What Managed Care Organizations Look For in a Physician
May 1st 1998ARLINGTON, Va--How do managed care organizations (MCOs) choose the physicians for their lists? The MCO’s ideal physician, as sketched by Melinda Privette, MD, JD, director of medical affairs for Blue Cross/Blue Shield of North Carolina:
Topotecan/Ara-C Promising, Not Standard in MDS
May 1st 1998FORT LAUDERDALE, Fla--The combination of topotecan (Hycamtin) and cytarabine (ara-C) has shown promising results in patients with myelodys-plastic syndrome (MDS), especially those with abnormalities of chromosomes 5 and/or 7 (-5/-7), but the findings for the combination are too preliminary to be included as standard of care in the NCCN’s practice guidelines for MDS.
Court Decision Ignores The Patient’s Right to Privacy in Gene Testing
May 1st 1998NEW ORLEANS--In 1955, a man dies at age 45 of a hereditary type of colon cancer, yet his wife is told he had a bowel obstruction, not cancer. Now, 27 years later, the man’s daughter is your patient and you have diagnosed her with multiple polyposis and colon carcinoma. In constructing the daughter’s medical history, you discover the history of hereditary cancer in the father.
‘Onerous Proposed Stark II Regulations Must Be Changed’
May 1st 1998ARLINGTON, Va--The proposed regulations of Medicare reimbursement have "gone from providing the dollars for care to making the clinical decisions," James L. Wade III, MD, president of the Association of Community Cancer Centers, said at the ACCC’s 24th Annual National Meeting.
Use of Aspirin as a Chemopreventive Strategy Is a ‘Close Call’
May 1st 1998BETHESDA, Md--"Will an aspirin a day keep the oncologist away?" John Baron, MD, PhD, asked at a colon cancer prevention workshop held in conjunction with the American Society of Preventive Oncology (ASPO) annual meeting. "Absolute benefits and absolute risks are small," he said, "which means it’s a close call."
Complex Chemoimmunotherapy Regimens on Horizon
May 1st 1998NEW YORK--Advances in immunotherapy are opening a wide array of potential uses in combination with chemotherapy in advanced cancers. Speaking at the Chemotherapy Foundation XV Symposium, Ezra M. Greenspan, MD, referred to the "mind-boggling" number of variables--optimum timing, dosing, and route of administration, for example--involved in putting together experimental combination regimens.
David E. Fisher Receives 1998 Gertrude B. Elion Cancer Research Award
May 1st 1998David E. Fisher, MD, PhD is the recipient of the sixth Gertrude B. Elion Cancer Research Award, sponsored by the American Association for Cancer Research (AACR). Since 1993, the award has been presented annually to one nontenured
ASCO ‘In Step’ With The March to End Cancer
May 1st 1998WASHINGTON--The American Society of Clinical Oncology (ASCO) has announced its support of "The March . . . Coming Together to Conquer Cancer," which will take place in the nation’s capital, and in dozens of US communities, on Saturday, September 26.
Growth of Hospice Movement Spurs Interest in Pain Care
May 1st 1998SAN DIEGO--With the explosion of the hospice movement, the creation of pain management teams, and the use of pain ladders to guide treatment, "pain management is becoming a trendy area of medicine," said Daniel B. Carr, MD, Saltonstall Professor of Pain Research, New England Medical Center. "We didn’t hear much about treating cancer pain 20 years ago; it was on the fringes."
Hematologists Detect Rare Side Effect of Antiplatelet Agent
May 1st 1998Detecting rare but serious side effects of drugs after they have been approved by the FDA is a difficult task. Postmarketing drug safety relies extensively on clinicians’ voluntary reporting of adverse effects to the FDA’s spontaneous reporting system, known as Med-Watch. The MedWatch program examines adverse effect reports and evaluates the possibility of drug causality. In some cases, the program identifies an adverse effect of a drug that was not reported in clinical trials.
