The oncologist
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COMMENTS FOR PROFESSOR BARRIE R. CASSILETH: I have enjoyed reading the two issues of The Oncologist I've received so far. I would like to make some comments on Dr. ⋯ But most oncologists, like Dr. Quah, indeed are faced with trying to advise patients about therapies for which there is little hard evidence. The best guiding principles at this point are to discourage remedies that promise cancer cure or are promoted for use instead of mainstream treatment, encourage non-invasive, comforting, complementary (adjunctive) therapies such as massage, green tea and qi gong, and check medical journals and newspapers for warnings such as those issued recently for Ma Huang (ephedrine), a still-common ingredient in herbal remedies widely available through catalogs and in health food stores.
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". we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military industrial complex." Dwight D. Eisenhower, 34th President of the United States (1953-1961). Farewell Address, January 17, 1961. ⋯ It is our responsibility to tout our accomplishments, admit our failures, and provide progressively better basic and clinical research with an eye toward future improvements in outcome. We must not be seen as yet another special interest come to drink at the well of public spending, but as advocates for the public good. If we fail to become important to those who control medical spending, we will be unable to make any important long-term contribution to those who matter most - our patients.
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CHARACTERISTICS AND PATHOLOGY OF MYELODYSPLASTIC SYNROME: Myelodysplastic syndrome (MDS) is a disease of the blood whose etiology is unclear. There is little that can be done therapeutically, and the prognosis for patients with this disease is poor. The main hematologic finding is anemia, but MDS responds poorly to the various kinds of drugs used to treat anemia, and in the past it was called refractory anemia. ⋯ From the standpoint of chromosomal research, it is believed that MDS occurs not from a single type of stem cell damage, but from an accumulation of multiple and random stem cell damage. MDS is a prime candidate for research on the onset of human leukemia, and when we combine what we know about MDS with its development into leukemia, we can understand the development of MDS from the standpoint of apoptosis, genetic abnormalities, chromosomal abnormalities and progression of cloning. RISK FACTORS: Many risk factors for MDS have been proposed, and it has been confirmed internationally that the four major risk factors are the blast cell ratio in the bone marrow, advanced age, chromosomal abnormalities, and thrombocytopenia.
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Dear Colleague: I remember, but just barely, what it was like to practice medicine in the first half of this century. My Dad was a general practitioner in a very small farming community in central Illinois, with a hospital of six beds and a trusting clientele. His patients thought he knew how to do everything: deliver babies, set broken bones and take out an appendix. ⋯ In this journal, we hope to put the best and latest information on cancer management before our readership, to prepare them for the future, and to do their best as a team for every patient. To this end, we hope to challenge the reader to understand what is new and better, and to let you glimpse the future, not only in terms of research, but also in terms of new team approaches to disease management. We hope to explore how cancer medicine could be and will be practiced as we pass through the economic revolution and return to the future.
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About twenty years ago, the leaders of the National Cancer Institute (NCI) decided to start a new branch in the Clinical Oncology Program of the Division of Cancer Treatment. That new entity was named the Clinical Pharmacology Branch (CPB), and its first leader was a brilliant, young, promising investigator named Bruce A. Chabner. ⋯ It is a pleasure for me to witness the launching of the second phase of an already tremendous career. From Advances in Cancer Treatment: The Chabner Symposium. Stem Cells 1996;14:64-65.