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SAN FRANCISCO-More than one-third of cancer outpatients report two or more symptoms such as pain, fatigue, nausea, depression, and sleep disturbances. Because severity of individual symptoms and risk of clinical depression both worsen as the number of symptoms increases, these symptom clusters or groupings have important clinical implications, according to Marylin J. Dodd, RN, PhD, professor of nursing at the University of California at San Francisco.

The National Cancer Institute (NCI) announced recently that it is expanding access to its clinical trials to more oncologists around the country. This new policy will allow cancer patients anywhere in the United States to participate more easily in advanced (phase III) treatment trials.

ORLANDO-Allogeneic bone marrow transplant (BMT) significantly reduced relapse rates and increased event-free survival (EFS) rates, but not overall survival, in adults with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission.

SEATTLE-A new HIV-1 vaccine that uses a replication-defective adenovirus vector has proved to be safe, well tolerated, and immunogenic to date in an ongoing phase I trial, according to research presented at the 9th Conference on Retroviruses and Opportunistic Infections (abstract 12). Emilio Emini, PhD, senior vice president of vaccine research at Merck Research Laboratories, presented the results.

Oncology care will be the focus of one of the new Medicare disease management demonstration programs soon to be initiated. Medicare remains convinced that disease management services can provide substantial savings. There is, however, a problem: Fee-for-service Medicare, which includes most recipients, does not allow for disease management, except in one or two instances, such as diabetes self-education. The Medicare+Choice program-comprised mostly of health maintenance organizations-offers disease management, but seniors have, for the most part, avoided this plan. Therefore, Medicare has selected 15 sites for case management and disease management services, which will be offered to Medicare fee-for-service beneficiaries with complex chronic conditions. Quality Oncology, Inc, of McLean, Va, will implement an urban disease management program targeting beneficiaries in Broward County, Fla.

SAN FRANCISCO-Routine use of aspirin provides a modest reduction in the recurrence of large bowel adenomas, according to the results of a randomized, double-blind, placebo-controlled study presented by the Polyp Prevention Study Group. Paradoxically, the group found that an 80 mg daily dose, the equivalent of one baby aspirin, was much more effective in preventing polyps than was the 325 mg daily dose, the amount contained in a typical adult aspirin.

ORLANDO-Giving rituximab (Rituxan) after high-dose chemotherapy/autologous peripheral blood stem cell transplantation for B-cell non-Hodgkin’s lymphoma (NHL) produced better survival and freedom from progression rates than would be expected with a conventional transplant regimen, according to a phase II study reported at the 43rd Annual Meeting of the American Society of Hematology (abstract 3578).

WASHINGTON, DC-Recombinant human erythropoietin is accepted treatment for chemotherapy-related anemia, but a panel of four oncology nurses convened to review an evidence-based clinical practice guideline for anemia concluded that guidelines are not being consistently followed. The panel’s findings were presented by Denise Oseguera, RN, of University of California, Los Angeles, and Susan Ross, MD, of MetaWorks Inc., Medford, Massachusetts.

HOUSTON-Patient satisfaction with patient-controlled analgesia (PCA) rose from 75% to 90% with an education program implemented by Elizabeth Fogarty, RN, and colleagues from the gastrointestinal surgery unit at The University of Texas M. D. Anderson Cancer Center. The patient and staff education program is now being used in nursing practice throughout the entire institution.

BOSTON-Fatigue is a worse problem than pain for most cancer patients but oncologists rarely know this because discussions with patients about symptom distress are typically "don’t ask, don’t tell." Physicians don’t ask, and patients don’t tell, according to Marybeth Singer, MS, RN.

WASHINGTON-InTouch magazine, published by PRR for cancer patients and their family members, has been selected by the US National Library of Medicine (NLM) to be indexed and included in Index Medicus and MEDLINE.

SEATTLE-A new CD-Rom provides a wide range of flexible, thorough and authoritative materials on end-of-life care. Nursing educators can adapt these materials to the needs of their programs and students and fill a serious gap in the curricula of many nursing schools, reported Diana J. Wilkie, PhD, RN, professor and pain management specialist at the University of Washington School of Nursing in Seattle.

BOSTON-Up to 70% of patients undergoing bone marrow transplantation suffer oral mucositis painful enough to require treatment with intravenous opioids. Nurses in the bone marrow transplant unit at Dana-Farber Cancer Institute in Boston became concerned that the lack of practice standards for managing this type of pain was resulting in suboptimal treatment and increasing the risk of adverse events. Barbara Fine, RN, BSN, and Maureen Lynch, MS, RN, developed an evidence-based practice algorithm and an approach to implementing it that was successful in changing established practice, improving outcomes, and increasing staff and patient satisfaction with pain control.

WASHINGTON, DC-A nurse-directed intervention to help chemotherapy patients manage pain and fatigue not only relieved those symptoms but also reduced the number of other symptoms patients suffered, according to Barbara Given, PhD, RN, professor of nursing at Michigan State University in East Lansing. She reported results on behalf of researchers at that institution, as well as at the University of Michigan in Ann Arbor and Yale University in New Haven, Connecticut.

