Oncology NEWS International Vol 7 No 5

Risk Assessment: Who Should Have BRCA Gene Testing

May 01, 1998

NEW ORLEANS--Most women with a family history of breast cancer have a familial predisposition to the disease, rather than true hereditary breast cancer. A comprehensive family history should guide the recommendations regarding testing for a genetic mutation, which, at about $2,400, should not be taken lightly, said speakers at an AMA-sponsored program on genetic medicine and the practicing physician.

NCI Office Focuses on Minority Accrual in Cancer Clinical Trials

May 01, 1998

BETHESDA, Md--Recruiting people from minority groups into clinical cancer trials calls for the biomedical community to be "compassionate, credible, and truthful" in how it portrays the value of those trials, Otis W. Brawley, MD, of the NCI’s Office of Special Populations Research, said at the American Society of Preventive Oncology annual meeting. "Physicians and medical institutions must have a good relationship with the people they serve," he said.

Increased Folate Level Appears to Lower Colon Cancer Risk

May 01, 1998

BETHESDA, Md--When it comes to avoiding colon cancer, Grandma was right: Eat your vegetables, take vitamins, and forget that burger, for goodness sakes. Edward Giovannucci, MD, conveyed this basic message at a workshop on preventing colon cancer, held in conjunction with the American Society of Preventive Oncology (ASPO) annual meeting.

Cluster of Risk Factors May Predict Increased Risk of Colon Cancer

May 01, 1998

BETHESDA, Md--Understanding the complex association of lifestyle and colon cancer risk requires evaluating a number of different behavioral factors, and these may best be studied as clusters rather than individual items, Martha Slattery, PhD, MPH, said at the American Society of Preventive Society (ASPO) meeting.

Colon Cancer Prevention Fits Into Healthy Lifestyle

May 01, 1998

BETHESDA--Diet, physical activity, obesity, and aspirin use all influence the risk of colon cancer, according to both the underlying biology and evidence from epidemiologic studies, Graham Colditz, MD, DrPH, associate professor of medicine, Harvard Medical School, said at the American Society of Preventive Oncology (ASPO) annual meeting.

When to ‘Walk Away’ from a Managed Care Contract

May 01, 1998

ARLINGTON, Va--When Arizona Oncology Associates (AOA), a 25-member group, "walked away" from a "bad" contract with a major local managed care organization (MCO), the practice prospered and the "majority of the patients we were caring for found ways to stay with us," Robert J. Brooks, MD, a medical oncologist in the group, said at the 24th Annual National Meeting of the Association of Community Cancer Centers (ACCC).

Nutritional Assessment ‘Vital,’ but Still Difficult to Do

May 01, 1998

NEW ORLEANS--Nutrition is a vital component of cancer management, yet nutritional assessment is still a very inexact science, Abby S. Bloch, PhD, RD, said at the 4th International Symposium on Nutrition and Cancer, sponsored by the Cancer Treatment Research Foundation and the Society for Nutritional Oncology Adjuvant Therapy.

Prevention Research Needs to ‘Go Mainstream’

May 01, 1998

BETHESDA, Md--Over the next decade, Americans should put more effort into eating better and instituting chemoprevention trials to reduce cancer risks, said Peter Greenwald, MD, DrPH, acting director of the NCI’s Division of Cancer Prevention.

Hyperthermia May Stimulate Immune System

May 01, 1998

BUFFALO, NY--Whole body hy-perthermia, similar to that of a prolonged mild fever, results in antitumor effects that may be due to increased immune system activity and increased induction of heat shock proteins (HSPs). "These proteins are the primary protectors of cells against further heat exposure and other stresses," said John Subjeck, PhD, of Roswell Park Cancer Institute, at the first meeting of the Regional Cancer Center Consortium for Biological Therapy of Cancer, hosted by Roswell Park.

Ultrasound Fails to Detect Local Recurrence Postcryosurgery

May 01, 1998

BOSTON--Transrectal ultrasound is not a reliable method for detecting residual or recurrent tumor in prostate cancer patients after cryosurgical ablation, due to the altered appearance of the gland on ultrasound after freezing, Caryl Salomon, MD, said at the 42nd Annual American Institute of Ultrasound in Medicine (AIUM) conference.

