Economic value of a cancer case management program.

Purpose: To assess the impact of the cancer support program (CSP), a telephonic case management program led by oncology nurses, on cancer-related medical costs and hospice use.

Methods: Members of large employer-funded health plans were referred to the CSP if they had a cancer diagnosis and met program criteria. Patients were referred to the CSP (July 2009-June 2011; index date is referral date) and chose to participate (participants) or not (nonparticipants).

Thrombotic thrombocytopenic purpura after cephalosporin administration: a possible relationship.

Background: Acquired thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder. The pathogenesis is believed to be mediated by an autoantibody directed against the metalloproteinase responsible for the degradation of the very-high-molecular-weight multimers of the vWF. The syndrome can be precipitated by a variety of conditions, and certain medications also have been implicated.

Serum cholesterol, beta-carotene, and risk of lung cancer.

This paper hypothesizes that beta-carotene mediates the association between low serum cholesterol and increased risk of lung cancer, predicts that the association should be greater in population strata with low intake of beta-carotene than in those with high intake if the hypothesis is correct, and investigates this prediction with data from a 24-year cohort study of 1,960 middle-aged employed men. In the total cohort, serum cholesterol was not related to risk of lung cancer. The relative risk associated with a difference of -1.

Dietary cholesterol and incidence of lung cancer: the Western Electric Study.

The hypothesis that dietary cholesterol is positively associated with lung cancer was investigated in a 24-year cohort study of 1,878 middle-aged men who were employed in 1958 by the Western Electric Company in Chicago. The relative risk of lung cancer associated with an increment in dietary cholesterol of 500 mg/day was 1.9 (95 percent confidence interval 1.

Phase II trial of 4' deoxydoxorubicin (DXDX) for unresectable non-small cell bronchogenic carcinoma. An Illinois Cancer Council study.

A phase II trial of 4' Deoxydoxorubicin (DXDX) was conducted in unresectable previously untreated non-small cell lung cancer patients. DXDX was administered every 3 weeks by short intravenous infusion at a starting dose of 30 mg/m2, with dose escalation to 40 mg/m2 toxicity permitting. Four responses, all partial, were observed in 35 evaluable patients, for a response rate of 11% (95% confidence limits 3.

Megestrol acetate used as primary hormonal therapy in stage D prostatic cancer.

The majority of patients with advanced prostatic cancer respond either to castration or estrogen therapy. In an attempt to identify an alternative hormonal therapy, 25 symptomatic stage D prostate cancer patients were treated with megestrol acetate as initial hormonal therapy. Thirty-three patients were evaluable for response as defined by the National Prostatic Cancer Project criteria.

Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men.

Mortality rates from colon cancer in the USA are highest in populations exposed to the least amounts of natural sunlight; differences in endogenous vitamin D production and calcium absorption could be responsible. To investigate this possibility, the association of dietary vitamin D and calcium with 19-year risk of colorectal cancer was examined in 1954 men who had completed detailed, 28-day dietary histories in the period 1957-59. Risk of colorectal cancer was inversely correlated with dietary vitamin D and calcium.

Progesterone receptor level as a predictor of response to megestrol acetate in advanced breast cancer: a retrospective study.

Megestrol acetate (160 mg/day) produced a response rate of 44% in a retrospective series of 39 evaluable patients with advanced breast cancer. The estrogen-receptor (ER) level was greater than 10 fmols/mg of protein in 28 patients, and the progesterone-receptor (PR) level was greater than 10 fmols/mg of protein in 26 patients. ER and PR levels, age, and disease-free interval were analyzed for their relationship to response.

The role of the human tumor stem cell assay in medical oncology.

The human tumor stem cell assay is a technique that allows in vitro sensitivity testing of antineoplastic agents against cells from tumor specimens removed from patients. This assay predicts clinical response to drugs and permits individualization of chemotherapy. It is more accurate in predicting drug resistance than drug sensitivity.

