Among the highlights in the April 1998 Cancer Watch issue are: A New Research Cooperative Group Sponsored by NCI, Hyperviscosity Syndrome in Patients with Ovarian Cancer, Cigar Smoking Causes Several Cancers, Detection of Breast Cancer in Coming Years, Toremifene in Postmenopausal Breast Cancer, Apoptosis in Cancer: Self-Destruction of the Cell, Report from Breast Cancer Prevention Trial, Risk of False Positive Results in Breast Cancer Screening, Excess Vitamin C Supplementation May Not be Good, Outpatient BMT Lowers Costs, Thiamine Supplementation for Cancer Patients, Mechanism of Action of Anticancer Soy Component, Cancer Immunotherapy, Is it a Mole or a Melanoma?, Melanoma-inhibiting Activity in Serum and Powerful Effect of Antismoking Advertisement.

• A New Research Cooperative Group Sponsored by NCI
• Hyperviscosity Syndrome in Patients with Ovarian Cancer
• Cigar Smoking Causes Several Cancers
• Detection of Breast Cancer in Coming Years
• Toremifene in Postmenopausal Breast Cancer

• Apoptosis has become a "fashionable" topic; as such, it is still very much in flux which makes a mini-review all the more difficult. In the recent decade, many tenets of oncology have been seriously eroded - which should encourage more humility and caution. Nature operates on the basis of imperfection - as seen by us. This is particularly valid for the phenomenon of cancer; for every complex question, there are simple answers which are almost always wrong. Today, we like to reduce the problem of malignant growth to an imbalance between physiological cell death and cell proliferation - and we affect a sublime indifference for all data which are inconvenient or point to a different direction. In sum: apoptosis occurs in normal as well as in malignant tissues; most cells from eukaryotes eventually self-destruct by activation of a sophisticated, complex suicide program. This appears to be one of the key biological regulatory mechanisms, along with cell growth and differentiation. Too little cell death may have catastrophic consequences; cancer is one of them.

• Tamoxifen, a synthetic hormone, has been used to treat breast cancer for decades and is now reported to have preventative effect. This agent, however, can have serious side effects. Women should evaluate benefits and risks cautiously before making a decision to take it.
  

• Screening mammography or clinical breast examination can save life, but wrong test results can jeopardize life. A 10-year retrospective study shows that a third of the women undergoing screening had false-positive results. And the risk of false positive results increase with the number of screening tests.

• The antioxidant vitamin C (ascorbic acid) is a dietary supplement. Harmful oxygen radicals are normally produced in the body that damage DNA causing mutation and cancer. These radicals are quenched by antioxidants such as vitamin C. Research shows that excessive vitamin C may also act as a prooxidant causing damage to DNA.

• Bone marrow transplantation (BMT) has traditionally been performed during lengthy, expensive inpatient hospitalization. A recent study at the Johns Hopkins Oncology Center shows that outpatient care during BMT is safe and effective, and can lower the costs of this very expensive procedure.
  

• Optimal nutrition in cancer patients supports general well-being, the immune response and corrects the frequent negative protein and lipid imbalances as well as vitamin deficiencies. The course of the malignant process itself and the effects of chemotherapy (including gastrointestinal distress and insufficient food intake) require adequate supplementation. Among others, thiamine deficiency has been readily recognized in many malignancies and since this vitamin has no well-defined toxic levels, it is usually oversupplied.
  

• Genistein, an isoflavonoids present in soy products, may reduce the expression of response-related genes.

• Cytotoxic T lymphocyte can be stimulated to elicit immune response against tumor cells by dendritic cells that have been transfected with RNA coding for a tumor-specific protein.

• Melanoma begins as a simple mole, but if not paid any attention, it grows and spreads very quickly claiming the life of the victim. However, if it is detected very early when it is less than a millimeter in thickness, total excision has almost 100% chance of cure.

• A Protein with melanoma-inhibiting activity was observed in 100 percent melanoma samples and it could serve as a tumor marker. Level of this protein also seems to have correlation with number of tumors and severity of the disease. Additionally, patients treated with combined surgery and chemotherapy, but still were unresponsive to treatment, showed increased level of this protein and died of rapidly progressing disease; while the patients who responded to treatment showed diminishing level of the melanoma-inhibiting protein.

• Media campaign is very powerful in sending the message that smoking is hazardous to health. The strategies found to be most effective in antismoking advertisement are aggressive attacks of the tobacco industry and elaboration of the harmful effects of secondhand smoking.

Glossary

• A glossary of unfamiliar words and jargons in Cancer Watch, April 1998.