Shying Away from the Cutting Edge

* "Shying Away From the Cutting Edge" (Health News, June 1) aptly, if unintentionally, illustrates why people with cancer might be reluctant to participate in clinical trials. Cancer doctors are quoted saying it's the "best way for their patients to get cutting-edge care." Later we learn that some people may "believe that a certain treatment is preferable and may be reluctant to be randomly assigned to a treatment." If oncologists continue to portray the treatments delivered in clinical trials as "state of the art" or "cutting edge," why would anyone want to risk randomization to a placebo or even standard care? It would be more honest to describe the care in clinical trials as treatments that may be cutting edge.

Maryann Napoli

Associate director

Center for Medical Consumers

New York

Breast Cancer Roulette

* I am one of the breast cancer survivors featured in the aptly titled "Breast Cancer Roulette" (Cover Story, April 27).

Just weeks after the article appeared, saying that I was cancer-free, I was diagnosed with metastatic breast cancer. Even though I had hoped this day would never come, or at least would come many years from now, I can still affirm that I wouldn't have changed my aggressive treatment plan, including autologous bone marrow transplant. I'm not sitting here wondering, "What if I'd tried that?" I've tried it all already, I'm just looking to the future and trying to make the best of it.

Laura Carter

Takoma Park

Health and the Welfare Gap

* "Health and the Welfare Gap" (Second Opinion, May 18) states that although "there's general agreement that the country should do more for children . . . any blueprint for the future is blurred."

Surely we as a nation can focus our vision long enough to provide access to equitable health care for our youngest citizens, regardless of their parents' income. America must embrace a base line of appropriate health care for all our children. This would elevate our health care status among the ranks of industrialized nations, and would mark us as a truly civilized society.

Irwin Redlener, MD

President, the Children's Health Fund

and the Children's Hospital at Montefiore

New York

Taking Aim at Rotavirus

* Licensing of the new rotavirus vaccine ("New Vaccine Takes Aim at Rotavirus," Health News, May 18) is an important step toward eliminating a major cause of infant suffering in the United States and abroad. I would like to add that development of the vaccine has been the life's work of Washington area scientist Albert Kapikian, who carried out critical research and development studies of the vaccine in his laboratory at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda.

Kapikian received the 1998 Children's Vaccine Initiative Pasteur Award for that achievement. I would like to acknowledge the enormous contribution he has made to the health of children everywhere.

Harold Varmus, MD

Director, National Institutes of Health

Bethesda

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