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National cancer advocacy groups leveled harsh criticism at Senate negotiators from both parties for their failure to include any significant enhancements of beneficiary entitlements in a pending Medicare legislative package. Ellen Stovall, president of the

OTTAWA, Canada-Radiation oncology has always been a resource- and data-intensive discipline, and the increasing use of intensity modulated radiation therapy (IMRT) has made the process of delivering radiation to cancer patients even more complex.

Although the title might be slightly misleading, Oncologic Imaging is actually a compendium of information on the detection, diagnosis, imaging, staging, and treatment of cancer. This is the second edition of a multiauthor book that first appeared in

ORLANDO-Randomized clinical trial data presented at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 1436) show that pain control medications delivered through an implantable intrathecal drug delivery system (IDDS) are significantly more effective than similar drugs given as oral or injectable formulations.

NEW ORLEANS-Fox Chase Cancer Center investigators presented further support for yearly mammograms in women age 40 and older at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO abstract plenary 2).

BERKELEY HEIGHTS, New Jersey-Genta Incorporated has initiated a new clinical trial with its lead anticancer drug Genasense in patients with multiple myeloma. The study will assess the safety and efficacy of Gena-sense in combination with thalidomide (Thalomid) and dexamethasone in patients who have failed standard therapy. The trial will be conducted at the University of Maryland and is sponsored by the NCI pursuant to Genta’s Cooperation Research and Development Agreement (CRADA). Genasense works by inhibiting the production of Bcl-2, a protein made by cancer cells that blocks chemotherapy-induced cell death. Genasense may enhance the effectiveness of current anticancer treatments, Genta said in a news release.

SAN FRANCISCO-An investigational test kit (Apomate) to measure apoptosis may be able to detect a positive or negative response to chemotherapy within just a few days of initiation of treatment, allowing nonresponders to switch quickly to a different treatment.

Women who received radiation therapy for Wilms’ Tumor are at increased risk of complications during pregnancy and, therefore, should be carefully assessed and monitored by their obstetricians. These conclusions were part of a National Wilms’

MILAN, Italy-Giving interleukin-2 (IL-2, aldesleukin, Proleukin) in combination with the anti-CD20 monoclonal antibody rituximab (Rituxan) may increase the antibody’s efficacy in lymphoma patients, apparently because it increases the number of natural killer (NK) cells. Researchers at a Clinical Development Conference sponsored by Chiron Corporation suggested that IL-2 be studied as a regular addition to rituximab therapy and also as an addition to rituxi-mab/chemotherapy regimens.

WASHINGTON-President Bush has nominated Mark B. McClellan, MD, PhD, who has held senior positions in both the Clinton and current Bush Administrations, as Commissioner of the Food and Drug Administration (FDA). If confirmed by the Senate, Dr. McClellan will assume a major health post that has remained vacant since the resignation of Jane E. Henney, MD, in January 2001.

ROCKVILLE, Maryland-The Food and Drug Administration (FDA) will consolidate the review of all new pharmaceutical products in its Center for Drug Evaluation and Research (CDER) by transferring the drug review duties currently handled by the Center for Biologics Evaluation and Research to CDER. Some reviews of biologics had gone to CDER previously, including those intended for use as oncologic drugs.

NIAGARA-ON-THE-LAKE, Ontario, Canada-Female survivors of childhood cancer are generally at increased risk of developing secondary breast cancer years after their initial disease. New research, presented at the 7th International Conference for Long-Term Complications of Treatment of Children and Adolescents for Cancer, hosted by Roswell Park Cancer Institute, is shedding light on this issue and helping practitioners determine how to best screen this population.

WASHINGTON-Tobacco retailers continue to reduce sales to children under age 18, as mandated by federal law. Overall, the national violation rate fell to 16.3% in 2001 from 40.1% in 1996, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

BOSTON-Researchers from the Awareness of Neutropenia in Chemotherapy (ANC) Study Group report that older cancer patients are at greater risk of death due to chemotherapy-related febrile neutropenia. They recommend that the elderly receive prophylactic colony-stimulating factors (CSFs) as adjuncts to CHOP and CHOP-like chemotherapy regimens.

NEW ORLEANS-Treatment with the radioimmunotherapy drug ibritumo-mab tiuxetan (Zevalin) appears to be safe and effective for patients with some of the most common types of non-Hodg-kin’s lymphoma (NHL) who have received prior external beam radiotherapy, Roger M. Macklis, MD, said at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO abstract 240).

WASHINGTON-For patients undergoing bone marrow transplant (BMT), viral respiratory infections can prove fatal. Viral respiratory infection was a contributing factor in two patient deaths during a 17-case viral respiratory outbreak among the staff, patients, and family members of a BMT unit, said Leslie D. Wehrlen, RN, BSN, OCN, clinical research nurse, Clinical Cancer Nursing Department, National Institutes of Health (NIH).

Cancer-related thrombocytopenia is a clinical problem. Unfortunately, the qualitative nature and quantitative extent of the problem has been poorly defined to date. Without knowing these two parameters, the risk/benefit ratio of any management option for cancer-related thrombocytopenia is impossible to calculate accurately. Drs. Goodnough and DiPersio have done an excellent job of delineating many of the potential risks of managing the problems associated with platelet transfusions.

