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CLEVELAND-Primary care physicians and their patients should make advance care planning part of their routine office visits. This is the message of the Education of Physicians in End-of-Life Care (EPEC) program, developed by the American Medical Association in conjunction with the Robert Wood Johnson Foundation.

WASHINGTON—The federal government has created an internet source that allows access to more than 27 million pages of tobacco industry papers, one that allows full-text searches of these key documents for the first time. The website, http://www.cdc.gov/tobacco, has four parts: citations from 4 million tobacco industry documents; a database for the Minnesota Select Set, which holds about 350,000 pages of documents used by attorneys in the state’s successful suit against the tobacco companies; a similar database containing nearly 7,000 documents from the British American Tobacco Co.;

NEW YORK-Marrow hypoplasia was achieved within 28 days in 14 of 41 patients with refractory leukemia after a first cycle of a new nucleoside analog, troxacitabine, Francis J. Giles, MD, associate professor of medicine, M.D. Anderson Cancer Center, reported at the Chemotherapy Foundation Symposium XVII.

CLEVELAND-While the majority of Americans wish to die in the comfort of their homes, most are actually dying in institutions, often with pain and other symptoms poorly controlled.

CHICAGO-V. Craig Jordan, PhD, has been named Diana, Princess of Wales, Professor of Cancer Research at Northwestern University. Dr. Jordan, a native of the United Kingdom, is professor of cancer pharmacology at Northwestern University Medical School and director of the Lynn Sage Breast Cancer Research program affiliated with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

NEW YORK-A simplified version of the Brief Symptom Inventory (BSI) that can be completed by patients in less than 2 minutes is speeding screening and referral for psychosocial problems at Johns Hopkins University cancer clinics.

The interim results of an ongoing phase II trial of IntraDose (cisplatin [Platinol]/epinephrine) were presented at the 17th Annual Chemotherapy Foundation Symposium in New York City. Of 29 evaluable patients with liver cancer, 12 (41%) responded to treatment. Of the 12 responders, 6 achieved a complete response (100% reduction in viable tumor volume), while the other 6 showed a more than 50% reduction in viable tumor. To date, 10 of the 12 responders remain in remission, while the 2 other patients maintained remissions for 200+ days. Median survival time from the date of diagnosis for all patients has not yet been reached and is currently in excess of 15 months.

WASHINGTON-An Institute of Medicine (IOM) committee has urged instituting a comprehensive strategy to sharply reduce medical errors that result in needless death and injury. According to an IOM report, one study put the annual number of deaths in the United States from medical mistakes at 44,000 and a second study concluded the toll reached 98,000.

SAN FRANCISCO-The Cancer Survival Toolbox is a set of self-learning audiotapes available in English and Spanish, designed for persons with cancer to help them develop skills needed to manage their cancer experience.

ROCKVILLE, Md—Evidence supporting the use of garlic in cancer prevention and the efficacy of preventive behavioral dietary interventions to reduce cancer risk will be assessed in studies ordered by the Agency for Health Care Policy and Research. The agency assigned the studies to two of its Evidence-based Practice Centers—the Research Triangle Institute and the University of North Carolina at Chapel Hill, and the University of Texas Health Sciences Center, San Antonio.

BETHESDA, Md-A new report from the California state government links secondhand smoke to a number of diseases, including lung and nasal-sinus cancers, heart disease, and sudden infant death syndrome (SIDS). The National Cancer Institute has taken the lead in distributing the 430-page document nationwide.

The Institute of Medicine (IOM) committee that released a report on medical errors in December recommended that physicians demonstrate “competence and knowledge of safety practices” through periodic reexamination and relicensing. The report, entitled “To Err is Human: Building a Safer Health System,” was written by a committee chaired by William Richardson, chief executive officer of the W. K. Kellogg Foundation. Most members of the 19-person committee were doctors.

BETHESDA, Md-G.D. Searle & Co. has won FDA approval for its COX-2 inhibitor Celebrex (celecoxib) as an oral adjunct to usual care (endoscopic surveillance and surgery) to reduce the number of adenomatous colorectal polyps in patients with familial adenomatous polyposis (FAP). The FDA initially approved Celebrex for treating osteoarthritis and rheumatoid arthritis in April 1998.

NEW ORLEANS-The use of highly active antiretroviral therapy (HAART) in HIV-infected individuals with lymphoma may make it possible for them to receive high-dose chemotherapy with autologous stem cell transplantation (ASCT), according to a study conducted at City of Hope National Medical Center, Los Angeles.

