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Thomas Scully, the new administrator of the Health Care Financing Administration, is moving fast to make improvements to Medicare. A proposal to collect and publish quality and outcome information on health-care practitioners who treat

NEW YORK-Eat your fruits and vegetables is generally good advice, but patients undergoing cancer therapy also need to heed the following warning: Wash them thoroughly, to prevent infection, said Stewart Fleishman, MD, director of cancer supportive services, Beth Israel Cancer Center, Continuum Health Partners, New York.

BALTIMORE, Md-Medicare will expedite coverage of pneumatic compression pumps for its beneficiaries with lymphedema. The new policy provides coverage for the pumps after a beneficiary undergoes conservative therapy, including elevation, exercise, and the use of a compression garment for a least 4 weeks without beneficial results. The new coverage eliminates the need for patients to buy a more expensive, custom-made compression garment before becoming eligible for a pump.

SAN FRANCISCO-Two brief questions can help clinicians decide which cancer patients might benefit from treatment with antidepressant drugs.

SAN FRANCISCO-Recombinant human keratinocyte growth factor (rHuKGF) reduces the risk of dose-limiting oral mucositis in patients with advanced colorectal cancer according to Stephen J. Clarke, MD, of Royal Prince Alfred Hospital, Camperdown, Australia. Reviewing results of a randomized, placebo-controlled trial of rHuKGF, Dr. Clarke also called for further study of the growth factor as an adjunct to standard chemotherapy.

SAN FRANCISCO-Glutamine appears useful in preventing taxane-induced neuropathies, according to Linda T. Vahdat, MD, assistant professor of medical oncology at Columbia University’s College of Physicians & Surgeons in New York City. A short course of oral glutamine given after high-dose paclitaxel (Taxol) significantly reduced the severity of peripheral neuropathy compared to prior patients who did not receive glutamine in a pilot study. Glutamine has also been under study for prevention of gastrointestinal toxicities associated with camptothecins.

WASHINGTON-A presidential commission has urged the enactment of a 17-cents-a-pack increase in the federal excise tax on cigarettes to pay for programs to aid tobacco farmers and support smoking cessation and prevention programs. It also recommended that the FDA be given strong regulatory powers over the tobacco industry.

SAN FRANCISCO-Umbilical cord blood from unrelated donors is an excellent source of hematopoietic stem cells for infants with either leukemia or an inherited disorder that can be treated with stem cell transplantation, Joanne Kurtzberg, MD, said at the 42nd Annual Meeting of the American Society of Hematology (ASH).

SAN FRANCISCO-Vowing to go to Congress, if necessary, Lawrence H. Einhorn, MD, president of the American Society of Clinical Oncology (ASCO), called for changes in Medicare documentation rules that he blamed for increasing work hours for physicians and cutting job satisfaction.

BOSTON-Men who have large prostate glands may have slightly more urinary symptoms after brachytherapy than men with smaller prostates, but this should not deter such men from having the treatment, Nelson N. Stone, MD, said at a poster session of the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

WASHINGTON-Under a bill introduced in the House, the National Institute of Environmental Health Sciences (NIEHS) would establish and operate six multidisciplinary research centers to study the effects of environmental factors on women’s health, with specific interest in cancer. Rep. Louise Slaughter (D-NY) is sponsoring the proposed legislation; 43 House members had joined as cosponsors of the bill as of May 15.

WASHINGTON-House members have introduced four bills that would enable taxpayers to support cancer research: One bill would allow a check-off box on income tax forms to provide contributions to a new Breast and Prostate Cancer Research Fund. Two bills would permit taxpayers to designate part or all of their income tax refund to research, either through the National Institutes of Health or the Department of Veterans’ Affairs. The last bill would authorize a matching grants program to encourage states to sell special license plates to provide funds for breast cancer research.

SAN FRANCISCO-Many patients and some physicians do not understand the purpose and fundamental concepts of clinical trials, according to a study of informed consent.

ATLANTA-Eleven persons who serve cancer patients with exceptional compassion received the 2000 Lane W. Adams Award for Excellence in Caring at the American Cancer Society (ACS) Board of Directors meeting.

SAN FRANCISCO-Phase III data show that iseganan, a selectively decontaminating rinse for the oral mucosa, increases by at least 30% the proportion of patients who get through stomatotoxic chemotherapy without developing ulcerative oral mucositis. An error in the randomization system, however, resulted in about one third of the 323 patients being given at least one drug bottle opposite to their randomization assignment and greatly reduced the power of the study, noted Williamson Z. Bradford, MD, PhD. Dr. Bradford is director of clinical science at IntraBiotics Pharmaceuticals Inc., Mountainview, California. IntraBiotics manufactures iseganan and sponsored the trial.

SAN FRANCISCO-The predatory sea snail (conus magnus) compensates for its lack of speed by stunning its prey with a fast-acting neurotoxin. Ziconotide, a synthetic peptide derived from that toxin, proves to have strong analgesic effects in many patients with otherwise intractable cancer pain and may be the vanguard of a new class of pain drugs.

