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Query: UMLS:C0006826 (cancer)
 1,092,456 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two policies of palliative thoracic radiotherapy for non-small-cell lung cancer have been compared in a randomised multicentre controlled trial. A total of 369 patients with inoperable, histologically or cytologically confirmed disease, too advanced for radical 'curative' radiotherapy, and with their main symptoms related to the primary intrathoracic tumour even if metastases were present, were studied. They were allocated at random either to a regimen of 17 Gy given in two fractions of 8.5 Gy 1 week apart (F2 regimen), or to a conventional multifractionated regimen of either 30 Gy in ten fractions or 27 Gy in six fractions (a biologically equivalent dose), given daily except at weekends (FM regimen). On admission, 93% of the patients had cough, 47% haemoptysis, 57% chest pain, 58% anorexia, and 11% dysphagia. As assessed by the clinicians, palliation of the main symptoms was achieved in high proportions of patients ranging in the F2 group from 65% for cough to 81% for haemoptysis and in the FM group from 56% for cough to 86% for haemoptysis. Haemoptysis, chest pain, and anorexia disappeared for a time in well over half the patients with these symptoms, and cough in 37%. For all the main symptoms, the median duration of palliation was 50% or more of survival. Performance status improved in approximately half of the patients with a poor status on admission. All these results were similar in the two treatment groups. As assessed daily by the patients using a diary card, the quality of life deteriorated slightly during treatment but then improved steadily during the next 5 weeks. The proportion of patients with dysphagia increased considerably during treatment, but fell to the pretreatment level during the next 2 weeks. The results were similar in the two groups. Radiation myelopathy was suspected in one (F2) patient. There was no difference in survival between the two groups (log-rank test), the median survival time from the date of allocation being 179 days in the F2 and 177 days in the FM group. In the light of all the findings, the regimen of two fractions of 8.5 Gy given 1 week apart is recommended.
Br J Cancer 1991 Feb
PMID:Inoperable non-small-cell lung cancer (NSCLC): a Medical Research Council randomised trial of palliative radiotherapy with two fractions or ten fractions. Report to the Medical Research Council by its Lung Cancer Working Party. 170 40

Gallbladder cancer afflicts predominantly women, the elderly, and persons with gallstones. Despite its producing symptoms of abdominal pain, nausea and vomiting, weight loss, jaundice, and anorexia, this disease remains difficult to detect. Even with contemporary imaging techniques, most gallbladder cancers escape diagnosis until the time of laparotomy. The aggressive character of this malignancy permits an overall 5-year survival rate of 3-5%. Although cures occur, the majority of operations performed for gallbladder cancer are for palliation. The objects of palliation include relief of pain, relief of jaundice, relief of intestinal obstruction, and the restoration of normal food intake. Resection of the tumor should be performed whenever possible; however, extensive operations including large liver resections and pancreaticoduodenectomy should be avoided in the presence of distant metastases. In the presence of large unresectable hilar masses, internal biliary bypass may relieve jaundice. Biliary-enteric anastomosis using the segment III duct exposed via the umbilical fissure may offer satisfactory relief of jaundice in selected cases.
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PMID:Palliative operative procedures for carcinoma of the gallbladder. 137 59

Eighty patients with Stage III and IV head and neck cancer were treated with a four-drug regimen consisting of bleomycin, vincristine, methotrexate, and mitomycin-C (BOMM regimen). Of 69 patients evaluable for response, 7 complete and 40 partial responses were achieved, with an overall response rate of 68%. The median duration of response was 13 weeks (range 3-41 weeks). Anorexia, lassitude, febrile reactions, and myelosuppression were major side effects. The BOMM regimen produced a response rate significantly better than VCR, BLM, and MTx combination (VBM) which we previously reported with improved response duration. This study demonstrates that the BOMM regimen, which can be administered on an outpatient basis, achieved a response rate comparable to cisplatin-containing regimens. The BOMM regimen may be beneficial to patients with poor general condition and/or marginal renal dysfunction who are in high risk of toxicity-associated cisplatin-containing regimens.
Cancer Invest 1991
PMID:BOMM regimen for the treatment of advanced head and neck carcinoma. 171 78

The cachexia associated with cancer and AIDS appears to result from a number of processes, most of which impair caloric intake. Although past attempts to reverse anorexia-cachexia have generally been disappointing, several promising new pharmacologic approaches are currently being evaluated, including megestrol acetate, hydrazine sulfate, metoclopramide, and dronabinol.
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PMID:Management of anorexia-cachexia associated with cancer and HIV infection. 172 21

A clinicopathologic study was done on 21 cases of superficial flat-type early gastric carcinoma (IIb type EGC). In one case there was the two IIb type EGC. Nine patients had no symptoms, whereas the other 12 had either epigastralgia, hematemesis, or anorexia. The preoperative diagnosis was accurate in 15 patients; eight were demonstrated by barium study, and 13 by endoscopy. The suspicious finding of IIb type EGC was either the disappearance or irregularity of the areae gastricae by barium study and a mucosal color change by endoscopy. Well-differentiated or moderately differentiated adenocarcinomas showed a slight redness of the affected mucosa whereas the poorly differentiated adenocarcinomas were pale in color. Histologically, many well-differentiated or moderately differentiated adenocarcinomas occupied the entire thickness of the mucosal layer whereas most of the poorly differentiated adenocarcinomas spread horizontally with preservation of non-cancerous glands and foveolae. The growth pattern was super type in ten lesions and small mucosal type in 12 and no pen-type growth was seen. Concerning the cell nuclear DNA ploidy pattern, 21 showed a low ploidy pattern and only one had a high ploidy pattern. The IIb type EGC seemed to have a less malignant potential from the viewpoint of growth pattern and DNA ploidy pattern. Care must be taken at the proximal line of excision of the tumor so as not to leave behind residual carcinoma cells.
Cancer 1992 Jan 15
PMID:Superficial flat-type early carcinoma of the stomach. 172 61

