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Dr. Hoffman and colleagues have persisted in their efforts to provide a safe, reliable pelvic prosthesis to protect the small bowel during high-dose radiation therapy. I started using this type of plastic device in the early 1980s as part of the management of advanced primary and recurrent rectal cancer.[1,2] Similar to data reported by Drs. Hoffman, Sigurdson, and Eisenberg in this issue, my colleagues and I at the National Cancer Institute also noted a learning curve that accompanied our experience. We reported our experience with two iliac artery fistulas that occurred after extensive radiation therapy, possibly due to the prosthesis.[3] Sepsis within the irradiated field and surrounding the prosthesis led to a prosthesis-related death in one patient. A second patient who had multiple postoperative complications died of a pulmonary embolus.

Dr. Hicks and his associates have written an excellent article that summarizes current knowledge about the biologic behavior of differentiated carcinoma of the thyroid gland and explores current controversies related to its management. Their review is reasonably complete, citing most of the important recent references on the subject. Regarding treatment con- troversies, the authors discuss the differing philosophies of various investigators and place into perspective the data supporting these opposing viewpoints.

The article by Hoffman, Sigurdson, and Eisenberg updates their experience in the use of temporary saline-filled tissue expanders (TEs) for small bowel exclusion. In their initial prospective study of 34 patients with a median time of patient surveillance after TE placement of 18 months, the authors demonstrated that small bowel was displaced from more than 95% of the radiation therapy treatment volume in 70% of 27 evaluable patients and from more than 75% of the treatment volume in 89% of patients.[1]

A pilot study conducted at the National Cancer Institute in Milan, Italy assessed the efficacy of six or eight cycles of paclitaxel (Taxol) 200 mg/m² q3wks plus doxorubicin (Adriamycin) (60 mg/m² q3wks) in 49 women with

BETHESDA, Md-National Cancer Institute officials have pledged to quickly correct deficiencies found in the infrastructure of its intramural clinical research program. A committee formed to evaluate the operations of NCI’s Division of Clinical Sciences (DCS) found that the NCI “had made progress in recent months [in correcting problems with the infrastructure] but still must implement several organizational changes to fully match the quality of the best research centers in the country.”

ASH-Rituximab (Rituxan), a chimeric anti-CD20 monoclonal antibody, recently received FDA approval for use in patients with relapsed or refractory follicular or low-grade, CD20-positive, B-cell non-Hodgkin’s lymphomas . Poster presentations at the annual meeting of the American Society of Hematology in San Diego suggest that:

The Sidney Kimmel Foundation for Cancer Research is seeking accomplished young investigators to apply for Kimmel Scholar Awards. The Kimmel Scholar Award, established in 1997, will be presented every year to up to 10 investigators who

NORWALK, Conn-A new team-based program instituted by Oxford Health Plans, Inc. is returning clinical autonomy to the specialists delivering care. Oxford has recently formed a subsidiary company-Oxford Specialty Management-through which integrated medical teams will deliver specialized patient care. To date, these teams have been established in 10 medical specialties, and more than 700 specialists have joined the program.

HOUSTON-For 24 years, young cancer patients at The University of Texas M.D. Anderson Cancer Center have celebrated the holiday season through their original creations of greeting cards and other gift items . Proceeds from 1996 sales totaled $891,000, which funds programs that benefit M.D. Anderson patients.

A second study shows that lycopene from tomato paste is better absorbed by the body than lycopene from fresh tomatoes, suggesting that processed tomato products-such as tomato paste, tomato sauce and ketchup-are a better source of this antioxidant.

BETHESDA, Md-The National Cancer Institute’s Office of Cancer Survivorship (OCS) has allocated $4 million ($2 million a year for 2 years) for the study of cancer survivorship issues in cancer-free individuals who have survived their disease at least 5 years. An additional $350,000 annually for 2 years from the Susan G. Komen Breast Cancer Foundation and its Baltimore affiliate will help fund the research.

CHICAGO-Laparoscopic colec-tomy increasingly is being performed for colorectal cancer, and, despite concerns about wound tumor implantation, it may be only a matter of time before this type of minimally invasive surgery is shown to be equivalent to open surgical resection, said Heidi Nelson, MD, associate professor of surgery, Mayo Clinic, at the annual scientific meeting of the American College of Surgeons.

NEW ORLEANS-It may be easier to develop a bone marrow transplant protocol than to design a perfect reimbursement system for these services under managed care.

NEW ORLEANS-In the treatment of cancer pain, physicians often withhold adequate analgesia out of fears that are largely unfounded in this population. As a result, cancer pain often robs patients of the opportunity “to see life as good” in their final days, Dr. Daniel Brookoff said at a cancer update, sponsored by the Ochsner Medical Foundation and the American Cancer Society.

