In late May, the National Comprehensive Cancer Network (NCCN) announced updates to two NCCN Clinical Practice Guidelines in Oncology(TM) -- Esophageal Cancer and Gastric Cancer.

The panel added oral fluoropyrimidine, Capecitabine (Xeloda(R), Roche) as an option for treatment of esophageal and gastric cancer due to favorable Phase III trials. The panel also states that capecitabine may replace 5-FU and oxaliplatin may replace cisplatin in triplet regimens for advanced esophageal and gastric cancer.

Additional updates and the NCCN Clinical Practice Guidelines in Oncology(TM) are available at www.nccn.org free of charge.

The Human Papillomaviruses (HPV) vaccine called Gardasil can protect from the infection of four types of the HPV virus. Two of these types cause up to 70 percent of all cases of cervical cancer.

Recommendations were released by the Advisory Committee on Immunization Practices (ACIP) regarding the use of Gardasil. The FDA approved Gardasil in June 2006.

The role of ACIP is to advise the Director of the Centers for Disease Control and Prevention (CDC) and the Secretary of the Department of Health and Human Services (HHS) about vaccine usage and vaccine-preventable diseases.

The recommendations published by the ACIP:

• Recommended age for routine vaccination of girls is 11-12 years.
• The vaccine can be given to girls as young as 9 years.
• Catch-up vaccination is recommended for girls and women between the ages of 13 and 26 years who were not vaccinated previously or who did not complete the full vaccine series (the vaccine is administered in three separate doses).
• Routine cervical cancer screening remains important following vaccination.

The ACIP's recommendations can influence policy and practice, but are not directly linked with school and daycare entry laws. These laws are made by individual states.

Simply being female puts all women at risk for breast cancer. That and age, race, family history, personal history, genetic make-up, when they had children, when they reach menopause, and a whole host of other possible factors.

Now U.S. doctors are officially calling body mass index, breast density, and alcohol consumption predictors of the disease, says Therese Bevers, medical director of the Cancer Prevention Center, at the University of Texas M.D. Anderson Cancer Center in Houston.

Bevers helped write updated guidelines for the prevention of breast cancer and presented them at the 12th annual National Comprehensive Cancer Network in Hollywood, Florida on Friday.

The guidelines, featuring the revised list of risk factors, also offer treatment options for women -- including bilateral mastectomy for women who have tested positive for the genes BRCA1 and BRCA2 as well as possible medical treatments with drugs such as tamoxifen and raloxifene.

They are called DES daughters, and they are the women who mothers took the anti-miscarriage hormone drug DES during pregnancy. It is estimated that millions of pregnant women were given this drug between the 1940s and 1960s, and it's now been determined that the daughters born to these women have not only an increased risk of a rare vaginal cancer but also nearly double the chance of developing breast cancer.

This sad finding has been addressed before but now more than ever, DES daughters are urged to stick to a strict breast cancer screening schedule.

A news brief published in the February 2007 issue of Good Housekeeping boldly reminds all women to comply with government guidelines that call for mammograms for all women every one to two years starting at age 40 and every year after the age of 50. But it's a different story for women exposed in utero to DES.

"If you were exposed to DES, be sure to let your doctor know and have a mammogram ever year, even in your 40s," says Julie Palmer, lead researcher of the DES study.

Cancer patients who have heart attacks are typically not treated with a course of life-saving aspirin because of the belief that these patients might experience lethal bleeding.

This belief is now under dispute and researchers at The University of Texas M. D. Anderson Cancer Center say that without aspirin, the majority of these patients will die. Their arguments, subject of a recent study, will be published in the February 1 issue of the journal Cancer.

Aspirin has been viewed as harmful because of its tendency to thin blood. Because cancer patients can experience low platelet counts and abnormal clotting, aspirin has been considered a contraindication. But this study found that nine of 10 cancer patients with low platelet counts who experienced heart attacks and who did not receive aspirin died. Only one patient died, however, in a group of 17 cancer patients who received aspirin.

This conclusion -- that aspirin helps people with cancer just as it does for people without cancer -- may help medical professionals determine guidelines for treatment of heart attacks in cancer patients. Because right now, physicians are uncertain about how to balance treatment for both conditions.

Hyperthermia therapy with radiation have been added to the 2007 National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for Breast Cancer as an approved treatment for recurrent breast cancer and other localized cancer recurrences.

According to an explanation by the BSD Medical Treat with Heat website, hyperthermia therapy uses heat, which has been shown to kill cancer cells, in the treatment of cancerous tumors. Hyperthermia therapy also appears to make radiation therapy more effective. "While it has been known for hundreds of years that fevers can kill cancer, only recently has technology been developed that can control and focus heat specifically on tumors. This technology is found in the BSD-500 Hyperthermia System."

The BSD-500 Hyperthermia System is already used in the treatment of skin cancers that are progressive or recurrent despite conventional therapy. To learn more about hyperthermia therapy, request a free information kit, learn treatment options, find a physician, or speak to a patient advisor, visit the Treat with Heat website.

Smoking is the biggest risk factor for lung cancer -- and 90 percent of all lung cancer cases are related to smoking. But family history is a risk factor too and can nearly double the risk of developing the deadly disease.

A study published in the October issue of Chest found by studying a population of Japanese adults that people with a first-degree relative -- mother, father, or sibling -- who had lung cancer had a 95 percent higher risk of contracting the disease. Those who smoked had the greatest risk, but those who did not smoke were still at risk. And women were more at risk than men. The type of lung cancer most associated with family history is squamous cell carcinoma.

The results of this study do not yet translate into recommended guidelines for screening. But those with a family history of lung cancer should make their physicians aware of their history. And perhaps one day people with family history will be identified as high-risk for lung cancer and will be included in further studies. In the meantime, these individuals should avoid all contact with all inhaled and second-hand smoke and should protect their children from all forms of tobacco smoke.

The U.S. Centers for Disease Control and Prevention estimates that more than 180,000 cases of lung cancer are diagnosed each year. About 170,000 die from the disease every year. It's the second leading cause of death for men and the third leading cause of death for women.

A review was done by an international panel of experts of literature concerning chronic myeloid leukemia (CML) for the recommendation of treatment options. The panel included ten members that reviewed 194 papers on CML written since 1998.

The article was recently published in the journal Blood. Gleevec (imatinib mesylate) has become a standard treatment for Philadelphia chromosome-positive CML. Specific guidelines for the use of Gleevec in the treatment of CML have recently been compiled.

• All newly diagnosed patients should be treated with 400 mg of Gleevec per day.
• Patients who do not respond to Gleevec should be treated with higher doses, an allogeneic stem cell transplantation, or experimental therapy. This experimental therapy could include agents designed to over come resistance to Gleevec.

Responses to treatment can be determined by several laboratory tests. Talk to your physician about specific details regarding responses to Gleevec.

Just before my treatment for breast cancer began and during a consultation about what chemotherapy drugs I was about to receive, my oncologist stepped away from my exam room to check on something. When she returned to the room, she told me that she was determining whether or not I qualified for a clinical trial. I had no idea what this meant at the time. All I knew was what she told me -- that my prognosis was too good at that moment to qualify for anything currently under study. I did not fit a profile for anything. I was not a candidate for a clinical trial.

I now know that clinical trials are a critical component of research -- they validate a drug's success or weakness and they provide hope for many who may be at the end of their treatment rope and need something new to consider. A clinical trial is a comparison of standard treatments to newer treatments in an effort to discover better methods for the diagnosis and treatment of cancer. Doctors, scientists, and other health professionals conduct these tests according to strict guidelines set by the Food and Drug Administration -- which establishes mandatory guidelines to ensure the maximum safety of the patient.

Clinical trials rely on volunteers -- and sadly, there is a current shortage of patients willing to participate in trials. Experts say that, for the past few decades, just five to 10 percent of all cancer patients in the United States have joined a clinical trial. There is an urgent need -- because the demand for willing, eligible participants far exceeds the supply. Some experts are even recommending that the small pool of candidates that does exist be rationed to only the most important cancer studies -- leaving other studies with no hope for completion. There is no good solution in sight. But the reasons for the shortage are becoming apparent. It's not that patients are unwilling to join. It's that they are unaware, uninformed, not even sure this opportunity is possible -- because doctors are not suggesting trials to their patients. Treatment on a protocol is more demanding for doctors than routine medical care. And it costs doctors to submit to a trial. And trials burden doctors with regulations and paperwork. And some doctors worry about litigation if something experimental goes wrong. So they often don't approach the topic -- and the result is that a wonder drug may sit in a dark freezer because there are not enough people to test it. This potential wonder drug may never show promise, may never save a life, may never see the light of day.

So I guess my oncologist was ahead of the game in this matter -- she compared my diagnosis and prognosis with the needs of all available clinical trials and found that there was not match. Had she not done this, I would have never thought to ask about the possibility -- which is exactly what patients should do instead of waiting for a doctor to make the suggestion. Because it may never happen.

For more information on clinical trials, please visit the Coalition of Cancer Cooperative Groups.

Celebrity Naked Chef Jamie Oliver has started a true food revolution to ban junk food and get fresh, tasty and, above all, nutritious food back on the school lunch menu. As a result of public demands for better food for England's school children -- inspired in part by Oliver's very vocal and public campaign -- government officials have announced new nutritional standards in how often school children can be served certain foods. According to the new guidelines for school lunches, school meals must be free from low quality meat products, fizzy drinks, crisps, and chocolates. Also banned is the sale of junk food at school and in vending machines. School lunch programs are required to provide at least two portions of fruits and vegetables, and to offer high quality meat, chicken or oily fish on a regular basis.

"This is a really ambitious program," Schools Minister Jim Knight told BBC radio. "It will take a long time to transform a whole culture around food and transform the health content of school meals, undoing decades of neglect." Yes, but change has to start somewhere -- and this seems a good start. Everyone talks about the problems of obesity in children and the long-term health consequences such as an increased risk for cancers later in life, but here is someone who took it on to inspire a nation to make a difference -- and appears to be succeeding. Hats off to Oliver!