Showing papers by "American Cancer Society published in 1987"

Survival experience in the breast cancer detection demonstration project

Abstract: Very high survival rates have been observed in four through 11 years of follow-up in 4,240 women with a histologically confirmed diagnosis of breast cancer in the Breast Cancer Detection Demonstration Project (BCDDP). The relative five, eight, and 10-year survival rates were 88, 83, and 79 percent, respectively. Allowances were made for lead-time bias among cancers detected through screening, and the validity of the findings was supported by internal analyses, which showed that length-time bias was of little, if any, importance, and that any possible “overdiagnosis” of cancer cases was also of small relevance. In view of current interest in the value of screening women before age 50, intensive analyses were made comparing the BCDDP data for women in their 40s with women in their 50s. In terms of kinds of breast cancers found, modality of finding them, and survival rates once they have been found, the parallel results for the two groups show that screening was vitually as effective in the younger as in the older women. Some authorities are of the opinion that the benefits of mammography after age 50 are well documented, but at younger ages the evidence is still inconclusive. The findings in this study show there is no doubt of the very successful results of screening for breast cancer with mammography in younger as well as older women. In comparing relative five-year and eight-year survival rates for women with invasive breast cancers detected through screening in the BCDDP, with those for cases diagnosed in the National Cancer Institute's Surveillance, Epidemiology and End Results (NCISEER) program from 1977 to 1982, it is seen that for individual subcategories by tumor size and nodal class, the survival rates are about the same. However, for overall invasive cancers, the five-year and eight-year survival rates were 87 and 81 percent, respectively, for the BCDDP, compared with 74 and 65 percent for SEER. Thus the substantial gains in survival followed the large shift toward a high proportion of cancers being diagnosed and treated in more favorable stages through the screening accomplishments. With respect to the relative case fatality rates, the complements of the relative survival rates, the eight-year rate of 19 percent for the BCDDP versus that of 35 percent for SEER connotes 46 percent fewer women dying in the BCDDP group.

Optimum Management of Nausea and Vomiting in Cancer Chemotherapy

Abstract: Nausea and vomiting continue to be critical problems in cancer chemotherapy, although considerable progress has been made toward understanding the neuropharmacological mechanisms of vomiting and how chemotherapeutic agents and antiemetics affect these mechanisms. The principles of behavioural psychology have also been applied in an effort to understand and effectively manage these complications which have potentially serious consequences. For example, there is now some degree of rationality to our use of metoclopramide for cisplatin-induced nausea and vomiting, the use of combination antiemetic regimens, and use of lorazepam for the prevention (albeit unproven) of anticipatory nausea and vomiting. It must be admitted, however, that our approach is for the most part still empirical

Increase of dihydrofolate reductase in peripheral blood lymphocytes of rheumatoid arthritis patients treated with low-dose oral methotrexate

Abstract: Because of a previously observed plateau of clinical response after long-term methotrexate (MTX) therapy for rheumatoid arthritis (RA), we investigated whether such treatment might lead to acquired resistance to the drug. We studied the activity of dihydrofolate reductase (DHFR) (the target enzyme of MTX) in peripheral blood mononuclear cells of 11 RA patients who had been treated with MTX for a median of 43 months. The enzyme levels were markedly increased compared with levels found in the cells of 6 RA patients treated with other slow-acting drugs. Quantitative dot-blot analysis of DNA from 7 of these patients showed no evidence of DHFR gene amplification. No correlation was observed between increased levels of DHFR and either response to therapy or to the weekly MTX dosage. Phytohemagglutinin-stimulated peripheral blood lymphocytes from 6 patients with increased levels of DHFR showed no evidence of MTX resistance in vitro. The increased DHFR levels may result from binding of MTX to the enzyme, which may block the normal degradation pathways; they do not appear to be a marker of impending drug resistance.

Youth cancer education through a combined American cancer society‐boy scouts of America pilot program

Abstract: A pilot cancer education program for Boy Scouts in grades six through nine was developed. Motivation to complete requirements was provided by awarding a “Cancer Awareness Patch.” Content of the program included health issues related to smoking and tobacco use, diet, and sun exposure, plus education about the practice of testicular self‐examination, and sunscreen usage. Retention of factual material was good up to 18 months post‐program. Participants developed positive attitudes toward lifestyle development and volunteerism. The program is recommended for supplementation of school health promotion curricula.

Preventive strategies for cancer in women.

Abstract: It is estimated that 480,000 types of cancer will occur in women during 1987, the most frequent being breast (27%), colon and rectum (16%), lung (11%), and uterus (10%). Of cancer deaths, lung (20%), breast (18%), and colorectal (14%) are most common. Uterine cancer is now the sixth cause of cancer death, after ovary and pancreas, due to the application of cancer detection. with an aging US population, cancer will become an even more significant health issue for women. Cancer in women aged 65 years and older occurs twice as frequently as in those aged 45 to 64 years. Melanoma is becoming an increasingly important public health problem because of its rising incidence during the last 20 years. Preventive strategies can be widely promoted to women in order to lower their cancer risk and to find cancer before symptoms appear. Smoking control, safe sun exposure, and simple recommendations for diet and nutrition can assist women in taking control of their lifestyles to reduce cancer risk. Early cancer detection, as outlined in the American Cancer Society's Cancer Related Checkup Guidelines, can be expected to find breast, colorectal, uterine, and other forms of cancer in asymptomatic women.

Mass screening for colorectal cancer--the Philadelphia experience.

Abstract: On May 18, 1985, the Philadelphia Division of the American Cancer Society and WCAU-TV entered into a jointly-sponsored colorectal health day to do mass screening throughout the greater Philadelphia area. This was preceded by a week-long series of television awareness programs, and an organization based on having individual hospital coordinators for those hospitals participating. A total of 46 hospitals in Pennsylvania alone participated in this project, and over 16,000 people were screened in a single day. 410 patients had positive stools for occult blood on site, and 359 were positive on take-home 3-packs. Rectal pathology was diagnosed initially in 502 patients. 13 colorectal cancers and 38 polyps have been diagnosed directly as a result of this screen. Total cost to the Cancer Society was $13,300, meaning each diagnosed cancer cost $1,023 and each cancer or polyp cost $266 in actual funds expended for the screen. This overwhelming response by the public to such a mass screening effort indicates the potential for such programs for colorectal cancer, and the techniques employed in planning, implementing, and following up on data retrieval are discussed. This mass screening effort should serve as a model for future projects, and emphasize the importance not only of interrelationships with the media, but also liaison efforts with a network of area hospitals and individual hospital coordinators.

The initiation ritual as a model for oncology counseling

Abstract: This article examines the use of the initiation ritual of primitive people, described in the works of Mircea Eliade, as a model for counseling cancer patients, giving both meaning and structure to the interactions between patient and counselor. Within this model the patient's encounter with death, whether feared or actualized, can be used as impetus toward personal growth, whatever the stage of the person's disease process. Case examples are given to illustrate how the model can be used in practice. Comparison is also made between stages and components of the initiation ritual and other techniques used to alter a person's consciousness.