PubMed Health⌕ Search

Biomedical subjects

S A Brosman

Publications and source records attributed to S A Brosman.

At least 19 recordsLinked to original sources
PubMed1992

Incidence and treatment of complications of bacillus Calmette-Guerin intravesical therapy in superficial bladder cancer.

Intravesical therapy with bacillus Calmette-Guerin (BCG) has proved to be more effective in the prophylaxis and treatment of superficial bladder tumors and carcinoma in situ than most chemotherapeutic agents. Compared to intravesical chemotherapy, instillations with BCG provoke more local and systemic reactions. In addition to the commonly induced granulomatous inflammatory changes in the bladder, which produce irritative symptoms, this therapy may cause systemic side effects varying from mild malaise and fever to, in rare instances, life-threatening or fatal sepsis. We report the incidence and varieties of toxicities in 2,602 patients treated with intravesical BCG. Side effects are classified according to local and systemic toxicity. Treatment options vary according to the severity of toxicity from delaying or withholding instillations to treatment with antituberculous drugs for up to 6 months. In general, 95% of the patients have no serious side effects. Recognition of risk factors, particularly traumatic catheterization or concurrent cystitis, that result in systemic BCG absorption, as well as the prompt and appropriate treatment of early side effects should significantly decrease the incidence of severe toxicity.

Administration, Intravesical↗
PubMed1992

Bacillus Calmette-Guérin immunotherapy. Techniques and results.

Intravesical instillation of bacillus Calmette-Guérin (BCG) has become an important adjunct in the management of patients with stages Ta and T1 transitional-cell carcinoma of the bladder and carcinoma in situ (CIS). For BCG to be effective, patients should be assigned to the appropriate protocol. With proper treatment, tumor recurrences can be prevented in as many as 80% of patients, residual tumor eradicated in 60%, and CIS eliminated in 70% of appropriately selected patients.

Administration, Intravesical↗
PubMed1991

Transrectal ultrasound-guided interstitial radiation therapy for localized prostate cancer.

The use of interstitial implants for the treatment of low-stage prostate cancer using transrectal ultrasound guidance is evaluated in 80 patients. This outpatient procedure involves the placement of needles through a template and into the prostate. Ultrasound guidance is used to place the needles into a preselected location. The needles are loaded with a radioactive source. In this study Palladium-103 was utilized. This technique allows accurate and complete seeding of the prostate. There was a 50 percent or greater decrease in prostate size in all of the patients who were implanted. Prostate-specific antigen (PSA) levels became normal or decreased by more than 50 percent in 97 percent of the patients. Most patients experienced urethral irritative symptoms which lasted up to five months, but none of the patients experienced rectal symptoms lasting longer than a month. The mean follow-up is 11.8 months which is too brief to ascertain the effectiveness of this therapy. The method appears to be safe and may represent an alternative to external beam irradiation.

Antigens, Neoplasm↗
PubMed1990

The preparation, handling and use of intravesical bacillus Calmette-Guerin for the management of stage Ta, T1, carcinoma in situ and transitional cell cancer.

The increasing use of bacillus Calmette-Guerin in the treatment of patients with low stage bladder cancer will inevitably bring attention to problems of proper use and toxicity. There is a need to identify patients who are most likely to benefit from this therapy and those who may be at risk for serious complications.

Administration, Intravesical↗
PubMed1989

A practical guide to the use of intravesical BCG for the management of stage Ta, T1, CIS, transitional cell cancer.

Intravesical instillations of BCG are effective in preventing tumor recurrence, eliminating existing tumor and treating CIS in a substantial number of patients. As with any type of therapy, side effects can occur. Because a live organism is being used, care must be taken in the handling and administration of the product. Patients should be informed about the common types of reactions so that these may be reported to the urologist. In turn, the urologist must decide if the treatment plan needs to be modified or the patient started on medications which can prevent or reduce the severity of the side effects. At times a decision must be made regarding withholding or delaying treatment and there are situations when BCG should be stopped.

Administration, Intravesical↗
PubMed1987

Ras related oncogene protein as a tumor marker in transitional cell carcinoma of the bladder.

An oncogene related protein has been detected in the urine of patients with transitional cell carcinoma (TCC). This is a 55 kilodalton protein (p55) which is immunologically related to the ras oncogene product p21. Sixteen patients with TCC (55%) and none of the controls exhibited high level of p55 expression (greater than or equal to 3X the level of background). There were ten cancer patients (35%) who had 2X the level of background and three patients (10%) who had the level of background. In contrast, there were two non-cancer patients with 2X level of expression (9%) and the remainder (91%) had the background level of p55 expression. The expression of the marker (p55) tends to correlate with tumor grade and stage and is elevated in patients with a history of multiple recurrences. The ras oncogene has been identified in the tissues of a wide variety of cancers and is not a marker which is specific for any single cancer. The identification of its related gene product in the urine may be useful as a marker for TCC.

Antigens, Neoplasm↗
PubMed1985

The use of bacillus Calmette-Guerin in the therapy of bladder carcinoma in situ.

Intravesical instillations of Tice strain bacillus Calmette-Guerin were given to 33 patients with biopsy proved carcinoma in situ. An induction phase consisting of 12 weekly instillations was followed by a maintenance phase of instillations bimonthly for 3 months and then monthly for 18 months. A total of 6 patients did not complete the induction phase because of adverse reactions but 4 were rendered free of tumor and have had no recurrence. Of the remaining 27 patients 18 became free of tumor after 12 weeks of therapy (3 had recurrences during the maintenance period), 6 after 18 weeks (with 1 recurrence) and 3 after 24 weeks. Thus, 31 of 33 patients (94 per cent) were rendered free of carcinoma in situ. There were 4 recurrences in these patients (13 per cent). The 27 patients who have remained free of disease have been followed for 1.75 to 8.5 years, with an average of 5.25 years. Side effects, principally bladder irritability, were a problem early in the study. With the use of isoniazid, nonsteroidal anti-inflammatory agents and bladder antispasmodics, the treatment has been safe and tolerated well. The study indicates that bacillus Calmette-Guerin is effective in eliminating carcinoma in situ in most patients, although prolonged treatment may be necessary. Maintenance therapy appears to be of value in reducing the incidence of recurrent tumor.

BCG Vaccine↗