Setting priorities for cancer control: an approach.
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Biomedical subjects
Publications and source records attributed to W B Patterson.
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A heterogeneous response to X-ray and far UV (254 nm) light irradiations was found in cultured skin fibroblast lines from 2 separate families with Gardner's syndrome. When compared to 2 normal control cultures and cultures from 2 patients with nonfamilial colon cancer, cultures from 4 clinically affected members of family 1 showed increased sensitivity to the lethal effects of both X-ray and UV light irradiations. These cells also showed a delayed pattern of X-ray potentially lethal damage repair (PLDR) and absent UV PLDR. In contrast, cultures from 3 members of family 2 (2 of whom were clinically affected) showed a normal response of survival and PLDR to both X-ray and UV light irradiations. Thus increased sensitivity of cultured skin fibroblasts to X-ray and UV light irradiations was not a consistent in vitro finding in patients with Gardner's syndrome. However, in families with Gardner's syndrome who demonstrate in vitro radiosensitivity, additional studies are needed to assess the usefulness of these techniques in detecting affected individuals prior to the development of colon carcinoma and other manifestations.
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Electrocoagulation of intraoral carcinoma has been utilized as primary curative treatment in a series of twenty-five patients. The technique described here employs a disk electrode, requires only light general anesthesia and has a low rate of complications. Eleven patients survived more than five years. Eight died of other diseases and only 6 died with recurrent cancer. This is an effective technique which deserves wider use.
Autologous, irradiated (10,000 rads) tumor cells mixed with C. parvum were given as weekly intracutaneous injections to fifteen patients with residual malignant disease. The toxicity was minimal and distinctly less than has been seen with tumor cell-BCG immunotherapy. A goal of 4 injections of 10(7) cells each was possible in only 4 patients because of limitations in methods of disaggregation and quantity of tumor available. The feasibility aspects are discussed and a case report of a prolonged regression is presented.
Traditionally, melanoma has been considered by surgeons to be a highly lethal malignancy, always requiring a radical surgical approach for optimal chance of cure. Yet melanoma patients who are now being referred for treatment frequently have small early lesions, and surgeons should develop a flexible attitude about management, limiting the size of their excisions and deferring node dissections in many early cases. An aggressive, radical approach remains appropriate for large lesions, progressively enlarging nodes and locally recurrent but not disseminated disease.
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Inflammatory fibrous polyp of the ileum is a rare condition. This report adds one patient to the 11 previously reported. These lesions usually involve intermittent, colicky abdominal pain, often of several weeks duration and occasionally as a cause of acute intestinal obstruction. X-rays usually show small bowel obstruction or intussusception, but may be completely normal. The pathological diagnosis is seldom made before microscopic examination of resected specimens. They are clinically interpreted to be neoplasm and treated by segmental resection. No recurrences have been reported after treatment. Etiology is unknown.