ONCOLOGY Vol 11 No 8 | Oncology

Can We Make Low-Fat Foods More Palatable?

August 01, 1997

Why we like--and eat--fatty foods was the focus of an address by Dr. Adam Drewnowski, PhD, University of Michigan School of Public Health, at a symposium, "Reducing Dietary Fat: Putting Theory Into Practice," held last December in New

The Prostate Cancer Intervention Versus Observation Trial (PIVOT)

August 01, 1997

As described by Wilt et al in their review, the Prostate Cancer Intervention Versus Observation Trial (PIVOT) is asking very important questions about the effect of surgical treatment vs observation, with delayed androgen deprivation available to both groups, in patients with localized prostate cancer. Clinicians who have suffered with the old Uro-Oncology Trial comparison of prostatectomy vs radiation hope that PIVOT provides answers rather than confusion.

Oligodendroglial Component in Anaplastic Astrocytomas: A Prognostic Factor for Survival

August 01, 1997

Perhaps contrary to expectations, the presence of an oligodendroglial component in patients with anaplastic astrocytomas was associated with a significantly longer survival than were pure anaplastic tumors. This finding emerged from a randomized

External Beam Radiation and Brachytherapy for Prostate Cancer: Worthwhile Long-Term Outcomes

August 01, 1997

Long recognized as standard treatment of gynecologic cancer and some other malignancies, brachytherapy may also play a role in the treatment of prostate cancer, said Dr. John C. Blasko of the University of Washington in Seattle.

Practical Tips for Caring for HIV/AIDS Patients

August 01, 1997

A nurse practitioner who has been caring for HIV/AIDS patients for over 15 years has some practical tips for dealing with the common symptoms associated with the disease. Dr. Gayle Newshan, PhD, NP, offered her advice during a recent

Research Helps Shed Light on Role of Apoptosis in Tumor Development and Growth

August 01, 1997

Many types of cells undergo apoptosis as part of the normal physiological process. An interruption in apoptosis is thought to be a primary cause of tumor growth. Two presentations concerning this subject were made at the 88th Annual Meeting of the

The Role of Exercise in the Prevention and Treatment of Cancer

August 01, 1997

Recent studies delineate the effect of exercise on specific cancers but much more research on the role exercise plays in the prevention and treatment of cancer is needed, according to Susan Oliveria, ScD, MPH, director of epidemiology at the

Will Current Clinical Trials Answer the Most Important Questions About Prostate Adenocarcinoma?

August 01, 1997

Outlined in the article by Thompson and Seay are a series of questions relevant to the spectrum of stages of prostate cancer ranging from prevention to the treatment of advanced disease. Given the prevalence of prostate cancer, the morbidity of the disease, and the death rate from prostate cancer of more than 40,000 men in the United States each year, these questions warrant answers as soon as possible.

Will Current Clinical Trials Answer the Most Important Questions About Prostate Adenocarcinoma?

August 01, 1997

Thompson and Seay have attempted to provide a concise overview of the treatment of both localized and metastatic prostate cancer. Also, they have listed most of the current clinical trials focusing on these issues, along with two current trials addressing the prevention of the disease. There is certainly no getting away from the fact that, even with the plethora of publications dealing with prostate cancer (1,643 in 1994 alone, as the authors point out), there are major gaps in our fund of knowledge about this disease entity.

Pap Smear Refined

August 01, 1997

The high proportion of false negatives associated with Pap smears spurred the development of more effective collection and diagnostic techniques for cervical cells. The Pap smear, a universal standard in the detection of cervical cancer, has recently

Oropharyngeal and Oral Cavity Cancer Surgical Practice Guidelines

August 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Laryngeal Cancer Surgical Practice Guidelines

August 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Prostate Cancer Clinical Trials of the Southwest Oncology Group

August 01, 1997

The Genitourinary (GU) Cancer Committee of the Southwestern Oncology Group (SWOG) has achieved repeated successes in conducting prospective studies of prostate cancer. This article is a summary of recently completed and current trials in prostate cancer and, as such, represents an intriguing snapshot of priorities in prostate cancer clinical trials in 1997.

Parotid Gland Cancer Surgical Practice Guidelines

August 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

SSO Practice Guidelines: Introductory Remarks

August 01, 1997

Thousands of practice guidelines/practice parameters have been published by various professional organizations. The American Medical Association,[1] American College of Physicians,[2,3] and others[4-6] have written extensively about

Prostate Cancer Clinical Trials of the Southwest Oncology Group

August 01, 1997

In 1941, Charles Huggins, Clarence Hodges, and R. E. Stevens reported on the beneficial effects of orchiectomy in 21 men with advanced prostate cancer.[1] Fifty-five years later, Southwest Oncology Group (SWOG) investigators were able to confirm, in a 1,387-patient intergroup comparative trial of bilateral orchiectomy with or without flutamide (Eulexin), that we still have nothing better to offer these men. This fact alone should underscore the critical need for well-planned, well-executed clinical trials in prostate cancer. The incidence and death rates continue to rise, and even today too few men are being enrolled in studies designed to alter these statistics.

The Prostate Cancer Intervention Versus Observation Trial (PIVOT)

August 01, 1997

The Prostate Cancer Intervention Versus Observation Trial (PIVOT) should prove interesting in that the study design will permit observation of the natural history of a potentially lethal malignant disease, influenced only by palliative treatments. My comments will focus on the concerns raised by this study design. I will not address possible biases of the trial introduced by: (1) enrollment of less than 20% of the eligible population; (2) an enrollment rate per participating center of less than 3 patients per year; (3) a 7-year enrollment period; and (4) a 12-year follow-up (for a total trial duration of 19 years).

