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Biomedical subjects

K Welvaart

Publications and source records attributed to K Welvaart.

84 records · Page 5Linked to original sources
PubMed1975

Palliative treatment with oral Estracyte in disseminated prostatic carcinoma.

In Roswell Park Memorial Institute, between 1969 and 1974, a total of 32 patients with widespread metastasized carcinoma of the prostate were treated with oral Estracyt. Objectively demonstrable remissions were achieved in eight patients (8/32 equals 25%). Subjective improvement of their general condition was experienced by 15 patients (15/32 equals 47%). The toxicity of Estracyt manifests itself with gastrointestinal disorders, which in most cases are amenable to anti-emetic treatment.

Administration, Oral↗
PubMedDate not supplied

Avoiding long-term disturbance to bladder and sexual function in pelvic surgery, particularly with rectal cancer.

Urinary and sexual dysfunction are common problems after rectal cancer surgery, and the likely cause is damage to the pelvic autonomic nerves during surgery. In recent years, attention has been focused on preserving the autonomic nerves through a technique which is usually combined with total mesorectal excision or radical pelvic lymphadenectomy. The autonomic nerves consist of the paired sympathetic hypogastric nerve, sacral splanchnic nerves, and the pelvic autonomic nerve plexus. We will demonstrate the anatomy of the pelvic autonomic nerves and the relation of these nerves to the mesorectal fascial planes, and review the medical literature on sexual and urinary dysfunction after rectal cancer surgery with and without autonomic nerve preservation.

Autonomic Nervous System↗
PubMedDate not supplied

Oral estramustine phosphate (NSC-89199) in the treatment of advanced (stage D) carcinoma of the prostate.

Thirty-two patients with stage D carcinoma of the prostate were treated with oral estramustine phosphate at a dose of 15 mg/kg/day from 3 to 15 months. Objective remissions, reduction of greater than 50 percent of measurable lesions such as soft tissue masses, lymph nodes, and prostatic masses, were seen in seven of 32 patients (22 percent response rate). Subjective response, ie, relief of pain, weight gain, sense of well being, snd improved performance status, occurred in all objective responders and in seven other patients with stable disease (15 of 32 patients = 47 percent). No hematologic, hepatic, or renal toxic effects were observed. Transient nausea occurred early in one half of the patients and nausea and vomiting was dose limiting in only two patients. Oral estramustine phosphate is well tolerated and worthy of further clinical use.

Acid Phosphatase↗
PubMedDate not supplied

Psychological effects of routine follow up on cancer patients after surgery.

OBJECTIVES: To assess the subjective value that patients with cancer place on regular follow up after operation; to see what effects regular follow up visits have on the patient's physical and psychological wellbeing; and to find out which variables influence patients wellbeing and attitudes to follow up. DESIGN: Survey by questionnaire. SETTING: University Hospital Leiden, the Netherlands. SUBJECTS: 127 Patients who had been operated on for cancer. INTERVENTIONS: 67 Patients were assessed one month before a routine follow up visit, and 60 on the day of the follow up; 46 of the second group were assessed again two weeks later. MAIN OUTCOME MEASURES: Answers to questions about physical and psychological wellbeing. RESULTS: Most patients were in favour of regular follow up visits at the hospital, and thought that the advantages outweighed the disadvantages. There were more reports of psychological than physical distress one month beforehand, but these were significantly less two weeks after the appointment compared with one month before (p = 0.003) and on the day of the appointment (p < 0.001). Regular follow up visits do not temporarily increase physical or psychological distress; rather there is a temporary decrease, less fear of recurrence, and less perception of any disadvantages. Women in general, and those with breast cancer in particular and patients with a lower educational standard in particular, had significantly more psychological complaints. CONCLUSIONS: Regular follow up visits are in general welcomed by patients who have had operations for cancer.

Adult↗
PubMedDate not supplied

Adjuvant chemotherapy for premenopausal breast cancer: a meta-analysis using quality-adjusted survival.

PURPOSE: Adjuvant chemotherapy for early breast cancer has been shown to offer an improvement in recurrence-free and overall survival, especially for younger women, but the acute toxic effects of this treatment discourage some physicians from prescribing it. The purpose of this analysis was to determine whether the benefit of 6 months of adjuvant CMF (cyclophosphamide, methotrexate, fluorouracil) treatment outweighs its costs in terms of toxic effects. METHODS: A meta-analysis of quality-adjusted survival was performed based on data from 1229 patients, aged 49 years or younger, randomized in eight trials comparing CMF versus no adjuvant systemic therapy. The eight trials were included in the worldwide overview conducted by the Early Breast Cancer Trialists' Collaborative Group. The Q-TWiST method was used in a meta-analysis that provided treatment comparisons incorporating differences in quality of life associated with the amount of time patients spend with subjective toxic effects, after relapse, and without symptoms of relapse. RESULTS: Within 6 years of follow-up evaluation for patients with node-positive disease, the benefit in terms of increased relapse-free and overall survival balanced the costs in terms of acute toxic side effects. This was true even for the extreme case in which a zero value was assigned to all 6 months during which patients might receive adjuvant CMF chemotherapy. Within 10 years of follow-up evaluation, treated patients gained an average of 1.5 years of relapse-free survival time, almost 1 year of overall survival time, and 1 year of time without symptoms and toxicity. CONCLUSIONS: Adjuvant chemotherapy for younger women with node-positive breast cancer provided substantial amounts of quality-adjusted survival time, even after accounting for costs associated with toxic effects of the treatment. The Q-TWiST method represents a valuable tool for comparing treatments because it incorporates patients' perceptions of their quality of life for therapeutic decision-making.

Antineoplastic Combined Chemotherapy Protocols↗