ONCOLOGY Vol 11 No 4 | Oncology

Vinorelbine/Doxorubicin Combination Demonstrates Major Antitumor Activity in Advanced Breast Carcinoma

April 01, 1997

Preliminary results from a study conducted by Dr. D. Firat and coworkers in Ankara, Turkey, confirm that the combination of vinorelbine (Navelbine) and doxorubicin has major antitumor activity when used as first-line therapy in advanced breast

Book Review: Physicians' Guide to the Internet

April 04, 1997

Those of us who have been involved in medicine for a number of years can remember a time when physicians were the ones who informed their patients about the latest advances in diagnosis and treatment. In the new electronic age, however, medic

An Overview of Adenocarcinoma of the Small Intestine

April 01, 1997

Neugut and colleagues have compiled a very comprehensive, thoughtful description of the incidence, epidemiology, etiology, clinical presentation, and treatment of small bowel malignancies. This is a very unusual tumor that few clinicians will encounter during their careers, and fewer still will diagnose preoperatively.

Roswell Park to Administer "Old" Drug in a New Way

April 01, 1997

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

NY Lt. Governor Calls for a Halt to HMO Abuses

April 01, 1997

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

New Vitamin D Compound Reduces Cell Proliferation Without Toxicity

April 01, 1997

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

Current Role of Protective Agents in Cancer Treatment

April 01, 1997

Dr. Schuchter's article explores the theoretical and practical aspects underlying the concept of cytoprotection, which has been recently introduced into the therapeutic armamentarium. Cytoprotection is contrasted with the related strategy of rescue, which has been widely applied since the cytokines granulocyte colony-stimulating factor (G-CSF, filgrastim [Neupogen]) and granulocyte-macrophage colony-stimulating factor (GM-CSF, sargramostim [Leukine, Prokine]) obtained FDA approval.

Quality of Life Among Long-Term Cancer Survivors

April 01, 1997

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.

An Overview of Adenocarcinoma of the Small Intestine

April 01, 1997

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.

Prostate Cancer: To Screen or Not to Screen?

April 01, 1997

In a lively session featured at the 32nd Annual Meeting of the American Society of Clinical Oncology (ASCO), Jerome P. Richie, md, Brigham and Women's Hospital, Boston, and Steven H. Woolf, md, mph, Medical College of Virginia,

Quality of Life Among Long-Term Cancer Survivors

April 01, 1997

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]

Quality of Life Among Long-Term Cancer Survivors

April 01, 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.

An Overview of Adenocarcinoma of the Small Intestine

April 01, 1997

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]

An Overview of Adenocarcinoma of the Small Intestine

April 01, 1997

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]

Sequential Dose-Dense Adjuvant Therapy With Doxorubicin, Paclitaxel, and Cyclophosphamide

April 01, 1997

The recognition of paclitaxel's (Taxol's) activity and non-cross-resistance with doxorubicin (Adriamycin) in the treatment of metastatic breast cancer has motivated study of the agent in the adjuvant setting. However, the ideal

Infusional 5-FU, Folinic Acid, Paclitaxel, and Cisplatin for Metastatic

April 01, 1997

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

Doxorubicin and Paclitaxel (Sequential Combination) in the Treatment

April 01, 1997

Based on preclinical data, we designed a phase I/II clinical trial to determine the efficacy and toxicity of doxorubicin followed by paclitaxel in the treatment of advanced breast cancer (either untreated or relapsed after

Current Role of Protective Agents in Cancer Treatment

April 01, 1997

The administration of intensive chemotherapy according to a rigid schedule improves response rates and duration of response. However, dose-limiting toxicities and resulting delays in therapy often interfere with therapy

Paclitaxel as First-Line Treatment for Metastatic Breast Cancer

April 01, 1997

When administered as a single agent in pretreated patients with advanced breast cancer, paclitaxel (Taxol) exhibits remarkable antitumor activity. This trial was undertaken to compare paclitaxel with standard

Paclitaxel and Epirubicin as First-Line Therapy for Patients With Metastatic Breast Cancer

April 01, 1997

Paclitaxel (Taxol) has aroused considerable interest for its high single-agent activity in breast cancer and novel mechanism of action. Epirubicin (Farmorubicin), the 4'epimer of doxorubicin (Adriamycin), also has high activity in

A Phase II Study of Doxorubicin/Paclitaxel Plus G-CSF for Metastatic Breast Cancer

April 01, 1997

This phase II trial was conducted to evaluate the percentage of objective responses and the toxicity profile of combination doxorubicin (Adriamycin) and paclitaxel (Taxol) with granulocyte colony-stimulating factor as first-line

Commentary (Grossman): Age-Specific Reference Ranges for PSA in the Detection of Prostate Cancer

April 01, 1997

Dr. DeAntoni has carefully reviewed the literature on age-specific reference ranges for prostate-specific antigen (PSA) in the diagnosis of prostate cancer and the controversy surrounding their use. Key to understanding of this debate are two fundamental concepts: (1) the definition of "clinically significant prostate cancer" and (2) the use of sensitivity and specificity, which is frequently obscured by the surrounding rhetoric. The assumption that all readers uniformly interpret the meaning of clinically significant prostate cancer and wish to achieve the same results by manipulating sensitivity and specificity is probably incorrect.

Commentary (Huben): Management of Asymptomatic Rising PSA After Prostatectomy or Radiation Therapy

April 01, 1997

As the number of cases of newly diagnosed prostate cancer has risen dramatically in the United States during the past decade, the management of a rising prostate-specific antigen (PSA) level following definitive therapy has become an increasingly common dilemma. Waxman and associates provide a concise, focused review of many of the key issues and controversies surrounding this dilemma. Several of these issues warrant particular attention.

Commentary (Klotz): Management of Asymptomatic Rising PSA After Prostatectomy or Radiation Therapy

April 01, 1997

This article addresses an increasingly common dilemma: the finding of a rising prostate-specific antigen (PSA) level in an asymptomatic patient following radical surgery or radiation therapy for prostate cancer. The incidence of prostate cancer has skyrocketed, and the number of men being treated with radiation or radical prosta-tectomy has similarly increased. The most common basis for the initial diagnosis of prostate cancer is an elevated PSA. For the patient who is already sensitized to PSA as a diagnostic marker, it is extremely distressing to learn that his PSA is rising following radical treatment. This is particularly true for the patient who has experienced a treatment-related adverse effect on quality of life. For the treating physician, this all-too common scenario is disappointing and even guilt-laden.

Commentary (Sarosdy): Age-Specific Reference Ranges for PSA in the Detection of Prostate Cancer

April 01, 1997

Dr. DeAntoni provides a timely, critical review of the concept of age-specific prostate-specific antigen (PSA) ranges, as well as other frequently used attempts to improve the accuracy of serum PSA testing in the diagnosis of unsuspected prostate cancer. His review is complete, and his assessments of each of the modalities reflect not only the majority view but also realistic appraisals of the limitations of this less-than-perfect test.