Several trials have shown that anthracyclines and taxanes can be combined to achieve response rates ranging from 70% to 90%, with complete responses ranging from 19% to 41%. In an attempt to increase the activity while
Recently initiated is a phase III randomized trial (MA.21 trial) of adjuvant chemotherapy for node-positive and high-risk node-negative, premenopausal and postmenopausal (£ 60 years) women with breast cancer who have
In their new book entitled Current Therapy in Cancer, Drs. Foley, Vose, and Armitage endeavor to provide a short and concise presentation of various cancers. Their purpose is to aid clinicians in presenting a succinct overview of individual
The Clinical Trials Referral Resource that appeared in the April issue of ONCOLOGY began a series on health-related quality of life (HRQOL). Part I of this series, which concludes this month, focuses on HRQOL questions in cancer treatment trials. Part II (on investigator-initiated HRQOL research) and part III (on HRQOL research as part of cancer prevention trials) will appear in upcoming issues. Information about these studies can be obtained from the contacts listed for each trial or from Edward L. Trimble, MD, MPH, at the Cancer Therapy Evaluation Program (CTEP), email@example.com or (301) 496-1196
According to a study conducted at Emory University, the prophylactic use of antidepressants is successful in preventing depression, anxiety, and physical distress in cancer patients. The study, published in the New England Journal of Medicine
George W. Bush’s arrival at the White House has given physicians new hope that a bill easing Medicare mistreatment of physicians will pass Congress this year and be signed by the President. The bill is called the Medicare Education and
Doxorubicin/paclitaxel (Taxol) combinations are very active in advanced breast cancer, with objective response rates up to 90%, but have shown a high incidence of cardiotoxicity. A phase I/II trial replacing
The article by Drs. Levine, Seneviratne, and Tulpule is an excellent review of the available literature on the incidence and treatment of lymphoma related to the acquired immunodeficiency syndrome (AIDS).
Tamoxifen (Nolvadex) does not affect cardiovascular risk in healthy women or those with coronary heart disease, according to a study published in the Journal of the National Cancer Institute (93:16-21, 2001). The study is part of the National
Advances in antiretroviral therapy have dramatically improved human immunodeficiency virus (HIV)-associated morbidity and mortality. The use of highly active antiretroviral therapy (HAART) has led to a decrease in the incidence of opportunistic diseases, including some malignancies. Moreover, increased use of effective antiretroviral therapy may alter the incidence, presentation, prognosis, and therapeutic recommendations for patients with acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin’s lymphoma.
The aging population poses new challenges to all fields of medicine and to gynecologic oncology in particular. In gynecologic oncology, issues that are germane to general medicine, cancer chemotherapy, radical surgery, and routine gynecology are all encountered on a regular basis. In clinical practice, the "very old" are often thought to tolerate standard treatments poorly. While comorbid conditions may be more prevalent, management decisions should be based on an assessment of individual function and not solely on numerical age. In the article by Mirhashemi and colleagues, this theme is conveyed throughout, as they describe the current management of gynecologic malignancies in older women.
Contrary to traditional medical advice that rest is the best medicine for fatigue caused by treatment for breast cancer, the largest study of its kind found that exercise improves physical functioning and weight control for many patients.
Over time, the spectrum of the acquired immune deficiency syndrome (AIDS) epidemic has changed, especially with the advent of highly active antiretroviral therapy (HAART). The goal of this article is to delineate changes
The American Cancer Society is one of a number of groups supporting a new bill that would authorize Medicare to pay for smoking cessation counseling and Medicaid to pay for both prescription and nonprescription smoking cessation drugs. The
Over the past 3 decades, hematopoietic stem cell transplantation has become a lifesaving art that is applied to a variety of malignant and nonmalignant disorders. In the 1970s, several groups demonstrated that advanced leukemia and aplastic anemia patients were cured using sibling-matched allogeneic bone marrow transplantation. By the 1980s, many published reports confirmed that relapsed and refractory lymphoma patients could attain long-term disease-free survival as a result of utilizing autologous bone marrow transplantation.
After nearly 30 years of dedication, the International Bone Marrow Transplant Registry (IBMTR) and the Autologous Blood and Marrow Transplant Registry (ABMTR), by nearly any criterion, can be considered a success. The Registry contains over 120,000 patient records that are an invaluable source of information on both autologous and allogeneic bone marrow transplantations. Through the voluntary efforts of more than 350 institutions, it annually registers over 20% of all transplants occurring in nearly 50 countries and, by some estimates, nearly half of all transplants in North America.
Breast Cancer On-Line (BCO) at www.bco.org is a multidisciplinary website based in the United Kingdom that may be useful to practicing oncologists, nurses, and scientists working in the field of oncology. The editor-in-chief is John Robertson,
The diagnosis and management of cancer in older women is becoming an increasingly common and challenging issue. Women who reach age 65 can expect to live an additional 17 years. Age is an important risk factor for developing cancer. Epidemiologic data from 1992 to 1994 reveal that invasive cancer develops in 1 of 5 women aged 60 to 79 years.
