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Biomedical subjects

M S Soloway

Publications and source records attributed to M S Soloway.

At least 37 records · Page 2Linked to original sources
PubMed1979

Proximal stent displacement as complication of pigtail ureteral stent.

The indwelling ureteral stent recently introduced by Cook offers relative ease of placement with a self-curling end which prevents migration down the ureter. We have seen 4 cases of proximal migration of these stents. The reasons for this event are described. Our experience suggests the placement of a suture in the distal portion of the catheter to allow retrieval of the catheter should migration occur.

Adult↗
PubMed1979

Cyclophosphamide, doxorubicin hydrochloride and 5-fluorouracil in advanced carcinoma of the prostate.

Combination chemotherapy consisting of cyclophosphamide, doxorubicin hydrochloride and 5-fluorouracil was evaluated in 21 patients with metastatic adenocarcinoma of the prostate who were unresponsive to conventional therapy. All patients had extensive bone metastases. Of the 21 patients 5 (29 per cent) had a subjective response and an additional 12 (57 per cent) remained stable for 2 to 13 months after initiation of therapy. The median survival of patients with a subjective response was 60 weeks compared to 40 weeks for the stable patients. Patients who progressed on therapy had a median survival of 22 weeks. The significant response rate with a corresponding improvement in survival for patients on this 3-drug regimen suggests a need for additional trials to determine the response rate and survival compared to single agents.

Adenocarcinoma↗
PubMed1979

Comparison of procarbazine, imidazole-carboxamide and cyclophosphamide in relapsing patients with advanced carcinoma of the prostate.

In this third cooperative chemotherapy trial of the National Prostatic Cancer Project 165 patients with histologically confirmed, relapsing clinical stage D prostatic cancer were randomized to receive either imidazole-carboxamide, procarbazine or cyclophosphamide. All patients had received and failed previous hormonal therapy. Patients whose disease progressed after 12 weeks on initial therapy were crossed over or randomized to receive an alternate drug. There were 129 patients available for comparison of treatments. The objective response rates (partial regression plus stable disease) were 26% for cyclophosphamide, 27% for imidazole-carboxamide and 14% for procarbazine. Subjective responses were noted in pain relief, improvement in performance status and weight gain. Procarbazine was associated with excessive toxicity, resulting in many patients (28%) discontinuing therapy within the first 3 weeks and closure of this particular arm of the study. The regimen of initial imidazole-carboxamide therapy with a later cross-over to cyclophosphamide when the disease continues to progress is associated with the longest increase in survival. Imidazole-carboxamide and cyclophosphamide appear to be active agents in advanced prostatic cancer and are worthy of continued use in this disease.

Aged↗
PubMed1979

The use of estramustine and prednimustine versus prednimustine alone in advanced metastatic prostatic cancer patients who have received prior irradiation.

Estramustine has been shown previously to be an effective drug in the treatment of metastatic prostatic cancer, demonstrating significant objective and subjective responses in long-term non-randomized trials and in other randomized trials. In this study prednimustine alone has shown a minimal over-all objective response rate of 12.9% of the cases, although with marked subjective improvement of pain relief and patient performance status. The combination of prednimustine with estramustine did not result in improvement of objective or subjective response parameters. The effects in terms of responses or in terms of toxicity for either agent were not additive when they were given in combination. Cross-over for those patients whose disease progressed on prednimustine therapy to estramustine had some benefit in over-all survival. Prednimustine alone or in combination with estramustine may be used safely and could improve markedly the quality of life for irradiated patients with advanced prostatic cancer who failed on hormonal treatment and have too poor a bone marrow reserve to be treated by other currently available myelosuppressive agents.

Chlorambucil↗
PubMed1979

The effect of platinum analogues and combination chemotherapy on murine bladder cancer.

