PubMed Health⌕ Search

Biomedical subjects

M M Henderson

Publications and source records attributed to M M Henderson.

At least 19 recordsLinked to original sources
PubMed1995

Nutritional aspects of breast cancer.

Nutrition, in its broadest sense, plays a clear role in breast cancer, identified through its relationship to such known risk factors as rate of growth and development, age at menarche, adult height, postmenopausal body weight, and fat distribution. The relative importance of daily diet is hotly debated. There is no agreement on the relative importance of nutrition's effect, the responsible food groups and nutrients, nor the age or ages at which it can be influential. Evidence linking breast cancer and diet comes from human ecologic and observational studies as well as a body of experimental feeding studies in rats and mice. The population studies, including increasing numbers of migrant studies, and the animal experiments suggest that high-fat diets promote breast cancer, particularly among older women. Studies that compare diets of persons with and without breast cancer and those that record breast cancer incidence among women with different dietary histories have been inconclusive enough as to warrant randomized intervention trials. Recognition of differences between the risk factors for premenopausal and postmenopausal women and increasing insight into the ages at which known risk factors exert their influence have helped in the design of these trials. Human feeding studies and the trials themselves are identifying metabolic changes and their biomarkers as well as biomarkers for changes in fat and nutrient intakes. The Women's Health Initiative Dietary Modification Trial was designed to show whether a sustained (9-year) low-fat, high-fruit-and-vegetable eating pattern will lower the incidence of breast cancer among women who will be between ages 59 and 88 when the trial ends, the time of peak incidence. Meanwhile, the Women's Intervention Nutrition Study will learn in approximately 5 years whether a low-fat, adjuvant eating pattern will improve the prognoses of postmenopausal women with early and moderate stage breast cancer and whether tamoxifen should be used as at least part of their treatment. The results of these trials will have important applications for both public health and the provision of medical care.

Adult↗
PubMed1994

Ethical issues: changing attitudes and practices.

Ethical questions about the conduct of cancer prevention research need to be addressed at individual, organizational, community, and national levels. These questions have been highlighted by the demands of women and minorities to be included in research, the participation of practicing clinicians in prevention research, the lack of consensus about the nature of the contract between participants and investigators, the locus of liability for public health interventions, the degree of safety needed for preventive interventions, the relative certainty needed to classify participants at high enough relative risk to be exposed to toxic or potentially toxic agents. A number of ongoing chemoprevention and behavioral intervention U.S. trials are used to illustrate these issues. A question will also be raised about the extent to which future preventive programs are determined by current decisions about priorities for research funding and whether these priorities match national needs and public preferences.

Anticarcinogenic Agents↗
PubMed1992

Role of intervention trials in research on nutrition and cancer.

Randomized intervention trials of manipulated dietary differences are needed to identify not only specific causal associations between diet and disease but also the safety of the tested dietary modifications and whether they can lower community-wide rates of disease. Randomized trials of manipulated dietary changes are also used to identify biological markers of exposure and indicators of possible mechanisms of disease. The latter include measurements of changes in levels of metabolites and changes in the frequency of occurrence of either predisposing or predisease conditions. This group of studies is stimulated to a great extent by a demand for short-term surrogate endpoint measurements and objective measures of compliance that will lower the cost of studies and improve their credibility. Another series of dietary trials focuses on interventions to bring about long-term changes in dietary behavior at both the individual and community levels. All trials are designed to be cost efficient and to limit the exposure of average and low-risk individuals to interventions that may have long-term adverse effects. This conservative approach leads to some confusion about which interventions are being tested for use in clinical settings to lower risk in high-risk individuals and which interventions are being tested because they have the potential to lower the overall rates of disease in communities.

Breast Neoplasms↗
PubMed1992

International differences in diet and cancer incidence.

International variations in the annual incidence rates of reproductive organ and gastrointestinal cancers suggest that they have environmental causes and can be controlled by public health approaches. Secular trends in the national incidence rates of these two groups of tumors and the experiences of migrants moving from countries with low rates to countries with higher rates of these cancers increase the likelihood that public health dietary interventions will lower cancer incidence rates. The results of recent correlation analyses of international variations in the consumption of dietary fat and incidence of large-bowel and hormone-dependent reproductive organ cancers suggest that both the total amount of fat and the specific fatty acids consumed are associated with the incidence of these cancers in national populations and that the associations strengthen with age and are strengthened rather than weakened by the inclusion of potentially confounding and modifying dietary and nondietary factors in the analysis. The consistency of estimates developed with coefficients derived from these analyses and the degree to which they agree with independent observations suggest that they can provide useful parameters for the design of trials to test the hypothesis that they measure causal associations.

