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SAN DIEGO-Just as a glacier may advance and retreat simultaneously, managed oncology care appears to be experiencing both integration and disintegration, said James L. Wade III, MD, president of the Association of Community Cancer Centers (ACCC).

With a few clicks of a computer mouse, scientists now can access a free on-line index that will soon show tens of thousands of

BALTIMORE-The $368.5 billion settlement worked out between 40 state attorneys general and the tobacco industry now faces the lengthy congressional process. Congress must enact and the President must sign into law a number of provisions to finalize the agreement.

Presenting the nursing perspective on cancer, Ms. Nora Jodrell, Macmillan Lecturer in Cancer Nursing and President Elect of

SAN DIEGO-Many oncologists attending a session on capitation at the Association of Community Cancer Centers’ 14th National Oncology Economics Conference may have hoped the speaker would reveal the “ideal rate” to charge for capitated oncology care, but, unfortunately, “there is no such thing,” Philip L. Beard told the gathering.

PHILADELPHIA-“Litigation is killing the Pap test. You have to allow patients to sue, but suing because the test is imperfect, we can’t allow,” Richard M. DeMay, MD, told Oncology News International. The solution, he believes, is “some sort of legislation.”

PHILADELPHIA-The American Association for Cancer Research (AACR) is seeking applications for its sixth annual Gertrude B. Elion Cancer Research Award, as well as Research Fellowships for young scientists.

TORONTO-Potent new anti-HIV three-drug “cocktails” are far more likely to fail in the real world of primary care than in carefully controlled clinical trials, researchers reported at the American Society for Microbiology’s 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). However, it appears that such failures are much less likely if patients are started on the three agents concurrently rather than sequentially.

NEW YORK-The North American Brain Tumor Coalition (NABTC) kicked off the first Brain Tumor Awareness Week, October 19 to 25, 1997. The national event is designed to educate the public about the impact of brain tumors, as well as highlight the need for increased research funding.

BETHESDA, Md-A major re-evaluation of the nation’s cancer surveillance system is in the offing. National Cancer Institute director Richard D. Klausner, MD, told the President’s Cancer Panel that he has asked for such a review by NCI staff, working with other relevant agencies such as the National Center for Health Statistics.

ATLANTA-Gazing up at a canopy of red fall foliage or a placid blue lake, the cancer patient is able to relax and momentarily forget the large radiation machine looming over her. She remains still and calm for her radiation treatment, and leaves the facility in good spirits. This is the goal of “visual therapy,” the use of nature photography throughout treatment centers but especially in high-stress areas such as radiation oncology.

HAMBURG-Pathologists may soon be able to obtain expert second opinions on specimens through microscope teleconferencing on the Internet, thanks to an oncologic pathology network now under development by a consortium of European Union pathologists and companies. In addition to allowing long-distance consultations, the EURO-PATH project-European Pathology Assisted by Telematics for Health-will provide pathologists with access to a multimedia European database.

There are many challenges facing those involved in chemotherapy drug development. In addition to identification of new agents, clinical investigators must address questions regarding the optimal methods of administration of established agents so as to maximize efficacy and minimize toxicity. Treatment toxicity affects not only morbidity and mortality but also issues of dose intensity, quality of life, and health-care costs. Therefore, there is great interest in preventing the side effects associated with chemotherapy.

Over the past 10 years, the Radiation Therapy Oncology Group has evaluated, by Phase III trials, the value of using a combination regimen, including androgen suppression (goserelin [Zoladex] and flutamide [Eulexin]) and radiation therapy, in locally advanced prostate cancer. Androgen suppression prior to or during radiation has not been shown to increase overall survival, but it has been shown to increase progression-free survival and freedom from distant metastases. In addition, a subset of men with poorly differentiated tumors who received goserelin following external beam radiation have had a significant overall survival benefit at 5 years’ follow-up. [Oncol News Int 6(Suppl 3):19-20, 1997]

Androgen deprivation has been used prior to radical prostatectomy in an attempt to improve local control of prostate cancer and delay time to cancer progression. Thirty men (mean age of 65) with clinical stage T3 adenocarcinoma of the prostate were entered into a phase II trial at the University of California, San Francisco, examining the effects of neoadjuvant androgen deprivation (luteinizing hormone-releasing agonist and an antiandrogen) before radical prostatectomy. Twenty-six of these patients subsequently underwent radical prostatectomy. Despite impressive physiological changes in prostate and tumor volume, stage reduction was noted in only 4 patients (15%). Overall, with a mean follow-up of 32.7 months, 72% of patients had evidence of disease recurrence, including detectable PSA. Several series suggest that in patients with stage T1 and T2 disease, the likelihood of a positive surgical margin after radical prostatectomy is decreased substantially by neoadjuvant deprivation. The effect on long-term disease-free survival, however, is still unknown. [Oncol News Int 6(Suppl 3):16-17, 1997

CHICAGO-A recurring theme voiced by members of the oncology community throughout a two-day conference on purchasing oncology services was the need for payers to financially support the participation of cancer patients in NCI-sanctioned clinical trials.

PHILADELPHIA-Fine needle aspiration (FNA) for breast cytology has a false-positive incidence “very close to zero,” Nadia Al-Kaisi, MD, said in an interview with Oncology News International. “For the past several years,” she said, “the accuracy has increased because of increased recognition of the cytologic features of the various benign and malignant lesions.”

MELVILLE, NY--Fonar Corporation has received a patent for new technology in the design of MRI machines for breast exams. By using a high throughput scanner, the company said, the machine should be able to achieve the patient volumes necessary to make MRI more affordable, possibly with scans as low as $80 to $150 versus the current $700 to $1,200.

ATLANTA-Is there any value to yet another debate on screening mam-mography for women aged 40 to 49? Maybe so when one of the speakers is a breast cancer survivor whose disease was diagnosed mammographically at age 39. Especially since that speaker-Frances M. Visco, JD-spoke against universal mammographic screening for younger women.

News in Brief...

BETHESDA, Md-The low-fat message isn’t reaching America’s children. A National Cancer Institute analysis finds that, on average, children consume 35% of their calories as fat and that this figures holds across age, sex, ethnic, and income categories.

BETHESDA, Md-Richard D. Klausner, MD, became the 11th director of the National Cancer Institute on Aug. 1, 1995. He took over a troubled organization, one torn by accusations of scientific misconduct against several of its researchers and grantees and the target of two critical evaluations.

SAN FRANCISCO-Most patients with squamous cell carcinoma (SqCC) of the head and neck are elderly, and this group has been well represented in studies of the disease, which generally include few patients under the age of 40, said Peter Lacy, MB, FRCSI, a fellow at the Clinical Outcomes Research Office, Washington University Medical Center (WUMC), St. Louis.