ElderWeb

Middle-class and upper-middle-class US and Canadian residents have similar odds of surviving cancer, but America's poorer residents do not fare as well as those in Canada, according to new study findings. The study was led by Dr. Kevin M. Gorey, of University of Windsor in Ontario, and reported on in the Journal of Public Health Medicine.

Among people on the bottom one third of the socioeconomic ladder, Canadians were about 35% more likely to survive cancer than similar US residents. The researchers attribute the results to the differences in the Canadian and US healthcare systems. Gorey noted that several previous studies have failed to detect a difference in cancer survival between the two countries, but the research did not break down the statistics by socioeconomic status. The disparity between the US and Canada was even greater when the analysis only included people who were diagnosed with cancer before age 65. In the US, most of these people would not be eligible for Medicare, the federal health insurance program for the elderly.

The Food and Drug Administration (FDA) has created a new cancer web site. The site provides both professionals and consumers with information about drugs approved for cancer treatment, disease summarys, and regulatory tools. The site is the first effort of the FDA to subdivide the drug information on their site by disease category. The site includes detailed data on approved oncology drugs, including uses, product labels, and transcripts of pertinent advisory committee discussions; a flow chart to help select the starting dosage for cytotoxic drugs in oncology; general advice on how to obtain access to experimental drugs; information about reporting adverse events; assessment tools for conducting clinical investigations, such as a staging manual for different types of cancers; and information about filing an application for an investigational new drug and about investigational review boards.

The current issue of the Journal of Clinical Oncology has a report from researchers who investigated complaints that breast cancer patients receiving chemotherapy have difficulty in their ability to remember, think, and concentrate. The research team was led by Dr. Ian F. Tannock of Princess Margaret Hospital in Toronto. Tannock's team found that, regardless of the women's mood, age and education, chemotherapy patients did show signs of mental impairment. They believe the cancer drugs may be acting on healthy brain cells, but that is still unclear. Tannock cautioned that this potential side effect should not scare away breast cancer patients, but that they should be fully aware of the possible adverse consequences of chemotherapy. He said, "As an oncologist, one thing that worries me is that some women might use this as an argument against a treatment that can help them."

A study in the latest issue of The Journal of the American Geriatrics Society found that poverty, lack of education and a lack of health insurance prevent many elderly black Americans from getting screened for cervical, breast and colon cancer. Dr. Verona Hegarty from the Veterans Affairs Medical Center in Durham, North Carolina, and colleagues conducted the research, and concluded that this lack of screening at least partly explains why blacks in the US are more likely to die of cancer than whites.

Previous studies have uncovered racial differences in cancer screening. To investigate why these differences occur, researchers interviewed more than 4,000 elderly Americans in 1986-1987 and followed up with nearly 3,000 people in 1992-1993. The follow-up survey included 1,246 blacks and 966 whites older than 70 years. Investigators asked patients about their use of the Pap smear; clinical breast examination and mammography; and rectal examination and fecal occult blood testing to diagnose colorectal cancer. Researchers concluded that black women were less likely than white women to be screened for cervical and breast cancer, and that elderly blacks were less likely to be screened for colon cancer.

American Home Products Corporation received U.S. Food and Drug Administration approval for Mylotarg, under accelerated approval provisions. Mylotarg is intended for the treatment of patients 60 years and older in first relapse with CD33-positive acute myeloid leukemia (AML) who are not considered candidates for cytotoxic chemotherapy.

Acute myeloid leukemia strikes over 9,000 Americans a year, most over age 60. Most eventually relapse, but standard treatment for this type of leukemia causes so many serious side effects in older patients who relapse, and is so much less effective in them, that many doctors do not offer it.

FDA oncology chief Dr. Richard Pazdur said that the hope is that Mylotarg will offer these elderly patients a viable option, but he cautioned that the drug's effects are not yet proved. The FDA approved Mylotarg under a special rule that lets promising drugs for certain lifethreatening diseases to sell before studies prove just how well they work.

Mylotarg was designated an orphan drug in November 1999.

The Colon Cancer Alliance (CCA) and Fleet Pharmaceuticals are conducting an online survey to identify barriers that prevent people from getting colorectal cancer screening done. They promise that survey results will be kept strictly confidential, and results will be reported in aggregate form without identifying particular individuals. They are asking people who visit the CCA site if they are willing to participate in this survey.

Marshall Kragen, a survivor of colorectal cancer, founded the Colon Cancer Internet Discussion List in 1996, a large international Internet "family" where individuals support one another in their battles with colorectal cancer. The CCA grew out of this discussion list, when list members, who had often talked about the lack of an organized effort to promote public awareness about colorectal cancer and to provide support services for those affected by the disease, created the organization to provide these resources. All the board members of the organization have a personal or family history of colorectal cancer.