Adult↗
PubMed1991

A population-based cancer prevention research unit.

The first U.S. population-based cancer prevention research unit identifies and tests primary prevention interventions that work at a community level. It selects the most common cancer sites and high impact, safe interventions, including the prevention and control of the use of tobacco and the identification of efficacious dietary interventions. A multidisciplinary team of investigators conceptualize, design, and implement interdisciplinary research projects within the framework of an over-all research plan. The interdisciplinary approach and the appropriateness of each project is assured by six core research resources which analyze enrollee and provider information from a large comprehensive health plan, monitor cancer registrations and health behaviors, facilitate general population and community-wide intervention strategies, provide expertise and tools for cost analysis, provide behavioral intervention expertise and tools, and provide tools for dietary measurements, nutrient databases, and short-term measurements of dietary effects. Current research projects include multicenter randomized chemoprevention trials, randomized community trials of smoking cessation and the prevention of tobacco use, community-based dietary change interventions, studies of the efficacy of a low-fat diet and of the diffusion and permanence of successful changes in fat consumption, and community-based intervention studies to increase rates of regular use of mammography.

Cancer Care Facilities↗
PubMed1990

Feasibility of a randomized trial of a low-fat diet for the prevention of breast cancer: dietary compliance in the Women's Health Trial Vanguard Study.

The Women's Health Trial Vanguard Study was conducted to examine the feasibility of a nationwide, randomized multicenter intervention trial to test the hypothesis that a low-fat diet followed for a period of 10 years will reduce breast cancer risk. Women ages 45-69 years at increased risk of breast cancer were randomized into intervention (low-fat diet, n = 184) and control (usual diet, n = 119) groups. On the basis of 4-day food records, baseline fat intakes were comparable in the two groups, averaging 1,718 kcal with 39% of energy as fat. Intervention women reported substantially lower fat intake at 6 (20.9% kcal), 12 (21.6%), and 24 months (22.6% kcal). In contrast, control women reported only slight reductions in fat intake (37.3% kcal at 12 months and 36.8% kcal at 24 months). Evidence that these women were indeed complying with the low-fat dietary intervention comes from (a) the reasonable nature of reported nutrient changes within food groups in the intervention women and (b) agreement between observed and expected differences in plasma total cholesterol between the control and the intervention groups. At 12 months, the observed control - intervention plasma cholesterol difference was 13.1 +/- 4.6 mg/dl while the expected difference based on the Keys equation was 15.1 +/- 1.1 mg/dl; at 24 months, the observed difference was 15.5 +/- 4.3 mg/dl and the expected difference was 12.0 +/- 1.2 mg/dl. These analyses indicate that the intervention women made substantial dietary changes and have successfully maintained these changes over a 2-year period. This study thus demonstrates the feasibility of a randomized trial with an intensive low-fat dietary intervention.

Aged↗
PubMed1990

Types of dietary fat and the incidence of cancer at five sites.

The specificity of a statistical association increases the likelihood that it represents a causal relationship. In exploring the relationship between dietary fat and cancer, specificity applies both to cancer sites (outcome) and to component fats (exposure). In this study, Armstrong-Doll criteria were used to select female cancer incidence data for breast, cervix, lung, and colon, and male incidence data for lung, colon, and prostate for 1973-1977 from 20 countries with reliable registry data. Truncated age-standardized rates were correlated with estimates of per capita disappearance of total fat and of saturated, monounsaturated, and polyunsaturated (total, fish omega-3, omega-6) fats in 1975-1977. Multiple regression analyses were standardized for estimated total calorie intakes and used to assess the association between each fat and incidence at each cancer site. Estimates of per capita dietary and crude fiber intakes were also included in the analysis. Total calorie intake was not associated with cancer at any site when controlled for total fat intake, whereas total fat intake was strongly associated with cancers of the breast, colon, and prostate even after adjustment for total calorie intake. Cancers of the lung and cervix were not correlated with dietary fat intake. Monounsaturated fat had no positive association with cancer at any site. Saturated fat was positively associated with incidence of cancers of the breast, colon, and prostate and polyunsaturated fat was associated with incidence of breast and prostate cancers but not colon cancer. Fiber intake, when included in the analysis, affected the magnitude of the fat-cancer correlations, particularly between total fat and colon cancer. Fish omega-3 polyunsaturated fat had a nonsignificant negative association with the cancer sites studied. The findings supported hypotheses based on the results of animal experiments showing that different kinds of fatty acids have different tumor-promoting capabilities.

