Tip Sheet


Breast Cancer's 'New Era'

Breast-cancer patients deserve good news, and they got a nice helping of it last week when a large, international clinical trial was halted early because the drug being tested was found to dramatically reduce the risk of relapse. The findings for the drug, letrozole--manufactured by Novartis and sold under the brand name Femara--electrified researchers and prompted them to abort the double-blind study of 5,187 women with early-stage disease and offer the treatment to the 2,594 patients who had been receiving a placebo. "This is the beginning of a new era in breast-cancer therapy," says Dr. Paul Goss, of Princess Margaret Hospital in Toronto, who directed the project.

Stopping such a big and important study is exceptional, but so were the results: letrozole reduced the risk of recurrence among older women by 43 percent. (Most of the 1 million women worldwide diagnosed with breast cancer each year are postmenopausal.) Goss and his colleagues in the United States and Europe were testing the drug as a follow-up treatment. The women in the letrozole study had recently completed (after surgery) the standard five-year course of tamoxifen, a powerful and widely used drug that eventually loses its effectiveness as, researchers believe, tumors become resistant to it. Until now, breast-cancer patients who finished tamoxifen treatment could only wait and hope that their cancer wouldn't recur--which it does, within five years, in up to 20 percent of such cases. Letrozole, previously approved by the U.S. Food and Drug Administration for advanced breast cancer, and readily available, offers an exciting new option for extending treatment of early-stage disease. "If it raises my chances even 1 percent, I say sign me up," says Debbie Lloret, 46, a New York City mother and breast-cancer survivor who has undergone two lumpectomies, a mastectomy, chemotherapy and is currently in her third year of tamoxifen. "I am so excited about this I can't even tell you."

Letrozole, like tamoxifen, works by interfering with the hormone estrogen, which feeds some breast-cancer cells; tamoxifen blocks estrogen receptors on the cells, while letrozole inhibits the creation of estrogen. (Letrozole is not effective when given alone to premenopausal women who ovulate, because they produce much more estrogen than postmenopausal women.)

Letrozole has side effects similar to what women experience during menopause, including hot flashes and osteoporosis. The study recommends that women receiving letrozole therapy take calcium and vitamin D and have a doctor monitor their bone density.

The news about letrozole is an exciting development for breast-cancer patients, but it is not the last word on the drug. An editorial accompanying the report (released early by the New England Journal of Medicine) notes that while "letrozole is generally well tolerated, concern about the consequences of long-term use remains." Goss points out that the study was never intended to examine long-term effects. His research group will continue to track the patients in the study, he says, and adds that so far there is no evidence of serious toxicity. New studies will have to be done to look at the potential risks and benefits of using letrozole for periods of longer than five years.

All of which means, as breast-cancer patients and their families know so well, proceed with caution. "This is no magic bullet and it is not the end of the journey," says Dr. Andrew von Eschenbach, director of the National Cancer Institute, which led the study in the United States. "There is much, much more to do. It is one step, but it is an important step."


Diamonds That Glow

Upscale Hong Kong clubgoers are ditching glow sticks in favor of something pricier: diamonds. Fluorescent gems, which contain traces of the element boron, cost 10 percent to 20 percent less than nonfluorescent stones because they can have a cloudy appearance. But shine a black light on them and they glow like a blue flame. The effect has inspired Barney Cheng, Hong Kong's premier couturier, to design his first jewelry collection around fluorescent diamonds. Among the made-to-order pieces are ID bracelets in pave settings (barneycheng.com; prices start at $3,300 for silver and $20,500 for platinum). Under a black light a secret message, like a name or a heart, emerges. Tip: If you want stones that glow especially brightly and don't mind a slightly milky look, choose ones with a fluorescence grade of "strong blue"--and check them under a jeweler's light first.


A Bum Rap

Why ski when you can slide down the slope on your bottom? Resorts across Europe are busy adding new toboggan runs, and sleds are on offer at almost every ski-rental store. Some top picks:

Val-Thorens, France: The highest run in Europe opened last year at the custom-built resort in Savoie. Start at 3,000 meters and drop to 2,300 in a vertiginous six-kilometer plunge. Not for the kids.

