, MSSW, said at the WHO workshop on cancer pain at the 8th World Congress on Pain.

Book Profiles 32 Women Who Fought Breast Cancer

October 01, 1996

BIRMINGHAM, Ala--In 1994, the Comprehensive Cancer Center of the University of Alabama at Birmingham commissioned photojournalist Melissa Springer to create an exhibit celebrating breast cancer survivors. Her finished project has now been published as A Tribe of Warrior Women.

New RIA Blood Test Predicts Breast Cancer Recurrence

October 01, 1996

CHICAGO--The Truquant BR RIA blood test (manufactured by Biomira Diagnostics, Inc.) has been shown to be a highly specific predictor of recurrent breast cancer. In clinical trials, positive test results predicted relapse 83% of the time, providing as much as a 12-month (average, 5 month) warning over clinical symptoms and/or other diagnostic methods for breast cancer recurrence.

Roxane HIV-Pain Scholars at Hopkins

October 01, 1996

COLUMBUS, Ohio--Roxane Laboratories has announced that Johns Hopkins University School of Medicine will implement the Roxane HIV-Pain Scholars program to train physicians, nurses, and pharmacists to treat and manage HIV-related peripheral nerve pain.

Six Factors Influence Long-Term Brain Cancer Survival

October 01, 1996

TAMPA, Fla--The average brain tumor patient survives just 1 year after diagnosis, so long-term survival, defined as living at least 100% longer than the median survival of historical controls, is especially remarkable. Previous studies have shown that only 7% to 10% of brain cancer patients survive long-term.

In Some Cases, Tests Show False HIV Antibody Response

October 01, 1996

VANCOUVER, BC--AIDS test results are not always what they seem, and current vaccine research may be headed in the wrong direction, Luc Montagnier, MD, said at the 11th International Conference on AIDS. Dr. Montagnier, of the Institut Pasteur, is a co-discoverer of HIV-1, the AIDS virus.

No Evidence Seen of 'Genetic Anticipation' In Familial Colon Cancer

October 01, 1996

BUFFALO, NY--New analysis of familial colorectal cancer data suggests that the disease is not associated with genetic anticipation--the earlier onset of disease in successive generations--said Gloria M. Petersen, PhD, at the Eighth Annual Meeting of the ICG-HNPCC (International Collaborative Group-Hereditary Nonpolyposis Colorectal Cancer).

IL-2 Immunotherapy Feasible, Studies Show

October 01, 1996

VANCOUVER, BC--Use of subcutaneous interleukin-2 (IL-2) to support CD8+ cell maturation in HIV- infected patients appears to be feasible, researchers reported at the 11th International Conference on AIDS.

Klausner Tells NCAB About Bypass Budget, Plans for HPV Vaccine

October 01, 1996

BETHESDA, Md--Planning for science is "oxymoronic," because you can't plan for results, NCI Director Richard Klausner told the National Cancer Advisory Board (NCAB). "Instead, you have to plan for facilitating large-scale thinking," he said.

Donor Lymphocytes May Reverse Relapsed Leukemia

October 01, 1996

CHICAGO--Donor lymphocyte infusion is proving to be a potent treatment for chronic myelogenous leukemia (CML) patients who relapse after allogeneic bone marrow transplant (BMT). It also may improve the overall outcome of CML patients after transplantation, said William Drobyski, MD, at the sixth annual Malnati Symposium in the Clinical Sciences, sponsored by Northwestern University School of Medicine.

CD8+ T Cells Play Central Role in Fighting HIV

October 01, 1996

VANCOUVER, BC--CD8+ T cells appear to play a central role in the body's strategy for fighting HIV, particularly in those patients known as long-term non-progressors or long-term survivors who remain well for many years despite being infected with HIV.

NY Yankee GM Spreads the Word About Prostate Cancer to African-American Men

October 01, 1996

NEW YORK--Baseball-Hall-of-Famer Bob Watson remembered feeling "on top of the world" in October, 1993, after being named the first African-American general manager of a major league ball club (the Houston Astros), but the very next year, at the age of 47, he was feeling "angry and afraid" after learning he had prostate cancer.

Cognitive Remediation Program for Young Cancer Patients Stresses Skills Acquisition

October 01, 1996

BUFFALO, NY--A cognitive remediation program that stresses skills acquisition rather than reiterative practice may improve attention and concentration deficits in cognitively impaired survivors of childhood cancer, Robert W. Butler, PhD, reported at the Fourth International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer.

