Smoking--a habit that can be broken.
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Biomedical subjects
Publications and source records attributed to N C Delarue.
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Clearly defined indications for major extirpation procedures in metastatic mammary carcinoma are lacking. A reassessment of experience with 222 patients (133 after adrenalectomies and 89 after hypophysectomies) was therefore undertaken. This experience has changed our previous opinions that such procedures should be used only at the end of a sequential program of treatment.It is now felt that extirpation is only contraindicated in menopausal women with a duration of disease less than two years or when there is symptomatic disease of vital organs. Otherwise, early extirpation is recommended. When vital organ involvement is recognized in the asymptomatic stage or when screening of premenopausal women by castration indicates continuing hormonal dependency, then early extirpation is indicated.Both the qualitative and the quantitative responses achieved exceed those obtained by other measures when widely disseminated disease is present. The objective remission rate (34% after adrenalectomy and 19% after hypophysectomy) for longer than six months is worth while.
Part I of this review described the pathogenesis of lung cancer and emphasized that it was largely a preventable disease. In the present paper, attention is drawn to the prevalent but false impression that treatment of established disease is quite in-effective. In eight consecutive series of cases (over 2300 patients) the authors have seen a change in the clinical environment in which lung cancer is treated-from one of discouragement and apathy to one of outspoken encouragement and enthusiasm.Complete preoperative assessment-an evaluation of the biology of the tumour-host relationship as well as technical resectability-avoids unnecessary surgical intervention and stimulates a trend to earlier referral. This has permitted increasing use of resection with a declining mortality and a continuing improvement in overall survival. On the basis of present resectability rates (37.5%) and a 39% five-year survival rate in those who have had curative resection, it is estimated that current over-all five-year salvage should exceed 13%. This is more than a five-fold increase in survival for all patients compared to that achieved by treatment before 1952.
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