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BETHESDA, Md--A new analysis of data from five large studies of smoking and health, which involved a total of nearly 2.75 million participants, reveals that mortality risks associated with cigarette smoking have surged over the last four decades, particularly for women.

BOSTON--Advances in three fields--imaging, medical physics, and computer technology--have led to the development of a radiation therapy modality that may represent a significant breakthrough in cancer treatment.

COLUMBUS, Ohio--Standardized descriptions of mammographic findings and standardized reporting of final assessments continue to play an important role in improving the predictive value of mammography, Lawrence W. Bassett, MD, said at the Ohio State University James Cancer Hospital and Research Institute's Third Oncology Update.

WASHINGTON--With regional hospital partnerships on the rise, cancer program administrators often find themselves charged with managing multi-institutional programs melded together within a system. Three middle managers who have been through such transformations offered their insider views at the Association of Community Cancer Centers (ACCC) meeting.

PARIS--Low-dose therapy with the differentiation-inducing agent azaciti-dine is transforming the formerly bleak prognosis for preleukemic myelodys-plastic syndrome (MDS), reported James Holland, MD, of Mount Sinai Medical Center, NY, at the Seventh International Congress on Anti-Cancer Treatment.

WASHINGTON--At its first public meeting, the new National Cancer Policy Board (NCPB) heard from a number of groups about the topics they believe should shape its early agenda. Not surprisingly, access to care proved a recurring theme, in one form or another.

NEW YORK--The development of guidelines for the management of psychological distress in cancer patients has lagged far behind that of treatment guidelines for specific cancers, said Jimmie Holland, MD, chair, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center.

MIAMI BEACH, Fla--Few women who undergo voluntary bilateral mastec-tomy as a prophylactic measure have regrets about having the surgery performed, according to a survey of 322 women who had the procedure. Patrick Borgen, MD, chief of the Breast Service at Memorial Sloan-Kettering Cancer Center, presented the data at the 14th Annual International Breast Cancer Conference.

THOUSAND OAKS, Calif--A new formulation of Neupogen (filgrastim or G-CSF) that contains sorbitol instead of mannitol is now available from Amgen.

NEW YORK--Children's fears about needles and their physical pain during medical procedures are not being adequately managed, according to a Gallop telephone survey of 500 children (aged 6 to 14), 1,000 parents of children under 14 (not parents of the children surveyed), and 300 pediatricians.

Mayo Clinic study of patient-physician communication found that patients frequently do not remember what their doctor tells them.

Data presented at the Fourth Conference on Retroviruses and Opportunistic Infections showed that the blood-brain barrier permeability of nevirapine (Viramune) is superior to that of other antiretrovirals in both in vitro and in vivo animal models.

NEW YORK--Researchers are accumulating more evidence that diets rich in tomato products may prevent several types of cancer. Although the chemical components of tomatoes that have anticancer properties remain to be identified, investigators are hopeful that lycopene, a little-known carotenoid responsible for the tomato's red color, will prove an effective tool in cancer prevention.

WASHINGTON--In today's evolving health care system, on-cologists and oncology centers must reach out to primary care physicians as never before. And unaccustomed as oncology is to such marketing efforts, the ways to a primary care practitioner's trust and allegiance provoke more than a little puzzlement within the specialty, according to Sara Sprague, RN, EdD, director of cancer services, Phoenix Memorial Hospital. She summed up the important issues of oncologist/primary care physician relationships at a roundtable discussion during the Association of Community Cancer Centers meeting.

WASHINGTON--A consortium of 11 cancer centers is in the midst of a phase I dose-escalation study of carmus-tine in brain cancer patients, using Guilford Pharmaceutical's Gliadel Wafer as the drug delivery vehicle.

This paper offers a very good overview of a large topic that encompasses a multitude of tumors, each with its own set of controversial issues in terms of diagnosis and management. The authors discuss the various diagnostic and therapeutic options available for these tumors in a general sense, rather than concentrating on the specifics of each pathology. Although this approach certainly provides a satisfactory overview, it does not delineate the many diagnostic and therapeutic dilemmas that may confront the practicing head and neck surgeon. However, given the space limitations for such a paper, a more detailed discussion probably was infeasible.

