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Most men diagnosed with prostate cancer are more than 65 years of age. Therefore, a discussion of the issues surrounding the diagnosis, prevention, and treatment of prostate cancer in older men is, in many ways, a review of

NEW ORLEANS-"Knots" in DNA may become potential targets of cancer therapeutics, according to an investigator who described these new structures at the 92nd Annual Meeting of the American Association for Cancer Research (AACR abstract 1123).

ST. LOUIS-Three-dimensional (3D) conformal radiation therapy is being widely used for treatment of prostate cancer and has been successful at reducing rectal toxicities. "Conformal radiotherapy has allowed dose escalation with acceptable or even reduced rates of severe morbidity," Jeff M. Michalski, MD, reported. He added, however, that "we have to start paying attention to the low-grade morbidity. Grade 1 and grade 2 toxicity may predict development of severe late complications." Dr. Michalski is assistant professor of radiology, Mallinckrodt Institute of Radiology, Washington University, St. Louis.

ST. LOUIS-Soon to be launched is a trial to determine if amifostine (Ethyol) with concurrent infusion of 5-fluorouracil will permit delivery of higher boost doses of radiation in unresectable or locally recurrent rectal cancer.

ST. CROIX-The discovery that radioprotectants can be used in some settings to protect normal tissues from radiation damage promises to greatly extend the usefulness of regimens that combine systemic chemotherapy and radiation therapy. The First Investigators’ Congress on Radioprotection, held June 7 to 10, 2001 served as a forum to review current progress and discuss new developments in strategies for radioprotection.

ROCHESTER, New York-Interleukin-6 (IL-6) and interleukin 1-alpha (IL-1a) are potentially useful predictors of risk for development of postradiation pneumonitis, according to Yuhchyau Chen, MD, PhD. "Delayed peak of pneumonitis occurs at 6 to 9 months, and we expect that there will be a role for radioprotective agents in this setting," she said. Dr. Chen is assistant professor of radiation oncology, University of Rochester Medical Center, New York.

DURHAM, North Carolina-"We have a positive randomized trial of amifostine (Ethyol), and it represents the first time that a treatment has been approved by the Food and Drug Administration (FDA) that interacts with radiation therapy," David M. Brizel, MD, said.

DETROIT-Intrarectal topical application of amifostine (Ethyol), given as a "mini-enema," is extremely tolerable, produces no systemic toxicity, and may be an alternative to systemic administration for preventing rectal damage in patients undergoing radiotherapy for prostate cancer. Results of a phase I study were reported by Edgar Ben-Josef, MD. He is associate professor in the Department of Radiation Oncology at Wayne State University’s Karmanos Cancer Institute in Detroit.

PHILADELPHIA-In designing trials of potential toxicity modifiers, consideration must be given to endpoint selection and correlation of endpoints, as well as sample size and analysis methods. Important design factors were reviewed by Charles B. Scott, PhD, associate director of quality of life research at the American College of Radiology in Philadelphia.

CHICAGO-Amifostine (Ethyol) has a number of effects on transcription factors and may also mimic antitumor gene therapy by upregulating expression of manganese superoxide dismutase (MnSOD), according to David J. Grdina, MBA, PhD, professor of radiation and cellular oncology at the University of Chicago.

TAMPA, Florida-Standards for reporting toxicity related to radiotherapy are at least 5 years behind those developed for chemotherapy and need to be improved before the field can advance, according to Andy Trotti, MD. "There is a need for a common late effects grading system and a need for reporting standards," Dr. Trotti said. He is program leader and director of clinical trials, Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.

SAN DIEGO-In his keynote address-"A Funny Thing Happened on the Way to Chemotherapy"-Daniel Shapiro, PhD, used his gift for stand-up comedy to relay an important message: Everyday, in ways they don’t even realize, oncology nurses make a huge difference in patients’ lives.

SEATTLE-Unrelieved cancer pain is a serious problem for over a million Americans with cancer. Many studies report factors that alleviate pain, but few report factors that aggravate it.

MAYWOOD, Illinois-A multidisciplinary initiative at Loyola University Medical Center has made significant strides toward achieving a standardized approach to pain management.

WASHINGTON-US cancer and AIDS mortality declined again in 1999, according to a new report from the Centers for Disease Control and Prevention (CDC). The preliminary age-adjusted death rate fell 0.9% for cancer and 3.6% for HIV disease.

