ONCOLOGY Vol 13 No 2

Administering cytarabine at levels substantially higher than the standard dose can cure nearly five times as many patients who have a certain type of acute myeloid leukemia (AML), according to a recent study.

In a session targeting novice bone marrow transplant (BMT) nurses, the Oncology Nursing Society (ONS) outlined what nurses should expect in treating BMT cases, from pretransplant to posttransplant, as well as related insurance and

Bone marrow transplantation (BMT) nurses need to educate themselves about their patients’ insurance coverage, said the Oncology Nursing Society (ONS) at its Eighth Annual Fall Institute. First, nurses must verify that patients have coverage and

Due to the psychosexual consequences and significant morbidity associated with the standard radical vulvectomy procedure, there has been a trend toward vulvar conservation in the management of women with vulvar cancer.

During the Oncology Nursing Society’s (ONS) Eighth Annual Fall Institute Meeting, oncology nurses discussed guidelines for implementing clinical trials within office-based community practices.

The University of Michigan (U-M) Comprehensive Cancer Center has launched an Internet site to serve the growing online community of cancer patients seeking trustworthy medical information. The web site, which is located at

Findings released from a national survey underscore what cancer patients already know: The fatigue following chemotherapy treatment has a sweeping impact on patients’ physical and emotional health, as well as their economic well-being.

The addition of the sleep hormone melatonin can boost the effectiveness of tamoxifen and help reverse tamoxifen (Nolvadex) resistance in the treatment of breast cancer, reported David E. Blask, MD, PhD, at a meeting on Comprehensive

In managing cancer pain, an alternative to the oral route of opioid administration may be considered under several circumstances. For example, the oral route may not be feasible due to impaired swallowing, gastrointestinal obstruction, poor

The practicing medical oncologist is faced with several options when selecting opioid analgesics. As Drs. Mercadante and Fulfaro underscore, when all routes of administration are available, the oral route is preferred.

The promise of using reverse transcriptase–polymerase chain reaction (RT-PCR) technology for the detection of circulating prostate cancer cells in peripheral blood, although technically feasible at the molecular level, has proven clinically impractical for routine implementation in patient management. Reverse transcriptase–polymerase chain reaction has been successfully applied to detect and quantify (relatively speaking) genes that are differentially expressed in cells and tissues obtained from patients during various stages of malignant growth. In addition, the method has been applied to the detection of circulating cancer cells in peripheral blood using highly specific primer sets for specific molecular targets. These include epithelial cell cytokeratins for breast cancer, as well as enzymes, such as tyrosinase for melanoma and prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) for prostate cancer, using either nonnested or nested methodologies.

The article by Drs. de la Taille, Olson, and Katz is an accurate and concise review of clinical studies for the detection of circulating prostate cancer cells using reverse transcriptase–polymerase chain reaction (RT-PCR) technology. These investigators from the Department of Urology at Columbia-Presbyterian Medical Center have as much experience as any group in the use of RT-PCR for this purpose. Initially very strong proponents of the efficacy of RT-PCR as a staging tool, they have become slightly more reserved in the current article. In this well-written review, the authors allude to a number of issues affecting RT-PCR results from prostate cancer patients that deserve further comment.

Dr. de la Taille and colleagues from Columbia University provide an overview of the concept of molecular staging” of prostate cancer using reverse transcriptase–polymerase chain reaction (RT-PCR). They do an admirable job of summarizing all of the currently available data on the results of this assay in the clinical staging of prostate cancer. As they note, only their group and one other have been able to demonstrate that a positive assay correlates with final pathologic stage. A limited number of other studies have suggested that the RT-PCR assay can predict prostate-specific antigen (PSA) recurrence.

The reverse transcriptase–polymerase chain reaction (RT-PCR) assay is an extremely sensitive technique for the detection of circulating cells expressing prostate-specific antigen (PSA) in prostate cancer patients. This

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 59 breast cancer experts and patient advocates participated. The proceedings of the conference will be published in six installments in successive issues of oncology. The first part, published last month, defined the problem and explored its magnitude and ramifications for patient management. This second part focuses on the benefits and risks of hormone replacement therapy (HRT) in patients with breast cancer. [ONCOLOGY 13(2):245-267, 1999]

Although the optimal route of administration of opioids is by mouth, some patients may require alternative routes during the course of their illnesses for several reasons. These include bowel obstruction, severe emesis, or severe

Chronic myelogenous leukemia (CML) is a myeloproliferative disorder that follows a characteristic clinical course in which a chronic phase of variable duration precedes an accelerated, and ultimately blastic, phase,

Anew Radiation Therapy Oncology Group (RTOG) study will determine whether thalidomide combined with radiation therapy can lengthen survival and time to disease recurrence in adults with glioblastoma multiforme.

Chronic myelogenous leukemia (CML) is an intriguing disease for reasons that point to important biological differences between this and other types of leukemia: