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Biomedical subjects

K C Calman

Publications and source records attributed to K C Calman.

At least 91 records · Page 5Linked to original sources
PubMed1981

The social, emotional and financial implications of adjuvant chemotherapy in breast cancer.

The incidence and severity of toxicity, the extent of emotional disturbance and cost of adjuvant chemotherapy were assessed in patients with early breast cancer randomized to receive either radiotherapy, chemotherapy (CMF) or radiotherapy followed by chemotherapy. Nausea and vomiting occurred in 85 per cent of patients receiving chemotherapy and contributed significantly to distress. Over one-third of patients required a wig or developed mucosal ulceration. Nevertheless, most patients were able to return to work during treatment. Leucopoenia was more commonly encountered in those patients who received radiotherapy prior to chemotherapy. Twelve months after mastectomy, psychiatric morbidity was present in 13 of 34 patients receiving chemotherapy with or without radiotherapy, compared with only 1 of 18 receiving radiotherapy alone. Anxiety was common in both groups. This trend was still present 6 months after the completion of chemotherapy. The cost of chemotherapy is discussed.

Breast Neoplasms↗
PubMed1981

Oestrogen-receptor status and endocrine therapy of breast cancer: response rates and status stability.

The concentration of cellular oestrogen receptor (RE) was measured in both the soluble and nuclear-pellet fractions of biopsies from 1,000 breast cancers. Data suggest that functional steroid RE is always in equilibrium between the soluble and nuclear fractions. However, biopsies from only one-third of patients contained detectable amounts of high-affinity RE in both fractions. Thirty patients out of 42 (71%) whose biopsies contained RE in both fractions, showed objective remission after receiving some form of hormonal manipulation as sole treatment. Response rates in the other categories ranged from 9% for those whose biopsies contained no detectable RE to 24% for those who displayed soluble RE alone. The presence of RE in both fractions of primary disease, whereas RE-negativity was maintained during progression from primary to secondary disease. Other aspects of RE status in relation to stage of disease are analysed.

Adult↗
PubMed1981

High-dose oral methotrexate.

In this study nine patients were treated with 250 mg of methotrexate (MTX) in divided oral doses every 2 weeks. Pharmacokinetic studies carried out on alternate courses showed no alteration with cycles in peak levels of the drug, the half-life of MTX, or the area under the concentration-time curve. Two partial responses (PR) were noted in head and neck squamous carcinoma. Three patients had stable disease and four progressed. Oral high-dose MTX produced predictable exposure of tumors to MTX, although the bioavailability was always less than the equivalent iv dose. Oral MTX was well tolerated by patients, toxicity was minimal, and no evidence of malabsorption of the drug was detected.

Administration, Oral↗
PubMed1980

Faecal bile acids and clostridia in the aetiology of colorectal cancer.

This study was undertaken in an attempt to confirm the increased bile-acid concentration in association with nuclear dehydrogenating Clostridia (NDC) in the faeces of colorectal cancer patients. We have studied 37 patients with colorectal cancer and 36 control patients with no known gastrointestinal disease. Stool specimens were obtained for biochemical analysis (total faecal bile acid (FBA), lithocholic deoxycholic and cholic acids) and NDC isolation. The mean total FBA concentration (mumol/g) in the control group was 20.5 +/- 2.2 (s.e.) significantly higher (P < 0.001) than the colorectal-cancer group (11.8 +/- 0.7). There was no statistically significant difference in the percentage distribution of the individual FBAs measured. NDC were isolated from the faeces of 64% of colorectal-cancer patients and 15% of control patients, this difference being statistically significant (P < 0.001). These results suggest that bacteria capable of metabolizing steroids may be implicated in the aetiology of colorectal cancer. However, the relationship between FBA and colorectal cancer requires further evaluation.

Aged↗
PubMed1980

Faecal bile acids and clostridia in patients with breast cancer.

We have studied 30 patients presenting with breast cancer and 36 control patients admitted to hospital for minor surgery. Stool specimens were obtained for bile acid analysis and bacterial nuclear dehydrogenation activity (NDC) estimation. The mean total faecal bile acid (FBA) concentration (mumol/g) in patients with breast cancer was 15.6 /+- 1.8 s.e., significantly lower than for control patients (20.5 /+- 1.9). NDC were isolated from the faeces of 58% of breast cancer patients an 15% of control patients, this difference being statistically highly significant (P less than 0.005). Increased bile-acid degradation by bacteria in the large bowel may explain the reduced FBA concentration in patients with breast cancer. Increased NDC isolation in breast-cancer patients suggests that oestrogen production in the colon may play a role in the aetiogy of breast cancer in some patients.