BMT Programs in the Managed Care Era

May 01, 1998

WASHINGTON--Although once a "very profitable program" for cancer centers, bone marrow transplants now present major financial challenges and risks in today’s managed care environment, said Patricia J. Goldsmith, vice president for Managed Care and Business Development, H. Lee Moffitt Cancer Center and Research Institute, Tampa.

Cancer Care Updates ‘Helping Hand’ Guide

May 01, 1998

NEW YORK--Cancer Care, Inc. has just released the second edition of A Helping Hand: The Resource Guide for People with Cancer, with support from Zeneca Pharmaceuticals. The handbook is designed to show newly diagnosed cancer patients the kind of help that is available and where it can be found.

NCCN Sees a Need for New Cancer Pain Practice Guidelines

May 01, 1998

FORT LAUDERDALE, Fla--Given the existence of the cancer pain guidelines formulated by the Agency for Health Care Policy and Research (AHCPR), is there really a need for the National Comprehensive Cancer Network (NCCN) to develop practice guidelines on cancer pain? Yes, asserted Richard Payne, MD, at the NCCN’s third annual conference.

Low-Dose Arsenic Leads to APL Remissions

May 01, 1998

NEW ORLEANS--All acute pro-myelocytic leukemia (APL) patients who took part in a pilot clinical trial of arsenic trioxide went into remission, according to a paper presented at the 89th annual meeting of the American Association for Cancer Research (AACR).

Experts Hail Medicare Funding of Colorectal Cancer Screening

May 01, 1998

WASHINGTON--The advent of Medicare-funded colorectal cancer screening this year followed on the heels of new colorectal screening guidelines issued last year. Some of the physicians and researchers who developed those guidelines gathered in Washington to celebrate the new Medicare benefit.

IL-15 May Offer Selective Chemoprotection: Animal Trials

May 01, 1998

BUFFALO, NY--Animal studies have shown that interleukin-15 (IL-15) effectively protects the host from chemotherapy-induced diarrhea, with maintenance of antitumor activity, said Youcef Rustum, PhD, of Roswell Park Cancer Institute, at the first meeting of the Regional Cancer Center Consortium for Biological Therapy of Cancer, hosted by Roswell Park.

Grape Seed Extract Has Cytotoxic Effects on Human Cancer Cells

May 01, 1998

NEW ORLEANS--An extract derived from the seeds of red grapes, currently available as a dietary supplement (Activin), has been shown to reduce tumor cell growth in human breast, lung, and gastric cancer cell lines, S. S. Joshi, PhD, of the University of Nebraska Medical Center, Omaha, reported at the American Association of Cancer Research 89th annual meeting. (See Figure showing the effects in breast cancer cells.)

Liability May Be Shifting From MDs to Managed Care Co’s

May 01, 1998

SANTA MONICA, Calif--Just as physicians carry malpractice insurance for protection, managed care organizations also purchase insurance to protect against lawsuits. An insurance industry executive suggests that managed care plans may now need to increase their malpractice coverage, as risk liability appears to be shifting from the physicians who provide health care to the insurance plans that pay the medical bills.

What Managed Care Organizations Look For in a Physician

May 01, 1998

ARLINGTON, Va--How do managed care organizations (MCOs) choose the physicians for their lists? The MCO’s ideal physician, as sketched by Melinda Privette, MD, JD, director of medical affairs for Blue Cross/Blue Shield of North Carolina:

HBV Vaccines in Edible Plants Under Study

May 01, 1998

BUFFALO, NY--Vaccines in bananas? The idea may not be farfetched, as researchers at the Roswell Park Cancer Institute have successfully tested transgenic plants that express a hepatitis B virus (HBV) antigen.

Topotecan/Ara-C Promising, Not Standard in MDS

May 01, 1998

FORT LAUDERDALE, Fla--The combination of topotecan (Hycamtin) and cytarabine (ara-C) has shown promising results in patients with myelodys-plastic syndrome (MDS), especially those with abnormalities of chromosomes 5 and/or 7 (-5/-7), but the findings for the combination are too preliminary to be included as standard of care in the NCCN’s practice guidelines for MDS.

