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Public policy initiatives and increased physician awareness are needed to maintain a healthy balance between the promise of genetic engineering and the potential for genetic discrimination, a Stanford/Veterans Affairs (VA) physician maintains. His

Tumor growth is the result of two opposing processes--cell division and cell loss. As long as division outpaces loss, tumors will continue to grow. The form of "active" cell death called apoptosis is now known to be controlled by specific genes, and it is hoped that manipulating the expression of these genes could shift the balance in favor of cell loss.

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,

The incidence of ductal carcinoma in situ (DCIS) has increased dramatically since the advent of screening mammography in the 1980s. The age-adjusted DCIS incidence rates increased 17.5% annually from 1983 to 1992.[1] The percentage of patients with DCIS treated with mastectomy has decreased from 71% in 1983 to 44% in 1992. The percentage of patients with DCIS undergoing lumpectomy and radiation in 1992 was 23.3% and lumpectomy only was 30.2%.

In this article, Dr. Rich traces the evolution of chemoradiation in cancer of the rectum from its role as adjuvant therapy to its role in neoadjuvant therapy and its potential as definitive therapy. The efficacy of irradiation and fluorouracil (5-FU)-based

In 1994, the results of a randomized intergroup trial coordinated by the North Central Cancer Treatment Group (NCCTG 86-47-51) indicated that protracted fluorouracil (5-FU) infusion during postoperative adjuvant radiation therapy results in

Quantitative radiation biology was revolutionized in 1956 when Puck and Marcus published the first cell survival curve, relating radiation dose to the fraction of cells surviving.[1] The term "survival" generated a great deal of discussion at that time and led to the definition of such terms as "reproductive death," "reproductive integrity," and "clonogenicity" (among others), all designed to explain that the end point of cell culture experiments is the loss of the cell's ability to divide indefinitely and produce a sizable visible clone.

In patients with an advanced disease or a terminal illness, it may become necessary to institute parenteral opioid therapy either on a temporary basis (for acute breakthrough pain) or permanently. Continuous intravenous or subcutaneous opioid infusions have been the mainstay of parenteral opioid therapy for oncologic pain. Patient-controlled analgesia (PCA) now offers an alternative modality, and Drs. Bruera and Ripamonti review the current status of this relatively new technique. Is there any evidence to suggest the superiority of one modality over the other for the treatment of oncologic pain?

The Van Nuys Prognostic Index (VNPI) is, in many ways, the best current approach for classifying patients with ductal carcinoma in situ (DCIS) according to their risk of local recurrence after breast-conserving therapy. However, this index has very important limitations.

Apoptosis is a mode of cell death that is currently of intense research interest in developmental and cancer biology. For more than 40 years, radiobiologists have been aware of cells in irradiated specimens that display the

Patient-controlled analgesia (PCA) is a relatively new technique in which patients are able to self-administer small doses of opioid analgesics when needed. Many different devices are available for opioid infusion, including

BETHESDA, Md--A federal advisory committee has recommended continuing the use of AZT (zidovudine) in HIV-infected pregnant women to prevent them from passing the virus on to their newborns. The group also urged the US Public Health Service to thoroughly reassess its guidelines for the use of AZT in pregnant women.

ROYAL OAK, Mich-Interstitial implants that deliver radiation therapy to the tumor bed alone after lumpectomy have been well tolerated with no significant acute or late toxicity in the first 50 patients in a Michigan study. In addition, with three years' median follow-up, no patients have recurred locally or distantly.

A major gene essential for controlling the synthesis of hereditary material and cell proliferation is also critically involved in determining the extent of malignant growth of cancer cells, reports a study published in a recent issue of the Proceedings of

Steven T. Rosen, MD, FACP, director of the Robert H. Lurie Cancer Center of Northwestern University, announced that the Center has been awarded a 4-year competitive renewal of its Cancer Center Support Grant (CCSG) from the National

For years, doctors have looked at tissue biopsies and spotted unusual cells that seem to have early signs of cancer. The problem is that, until recently, doctors have never had the right tools to extract the cells from the tissue, leaving them with no

WASHINGTON--A new survey of pharmaceutical and biotechnology companies by the Pharmaceutical Research and Manufacturers of America (PhRMA) has identified 122 drugs and vaccines in testing to prevent HIV infection or to treat AIDS and AIDS-related diseases. These drugs are in addition to the 42 medications already approved and on the market in the United States.