Adult↗
PubMed1980

Adjuvant chemotherapy and immunotherapy for colorectal cancer: preliminary communication.

Following surgical resection of Dukes' B or C colorectal cancers 72 patients have been randomly allocated to receive: 5-fluorouracil; or 5-fluorouracil and levamisole; or no treatment. Adjuvant treatment was continued for one year. 66 patients remain evaluable for up to 24 months. Preliminary results show no significant differences in survival or recurrence rates. Two patients receiving 5-fluorouracil and levamisole developed severe, but reversible, neutropenia. Other side effects were uncommon.

Clinical Trials as Topic↗
PubMed1979

Enhancement of methotrexate absorption by subdivision of dose.

A comparison was made in fasting patients between a single 100 mg oral dose of methotrexate formulated as its sodium salt in a palatable syrup and the same total quantity of drug administered in four divided doses of 25 mg taken at 2-h intervals. Allocation to the order of these treatment schedules was on a random basis. The area under the serum methotrexate concentration-time curve until 50 h was found to be considerably greater after the divided dose regimen, the mean ratio AUC 25 mg x 4/AUC 100 mg being 1.86 (+/- 0.90). There was no significant difference in peak serum methotrexate concentrations or methotrexate half-life estimates between the two regimens, however. The results of this study are consistent with saturation of an intestinal transport process when methotrexate is administered orally in a single large dose.

Half-Life↗
PubMed1979

Bioavailability of methotrexate: implications for clinical use.

The absorption of oral methotrexate in syrup form has been compared in six patients with that of an identical IV dose (50 mg/m2). There was variable absorption amongst the group with respect to maximum levels achieved and the time taken to reach those levels. The area under the time-concentration curve was always smaller when the drug was given orally than after IV administration. A total of 33 patients receiving methotrexate for a variety of tumour types were followed for response to treatment and toxicity. A significantly longer methotrexate half-life (t1/2) was found in nine partial responders (9.2 +/- 1.6 h) than in the nonresponders (3.8 +/- 0.7 h). Severe methotrexate toxicity was not seen though occasional mucositis, conjunctivitis, and diarrhoea occurred in seven patients. The side effects could not be predicted from the dose, the bioavailability data, or the serum creatinine. Measurements of serum and urine methotrexate levels are useful in the assessment of absorption and bioavailability of the drug the prediction of tumour response.

Administration, Oral↗
PubMed1979

Serum, tear and salivary concentrations of methotrexate in man.

1. Methotrexate handling has been studied in four patients with psoriasis and eleven patients with neoplastic disease. 2. Methotrexate levels in serum, tears and saliva were measured by radioimmunoassay while protein binding studies were performed by continuous ultrafiltration. 3. There was a close correlation between methotrexate concentrations in tears and serum (P less than 0.001, r = 0.714). Parotid salivary and serum methotrexate levels were similarly correlated (P less than 0.001, r = 0.557) but not mixed salivary and serum levels (P greater than 0.1, r = 0.232). 4. The mean protein binding was 95.11% +/- 2.26 (s.d.) while the ratio of methotrexate levels in tears to the free serum methotrexate level was 1:1.04. The corresponding parotid salivary level: free serum level ratio was 1:18.11. 5. No relationship could be determined between the methotrexate levels in tears and conjunctivitis observed in some of the patients under study.

Humans↗
PubMed1979

Nutritional support in patients with malignant disease.

Clinicians have long been aware of the major nutritional and metabolic abnormalities that occur in patients with cancer. Such abnormalities are varied and hence both the indications and techniques for their correction are also diverse. The aim of the present paper is to consider certain specific aspects of nutritional support in cancer and the authors end with a brief review of areas of study which may prove useful in future.

Diet↗
PubMed1977

Nuclear oestrogen receptors and treatment of breast cancer.

In an attempt to improve the predictive value of oestrogen-receptor measurements in breast-tumour biopsy specimens, oestrogen receptor was measured at both cytoplasmic and nuclear levels. Although 33% of patients had receptors at both levels, another 17% had cytoplasmic but no nuclear receptors. Theoretically, this latter group would not be expected to respond to hormone therapy. 7% had nuclear but not cytoplasmic receptors. The six-month follow-up data for the group of patients with receptors at both cytoplasmic and nuclear levels suggests qualitatively that this group has a good chance of responding favourably to hormone therapy. Much larger numbers must be accumulated before quantitative conclusions can be reached.

Breast Neoplasms↗