ONCOLOGY Vol 14 No 4 | Oncology

Thalidomide Active in Advanced Multiple Myeloma

April 01, 2000

Mayo Clinic investigators confirmed a recent study showing the activity of thalidomide (Thalomid) in advanced multiple myeloma. Although the drug needs to undergo further clinical trials, it may provide myeloma patients with a new treatment

Bexxar Plus Fludarabine Effective First-Line Therapy for NHL

April 01, 2000

In a study of previously untreated patients with lowgrade or follicular non-Hodgkin’s lymphoma (NHL), all patients responded to the combination of tositumomab and iodine I 131 tositumomab (Bexxar) and fludarabine (Fludara). When compared to

Tamoxifen Prophylaxis Is Cost-Effective, Should Be Covered by Insurance

April 01, 2000

According to the first cost-effectiveness analysis of tamoxifen (Nolvadex), high-risk women who use tamoxifen to prevent breast cancer should be reimbursed by medical insurance in the same way as other preventive drugs and procedures are

Results of Lymphoma Vaccine Study Prompt Large- Scale Trial

April 01, 2000

Researchers at the National Cancer Institute (NCI) have reported an antitumor effect in a small group of patients with lymphoma who were vaccinated with an experimental B-cell lymphoma vaccine over a 5-year period. These promising

Physicians May Not Be Removing Enough Breast Tissue in Younger Patients

April 01, 2000

Younger women who undergo lumpectomy to remove noninvasive breast cancer cells are significantly more likely to experience a recurrence than older patients, in part, because physicians may not be removing enough breast tissue during

Adjuvant Therapy Improves Survival in Patients With Locally Advanced Prostate Cancer

April 01, 2000

Hormonal therapy with the goserelin acetate implant (Zoladex) significantly increases overall survival rates in patients with locally advanced prostate cancer when administered at the onset of conventional external irradiation and continued for 3 years.

Sedation in the Imminently Dying Patient

April 01, 2000

It is a propitious time for the publication of Dr. Wein’s thoughtful paper on sedation in the imminently dying. Although this intervention has been accepted by most palliative care specialists for many years, it seems to be unfamiliar to many oncologists. The numerous surveys[1-7] and published guidelines[8] that have informed discussions of the technique have not appeared in the oncology literature and probably have been read by few of the front-line clinicians who care for dying cancer patients. Like the broader model of palliative care of which it is part, sedation in the imminently dying must be “mainstreamed”-ie, understood in all its complexity by clinicians whose patients may benefit most from its skillful application.

Sedation in the Imminently Dying Patient

April 01, 2000

Sedation is a clinically important therapeutic intervention in the imminently dying patient. As the patient with an advanced, irreversible illness nears the end of life, symptoms accumulate that are progressively more difficult to

Adenocarcinoma of the Esophagus: Risk Factors and Prevention

April 01, 2000

Esophageal cancer poses an interesting challenge for oncologists. Esophageal squamous cell cancer has the most varied geographical incidence of any cancer, suggesting the existence of critically important environmental and molecular epidemiologic factors. These factors remain largely unrecognized.

Sedation in the Imminently Dying Patient

April 01, 2000

Over the past decade, increased attention has focused on the care of dying patients. The role of the physician in caring for these patients has been the subject of renewed interest and intense, sometimes passionate, debate. Patient groups have formed to advocate for the promotion of compassion in the care of the dying, and some of these advocacy groups have asserted a fundamental “right” to physician-assisted suicide. The US Supreme Court has ruled against a constitutional right to physician-assisted suicide but has asserted its willingness to reconsider the issue if it learned that dying patients were not receiving appropriate, high-quality end-of-life care.[1]

Adenocarcinoma of the Esophagus: Risk Factors and Prevention

April 01, 2000

Esophageal cancer is a relatively rare but deadly cancer in the United States. Even in patients with limited locoregional disease at the time of diagnosis, who have received aggressive multimodality therapies as part of clinical protocols, median survival is only 17 months and 3-year survival, only 30%.[1,2] Patients with metastatic disease have a 6-month median survival, which is not improved by the administration of chemotherapy.

Endocrine Therapy for Breast Cancer

April 01, 2000

In an admirably concise fashion, Dr.Pritchard summarizes the results of trials randomizing tens of thousands of women in order to evaluate various types and uses of endocrine treatment over more than 50 years. I would never have predicted these results

Endocrine Therapy for Breast Cancer

April 01, 2000

In addition to ovarian ablation by means of surgery or irradiation, a wide variety of endocrine agents are now available for the management of breast cancer, in both the metastatic and adjuvant settings. Currently available

Adenocarcinoma of the Esophagus: Risk Factors and Prevention

April 01, 2000

Esophageal cancer, with an estimated number of 12,300 new cases in the year 2000, is relatively uncommon in the United States but produces a high number of annual deaths, estimated at 12,100. Moreover, the incidence of the

Biological Basis of Radiation Sensitivity

April 01, 2000

Local tumor recurrence after radiation therapy is due primarily to the failure to eradicate all of the tumor cells within the treatment fields. Theoretically, all cancers could be controlled locally if a sufficiently high radiation dose

Commentary (Lenzi/Yalcin): Management of Patients With Cancer of Unknown Primary Site

April 01, 2000

The article by Drs. Hainsworth and Greco is a timely review of the management of patients presenting with metastatic cancer in the absence of a documented site of origin (cancer of unknown primary site). These patients constitute a significant proportion (approximately 5%) of all patients with cancer.

Commentary (Kessinger): Management of Patients With Cancer of Unknown Primary Site

April 01, 2000

Over the past 2 decades, advances in clinical oncology have occurred at a whirlwind pace, as new surgical, diagnostic, preventive, immunotherapeutic, chemotherapeutic, radiotherapeutic, and molecular resources and techniques have become available. As one result, the death rate from cancer in the United States has decreased during the past decade.[1] Thanks to these advances, many patients have replaced feelings of hopelessness with hope for a cure.

Endocrine Therapy for Breast Cancer

April 01, 2000

Endocrine therapy is the oldest form of treatment for metastatic breast cancer. The availability of numerous new endocrine agents during the past 10 years has led to significant changes in the use of this form of therapy. This article identifies