Adjustment and discussion of cancer: a comparison of breast and prostate cancer survivors.

Supportive conversations may facilitate adjustment among cancer patients early in treatment. However, little is known about how cancer discussion is related to adjustment among long-term survivors of cancer or how gender differences may influence associations between cancer discussion and adjustment. The purpose of this study was to examine possible moderator effects of gender on associations between cancer discussions and adjustment among survivors of breast or prostate cancer.

An analysis of male and female breast cancer treatment and survival among demographically identical pairs of patients.

Background: Male breast cancer is rare, and there are no large comparative studies to guide treatment. We used National Cancer Data Base data on 4755 men and 624,174 women who had breast cancer (1985-1994) to identify equivalent groups of male and female breast cancer patients.

Methods: For each man with breast cancer, the next woman treated at the same hospital was sought who matched the man's age (within 5 years), ethnicity, income category, and stage.

Increased intensification and total dose of cyclophosphamide in a doxorubicin-cyclophosphamide regimen for the treatment of primary breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-22.

Purpose: The National Surgical Adjuvant Breast and Bowel Project (NSABP) initiated a randomized trial (B-22) to determine if intensifying but maintaining the total dose of cyclophosphamide (Cytoxan, Bristol-Myers Squibb Oncology, Princeton, NJ) in a doxorubicin (Adriamycin, Pharmacia, Kalamazoo, MI)-cyclophosphamide combination (AC), or if intensifying and increasing the total dose of cyclophosphamide improves the outcome of women with primary breast cancer and positive axillary nodes.

Patients And Methods: Patients (N = 2,305) were randomized to receive either four courses of standard AC therapy (group 1); intensified therapy, in which the same total dose of cyclophosphamide was administered in two courses (group 2); or intensified and increased therapy, in which the total dose of cyclophosphamide was doubled (group 3). The dose and intensity of doxorubicin were similar in all groups.

Peritoneal venous shunting for the treatment of lymphatic ascites following retroperitoneal lymph node dissection.

We report a case of refractory lymphatic ascites following retroperitoneal lymph node dissection and venacavectomy. Placement of a Denver peritoneal venous shunt resulted in resolution of the ascites and marked improvement in the patient's nutritional parameters. Shunt occlusion 2 months following placement demonstrated no recurrence of the ascites.

Radiolabeled antibody imaging of patients with potentially resectable colorectal adenocarcinoma.

Thirty-two patients with potentially resectable recurrent colorectal adenocarcinoma were imaged with the radioimmunoconjugate 111In-satumomab pendetide to determine whether imaging supplies clinically relevant information relating to the extent of disease in patients with different presenting characteristics. Patients included 12 with increasing carcinoembryonic antigen (CEA) without anatomical evidence of recurrence, 13 with radiological abnormalities consistent with apparently isolated metastases, and 7 with recurrence and anatomical abnormalities of unclear significance. 111In-satumomab pendetide imaging detected extrahepatic abdominal and pelvic disease in 16 subjects.

Handling of cytotoxic drugs by healthcare workers. A review of the risks of exposure.

Increasing utilisation of chemotherapeutic agents in treating patients with malignancy has led to the potential for widespread exposure of healthcare workers who come into contact with patients or these agents in the work place. Unfortunately, these drugs are toxic to both the abnormal and normal somatic cell. This occurs in the patient, and is also likely to affect any individual exposed.

Diet intervention methods to reduce fat intake: nutrient and food group composition of self-selected low-fat diets.

A multicentered pilot study was conducted to test an intervention protocol designed to reduce fat intake to 15% of energy intake. Eligible subjects were postmenopausal women with stage II breast cancer whose baseline fat intake was more than 30% of energy intake. The low-fat diet intervention protocol consisted of bi-weekly individual counseling sessions with emphasis on substitution of lower-fat foods for high-fat foods and maintenance of nutritional adequacy.

Unpublished Data Summaries and the design and conduct of clinical trials. The Nutrition Adjuvant Study experience and commentary.

A trend in cancer clinical investigation has been the application of new analytic techniques and reporting forums to summarize developing trial results. Examples include: Consensus Conferences, Meta-Analyses, and most recently (in the breast cancer area), the "Clinical Alert." These Unpublished Data Summaries have been widely disseminated in lay and scientific communities and have frequently engendered debate conducted in the absence of primary information.

Doxorubicin-containing regimens for the treatment of stage II breast cancer: The National Surgical Adjuvant Breast and Bowel Project experience.

Despite numerous reports of findings obtained following the use of doxorubicin (Adriamycin [A]; Adria Laboratories, Columbus, OH) for the postoperative treatment of patients with primary breast cancer and positive axillary nodes, no clear consensus exists regarding its worth when used in that setting. In June 1981, the National Surgical Adjuvant Breast and Bowel Project (NSABP) implemented two randomized clinical trials aimed at evaluating the worth of doxorubicin when administered in conjunction with melphalan (L-PAM) and fluorouracil (5-FU) (PF). A prior NSABP study identified cohorts of patients who did or did not benefit from tamoxifen (TAM, T) when used with chemotherapy.

[Lymphoepithelial hyperplasia of the tonsil at the base of the tongue].

A case report is communicated on lymphoepithelial hyperplasia of the tonsil at the base of the tongue. This may be demonstrated during radiological double contrast examination of the oesophagus as a protrusion of the mucosa of the hypopharynx with smooth or nodular relief pattern. Differential diagnosis is necessary especially against malignant neoplasms.

Preparation and administration of chemotherapy. Haematological consequences for hospital-based nurses.

