ONCOLOGY Vol 9 No 2

New clinical research shows that a noninvasive test, the Breast Biophysical Examination (BBE), may help physicians more effectively detect breast cancer, as well as identify women who do not have cancer. The research, funded in part by the National Cancer Institute, was presented at the 17th Annual San Antonio Breast Cancer Symposium.

According to the Pharmaceutical Research and Manufacturers of America, as of 1993, 124 cancer drugs were in some stage of development at 49 pharmaceutical companies and the National Cancer Institute. The report was based on an NCI survey.

Survival and local control rates for limited stage small-cell lung cancer patients treated with either once-daily or twice-daily thoracic radiation plus cisplatin (Platinol) and etoposide (VePesid) are substantially better than with previously reported

First in a series of articles on how economic factors, managed care, and other aspects of health care reform affect physicians in the various oncology specialties, and ultimately their patients. The series was compiled for ONCOLOGY

Are women being sold a "bill of goods" about prophylactic mastectomy? Although it may decrease the risk of cancer somewhat, it should not be touted as a panacea, says Dr. Susan Love

Tamoxifen (Nolvadex), a nonsteroidal antiestrogen, was first approved by the FDA for the treatment of patients with breast cancer in 1978. Large clinical trials have demonstrated a recurrence-free and overall survival benefit

In his excellent review, Dr. Barakat has made many useful observations about the effects of tamoxifen (Nolvadex) on the endometrium. As the potential number of women on tamoxifen increases, several points merit emphasis and dissemination to all gynecologists who may be asked by medical oncologists to render opinions on such patients.

Tamoxifen (Nolvadex) is widely used in the treatment of breast cancer. It is effective in the management of both early stage and advanced disease. The recent comprehensive meta-analysis of systemic treatment in early breast cancer reported that tamoxifen reduced the annual odds of breast cancer recurrence by 25%, and the risk of death by 16%, compared with patients not treated with tamoxifen [1]. The benefits are even more pronounced in postmenopausal patients, with 29% decreases in recurrence and 20% reduction in the risk of death. The risk of contralateral primary breast cancer is also decreased by approximately 28% in women receiving adjuvant tamoxifen [2]. This has prompted its use in prevention trials; the National Surgical Adjuvant Breast and Bowel Project Prevention trial (NSABP P1) is an ongoing trial randomizing women at high risk for breast cancer to receive tamoxifen or placebo. Tamoxifen's use in otherwise healthy women has brought attention to the few potential toxicities of the drug.

Papillary thyroid cancer is predominantly a sporadic disease that usually presents as an asymptomatic thyroid mass in a euthyroid patient. Irradiation to the neck during childhood significantly increases the subsequent risk of

Dr. Vassilopoulou-Sellin begins her discussion advocating near total thyroidectomy with post-operation radiation iodine ablation for most patients. This is a thesis that can be questioned in terms of the numerous studies in recent years about risk

Approximately one third of patients with epithelial ovarian cancer present with localized or early-stage disease. Prognostic features identify certain subsets of patients with good risk characteristics who do not require adjuvant

The paper by Schilder et al is an outstanding review of the current status of the management of women with early-stage ovarian cancer. As the paper makes clear, despite the efforts of numerous cancer research groups around the world, an optimal treatment strategy for early-stage ovarian cancer has yet to be defined.

Schilder and colleagues have provided a detailed and excellent review of the management of early ovarian carcinoma. Several areas of the review deserve comment and will be considered in the following order: staging and prognostic factors, conservative surgery, and adjuvant therapy.