Among the highlights in the November 1996 Cancer Watch issue are: Anti-tumor Virus?, Bacterial Vaginosis and Cervical Neoplasia, Human Papillomavirus and Esophageal Cancer, Endometrial Cancer: Treatment, DNA, The Master Molecule: Managing Access to the Genome, Tamoxifen Treatment: For How Long?, Good News from the National Cancer Institute, Beta-Carotene and Smokers, Report from Chemotherapy Foundation Symposium and Infection Control in Immunocompromised Patients.

• A mutated form of adenovirus is found to grow only in cells that do not have functional p53 protein such as many cancer cells and lyse them. This strategy should be of value to design treatment for p53-deficient human cancers.

• Vitamins such as A, C, and E and/or folate intake throughout pregnancy may reduce the risk of having a child who would develop brain tumor by the age of five.

• Antibody to human papillomavirus 16 has been detected in many patients with esophageal cancer, indicating that this virus may cause this cancer.

• Surgery is the standard treatment for endometrial cancer. Depending on the stage and grade of the disease adjuvant radiotherapy is recommended. For advanced disseminated cases the treatment is tailored for the particular patient. Hormonal therapy with progestogens and tamoxifen or doxorubicin alone has been tried with some success. Combination chemotherapy with platinum-based compounds and hormonal agents are being investigated.

• New investigations suggest that a class of proteins called linker histones act as gate keepers to the genome controlling accessibility to specific genes.

• Tamoxifen is now routinely employed as adjuvant hormone therapy in early stage breast cancer, but its optimum duration of application is not established. Two new reports from multicenter randomized trials indicate that five years may be the optimum length of time necessary to obtain benefits from this treatment. Discontinuation of treatment after five years still maintains the beneficial effects.

• While reviewing mortality data the National Cancer Institute’s (NCI’s) statisticians noticed a clear break in the historical trends occurring in the early 1990s: a downturn from the gradual climb in mortality rates that has been observed over the past several decades. So they decided to release the preliminary information to the public. On November 14, 1996 NCI announced that the cancer death rate in the US fell by three percent between 1991 and 1995, the first sustained decline since national record-keeping was initiated in 1930. Data presented today are preliminary and the exact number could change slightly, but the officials believe that the trend is real.

• Cancer prevention trial using vitamin supplements was stopped in January of this year before its completion. This action was taken because preliminary analyses of the data indicated that b-carotene supplementation might increase lung cancer incidence in high-risk individuals such as heavy smokers and those exposed to asbestos occupationally. Further analyses confirm this observation and the researchers suggest that these high-risk individuals should be discouraged from taking b-carotene supplementation. However, b-carotene intake from diet does not pose any hazard.

• Chemotherapy is one of the standard treatments for most cancers. Adjuvant chemotherapy is employed after surgery or radiation to prevent spread of the disease. Chemical agents employed to kill the cancer cells, unfortunately also kill healthy cells. For years researchers have been trying to develop better drugs, modified mode of delivery and innovative dosing to overcome the adverse side effects of potent chemicals. With improvement in therapeutic strategy in mind, researchers with varied ideas gathered in New York City in the first week of November at the Chemotherapy Foundation Symposium to discuss their ideas for tomorrow.

• Agents useful in combating the consequences in immunocompromised cancer patients of extreme vulnerability to infection were the focus of prominent sessions at the recent 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Despite increased use of risk-reducing strategies (preventive antibiotics and hematopoietic growth factors), patients with severe neutropenia (reduced white blood cell counts) are at great risk for infection, according to Kenneth V.I. Rolston, professor of medicine, M.D. Anderson Cancer Center, University of Texas, Houston. When febrile episodes occur, however, new broad spectrum agents may allow treatment without hospitalization for a subset of low risk patients.

• A glossary of unfamiliar words and jargons in Cancer Watch, November 1996.