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Thousands of practice guidelines/practice parameters have been published by various professional organizations. The American Medical Association,[1] American College of Physicians,[2,3] and others[4-6] have written extensively about

This review of prostate-specific antigen (PSA) by Pannek and Partin, two experts in the prostate marker field, comes at a very good time-a point at which great changes are occurring after a relatively long period of stability. I expect that this trend will continue. Moreover, given the rapid developments occurring in this area, some of the statements made in both the review and my commentary will probably need to be modified within the next 12 months, with further revisions necessary thereafter.

Treatment of esophageal carcinoma requires the realization that this neoplasm is not a single entity with a uniformly poor prognosis. As with any other malignancy, disease stage has prognostic and therapeutic

Radical cystectomy remains standard management for patients with locally advanced T2 through T4, N0, M0 transitional cell carcinoma of the urinary bladder.

HOUSTON--In the current health care environment, peaceful deaths are seriously threatened as clinicians attempt technological brinkmanship and patients and families demand that "everything be done" to extend life, said Rebecca Pentz, PhD, a clinical ethicist at The University of Texas M.D. Anderson Cancer Center.

WASHINGTON--To maintain its world leadership in clinical care, the nation should levy a 1% tax on health care premiums to pay for clinical research, Kenneth I. Shine, MD, president of the National Academy of Sciences' Institute of Medicine (IOM), has proposed.

BETHESDA, Md--The FDA's Oncology Drugs Advisory Committee (ODAC) voted 8 to 4 to recommend that the agency grant traditional new drug approval to Bristol-Myers Squibb's Taxol for Injection Concentrate (paclitaxel) for the second-line treatment of AIDS-related Kaposi's sarcoma (KS).

SEATTLE--Physicians and nurses frequently confront ethical dilemmas in caring for cancer patients, and these must be resolved on an individual basis, through established principles, Tom McCormick, DMin, senior lecturer in medical ethics, University of Washington, told the Association of Pediatric Oncology Nurses. "I don't think we'll ever see the day," he said, "when we can put all of the alternatives into a computer, press a button, and ask the computer to come up with a decision."

Why we like--and eat--fatty foods was the focus of an address by Dr. Adam Drewnowski, PhD, University of Michigan School of Public Health, at a symposium, "Reducing Dietary Fat: Putting Theory Into Practice," held last December in New

NEW ORLEANS--Informed consent has historically focused on physical risks, but genetic testing will move informed consent into psychosocial areas, Karen Rothenberg, JD, MPA, Marjorie Cook Professor of Law, University of Maryland School of Law, said at the 21st annual meeting of the American Society of Preventive Oncology (ASPO).

Long recognized as standard treatment of gynecologic cancer and some other malignancies, brachytherapy may also play a role in the treatment of prostate cancer, said Dr. John C. Blasko of the University of Washington in Seattle.

A nurse practitioner who has been caring for HIV/AIDS patients for over 15 years has some practical tips for dealing with the common symptoms associated with the disease. Dr. Gayle Newshan, PhD, NP, offered her advice during a recent

PALM BEACH, Fla--A urologist believes his unique viewpoint can be helpful to radiation oncologists doing brachy-therapy and to his fellow urologists. "By 2005," said Nelson Stone, MD, of Mt. Sinai Medical Center, NY, "projections indicate that two thirds of prostate cancer cases will be treated with brachyther-apy or external beam irradiation. If urologists don't get on board, they'll be treating half of the cases they are now."

Many types of cells undergo apoptosis as part of the normal physiological process. An interruption in apoptosis is thought to be a primary cause of tumor growth. Two presentations concerning this subject were made at the 88th Annual Meeting of the

NEW ORLEANS--Colorectal cancer surveillance intervals can be lengthened for some patients following initial polypectomy, two large studies suggest.

WASHINGTON--This spring, the American Cancer Society (ACS) and the Children's Defense Fund led an influential coalition of more than 150 groups in active support of the CHILD Act, sponsored by Sen. Orrin G. Hatch (R-Utah) and Sen. Edward M. Kennedy (D-Mass).

WASHINGTON--An international panel of medical experts convened by the American Digestive Health Foundation released information, during Digestive Disease Week 1997, on the epidemiology, diagnosis, and treatment of Helio-bacter pylori, the bacterium known to cause most ulcers and also to be closely associated with gastric cancer.

WASHINGTON--Three internationally renowned scientists received the 1997 General Motors Cancer Research Foundation Science Awards for their groundbreaking discoveries. Each of the award winners was given a gold medal and a $100,000 prize during ceremonies held at the Library of Congress.

PALM BEACH, Fla--The increased use of prostate brachytherapy has prompted the American Brachytherapy Society to establish a group to formulate standards and treatment guidelines, Peter D. Grimm, DO, said at the Society's 19th annual meeting.

WASHINGTON--The number of deaths from AIDS has fallen 19%, from 37,900 in the first nine months of 1995 to 30,700 for the same time period in 1996, the Centers for Disease Control and Prevention (CDC) has announced. And, for the first time, the number of AIDS-related deaths has dropped among women, albeit by only 7%, as compared to 22% among men.

BETHESDA, Md--A two-drug combination used as initial therapy has proven more effective in limiting disease progression or death in children with symptomatic HIV disease than didanosine (ddI, Videx) alone.

Recent studies delineate the effect of exercise on specific cancers but much more research on the role exercise plays in the prevention and treatment of cancer is needed, according to Susan Oliveria, ScD, MPH, director of epidemiology at the

BETHESDA, Md--The Oncology Drugs Advisory Committee (ODAC) declined to recommend that the FDA approve two medications: ILEX Oncology's Zyrkamine (mitoguazone dihydrochloride) and Janssen's Liazal Tablets (liaro-zole fumarate).

WASHINGTON--Addressing an American Gastroenterological Association (AGA) symposium on NSAIDs during Digestive Disease Week, Dr. Robert Sandler, of the University of North Carolina, Center for Gastrointestinal Biology and Disease, posed two questions:

BETHESDA, Md--A multistate, case-control study involving more than 1,200 children has failed to document a link between electromagnetic fields in and around the home and acute lymphoblastic leukemia (ALL), the most common form of cancer in children.

WASHINGTON--Colorectal cancers in patients younger than age 40 are reputed to behave more aggressively than similar lesions in persons over 40, resulting in poorer survival. Younger patients have also been reported to present with a higher tumor stage.

HOUSTON--Combining spinal stabilization with currently used surgical procedures is producing improved results in spinal cord compression patients, Ziya Gokaslan, MD, a neurosurgeon at The M.D. Anderson Cancer Center, reported at a symposium on cancer and the central nervous system.

REHOVOT, Israel--A new form of high spacial resolution magnetic resonance imaging (MRI) may improve the diagnosis of breast and other cancers, and may aid in predicting cancer prognosis and monitoring the effectiveness of therapy, says Hadassa Degani, PhD, of the Weizmann Institute of Science.

CHICAGO--When physicians squared off on the issue of brachytherapy (interstitial radioactive seed placement) for prostate cancer at the Prostate Cancer Shootout II conference, the lines could not have been drawn more clearly.

DENVER--Delivery of fentanyl citrate via the oral mucosa was shown to relieve breakthrough cancer pain within 15 minutes in two thirds of patients, and sometimes within 5 minutes, according to studies presented at the American Society of Clinical Oncology meeting.