The Canadian journal of oncology最新文献

The ovarian cancer discussion group is one of a few such groups that can be reached via Internet e-mail. Messages posted by members of this group illustrate very well the kind of "small, intimate benefits" that can be found in the discourse among subscribers to Internet discussion groups of this kind. An example is used to illustrate the interest in advocacy-related issues shown by members of this particular group.

Creatine kinase BB isoenzyme (CK-BB) is overexpressed in many tumor tissues, including ovarian cancer. Using a highly sensitive and specific immunofluorometric method, CK-BB levels in 89 primary ovarian cancer cytosolic extracts have been measured and the associations between CK-BB and clinicopathological features of ovarian cancer have been studied. It was found that CK-BB levels are higher in endometrioid cell carcinomas. No clear association was established between CK-BB levels and patient age, menopausal status, clinical stage, histological grade or size of residual tumor. CK-BB was not associated significantly with either disease-free or overall survival of the patients. Based on these data, it was concluded that there is no prognostic value of CK-BB in ovarian cancer. Drugs that target CK-dependent energy metabolism of tumor cells may not be selective in ovarian cancer therapy.

Interactive communication on the Internet, as illustrated by the e-mail-based breast cancer discussion group, provides an alternative to the telephone, the fax machine and regular mail, and is a resource for communications research, the potential of which is only beginning to be appreciated. At least some of the messages posted to such discussion groups could be regarded as a form of "journaling". Such messages are eminently suitable for qualitative data analysis.

Accurate classification and staging of cancers enables physicians to select appropriate treatments, to evaluate outcomes of health management more reliably, to compare and interpret statistics reported from various institutions on a local, regional, national and international basis more consistently and to assist exchanges of information between different centers of treatment. This paper examines group interview methodology to develop the first-ever survey of Canadian cancer care specialists pertaining to staging systems. It is shown how the responses provided by participants contributed to the formulation of testable hypotheses and shaped the development of survey questions. As well, experiences are shared regarding the technical issues that arose using the focus group technique with physicians. In conclusion, there is a brief discussion of how the use of staging classification systems might be understood from the perspective of diffusion theory and social marketing (i.e., how information about cancer staging has been communicated and disseminated.

Hereditary nonpolyposis colorectal cancer (HNPCC) is a genetic disorder characterized by a strong family history of colorectal and extracolonic cancers, usually at a young age. This article presents a new provincial service for families with HNPCC. The Steve Atanas Stavro Familial Gastrointestinal Cancer Registry at Mount Sinai Hospital is accruing patients that meet a set of criteria establishing a putative diagnosis of HNPCC. The objectives of the Registry are to develop and assess patient pedigrees, to coordinate screening procedures for at-risk persons, to maintain a prospective database of patient information, to provide education and support for families and to contribute to research. To date, surgeons and patients are the most common referral sources, while oncologists and geneticists are the least common. The ultimate goal of the HNPCC service is the secondary prevention of cancer and a corresponding decrease in mortality for HNPCC family members.

High-dose chemotherapy (HDCT) and autotransplantation of hematopoietic cells is being investigated as a therapy for either metastatic or localized high-risk breast cancer. Breast cancer has a tendency to metastasize to the bones and the bone marrow (BM) and therefore the probability of harvesting malignant cells when collecting stem cells for autotransplantation appears high. Thus, the elimination or decrease of this contamination in the transplanted product appears mandatory. Autologous peripheral blood stem cell transplantation (PBSCT) has shown significant advantages over autologous bone marrow transplantation (ABMT) in improving the feasibility of HDCT, while possible limiting the BM contamination. The transplantation of only CD34+ products may even be a further advance. The role of ex vivo purging of cancer cells has not been established in ABMT or PBSCT. The question remains if the positive selection of CD34+ products is sufficient for controlling cancer cell contamination or if this product should be purged as well. The review of the literature suggests that contamination of the bone marrow could have an impact in terms of risk or relapse and could thus play a role as a pejorative prognostic factor. These data, although not totally adequate for the autotransplantation setting, are raising concerns over the probability of reinfusing malignant cells at time of autotransplantation following HDCT. There is a tremendous need to address these concerns in the laboratory along with prospective clinical trials. Until further data is available, this risk must be taken into consideration when patients with breast cancer are treated with curative intent.

The National Cancer Institute of Canada (NCIC) conducted a survey of representatives of its stakeholder populations (members of the cancer research and control communities, past and present NCIC grantees, senior administrators in academic institutions, NCIC governing committee representatives and major partners) to get input on proposals to restructure the NCIC's research programs. The survey results demonstrate support for changes that are likely to significantly alter how the NCIC operates as well as the programs it sponsors. The results suggest support for increasing the percentage of NCIC funds allocated to the Individual Operating Grants area and for changing the NCIC's programs and operating procedures. While there was widespread support for an NCIC-sponsored regional development initiative, many issues remain unresolved, such as what type of cancer research to develop within the provinces.

The process of measuring health-related quality of life (HQL) in oncology is reviewed and the role of these results in clinical practice and clinical trials is discussed. It is determined that comparisons of HQL measurement instruments are needed to clarify which questionnaires are preferable in particular populations or situations. "Calibration" data are also needed, to help explain the meaning of HQL scores and to link them to external reality. In phase III clinical trials, HQL assessment is most important in trials involving disease sites and stages with a poor prognosis and when comparing treatments not expected to affect survival.