PITTSBURGH-Although not designed specifically to answer the question, NSABP B-15 and B-16 provide no evidence that delay in radiation therapy, to allow administration of adjuvant chemotherapy, increases the risk of ipsilateral breast cancer recurrence in node-positive patients undergoing breast-conserving surgery. E.P. Mamounas, MD, presented the updated results of these two trials at a general session of the San Antonio meeting. Dr. Mamounas is with the NSABP at the University of Pittsburgh, and is also medical director of the Mount Sinai Center for Breast Health, Beachwood, Ohio.

WASHINGTON--President Clin-ton calls his new national AIDS strategy an important milestone in the history of efforts to end the pandemic that has killed more than 343,000 Americans since 1981. "In the 15 years of this epidemic, we have never had such a unified strategy," the President said. "These goals will guide our work in the coming term and, more specifically, in the coming year."

CHICAGO--A percutaneous breast biopsy method that uses a thin rotating blade to snip off tissue and a vacuum element to withdraw pathological samples is proving to be three times more accurate and two times faster than core needle biopsy, said Roger J. Jackman, MD, of the Department of Diagnostic Radiology, Palo Alto Medical Clinic, Calif, at the annual meeting of the Radiological Society of North America (RSNA).

CHICAGO--Although ultrasound has been the primary imaging technique used in the assessment of the prostate gland for potential malignancy, it has been secondary to PSA assays and the digital rectal examination as a screening technique because "the cost-benefit ratio is too low to warrant its use," Matthew D. Rifkin, MD, said at the annual meeting of the Radiological Society of North America. New technological refinements of sonographic equipment, however, may allow a bigger role for ultrasound in prostate cancer in the future, said Dr. Rifkin, chair of the Department of Radiology, Albany Medical College, NY.

WASHINGTON--Managed care seems a topic certain to generate bipartisan attention during the 105th Congress, with several bills already introduced and others on the way.

BETHESDA, Md--The NIH Consensus Development Conference was unanimous in its decision not to recommend routine screening mammography for women aged 40 to 49, saying that the evidence to date does not show that any possible benefits outweigh potential risks.

Raising the normal retirement age in the United States to age 70 could save the federal government billions of dollars each year and help shore up the ailing Social Security trust fund over the long term, according to two university researchers.

Scientists are discovering the proteins that control the way human DNA copies itself, a breakthrough that may lead to new treatments for cancer or heart disease.

RARITAN, NJ--Procrit (Epoetin alfa) has received marketing clearance by the FDA for use in reducing the need for allogeneic blood transfusions in anemic patients scheduled to undergo elective noncardiac, nonvascular surgery. Patients should be at high risk for perioperative transfusion with significant, anticipated blood loss. Procrit is not indicated for anemic patients who are willing to donate autologous blood.

Recombinant human interleukin-11 (IL-11 [Neumega]) stimulates platelet production and inhibits inflammation in clinical studies in cancer patients, according to research presented at a symposium held last summer in New York City. The potential

CHICAGO--According to the clinical literature, men with a prostate-specific antigen density (PSAD) level less than 0.15 ng/mL do not need ultrasound-guided biopsy because the PSAD is considered normal or reflects only a benign process.

CHICAGO--Positron emission tomography (PET) has excellent potential as a screening test for spotting axillary lymph node metastases in women with newly diagnosed, early-stage breast cancer, thereby sparing many women from unnecessary lymph node dissection, Lee Adler, MD, of Case Western Reserve University, said at the Radiological Society of North America meeting.

TOLEDO, Ohio-Researchers at the Medical College of Ohio have treated a series of breast-conservation patients with intraoperative electron beam radiation to the tumor bed, in conjunction with a course of 45 to 50 Gy of external beam radiation.