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Biomedical subjects

G S Rogers

Publications and source records attributed to G S Rogers.

At least 19 recordsLinked to original sources
PubMed1997

New approaches to treating advanced melanoma: adjuvant treatment of high-risk primary melanoma and boron neutron capture therapy.

Malignant melanoma is associated with an excellent long-term prognosis when detected and treated at an early stage. Surgery alone is sufficient for patients with thin melanomas. Patients with thicker tumors, who are at higher risk for metastasis, may benefit from additional therapy beyond surgical removal of the tumor. Adjuvant therapies are designed to reduce the risk of melanoma recurrence. In particular, the immunotherapies, which boost the host's immune response to the cancer, are proving to be valuable adjuncts to surgery. Once melanoma has metastasized to a visceral organ, the prognosis is poor. Metastatic melanoma has a poor response to most conventional treatments. Boron neutron capture therapy is a novel approach to cancer management. It is a binary therapy combining low energy, nonionizing neutron irradiation with a stable isotope of naturally occurring boron avidly absorbed by the tumor. The combined approach currently under investigation results in highly selective tumor destruction.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Management of stage I malignant melanoma.

BACKGROUND: Because of the rising incidence of melanoma, dermatologists are increasingly responsible for diagnosing and managing patients with this cutaneous malignancy. Fortunately, with the increased awareness and emphasis on early detection, most patients will present with tumors that have not yet spread beyond their primary focus in the skin (ie, Stage I). Dermatologists must, therefore, be fully versed in the diagnosis and management of Stage I melanoma. OBJECTIVE: This review article focuses on the most important issues related to the diagnosis and management of Stage I melanoma. An emphasis will be placed on surgical management. RESULTS: The mainstay of therapy for most patients with Stage I melanoma is surgery. The important principles of diagnostic biopsy and surgical excision will be discussed. There are several additional modalities that may be useful as adjuvants to surgical therapy or as primary therapy in situations when surgery is not feasible. Those include elective lymph node dissection, hyperthermic isolation limb perfusion, radiotherapy, cryotherapy, chemotherapy, and immunotherapy. These will all be reviewed. CONCLUSIONS: With a thorough understanding of the important principles and controversies related to the management of Stage I melanoma, dermatologists can effectively manage the growing number of patients with this malignancy.

Biopsy↗
PubMed1994

Skin growths in the aged. Treatment considerations.

Skin disorders are very common among elderly people. All physicians who care for this population should possess the ability to recognise common benign growths. Primary care physicians should also have the ability to recognise premalignant and malignant lesions, so that early diagnosis and treatment is possible. It is puzzling that the organ system most amenable to examination is so often overlooked in routine examinations. By simply taking the time to perform a skin examination, morbidity and mortality can be decreased. Through improvements in pharmacotherapy, particularly the development of more effective sunscreens, it may eventually be possible to markedly reduce the development of many benign and malignant skin lesions.

Age Factors↗
PubMed1993

Melanoma update. Second primary melanoma.

BACKGROUND: Second primary melanoma is not a rare phenomenon. It occurs in at least 3 to 6% of melanoma patients and up to a third of individuals from melanoma-prone families. OBJECTIVE: To review the clinical and histologic features of multiple primary melanoma. A schema for follow-up of these patients is presented. CONCLUSIONS: As the incidence of melanoma continues to rise, we will be faced with an ever increasing number of patients who have survived their tumor. These patients are at risk for subsequent melanomas. This article reviews the literature regarding multiple primary melanoma, and discusses patient management.

Humans↗
PubMed1993

Wound healing and aging.

Age-related differences in wound healing have been clearly documented. Although the elderly can heal most wounds, they have a slower healing process, and all phases of wound healing are affected. The inflammatory response is decreased or delayed, as is the proliferative response. Remodeling occurs, but to a lesser degree, and the collagen formed is qualitatively different. Diseases that affect wound healing are more prevalent in the elderly and have a greater adverse effect on healing than in young adults. Thus, particularly in the elderly, concomitant medical problems should be treated vigorously to allow for maximum healing. Recent trials of novel therapies to enhance wound healing suggest, however, that much can be done to improve the prognosis of elderly patients with risk factors known to adversely affect wound healing.

Adult↗
PubMed1991

Surgical management of stage I malignant melanoma.

