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Many patients misunderstand when their healthcare providers use terms such as “high” or “low” to explain their cancer risks, according to a Mayo Clinic study published in the August 2000 issue of the Journal of Psychosocial Oncology.

The article by Schwartz and colleagues is important and timely, and brings into focus an essential component of the practice of oncology. Posttreatment follow-up is not often emphasized in the training of our residents and fellows, and is often based on

Smoking is the leading cause of preventable disease and death in the United States. The health consequences of smoking impose a substantial economic toll on persons, employers, and society. Smoking accounts for $50 billion to $73 billion in annual medical-care

This phase I study examines the dose escalation of UFT given in combination with fixed doses of oral leucovorin and weekly doses of paclitaxel in patients with metastatic solid tumor malignancies (excluding colorectal cancer). There are two main objectives for this study.

The combination of irinotecan and fluorouracil (5-FU) is synergistic when applied to human colon cancer cell lines in vitro and appears to be schedule-dependent: maximal activity occurs when irinotecan is administered prior to 5-FU. In this phase I study, irinotecan is administered in combination with UFT and leucovorin in patients with advanced solid tumors.

A prospective randomized trial to evaluate the efficacy of maintenance chemotherapy after surgical treatment of head and neck carcinoma was performed at 67 institutions. A comparison was made between the following two groups: the treatment group, which received 1-year oral administration of UFT at 300 mg/d following curative surgical treatment (UFT arm), and the nontreatment group, which received curative surgery alone (control arm).

Treatment with UFT for spontaneous lung metastasis of murine renal carcinoma (RENCA) after resection of the primary tumor has resulted in significant prolongation of the life span of tumor-bearing animals. UFT inhibited the growth of metastatic nodules in the lung, apparently via decreased density of microvessels in the metastatic foci. Subsequent experiments used dorsal air sac assay to directly trace newly forming microvessels.

In a trial of adjuvant chemotherapy with mitomycin and 5-FU followed by oral UFT for T1 and T2 gastric cancer after curative gastrectomy, there was no significant difference in survival between the treated and control (surgery alone) groups (5-year survival rate, 82.9% control vs 85.8% treated). Although not significantly different, 5-year survival for patients with T2 cancer was slightly higher in the treated group than in the control group (76.9% control vs 83.0% treated).

The mechanism of action of fluorouracil (5-FU) and the oral fluoropyrimidines and the importance of biochemical modulation and inhibition of dihydropyrimidine dehydrogenase for oral application of the prodrugs of 5-FU are discussed.

In a step toward a clinical trial, the tumor response and survival of a weekday-on/weekend-off schedule of UFT was compared with its conventional daily schedule in a cancer-bearing rat model. The dose-intensive schedule-600 mg of UFT for 5 days followed by 2 drug-free days-amounts to a weekly dose similar to the conventional schedule of 400 mg/day. The weekday-on/weekend-off schedule provided increased survival and significantly greater antitumor activity than the conventional daily schedule, with no difference in adverse reactions.

Over the past decade, increasing data have emphasized both the importance of dihydropyrimidine dehydrogenase (DPD), the initial, rate-limiting enzyme in the catabolism of fluorouracil (5-FU), and its role as a control step in 5-FU metabolism, regulating the availability of 5-FU for anabolism.

MEMPHIS, Tennessee-At St. Jude Children’s Research Hospital, children as young as 12 months are being treated for brain tumors with 3D conformal radiation therapy, said Thomas E. Merchant, MD, clinical director of the Department of Radiation Oncology.

NEW YORK-Visitors to the Eye Cancer Network (ECN) website (www.eyecancer.com) can access a wealth of information on ocular cancers, including an extensive collection of clinical photographs (see images). The site is well designed, leading visitors logically and quickly to specific information and related links. For example, a visitor seeking information on retinal tumors easily finds the topic in the Eye Conditions index, where it is subdivided into retinoblastoma, retinal pigment epithelial tumors, retinal pigment epithelial hypertrophy, and von Hippel angioma.

BETHESDA, Md-In its first year, the Study of Tamoxifen and Raloxifene (STAR) enrolled 6,139 of the 22,000 postmenopausal women it hopes to recruit. “Six thousand in, 16,000 to go,” the National Cancer Institute (NCI) said in a press release.

HOUSTON-Thrombopoietin-like drugs may be a better bet for moderating the effects of chemotherapy-induced myelosuppression than either granulocyte colony stimulating factor (G-CSF) or granulocyte-macrophage colony stimulating factor (GM-CSF). Ongoing clinical trials with a recombinant human thrombopoietin (rhTPO) were described by Saroj Vadhan-Raj, MD, of Texas M. D. Anderson Cancer Center in Houston, at a clinical investigators’ workshop. That workshop was sponsored by M.D. Anderson and Pharmacia Oncology.