The drug raloxifene (Evista) significantly reduces the risk of invasive breast cancer in postmenopausal women, according to the results of a large-scale study involving the University of Pittsburgh Graduate School of Public Health (GSPH) and
Estramustine is nornitrogen mustard linked to estradiol. It binds to tubulin and to microtubule-associated proteins, depolymerizes cytoplasmic microtubules, and disrupts the nuclear matrix. It has limited clinical
Anecdotal reports of cognitive compromise among patients treated with chemotherapy are relatively common among breast cancer survivors and may play an important role in adversely affecting functioning in multiple domains. As noted by Dr. Olin,
The demographics of the US population continue to change dramatically, as the absolute number and proportion of older people relative to the remainder of the population increases. Last year, the number of persons older than 65 years was estimated to be 35 million, representing almost 13% of the overall population; by 2030, the older population is expected to double. Along with the general aging of the population, the percentage of persons older than 85 years is also growing rapidly, as is the ethnic and racial diversity within the older population.
A study was undertaken to evaluate the question of cure in "young" men with prostate cancer treated by external-beam radiation. Results in young men (£ 65 years) were compared to older men. Biochemical freedom from failure was examined to 10 years’ follow-up, and hazard functions for failure vs time were reported. Results show that prostate cancer patients are cured by external-beam radiation and that there is no difference in results for young or older men. Few failures occur after 5 years’ follow-up and the percentage cured is similar to that with prostatectomy, with much less morbidity. Appropriate dose is necessary to optimize outcome. [ONCOLOGY 15(5):563-574, 2001]
Several attempts have been made to improve the survival rates of breast cancer patients. The benefit of adjuvant chemotherapy was clearly shown, but the absolute difference of 2% to 11% in overall survival, depending on the
The aging of the population is a social phenomenon that will present a challenge to clinical practice in the 21st century. Women constitute a majority of the elderly population as they outlive males by 5 to 7 years. Ovarian,
About 50,000 hematopoietic stem cell transplantations are performed yearly, primarily for malignancies. Use of this therapy increased dramatically over the past 30 years due to its proven and potential efficacy in diverse
Dr. Julie Olin has highlighted an important issue for patients and providers contemplating systemic therapy for breast cancer: how the brain works after such treatment. Her excellent article summarizes four important studies, identifies the research design problems and questions raised by these and other studies, and proposes a model for how chemohormonal therapy might affect cognitive functioning and quality of life (see Figure 1 of her article). Finally, she identifies how actual, as well as potential, cognitive impairment might influence patient decisions and care (the author’s Table 1).
In this issue of ONCOLOGY, Dr. Hanks further establishes his legacy by leading the charge for radiotherapy as the treatment of choice in men with clinically localized prostate cancer. Most urologists and some radiation oncologists tend to consider
The aromatase inhibitors represent an important class of hormonal agents for the management of breast cancer. The third-generation aromatase inhibitors have replaced megestrol acetate as second-line hormonal
The editors of this impressive new book indicate in their preface that this text was compiled to give "undivided attention" to granulomatous disorders other than sarcoidosis. Toward that end, they have assembled an impressive array of experts from
The 3rd Investigators’ Workshop, sponsored by The University of Texas M. D. Anderson Cancer Center, included five separate scientific sessions. The topics covered were colorectal carcinoma, lung carcinoma, breast carcinoma, miscellaneous
Colorectal cancer is the second leading cause of cancer-related death in the United States. An estimated 135,400 new cases and 56,700 deaths from colorectal cancer are expected during 2001. Since the mid-1990s, national guidelines have
Liposomal-Encapsulated Chemotherapy: Preliminary Results of a Phase I Study of a Novel Liposomal Paclitaxel
Liposome encapsulation of antineoplastic drugs entered clinical testing in the late 1980s. As carriers for a variety of agents, liposomes can allow successful delivery of agents that may be subject to rapid degradation in
Tamoxifen (Nolvadex) has long been established as "standard" adjuvant therapy for receptor-positive, early-stage breast cancer. Results from clinical trials suggest that after approximately 5 years, tamoxifen may lose its
The report by Hanks and colleagues examines two controversial issues that are related to the treatment of prostate cancer with external-beam radiotherapy: (1) the outcome of younger vs older men, and (2) the relative risk of relapse with follow-up beyond 5 years. The findings of their study are important not only in addressing these points, but also because they shed light on another concern often raised by urologists.
An underinvestigated area of breast cancer survivorship involves the possible impairment of cognitive function following adjuvant chemohormonal therapy. Numerous reports of disturbing and disruptive changes in short- and