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Biomedical subjects

R Grundy

Publications and source records attributed to R Grundy.

5 recordsLinked to original sources
PubMed1990

Quality of life after treatment for testicular cancer--the patient's view.

Twenty-eight patients cured of testicular cancer by cisplatin-based chemotherapy were asked for their own views of the long-term psychological and social effects of their treatment. Their views were compared with a group of 34 testicular cancer patients cured by radiotherapy who were matched for age, social class and time since treatment. A category rating type questionnaire was used with questions concerning general health, subjective side-effects of treatment, employment, relationships, reproduction and mood. The principal differences were (1) the chemotherapy group reported a greater prevalence of physical side-effects, (2) the radiotherapy group reported greater anxiety and depression since treatment and (3) a significant number of patients in the chemotherapy group felt that their illness had had beneficial effects on their relationships with family and friends.

Adult↗
PubMed1990

Long-term toxicity of chemotherapy for testicular cancer--the cost of cure.

Twenty-seven patients cured of advanced testicular cancer by cisplatin-based chemotherapy have been assessed, a median of 30 months after start of treatment, for the long-term effects of such treatment on renal, endocrine, audiometric, reproductive and respiratory function. To control for the effects of orchidectomy on endocrine function a similar group of 11 patients cured by orchidectomy alone was also assessed. The extents of impairment in hearing and renal function were related to the total dose of cisplatin received, while the majority of patients had respiratory impairment which was, in part, related to the total dose of bleomycin. TSH was significantly higher in the chemotherapy group although serum free thyroxine and free T3 were normal in all. FSH was raised in 67% of the chemotherapy group although serum free thyroxine and free T3 were while LH was raised in 75% and 45% respectively. Serum testosterone was normal in all. The levels of FSH and LH were both independently correlated with age of the patient while FSH was higher in patients having more chemotherapy and had a tendency to fall towards normal with time since treatment. Over half the patients had normal sperm concentrations although 74% had a raised proportion of abnormal sperm. Indices of sperm function were worse in patients having more chemotherapy but sperm number increased towards normal with time since treatment, particularly after the second year. The long-term side-effects of chemotherapy for testicular cancer are thus generally mild but are largely irreversible and their severity is related to the total amount of chemotherapy received. As their longer term significance is not clear we would recommend that, in the treatment of testicular cancer, doses of chemotherapy are reduced to the minimum required for cure. Assessment of long-term side-effects of chemotherapy for testicular cancer should be a mandatory part of any study of such treatment and should be considered in any comparison of different therapies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Preventive care card for general practice.

A new preventive care card for use in general practice has been designed and produced by a working party of general practitioners from the local medical committees of Devon and Cornwall and the Tamar faculty of the Royal College of General Practitioners. The new card, which is described in this paper, is proposed as a replacement for forms FP7A and FP8A in general practice records.

Family Practice↗
PubMed1988

Pre-emptive (neo-adjuvant) chemotherapy prior to radical radiotherapy for fit septuagenarians with bladder cancer: age itself is not a contra-indication.

Advanced age has often been cited as a contra-indication to the use of cytotoxic chemotherapy or aggressive combined treatment regimens. Fifteen patients, aged between 70 and 79 years (mean 73.1), have been treated for high grade, invasive bladder cancer using neoadjuvant intravenous cisplatin (80-100 mg/m2) plus radical radiotherapy (60 Gy in 6 weeks). Objective response was achieved in 14 patients. The median survival was 22 months, with 6 patients surviving 3 years or longer. Acute and late side effects were not excessive (no cases of W.H.O. grade IV toxicity), as demonstrated by clinical examination and the use of questionnaires (including linear analogue self-assessment scales) to assess quality of life. This aggressive treatment programme can achieve a high remission rate and prolonged survival in elderly patients with high risk bladder cancer without causing excessive morbidity.

Acute Disease↗