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Biomedical subjects

D W W Newling

Publications and source records attributed to D W W Newling.

9 recordsLinked to original sources
PubMed2002

Abnormalities detected in metaphase chromosomes in bladder carcinoma: prognostic value and comparison with histopathological factors.

The objective of this study was to detect the incidence and prognostic value of chromosomal aberrations in metaphase chromosomes (hypodiploidy, hyperdiploidy and/or structural abnormalities) in Ta and T1 transitional cell carcinoma (TCC) of the bladder. Of 266 patients, the metaphase chromosomes of the primary tumour were studied using a direct microscopic analysis and classified into two categories: normal and abnormal. Recurrence and progression were prospectively recorded during a median follow-up period of 40 months and in a retrospective analysis compared with other prognostic factors. Chromosomal abnormalities were found in 48% of Ta tumours and in 92% of T1 tumours. In univariate analysis, chromosomal abnormalities were associated with recurrence-free survival ( P=0.03) and progression-free survival ( P=0.01). In multivariate analysis, chromosomal abnormalities (RR=1.98) and age (RR=0.64) were independent predictors of recurrence-free survival but not progression-free survival.

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PubMed2001

Safety and efficacy of a non-steroidal anti-androgen, based on results of a post marketing surveillance of nilutamide.

The use, tolerability and efficacy of the non-steroidal anti-androgen nilutamide (Anandron(R)) in daily clinical practice was investigated in this 5-y project. In total 725 patients were recruited from 27 Dutch centres. The investigated population was very heterogeneous and different therapeutic options were reported. We may conclude that in general good results have been obtained, especially in first line combination therapy combined with luteinising hormone releasing hormone (LHRH) agonists. Patients with a good performance status at inclusion seem to benefit more from nilutamide combination therapy.Prostate Cancer and Prostatic Diseases (2001) 4, 112-117

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PubMed2000

Tailoring of hormonal therapy in prostate cancer.

With an increasing interest in the early introduction of hormonal therapy in patients who cannot be cured of their prostate cancer by radical surgery or radiotherapy, there is a need to consider the most patient-friendly, effective hormonal therapy at each stage of the disease, thereby hoping not only to improve the quantity of the patient's life but also to maintain a reasonable quality of life. With the development of new hormonal therapies such as non-steroidal androgens, LHRH-antagonists and differentiation agents, urologists need to look again at the hormonal status of their patients before prescribing an appropriate therapy. There is increasing evidence that at certain stages of the disease patients are prepared to trade off the length of life for improved quality and bearing this in mind there needs to be some substantial re-thinking over the most appropriate therapy, particularly at early stages of the patient's disease and following progression to the later stages. Prostate Cancer and Prostatic Diseases (2000) 3, 21-27

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PubMed2000

New strategies for the treatment of hormone-independent prostate cancer.

It is quite likely that in every prostate cancer, at the start of clinical disease there are hormone-independent cells present. These cells may be sensitive to changes in the diet, to chemotherapeutic agents, to immunological agents, to the use of vaccines or may be sensitive to radiotherapy. The introduction of these non-hormonal therapies has classically been reserved for the time when the patient has exhausted all other treatment therapies and has a large tumour volume which will almost certainly not respond to such treatments. The purpose of this chapter will be to try to arrive at a more sensible definition of hormone-independent disease than has been used in the past, to outline some of the new treatment strategies and to make suggestions as to where in the natural history of the disease these would be most effectively and easily employed.Prostate Cancer and Prostatic Diseases (2000) 3, 290-295

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PubMed1999

Clinical trials in prostatic cancer-interpretations and misinterpretations.

New agents and therapies in prostate cancer, as in other diseases, need to be accurately, comprehensively and logically developed. The golden standard, a prospective, randomised phase III study can only be carried out efficiently if phase I and phase II studies have been completed. The advent of new therapies which will be used in early stage disease, necessitates the development of new methods of measuring their activity and correlating it with an influence on the natural history of the disease. Efforts to get results more quickly by using weaker endpoints and retrospectively carrying out metanalyses have their disadvantages and dangers. This review will attempt to investigate how clinical trials from phase I through to phase IV in prostate cancer might be improved and made more easily interpretable. It will cover such aspects as the recruitment to trials, the demands of good clinical practice, the use of surrogate endpoints and attempt to give some indications how the newer therapeutic options can be reliably and quickly investigated through clinical trials.

Journal Article↗
PubMed1998

Prostate cancer and sexual function.

Erectile dysfunction is a condition affecting 1 in every 10 men. Although its occurrence is related to ageing, illness and its necessary therapy can play a major role. Prostate cancer can lead to erectile dysfunction both psychologically through depression and emotional distress, and physically through therapy for the disease. An international quality of life survey involving 401 patients with prostate cancer was conducted. The objectives of the study were to investigate the patients' understanding of the treatment options they received, to explore the importance of the patient-doctor communication in the treatment of prostate cancer and to see what effect treatment had on patient's sexual function. One of the main findings of the survey was that too little counselling or information on treatment options and their effects on sexual function was provided to patients. Patients themselves felt that psychosexual counselling, in particular, would be helpful. In addition, therapy for prostate cancer appears to have a significant impact on patients' lifestyle and also on their libido, sexual function and activity.

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PubMed1998

Neurotrophic factors in prostate and prostatic cancer.

Recent progress in growth factor research has led to a reexamination of the involvement of neurotrophic factors outside their classical domain of the nervous system. These last few years have seen a substantial accumulation of data concerning Nerve Growth Factor (NGF)'s prevalence within the prostate. NGF and its receptors were reported from the normal prostatic tissue, benign hyperplasia and prostatic cancer. Divergent ideas about the biological role of this factor, its specific distribution pattern within the tissue and its implication in the progression of carcinogenesis have been proposed. Especially the role of NGF in the metastatic process bears direct clinical relevance for research in this area. Many questions remain to be solved like the one on the prevalence of other neurotrophic factors. It is now increasingly becoming clear that neurotrophic factors do play a role in normal physiology and pathology of prostatic cells, opening up new prospects for diagnosis and treatment.

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