Faculty Bibliography

His team's findings support the growing view that oncologists continue to prescribe chemotherapy for too many cancer patients when clinical evidence indicates they are in the terminal stages of the disease. There are no guidelines for the appropriate use of chemotherapy at the end of life based on scientifically controlled trials or consensus statements, [Ezekiel Emanuel] said. The researchers used standard textbooks to classify whether different cancers were generally responsive or unresponsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gallbladder, kidney, liver, pancreatic and melanoma. This summer, [Michael Glantz] will start work at the Barrow Institute in Phoenix, and he said his team would begin studies to determine whether marriage counseling or other types of counseling can help patients with brain tumors and their spouses cope with the disease. Depression and fatigue are frequent problems of patients undergoing chemotherapy, and a common notion among cancer doctors is that they are linked. But in a study by Dr. Gary Morrow's team from the University of Rochester Cancer Center, they were found not to be linked

His team's findings support the growing view that oncologists continue to prescribe chemotherapy for too many cancer patients when clinical evidence indicates they are in the terminal stages of the disease. There are no guidelines for the appropriate use of chemotherapy at the end of life based on scientifically controlled trials or consensus statements, [Ezekiel J. Emanuel] said in an interview. The researchers used standard textbooks to classify whether different cancers were generally responsive or unresponsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gallbladder, kidney, liver, pancreatic and melanoma. Additional studies are needed in order to confirm such findings nationally and to develop guidelines for when chemotherapy should be stopped in terminal cases, Emanuel said. He also urged studies to determine how much managed care and traditional fee-for-service practices influenced the timing of chemotherapy

His team's findings support the growing view that oncologists continue to prescribe chemotherapy for too many cancer patients when clinical evidence indicates they are in the terminal stages of the disease. There are no guidelines for the appropriate use of chemotherapy at the end of life based on scientifically controlled trials or consensus statements, Dr. [Ezekiel J. Emanuel] said in an interview. Dr. Emanuel's team from Boston University and Stanford University linked information from death certificates in Massachusetts and Medicare billing records. The researchers used standard textbooks to classify whether different cancers were generally responsive or unresponsive to chemotherapy. Responsive cancers included in the study were breast, colon and ovarian. Unresponsive cancers included gallbladder, kidney, liver and pancreatic cancer and melanoma. Additional studies are needed before such findings can be confirmed nationally and to develop guidelines on when chemotheraphy should be stopped in terminal cases, Dr. Emanuel said. He also urged studies to determine how much managed care and traditional fee-for-service practices influenced the timing of chemotherapy. In addition, he said, studies are needed to better understand how the interaction among doctors, patients and families influence the use of chemotherapy in terminal stages of cancer

Yesterday, researchers told participants at a meeting of the American Society of Clinical Oncology that Gleevec was producing equally striking benefits among patients with advanced cases of an intestinal cancer known as GIST, for gastrointestinal stromal tumor. Of 86 patients who had taken Gleevec for three or more months in a study last summer reported by Dr. Charles D. Blanke of the Oregon Health & Science University in Portland, the GIST went into remission in 51 of them, or 59 percent. Still, Blanke and other scientists warned that Gleevec failed in a number of GIST patients and that doctors did not know if GIST cells would develop resistance to Gleevec

[Charles D. Blanke] and other scientists said that Gleevec failed in a number of GIST patients and that doctors did not know if GIST cells would develop resistance to Gleevec

Johns Hopkins officials have questioned whether FDA approval was required for the asthma study; nonetheless, they said they have temporarily halted any studies involving drugs for which the FDA has not given permission for experimental use until they consult with the drug agency. The FDA licensed hexamethonium as a pill for treatment of high blood pressure in the 1950s, but the manufacturer withdrew it from the market in the 1970s after new laws required that drugs meet both safety and effectiveness standards instead of the earlier standard of safety, said Dr. David Lepay, an FDA official. Johns Hopkins officials last night said the researcher who led the study, Dr. Alkis Togias, and the review board did not believe that they needed FDA approval for inhaled hexamethonium because it was being used for basic physiology tests and not to test its therapeutic value

Whether the device that was implanted near [Dick Cheney]'s left shoulder will prevent him from casting with his right arm this week is uncertain. Saturday, Dr. Jonathan S. Reiner, Cheney's cardiologist, said his team had advised Cheney against vigorous upper- body exercise 'for the next several days certainly, and maybe the next couple of weeks.'

[Jonathan Reiner] said his team wanted [Dick Cheney] to continue his regular aerobic exercising. The temporary ban on upper-body exercise is to provide enough time for the device, known as an implantable cardioverter defibrillator, or ICD, to settle in place near his left shoulder, and for the incision to heal. It will take several weeks for Cheney's body to form the scar tissue that will secure the device. Cheney needed the device because an electrocardiogram test performed two weeks ago detected four episodes of a very rapid and potentially fatal heart rhythm known as ventricular tachycardia, which stopped on their own after two seconds or less

Whether the device that was implanted near Mr. [Dick Cheney]'s left shoulder will prevent him from casting with his right arm this week is uncertain. At a news conference on Saturday, Dr. Jonathan S. Reiner, Mr. Cheney's cardiologist, said his team had advised Mr. Cheney against vigorous upper body exercise ''for the next several days certainly, and maybe the next couple of weeks.'' Dr. Reiner said his team wanted Mr. Cheney to continue his regular aerobic exercising. The temporary ban on upper body exercise is to provide enough time for the device, known as an implantable cardioverter defibrillator, or I.C.D., to settle in place near his left shoulder and for the incision to heal. It will take several weeks for Mr. Cheney's body to form the scar tissue that will secure the device, a model known as Medtronic GEM III DR

[Jonathan Reiner] said he had been explicit in telling [Dick Cheney], 60, that 'this procedure and this device would not in any way impair his ability' to perform his duties. Cheney has been hospitalized three times since November. He suffered a minor heart attack during the recount that followed the presidential election, and doctors installed a wire mesh stent to keep a clogged coronary artery open. That artery narrowed again, requiring another procedure to reopen it in March. Assuming that Cheney's disease proves manageable for the next three years, the big political decision for [Bush] would come in 2004, when he would have to decide whether Cheney should once again be his running mate