ATLANTA-Smoking rates among adults in the United States have dropped dramatically over the past 30 years, from 44% in 1965 to 25.5% in 1990, but now the rate seems to have leveled off, the Centers for Disease Control and Prevention (CDC) said in a report.

WASHINGTON-Americans across the political spectrum would prefer that Congress raise the federal excise tax on cigarettes rather than cut funding for existing programs or spend Social Security funds in order to meet federal budget needs, according to a new poll.

NEW YORK-On October 4, Sister Elizabeth Vermaelen, president of the Sisters of Charity of St. Vincent de Paul of New York, welcomed His Eminence John Cardinal O’Connor, New York Mayor Rudolph Giuliani, and more than 200 other guests to celebrate the grand opening and dedication of The Saint Vincents Comprehensive Cancer Center.

The Senate’s only physician, Sen. Bill Frist (R-TN), told FDA Commissioner Jane Henney, MD, that when Congress rewrites the “off-label” drug marketing law, the new version should give physicians more credit for being sophisticated

TOWSON, Md-New breast biopsy techniques are making it more likely that one-stop procedures will become standard of care for small lesions. With this technique, lesions are sampled and removed for biopsy in a minimally invasive procedure, said Rachel Brem, MD, assistant professor of radiology and oncology at the Johns Hopkins Medical Institutions’ Breast Imaging Center.

WASHINGTON-National Cancer Institute director Richard D. Klausner, MD, was among the names immediately mentioned as Washington policy wonks and the biomedical community began speculating about who might replace Harold Varmus, MD, as director of the National Institutes of Health.

BUFFALO, NY-The 1990s have seen a new focus on cancer prevention, particularly chemoprevention. Researchers must use results of basic, clinical, and translational chemoprevention studies to design more effective trials to further this field, Scott M. Lippman, MD, said at the New Horizons in Cancer Prevention Symposium, hosted by Roswell Park Cancer Institute.

HOUSTON--Development of a specialized anesthesiology pain team led to a jump in pain consultations by anesthesiologists and in the number of anesthetic procedures performed for pain control at The University of Texas M.D. Anderson Cancer Center

MADISON, Wis-In attempting to increase availability of opiates for pain, "we are really up against the war on drugs," David E. Joranson, MSSW, said, "because it is the same laws aimed at preventing illicit narcotic trafficking that also control medical availability of opioid analgesics, and some governments may be reluctant to relinquish that control."

MINNEAPOLIS-United-Healthcare, a subsidiary of UnitedHealth Group, has announced that it is further advancing its philosophies on consumer choice and physician autonomy through an initiative called Care Coordination. The new initiative makes obsolete certain programs associated with traditional managed care, such as preauthorization for inpatient hospital procedures.

A three-day interdisciplinary cancer conference will be held March 2 through 4, 2000, at the Best Western Gateway Grand in Gainesville, Florida. The seminar will emphasize the latest advances in radiation therapy techniques and results. It will include refresher courses by senior faculty, panel discussions, and new departmental research results. Visiting Professor will be Professeur Jean-Pierre Gerard, Service de Radiotherapie-Oncologie, Hôpitaux de Lyon, France. Other presentations will be made by clinicians from the Department of Radiation Oncology,University of Florida.

CLEVELAND-Communication between patients and a medical team can be improved with a single, brief workshop, according to a study conducted by the Toronto-Sunnybrook Regional Cancer Centre, University of Toronto.

VANCOUVER, BC-Drug dependence is not physical dependence alone, nor is it the same as drug tolerance. "Drug dependence is primarily psychological dependence, or compulsive use of drugs for their mood-altering effects and continued use despite harm," David E. Joranson, MSSW, said at the WHO workshop on cancer pain.

ATLANTA, Ga-A group of mainly low-income African-American cancer patients had no difficulty completing a multidimensional pain measure, and among the unidimensional measures tested, preferred a faces scale, Deborah B. McGuire, PhD, RN, told Oncology News International at her poster presentation at the 8th World Congress on Pain

BETHESDA, Md-Two components of the National Institutes of Health will spend about $70 million over 5 years to fund Transdisciplinary Tobacco Use Research Centers at seven universities. The first year’s grants from the National Cancer Institute and the National Institute on Drug Abuse (NIDA) will total $14.5 million. In addition, the Robert Wood Johnson Foundation has committed another $14 million over the 5 years.

WASHINGTON-The latest effort to establish whether exposure to radiation during nuclear weapons tests caused leukemia in some military personnel has left the issue largely unresolved. The study by the Institute of Medicine (IOM) found a 14% increase in leukemia deaths among test participants, compared with a control group, but the increase was not significant. The increase was significant, however, for soldiers exposed to land-based testing.