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M J Markham

Publications and source records attributed to M J Markham.

4 recordsLinked to original sources

Effect of tamoxifen treatment on cortisol metabolism and the course of the disease in advanced breast cancer.

Twenty-nine postmenopausal women with advanced breast cancer were treated with Tamoxifen, a nonsteroidal antiestrogen. The effect of the drug on the plasma concentration, production rate, and metabolism of cortisol was measured, and the relationship of the changes in these parameters to the course of the disease was investigated. After six weeks of Tamoxifen treatment the plasma cortisol concentration and the cortisol-binding globulin concentration increased by 26 and 64%, respectively, but the production rate of cortisol and the urinary excretion of its tetrahydro metabolites THF, ATHF, and THE decreased by 35 and 13%, respectively; all of these changes were statistically significant. When the group consisting of complete or partial responders was compared with one consisting of patients whose disease remained stable or worsened, no significant difference was detected between these two groups in the change in any of the above parameters. It was concluded that any improvement due to Tamoxifen was not related to changes in cortisol metabolism.

Aged↗

Tamoxifen flare.

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Acute Disease↗

Presumed immune thrombocytopenia and carcinoma: report of three cases and review of the literature.

Three patients presenting in a one-year period with coexisting carcinoma and presumed immune thrombocytopenia are the subject of this report. Review of the literature disclosed a paucity of previous reports of this association. Possible pathogenic mechanisms resulting in this association are discussed. All three patients responded to corticosteroids in usual doses used in treatment of chronic idiopathic thrombocytopenic purpura. The association of carcinoma with immune thrombocytopenia may be more common than has been previously appreciated.

Adrenal Cortex Hormones↗

Effect of tamoxifen treatment on estrogen metabolism in postmenopausal women with advanced breast cancer.

The effect of tamoxifen therapy on plasma estrone and estradiol concentration, urinary excretion of estrone, estradiol, and estriol glucuronides, and metabolism of a tracer of 3H-estradiol was studied in 12 postmenopausal women with metastatic breast cancer. The most striking change observed was consistent increase in the 72-hour urinary recovery of total radioactivity after the tracer, from a mean of 47% to a mean of 61% of the dose. This increase was accounted for by a corresponding increase in the recovery of total glucuronide radioactivity, from a mean of 32% to a mean of 44% of the dose; there was no change in the proportions of estrone, estradiol, estriol, or 2-hydroxyestrone in the glucuronide fraction. The most likely explanation for this finding is that the estrogen-receptor-blocking effect of tamoxifen decreases estrogen uptake by various tissues and permits the estrogen to be excreted in the urine instead. There was also a small but consistent and significant decrease in plasma estrone (from 47 to 36 pg/ml) and estradiol (from 15 to 13 pg/ml), with no change in urinary excretion of estrogen glucuronides. The drop in plasma estrogen levels without a decrease in estrogen production suggests that tamoxifen may increase the metabolic and/or renal clearance of estrogen metabolites. There was no correlation between the observed effects of tamoxifen and the pretreatment estrogen-receptor status of the patient or her response to tamoxifen therapy.

Aged↗