Faculty Bibliography

Of 975 women assigned to a low-fat diet, 96, or 9.8 per cent, had recurrences. But 181 of 1,462 women, or 12.4 per cent, who were assigned to maintain their usual diet had their cancer return. Although the treatments varied, the two groups were equivalent because the women were assigned at random to follow a low-fat diet. The additional benefit from diet, [Rowan T. Chlebowski] said, was equivalent to adding a new drug to their regimen. The study began in 1994 and enrolled 2,437 postmenopausal women with early-stage breast cancer. Of them, 975 were assigned to a diet so low in fat that, Chlebowski said, it was about as low as possible without being a vegetarian diet. They consumed on average 33.3 grams of fat a day

[Bobby Short] reportedly entered a hospital less than a week before his death, thinking his abdominal symptoms were from diverticulitis, only to be diagnosed with leukemia. He succumbed to the disease a few days later. But diverticulitis, an infected wall of the large intestine caused by an in-pocketing of the bowel lining, is not at all similar to leukemia. So were there telltale signs of leukemia overlooked in the months before Short's death?

New studies show that Americans generally receive high-quality cancer care but that closer monitoring is needed to explain significant geographic variations in practices. Also, cancer specialists say they need improved training in communication so they can better advise terminally ill patients about how long they have to live and the care they wish to receive. The findings were presented at a meeting of the American Society of Clinical Oncology here Sunday. In the United States, about half a million people die of cancer each year

In the study, survival strongly correlated with the number of lymph nodes removed, Dr. [Natalie G. Coburn] said. Standard guidelines call for removal and examination of at least 15 lymph nodes for stomach cancer. Adherence to the guidelines varied geographically. More than twice as many patients in Hawaii (33.4 percent) survived five years after detection of stomach cancer than in Utah (16.2 percent). In Hawaii, the median number of lymph nodes removed was 15, compared with 6 in Utah. But even in Hawaii, 47.5 percent of patients did not have enough lymph nodes removed, Dr. Coburn said

BACKGROUND: We sought to determine the prevalence of active tuberculosis among ambulatory HIV-infected persons in Tanzania with CD4 cell counts of > or =200 cells/mm3 and a bacille Calmette-Guerin vaccination scar. METHODS: Subjects who volunteered for a tuberculosis booster vaccine trial were screened for active tuberculosis by obtainment of a history, physical examination, chest radiography, sputum culture and acid fast bacillus (AFB) stain, and blood culture. All subjects underwent a tuberculin skin test (TST) and lymphocyte proliferation assays (LPAs) for detection of responses to mycobacterial antigens. RESULTS: Active tuberculosis was identified at baseline in 14 (15%) of the first 93 subjects who were enrolled: 10 (71%) had clinical tuberculosis (symptoms or chest radiograph findings), and 4 (29%) had subclinical tuberculosis (positive sputum AFB stain or culture results but no symptoms or chest radiograph findings). An additional 6 subjects with subclinical tuberculosis were identified subsequently. The 10 subjects with subclinical tuberculosis included 3 with positive sputum AFB stains results and 7 who were only identified by a positive sputum culture result. Compared with subjects who did not have tuberculosis, the 10 subjects with subclinical tuberculosis were more likely to have peripheral lymphadenopathy, positive TST results, and elevated LPA responses to early secreted antigenic target-6 (ESAT). Eight of 10 patients had received isoniazid because of a positive TST result before active tuberculosis was recognized. CONCLUSIONS: Clinical and subclinical tuberculosis are common among ambulatory HIV-infected persons, and some cases can only be identified by sputum culture. World Health Organization guidelines for screening for latent tuberculosis before treatment do not recommend sputum culture and, therefore, may fail to identify a substantial number of HIV-infected persons with subclinical, active tuberculosis

A drug now used to treat breast cancer might be able to prevent prostate cancer in men with a precancerous condition, doctors said here Saturday. Another study suggested that the widely used cholesterol-lowering drugs called statins might stave off breast cancer. The prostate cancer study was a randomized clinical trial involving 514 men with precancerous lesions analogous to polyps for colon cancer. The condition is called prostate intraepithelial neoplasia, or P.I.N. After statistically controlling for a number of factors like age, smoking and diabetes, the researchers found a 51 percent lower risk of breast cancer among the statin users, Dr. [Vikas Khurana] said. He said data on the specific statins that were prescribed have not been analyzed yet

A drug now used to treat breast cancer might be able to prevent prostate cancer in men with a precancerous condition, doctors said yesterday. Another study suggested that the widely used cholesterol- lowering drugs called statins might stave off breast cancer. The prostate cancer study was a randomized clinical trial involving 514 men with precancerous lesions analogous to polyps for colon cancer. The condition is called prostate intraepithelial neoplasia, or PIN. After statistically controlling for a number of factors like age, smoking and diabetes, the researchers found a 51 percent lower risk of breast cancer among the statin users, [Vikas Khurana] said. He said data on the specific statins that were prescribed have not been analyzed yet

ORLANDO, Fla. -- A drug now used to treat breast cancer might be able to prevent prostate cancer in men with a precancerous condition, doctors said yesterday. Another study suggested that the widely used cholesterol-lowering drugs called statins might stave off breast cancer. The statin study analyzed medical records of 40,000 women in the database of the Veterans Affairs medical system. It found that women who used statins were half as likely to develop breast cancer as those who did not. But such studies looking back at medical records are not as reliable as clinical trials. There is evidence that estrogen, normally thought of as the female hormone, also helps fuel prostate-cancer growth. Dr. Mitchell Steiner, professor of urology at the University of Tennessee, theorized that blocking estrogen might provide a treatment or preventative with fewer side effects

Pancreatic cancer: A study found that the drug gemcitabine can reduce the recurrence of pancreatic cancer when used after surgery to remove a tumor. The drug, sold as Gemzar by Eli Lilly, is now approved for treating pancreatic cancer after surgery is no longer possible. But the finding might apply to only about 20 percent of patients, since most cases of pancreatic cancer are diagnosed after it is too late for surgery, said Dr. Michael Arning, medical director for the drug at Lilly

A drug called Avastin, which works by choking off the blood supply to tumors, prolongs the lives of patients with lung cancer and also significantly delays the worsening of breast cancer, according to the results of clinical trials. The cancer drug Herceptin, when used after surgery to remove breast tumors, cuts by about half the chance that breast cancer will recur. Avastin, when added to chemotherapy, extended the median survival of people with advanced lung cancer about two months. After two years, only 22.1 percent of those who got Avastin were still alive, although that was an improvement over the 16.9 percent who got only chemotherapy