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Those of us who have been involved in medicine for a number of years can remember a time when physicians were the ones who informed their patients about the latest advances in diagnosis and treatment. In the new electronic age, however, medic

BOCA RATON, Fla--Recent data on the topoisomerase I inhibitor irinote-can (Camptosar) are quite encouraging for its use in refractory colorectal cancer, Dr. Leonard Saltz said at the annual meeting of the Network for Oncology Communication and Research.

FORT LAUDERDALE, Fla--The member institutions of the National Comprehensive Cancer Network (NCCN) must adapt to the changing health care system and "help to shape that change in a positive manner for all in cancer care," William T. McGivney, PhD, said in his State of the NCCN address at the network's second annual conference. Dr. McGivney was recently named chief executive officer of the alliance.

SEATTLE--"In every area of government, the most important legacy of the last Congress was the agreement to balance the budget by the year 2002," David Goldston said at the annual meeting of the American Association for the Advancement of Science.

ROCKVILLE, Md--The FDA has given Agouron Pharmaceuticals clearance to market its protease inhibitor Viracept (nelfinavir mesylate), under the accelerated approval process. Viracept was approved in both adult and pediatric formulations, for the treatment of HIV when antiretroviral therapy is warranted.

Neugut and colleagues have compiled a very comprehensive, thoughtful description of the incidence, epidemiology, etiology, clinical presentation, and treatment of small bowel malignancies. This is a very unusual tumor that few clinicians will encounter during their careers, and fewer still will diagnose preoperatively.

NEW YORK--New information about pain pathogenesis is paving the way for future analgesics, Kathryn J. Elliott, MD, said at a conference on chemical dependency and pain management, sponsored by Memorial Sloan-Kettering Cancer Center.

BETHESDA, Md--The President's Cancer Panel, after nearly a year of study, has concluded that managed care overall has adversely affected clinical cancer research, patient access to clinical trials, and physicians who participate in studies.

Roswell Park Cancer Institute is currently recruiting patients for the first phase I study to test a novel method of delivering cisplatin (Platinol) to tumors. The new treatment, called SPI-77, carries cisplatin via a special vehicle called a STEALTH

HMO abuses are the single largest health problem in America today," said New York State's Lieutenant Governor Betsy McCaughy Ross. New York recently became the first state in the nation to ban "drive-through mastectomies," when it

BUFFALO, NY--Researchers at Roswell Park Cancer Institute are recruiting patients for enrollment in 19 different protocols testing unique treatments for HIV-infected individuals. The goal of these protocols is to preserve or enhance the fragile immune system while treating and preventing malignancy.

NOTTINGHAM, UK--Some researchers have hypothesized that tamox-ifen resistance occurs because tumor cells lose estrogen receptors over time. But new data suggest that this is not the case.

BETHESDA, Md--Ending what began as a year's evaluation of scientific evidence and became an emotionally charged public debate, the National Cancer Institute has recommended that women between ages 40 and 49 get a screening mammogram every one or two years.

Ferrell and Hassey Dow summarize research on the domains of quality of life (QOL) most important to the adaptation of survivors, and offer insights about possible interventions to support and promote this adaptation. In addition, they note that the field is poised to make great progress in understanding the concerns and needs of survivors, due, in part, to the establishment of the Office of Cancer Survivorship, an institutional home at the National Cancer Institute (NCI) that will coordinate and promote research on this critical topic.

Small intestinal epithelial cells are remarkably resistant to the development of benign or malignant neoplasms. Why small-bowel adenocarcinomas are so rare compared to colorectal adenocarcinomas is unknown. Thus, the work of Neugut et al is important, as they provide an excellent overview of the current knowledge of this unique tumor, and the problems and limitations encountered in such research.

Thanks to advances in cancer diagnosis and treatment, there are now more than 10 million cancer survivors in the United States. Successful treatment of cancer has resulted in increased demands on survivors and has had diverse effects on the quality of life (QOL) of patients and their families. A model of QOL encompassing dimensions of physical, psychological, social, and spiritual well-being has been applied to illustrate the multidimensional needs of cancer survivors and the necessity of comprehensive care extending over the long term. Data from a recent survey of members of the National Coalition of Cancer Survivorship (NCCS) is presented, along with a summary of issues compiled by the NCCS that merit future attention. [ONCOLOGY 11(4):565-571, 1997]

For the sake of the 7.4 million Americans alive today who have a history of cancer, Ferrell and Hassey Dow's paper is important. Understanding more about the problems and issues faced by these individuals and their families, as well as identifying effective ways to ensure that they experience a high quality of survival, are significant issues for cancer care and research.

Of all the digestive tract tumors, small-bowel cancers are the least common. Why should we study these rare tumors, and what, if anything, can we learn from them? Sometimes the absence of an important event can provide the answer to a difficult problem. For example, consider the famous Sherlock Holmes mystery story, "Silver Blaze," in which the master sleuth solved a challenging case, simply because the watchdog didn't bark when he should have, implying that the murderer was well known to the dog.[1]

Even though the small intestine contains 90% of the gastrointestinal tract mucosa and is located between the stomach and large intestine, two organs with a high cancer incidence, adenocarcinoma of the small intestine is 1/50th as common as adenocarcinoma of the large bowel. In several other respects, small-intestinal adenocarcinoma resembles large bowel adenocarcinoma; eg, it arises from adenomatous polyps, co-occurs in the same individuals, and has a similar pattern of incidence rates by country. Small-intestinal adenocarcinoma is diagnosed prior to surgery in only about 50% of cases and often occurs in conjunction with small bowel obstruction. The mainstay of treatment is surgery; prognosis depends on stage at presentation. Little is known about the use of radiotherapy and chemotherapy in this malignancy, but most physicians utilize therapeutic strategies modeled on the management of large-intestinal adenocarcinoma. Clarification of the reason for the low incidence of small-intestinal adenocarcinoma could lead to new interventions for the prevention of colorectal cancer. [ONCOLOGY 11(4):529-536, 1997]

FORT LAUDERDALE, Fla--The new NCCN practice guidelines on antiemesis in patients receiving chemotherapy are divided into four categories based on the emetogenic potential of the chemotherapy regimen, ie, high, moderate, low, and unlikely, and further divided into primary treatment, breakthrough treatment, and use in subsequent chemotherapy cycles. The guidelines also cover antiemesis for radiation-induced nausea and vomiting.