Sesto, Italy: A bending, five-kilometer run that follows a forestry road through the spruce woods in one of the most dramatic patches of the Dolomites.

Grindelwald, Switzerland: The longest toboggan ride in Europe, this 16.5-kilometer course can take half an hour to complete. And it's not for slackers: the cable car only reaches halfway up the mountain.

Bleckenau, Germany: A superscenic, 4.5-kilometer swoop through the Bavarian countryside that starts at the old royal hunting lodge of Bleckenau and passes beneath the walls of Neuschwanstein, the showpiece neo-gothic castle.

Schladming, Austria: Perfect for nighttime thrills, this seven-kilometer run stays open until 10 p.m. Dine at the restaurant on the peak, then slide home to bed in the valley.


A Sweet Sampler

October is the sweetest month, at least in Perugia, Italy, home of the 10th annual Eurochocolate festival, which opens this week. Tip Sheet tested some of the new chocolates recommended by organizers:

Ethnic Chocolate (www.domori.com): We liked the Green, a mix of chocolate liquor, cocoa butter and green tea. As an added bonus, the makers vow to leave endangered cacao varieties unharmed. Is this truly guilt-free chocolate?

Chocolate di Bruco (cioccolatodibruco.com) won last year's "best handmade chocolate" award. Of their five varieties of cacao infused with essential oils, we recommend the Dark Chocolate with Anise.

Spiced Chocolate by Streglio (www.streglio.it) includes unusual flavors like ginger and hot pepper. Go for the cinnamon.

ICAM (icamcioccolato.it) and Sugar Company (sugarcompany.it) offer a line of sugar-free sweets. Stick to the real stuff. What good is chocolate without a little remorse?

Ask Tip Sheet If you're feeling under the weather, should you continue with your exercise regime, or will it make you sicker? I've heard conflicting advice.

If you've just got a head cold, exercise is a fine idea. It may not be pleasant at first, but it'll restore your energy. If it's the flu that's troubling you, though--especially if you have muscle aches, fever or a phlegm-producing cough--skip workouts that leave you short of breath and stick to gentle stretches only. (Or just lie on the couch. Hey, you've got an excuse.) Whatever you do, drink plenty of water, since exercise and sickness can both leave you dehydrated.


Going Ga-Ga For George

Intolerable Cruelty," the Coen brothers film starring heartthrob George Clooney, is rolling out worldwide this month. If it hasn't yet reached your shores, check out these Clooney videos while you wait.

Solaris: There was some serious schadenfreude when this prestige picture tanked. Now it's hip in Hollywood to say the space-age film was robbed. Believe the hype, this one deserves another watch.

Ocean's 11: Clooney starts and ends this heist film in a tuxedo and stays classy all the way through. Come for Julia Roberts, stay for Elliott Gould.

O Brother, Where Art Thou? Even a Grammy for its soundtrack couldn't make this Coen brothers film uncool.

Three Kings: Get over your rightful shame in renting a movie with Mark Wahlberg on its cover. This 1999 sleeper about soldiers after the first gulf war resonates today.

Out of Sight: 'One of J. Lo's best' may sound like faint praise, but seriously, Cloonifer rocks.

The oldies: That villa at Lake Como didn't pay for itself. Before he was famous, Clooney brought in the bucks with roles in stinkers like "Return of the Killer Tomatoes," and as a "lip-syncing transvestite" in "The Harvest."

Gardening: Autumn

Fall is the new spring: horticulturists say it's the perfect time to plant most trees, shrubs and perennials. So put down that rake.

Thompson & Morgan This Suffolk, England-based company has one of the world's largest seed catalogs. They ship worldwide.


Crocus Home to more than 4,000 plant varieties, from irises to fig trees. Its detailed tips, including predesigned borders, will have you hoeing in no time.


Forest Farm The place for year-round color. Get peonies or poppies for spring blooms; autumn crocus or snowberry for early winter bursts.


Brent and Becky's Bulbs Bulbs R Us. Some 200 kinds of tulips alone, or try mixing alliums and hyacinthus.