Among the highlights in the February 1999 Cancer Watch issue are: Isoflavone Metabolites - An Emerging Class of Anticancer Compounds, The Determination of Drug Metabolism Mutations, The APC Gene Causes Mutations in Cancer, Nail-Apparatus Melanoma (NAM), Fatty Liver After Adjutant Tamoxifen Therapy, New Clinical Trial Report On Cervical Cancer Treatment, The Safety of Breast Implants, Organochlorine Exposure and Risk of Breast Cancer, Prophylactic Mastectomy, Genetic Risk and Breast Cancer Survival, Organ Transplant and Risk of Malignancy, Use of Resistance Modulator in Refractory Myeloma, Brain Irradiation Leads to Secondary Tumors, Calcium Supplement to Prevent Colorectal Adenomas, New, Non-toxic Treatment for Kaposi's Sarcoma, Lymphoma Vaccine Has Anti-tumor Effect and Risk Reduction in Familial Gynecologic Cancer.

• Isoflavone Metabolites - An Emerging Class of Anticancer Compounds
• The Determination of Drug Metabolism Mutations
• The APC Gene Causes Mutations in Cancer
• Nail-Apparatus Melanoma (NAM)
• Fatty Liver After Adjutant Tamoxifen Therapy

• The National Cancer Institute (NCI) reports the findings of five different randomized trials demonstrating that women suffering from invasive cervical cancer benefited significantly from combination of radiotherapy and chemotherapy. Among the three chemotherapeutic agents used, cisplatin appeared to be the most effective in improving survival.

• Most breast implants are performed for cosmetic reasons; only a fifth of all patients have had an implant for reconstruction following mastectomy for cancer. Obviously, these two groups are very different and they may have different risk factors. Major concern for breast implants was long-range morbidity such as connective tissue disorder and immunologic disturbances. The association with subsequent breast cancer was not properly reviewed. Large-scale, careful study now shows a decreased risk for breast cancer after breast implants and in smaller studies with cancer patients who had reconstructive implants, a lower risk of death due to breast cancer, distant metastases and local recurrence was observed.

• Certain organochemicals which are present in the atmosphere may have weak estrogenic activity and therefore may increase the risk of breast cancer. A prospective study suggests that exposure to dieldrin significantly increases the risk of breast cancer.

• Incidence and death from breast cancer, in high-risk women, can be prevented to a significant degree by prophylactic mastectomy.

• Women with breast or ovarian cancer with mutations of BRCA1 and BRCA2 genes do not show any adverse survival prognosis.

• Cyclosporine, an immunosuppressive drug, used to prevent organ rejection in transplant patient increases risk of cancer in these patients by stimulating TGF-beta expression. Heightened cancer risk in transplant patients is thought to be due to impaired immune surveillance induced by the drugs. Present study gives an alternative mechanism that is independent of host immunity and can be explored for novel therapeutic strategies for transplant patient to prevent cancer incidence among them.

• One major problem with chemotherapy is the development of multidrug resistance. Several underlying mechanisms are discovered that are responsible for the eventual failure of drug treatment. Research, however, shows that addition of certain agents to the standard treatment regimen can induce response to some cancer patients who were refractory to the drug alone.

• Secondary cancers represent serious late complications after successful treatment of malignant diseases. Especially in children whose life expectancy is long all measures should be taken to avoid development of new cancers.

• Calcium supplementation may reduce the risk of recurrent colorectal adenomas to a moderate degree. It may also have chemopreventative effect against this disease.

• New York researchers have developed a novel, relatively non-toxic approach to treat Kaposi's sarcoma with an anti-angiogenesis therapy that may eventually be applied to multiple malignancies.

• Eliciting immune response is the main purpose of vaccination. Immunogenic antigen for cancer vaccine is obtained from patients own tumors. A lymphoma-specific vaccine developed recently also show anti-tumor effect.

• Our concept of the primary stimulus which causes the accumulation of genetic errors and ultimately leads to neoplastic transformation has changed with time; virus infections and environmental factors as principal culprits have prevailed for a while and have quietly faded away. Carcinogenesis (with the exception of sunlight, smoking and a very few specific carcinogens) is now firmly the result of susceptibility genes. Mothodological improvements permit analysis of human cancers which show increasingly that malignant cells contain numerous and varied genetic alterations, ranging from translocations and mutations to gene amplifications. Increased cell division dramatically increases the frequency of such events; since initially most gynecological cancers are hormone dependent, the interplay of the endocrine system with the genetic make-up of an individual is the major risk factor in the development of breast, ovarian and endometrial cancers. As yet, the question has not been answered: does screening for and/or the recognition of such risk factors improve the outcome of these cancers or (the ultimate goal) help in their prevention? So far, the US Preventive Services Task Force (in l996) had no recommendation for or against routine counselling of women about measures for the prevention of gynecologic malignancies. This mini-review tries to update recent trends and the improved understanding of risk reduction strategies.

Glossary

• A glossary of unfamiliar words and jargons in Cancer Watch, February 1999.