This study examined the question of whether previous exposure to cytostatic drugs by oncology nurses was sufficient to lead to haematological phenotypical subclinical abnormalities which had previously been identified in a population of patients who had received chemotherapy as an adjuvant to breast surgery. A comparison of baseline haematological parameters, and the results of a prednisolone stimulation test, was made between nurses regularly coming into contact with such agents and age-adjusted group of nurses who had not been exposed. Although there is a persistent trend toward lower neutrophils, platelets, monocytes and neutrophil reserves in the nurses who handled antineoplastic agents, a statistically significant decrement in these parameters was not identified.

A breast cancer Nutrition Adjuvant Study (NAS): protocol design and initial patient adherence.

To evaluate the feasibility of using a reduction in dietary fat intake as a component of treatment regimens for patients with resected breast cancer, a multi-disciplinary cooperative group protocol was developed. Females 50 to 75 years of age with stage II breast cancer who completed primary local therapy were eligible for randomization to a Control Dietary Group in which dietary fat intake was to remain unchanged from baseline level (at approximately 38% of calories derived from fat) and an Intensive Intervention Dietary Group designed to reduce dietary fat intake. Both Dietary Groups were given tamoxifen 20 mg/day.

B16 melanoma in hairless mice: a model for thermographic research.

Little is understood concerning the mechanism of tumor-induced thermographic abnormalities observed in man. An ideal animal model is lacking. In an effort to create such a model we have worked with hairless mice, subcutaneously inoculated with B16 melanoma cells.

Malignant melanoma in childhood and adolescence.

A retrospective chart review of 25 patients under the age of 20 years with malignant melanoma, diagnosed between the years 1938 and 1984 at the University of Iowa Hospitals and Clinics, was conducted. Nine of the patients were under the age of 14 years, and 18 patients were females. There appeared to be a frequent delay in diagnosis of the primary lesion, occasionally incorrect initial diagnosis, and under-treatment in these young patients.

Sister chromatid exchange analysis in nurses handling antineoplastic drugs.

Sister chromatid exchange (SCE) analyses were carried out in hospital nurses to determine whether an increased frequency of SCE may be used as an indicator of occupational exposure to potentially harmful antineoplastic drugs. In our study of 18 oncology nurses who handled these agents for an average of three days per week, we found no increase in mean SCE frequency (9.3 +/- 1.

Chemotherapeutic toxicity--the relationship between patients' pretreatment expectations and posttreatment results.

Patients receiving the same cancer chemotherapy regimens exhibit a highly variable incidence of toxic side effects. We studied 56 patients about to receive chemotherapy for the first time to determine whether their expectations of individual side effects were associated with the frequency and severity of the toxicity that they subsequently experienced. Patients completed a self-report questionnaire containing a list of 16 potential toxicities, asking them to indicate how certain they were of experiencing or not experiencing each.

Temperature over tumors in hairless mice.

The question of whether tumors are warmer or colder than surrounding tissue is considered in these experiments which use a highly suitable animal model, the hairless mouse. Temperatures of skin over induced growing subdermal tumors in these mice were monitored by AGA 680 Color Thermovision. The skin over the tumors does not cool over time but on the contrary becomes warmer.

Neurosarcomatous malignant melanoma arising in a neuroid giant congenital melanocytic nevus.

We report a case of neuroid giant congenital melanocytic nevus (GCMN) in which a malignant schwannomalike tumor developed. Literature review reveals that neurosarcomatous differentiation occurs among malignant tumors arising in GCMNs, apparently with greater incidence in those GCMNs showing benign neuroid differentiation. Although the differences between neuroid melanocytes and Schwann's cells may be more conceptual than real, we believe that the current tumor arising within a melanocytic nevus is likely of neuroid melanocytic origin and best designated as neurosarcomatous malignant melanoma.

Phase II study of dibromodulcitol and BCNU in metastatic malignant melanoma.

Dibromodulcitol (DBD) and BCNU were administered to 20 patients with metastatic malignant melanoma who had not received prior chemotherapy. One complete and three partial responses were noted; duration of response was short. Dose limiting toxicity was thrombocytopenia.

Sexual functioning among breast cancer, gynecologic cancer, and healthy women.

An investigation was conducted to determine the specific type of sexual functioning deficits and the relationship between global sexual satisfaction and adjustment in two related life areas, the marital relationship and a woman’s body image, for two groups of cancer patients at high risk for sexual difficulties. Analyses revealed that the aspects of sexual functioning for matched samples of breast cancer patients and gynecologic cancer patients that differed from those of healthy women were the frequency of sexual behaviors and the level of sexual arousal. Whereas women’s evaluations of their current sexual life had no relationship to their marital adjustment ratings, analyses suggested that body image disruption may be a prevalent problem for gynecologic cancer patients.

Specimen xeroradiography after needle localization and biopsy of noncalcified, nonpalpable breast lesions.

Xeroradiography was used to detect and aid in needle localization of 63 nonpalpable breast lesions over an 8-year period. In 28 patients (44%), no microcalcifications were present in the lesion biopsied. Xeroradiographs of these noncalcified lesions after their submersion in water carried a clean and close resemblance to their in vivo appearance and aided the pathologist in localizing the abnormality within the biopsy specimen.

Male breast carcinoma.

Fifty men with primary breast carcinoma were seen between the years 1938 and 1983 at the University of Iowa Hospitals and Clinics. In most patients, there was a significant delay between the onset of symptoms and seeking medical advice (mean, 21 months; range, 1-156). The vast majority of patients were treated by simple, modified radical, or radical mastectomy.

Carcinoid tumors of the gastrointestinal tract.

Carcinoid tumors continue to be of specific clinical interest because of their diverse presentation, hormonal secretion, and malignant potential. One hundred ninety-two patients with carcinoid tumors were treated at the University of Iowa Hospitals and Clinics between 1938 and 1982. The most common location of these tumors was the appendix (30%), followed by the ileum (23%) and rectum (9%).