Among the highlights in the January 2000 Cancer Watch issue are: Mismatch DNA Repair in Cancer, Hepatitis B Vaccine as the First Anti-Cancer Vaccine, Evolution of Genetic Theory, DNA Damage and Faithful Genome Maintenance by DNA Repair, Initial Stages of Tumor Cell-Induced Angiogenesis, Fluid Hysteroscopy and Spread of Tumor Cells, HPV Testing for Cervical Cancer Screening, An Alternative Strategy to Halt Ovarian Cancer Cell Growth, Why Women Have Higher Risks of Smoking-Related Lung Cancer, Thalidomide for Cancer Treatment, Butter that May Fight Cancer, Palliative Care in Cancer.

• A Genetic Data Base for Cancer
• Serum HER-2/neu Quantitation in Cancer
• Mismatch DNA Repair in Cancer
• Hepatitis B Vaccine as the First Anti-Cancer Vaccine

• A millennium is not long and a century even shorter, in the context of evolution of life. But in a short period of time biologists have gathered remarkable knowledge about the functioning of living system; they have applied this knowledge to monitor and to manipulate the molecule, DNA..

• The DNA in the genome is highly susceptible to endogenous and exogenous damaging factors. To maintain the integrity of the genome very sophisticated repair systems exist that recognize the altered region and signals various protein factors and enzymes to the site.

• The process of angiogenesis may be initiated by the tumor cells at a very early stage of growth, when the tumor mass contains only about 100 to 300 cells, and not millions of cells as was previously thought. There is definite communication between the cancer cells and host blood vessel before clear evidence of tumor-induced angiogenesis. Inhibition of this communication at a very early stage may prevent tumor formation.

• Distension of uterus during fluid hysteroscopy may cause tumor cells to spread to the abdominal cavity. To positively diagnose endometrial cancer, some women may require dilatation of the cervix in order to obtain tissue sample from the uterine cavity. To increase the sensitivity of this procedure, fluid hysteroscopy is introduced and is widely applied.

• Several types of the human papillomavirus are known to cause most cervical cancers. A sensitive method to determine HPV DNA can be a useful tool in screening high-risk individuals.

• Tumor growth promoting effect of a gene can be counter balanced by gene therapy that introduces a tumor suppressor gene. Expression of the tumor suppressor gene is found to stimulate apoptosis as well as cell division arrest. The effect observed in cell culture system suggests that this gene therapy strategy may be significant in treating ovarian cancer that does not respond very well to various chemotherapeutic agents.

• Women have higher risks of lung cancer. This may be due to the presence of two active genes of a receptor protein GRPR, activated by nicotine to stimulate lung cell growth. These genes are present on the X chromosome. Though one copy of the genes is usually inactive on the X chromosome, the gene of this receptor protein avoids inactivation in certain females. GRPR mRNA could be used as a molecular marker to identify individuals at high risk for lung cancer.

• Thalidomide, known for its severe adverse effect on limb development in the unborn child, is found to have certain beneficial effects in cancer patients.

• Though fats containing unsaturated fatty acids are dubbed "bad" as far as blood vessels are concerned, yet one unusual fat containing linoleic acid, an unsaturated fatty acid with two double bonds, is found to prevent cancer. This fat, conjugated linoleic acid is present in meat and milk of cow. It is not naturally abundant but supplement of cow’s diet with sunflower oil can increase concentration of this fat in the milk significantly.

• By definition, palliative care is concerned with the physical, psychosocial and spiritual well being in progressive and usually non-curable disease. With growing life expectancy and the increasingly successful management of cardiovascular disease, the leading cause of mortality in Western countries will soon be from malignant disease. This will pose increasing demands on palliative care services, such as hospices; already, there are now over 3600 such institutions in North America. Their focus should be optimizing the quality of life remaining to the patients and support for their families. Nevertheless, care offered to individuals shortly before their death is often a neglected subject and there is very little guidance on the best management of pain, symptoms and the emotional needs during the last days of cancer patients.

• It has become general practice to express scientific results, opinions and even theories in a colorless, neutral style: "it appears"…"it seems"…"it has been found…". After over thirty years in the equally frustrating and fascinating business of oncology, I venture to express myself, for myself. This is of course individualistic, subjective and often controversial. However, age permits retrospection and hindsight offers a comfortable armchair from which to look around. Age also brings about the dubious privilege of having one’s mistakes tolerated or forgotten (together with the author). Serendipity, empiricism and almost any branch of science have all contributed – not necessarily in this sequence – to what we now consider state of the art in oncology. Collaborative efforts in sometimes unrelated disciplines often bear unexpected fruit and only emphasize the need to keep trying.

• A glossary of unfamiliar words and jargons in Cancer Watch, January 2000.