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WASHINGTON-Most Americans worry about developing cancer and being overweight, but few of them recognize that excessive pounds are a risk factor for some common cancers, according to a new survey commissioned by the American Institute for Cancer Research (AICR). Of those polled, 61% said they were either very or somewhat concerned about receiving a diagnosis of cancer. Yet when asked to name major risk factors for cancer other than smoking, only 6% listed overweight or obesity.

Steven Grunberg, one of the pioneer clinical investigators in the development of modern antiemetics, describes various approaches to the management of this important complication of cytotoxic chemotherapy. Dr. Grunberg describes the use of phenothiazines and antidopaminergic agents as antiemetics, the discovery that steroids could serve as effective adjuvant antiemetic agents, and the development of the serotonin (5-HT3)-receptor antagonists. Thus, we have compazine, metoclopromide, decadron, and a set of 5-HT3 antagonists-ondansetron (Zofran), dolasetron (Anzemet), and granisetron (Kytril)-in our therapeutic armamentarium.

A new partnership between the National Institutes of Health and five major drug companies will provide a total of $6 million to several cancer centers to find ways to increase accrual to early clinical trials. The five pharmaceutical firms involved in the

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.

BARCELONA, Spain-A new anti-HIV agent from Roche and Trimeris, Inc has a unique mode of action that suggests it will be active in HIV infections that have developed resistance to other antiretroviral agents and can be combined with other agents without substantially increasing toxicity.

EVANSTON, Illinois-Patients with low literacy have often been excluded from assessments of self-reported health outcomes, but that may change thanks to a new multimedia tool called the Talking Touchscreen.

ORLANDO-The routine use of ductal lavage in a high-risk breast surgical oncology practice will identify many patients who may benefit substantially from chemoprevention with tamoxifen (Nolvadex), and may detect rare contralateral breast cancers missed by traditional methods, according to a report at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 193).

NIAGARA-ON-THE-LAKE, On-tario, Canada-With the increasing success in the treatment of childhood leukemia and other cancers, possible long-term problems need to be addressed, said Sue Kaste, DO, St. Jude Children’s Research Hospital.

ORLANDO-Uncircumcised men are at increased risk of HIV infection. A new study presented at the 100th Annual Meeting of the American Urological Association (abstract 111) suggests that this is due to high numbers of HIV target cells in the foreskin. Carlos R. Estrada, MD, of Rush-Presbyterian-St. Luke’s Medical Center, Chicago, and his colleagues evaluated 8 pediatric and 6 adult foreskins with and without a history of HIV-1 infection. Cervical biopsy tissue served as a control.

WASHINGTON-The next 2 decades will see an increasing shortage of nurses if current trends continue, according to a report by the Health Resources and Services Administration. The report points to a worsening shortfall as nurses retire and too few new people enter the field. In the year 2000, there were an estimated 1.89 million registered nurses in the United States, while the demand for nurses was 2 million, a gap of 6%.

ROCKVILLE, Maryland-The US Food and Drug Administration has announced a major new initiative to revise its regulations governing pharmaceutical manufacturing and product quality. Focused on the agency’s current Good Manufacturing Practice (cGMP) program, the new effort seeks to improve public health promotion and protection. It will apply to veterinary and human drugs, including vaccines and other human biological drug products.

NIAGARA-ON-THE-LAKE, Ontario, Canada-Survivors of childhood brain tumors appear to have a high risk for non-neurological late effects such as endocrine disorders, according to a report (abstract 7) presented at the 7th International Conference for Long-Term Complications of Treatment of Children and Adolescents for Cancer, hosted by Roswell Park Cancer Institute.

ORLANDO-A promising approach in vector vaccine development is the use of a combination of vaccination strategies that enhance T-cell responses for specific tumor-associated antigens, said Jeffrey Schlom, PhD, chief of the Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institutes, Bethesda, Maryland.

WASHINGTON-The imaging methods presently used to detect, diagnose, and stage breast tumors have significant flaws, as shown by the roughly 75% of breast biopsies that return normal results. These "completely unnecessary" procedures impose "huge costs" and "unnecessary trauma," said Craig S. Levin, PhD, assistant professor of radiology, University of California, San Diego, and the Department of Nuclear Medicine, San Diego VA Medical Center.

ORLANDO-Treatment of unre-sectable hepatocellular carcinoma (HCC) with 90-yttrium-embedded glass micro-spheres (TheraSphere, MDS Nordion) appears to be safe, effective, and less toxic than the alternative, transarterial che-moembolization (TACE).

