The past 20 years have seen a rapid increase in our understanding of the biology of cancer. And, advances in understanding the genetics of cancer are beginning to have an impact on the clinical management of malignant disease. Many of the genetic changes that underlie malignant transformation of cells and/or that distinguish malignant clones can be used as markers to diagnose, monitor, or characterize various forms of cancer.

The purpose of this volume is to assess the current status of genetic testing in cancer management both from the standpoint of those tests and genetic markers that are presently available and from the perspective of genetic approaches to cancer testing that are likely to have an impact on cancer management in the near future.

Contents

• PANEL FOR THE RESEARCH BRIEFING ON ADVANCES IN UNDERSTANDING GENETIC CHANGES IN CANCER: IMPACT ON DIAGNOSIS AND TREATMENT DECISIONS IN THE 1990s
• Statement of Purpose
• 1. Introduction
  • Outline of Molecular Genetics
  • Brief Overview of Cancer Genetics
• 2. Testing for Tumor-Specific Genetic Markers
  • Microscopic Detection of Alterations in DNA Structure
  • Techniques for Detecting Changes in DNA Structure at the Submicroscopic Level
  • Techniques for Detection of Point Mutations in DNA
  • Techniques Directed at Analysis of RNA
  • Techniques for Analyzing Changes at the Protein Level
• 3. Hematologic Cancer
  • Chronic Myelogenous Leukemia
  • Chronic Lymphocytic Leukemia
  • Acute Lymphocytic Leukemia
  • Acute Myelogenous Leukemia
  • Myelodysplastic Syndromes
  • Lymphoma
• 4. Solid Tumors
  • Chromosomal Aberrations of Diagnostic Importance
  • Chromosomal Aberrations of Prognostic Importance
  • Genetic Markers of Predisposition to Cancer
  • Genetic Changes and Tumor Progression
  • Cancer-Associated Genetic Changes and Environmental Mutagens
  • Viral Markers in Cancer Diagnosis
• 5. Summary and Specific Recommendations
  • Practical Aspects of Genetic Analysis: From Patient to Diagnostic Laboratory
  • The Molecular Diagnostic Laboratory
  • Implications of Commercialization
  • Future Needs
• 6 References
• [Plates]

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 Congressional charter responsibility to be an advisor to the federal government, and its own initiative in identifying issues of medical care, research, and education.

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