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Quality of life in men with urinary incontinence after prostate cancer surgery.

Quality of life assessment is significant to health care providers because it helps us understand the experience of well-being as it relates to an illness and its severity, symptoms, and co-morbidities. Attempting to deduce the influence of illness on quality of one's life is complex; however, this area of research has demonstrated that the measurement of quality of life is as important in providing comprehensive care as the treatment itself. Prostate cancer is the most prevalent cancer in American men. Radical prostatectomy is frequently considered the treatment of choice for localized prostate cancer. Despite its widespread use, considerable morbidity exists, including erectile dysfunction and urinary incontinence. Although not all men who undergo radical prostatectomy will experience urinary incontinence, those who do find that it influences their daily lives, affecting the clothes they wear, their activities, sleep patterns, social relationships, and self-esteem. Based on the compelling nature of this problem, this article will focus on the effects that urinary incontinence has on the quality of life in men who undergo surgical treatment for prostate cancer.

Humans↗

Common features and surgical interference in a prevalent oral cancer in Saudi Arabia (a preliminary report).

Oral carcinoma is the third most common malignant neoplasm in the Western region of Saudi Arabia. Its specific pathological features and possible aetiological factors contributing to its high incidence are discussed. The role of 'Shamma', which is a quid used by many local inhabitants, is also discussed. Our experience with the first four cases treated by surgery is presented. Recommendations are made for the early diagnosis and detection of oral carcinoma in this region.

Adult↗

A papillomavirus DNA from a cervical carcinoma and its prevalence in cancer biopsy samples from different geographic regions.

DNA from one biopsy sample of invasive cancer of the cervix contained sequences hybridizing with human papillomavirus (HPV) type 11 DNA only under nonstringent conditions. This DNA was molecularly cloned in lambda phage. Under stringent conditions of hybridization it cross-hybridized to a minor extent (less than 0.1%) with HPV types 10, 14, and 15 and showed no homology with DNA of other human HPV types. We therefore propose to designate it tentatively as HPV 16. HPV 16 DNA was used as a probe to test additional cancer biopsy samples from cervical, vulval, and penile cancer, as well as benign genital warts (condylomata acuminata) and cervical dysplasias for the presence of homologous sequences. In 61.1% (11/18) of cervical cancer samples from German patients sequences were found hybridizing with HPV 16 DNA under conditions of high stringency. In contrast, only 34.8% (8/23) of cancer biopsy samples from Kenya and Brazil revealed this DNA. Vulval and penile cancer biopsy samples hybridized to 28.6% (2/7) or 25% (1/4), respectively. Only 2 out of 33 condylomata acuminata contained HPV 16 DNA. Both positive tumors harbored in addition HPV 6 or HPV 11 DNA. The data thus indicate that HPV 16 DNA prevails in malignant tumors, rendering an accidental contamination with papillomavirus DNA from adjacent papillomas rather unlikely. The rare presence in benign genital papillomas in addition to common genital papillomaviruses suggests a dependence of HPV 16 replication on helper virus.

Bacteriophage lambda↗

The prospects of retinoids in the treatment of prostate cancer.

Prostate cancer is the most prevalent cancer amongst males and accounts for 13% of cancer deaths in this population in the US. Aggressive, androgen-independent, metastatic prostate cancer is incurable, and the search for new therapies has been directed towards identifying agents that block proliferation and induce differentiation and/or apoptosis of prostate cancer cells. Retinoid receptor agonists, such as all- retinoic acid, can induce apoptosis of prostate cancer cells, but clinical studies have demonstrated only mild to moderate efficacy. Retinoic acid receptor antagonists are a new class of retinoids, and pre-clinical studies have shown that they potently inhibit the growth of prostate cancer cells and induce apoptosis. Here, we review whether retinoids have a role in the fight against prostate cancer.

Animals↗

Population-based study of the relationship between hospital surgical volume and 10-year survival of breast cancer patients in Osaka, Japan.

Breast cancer is the most prevalent cancer among Japanese women; however, its outcome has never been analyzed in relation to hospital volume in Japan. We utilized data from the Osaka Cancer Registry for investigating correlations between hospital volume and 10-year survival of breast cancer patients. According to the total number of surgical procedures of breast cancer in each hospital during the period 1985-1991, we classified reporting hospitals in Osaka into four categories (high, medium, low, very low). The survival analysis was restricted to the 4333 female patients reported who were 30-64 years old, living in Osaka Prefecture (except for Osaka City), and for whom active follow up was available more than 10 years after diagnosis. In total, the relative 10-year survival was 79.7% in the high-volume, 80.3% in the medium-volume, 78.2% in the low-volume, and 68.2% in the very low-volume hospitals. After adjustment for age at diagnosis, clinical stage and clues for detection with the Cox regression model, the patients who received care in the very low-volume hospitals had a significantly higher risk of death than those in the high-volume hospitals. Meanwhile, no significant differences in risk were observed for the other two categories. These findings led us to conclude that the surgical volume of the hospitals did not affect the 10-year survival rate significantly, except for the very low-volume hospitals in Osaka, Japan. However, the study of these relationships should be continued and expanded in future to include quality of life.