Media Attention to Prostate Cancer Lags Behind Breast Cancer, Advocate Says

October 01, 1996

NEW YORK--Michael Korda, best-selling author and editor-in-chief and vice president of Simon and Schuster, had never heard of PSA until a routine test showed that his was elevated; he had never thought about prostate cancer as something that could happen to him. After all, he was asymptomatic, a "fanatic exerciser," had given up smoking 20 years ago, and ate carefully.

NCAB Hears Report From Genetic Testing Task Force

October 01, 1996

BETHESDA, Md--The increasing commercial interest in developing tests for genetic disorders makes it imperative to come up with guidelines for use of such tests as quickly as possible, Neil Holtzman, MD, MPH, head of the genetic task force assembled by the NIH and DOE, told the National Cancer Advisory Board (NCAB).

Researchers Explore Role of HHV-8 in Kaposi's Sarcoma

October 01, 1996

VANCOUVER, BC--The discovery in 1994 of a new human herpesvirus associated with Kaposi's sarcoma (KS) brought some order to the previously contentious discussion about causes of the disease in patients with HIV. Researchers at the 11th International Conference on AIDS further nailed human herpesvirus-8 (HHV-8, also known as Kaposi's sarcoma-associated herpesvirus or KSHV) as the culprit in many, if not most, cases of KS (see also, page 1).

Leukemia Society Offers Patients Peer Counseling

October 01, 1996

NEW YORK--The Leukemia Society of America has launched First Connection, a pilot program for helping newly diagnosed leukemia patients and their families receive counseling and information in the initial hours after diagnosis. Patients will be visited by a specially trained peer volunteer who has gone through a similar experience.

Panel Finds Novantrone Beneficial in Advanced Prostate Cancer

October 01, 1996

GAITHERSBURG, Md--Members of the FDA's Oncology Drug Advisory Committee (ODAC) agreed that Immu-nex Corp.'s Novantrone (mitoxan-trone)--in combination with corticosteroids--offers a clinical benefit to patients with hormone-resistant prostate cancer.

New Treatments for Prostate Cancer Are in the Pipeline

October 01, 1996

NEW YORK--Pharmaceutical companies are currently investigating 25 new treatments for prostate cancer, including a potential vaccine, Alan Holmer, president of the Pharmaceutical Research and Manufacturers of America, said at a media briefing conducted by the American Cancer Society and the New York City-based Cancer Research Institute.

'Dual Standard Exists in Management of Cancer Pain'

October 01, 1996

VANCOUVER, BC--How much insulin do you give a patient with diabetes--as much as is required to control blood sugar. "The same is true for opioids and patients with cancer pain, "Richard B. Patt, MD, said at a symposium held in conjunction with the 8th World Congress on Pain. "The only difference is we don't have a blood test to measure a patient's opioid requirement the way we do with insulin."

Administrators Need To Rethink Traditional Oncology Care Units

October 01, 1996

SAN DIEGO--Because of the new realities of health care, it is time to rethink the concept of traditional oncology units, Jeanne T. Reardon, RN, said at the 8th Annual Cancer Care Symposium sponsored by the Society for Ambulatory Care Professionals and Health Technology Assessment of the American Hospital Association.

Women, Kids from the Heartland Express Feelings about Breast Cancer

October 01, 1996

OKLAHOMA CITY--Project Wo-man, a committee of the American Cancer Society (ACS)--has published a book depicting the experiences of Oklahoma women with breast cancer as expressed by the women themselves, their friends, children, and other loved ones through stories, photographs, and artwork (see illustrations at right and on page 1).

HHV-8 Linked to New Type of AIDS- Related Lymphoma

October 01, 1996

VANCOUVER, BC--Human herpesvirus-8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus or KSHV, appears to be linked to the development not only of Kaposi's sarcoma (KS) but also to a newly identified type of AIDS lymphoma, Alexandra Levine, MD, said at an educational symposium at the 11th International Conference on AIDS.

ODAC Votes Neither Yea nor Nay on Remisar for Bladder Cancer

October 01, 1996

GAITHERSBURG, Md--Faced with significant differences between FDA staff and company-associated scientists in the analysis of data from two clinical studies, the FDA's Oncology Drugs Advisory Committee (ODAC) declined to vote either way on whether to recommend approval of Pharmacia & Upjohn's Remisar (bropirimine tablets) for the treatment of patients with BCG-refractory or BCG-intolerant urinary bladder carcinoma in situ (CIS).

Physicians' Self-Defenses Can Interfere With Patient Care

October 01, 1996

OWINGS MILLS, Md--"I once worked with an oncologist who would not treat a child the same age as his son. One year it was 10; the next year, 11," said Daniel Timmel, LCSW, of the Medical and Chirurgical Faculty of Maryland (the state medical society). "Defenses are very interesting."

