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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endometrial cancer is the cause of considerable morbidity among women, but the disease has been underrated and its management more casual than its virulence warrants. Endometrial carcinoma is the most frequently diagnosed invasive neoplasm of the female genital tract in the US, and is third in incidence after breast and colonic cancer. The white population of the US has the highest age standardized incidence of endometrial cancer in the world, India and Japan have the lowest, and the European countries occupy intermediate positions. Between 75% and 80% of women diagnosed with endometrial cancer are postmenopausal, and the mean age at diagnosis is about 60 years. In many cases endometrial hyperplasia is misdiagnosed as frank malignancy. The predisposing factors for endometrial cancer seem to be obesity, hypertension, diabetes mellitus or an abnormal glucose tolerance curve, and prolonged or unopposed estrogen stimulation. Raised estrogen levels may occur in the following situations: 1) women with functioning ovarian tumors that produce estrogen; 2) women with polycystic ovarian disease; 3) women with ovarian dysgensis (Turner's syndrome) managed with estrogen replacement therapy; 4) women taking high estrogen sequential oral contraceptives (OCs); and 5) women undergoing estrogen replacement therapy. There is an increased risk of endometrial carcinoma associated with nulliparity. Carcinoma of the endometrium occurs in a variety of subtypes, the most frequent being adenocarcinoma, followed by adenocanthoma, adenosquamous carcinoma, clear cell carcinoma, papillary adenocarcinoma, and secretory carcinoma. Overall 5-year survival rates are 72% for adenocarcinoma, 68% for adenocanthoma, and 26% for adenosquamous carcinoma. The true extent of endometrial cancer can be ascertained only after exploratory laparotomy and then various therapies may be used according to the stage of the disease.
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PMID:Carcinoma of the endometrium. 637 16

We report an incidence of thrombosis of 17.6% in 159 patients treated with a five-drug chemotherapy regimen (cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone) for Stage IV breast carcinoma. Chi-squared analysis of risk factors for thrombosis (ambulatory status, obesity, family history, smoking, diabetes mellitus, hypertension, liver dysfunction, thrombocytosis, and previous endocrine therapy) showed no difference between the patients who had a thromboembolic event and those who did not. Statistical analysis revealed that a significantly higher incidence of thrombosis occurred during the chemotherapy regimen than when off this regimen (P less than 0.05). Detailed coagulation studies done prospectively on 10 patients receiving the five-drug chemotherapy regimen compared with 10 control patients showed a significantly elevated Factor VIII antigen:activity ratio in the group receiving the chemotherapy regimen compared with the control group and normals. These results implicate the chemotherapeutic regimen in the pathogenesis of the increased incidence of thrombosis. The pathophysiology of thrombosis in settings such as this awaits better in vitro tests defining the "hypercoagulable state."
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PMID:Increased incidence of thromboembolism in stage IV breast cancer patients treated with a five-drug chemotherapy regimen. A study of 159 patients. 654 74

A case-control study is presented that estimates ovarian cancer risk for various factors, including diet. Data collected by interview between 1957 and 1965 for 274 white women aged 30-79 years with epithelial carcinoma of the ovary are compared to data similarly collected for 1,034 hospital controls. Relative risk estimates are presented for the total group as well as for premonopausal (ages 30-49) and postmenopausal (ages 50-79) are groups. In the total group, cancer risk increased with increasing age at first marriage (P less than .01) and previous history of benign breast disease (P less than 0.1), and risk decreased with increasing number of previous pregnancies (P less than .01). In the 50- to 79-year age group, a marginally significant trend for decreasing risk with increasing obesity was observed (P less than .10). There was no significant risk (i.e., P less than .10) associated with the consumption of alcohol, cigarettes, coffee, tea, total dietary protein, vitamin C, or fat at any age. In the 30- to 49-year age group only, increased risk (P less than .01) was seen in women reporting diets low in fiber and vitamin A from fruit and vegetable sources. Multiple regression analysis demonstrated that the apparent protective effect of vitamin A in the 30- to 49-year age group (but not dietary fiber) was independent of the nondietary factors analyzed in this study (P less than .05).
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PMID:A case-control study of dietary and nondietary factors in ovarian cancer. 657 62

