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Biomedical subjects

R R Love

Publications and source records attributed to R R Love.

At least 91 records · Page 5Linked to original sources
PubMed1988

A phase II evaluation of combination chemotherapy plus aminoglutethimide in women with metastatic or recurrent breast carcinoma. An Eastern Cooperative Oncology Group Pilot Study.

The Eastern Cooperative Oncology Group (ECOG) conducted a pilot study of combination chemotherapy with cyclophosphamide, doxorubicin, and 5-fluorouracil plus aminoglutethimide (250 mg three times daily with hydrocortisone supplementation of 40 mg daily) as primary therapy for estrogen receptor-positive or unknown advanced breast carcinoma to assess whether these agents can be safely combined and to provide a preliminary estimate of response rate. A total of 47 patients, 45 with metastatic breast cancer and two with stage IV disease who were rendered clinically disease free following surgical resection of chest wall recurrence, were treated. Leukopenia and mucositis were the most frequent toxicities requiring dose reduction, but only five patients (10.6%; 95% confidence interval, 1.8-18.4%) experienced life-threatening leukopenia (less than 1000/mm3) at some point during their therapy. Neurologic side effects attributed to aminoglutethimide, predominantly lethargy, were reported in less than one-third of patients, and rarely required dose reduction. One elderly patient developed clinical hypothyroidism during the first 3 months on therapy and experienced a cardiac arrest at home while receiving supplemental thyroid hormones. The overall complete plus partial response rate in 45 patients was 55.5% (95% confidence interval, 41-70%). Among 16 patients with measurable disease, the complete plus partial response rate was 75% (95% confidence interval, 54-96%). The complete plus partial response rate in 29 patients with nonmeasurable but evaluable disease was 45% (95% confidence interval, 27-63%) and an additional 14% had improvement in bone pain. Eight patients electively discontinued chemotherapy after 7-24 months of therapy, but continued aminoglutethimide. The median time to disease progression is 462 days (15.4 months); 25% of patients died by 552 days (18.4 months), and the median duration of survival is predicted to be 889 days (29.6 months). We conclude that aminoglutethimide can be combined with this doxorubicin-based regimen with acceptable toxicity and an overall response rate which is similar to that observed on prior ECOG trials with cyclophosphamide, doxorubicin, and 5-fluorouracil.

Adult↗
PubMed1986

Lymphocele after retroperitoneal node dissection for testis tumor.

A patient is presented in whom a lymphocele developed after a retroperitoneal lymph node dissection for Stage II embryonal carcinoma of the testicle. The benign nature of this lymphocele has been confirmed not only by the diagnostic procedures outlined, but by its stability over a 42-month follow-up period with no further antitumor therapy. We conclude from reviewing the literature that while aggressive measures are necessary to confirm the diagnosis of a lymphocele, its management should be expectant. If significant obstruction of neighboring structures occurs, an attempt at percutaneous drainage (and possibly sclerosis) seems appropriate despite potential risks of interventional treatment such as hemorrhage and introduction of infection. Open procedures for marsupialization and drainage should be reserved for cases in which more conservative measures fail.

Adult↗
PubMed1986

Education in cancer prevention for primary care clinicians.

In response to increased public interest in cancer prevention and rapidly escalating health care costs, the National Cancer Institute supported the development of cancer prevention courses for health professionals. A multidisciplinary group of physicians, behavioral scientists, and educators developed, field-tested, revised, and evaluated a 12-module, 24-classroom-hour clinical preventive oncology course for primary care physicians. A rationale for education in cancer prevention is presented, the new clinical discipline of preventive oncology is defined, and contributory disciplines are identified. A curriculum based upon detailed learning objectives is described, short-term evaluation data are presented, and a methodology for incorporating a didactic course into a residency program is suggested. The positive reception given to this course by residents warrants optimism concerning application of a biopsychosocial or self-regulative model rather than the traditional biomedical one to clinical medicine and its teaching.

Attitude of Health Personnel↗
PubMed1986

Anxiety and drug taste as predictors of anticipatory nausea in cancer chemotherapy.

Interview data from 192 patients receiving cytotoxic chemotherapy for the first time were analyzed to identify factors predictive of the development of anticipatory nausea. Posttreatment nausea and vomiting (particularly vomiting), tastes of drugs during injections, and anxiety before injections were all associated with an increased probability of anticipatory nausea. An index consisting of those three variables, plus age, was found to have good predictive power, even when the predictor variables were assessed only at the first chemotherapy administration and the index was used to predict the development of anticipatory nausea at any time during the first six chemotherapy cycles.

Adolescent↗
PubMed1986

Adenomas are precursor lesions for malignant growth in nonpolyposis hereditary carcinoma of the colon and rectum.