SANTA MONICA, Calif-It can be especially difficult for physicians and managed care organizations to defend against patient lawsuits that include legal causes of action other than medical malpractice or negligence, said Michael Gonzalez, Esq, a defense attorney and partner in the Los Angeles firm of Kern, Streeter & Gonzalez.

1998-1999 Research Fellowship in Basic Research: This Fellowship, sponsored by the AACR, will provide a 2-year grant of $30,000 per year to a young scientist in North, Central, or South America engaged in meritorious basic cancer research.

NEW YORK-Two breast cancer survivors-one an oncologist from Albert Einstein College of Medicine, the other, the head of the National Alliance of Breast Cancer Organizations (NABCO)-were among those offering special perspectives at a public meeting on clinical and public policy issues related to breast cancer, sponsored by NABCO and held at Memorial Sloan-Kettering Cancer Center.

HAYWARD, Calif-Aradigm Corporation is working with SmithKline Beecham to develop a self-administered pulmonary drug delivery system to provide rapid pain relief. The new product is being developed for the treatment of cancer-related pain, especially breakthrough pain, as well as postoperative pain.

NEW ORLEANS-Although a good examination for oral cancer takes less than a minute to perform, most physicians do inadequate exams or fail to screen for oral cancer at all, according to the professor and head of oral pathology at Louisiana State University School of Medicine, New Orleans.

ORLANDO-Permanent trans-peritoneal ultrasound-guided radioactive implants (brachytherapy) get high marks for quality of life (QOL) in men with clinically localized prostate cancer, V. Elayne Arterbery, MD, reported in a poster session at the annual meeting of the American Society of Therapeutic Radiology and Oncology (ASTRO).

"There is both good and bad news about cancer in Europe,” said Dr. Peter Boyle of the European Institute of Oncology, Milan, Italy, at the 1997 European Cancer Conference. “One welcome development is the large decrease in the incidence of

BETHESDA, Md-As life after a cancer diagnosis grows longer for more patients, how these survivors live with their disease grows more important. Now, the National Cancer Institute’s Office of Cancer Communications has issued The Cancer Journey: Issues for Survivors, a training program for all health care professionals, including nurses, doctors, social workers, and therapists, to help them understand issues cancer survivors face.

NEW ORLEANS-Improved treatment of cancer has not come without a price, including pulmonary complications directly related to radiation therapy, chemotherapy, and surgery. These were described in a symposium at the American College of Chest Physicians annual meeting.

CHICAGO-Hepatic artery infusion of fluorodeoxyuridine (floxuridine or FUDR) theoretically should benefit colorectal cancer patients with metastases in the liver because it delivers chemotherapy directly into the tumors. This not only raises intratumoral drug levels but also prolongs the duration of exposure of the tumors to chemotherapy without increasing toxicity.

NEW ORLEANS-There have been mountains of evidence from laboratory and epidemiologic studies about cancer prevention through nutrition, but only a “molehill” of intervention trials that will move the cancer prevention field forward, Dr. Daniel W. Nixon, president of the Society for Nutritional Oncology Adjuvant Therapy (NOAT), said at the 4th International Symposium on Nutrition and Cancer, jointly sponsored with the Cancer Treatment Research Foundation.

SANTA MONICA, Calif-The managed care system of delivering medical benefits has not only altered the way physicians provide care but also drastically changed the landscape in health care law, said Mark O. Hiepler, Esq, a plaintiff attorney and partner in the firm of Hiepler & Hiepler, Oxnard, California.

PHOENIX, Ariz-A woman with an indeterminate mammogram is often told to “wait and see what develops,” and to schedule another mammogram in 3 to 6 months. The radiodiagnostic test Miraluma (Kit for the Preparation of Technetium Tc99m Sestamibi) offers a noninvasive second step to women who might otherwise have to “wait and see,” Hirsch Handmaker, MD, said in an interview.

NEW ORLEANS-Heavy drinking can lead to cancer of the head, neck, esophagus, and liver, but whether moderate alcohol consumption increases risk at these sites is still unclear, said Matthew P. Longnecker, MD, of the National Institute of Environmental Health Sci-ences, Research Triangle Park, NC.

RESEARCH TRIANGLE PARK, North Carolina-Saccharin just missed winning a reprieve. By a 4-to-3 vote, an advisory panel recommended that the federal government continue to list the artificial sweetener as “reasonably anticipated to be a human carcinogen.”

TORONTO-Neutropenic cancer patients are often given quinolones in an attempt to ward off infection, but a recent metaanalysis suggests that little is gained from prophylaxis. Furthermore, development of quinolone resistance in such patients may deprive clinicians of an effective oral therapy that could be used as outpatient treatment in patients who do develop infections.