ROCKVILLE, Md-Three new research centers will focus on how market forces affect the quality of health care, access to it, and its cost. The Agency for Healthcare Research and Quality (AHRQ) expects to support the centers with grants totaling $12.5 million over the next 5 years. The three centers are located at Harvard Medical School, University of California, San Francisco, and RAND, Santa Monica, California.

CONCORD, Calif-Siemens Oncology Care Systems Group has unveiled the PRIMATOM System, which combines a CT scanner with a linear accelerator for radiation therapy. The machine is currently in use at the Carol G. Simon Cancer Center at Atlantic Health System’s Morristown Memorial Hospital, New Jersey.

WASHINGTON-Tobacco companies, which were banned from touting their products on billboards last year, have increased their advertising at point-of-sale locations, such as convenience stores, according to a new study funded by the Robert Wood Johnson Foundation.

NEW ORLEANS-The addition of rituximab (Rituxan)-a monoclonal antibody directed against the CD20 antigen-to a fludarabine/cyclophosphamide (FC) regimen for the treatment of chronic lymphocytic leukemia (CLL) led to a surprisingly improved complete remission rate with no increase in toxic effects, Michael J. Keating, MD, said at a poster session at the 36th Annual Meeting of the American Society of Clinical Oncology.

Surviving cancer is a joyous thing in itself. A new awards program will spotlight that joy and share the stories of 12 survivors who are “everyday heroes,” in an effort to help others who are struggling with the disease.

CHARLOTTESVILLE, Virginia-Administering camptothe-cins, such as irinotecan (Camptosar), or giving 5-fluorouracil (5-FU) at the right time of day might reduce toxicity and permit use of significantly higher doses. Tyvin A. Rich, MD, Department of Radiation Oncology at the University of Virginia in Charlottesville, Virginia, discussed this chronotolerance data during a workshop sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology.

ARLINGTON, Va-In addition to his regular family practice, Mark Renneker, MD, plies a second career, helping other physicians’ patients to understand their illnesses and seek out the best possible therapies. He provides intensive, personalized medical research to clients across the country and assistance in making decisions based on that information.

NEW ORLEANS-A modified form of erythropoietin (epoetin alfa, EPO) may allow for less frequent dosing in anemic cancer patients than currently available forms of the drug.

ARLINGTON, Va-Cancer patients often distinguish between curing a disease and healing the illness, between alleviating pain and alleviating suffering, Michael Lerner, PhD, said at the Comprehensive Cancer Care 2000 conference. He defined healing as the inner human potential to become whole.

NEW ORLEANS-Alteplase (Activase), a tissue plasminogen activator (tPA) produced by recombinant DNA, appears to be a safe, feasible, and economically attractive alternative to urokinase (Abbokinase) for clearing occluded central venous access devices (CVADs), a study among cancer patients shows.

WASHINGTON-Fully implementing proven antismoking programs and approaches could slash the smoking rate of teenagers and adults by half in the United States within the decade, according to “Reducing Tobacco Use,” a new report from the US Surgeon General.

HOUSTON-"Cisplatin (Platinol) has served us well, but we need to move on and study combinations with less toxic carboplatin (Paraplatin) or oxalipla-tin in gastric and gastroesophageal junction cancers," Jaffer Ajani, MD, told the clinical investigators’ workshop. Dr. Ajani is Professor of Medicine, Department of Gastrointestinal Oncology, M. D. Anderson Cancer Center in Houston, and also served as program chairman for the workshop. The workshop was sponsored by the University of Texas M. D. Anderson Cancer Center, and supported by an unrestricted educational grant from Pharmacia Oncology.

NASHVILLE-A variety of novel therapeutic mechanisms that utilize our knowledge of cancer biology holds great promise for the future treatment of advanced colorectal cancer (CRCA), Jordan D. Berlin, MD, told a clinical investigators’ workshop. Predicting that these new advances will end the reign of 5-fluorouracil (5-FU) as the only colorectal cancer treatment option, Dr. Berlin declared, ‘‘The era of 5-FU vs 5-FU regimens is over.”

SAN ANTONIO-“Ninety-nine percent of the people you treat are not going to sue you,” Marilyn Frank-Stromborg, EdD, JD, said at the Oncology Nursing Society’s 25th Annual Congress. But for that small percentage of cases where there are going to be problems, you must know how to protect yourself and your institution, she said, and that begins with the practice of “defensive documentation.”

ROCKVILLE, Md-The Food and Drug Administration’s Center for Drug Evaluation and Research (CDER) has opened a new “Oncology Tools” website. It provides specialized information for health professionals, and allows patients and other consumers to access such information as cancer drug labels, approval summations, and Oncologic Drugs Advisory Committee (ODAC) meeting transcripts. The website may be found at http://www.fda.gov/cder/cancer.