The survival experience of 2,956 invasive breast carcinoma cases identified among the 5 major ethnic groups in Hawaii between 1960 and 1979 was studied. The study population consisted of 1,174 Caucasian, 972 Japanese, 458 Hawaiian, 226 Chinese, and 126 Filipino women. A multivariate analysis based on the proportional hazards regression model revealed that after simultaneous adjustment for stage of disease, age, and socioeconomic status (SES), Filipino and Hawaiian patients had significantly poorer survival than Japanese and Caucasian patients. Hawaiian women also had a significantly poorer survival than Chinese women. Survival was higher in patients between the ages of 45 and 54 years compared to those younger or older, in patients with localized tumors compared to those with more advanced tumors, and in patients with middle or high SES compared to those with the low SES. Histology and marital status were not associated with survival. The possibility that other factors such as obesity, estrogen receptor status, treatment, and nutritional and hormonal status could explain the remaining observed racial differences in breast cancer survival is discussed.
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PMID:Relationship of ethnicity and other prognostic factors to breast cancer survival patterns in Hawaii. 659 37

Breast cancer among Japanese females was characterized by a relatively low incidence and good prognosis. But recently its morbidity is increasing and its biological behavior is changing. The chronological changes and prospective features of breast cancer among Japanese females are follows: 1. Increase of morbidity and mortality 2. Increase of the ratio of poorly differentiated carcinoma and decrease of well differentiated carcinoma 3. Increase of the incidence of lobular carcinoma 4. Increase of the case of the aged females Above items show that breast cancer among Japanese females is becoming westernizing. The case-control study on "breast cancer occurrence and obesity" shows that an obesity of the aged is a significant high risk factor for breast cancer occurrence. There fore, it would be effective that the prevention of overweight at the postmenopausal women to reduce the breast cancer occurrence. The chronological rise of overall 10-year survival rate of operated breast cancer is caused by increasing the ratio of early stage cases. Suggesting an importance of regular self-examination of the breast. Furthermore, it is important to establish an adjuvant therapy without causing side effect for curatively operated cases. Concerning the cancer of the uterus among Japanese females, the chronological occurrence rate of endometrial cancer is increasing, while the death rate of cervical cancer is decreasing.
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PMID:[Breast cancer in Japan--past trend and future prospect]. 671 67

Small bowel transit was performed in 50 patients with bladder or prostatic carcinoma. The patients were all examined in supine and prone positions; some were also studied in 25 degrees Trendelenburg position and 25 degrees inclined procubitus to investigate the effect of the various positions on the displacement of the small bowel loops out of the true pelvis. The prone position proved to be superior to the supine position in 78% of patients. A mean displacement of 0.9 cm was obtained. Greatest shifts generally were found in the Trendelenburg position and inclined procubitus, with a mean displacement of 1.9 and 2.0 cm, respectively. The patients' height, weight, maximal abdominal circumference and Quetelet's index were analyzed with regard to the shifts of bowel loops under the various conditions. Only weight and Quetelet's index were correlated with the shifts in the Trendelenburg and inclined procubitus positions. The shifts were generally larger in case of heavier patients. We conclude that pelvic irradiation should preferably be done in the Trendelenburg or inclined procubitus position, especially in case of obesity.
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PMID:Irradiation of true pelvis for bladder and prostatic carcinoma in supine, prone or Trendelenburg position. 685 61

Estrogen has been used to induce a wide variety of tumors in various animal species but only the rabbit is reported to reliably develop endometrial carcinoma. Variables associated in humans with an increase susceptibility to endometrial adenocarcinoma include aging, obesity, liver diseases, polycystic ovary disease, and ovarian tumors. In women estrogen induces mitotic activity in the endometrium and promotes the proliferation of the endometrium. Current concern that estrogen replacement therapy in postmenopausal women may be associated with increased risk of endometrial adenocarcinoma is based on: 1) reports of increased incidence of the disease, and 2) epidemiologic studies associating estrogen administration with an increased risk of endometrial carcinoma. The author draws the following conclusions based on the existing data: 1) there is likely a small but significant increase in the risk of development of endometrial adenocarcinoma among menopausal women on estrogen replacement therapy; 2) the increase in risk appears to be greatest for women who do not have any of the constitutional stigmas that would ordinarily place them at higher risk for adenocarcinoma; 3) risk increases with increasing duration of therapy, probably following a latent period of undetermined duration; 4) risk increases with increasing dose of estrogen; 5) progestin administration likely affords some protection against the risk, but the potential risks of administering the hormonal equivalent of a combination oral contraceptive periodically to elderly women have yet to be examined carefully; and 6) careful surveillance of patient populations on estrogen replacement therapy may limit the risk of adenocarcinoma associated with estrogens to early, highly curable lesions. It is incorrect to assume that estrogen actually causes carcinoma of the endometrium; it more likely induces a precancerous hyperplastic state in a dose-related fashion and only certain individuals ultimately develop invasive carcinoma.
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PMID:Does estrogen cause adenocarcinoma of the endometrium? 701 37