Adult↗

Interactive effects of antifungal and antineoplastic agents on yeasts commonly prevalent in cancer patients.

The effects of combinations of antifungal and antineoplastic drugs on inhibition of the growth of yeasts which commonly infect cancer patients have been analyzed. It was shown that (i) inhibitory drug combinations could be selected in which all drugs were at levels far below their individual MICs; (ii) interactive effects among antineoplastic and antifungal drugs may be very large; (iii) optimum combinations of drugs for inhibition of yeast growth depended upon both the relative and absolute concentrations of the drugs in the mixture; (iv) drug combinations which were effective at low levels in inhibiting one test yeast were also generally effective against other species, but the levels of susceptibilities and, to a lesser extent, the best ratios of drugs in the test combinations varied with species; and (v) to quantitatively evaluate drug interactions, it is necessary to carefully define and control all experimental conditions, absolute and relative concentrations of drugs used, and the organisms tested.

Antifungal Agents↗

Current treatment options for endometrial cancer.

In North America, endometrial cancer is the most prevalent cancer of the female genital tract. On the basis of clinical and histologic variables, two main types of endometrial cancer have been described: Type I tumors, which are usually well differentiated and endometrioid in histology and account for the majority of cases; and Type II, which are poorly differentiated tumors, often with serous papillary or clear cell histology. Due to the early declaration of the disease by vaginal bleeding, approximately 80% of endometrial cancers are diagnosed at an early stage. Total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymph node dissection remains the cornerstone of treatment. Tumor stage, histologic grade and depth of myometrial invasion are the most important prognostic factors. If myometrial invasion to 50% or more of the myometrial width and/or grade 2 or 3 histology is present, pelvic radiotherapy is indicated to reduce the risk of pelvic recurrence. Postoperative radiation therapy may improve local control but does not affect survival for Stage I endometrial cancer patients. Systemic chemotherapy is typically reserved for women with disseminated primary disease or extrapelvic recurrence. Although the combination of cisplatin plus doxorubicin is commonly used, carboplatin plus paclitaxel represents an efficacious, low-toxicity regimen for managing advanced or recurrent endometrial cancer. Recently, a significant percentage of Type II uterine tumors have been found to overexpress the epidermal growth factor Type II receptor. Anti-HER-2/neu-targeted therapy might be a novel and attractive therapeutic strategy in patients harboring this biologically aggressive variant of endometrial cancer.

Antibodies, Monoclonal↗

Second-line treatment of postmenopausal women with advanced breast carcinoma.

Breast cancer is the most prevalent cancer in women and, currently, there is no standard of care for the treatment of metastatic disease. Treatment options are based on a number of tumor- and patient-related factors. This review explores some of these options, including the use of hormonal manipulation in the treatment of hormone-positive disease, current chemotherapy options and the use of targeted therapies, such as trastuzumab.

Antineoplastic Agents↗

Genetic instability in the RAD51 and BRCA1 regions in breast cancer.

Breast cancer is the most prevalent cancer type in women. Accumulating evidence indicates that the fidelity of double-strand break repair in response to DNA damage is an important step in mammary neoplasias. The RAD51 and BRCA1 proteins are involved in the repair of double-strand DNA breaks by homologous recombination. In this study, we evaluated loss of heterozygosity (LOH) in the RAD51 and BRCA1 regions, and their association with breast cancer. The polymorphic markers D15S118, D15S214 and D15S1006 were the focus for RAD51, and D17S855 and D17S1323 for BRCA1. Genomic deletion detected by allelic loss varied according to the regions tested, and ranged from 29 to 46% of informative cases for the RAD51 region and from 38 to 42% of informative cases for the BRCA1 region. 25% of breast cancer cases displayed LOH for at least one studied marker in the RAD51 region exclusively. On the other hand, 31% of breast cancer cases manifested LOH for at least one microsatellite marker concomitantly in the RAD51 and BRCA1 regions. LOH in the RAD51 region, similarly as in the BRCA1 region, appeared to correlate with steroid receptor status. The obtained results indicate that alteration in the RAD51 region may contribute to the disturbances of DNA repair involving RAD51 and BRCA1 and thus enhance the risk of breast cancer development.

Adult↗