SAN FRANCISCO-The antiangiogenesis drug recombinant human endostatin (rHE) shows evidence of safety, biologic activity, and antitumor activity in the setting of phase I trials, Roy S. Herbst, MD, PhD, said at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO) in San Francisco.

BOSTON-In a letter to the editors of the New England Journal of Medicine, researchers from two cooperative groups call for "vigilant monitoring" of patients receiving the combination of irinotecan (Camptosar), fluorouracil (5-FU), and leucovorin for metastatic colorectal cancer, due to an excess number of deaths observed in patients receiving this combination in two randomized NCI-sponsored trials. They added that specific clinical factors that increase the risk of adverse effects in patients receiving this regimen have not yet been identified.

SAN FRANCISCO-Definitive head and neck radiation produces two treatment morbidities that can affect tolerance and result in treatment breaks. Chronic xerostomia commonly occurs after 50 Gy of radiation and acute, transient mucositis can cause treatment delays that affect the efficacy of the regimen. The Radiation Therapy Oncology Group (RTOG) recently completed a randomized, placebo-controlled trial to see if pilocarpine given concurrently with radiation could prevent those toxicities.

SAN FRANCISCO-Many signaling cascade proteins, such as Ras, that lead to cancerous changes require an isoprenyl moiety attached by farnesyl transferase for activity. Farnesyl transferase inhibitors (FTI) are under study as a possible way to derail cancer progression. Three early studies of one such compound, R115777, show that it has promise against breast, colorectal, and other solid tumors. Janssen Research Foundation of Titusville, New Jersey, sponsored all three studies.

BETHESDA, Maryland-Fatigue among cancer patients "is an important problem, and it’s a legitimate topic for clinical investigation," National Cancer Institute Clinical Director Gregory A. Curt, MD, told Oncology News International, lamenting, " I don’t think it’s high on the radar for the physicians."

WASHINGTON-Disease-free survival improved significantly for patients with resectable colon cancer who received portal vein infusion of fluorouracil (5-FU) after surgery, said Mark S. Roh, MD, of the National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Center, Pittsburgh. Patients did not, however, experience any improvement in their rate of liver metastasis, he added.

SAN FRANCISCO-In a phase II trial of the chimeric monoclonal antibody 131I-chTNT-1/B (Cotara), survival in 22 patients with recurrent glioblastoma multiforme was significantly increased, compared with that of historical controls.

WASHINGTON-Although locating sentinel lymph nodes (SLNs) for biopsy often depends on radioisotope mapping, the node with the highest isotope uptake is not necessarily the one likeliest to contain metastasis, said Robert C. G. Martin, MD, of Memorial Sloan-Kettering Cancer Center.

SAN FRANCISCO-Inhaled fentanyl can relieve the dyspnea that afflicts 70% of cancer patients and improve oxygen saturation in these patients. Patrick J. Coyne, RN, MSN, reported that fentanyl, currently used for breakthrough cancer pain, can be given through usual home health-care services.

SAN FRANCISCO-A high-volume specialist palliative care unit (PCU) set up to improve end-of-life care for patients at Medical College of Virginia hospitals met patient goals for care and generated a profit for the hospital, despite caring for many indigent patients.

SAN FRANCISCO-A trial to compare comprehensive medical management (CMM) to CMM plus intrathecal morphine delivery via an implantable, programmable drug delivery system (IDDS) showed that the pump improved pain control by more than 15% and reduced medication side effects by nearly 50%. "The pump not only improved pain control and quality of life in patients with otherwise intractable cancer-related pain," Thomas J. Smith, MD, one of the study chairmen, told ONI, "but reduced costs associated with medication and side effects so much that by the third month of treatment, intrathecal morphine delivery should become cost-effective compared to the high doses of oral morphine typically used in these patients."

SAN FRANCISCO-An inexpensive over-the-counter veterinary preparation known as Bag Balm can curtail palmar-plantar erythrodysesthesia (hand-foot syndrome) and so eliminate the need to reduce chemotherapy dosages. Nadine Tchen, MD, reported that 8 of 12 patients treated with Bag Balm after developing hand-foot syndrome either had improvement or stabilization of symptoms, and were able to continue chemotherapy without changes in dose or schedule, following treatment with Bag Balm. Dr. Tchen is a clinical fellow in the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada.

SAN FRANCISCO-A new surgical method for reversing facial paralysis in brain tumor patients (see photo) will be reported at the Ninth International Facial Nerve Symposium taking place July 29 to August 1.

BETHESDA, Md-The overall incidence of cancer in the United States dropped an average of 1.1% per year, and the mortality rate also declined an average of 1.1% per year during the period 1992 to 1998, according to an annual report on the status of cancer prepared by four cancer organizations.