A 13-year-old girl with Prader-Willi syndrome was admitted to our hospital with an 18-month history of anal bleeding and mucus discharge on defecation. Physical examination revealed obesity, hypogonadism, hypotonia and hypomentia. On digital examination, a nodular mass was palpated on the right wall of the ampulla recti, which was suspected to be carcinoma on a barium enema study. Proctoscopic examination revealed a large, irregular ulceration with white slough at the base, surrounded by the nodular and lumpy mucosa. The lesion was excised by the abdomino-anal pull-through method. The resected specimen showed a lesion of large, shallow, irregular ulcer, 5.0 x 2.2 cm in size. Microscopic examination revealed obliterated lamina propria by fibroblasts and muscle fibers derived from the muscularis mucosae, and misplaced cystic dilated glands in the submucosa at the margin of the ulcer. The gross and microscopic appearances are identical to those of "solitary ulcer of the rectum" described by Madigan and others, and similar to those of "colitis cystica profunda" described by Goodall and others. According to these findings, this lesion was diagnosed as solitary ulcer of the rectum. In the present report, the relationship between solitary ulcer of the rectum and colitis cystica profunda was discussed.
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PMID:Solitary ulcer of the rectum: report of a case and review of the literature. 702 2

The epidemiology of cancer of the endometrium is summarized. The findings are reported, and emphasis is on preventive approaches to cancer of the endometrium, particularly as to the role that physicians as well as women themselves can play. Attention is directed to incidence patterns, geographic distribution, age, race, time trends, survival rates, histopathologic consideration, and etiologic considerations (hormonal factors, obesity, diabetes mellitus, hypertension, and familial disposition). Recent reports indicate an increase in endometrial carcinoma, while the incidence of cervical carcinoma has substantially decreased. Endometrial cancer is usually a disease associated with postmenopausal women, mostly in the 6th and 7th decades, although rare cases have been reported in women under age 20 and over age 90. It is estimated that in 1981 there will be 38,000 newly diagnosed carcinomas of the endometrium and 3200 deaths due to endometrial carcinoma. There is little reliably comparable information available on endometrial cancer in different regions of the world. The incidence rate for endometrial cancer for U.S. white women is nearly double that for black women. For almost 4 decades before 1970 the incidence of cancer of the corpus uteri remained relatively stable. In a study conducted by Weiss et al. it was shown that the incidence of endometrial cancer increased by 34-75% between 1969 and 1973 in spite of a presumed increase in the rate of hysterectomy, which means a decreased population at risk during this same period. It is clear that obesity is a key risk factor for endometrial cancer, particularly as this obesity appears to be related to a high fat diet and consequently to higher levels of plasma urinary estrogens. It also appears that patients with heightened estrogenic stimulation reflected by a late menopause and heavy menstrual flow are at greater than average risk for endometrial cancer. As far as postmenopausal hormonal replacement therapy is concerned, the evidence appears strong that their use does increase the risk of endometrial cancer, particularly if such therapy is given for a long period of time and at relatively high doses. Possibly the ideal solution may be to give, when indicated, hormone replacement therapy at the least possible estrogen dose and together with progesterone, and to take the medication in cycles rather than on a constant basis.
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PMID:Epidemiology of cancer of the endometrium. 703 6

The techniques used for determination of hormone receptors have provided a biochemical basis to the concept of hormone-dependence in breast cancer. By medical experience clinical factors were established for determination of hormonal treatment in breast tumors. The criteria used need now to be re-evaluated in terms of hormone receptor contents. We analysed a group of 155 patients with histologically confirmed breast carcinoma in which estradiol receptor determination was performed. Of these tumors 54% had more than 10 fmol of estradiol per mg protein. Menopause, advanced age, late first childbirth, obesity, early menopause and nuliparity were associated, in that order, with the presence of estrogen receptors in breast tumors. Prognostic stratification analysis brought out polar groups of estrogen receptor contents. Young, premenopausal women with children had only 16% estrogen receptor-positive tumors. Postmenopausal women, either without children or with late first childbirth had as much as 81% of estrogen receptor containing tumors. Clinical variables related to the presence of estrogen receptor positive tumors in the breast cancer population were coincident to risk factors for breast cancer in the healthy population. Possible implications of this coincidences are discussed.
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PMID:Clinical factors related to the presence of estrogen receptors in breast cancer: a prognostic stratification analysis. 713 36


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