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Biomedical subjects

Julie A Chacko

Publications and source records attributed to Julie A Chacko.

2 recordsLinked to original sources

Association between marijuana use and transitional cell carcinoma.

OBJECTIVES: Marijuana smoking has been implicated as a causative factor in traditionally tobacco-related tumors of the head and neck and of the lung. When associated with marijuana use, such tumors occur in a much younger patient population than do similar tumors in tobacco smokers. Owing to the large number of young men with a history of marijuana presenting with transitional cell carcinoma to VA facilities, this study was designed to compare the marijuana use among young (aged less than 60 years) transitional cell carcinoma patients with that among age-matched controls. METHODS: Fifty-two men aged less than 60 years presenting consecutively with transitional cell carcinoma and 104 age-matched controls (defined by having no history of transitional cell carcinoma, hematuria, or irritative voiding symptoms, as well as unremarkable results on urinalysis and urine cytology) completed questionnaires about exposure to various potential carcinogens, including radiation, Agent Orange, smoked or processed meats, dyes, tobacco, and marijuana. RESULTS: Of the 52 transitional cell carcinoma patients, 46 (88.5%) reported a history of habitual marijuana usage, and 72 (69.2%) of the age-matched controls gave a history of habitual marijuana use. This difference was statistically significant (P = 0.008). In those with transitional cell carcinoma, marijuana use significantly correlated with tumor stage, grade, and number of recurrences. CONCLUSIONS: Marijuana smoking might increase the risk of transitional cell carcinoma.

Carcinoma, Transitional Cell↗

Vasectomy and prostate cancer characteristics of patients referred for prostate biopsy.

PURPOSE: The prospect of an association between vasectomy and prostate cancer has gained widespread attention and has potentially influenced patterns of referral. In patients referred for prostate needle biopsies we compared the incidence and characteristics of prostate cancer in those reporting a history of vasectomy to those denying prior vasectomy. MATERIALS AND METHODS: A total of 585 consecutive prostate biopsy procedures were performed on 522 veterans during a 42-month period. Upon questioning 101 patients (19.3%) reported prior vasectomy. From the remaining 421 patients 202 consecutive age matched controls were selected. Pre-procedure prostate specific antigen levels, digital examination findings, incidence of prostate cancer, cancer grade and tumor length on biopsy cores were compared between the patients with and without a history of vasectomy. RESULTS: Of the 101 patients who reported a history of vasectomy 46 (45.5%) had prostate cancer compared to 98 (48.5%) of the 202 age matched controls, and this difference was not statistically significant. Of the patients with prostate cancer those with prior vasectomy less frequently had an abnormal digital examination and lower prostate specific antigen levels, lower Gleason grade, lower clinical stage and shorter length of cancer on biopsies. CONCLUSIONS: We found no increase in prostate cancer incidence or severity in patients referred for prostate biopsy who had undergone prior vasectomy. In fact, prostate cancer was less common with fewer poor prognostic indicators in patients with previous vasectomy. These findings may be secondary to either selection bias, as patients with a vasectomy may seek more routine medical care, or a greater tendency of primary providers to refer these patients for evaluation.

Adult↗