FRANKLIN, Tenn--National Cancer Survivors Day 1997, the world's largest cancer survivor event, is set for Sunday, June 1. This 10th anniversary Celebration of Life will recognize America's 7.4 million cancer survivors and those who support them.

The Position Statement on the Use of Placebos for Pain Management in Patients with Cancer, developed recently by the Oncology Nursing Society (ONS), has been endorsed by 24 nursing and other healthcare organizations.

BUFFALO, NY--The Medicaid Managed Care Act of 1996 and the pending 1115B waiver in New York State would mandate that all Medicaid recipients be transferred to managed health care plans. (Such transfers are currently voluntary.) In New York State, more than 65% of persons with HIV are either in Medicaid or are Medicaid-pending.

CHICAGO--Cellular tumor bio-markers may be able to identify patients with N1 non-small-cell lung adenocarcin-oma who could achieve better survival and control of metastasis through aggressive adjuvant therapy, Ritsuko Komaki, MD, said at the Radiological Society of North America meeting.

NEW YORK--Good communication about the dying process can reduce fear and promote decision-making, but accurate information about resuscitation and artificial hydration and feeding is often not communicated, Judith C. Ahronheim, MD, said during a teleconference on communication of end-of-life issues organized by Cancer Care, Inc.

A test measuring the status of DNA multiplication in tumor cells (ploidy), along with other known predictors of treatment response, could provide guidance in selecting chemotherapy for infants with neuroblastoma, the most common childhood

PARIS--Detection rates of ductal carcinoma in situ (DCIS) have soared thanks to mammography but, to date, only one randomized trial has attempted to quell the resulting therapeutic turmoil. Now, eight-year follow-up results from that NSABP trial indicate that the advantages of breast irradiation following local excision continue to be maintained over the long term. "All patients benefit from radiation," Bernard Fisher, MD, scientific director of the NSABP, said at the Seventh International Congress on Anti-Cancer Treatment (ICACT). "The most optimal prevention of second ipsilateral breast tumors is free specimen margins and post-lumpectomy radiation."

CHICAGO--Investigators at the John Wayne Cancer Center, Santa Mon-ica, Calif, have discovered a lipid that appears to be unique to multidrug-resistant (MDR) cancers.

The first 15 years of the AIDS pandemic can be summarized simply by the oxymoron "constant change." The syndrome unfailingly has presented new challenges and demanded nearly continual refinement of our patterns of management. In the future, progressively more effective antiretroviral therapy paradoxically may permit infected patients to live longer and fall victim to more HIV-related and HIV-independent malignancies. Swift's review of the role of radiation therapy in the setting of HIV infection therefore provides a useful "snapshot" of current standards and a necessary warning of likely changes to come. Several points warrant emphasis.

Concerns over the rising costs of health care in the United States have recently focused attention on the young discipline of health services research.

Anal carcinomas are an uncommon group of heterogeneous lesions that have represented a therapeutic enigma for many years. The mere rarity of these cancers alone has proven to be a major impediment to the formulation of a standardized

With the introduction of increasingly effective antiretroviral agents for the management of AIDS, the life expectancy of appropriately treated patients will continue to lengthen, as will the length of time during which infected patients may develop malignancies, both HIV-related and non-HIV-related. The management of such patients will require careful consideration of the impact of all oncologic therapy on the immune system's ability to hold the virus at bay. Radiation therapy, with its recognized immunosuppressive effects, plays an important role in the management of the major AIDS-defining neoplasms, Kaposi's sarcoma, primary central nervous system lymphoma, and cervical carcinoma, and is used in approximately 50% of patients with non-HIV-related malignancies at some point in the disease course. The judicious use of radiation therapy and proper integration of aggressive antiretroviral therapy can result in control of malignancies without contributing to the rapid progression of HIV disease. [ONCOLOGY 11(5):683-694, 1997]

BETHESDA, Md--Managed care, more than other types of medical coverage, imposes a "hassle factor" on oncologists and their patients, and restrains patients from participating in clinical trials, a survey by the Association of Community Cancer Centers (ACCC) has found.

Those of us who have been involved in medicine for a number of years can remember a time when physicians were the ones who informed their patients about the latest advances in diagnosis and treatment. In the new electronic age, however, medic