Cis-diamminedichloroplatinum II currently is the most effective chemotherapeutic agent in advanced bladder cancer. However, most of the objective responses are partial and/or of limited duration (average 6 months). In an effort to identify a more effective compound with less toxicity platinum analogues have been synthesized. Since results in the carcinogen-induced murine bladder cancer model have correlated with activity of drugs in man this model was used to evaluate 4 of these analogues. Although not as effective as the parent compound, cis-diamminedichloroplatinum, they exhibited significant antitumor activity in the poorly differentiated transplanted tumor. However, they were not able to reduce the incidence or size of primary tumors. Another approach to enhance tumor cell kill is combination chemotherapy. The addition of cyclophosphamide or cyclophosphamide and doxorubicin hydrochloride to cis-diamminedichloroplatinum produced a greater tumor inhibition than cis-diamminedichloroplatinum alone in experiments with the transplanted and the primary tumor models. It is hoped that these studies will continue to provide background information for the design of disease oriented phase I and II clinical trials.

Animals↗
PubMed1978

Does cyclophosphamide induce bladder cancer?

An increasing incidence of bladder neoplasms temporally associated with chemotherapy, usually cyclophosphamide, is being reported. These secondary primary bladder malignancies are characteristically found in two groups of patients: those with lymphoproliferative or myeloproliferative tumors, and those with immunosuppression after organ transplantation. A case of adenocarcinoma of the bladder associated with malignant lymphoma is reported, and the known cases of second primary bladder malignancies after cyclophosphamide therapy as reported in the literature are reviewed. Studies relating to the enhanced occurrence of second primary cancers in lymphoproliferative disorders are presented. The recognized urologic toxicities of cyclophosphamide, including cytopathologic changes in animals and humans, are discussed. The observed association between immunosuppression and second primary malignancies is explored, as supported by studies on congenital immunodeficiency in humans, viral oncogenesis in experimental animals, and neoplasia after organ transplantation. Possible mechanisms of carcinogenesis associated with cyclophosphamide are reviewed, including suppression of humoral and cell-mediated immune defense mechanisms, direct carcinogenesis, or cocarcinogenesis. A plea is made for the orderly reporting and careful documentation of bladder tumors in patients receiving cyclophosphamide. It is suggested that prospective studies in these patients and in patients receiving cyclophosphamide for nonmalignant disorders would be of value in assessing the culpability of cyclophosphamide as a carcinogen.

Abdominal Neoplasms↗
PubMed1978

Role of nurse clinician in urologic oncology.

The incorporation of single and combination chemotherapy into the therapeutic regimen for some advanced genitourinary tumors has greatly added to the myriad of medical and psychologic problems already present in these patients. Working closely with a urologist, a nurse clinician can be of significant help in the total care of this group of patients. Due to the seriousness and chronicity of the neoplastic process, the emotional and social impact as well as physical factors affect all phases of the patient's life, as well as the lives of family members. The incorporation of traditional nursing values into the medical education of nurse clinicians helps to prepare them to deal with these problems, and their participation serves to make the medical team more complete.

Aged↗
PubMed1978

Serial multiple-site biopsies in patients with bladder cancer.

A prospective study was done on 52 patients with bladder cancer to determine the incidence of atypia, carcinoma in situ and carcinoma in selected site biopsies from normal-appearing mucosa at the time of initial and subsequent endoscopy. Biopsies at initial endoscopy revealed abnormalities in 33 per cent of the patients, while 77 per cent of 43 patients undergoing 3-month selected site biopsies had at least 1 abnormal biopsy during a 1-year period.

Adult↗
PubMed1978

Cis-diamminedichloroplatinum II in advanced urothelial cancer.

Thirteen patients with advanced urothelial cancer received a minimum of 2 courses of cis-diamminedichloroplatinum II. Of these patients 6 (46 per cent) achieved a partial response with an average duration of more than 6 months. One patient has received cis-diamminedichloroplatinum for more than 1 year and has no clinical evidence of tumor (complete response in lung metastasis plus excision of local recurrence). The routine administration of intravenous fluids and mannitol immediately before cis-diamminedichloroplatinum prevented the nephrotoxicity associated with this drug. An outpatient setting was well tolerated in most instances. This report confirms the activity of cis-diamminedichloroplatinum in urothelial cancer and suggests its use as an adjuvant to operation and/or radiotherapy in selected cases.

