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The National Institutes of Health convened a panel of experts last month to evaluate recent studies and resolve issues regarding adjuvant therapy for patients with colon and rectal cancer. The 13-member panel, chaired by Glenn Steele, M.D., chairman of surgery at New England Deaconess Hospital in Boston, concluded that adjuvant therapy following surgery for specific stages of colon and rectal cancer may effectively reduce recurrence of disease and improve patient survival Surgery wUl be the primary treatment for the estimated 150,000 new cases of colon and rectal cancers diagnosed in 1990. Addressing the needs of the significant number of patients for whom the disease reappears, the panel recommended that: • Clinical trials should continue to identify and refme adjuvant therapy.
No More Dukes' • Clinicians should uniformly use the American Joint Committee on Cancer system for classifying stages of colon and rectal cancer in place of other systems. The AJCC, or TNM, system is based on descriptions of tumor size (T), lymph node involvement (N), and presence or absence of metastasis (M). • Researchers should conduct separate clinical trials for colon and rectal cancer patients to define appropriate adjuvant strategies. • Patients with stage I colon and rectal cancers do not warrant adjuvant treatment. • Adjuvant therapy with 5-fluorouracil and levamisole should be offered to all stage HI colon cancer patients who are unable to enter clinical trials and
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are without medical or other contraindications to treatment.
Rectal Cancer Patients • Postoperative adjuvant treatment combining chemotherapy and radiation therapy should be offered to all stage II and III rectal cancer patients who are not in clinical trials and are without medical and other contraindications to treatment. • Future clinical trials for colon and rectal cancer on adjuvant therapies should add immune system stimulators to and integrate radiation therapy with current treatments. Drug mechanisms should also be studied. • Early stage patients at risk of recurrence should be identified using biologic, anatomic, or genetic characteristics. • Patients' quality of life and benefits versus costs of adjuvant therapy should be evaluated. • Adjuvant therapy clinical trials should address the reported differences in incidence and survival in various ethnic and sotioeconomically disadvantage^ groups. — By Andree Jacobs-Perkins
Dr. Glenn Sleek
Cancer Groups, Dermatologists Push For 'Library Look' A good tan soon may no longer be considered the sign of an active, healthy person if some cancer organizations and the American Academy of Dermatology have their way. As summer approaches, these organizations are pushing hard to publicize the fact that a tan is not healthy at all—and that it substantially increases risk of skin cancer.
Lighten Up The AAD is entering the 6th year of a campaign to prevent and detect melanoma and other skin cancers. As in the past, the Academy is sponsoring free skin examinations in hospitals, clinics, and health fairs throughout the country during May, which has been designated National Melanoma/Skin Cancer Detection and Prevention Month. Academysponsored screenings have detected over 20,000 cases of suspected skin cancer since 1985. "Personally, I'm convinced that this program saves lives," said Howard K. Koh, M.D., a dermatologist and oncologist at Boston University and chairman of the AAD committee on melanoma/skin cancer screening programs. He said the people who show up for screenings are people who need to do so. "The people who show up appear to be at high risk." With the help of slogans such as "Lighten Up," the Academy is conducting a media blitz to publicize its campaign. Numerous press releases concerning melanoma and other skin cancers and a poster featuring comic-strip character Cathy are being distributed, and Joel Mole, the Academy's official Journal of the National Cancer Institute
Downloaded from http://jnci.oxfordjournals.org/ at University of Bath Library & Learning Centre on July 3, 2015
Consensus Developed For Colon/Rectal Cancer
The National Institutes of Health convened a panel of experts last month to evaluate recent studies and resolve issues regarding adjuvant therapy for patients with colon and rectal cancer. The 13-member panel, chaired by Glenn Steele, M.D., chairman of surgery at New England Deaconess Hospital in Boston, concluded that adjuvant therapy following surgery for specific stages of colon and rectal cancer may effectively reduce recurrence of disease and improve patient survival Surgery wUl be the primary treatment for the estimated 150,000 new cases of colon and rectal cancers diagnosed in 1990. Addressing the needs of the significant number of patients for whom the disease reappears, the panel recommended that: • Clinical trials should continue to identify and refme adjuvant therapy.
No More Dukes' • Clinicians should uniformly use the American Joint Committee on Cancer system for classifying stages of colon and rectal cancer in place of other systems. The AJCC, or TNM, system is based on descriptions of tumor size (T), lymph node involvement (N), and presence or absence of metastasis (M). • Researchers should conduct separate clinical trials for colon and rectal cancer patients to define appropriate adjuvant strategies. • Patients with stage I colon and rectal cancers do not warrant adjuvant treatment. • Adjuvant therapy with 5-fluorouracil and levamisole should be offered to all stage HI colon cancer patients who are unable to enter clinical trials and
820
are without medical or other contraindications to treatment.
Rectal Cancer Patients • Postoperative adjuvant treatment combining chemotherapy and radiation therapy should be offered to all stage II and III rectal cancer patients who are not in clinical trials and are without medical and other contraindications to treatment. • Future clinical trials for colon and rectal cancer on adjuvant therapies should add immune system stimulators to and integrate radiation therapy with current treatments. Drug mechanisms should also be studied. • Early stage patients at risk of recurrence should be identified using biologic, anatomic, or genetic characteristics. • Patients' quality of life and benefits versus costs of adjuvant therapy should be evaluated. • Adjuvant therapy clinical trials should address the reported differences in incidence and survival in various ethnic and sotioeconomically disadvantage^ groups. — By Andree Jacobs-Perkins
Dr. Glenn Sleek
Cancer Groups, Dermatologists Push For 'Library Look' A good tan soon may no longer be considered the sign of an active, healthy person if some cancer organizations and the American Academy of Dermatology have their way. As summer approaches, these organizations are pushing hard to publicize the fact that a tan is not healthy at all—and that it substantially increases risk of skin cancer.
Lighten Up The AAD is entering the 6th year of a campaign to prevent and detect melanoma and other skin cancers. As in the past, the Academy is sponsoring free skin examinations in hospitals, clinics, and health fairs throughout the country during May, which has been designated National Melanoma/Skin Cancer Detection and Prevention Month. Academysponsored screenings have detected over 20,000 cases of suspected skin cancer since 1985. "Personally, I'm convinced that this program saves lives," said Howard K. Koh, M.D., a dermatologist and oncologist at Boston University and chairman of the AAD committee on melanoma/skin cancer screening programs. He said the people who show up for screenings are people who need to do so. "The people who show up appear to be at high risk." With the help of slogans such as "Lighten Up," the Academy is conducting a media blitz to publicize its campaign. Numerous press releases concerning melanoma and other skin cancers and a poster featuring comic-strip character Cathy are being distributed, and Joel Mole, the Academy's official Journal of the National Cancer Institute
Downloaded from http://jnci.oxfordjournals.org/ at University of Bath Library & Learning Centre on July 3, 2015
Consensus Developed For Colon/Rectal Cancer