Court Decision Ignores The Patient’s Right to Privacy in Gene Testing

May 01, 1998

NEW ORLEANS--In 1955, a man dies at age 45 of a hereditary type of colon cancer, yet his wife is told he had a bowel obstruction, not cancer. Now, 27 years later, the man’s daughter is your patient and you have diagnosed her with multiple polyposis and colon carcinoma. In constructing the daughter’s medical history, you discover the history of hereditary cancer in the father.

‘Onerous Proposed Stark II Regulations Must Be Changed’

May 01, 1998

ARLINGTON, Va--The proposed regulations of Medicare reimbursement have "gone from providing the dollars for care to making the clinical decisions," James L. Wade III, MD, president of the Association of Community Cancer Centers, said at the ACCC’s 24th Annual National Meeting.

Use of Aspirin as a Chemopreventive Strategy Is a ‘Close Call’

May 01, 1998

BETHESDA, Md--"Will an aspirin a day keep the oncologist away?" John Baron, MD, PhD, asked at a colon cancer prevention workshop held in conjunction with the American Society of Preventive Oncology (ASPO) annual meeting. "Absolute benefits and absolute risks are small," he said, "which means it’s a close call."

Complex Chemoimmunotherapy Regimens on Horizon

May 01, 1998

NEW YORK--Advances in immunotherapy are opening a wide array of potential uses in combination with chemotherapy in advanced cancers. Speaking at the Chemotherapy Foundation XV Symposium, Ezra M. Greenspan, MD, referred to the "mind-boggling" number of variables--optimum timing, dosing, and route of administration, for example--involved in putting together experimental combination regimens.

Rectal Cancer Said to Require Extensive Preop Evaluation

May 01, 1998

COLUMBUS, Ohio--Rectal cancer is treated with a wide variety of operations and adjuvant therapy. This variety makes extensive preoperative evaluation mandatory, said Karamjit Khanduja, MD, chief of the Division of Colon and Rectal Surgery, Mt. Carmel Health, Columbus, Oho.

Stone-Age Brazilian Tribe Infected With TB May Face Extinction

May 01, 1998

NEW YORK--An outbreak of tuberculosis (TB) in a stone-age Brazilian Indian tribe is producing mortality rates 100 times higher than were reported in New York City at the peak of the multidrug-resistant TB epidemic in 1994.

ASCO ‘In Step’ With The March to End Cancer

May 01, 1998

WASHINGTON--The American Society of Clinical Oncology (ASCO) has announced its support of "The March . . . Coming Together to Conquer Cancer," which will take place in the nation’s capital, and in dozens of US communities, on Saturday, September 26.

Growth of Hospice Movement Spurs Interest in Pain Care

May 01, 1998

SAN DIEGO--With the explosion of the hospice movement, the creation of pain management teams, and the use of pain ladders to guide treatment, "pain management is becoming a trendy area of medicine," said Daniel B. Carr, MD, Saltonstall Professor of Pain Research, New England Medical Center. "We didn’t hear much about treating cancer pain 20 years ago; it was on the fringes."

Hematologists Detect Rare Side Effect of Antiplatelet Agent

May 01, 1998

Detecting rare but serious side effects of drugs after they have been approved by the FDA is a difficult task. Postmarketing drug safety relies extensively on clinicians’ voluntary reporting of adverse effects to the FDA’s spontaneous reporting system, known as Med-Watch. The MedWatch program examines adverse effect reports and evaluates the possibility of drug causality. In some cases, the program identifies an adverse effect of a drug that was not reported in clinical trials.

NCCN’s New Guidelines for Colon Cancer Screening Reflect ‘Remarkable Consensus’

May 01, 1998

FORT LAUDERDALE, Fla--The National Comprehensive Cancer Network (NCCN) colon cancer screening guidelines committee came to "a remarkable degree of consensus on the recommendations," Stephen Gruber, MD, PhD, MPH, said at the group’s third annual conference. The NCCN is a coalition of 16 leading US cancer centers.

Multidisciplinary Approach to Managing Cancer Distress

April 30, 1998

Fort Lauderdale, Fla--Every cancer patient must deal with the psychological issues inherent to all stages of the disease, making the recognition, diagnosis, and treatment of distress critical to total care of the person with cancer, Jimmie Holland, MD, of Memorial Sloan-Kettering Cancer Center, said at the third annual conference of the National Comprehensive Cancer Network (NCCN).