Randomized evaluation of combination chemotherapy vs. observation alone following response or stabilization after oophorectomy for metastatic breast cancer in premenopausal women.

Premenopausal patients with progressive measurable metastatic breast cancer who demonstrated either stable or responsive disease 12 weeks following oophorectomy were randomized either to receive cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) combination chemo-therapy (20 patients) or to continue under observation alone (14 patients). Since the study began in 1974, data on receptor status were not required for entry into the study. Stratification for randomization was based on the nature of the oophorectomy response (stable vs.

Vindesine: phase II evaluation in colon cancer and description of its platelet stimulating activity.

Fifteen previously treated patients with measurable metastatic colon carcinoma were entered into a phase II study of vindesine, 3 mg/m2/week IV. Fourteen patients were evaluable for response. No objective tumor response was observed; however, seven patients experienced stable disease lasting 9, 10, 13, 15, 16, 19, and 26 weeks.

Dietary vitamin A and risk of cancer in the Western Electric study.

Intake of dietary provitamin A (carotene) was inversely related to the 19-year incidence of lung cancer in a prospective epidemiological study of 1954 middle-aged men. The relative risks of lung cancer in the first (lowest) to fourth quartiles of the distribution of carotene intake were respectively, 7.0, 5.

Radiation carcinogenesis in man: new primary neoplasms in fields of prior therapeutic radiation.

Nine patients are presented in whom new malignant neoplasms developed in fields of prior irradiation. The prior irradiation had been administered to these patients for previously confirmed cancers, lesions suspected of being cancer (but never confirmed as such), and for non-neoplastic disorders. Each of these cases is relatively unique and several present the first association between prior radiation therapy and the subsequent neoplasm or neoplasms which developed.

Cytotoxic chemotherapy for cancer in Felty's syndrome: role of lithium carbonate.

A 61-yr-old white man with Felty's syndrome, who had previously undergone splenectomy, presented for cytotoxic chemotherapy. Random granulocyte counts remained low, prohibiting the initiation of such treatment. A trial of lithium carbonate was instituted, resulting in prompt elevation of granulocyte counts into the normal range.

High blood pressure and 17-year cancer mortality in the Western Electric Health Study.

A positive association between elevated blood pressure and risk of death from cancer has been observed in four long-term prospective studies. In the Western Electric Health Study, the relationship was specific to death from renal cell carcinomas and epidermoid cancers of the head and neck. The relationship with epidermoid head and neck cancer was indirect, resulting from the effects of alcohol consumption on both blood pressure and on risk of this cancer.

5-Fluorouracil, methyl-CCNU, and radiotherapy with or without testolactone for localized adenocarcinoma of the exocrine pancreas: a Southwest Oncology Group Study.

Since August 1975, 69 patients with localized pancreatic carcinoma (extent of tumor confined to a 15 cm x 15 cm radiotherapy port) have received either Regimen A, comprising radiotherapy (6,000 rad) to the tumor area with simultaneous combination chemotherapy utilizing methyl-CCNU, 125 mg/m2 orally, every six weeks, and 5-fluorouracil, 400 mg/m2 intravenously, weekly; or Regimen B, comprising Regimen A with the addition of testolactone, 200 mg, orally every day. Thirty-eight patients on Regimen A and 30 patients on Regimen B are currently evaluable. Median survival, which appeared not to be affected by the addition of testolactone, was 38 weeks for those on Regimen A and 30 weeks for those on Regimen B (P = 0.

MItomycin C, methyl-CCNU and 5-fluorouracil in the treatment of metastatic colorectal carcinoma.

The combination of mitomycin C, methyl-CCNU and 5-fluorouracil produced no objective tumor regressions in 25 evaluable patients with metastatic colorectal carcinoma. Patients who achieved stable disease survived significantly longer than patients who had progressive disease. This difference appeared to be more probably related to pre-treatment characteristics of the patients than caused by treatment.