High-dose megestrol acetate has been associated with increased appetite and weight. To examine the effects of high-dose megestrol acetate in the treatment of anorexia and weight loss in patients with advanced hormone-insensitive malignant lesions, a randomized double-blind placebo-controlled trial was conducted. Patients receiving megestrol acetate for 1 month reported a significant improvement in appetite and adequacy of food intake compared with those receiving placebo. A three-item scale measuring appetite, adequacy of food intake, and concern about weight revealed a higher improvement with megestrol acetate than with placebo. Patients who worsened while receiving placebo had similar favorable changes after the cross over to megestrol acetate. These data indicate that megestrol acetate may improve appetite and food intake in patients with advanced cancer.
Cancer 1992 Mar 01
PMID:Megestrol acetate in cancer anorexia and weight loss. 173 26

Emphasis has been placed on the understanding of the regulation of food intake in the hope of aiding the battle against obesity and of helping to ameliorate the anorexia of cancer and eating disorders. Available data suggest that the regulatory system is multifaceted and complex. This review focuses on current research on the regulation of appetite and satiety by carbohydrates, fats, and proteins as well as by artificial sweeteners. Some methodological problems and potential mechanisms of action at the biochemical level are discussed. Evidence suggests that organisms are more successful in defending against calorie dilution than in adjusting to increases in calories. The implications of that defense relative to the use of ersatz nutrients are explored.
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PMID:The influence of food on food intake: methodological problems and mechanisms of action. 174 52

A care system for cancer bearing patients at a highly advanced stage should be informed by a better quality of life based on a life style of the patients and their families. These patients are suffering from various types of trouble including pain, loss of appetite and nausea, which preclude oral intake. Radiotherapy or chemotherapy can be another factor aggravating their nutritional state. In terms of nutritional management, intravenous or enteral alimentation is indispensable, but these conventional alimentary supports generally lead to prolonged hospitalization and re-admission. If parenteral nutritional care can be given to patients at home and not in the hospital, it is leading to the improved quality of life would result. We focus on the issue of home alimentary care, especially intravenous alimentation, for cancer patients at the terminal stage from the nursing standpoint.
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PMID:[Nutritional support for cancer bearing patients]. 174 69

Health professionals should not be forcing the terminal patient into preestablished stages, but rather should take into account the actual experiences of the individual. The purpose of this study was to identify the defining characteristics of the dying process within the terminal phase. A retrospective audit of 11 deceased clients' charts from a hospice program was conducted. Each client had been diagnosed with terminal cancer. Defining characteristics of the process of dying were delineated and organized into groups of subjective and objective phenomena. These included anorexia, absence of pain, nausea, vomiting, tachycardia, respiratory status, withdrawal of self, secretions, mental status, urinary output, restlessness, bowel sounds, blood pressure, internal temperature, skin temperature, skin color, edema, and diaphoresis. Although the sample size was small, these findings confirmed that the dying process for terminal cancer patients was an individualized experience. Additional research is needed to build on this framework.
Cancer Nurs 1991 Dec
PMID:Process of dying. Defining characteristics. 176 Aug 4

Four patients underwent intraoperative photodynamic therapy after surgery with meso-tetra-(hydroxyphenyl)-chlorin (mTHPC-PDT) for diffuse malignant mesothelioma. Preliminary procedures were performed in two patients in order to establish the efficacy of mTHPC-PDT and to optimise its tumoricidal effect. The tumoricidal effect was related to the mTHPC dose, light dose and the time interval between sensitation and activation. 0.3 mg kg-1 mTHPC activated after 48 h with 10 Joules cm-2 of non-thermal laser light at 650 nm resulted in a 10 mm deep tumour infarction, due to tumour vessel necrosis and thrombosis. The mTHPC tissue concentration was up to 14 times higher in the tumour than in normal tissues. Skin photosensitivity was mild, dose dependent and occurred 3 to 10 days after administration of mTHPC. According to the results obtained, intraoperative mTHPC-PDT was performed following pleuropneumonectomy in two, pleurectomy and lobectomy in one and pleurectomy in one patient. Ten Joules cm-2 were delivered to the diaphragm and the costophrenic sulcus and 5 Joules cm-2 to the remaining thoracic cavity. The postoperative course was marked by loss of appetite, fluid retention, hypoproteinemia and severe chest pain. One patient succumbed from aspiration pneumonia. The remaining patients developed no neural or vascular alterations and no bronchial stump insufficiency during follow-up. mTHPC-PDT following surgical tumour resection deserves further evaluation in good risk patients with diffuse malignant mesothelioma.
Br J Cancer 1991 Dec
PMID:Photodynamic therapy with chlorins for diffuse malignant mesothelioma: initial clinical results. 176 75


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