Adult↗
PubMed1990

Attitudes of nursing students toward patients with AIDS.

Nursing students (N = 124) voluntarily completed a questionnaire designed to measure attitudes towards patients with AIDS. The questionnaire included one of two vignettes, a prejudicial evaluation scale, and the Index of Homophobia. Results indicate that nursing students expressed a significantly more negative attitude toward the homosexual patients with AIDS. Homophobia accounted for a substantial amount of variation in the difference in expressed attitude between heterosexual and homosexual AIDS patients. The researchers recommend that nursing students and other prospective health care workers be provided educational programs dealing with AIDS which include study of homophobia and homosexuality.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Results of a randomized feasibility study of a low-fat diet.

A 2-year randomized clinical trial was conducted to test whether free-living women aged 45 to 69 years can reduce the fat content of their diet from the typical US level of approximately 39% to 20% of energy from fat, using readily available foods, when given nutritional and behavioral counseling and social support. Three clinical units randomized 303 selected volunteers into intervention (low-fat eating plan) or control (customary diet) groups. The two groups were comparable at baseline. The intervention group received nutrition instruction and behavioral counseling largely in permanent groups of 12 to 15 participants meeting weekly, then biweekly, and finally monthly. At 6 months, they had substantially reduced the mean proportion of total energy from fat from 39.1% to 20.9%, compared with the control group's nonsignificant reduction from 39.0% to 38.1%. At 12 and 24 months, they sustained the reduction of energy from fat. Weight loss and plasma cholesterol level changes in the intervention group supported the self-recorded dietary intake changes. Attendance at intervention sessions averaged 75% during the first 6 months and, subsequently, 60% to 70%. Four-day food records for the randomized women were obtained at 6 and 12 months from approximately 95% and at 24 months from 87%. A clinical trial of a low-fat diet is feasible in women.

Aged↗
PubMed1985

Rationale and design of cancer chemoprevention studies in Seattle.

Three cancer prevention trials are currently in their early phases at The Fred Hutchinson Cancer Research Center, the University of Washington School of Public Health and Community Medicine, and the Swedish Hospital. All 3 studies are randomized and placebo controlled. One large-scale study involves the daily administration of retinoids to persons with asbestos-related lung disease in an attempt toward reduction of their high risk for bronchogenic carcinomas and mesotheliomas. A second study involves administration of the same agents to long-term heavy smokers; a substantial feasibility and toxicity pilot study will precede a full-scale prevention trial. In the third trial, folic acid administration is evaluated in relation to the progression and regression of cervical dysplasia among women with abnormal Pap smears. We report here the rationale and the design for these 3 studies.

Asbestosis↗
PubMed1984

Cancer advisory board.

Explore the source record for details and available documents.

National Institutes of Health (U.S.)↗
PubMed1983

The use of levamisole as an adjunct to chemotherapy and radiotherapy in the treatment of small cell carcinoma of the lung.

To test the efficacy of immunotherapy in the treatment of small cell carcinoma of the lung, patients were allocated at random, in a double-blind controlled trial, to treatment with either levamisole or placebo as an adjunct to chemotherapy with multiple drugs (cyclophosphamide, vincristine, methotrexate and adriamycin) and to radiotherapy. We report here the results of a pilot study of 13 patients. The median survival period of the patients who were given levamisole was 25 weeks. This was significantly shorter (P less than 0.05) than that of the patients who were given placebo (46 weeks).

Adult↗
PubMed1979

Small cell carcinoma of the lung. Prognosis in relation to histologic subtype.

Forty-six of 59 patients with small cell carcinoma of the lung who were treated with multiple drug chemotherapy and radiotherapy were subclassified according to the World Health Organization classification. Subtyping was not possible in the 13 other patients who were diagnosed on sputum cytology findings alone. There was no significant difference in extent of disease, response, duration of response to treatment, or median survival between the different subtypes. Two main difficulties arise in applying the subtyping classification. First, many tumors showed features of several histologic subtypes, implying the existence of a morphologic continuum within the general group of small cell anaplastic carcinomas. Second, tissue crushing artefact was common. Our results do not reveal any advantage in knowing the tumor subtype. It remains essential to differentiate small cell anaplastic carcinoma from other forms of lung carcinoma not responsive to chemotherapy.

Antineoplastic Agents↗