Imagery and Hypnosis in the Treatment of Cancer Patients

August 01, 1997

Spiegel and Moore draw an important distinction between the use of psychological techniques to promote quality of life and their use to promote quantity of life. On the one hand, a considerable body of research documents that hypnosis and other psychological techniques improve the quality of life of cancer patients. On the other hand, only limited empiric evidence supports the view that imagery and other psychological techniques increase the quantity of life of cancer patients.

Thyroid Cancer Surgical Practice Guidelines

August 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Will Current Clinical Trials Answer the Most Important Questions About Prostate Adenocarcinoma?

August 01, 1997

Despite a heightened focus of the medical and research community on prostate cancer, many important questions about this disease remain unanswered. These include questions about the possible prevention of prostate cancer, as well as the optimal treatment approaches for localized, locally advanced, metastatic, and hormone-refractory disease. A whole host of prospective, well-designed clinical trials are currently in progress that should answer many of these questions. This review briefly explores some of these unresolved issues and describes ongoing trials designed to address them. [ONCOLOGY 11(8):1-11, 1997]

The Prostate Cancer Intervention Versus Observation Trial (PIVOT)

August 01, 1997

The Prostate Cancer Intervention Versus Observation Trial (PIVOT) is a randomized trial designed to determine whether radical prostatectomy or expectant management provides superior length and quality of life for men with clinically localized prostate cancer. Conducted at Department of Veterans Affairs and National Cancer Institute medical centers, PIVOT will enroll over 1,000 individuals less than 75 years of age. The primary study end point is all-cause mortality. Secondary outcomes include prostate cancer- and treatment-specific morbidity and mortality, health status, predictors of disease-specific outcomes, and cost-effectiveness. Within the first 3 years of enrollment, over 400 men have been randomized. Early analysis of participants' baseline characteristics indicate that enrollees are representative of men diagnosed with clinically localized prostate cancer throughout the United States. Therefore, results of PIVOT will be generalizable. These results are necessary in order to determine the preferred therapy for clinically localized prostate cancer. [ONCOLOGY 11(8):1133-1143, 1997]

Imagery and Hypnosis in the Treatment of Cancer Patients

August 01, 1997

Many patients with cancer often seek some means of connecting their mental activity with the unwelcome events occurring in their bodies, via techniques such as imagery and hypnosis. Hypnosis has been shown to be an

Review of Docetaxel/Doxorubicin Combination in Metastatic Breast Cancer

August 01, 1997

Docetaxel (Taxotere) and doxorubicin (Adriamycin) have each demonstrated significant activity in metastatic breast cancer. Thus, the combination of docetaxel and doxorubicin has been evaluated in phase I trials to

Prostate Cancer Clinical Trials of the Southwest Oncology Group

August 01, 1997

The changing clinical dynamics of prostate cancer have resulted in a broadening of the research focus of the Genitourinary (GU) Cancer Committee of the Southwest Oncology Group (SWOG). Beginning with an emphasis on hormone-refractory disease in its early years, SWOG prostate cancer trials now cover the entire spectrum of the disease: localized, locally advanced, metastatic and hormone-refractory disease. As the world's largest GU cancer research group, the GU committee of SWOG has pioneered studies in combined androgen therapy for metastatic disease, quality-of-life (QOL) assessments for patients with localized and advanced disease, adjuvant therapy models, and prostate cancer chemoprevention. The committee has also formed the GU Global Group, whose purpose is to convene the chairs of the GU committees of all the major national and international oncology cooperative groups. Meeting semiannually, this group discusses activities within their respective organizations, plans collaborative strategies and protocols, and establishes global strategy in prostate cancer clinical research. The future directions of national and international prostate cancer trials will build on this broad foundation of well-conceived, logically sequenced studies. [ONCOLOGY 11(8):1155-1170, 1997]

PSA Nadir Levels After Radiotherapy for Prostate Cancer: A Powerful Prognostic Variable

August 01, 1997

A prostate-specific antigen (PSA) nadir level of up to 1 ng/mL after three-dimensional conformal radiotherapy for patients with localized prostate cancer is a powerful prognostic variable, according to Dr. Michael Zelefsky of the Department of

Radiation Therapy vs Surgery for Early-Stage Prostate Cancer: Similar Rates of Biochemical Failure

August 01, 1997

No difference in the rates of biochemical failure was found between patients with stage T1 or T2 prostate cancer and a prostate-specific antigen (PSA) level of up to 10 ng/mL treated with radical prostatectomy and those treated with radiation

Laryngeal Cancer Surgical Practice Guidelines

August 01, 1997

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in

Imagery and Hypnosis in the Treatment of Cancer Patients

August 01, 1997

Spiegel and Moore provide an excellent review of the utility of psychological therapeutic techniques in cancer patients. These techniques are frequently viewed with alarm by the medical community because of unsubstantiated claims that they improve survival in cancer patients. Patients who expect such techniques as visual imagery to change the course of their illness may experience poorer psychological adjustment and needless guilt. However, it is a shame to "throw the baby out with the bath water." Psychological techniques have a significant role to play in the treatment of cancer patients.