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With the introduction of increasingly effective antiretroviral agents for the management of AIDS, the life expectancy of appropriately treated patients will continue to lengthen, as will the length of time during which infected patients may develop malignancies, both HIV-related and non-HIV-related. The management of such patients will require careful consideration of the impact of all oncologic therapy on the immune system's ability to hold the virus at bay. Radiation therapy, with its recognized immunosuppressive effects, plays an important role in the management of the major AIDS-defining neoplasms, Kaposi's sarcoma, primary central nervous system lymphoma, and cervical carcinoma, and is used in approximately 50% of patients with non-HIV-related malignancies at some point in the disease course. The judicious use of radiation therapy and proper integration of aggressive antiretroviral therapy can result in control of malignancies without contributing to the rapid progression of HIV disease. [ONCOLOGY 11(5):683-694, 1997]

BETHESDA, Md--Managed care, more than other types of medical coverage, imposes a "hassle factor" on oncologists and their patients, and restrains patients from participating in clinical trials, a survey by the Association of Community Cancer Centers (ACCC) has found.

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.

Preliminary results from a study conducted by Dr. D. Firat and coworkers in Ankara, Turkey, confirm that the combination of vinorelbine (Navelbine) and doxorubicin has major antitumor activity when used as first-line therapy in advanced breast

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.

A protein located on the membrane of a cell's energy source can block the signal that tells cells to die, according to a study by researchers at The University of Texas (UT) Southwestern Medical Center at

Spontaneous return of sensibility to the breast often occurs following reconstruction with autologous tissue, according to a study published in the February issue of Plastic and Reconstructive Surgery.

Clinical data from the initial study of the BreastAlert Differential Temperature Sensor support its usefulness for indicating the possibility of heat-emitting, medically significant breast disease, including

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.

Scientists have developed a drug and radiation regimen for reducing locally advanced and inoperable tumors in the pancreas and stomach.

Culture appears to influence people's perceptions of narcotic pain relief after surgery, say researchers who have surveyed fracture patients in Northern California and in Vietnam.

Scientists at Stanford University have done the next best thing to packaging living cells in individual boxes for study.

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.

A newly synthesized vitamin D5 compound designated 1-alpha-(OH)D5, unlike the natural active metabolite [1-alpha,25(OH)2D3] of vitamin D3, strongly inhibited the development of precancerous cells in animal breast organ culture studies but did not

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]

This special series on cancer and genetics is compiled and edited by Henry T. Lynch, MD, director of the Hereditary Cancer Institute and professor of medicine and chairman of the Department of Preventive Medicine and Public