GERING, Neb. (AP) — Officials say a wildfire south of Gering in the Nebraska Panhandle has been brought under control.

The fire had blackened about 100 acres (40 hectares) of land by Tuesday evening. It’s believed to have been started by a lightning strike Monday.

Region 22 Emergency Management Director Tim Newman says the fire’s been hard to fight because of the thick underbrush and the gullies that characterize the Wildcat Hills-area land.

Aircraft dropped fire retardant to help the firefighters from several departments. No injuries have been reported.

CHADRON, Neb. (AP) — A Nebraska county treasurer accused of forgery and official misconduct has taken a plea deal.

Court records say 65-year-old Barb Sebesta pleaded no contest Tuesday to three misdemeanor counts of official misconduct as Dawes County treasurer. Prosecutors dropped three more misconduct counts and one of forgery in exchange for Sebesta’s pleas. Her sentencing is set for Sept. 8.

She declined to comment Wednesday and referred an AP reporter to her attorney, who didn’t immediately return a message.

A state audit alleged Sebesta altered a check written by a taxpayer. Sebesta has said she was trying to clarify the proper amount for a bank. She also was accused of twice failing to collect sales tax and of failing to maintain trust balances in a timely fashion.

SILVER SPRING, Md. (AP) — The Latest on a Food and Drug Administration panel’s review of a gene therapy treatment (all times local):

3:30 p.m.

A panel of cancer experts has voted in favor of a leukemia treatment which could be the first gene therapy available in the U.S.

The Food and Drug Administration advisory panel voted 10-0 on Wednesday to recommend approval of the treatment developed by the University of Pennsylvania and Novartis Corp. The one-time treatment would be for children and young adults with advanced leukemia.

The therapy could be the first of a wave of treatments custom-made to target a patient’s cancer. Called CAR-T, it involves removing immune cells from a patients’ blood, reprogramming them to create an army of cells to recognize and destroy cancer and injecting them back into the patient.

The FDA is not required to follow the panel’s recommendation but often does.

10:30 a.m.

Cancer experts who advise government regulators are reviewing what could be the first gene therapy approved in the U.S.

The Food and Drug Administration panel is holding a hearing Wednesday to discuss the treatment developed by the University of Pennsylvania and Novartis Corp. The drugmaker is seeking approval to use the one-time treatment for children and young adults with advanced leukemia.

The therapy could be the first of a wave of cancer treatments custom-made to target a patient’s cancer. Called CAR-T, it involves removing immune cells from a patients’ blood, reprogramming them to create an army of attack cells and putting them back into the patient.

The panel is reviewing the safety, effectiveness and production of the treatment. It will vote on whether to recommend FDA approval.

The biopsy shows cancer, so you have to act fast, right? Not necessarily, if it’s a prostate tumor.

Men increasingly have choices if their cancer is found at an early stage, as most cases in the U.S. are. They can treat it right away or monitor with periodic tests and treat later if it worsens or causes symptoms.

Now, long-term results are in from one of the few studies comparing these options in men with tumors confined to the prostate. After 20 years, death rates were roughly similar for those who had immediate surgery and those initially assigned to monitoring, and surgery had more side effects.

“Many men, when they hear the word cancer, you want to do something about it,” said one study leader, Dr. Gerald Andriole, urology chief at Washington University in St. Louis, Missouri. “The reality is, if you have a low-risk cancer, like the study shows, you don’t need treatment, certainly not urgently.”

It’s not all black and white, though. Early stage doesn’t necessarily mean low risk. Some results in the study lean in favor of surgery, and it does have some advantages. It also may improve survival for certain groups. Here’s what this and other studies tell us about who does and doesn’t benefit from surgery.

WHY NOT TREAT EVERYONE?

Start with a fact many find hard to accept: Not all cancers are destined to kill. Some prostate tumorsare deadly, but most grow so slowly that men will die of something else.

Treatments — surgery, radiation or hormone therapy — can cause impotence, incontinence, infections and other problems, and sometimes do more harm than the disease ever would.

Monitoring doesn’t mean do nothing. Men can get frequent tests, and there are more and better ways to detect disease progression now than there used to be, so there’s usually still a chance to treat and potentially cure it if it starts to worsen, Andriole said.

WHAT THE EVIDENCE SAYS

Only a few studies have tested monitoring versus immediate treatment. One found no difference in death rates after more than 20 years; another found surgery improved survival odds, but only for men under 65.

Those were done before wide use of PSA blood tests, back when more tumors were found because they caused symptoms, which often means more advanced disease.

Researchers wondered: Would the results be the same with modern screening and treatments?

The new study, sponsored by the U.S. Department of Veterans Affairs, aimed to answer that. Doctors assigned 731 men to observation or surgery. After a decade, survival rates were similar, but doctors wanted longer follow-up.

Now, after 20 years, two thirds of these men have died and the original conclusions still stand, though the numbers leaned in surgery’s favor. Fewer men died in the surgery group, but the difference was small enough that it could have been due to chance. Only about 9 percent of men ultimately died from prostate cancer, showing how relatively seldom the disease proves fatal.

Results are in Thursday’s New England Journal of Medicine.

DID SURGERY DO ANY GOOD?

Yes. Fewer men in the surgery group later had treatment because there were signs the disease might be worsening — 34 percent, versus 60 percent of the group assigned to monitoring. In many cases, it was prompted by rising PSA levels, but surgery also clearly prevented more cases from spreading throughout the body.

Half of the group assigned to monitoring wound up getting some sort of treatment within five years. In one quarter of those cases, men “just got fed up” with monitoring and thinking about cancer, Andriole said. The rest were prompted by signs of progression.

Surgery also may have improved survival for men in the middle range of risk, with PSA levels between 10 and 20, and a Gleason score (a measure of how aggressive cancer cells look under a microscope) of 7. Only about one quarter to one third of men in the U.S. fall in this category, though. Most men are early stage and low risk.

“Surgery is right for the right person, and it’s somebody with intermediate-risk disease,” Andriole said.

SIDE EFFECTS

Surgery had more side effects — 15 percent of men in that group later sought treatment for trouble having sex, and 17 percent, for incontinence. The numbers were 5 percent and 4 percent, respectively, of men assigned to observation.

“You can’t divorce quality of life outcomes from cancer outcomes because they both count for patients,” said Dr. David Penson, Vanderbilt University’s urology chief, who had no role in the study.

“Some guys will look at this and say, ‘I don’t want to be impotent, I don’t want to be incontinent,'” and will forgo surgery even if there’s a chance it will help them live longer, he said. “In the end, each man’s going to make his own decision.”