WASHINGTON-The Bush Administration has begun a reorganization of the Health Care Financing Administration (HCFA) by changing its name and creating three new centers to administer its activities. The agency is now the Centers for Medicare and Medicaid Services (CMS). The three new centers, according to CMS, "reflect the agency’s major lines of business."

WASHINGTON-Oncology is in transition from its traditional methods of diagnosing and treating cancer to a reliance on molecular changes within cells-and the science behind this paradigm shift will lead to new drugs to attack precancerous conditions as well, several cancer researchers said at a congressional briefing.

PHILADELPHIA-A study presented at the Oncology Nursing Society’s 26th Annual Congress in San Diego underscores the challenge of managing cancer-related fatigue: Fatigue frequently is part of a cluster of interrelated symptoms, such as pain, depression, and poor sleep quality.

SAN DIEGO-Power to shape health care policy and practice was on the minds of thousands of oncology nurses who attended the Oncology Nursing Society’s 26th Annual Congress. Roused by their leaders and a mariachi band marching down the aisle of the Convention Center at the opening session, more than 5,000 nurses from around the world proclaimed in unison, "We will be heard! We will be heard! We will be heard!"

BOSTON-Outpatient infusion units around the country have experienced soaring numbers of patients due to changes in reimbursement as well as increasingly complex cancer treatments. In a move that contributed to this growth, oncologists at the Massachusetts General Hospital (MGH), supported by the literature, began giving 2-hour infusions of pamidronate (Aredia®) for prevention of skeletal complications from several malignancies.

SAN FRANCISCO-Potentially therapeutic concentrations of ZD1839 (Iressa) inhibit phosphorylation in HER2-overexpressing breast tumor cell lines that coexpress HER1, Stacy Moulder, MD, Vanderbilt University Medical Center, said at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO).

TAMPA, Florida-A rehabilitation group program-Energy for Living With Cancer-has the ability to reduce fatigue-related distress and improve quality of life, according to program developer Sandra Holley, PhD, ARNP, a nurse scientist at the James A. Haley Veterans Administration Medical Center, Tampa. Dr. Holley presented her results in a poster session at the Oncology Nursing Society’s 26th Annual Congress.

HOUSTON-Cancer patients receiving aggressive treatment often face difficult decisions. Nurses will often help patients and their families through them-but the nurses may need support themselves, says a nurse who co-authored a study looking at nurse utilization of hospital ethics rounds.

PITTSBURGH-Two recent reports by the Health Resources and Services Administration spotlight a difficult situation in health care today, both for providers and patients. The agency’s 2000 "National Sample Survey of Registered Nurses" found a significant decline in the rate of increase for people entering nursing-from 14.2% between 1992 and 1996, to 4.1% between 1996 and 2000-at a time of greater population growth and aging.

INDIANAPOLIS-Transplant patients may maintain a central line for 6 months to a year. At high risk for infection, they must know how to take care of their line. But when do they learn? Teachable moments can be few and far between, according to Indiana University Hospital nurses who made a video to help solve the problem.

WASHINGTON-The tobacco wars continue in the nation’s capital. The Bush Administration has announced it will seek a settlement of the federal lawsuit against the tobacco industry, initiated during the Clinton Administration to recover profits the industry made through alleged fraudulent practices.

Written by Jimmie C. Holland, MD, and Sheldon Lewis, this book focuses on the "human effects" as opposed to the

AUSTIN, Texas-Although the nursing profession supports patient empowerment and self-determination in health care decision-making, patient requests for assisted dying raise difficult issues. A study reported at the Oncology Nursing Society’s 26th Annual Conference explored the symptom management strategies that some nurses use to either counter or preempt patient requests for help in dying.

WASHINGTON-Colorectal cancer patients with unresectable liver metastases responded better to a regimen of regional and systemic chemotherapy plus cytoreduction than to cytoreduction alone, said David Litvak, MD, of the John Wayne Cancer Institute, Santa Monica, and Century City Hospital, Los Angeles.

SAN DIEGO-Lead aprons, radiation badges, and patient laundry are not the normal concerns of nurses. But as new radioimmunotherapy agents are evaluated and introduced into practice, nurses will need to familiarize themselves with radiation safety precautions, said Patricia A. Kramer, RN, MSN, a San Francisco-based oncology nurse educator and consultant. Patient education and instruction throughout the whole process is key.