In part because of the increased public awareness regarding skin cancer, patients are presenting to their physician with thinner melanomas. Many lesions are now found in the in situ phase. The vast majority of melanomas referred to or diagnosed in the Skin Oncology Program at Boston University are less than 2 mm in thickness. In the increasingly uncommon situation of thicker lesions, the standard 3-cm margin excision continues to be performed until clinical trials indicate that lesser margins are safe. Definitive surgery is only part of the physician's responsibility in caring for the patient with melanoma. These patients need to be followed up on a regular basis for life, because of the long latent period for risk of metastasis and to facilitate early detection of new primary melanomas.

Biopsy↗
PubMed1990

The senile epidermis: environmental influences on skin ageing and cutaneous carcinogenesis.

There is a wealth of new knowledge regarding mechanisms of carcinogenesis and their interaction with senescence and environmental insults, particularly on the effects of UV irradiation on the skin. Innovations and advances in tissue culture techniques now permit in vitro studies of keratinocytes and other benign and malignant skin-derived cells. The ageing processes and cutaneous neoplasia, therefore, can now be studied at the cellular level. New insights regarding the interrelationship of ageing, environment and cutaneous neoplasia are close at hand. Depletion in the number of Langerhans cells and suppression of their function in ageing and UV-exposed skin may allow tumour cells to overcome the host's defence system. The potential increase in UV irradiation due to depletion of the ozone layer may increase the incidence of skin tumours. Carcinogenesis involves three distinct steps: initiation, promotion, and malignant conversion. The mechanism has been studied in mice, where it is suggested the c-ras oncogene may play an important role.

Animals↗
PubMed1990

Prognostic factors in thin cutaneous malignant melanoma.

A small subset of patients with thin (less than 0.76 mm thick) primary cutaneous malignant melanomas develop metastases. Features that may help differentiate higher and lower risk lesions in this thickness range are reported to include the patient's age and sex, anatomic site and diameter of the primary lesion, Clark level of invasion, development of a vertical growth phase, the mitotic index, ulceration, regression, and cellular aneuploidy. In this report, we review the literature regarding the significance of these factors on the patient's prognosis.

Female↗
PubMed1990

The role of chemical peeling in the treatment of photodamaged skin.

Management of the aging face involves evaluation of the degree of solar elastosis, rhytidosis, and the structural changes associated with senescent skin. Chemical facial exfoliation is divided into deep, medium, and superficial based upon depth of penetration of the caustic agent used. Knowledge of the appropriate indications and technique are essential in obtaining optimal clinical results.

Chemexfoliation↗
PubMed1989

Narrow versus wide margins in malignant melanoma.

Although wide surgical excision is the accepted treatment for thin malignant melanomas, there is reason to believe that narrower margins may be adequate. A randomized prospective study to assess the efficacy of narrow excision (excision with 1-cm margins) for primary melanomas no thicker than 2 mm was conducted at the National Institute of Health in Milan, Italy, and five other countries. Narrow excision was performed in 305 patients and wide excision (margins of 3 cm or more) in 307 patients. The major prognostic criteria were well balanced in the two groups. The mean thickness of the melanomas was 0.99 mm in the narrow-excision group and 1.02 mm in the wide-excision group. The subsequent development of metastatic disease involving regional nodes and distant organs was not different in the two groups (4.6% and 2.3%, respectively, in the narrow-excision group as compared with 6.5% and 2.6% in the wide-excision group). Disease-free survival rates and overall survival rates (mean follow-up period was 55 months) were also similar in the two groups. Only three patients had a local recurrence as a first relapse. All had undergone narrow excision, and each had a primary melanoma with a thickness of 1 mm or greater.

Humans↗
PubMed1989

Malignant melanoma: early detection and treatment.

The primary care physician has a critical role in the early detection and cure of malignant melanoma. We present an overview of melanoma epidemiology, offer guidelines for recognition of melanoma and its precursors, review prognosis and staging, and describe the latest developments in surgical and medical treatment.

Biopsy↗
PubMed1988

Determination of sex steroid receptor in human basal cell carcinoma.

The role of estrogens in the development of skin cancer is controversial. Sex steroids have a profound effect on the epidermis and epidermal appendages. Estradiol in pharmacologic doses has been reported to stimulate basal cell carcinoma in an animal model. Sex hormones act by means of a specific protein receptor. In this study we used a specific, highly sensitive monoclonal antibody to evaluate sex steroid receptors in human basal cell carcinoma. No estrogen or progesterone receptor protein was detected in the basal cell tumor, despite clear positive control tissues. We conclude that these sex steroid receptors are not present in significant amounts to mediate a direct effect in basal carcinoma.

Adult↗