Showing papers in "CA: A Cancer Journal for Clinicians in 1984"

A comparison of the use of smokeless tobacco in rural and urban teenagers.

Abstract: This paper compared the use of smokeless tobacco and its effects in rural and urban teenagers. A random sample of 445 subjects from rural Colorado were examined: 82.9 percent of the total sample were Caucasian, and 94.6 percent of those who used smokeless tobacco were Caucasian. This percentage supports the findings of an earlier urban study that the habit is predominantly one of male Caucasians. The average age of the users was 16.7 years, slightly older than in the urban study. Of the rural users, 62.5 percent had lesions of the oral tissues, compared with 48.7 percent lesional incidence in urban users. In both studies, those subjects with lesions had longer daily contact with smokeless tobacco, as well as a longer history of use than those without lesions. These are numerical averages that reflect great individual variations in susceptibility. The average duration of use for rural and urban users with lesions was almost the same; the development of lesions appears to be related to the length of daily exposure, which, on the average, was greater among rural users than urban users. Additionally, more than twice as many degree 3 lesions were found among users in the rural study. The habituating effects of nicotine and the influence of this substance on the future tobacco-usage patterns of youngsters who presently use smokeless tobacco are areas of concern. It is hoped that additional research will further delineate the scope of this current health problem.

Smokeless tobacco and oral cancer: a cause for concern?

Abstract: Until recently, the use of smokeless tobacco had been restricted to a relatively small percentage of the United States population. The increased promotion and use of both snuff and chewing tobacco raise the question: What effect will such habits have on oral disease and the incidence of oral cancer? Although information for the US is sparse, extensive epidemiologic data are available from India, where the use of tobacco is prevalent and the incidence of oral cancer very high. The Indian data suggest that oral cancer and precancerous lesions occur almost solely among those with tobacco habits, the rate of malignant transformation of precancerous lesions is not greater than in the West, the relative risk of developing oral cancer is similar in India and in the US, and this risk rises with duration of use. Thus, it seems likely that increased usage of smokeless tobacco in the US will eventually lead to an increased incidence of precancerous and cancerous oral lesions in Americans.

Sexual rehabilitation of urologic cancer patients: a practical approach.

Abstract: Sexual rehabilitation is an important aspect of preserving a patient's quality of life after treatment for urogenital cancer. Sexual rehabilitation does not usually require a specialized program, but can be an integral part of cancer treatment. Members of the health care team can provide sexual information for the patient and partner, as well as assess the need for more intensive marital or sex therapy. This paper presents specific sexual issues related to prostate, bladder, testicular, and penile cancers.

Tumors of the major and minor salivary glands

Abstract: Surgery for salivary gland tumors requires technical skill, competence in head and neck anatomy, and a familiarity with a variety of tumors. Benign salivary tumors at all sites should be 100 percent curable, with a local recurrence rate of less than five percent; these local failures should be curable with further surgery. The majority of parotid tumors are benign. Sixty-two percent of patients with malignant parotid tumors will be alive at five years, 54 percent at 10 years, and 47 percent at 15 years. These survival rates for malignant parotid tumors are better than those for malignant tumors in the submaxillary and minor salivary glands and may be explained in part by the presence of a higher percentage of low-grade malignant tumors in the parotid gland. Since most submaxillary gland tumors are malignant, they are more dangerous than parotid tumors. A total of 80 percent of patients with submaxillary gland tumors die as a result of cancer. Almost all minor salivary gland tumors are malignant; curability relates to size, local extension, histology, and nodal metastases. Forty-five percent are alive at five years, and 21 percent at 15 years. Wide-field radical surgical excision is needed for malignant salivary tumors to minimize local recurrences and treatment failures. Future improvement in treatment results will be made possible by increased awareness of this group of tumors, earlier diagnosis when tumors are still small, more radical extirpation, and greater use of postoperative radiation therapy.

Primary cardiac osteosarcoma: Multidisciplinary aspects applicable to extraskeletal osteosarcoma generally

Abstract: An osteosarcoma, primary in the right ventricular epicardium, produced pericardial constriction. Intense activity on technetium-99m bone scintigraphy led to a correct preoperative diagnosis. Biopsy of unrepresentative tissue clouded the diagnosis, and autopsy resolved the issue. Several clinicopathologic correlations are presented. Major therapeutic advances mandate early recognition of extraskeletal osteosarcoma, and the topic is reviewed in regard to cardiac cancers in general. The need to biopsy both hard and fleshy areas of unusual tumors is reviewed.

Classics in oncology: Asbestos exposure and neoplasia

Abstract: Building trades insulation workers have relatively light, intermittent exposure to asbestos. Of 632 insulation workers, who entered the trade before 1943 and were traced through 1962, 45 died of cancer of the lung or pleura, whereas only 6.6 such deaths were expected. Three of the pleural tumors were mesotheliomas; there was also one peritoneal mesothelioma. Four mesotheliomas in a total of 255 deaths is an exceedingly high incidence for such a rare tumor. In addition, an unexpectedly large number of men died of cancer of the stomach, colon, or rectum (29 compared with 9.4 expected). Other cancers were not increased; 20.5 were expected, and 21 occurred. Twelve men died of asbestosis.

The management of patients with colorectal adenomas.

Abstract: The management of a patient with a colorectal adenoma aims at removal of adenomas that are missed initially or develop subsequently. Classification of adenomas permits the separation of patients into those at minimal and high risk of developing recurrent or new adenomas. Follow-up schedules for these two groups are based on currently available clinical and pathologic data.

Survival in untreated and treated cancer

Abstract: During 1935 to 1951, a total of 75,494 cancer cases occurred among the inhabitants of Connecticut, of whom there were 2,000,000 in 1950. The five-year survival rate has improved gradually from 12 and 19 percent of all males and females, respectively, in 1935 to 1940, to 20 and 32 percent, respectively, during 1947 to 1951. This improvement is not due to earlier diagnosis of the cases, as can be seen from the similar distribution of localized and disseminated cases during the whole period of study. The improvement has occurred in cancer that is diagnosed when it is clinically localized and when it involves regional areas, but not when it is disseminated. The most marked improvement is recorded for cancers of the colon and rectum in both sexes, and of the uterine cervix in women. The data are compared with survival rates anticipated in untreated neoplastic disease. A new era of detection and treatment of cancer is being entered through the studies on in situ and occult cancers among the population.

Locating pheochromocytomas by scintigraphy using 131I-metaiodobenzylguanidine.

Abstract: Scintigraphy with 131I-MIBG has located most pheochromocytomas. The detected tumors have been intra-adrenal, extra-adrenal, malignant, and familial in type. The method is safe, but requires images taken over three days to attain optimal results. Because of its ability to screen all sites where primary pheochromocytomas may reside, scintigraphy should be employed as the initial procedure in the search for these tumors. It may be the only technique that will locate extra-adrenal pheochromocytomas. The rate of false-negative results is about 10 percent; therefore, other techniques such as computed tomography will be necessary to help find the few elusive pheochromocytomas.

The hospice movement: an oncologist's viewpoint.

Abstract: In this broad survey, we have touched on the recent creation of special facilities for patients with advanced cancer and their relevance to the overall program of cancer control. Also discussed were a number of ethical dilemmas arising from our efforts to provide improved care for the social and emotional problems afflicting our patients. When all is said and done, however, all our efforts are designed to alleviate human suffering. There may not be such a large gap between basic cancer research, medical oncology, and the hospice movement as has sometimes been perceived.