DUARTE, California-Nurses play a crucial role in the quality of patients’ experience at the end of life, but nursing schools have not traditionally provided high-quality training in caring for the dying, according to Rose Virani, RNC, MHA. Now a program funded by the Robert Wood Johnson Foundation aims to upgrade the offerings of the nation’s nursing schools through specialized end-of-life courses for nursing educators.

WASHINGTON, DC-Oncology Nursing Society (ONS) President Paula T. Rieger, RN, MSN, has made "more seats at the table" her model for internal ONS matters, for improving oncology practice, and for giving nurses and patients more voice in health policy. An advanced practice nurse, Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center in Houston, Ms. Rieger discussed these issues in her presidential address to the 27th Annual Congress of the Oncology Nursing Society. With 30,000-members, ONS is the world’s largest professional oncology association.

Wireless tablet-sized computers and user-friendly software may soon be helping investigators collect clinical trials toxicity data. A new handheld prototype with all the capabilities of a standard laptop computer was demonstrated at the LENT IV workshop.

ALEXANDRIA, Virginia-More than 20 national advocacy groups, professional medical societies, and scientific organizations have joined to form the Alliance for Childhood Cancer to support quality cancer care for children and adolescents.

ROCKVILLE, Maryland-The Food and Drug Administration has warned three Internet pharmacies selling nicotine-laced lollipops and lip balms as smoking cessation aids that the products appear to be illegal and ordered them pulled from the marketplace.

ST. PETERSBURG, Florida-As cancer survival increases, outcomes research must focus on both quality of life and length of survival, and must define and quantify late effects of cancer treatment, Noreen Aziz, MD, PhD, MPH, said at the Late Effects of Normal Tissues (LENT) IV workshop on late effects criteria and applications.

SAN FRANCISCO-When combined with TRAIL (TNF-related apoptosis-inducing ligand), resveratrol-an antioxidant and anti-inflammatory flavinoid found in red wine-promotes apoptosis in a variety of cancers, including difficult-to-treat brain cancers, according to a study presented at the 93rd Annual Meeting of the American Association for Cancer Research (abstract 4238).

SAN FRANCISCO-Complete axillary lymph node dissection followed by chemotherapy is standard treatment for larger breast tumors, but it is less frequently performed when the tumor is smaller than 1 cm. Still, approximately 5% to 8% of these small breast tumors are very aggressive. Currently, there is no way to identify which of these small tumors are more likely to metastasize and thus should receive more appropriate treatment.

SAN FRANCISCO-Although tamoxifen (Nolvadex) kills glioma cells in culture, it has not been effective in prolonging survival in patients with recurrent glioma. A study presented at the 93rd Annual Meeting of the American Association for Cancer Research (abstract 2442), however, found that pretreating with propylthiouracil and Lugol’s solution (a solution of potassium iodide and iodine) to induce chemical hypothyroidism prior to high-dose tamoxifen therapy resulted in dramatic increases in survival time in these patients.

WASHINGTON-The Bush Administration has abandoned plans to suspend the Food and Drug Administration’s "pediatric rule," which requires pharmaceutical companies to study the use of drugs in pediatric patients when seeking new drug applications.

PORTLAND,Oregon-Aerobic exercise can sharply reduce the bone-wasting effects of chemotherapy, according to Anna L. Schwartz, PhD, associate professor and research scientist at the Oregon Health and Science University School of Nursing in Portland. Osteoporosis is becoming an increasingly common and troublesome side effect of chemotherapy, particularly in breast cancer, she reported. In addition to the treatment regimens, premature menopause and inactivity all contribute to a decline in bone mineral density (BMD). Aerobic exercise can reduce this decline and help prevent treatment-related weight gain while increasing muscle strength.

NEW YORK-A drug that targets a protein important to two cancer cell pathways will be tested in combination with paclitaxel (Taxol) in phase II clinical trials slated to begin soon at Memorial Sloan-Kettering Cancer Center and the Mayo Clinic, Neal Rosen, MD, PhD, said at a "Meet the Experts" media briefing sponsored by the American Society of Clinical Oncology.

BALTIMORE-Between 65% and 85% of advanced cancer patients suffer pain, but between 85% and 95% of those patients, if properly treated, can experience relief. Providing effective pain management is a multidisciplinary effort requiring detailed planning and persistent implementation by a team committed to using a variety of resources and techniques. These concepts and how they are integrated into the Johns Hopkins approach to pain management were described by Suzanne A. Nesbit, PharmD, BCPS, clinical specialist in pain management in the Department of Pharmacy at Johns Hopkins Hospital in Baltimore and Kathy Smolinski, LCSW-C, senior clinical social worker in the Cancer Pain Service of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.

BETHESDA, Maryland-The understanding of carcinogenesis that has emerged from molecular and genetic studies has provided a new vision of treatment, commonly called molecular targeting. In it, debilitating cytotoxic drugs will give way to agents that target specific proteins that mark specific cancer cells.

InTouch magazine, a sister publication of ONCOLOGY and Oncology News International, has been selected by the National Library of Medicine to be indexed and included in Index Medicus and Medline. InTouch is published by PRR for cancer patients and their families.

NEW YORK-The next decade will bring advances in pain management as a direct result of research currently making its way from bench to bedside, said pain management expert Russell K. Portenoy, MD.