The relationship of adenoma to carcinoma of the colon and rectum in individuals of families with nonpolyposis hereditary carcinoma of the colon and rectum syndrome is uncertain. In five families with hereditary carcinoma of the colon and rectum, the medical records of 39 patients who had 50 instances of carcinoma of the colon and rectum develop were studied. Six instances of disease were found in adenomas: Dukes' A in two; Dukes' B in three, and Dukes' C in one. The malignant polyp was the only neoplastic lesion in the colon in five of these instances. In only 12 of the patients (31 per cent) were adenomas (seven patients) or secondary disease (five patients) ever found. These data suggest that while uncommon adenomas are precursor lesions for malignant neoplasms in patients with carcinoma of the colon and hereditary carcinoma of the colon and rectum syndrome.

Adenocarcinoma↗
PubMed1986

Psychosocial consequences of cancer chemotherapy for elderly patients.

The purpose of this study was to determine whether elderly patients receiving cancer chemotherapy experience more emotional distress, difficulty with side effects, and disruption in activities than younger patients. A sample of 217 patients receiving initial chemotherapy treatment for breast cancer or lymphoma was interviewed several times over the first 6 months of treatment. Patients ranged in age from 19 to 83. Included in the interviews were questions on presence, duration, and severity of side effects; response of disease to treatment; and 0-10 ratings of emotional distress, difficulty, and life disruption due to chemotherapy. Information on drugs given, doses, and schedules was obtained from medical charts. In general, elderly patients reported no more difficulty with treatment or emotional distress than did younger patients. This general pattern held across disease types, with some exceptions. These results, combined with previously published studies on the physiological effects of chemotherapy in the elderly, indicate that aggressive treatment should not be withheld from older patients simply because of their age.

Adult↗
PubMed1985

Breast cancer-related inquiries by patients to a telephone information service.

The authors studied 2804 breast cancer-related inquiries that were made in 1226 patient calls placed to a cancer hotline between 1979 and 1983. One third of the inquiries concerned treatments or their side effects. Questions about rehabilitation, biology, and specialists accounted equally for another third of the inquiries. The patient-directed nature of these telephone inquiries suggests that these data may provide a particularly accurate assessment of breast cancer patients' needs for information and counseling that are being inadequately addressed under conventional medical care.

Adult↗
PubMed1985

Small bowel cancers, B-cell lymphatic leukemia, and six primary cancers with metastases and prolonged survival in the cancer family syndrome of Lynch.

The Cancer Family Syndrome of Lynch (CFS) is characterized by the frequent occurrence of multiple types of cancers, often adenocarcinomas of the colon, endometrium, and breast, at early ages in a pedigree pattern suggesting an autosomal dominant mechanism of inheritance. An unusual CFS pedigree is presented in which members exhibited rare cancers, six primary cancers, and prolonged survival.

Adenocarcinoma↗
PubMed1985

Short term high density systemic therapy for metastatic breast cancer.

Twenty-three patients with metastatic breast carcinoma were induced with a complex systemic therapy regimen in an attempt to ascertain if a complete remission rate greater than 50% could be obtained with intensive drug exposure. The durability of the remissions was observed by discontinuing therapy after 3 cycles in complete remission or after 6 cycles of treatment, whichever was longer. In 13 patients consolidation radiation therapy to the pre-treatment sites of disease was administered after discontinuing systemic therapy. Each 28 day cycle of the drug regimen consisted of pulses of adriamycin, vincristine, dibromodulcitol, prednisone, methotrexate with leukovorin rescue, hexamethylmelamine, bleomycin (discontinued after entry #17), fluoxymesterone, and tamoxifen. Eighteen of the 23 patients achieved complete remissions (78%) and 3 had partial remissions. The median times to treatment failure and survival were, respectively, 12.3 and 19.4 mos. The times for complete remission patients were, respectively, 13.5 and 23.9 mos. Consolidation radiotherapy at greater than or equal to 40 Gy to drug induced pre-study sites of complete remission was associated with first relapses at pre-study sites in 5/30 (17%) instances, compared to 21/35 (60%) in sites not receiving radiotherapy. Side-effects were commensurate with the intensity of the treatment program and are detailed in the text. Although the achievement of a high complete remission rate is promising, the failure to extend their duration beyond that of historical data suggests that additional conceptual and therapeutic approaches need to be explored.

Altretamine↗
PubMed1985

Normal mucosal histochemistry and histopathology in familial colorectal cancer.

Histochemical and histopathologic changes have been described in mucosa adjacent to and overlying neoplasms and non-neoplastic conditions of the large bowel. These changes are considered by some investigators to be preneoplastic changes. We studied mucosal biopsy specimens obtained at colonoscopy from all sections of large bowel in 34 asymptomatic subjects. Every subject had a documented family history of colorectal cancer (Cancer Family Syndrome of Lynch); in addition, two had previous colorectal cancers and two had cancers diagnosed at the time of colonoscopy. Consistent interpretations of mucin species secretion were not obtained. Microscopic mucosal abnormalities were not detected. Mucin histochemical and histopathologic changes are not promising markers for colorectal cancer in the Cancer Family Syndrome of Lynch.

Adult↗