NIH Grand Rounds Interactive TV Series Will Premiere Next Year

October 01, 1996

BETHESDA, Md--A clinical education television series--Bench to Bedside--NIH Grand Rounds--is set to debut on January 15, 1997. Once a month, the world's leading clinicians from the various NIH institutes will discuss critical medical topics of the day.

Water-Soluble Version of Etoposide Now Available

October 01, 1996

PRINCETON, NJ--Bristol-Myers Squibb Company has received FDA clearance to market Etopophos (etoposide phosphate) for injection, a new water-soluble version of its anticancer drug VePesid (etoposide).

Apply Now for AACR Cancer Research Awards

October 01, 1996

The American Association for Cancer Research (AACR) has announced the availability of its four annual research awards. The Gertrude Elion award, provided through an educational grant from Glaxo Wellcome Oncology, is open to nontenured cancer researchers in clinical, basic, or translational research in the United States and Canada.

New Prostate Cancer Book Answers Patients' Queries

October 01, 1996

NEW YORK--Marion Morra, associate director of the Yale Cancer Center, has collaborated with her sister Eve Potts, a medical writer for more than 30 years, to produce The Prostate Cancer Answer Book: An Unbiased Treatment Guide, published in September by Avon Books to coincide with Prostate Cancer Awareness Month.

National Study to Follow Patient Outcomes After BRCA1 Genetic Testing

October 01, 1996

SALT LAKE CITY--Myriad Genetic Laboratories, Inc. and the American College of Surgeons (ACS) have announced a long-term study that will follow the outcomes of patients currently undergoing BRCA1 genetic analysis for breast and ovarian cancer susceptibility.

New, Safe Technique To Expand CD4+ Cells Discovered

October 01, 1996

VANCOUVER, BC--Expansion of CD4+ cells could help reconstitute the immune system in patients with AIDS. However, this approach has been unfeasible because stimulation of a patient's CD4+ cells to replicate also leads to HIV replication and greater cell death.

Kopans Receives the Kushner Writing Award

October 01, 1996

BETHESDA, Md--Daniel B. Kopans, MD, of the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, has received the 1996 Rose Kushner Award for Writing Achievement in the Field of Breast Cancer for best scientific article.

Tamoxifen Prevention Study Enrollment Nears Completion

October 01, 1996

BETHESDA, Md--The Breast Cancer Prevention Trial (BCPT), launched in 1992, will need fewer women than originally estimated for completion. Although planned for 16,000 women, the trial now has more than 12,000 enrolled, and needs only another 1,000 for completion, which is expected next year.

Study Finds No Abrupt Change at Age 50 Of Mammography Yield on Breast Biopsy

October 01, 1996

BOSTON--Previous study results showing that screening mammography is beneficial only in women over age 50 may stem from inappropriate grouping of age-based data rather than an actual change in benefit at age 50, Daniel B. Kopans, MD, and his colleagues assert in a new study.

New SSRI Antidepressants Offer Advantages in Cancer Patients

October 01, 1996

A 43-year-old married man was referred to Memorial Sloan-Kettering Cancer Center in June, 1995, for further management of a malignant brain tumor. He was asymptomatic until April, 1994, when he suffered a generalized seizure and was admitted to a local hospital. An MRI revealed a right parietal lobe lesion. The tumor was resected and found to be a glioblastoma multiforme.

Optimal Duration of Tamoxifen Requires More Investigation

October 01, 1996

An expert panel of nine international cancer researchers and practicing oncolo-gists met in Boston to discuss the past, present, and future uses of antiestrogens in the treatment of breast cancer. This article represents the first in a series of reports based on the symposium presentations that will be featured in subsequent issues of Oncology News International.The symposium was sponsored by Zeneca Pharmaceuticals.

Amy Langer on Leave of Absence From NABCO After Automobile Accident

October 01, 1996

NEW YORK--Amy S. Langer, of the National Alliance of Breast Cancer Organizations (NABCO), has taken a leave of absence from her position as executive director, due to extensive injuries suffered in a serious car accident in upstate New York.

M.D. Anderson Unveils Mammography Van

October 01, 1996

HOUSTON--Just in time for Breast Cancer Awareness Month, The University of Texas M.D. Anderson Cancer Center has unveiled a mobile mam-mography program that will bring screening mammography to corporate and community locations throughout the Houston area.

Opioids Compatible With Most Adjuvant Agents in Solution

October 01, 1996

HOUSTON--Opioid solutions appear to be physically compatible with a number of adjuvant agents used in supportive care, researchers from M.D. Anderson Cancer Center report. They evaluated the physical compatibility of four injectable opioids--fentanyl, hydro-morphone, methadone, and morphine--with 14 drugs used for pain and symptom management (see table) for 48 hours.