Among the highlights in the December 1998 Cancer Watch issue are: Apoptic Index and bcl-2 Expression: A Firm Correlation, but not an Independent Prognostic Factor in Breast Cancer, Killing Tumor Cells with Viruses, Kytril Tablet for Nausea and Vomiting in Cancer Patients, Variability Found in Reading Mammogram, Human Embryonic Stem Cells Grown in vitro, Advances in Technology: Positron Emission Tomography for Staging Cancer, National Cancer Institute Launches Imaging Initiative, An Agent to Assist in Gene Replacement Therapy, A Single-Agent Chemotherapy for Ovarian Cancer, Engineered Enzyme to Inhibit Kaposi's Sarcoma Growth, Further Investigation in Telomerase Function, Chronic Depression and Cancer Risk in the Elderly, Chemotherapy in the Treatment of Early Breast Cancer and Cancer Treatment with "Unconventional" Medicine.

• Apoptic Index and bcl-2 Expression: A Firm Correlation, but not an Independent Prognostic Factor in Breast Cancer
• Killing Tumor Cells with Viruses
• Kytril Tablet for Nausea and Vomiting in Cancer Patients
• Variability Found in Reading Mammogram
• Human Embryonic Stem Cells Grown in vitro

• Positron emission tomography, an imaging technique that provides physiological function of cells, is used in diagnosing and staging cancer. This procedure can be very useful in early prediction of treatment success.

• Non-invasive imaging techniques are routinely employed in cancer diagnosis and staging. The field is expanding very rapidly. One of the challenges for the 21st century is to improve these technologies so that actual molecular events taking place in the body can be imaged. This will enable to monitor success of therapeutic intervention in record time.

• A natural metabolic byproduct of estrogen when used in conjunction with vector-mediated p53 gene therapy induces expression of the gene product and stabilizes it to induce apoptosis in metastatic lung cancer cells in animal model. The agent, 2-methoxyestradiol, is nontoxic and specifically acts on cancer cells to induce p53 protein. This agent in combination with wild-type p53 gene transfer may have useful application in metastatic cancer treatment.

• Combination of several agents is usually employed in chemotherapy for ovarian cancer. Optimal dose of these may have toxic side effects. Since platinum-based therapeutics are very effective against this cancer, a clinical trial is conducted to determine the efficacy of single-agent carboplatin to treat ovarian cancer. The result shows that optimal dose of carboplatin can be used alone for the treatment of advanced ovarian cancer.

• Preparations of human chorionic gonadotropin (hCG) have exhibited anti-Kaposi's (KS) sarcoma activity. A contaminant with RNase activity is thought to be the therapeutically active factor. A slightly modified form of this enzyme is fabricated by recombinant technology and is shown to have anti-KS activity.

• A new protein, tankyrase, associated with the human telomere complex has been identified. This protein has enzymatic activity that transfers ADP-ribose from NAD+ onto target proteins. By modifying telomerase-binding proteins this enzyme can regulate telomere function.

• A large population-based prospective study that examined cancer among chronically depressed older people has found that those depressed over a 6-year period were 88% more likely to develop cancer than people who were not chronically depressed.

• In the past two decades, significant changes in the treatment of early breast cancer have led to prolonged survival and a general downtrend in mortality in patients with the disease. These improvements are the result of earlier detection and the introduction of systemic adjuvent treatment, including polychemotherapy. Combination chemotherapy is now recommended as standard care, regardless of the age of the patient.

• November 98 was an exceptional busy month for publications on the topic of unconventional medicine – as opposed to traditional therapy; such an outburst of opinions and information, coming from the "establishment", has never been voiced before – and if, with a mostly negative slant. The fact that 9 specialty issues of the Archives together with the imposing JAMA devoted scores of pages to alternative treatment methods reflects both the pressure from the public and a conscious effort to integrate – if at all possible – "medical interventions which are not taught extensively at US medical schools". In some diseases, the results reported are definitely promising; unconventional treatment of cancer remains perhaps the most contentious, mainly because of the inherent difficulties of the proper design and meaningful evaluation of valid trials. Cancer therapy is, at best, an uphill battle; oncologists are understandably reluctant to abandon accepted treatment, which offers at least some promise, for modalities whose mechanisms of action are not understood or proven in large numbers of patients; yet, it may well be that not everything can be understood nor statistically supported and will remain in the realm of anecdotal evidence, even if it was of benefit to individual patients.

Glossary

• A glossary of unfamiliar words and jargons in Cancer Watch, July-December 1998.