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Detecting rare but serious side effects of drugs after they have been approved by the FDA is a difficult task. Postmarketing drug safety relies extensively on clinicians’ voluntary reporting of adverse effects to the FDA’s spontaneous reporting system, known as Med-Watch. The MedWatch program examines adverse effect reports and evaluates the possibility of drug causality. In some cases, the program identifies an adverse effect of a drug that was not reported in clinical trials.

Among the most challenging problems in medicine is the management of patients with simultaneous cancer, pain, and psychological chemical dependency (substance abuse). It has been our experience at the UT

Results of treatment for patients with salivary gland carcinoma have improved in recent years, most likely due to earlier diagnosis and the use of more effective locoregional therapy. Salivary gland tumors are treated surgically, often in conjunction with postoperative radiation therapy when the tumor is malignant. Good results rest strongly on the performance of an adequate, en bloc initial resection. Radical neck dissection is indicated in patients with obvious cervical metastasis, and limited neck dissection may be appropriate in patients with clinically negative nodes in whom occult nodal involvement is likely. Postoperative radiation therapy should be administered when the tumor is high stage or high grade, the adequacy of the resection is in question, or the tumor has ominous pathologic features. Neutron beam therapy shows promise in controlling locoregional disease but requires further study. No single chemotherapeutic agent or combination regimen has produced consistent results. At present, chemotherapy is clearly indicated only for palliation in symptomatic patients with recurrent and/or unresectable cancers. Patients with salivary gland carcinomas must be followed for long periods, as recurrence may occur a decade or more following therapy. Distant metastasis appears to occur in approximately 20% of patients.[ONCOLOGY 12 (5): 671-683, 1998]

The relationship between the therapeutic use of potentially abusable drugs for symptom control and the multifaceted nature of abuse and addiction is extremely complex. Research is only beginning to elucidate the

Low-grade non-Hodgkin’s lymphoma (NHL) is an indolent form of the disease with a generally slow course of progression. Although still usually incurable, low-grade disease has shown responsiveness to some of the newer

This comprehensive, well-written review of small-cell lung cancer by Drs. Clark and Ihde covers nearly all of the important clinical issues. However, a few areas warrant additional comment and discussion.

Fort Lauderdale, Fla--Every cancer patient must deal with the psychological issues inherent to all stages of the disease, making the recognition, diagnosis, and treatment of distress critical to total care of the person with cancer, Jimmie Holland, MD, of Memorial Sloan-Kettering Cancer Center, said at the third annual conference of the National Comprehensive Cancer Network (NCCN).

Drug abuse presents a complex set of physical and psychosocial issues that complicate cancer treatment and pain/symptom management. Most oncologists are not be well versed in either the conceptual or practical issues related to addiction.

PHILADELPHIA--An expanding understanding of chronic neuropathic pain has led scientists to promising new treatments. One drug is already approved, as an antiseizure medication, and others may be in use within 3 years, Gary J. Bennett, PhD, said at a special panel held at the American Association for the Advancement of Science (AAAS) meeting.

WASHINGTON--The Food and Drug Administration plans a national multimedia education and advertising campaign aimed at reducing illegal sales of tobacco products to children. It will feature public service announcements on the radio by Vice President Al Gore.

BUFFALO, NY--Some researchers are beginning to think of cancer as a chronic inflammatory disease, and new research shows that patients with increased numbers of dendritic cells as part of their immune response to their tumor have a better prognosis.

The Oncology Nursing Society (ONS) announced that the organization’s cancer information service, ONS Online (http://www.ons.org), is now available to the public. The launch to the public coincides with the completion of improvements to the service that simplify access to cancer treatment and nursing information. The Oncology Nursing Society initiated the public-access project in response to requests from non-member users.

MIAMI, Fla--Some of the proposed regulations to implement the Stark II legislation (limiting physician self-referrals) are so bizarre "you don’t know whether to laugh or cry," said Joseph S. Bailes, MD, chairman of ASCO’s clinical practice committee and 1999 president-elect.

Single-agent Doxil, a formulation of pegylated liposomal doxorubicin HCl, produces a higher response rate in patients with severe AIDS-related Kaposi’s sarcoma (KS) than does the combination of bleomycin and vincristine (BV), according to a study published in the February issue of the Journal of Clinical Oncology.