In his article, Dr. Grunberg charts the history of our understanding of chemotherapy-induced nausea and vomiting, and the discovery and development of drugs for its prevention. He places appropriate emphasis on the serotonin (5-HT3) antagonists-notably, ondansetron, granisetron, and dolasetron-which have revolutionized the field over the past decade.

Quon and Harrison have performed a considerable service to patients with head and neck cancers by reminding the oncology community that a state-of-the-art treatment team must include state-of-the-art brachytherapy

Soft tissue sarcomas in adults are rare malignancies with diverse histologies that have historically been classified together, mostly for convenience. In truth,

Studies on human erythropoietin (EPO) demonstrated that there is a direct relationship between the sialic acid-containing carbohydrate content of the molecule and its serum half-life and in vivo biological activity, but an

Nausea and vomiting are the toxicities of chemotherapy most feared by the cancer patient. However, increased understanding of the mechanisms of nausea and vomiting has led to greatly improved control of this toxicity.

Drs. Quon and Harrison have written an excellent review on the role of brachytherapy in the management of head and neck cancer. Brachytherapy is a time-honored technique, and the authors have carefully reviewed the pertinent literature extolling its virtues. However, there are many papers that fail to document efficacy of brachytherapy over conventional techniques, demonstrating that, similar to surgery, the technique is both patient- and operator-dependent.

Brachytherapy is a therapeutic modality that may provide a significant improvement in the therapeutic ratio when appropriately applied, and hence, is an appealing treatment strategy for the head and neck. For several

Malignant small bowel tumors are extremely rare, accounting for 0.1% to 0.3% of all malignancies. Fewer than 2,400 new cases of small bowel malignancy are reported in the United States each year.[1] Malignant tumors, which account for about two-thirds of all primary small bowel tumors, consist of four primary subtypes: adenocarcinoma, carcinoid tumor, lymphoma, and sarcoma (or gastrointestinal [GI] stromal tumor). Each malignancy is characterized by unique predisposing factors, anatomy, and biology. The prevalence, pattern, and relevance of both regional lymph node and distant metastases differ. As a result, the study of malignant small bowel tumors, taken as an aggregate, is fraught with difficulty.

BOSTON-The elderly may suffer more from the side effects of chemotherapy, but toxicity should not necessarily prevent them from receiving life-saving or palliative treatment, according to two speakers at the 14th international meeting of the Multinational Association for Supportive Care in Cancer (MASCC) and International Association for Oral Oncology.

WASHINGTON-A National Cancer Institute (NCI) summary of the link between diet and health among African-American men shows the impact of their eating habits and how increased consumption of fruits and vegetables can reduce the risk of many diseases, including some cancers.

ORLANDO-"Vaccines based on characterized tumor antigens have the advantage of potential tumor specificity from the start," Ronald Levy, MD, chief, Division of Oncology, Stanford University School of Medicine, said at an ASCO satellite symposium on cancer vaccines. Development of such vaccines requires definition and isolation of a specific target, and production of the purified target antigen, he said.

Edited by John Mendolsohn, MD, Peter M. Howley, MD, Mark A. Israel, MD, and Lance A. Liotta, MD, PhD, The Molecular Basis of Cancer is designed for students, researchers, and physicians in a variety of disciplines. It does not provide a detailed description of the clinical manifestations of human neoplasia. There is, instead, an extensive presentation of the scientific basis of cancer development and therapy. The book includes the contributions of 61 authors, virtually all of whom are recognized experts in their respective fields, from throughout the United States and Europe. The references are comprehensive and relatively current, given the lag time in going to press. The book will certainly benefit both basic scientists and clinicians alike.

On the following pages are examples of commonly used scales for evaluating quality of life and symptoms associated with anemia in patients with cancer. Please note that some of the scales are copyrighted (and marked as such herein) and may not be reproduced in anyway without the express written consent of the copyright holders.

The anemia of chronic disease traditionally is defined as a hypoproliferative anemia of no apparent cause that occurs in association with an inflammatory, infectious, or neoplastic disorder, and resolves when the underlying disorder is corrected. Disordered iron metabolism as manifested by a low serum iron, decreased serum transferrin, decreased transferrin saturation, increased serum ferritin, increased reticuloendothelial iron stores, increased erythrocyte-free protoporphyrin, and reduced iron absorption, is a characteristic feature of the anemia of chronic disease and has been thought to be a major factor contributing to the syndrome.

In its hormonal role, erythropoietin is produced by the kidney in response to hypoxic stress and signals the bone marrow to increase the number of circulating erythrocytes. It has become clear in recent years, however, that erythropoietin and its receptor are members of a cytokine superfamily that mediates diverse functions in nonhematopoietic tissues. Nonhormonal erythropoietin actions include a critical role in the development, maintenance, protection, and repair of the central nervous system (CNS).