Management of Malignant Tumors of the Salivary Glands
May 1st 1998Results of treatment for patients with salivary gland carcinoma have improved in recent years, most likely due to earlier diagnosis and the use of more effective locoregional therapy. Salivary gland tumors are treated surgically, often in conjunction with postoperative radiation therapy when the tumor is malignant. Good results rest strongly on the performance of an adequate, en bloc initial resection. Radical neck dissection is indicated in patients with obvious cervical metastasis, and limited neck dissection may be appropriate in patients with clinically negative nodes in whom occult nodal involvement is likely. Postoperative radiation therapy should be administered when the tumor is high stage or high grade, the adequacy of the resection is in question, or the tumor has ominous pathologic features. Neutron beam therapy shows promise in controlling locoregional disease but requires further study. No single chemotherapeutic agent or combination regimen has produced consistent results. At present, chemotherapy is clearly indicated only for palliation in symptomatic patients with recurrent and/or unresectable cancers. Patients with salivary gland carcinomas must be followed for long periods, as recurrence may occur a decade or more following therapy. Distant metastasis appears to occur in approximately 20% of patients.[ONCOLOGY 12 (5): 671-683, 1998]
Multidisciplinary Approach to Managing Cancer Distress
April 30th 1998Fort Lauderdale, Fla--Every cancer patient must deal with the psychological issues inherent to all stages of the disease, making the recognition, diagnosis, and treatment of distress critical to total care of the person with cancer, Jimmie Holland, MD, of Memorial Sloan-Kettering Cancer Center, said at the third annual conference of the National Comprehensive Cancer Network (NCCN).
Prevalence of Substance Abuse Disorders in Cancer Patients
April 6th 1998Drug abuse presents a complex set of physical and psychosocial issues that complicate cancer treatment and pain/symptom management. Most oncologists are not be well versed in either the conceptual or practical issues related to addiction.
Research into Neuropathic Pain Yields Potential Therapies
April 1st 1998PHILADELPHIA--An expanding understanding of chronic neuropathic pain has led scientists to promising new treatments. One drug is already approved, as an antiseizure medication, and others may be in use within 3 years, Gary J. Bennett, PhD, said at a special panel held at the American Association for the Advancement of Science (AAAS) meeting.
Vice President Gore Is Featured In Antismoking Radio Spots
April 1st 1998WASHINGTON--The Food and Drug Administration plans a national multimedia education and advertising campaign aimed at reducing illegal sales of tobacco products to children. It will feature public service announcements on the radio by Vice President Al Gore.
Genetically Modified Dendritic Cells Enhance Immune Response
April 1st 1998BUFFALO, NY--Some researchers are beginning to think of cancer as a chronic inflammatory disease, and new research shows that patients with increased numbers of dendritic cells as part of their immune response to their tumor have a better prognosis.
Public Access to ONS Online Cancer Information Service Now Available
April 1st 1998The Oncology Nursing Society (ONS) announced that the organization’s cancer information service, ONS Online (http://www.ons.org), is now available to the public. The launch to the public coincides with the completion of improvements to the service that simplify access to cancer treatment and nursing information. The Oncology Nursing Society initiated the public-access project in response to requests from non-member users.
Proposed Stark II Regulations Spell Trouble for Oncology Care
April 1st 1998MIAMI, Fla--Some of the proposed regulations to implement the Stark II legislation (limiting physician self-referrals) are so bizarre "you don’t know whether to laugh or cry," said Joseph S. Bailes, MD, chairman of ASCO’s clinical practice committee and 1999 president-elect.
Pegylated Liposomal Doxorubicin May Be an Effective Treatment for Kaposi’s Sarcoma
April 1st 1998Single-agent Doxil, a formulation of pegylated liposomal doxorubicin HCl, produces a higher response rate in patients with severe AIDS-related Kaposi’s sarcoma (KS) than does the combination of bleomycin and vincristine (BV), according to a study published in the February issue of the Journal of Clinical Oncology.
Bishop Is Named New Chair of NCAB
April 1st 1998WASHINGTON--President Clinton has appointed J. Michael Bishop, MD, as chair of the 18-member National Cancer Advisory Board (NCAB), which advises the National Cancer Institute director. He replaces Barbara K. Rimer, DrPH, of Duke University, who resigned last fall to head the NCI’s new Division of Cancer Control and Population Science.