Alterations in a gene discovered last year by UT Southwestern Medical Center in Dallas scientists have been linked to breast, ovarian, and uterine cancers, the researchers reported in the February issue of Human Molecular Genetics.

WASHINGTON--President Clinton has appointed J. Michael Bishop, MD, as chair of the 18-member National Cancer Advisory Board (NCAB), which advises the National Cancer Institute director. He replaces Barbara K. Rimer, DrPH, of Duke University, who resigned last fall to head the NCI’s new Division of Cancer Control and Population Science.

WASHINGTON--Major public health groups have agreed to a united stand on the elements they want to see included in any comprehensive tobacco legislation passed by Congress.

MEMPHIS, Tenn--Children with acute lymphoblastic leukemia (ALL) who are in apparent remission but have detectable residual leukemic cells using immunologic techniques are four to nine times more likely to relapse than those with no detectable leukemic cells, says Dario Campana, MD, PhD, of St. Jude Children’s Research Hospital.

Despite theoretical concerns, children born to survivors of childhood cancer are at no greater risk of genetic disease than the general population, according to the largest study of its kind, published in the January issue of the American Journal of Human Genetics.

Congressman John B. Porter (R-IL), an advocate of biomedical research funding, was awarded the 1998 James Ewing Layman’s Award at the 51st Annual Cancer Symposium of the Society of Surgical Oncology (SSO) in San Diego, California. The award is presented annually to a nonphysician who has made a significant contribution to improving the care of cancer patients.

BUFFALO, NY--Six major cancer centers in the tri-state area of Western New York, Western Pennsylvania, and Ohio have joined forces to create a regional consortium to address clinical and scientific issues related to immunotherapy and other biological strategies in the treatment of cancer.

ORLANDO--Last year, more than 80% of eligible patients at Response Oncology were preapproved for autologous stem cell transplant in an average of 28 days. "The skill of case managers has been instrumental to this success,"

Scientists have long proposed that diets high in soy may contribute to the lower incidence of certain cancers in Asian countries. Now, a University of Southern California/Norris Comprehensive Cancer Center study of genistein, an active component of soy products, provides one explanation of how soy could protect cells against cancer.

BUFFALO, NY--Dendritic cells play a critical role in the immune response to cancer and to the human immunodeficiency virus (HIV). Their function is to migrate to sites of inflammation, take up antigen, and present the antigen to T cells to create an immune response. [See related story on page 7.]

PARIS--Although axillary dissection has long been a cornerstone of the surgical management of breast cancer, its role is now the focus of heated debate. Supporters of the procedure claim that it is justified because it provides important prognostic information, guides the choice of systemic therapy, and helps control regional disease. In addition, they say, the morbidity associated with today’s less extensive dissections is considerably lower than in the past.

PHILADELPHIA--Science in the courtroom has drawn increasing attention in recent years, and has generated proposals that justice would be better served if judges relied on their own panels of expert witnesses when they try complicated cases. A group of panelists at the annual meeting of the American Association for the Advancement of Science (AAAS) addressed this idea and the overall status of science and litigation.

NEW YORK--Contrary to the fears of restaurateurs and bar owners, smoking bans may actually be good for business. In a survey from the University of Massachusetts and Boston University, two-thirds of 2,356 adult Massachusetts residents sampled reported that smoking bans in restaurants and bars would not affect their patronage.

WASHINGTON--For the first time since 1973, when the government began tracking cancer rates, epidemiologists have documented a significant drop in overall cancer incidence in the United States. They also found that mortality rates for all cancers combined continued to drop in 1995.

The establishment through legislation of a national tobacco control policy based on a widely publicized negotiated deal between the tobacco industry and some state attorneys-general would be less effective than no federal legislation at all in promoting public heath and reducing smoking, concludes a new analysis.

ORLANDO--A group of San Diego County oncologists, spurred by the rapid advancement of managed care in California, felt they were taking the right step in forming an independent practice association (IPA) known as the Cancer Care Specialist Medical Group (CCSMG). But the group failed to survive. Joel Lamon, MD, a founding member, conducted a postmortem of this IPA at ASCO’s fall educational meeting.