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This article is the last in a series focusing on ethical issues in cancer care, prepared by researchers at Northwestern University. The articles highlight selected ethical issues, place the issues in the context of relevant literature, and comment on their significance in oncology practice. These issues are discussed in greater depth in Ethical Issues in Cancer Care (Kluwer, 1999).

FORT LAUDERDALE, Florida-Modifications in the National Comprehensive Cancer Network’s (NCCN) 2001 guideline for small-cell lung cancer (SCLC) include changes in surgical management of SCLC and carcinoid tumors, as well as treatment modifications involving the timing and dose of chest radiotherapy, use of prophylactic cranial irradiation, and additional drugs available for relapsed patients.

NEW YORK-With new tests, it is easy to identify certain gene mutations associated with a predisposition to cancer. But it is more difficult to deal with the social and legal consequences of those tests, a panel of experts said at a briefing organized by the American Society of Clinical Oncology (ASCO) and entitled "The Human Genome and its Implications for Cancer." Kenneth Offit, MD, MPH, discussed a case that he faced at Memorial Sloan-Kettering Cancer Center, where he is chief of the Clinical Genetics Service, Department of Human Genetics.

NEW YORK-Despite considerable progress in the management and treatment of cancer in the overall population, cancer-related mortality among the elderly increased by 20% between 1970 and 1984. Cancer is often undertreated in the elderly, which affects their prognosis, said Roberto Bernabei, MD, of the Universita Cattolica del Sacro Cuore, Rome.

CHARLOTTE, NC-Mobile mammography programs that serve poor and working women in hard-to-reach, rural communities are an endangered species, according to Jean Griswold, founder and CEO of Mobile Health Outreach, Inc., one of the oldest surviving programs in the United States.

PEAPACK, NJ- Pharmacia Oncology has announced the 11 recipients of its first $1 million Ellence Research Fund, aimed at promoting research to advance the use of anthracyclines in various cancer settings. The recipients were chosen by a scientific advisory board composed of leading oncologists. The company has created a second $1 million Ellence Research Fund and is currently accepting research proposals.

BOSTON-Hyperfractionated radiation improved local control and survival rates for advanced pharyngeal and laryngeal cancer patients in a randomized Canadian study presented at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

CHICAGO-With the Internet, specialty radiology departments should be able to provide a virtual link that gives clinicians anywhere in the country or the world the same access to expert image interpretation as their colleagues in major metropolitan areas, said Michael P. Recht, MD, director of the Section of E-Radiology, Cleveland Clinic Foundation. He spoke at the 86th Annual Meeting of the Radiological Society of North America (RSNA).

BETHESDA, Md-An addendum to the National Toxicology Program’s Ninth Report on Carcinogens moves the dioxin TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) from the "reasonably anticipated" to cause human cancers category to the "known to be a human carcinogen" designation. A legal challenge to the change prevented the new designation from being published in the full report last May.

Oncologists who have a financial interest in-or are thinking about investing in-a related business that provides such things as magnetic resonance imaging, computed tomography, or radiology services should pay attention to the final rules from the

CHICAGO-In HIV-positive patients, antiretroviral therapy should be started when CD4+ lymphocyte counts drop below 350 cells/mL3, according to a new study reported at the 8th Conference on Retroviruses and Opportunistic Infections.

WASHINGTON-Only 17 states have committed substantial funds from the tobacco settlement to tobacco prevention and cessation programs, according to a new report released by the American Cancer Society, American Heart Association, Campaign for Tobacco-Free Kids, and American Lung Association.

BOSTON-A Rare Cancer Network study of testicular lymphoma found that relapses are most likely to occur in the central nervous system (CNS), Mahmut Ozsahin, MD, PhD, said at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology.