The CancerWeb Report, What's New In Cancer: January, 1997
Childhood Cancers

• Childhood cancer and smoking by fathers - A most unusual finding was reported by researchers at the University of Birmingham in the UK in the January, 1997 issue of the British Journal of Cancer. While intuitively we might expect smoking by mothers to be most critical to fetal and infant health, because of the intimate relationship with the fetus and later the nursing infant, this study found that paternal smoking was the strongest factor. The study included 1549 children for whom complete information was available, out of a potential total of 1952 in England, Scotland and Wales who died from cancer between 1953 and 1955. About 15% of all childhood cancers could be attributed to smoking by fathers. (Sorahan, Br J Cancer 75:134, 1996)

  Editor's Comment: - The researchers pointed out that while no reports have clearly associated maternal smoking with childhood cancer, three studies, including one in the UK covering 1977-81, have shown an association with paternal smoking. The most likely basis, the authors of the study said, would be mutagenic effects of tobacco carcinogens on sperm. But why would this not affect the ovum also? Unlike ova which are ready made and only maturing within the ovary, sperm cells are continually being produced by cell division, and dividing cells are the ones most likely to be affected by carcinogens. Carcinogens would also be expected to have effects on the dividing cells of the fetus, but it may be that the predominant effect would be to cause very early spontaneous abortion and reabsorption of the fetus. Also there might be metabolic inactivation of the carcinogens in the placenta. There is evidently much that is still unknown about this finding.

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• The role of preoperative chemotherapy in non-metastatic osteosarcoma - A multi-institutional Cooperative Children's Group study examined the role of preoperative chemotherapy (neoadjuvant) in osteosarcoma. Treatment comprised preoperative chemotherapy, surgery, and postoperative chemotherapy. As reported in the January, 1997 issue of the Journal of Clinical Oncology, they found that a good response to preoperative chemotherapy as determined by histology was predictive of increased survival. The 8-year event-free and overall survival figures were 81% and 87% for those who had a good histologic response, but only 46% and 52%, respectively, for those with a poor response. (Provisor, J Clin Oncol 15:76, 1997)

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• Premedication for painful procedures in children - Premedication for children undergoing such procedures as spinal taps, bone marrow aspiration, and biopsies, is frequently unsatisfactory. Many regimens produce undesirable sedative effects or side reactions. The Children's Research Foundation of Cleveland sponsored a study comparing a cocktail of meperidine/midazolam (MM) with ketamine/atropine/midazolam (KM). Results were published in the January, 1997 issue of the Journal of Clinical Oncology. KM use gave earlier readiness (19 versus 24 minutes) and quicker recovery (39 versus 75 minutes), and there were fewer side effects in terms of hypoxia, hypotension, and reduced respiratory rate, than with MM. No child had persistent behavioral abnormalities and all had amnesia for the procedures done. Both parents and children preferred KM over MM. (Marx, J Clin Oncol 15:94, 1997)