Adult↗
PubMed1978

Immunogenicity of N-[-4-(5-nitro-2-furyl)-2-thiazolyl]formamide-induced bladder cancer.

Five transplantable TCC initially induced by the carcinogen FANFT were systematically tested for individual immunogenicity and then for the presence of cross-reacting tumor antigens. The classic amputation challenge technique was used. Three of the 5 tumors were immunogenic, as determined by their ability to reduce the growth of a challenge tumor dose in mice immunized with the same bladder tumor. Prior immunization with one of the immunogenic tumors failed to reduce the incidence or growth of primary bladder tumors induced by the ingestion of 0.1% FANFT in C3H/HeJ mice. The lack of cross-reacting tumor antigens has important implications for the use of allogeneic tumor cells as an antigen source in immunotherapy.

Animals↗
PubMed1978

Effectiveness of long-term chemotherapy and/or BCG on murine bladder cancer.

Cure following surgery of bladder cancer is limited by recurrence of the original tumor or by the development of new primary tumors. TCC of the bladder induced in C3H/HeJ mice by FANFT closely resemble their human counterpart and have been used to evaluate the effect of chemotherapy and/or BCG on the induction and growth of these tumors. Three hundred five mice were divided into a control group of 30 and 11 treatment groups of 25. Therapy was initiated at 5 and 7 months after FANFT. The first tumors in this system are observed at 8 months with an expected incidence of 70-90% by 11 months. Therapy consisted of: 1) BCG; 2) cyclophosphamide; 3) cyclophosphamide + BCG; 4) cyclophosphamide + 5-FU; 5) cyclophosphamide + adriamycin; and 6) adriamycin. All mice were killed after 11 months on FANFT. Bladders were wieghed and the tumors were staged. Tumor incidence was reduced by only two regimens: adriamycin and cyclophosphamide + adriamycin. Cyclophosphamide significantly reduced subsequent tumor volume compared with the control group, with the effect being more pronounced in mice beginning treatment at 5 months. The combination regimens were superior to cyclophosphamide alone. BCG did not potentiate the antitumor action of cyclophosphamide and, when used alone, actually enhanced tumor growth (P less than 0.025). The use of BCG immunotherapy should be cautioned, but the effectiveness of the antineoplastic drugs suggests their use in clinical trials in patients with bladder cancer.

Animals↗
PubMed1978

The use of estramustine and prednimustine versus prednimustine alone in advanced metastatic prostatic cancer patients who have received prior irradiation.

Estramustine has been shown previously to be an effective drug in the treatment of metastatic prostatic cancer, demonstrating significant objective and subjective responses in long-term non-randomized trials and in other randomized trials. In this study prednimustine alone has shown a minimal over-all objective response rate of 12.9 percent of the cases, although with marked subjective improvement of pain relief and patient performance status. The combination of prednimustine with estramustine did not result in improvement of objective or subjective response parameters. The effects in terms of responses or in terms of toxicity for either agent were not additive when they were given in combination. Cross-over for those patients whose disease progressed on prednimustine therapy to estramustine had some benefit in over-all survival. Prednimustine alone or in combination with estramustine may be used safely and could improve markedly the quality of life for irradiated patients with advanced prostatic cancer who failed on hormonal treatment and have too poor a bone marrow reserve to be treated by other currently available myelosuppressive agents.

Drug Therapy, Combination↗
PubMed1977

Anuria following silver nitrate irrigation for intractable bladder hemorrhage.

Intravesical silver nitrate has been used for intractable bladder hemorrhage. A case of anuria resulting from this technique is reported. The etiology of anuria in this patient was probably owing to obstruction from deposition of silver salts. The level of obstruction was the ureterovesical junction on 1 side and the collecting ducts at the renal papillae on the other side. Therapy consisted of vigorous endoscopic evacuation of deposited silver salts from the bladder and hemodialysis with good results.

Adult↗