Drs. Goodnough and DiPersio present an authoritative and informative discussion of the management of thrombocytopenia in the cancer patient, emphasizing the risks of platelet transfusions, the safety of a platelet count threshold of < 10,000/µL for prophylactic transfusions, and issues related to the optimal type of platelet product and dose of platelets. The authors make the important point that although the risk of transmission of viral infections has decreased markedly due to the addition of nucleic acid testing for hepatitis C and human immunodeficiency virus (HIV),[1] sepsis due to bacterial contamination remains a serious risk, particularly for the neutropenic patient.[2] The fever and chills that occur within 6 hours after a platelet transfusion usually are associated with nonhemolytic febrile transfusion reactions, but the more dangerous possibility of bacterial sepsis from contamination should be considered, particularly in the neutropenic patient, and treated empirically until bacterial cultures prove otherwise.

Dr. Nemunaitis gives a scholarly and informative historical review of antineoplastic viral therapy using recombinant DNA biotechnologies. The field predates the polymerase chain reaction and restriction enzymes; it has its roots in observations by Jenner and experiments that are over 100 years old.

Approximately 30 years passed between the first description of a paraneoplastic neurologic disorder[1] and the demonstration of an immunologic pathogenesis for one of these syndromes.[2] In the almost 4 decades since, the paraneoplastic neurologic disorders have been subjected to study far out of proportion to their clinical prevalence. These disorders stimulate clinical research because (1) paraneoplastic neurologic syndromes are frequently the presentation of a malignancy, (2) they may bode well for a more favorable tumor prognosis,[3,4] and most importantly, (3) they yield insight into the workings of malignancy and the pathogenesis of neurologic disorders, particularly neurologic degenerations.

William Pirl and Jeffrey Mello present an informative overview of the psychological impact of prostate cancer. They also provide a practical framework for distress management, as promulgated by the National Comprehensive Cancer Network (NCCN).

During the HIV epidemic in the 1980s, more than half of the hemophiliac patients living in many countries, including the United States, France, Denmark, and Japan, became infected with HIV as a result of blood transfusions with contaminated blood or blood products.[1,2] Since the clotting factor needed to treat hemophiliacs was manufactured by pooling plasma from thousands of donors, even one HIV-infected donor could contaminate the entire supply, infecting hundreds.

The authors challenge the notion that men with prostate cancer exhibit little psychological difficulty. In fact, we do not know much about actual distress rates in men with prostate cancer because few studies have directly measured distress in this population. Likewise, we do not know if the distress experienced by prostate cancer patients is qualitatively different from that of other cancer patients. By assuming that all men with prostate cancer "do well," we, as clinicians and researchers, may fail to ask patients important questions.

Drs. Goodnough and DiPersio should be commended for contributing such a well-written, well-referenced, objective, and authoritative review of issues in the management of cancer-related thrombocytopenia. Their article focuses primarily on platelet transfusion risks, rational transfusion thresholds, and potential novel pharmaceutical triumphs. The general lack of large-scale, definitive clinical trials in this field is appreciated and emphasized throughout. Much to my disappointment, the authors seem to have passed on the opportunity to provide the oncology community with any form of evidence-based (or evidence-lacking, as the case may be) and practical guideline for the treatment of thrombocytopenia.

Over the past decade, interest has been growing in the quality of life of men with prostate cancer. Traditionally considered a group with few psychological complications, 10% to 20% of men with prostate cancer are found to have clinically significant levels of psychological distress. This article reviews the prevalence of psychiatric symptomatology among prostate cancer patients, the psychological challenges of coping with the disease, and general guidelines for treatment. [ONCOLOGY 16:1448-1467, 2002]

The use of live viruses for the treatment of cancer has been extensively studied in several preclinical and clinical models, as discussed in Nemunaitis’ thorough historical review of the subject.

Pirl and Mello carefully review the current state of knowledge about the psychological complications of prostate cancer. Their discussion is worth reading, particularly by those who treat patients with the disease. To put this knowledge in context for the general reader, we should give some thought to what this review illustrates about all patients with a serious life-threatening illness.

LOS ANGELES-A retrospective study indicates that 18F-fluorodeoxyglu-cose (FDG)-PET may be a good tool for predicting osteosarcoma patients’ response to chemotherapy, said Christiane Franzius, MD, and colleagues from the Department of Nuclear Medicine, University of Munster, Germany.

WASHINGTON-The human body has strong immune defenses against cells of foreign species. For example, cells that produce a sugar known as galactose-alpha(1,3)galactose, found in many mammalian species but not in humans, trigger a hyperacute response in humans that destroys the great majority of the interloper cells. Cancer cells, however, which also contain many molecules not found in normal cells, nonetheless often elude the immune system’s defenses.

BETHESDA, Maryland-Calling his initial months as director of the National Cancer Institute (NCI) "absolutely exhilarating," Andrew C. von Eschen-bach, MD, described three interrelated themes that will guide his leadership of the Institute. The three, he said at a meeting of the National Cancer Advisory Board (NCAB), are patient centricity, a more active leadership by NCI in the National Cancer Program, and collaborations and partnerships beyond the Institute’s usual sphere of activities.