Course Of Neoplastic Disease Research Articles

Is positive correlation between cortisol and met-enkephalin concentration in blood of women with breast cancer a reaction to stress before chemotherapy administration?

The role of stress in the course of neoplastic diseases has been emphasised over the past few years. Organism defence in form of increased release of hormones, corticosteroids and endogenous opioids should be assessed as a particular form of adaptation. Interactions between stress hormones and others which may influence the growth of breast cancer cells are possible. In this study, the concentration of cortisol and met-enkephalin vis-à-vis growth hormone, insulin-like growth factor-I, prolactin, estradiol, progesterone and melatonin in blood of women with breast cancer before the first cycle of supplementary chemotherapy was compared to that of healthy women. In a group of patients with breast cancer, before the first cycle of chemotherapy, high hypercortisolemia and positive correlation between cortisol and met-enkephalin was observed which may be a result of stress at the beginning of such treatment. A negative correlation between prolactin and met-enkephalin in this group can indirectly testify to essential participation of endogenous opioids in hormonal regulation and can be a response to stress caused by beginning chemotherapy.

Von Willebrand Factor in Plasma of Patients with Advanced Stages of Larynx Cancer

arterial hypertension, myocardial infarction, lupus Our study group consisted of 37 patients, all men erythematosus, and rheumatoid arthritis and are aged 42 to 76 years (mean 54 years), with histopathusually explained as an acute phase reactant or ologically recognised planoepithelial carcinoma of marker of endothelial injury [3–9]. In neoplastic larynx. The stadium of carcinoma was evaluated diseases both increased and decreased levels of as T, N, M, and stages (Table 1). The control group von Willebrand factor are reported. Usually in the consisted of 48 healthy men, aged 28–63 years course of neoplastic disease a tendency to reach (mean 46 years). The patients were categorised increased plasma levels of vWf:Ag is observed [10– into groups according to tumor size (T3–T4), metas13]. Sometimes decreased levels associated with tasis to lymph nodes (N2–N2), and stages III–IV. acquired von Willebrand Disease were recorded We did not observe patients with remote metastasis for Wilms’ tumor and adrenocortical adenocarciso they should all be classified as M. Blood samples noma [14,15]. Recent studies suggest that increased of patients were drawn before operation from cubilevels of vWf:Ag correlate with progression of distal vein after minimal stasis. Blood was collected ease, metastasis, or survival time and thus may into 125 nM sodium citrate in ratio 1:9 volume have a prognostic significance [10,11,13]. blood. After centrifugation at 3000g for 10 minutes Studying the literature we found only one report the plasma was frozen in polystyrene tubes and referring vWf:Ag concentrations in larynx cancer. stored at 2408C. The levels of vWf:Ag were meaPublished results included among other types of sured by enzyme linked immunosorbent assay head and neck cancer a group of 10 patients with (ELISA) using commercial antisera (Dako, Glos-

Comparison of the Clinical Relevance of CEA, CA 15-3 and MCA in Breast Cancer

Background: Tumor marker determinations are helpful parameters in the control and follow-up of the clinical course of neoplastic diseases. The serum concentrations of the three tumor markers CEA, CA 15-3 and MCA have been evaluated to comparatively investigate their clinical relevance in breast cancer patients. Patients and Methods: Simultaneous determinations of the serum concentrations of the three tumor markers CEA, CA 15-3 and MCA were performed in 419 sequential breast cancer patients. CEA and MCA were determined by means of enzyme immunoassays and CA 15-3 by a radio-immunoassay. Results: The serum concentrations of all three tumor markers correlate with tumor activity and tumor mass. The receiver operating characteristics (ROC) curves show that CA 15-3 has the greatest sensitivity and specificity. All three tumor markers did not reveal any dependence on age, but on the location of metastases; the median serum values decrease in the following sequence: osseous, visceral, and soft-tissue metastases. With a combination of tumor markers, the gain in sensitivity is associated with a loss of specificity, the combination of CEA + CA 15-3 appears to be the most favorable one. The combination of all three tumor markers does not show any advantage over the double combination CEA + CA 15-3. Conclusions: CA 15-3 has the highest sensitivity and specificity. As a combination of tumor markers CA 15-3 + CEA is recommended in breast cancer patients.

The role of psychosocial stressors, personality and coping in the multifactorial origin, initiation and clinical course of neoplastic disease and in host-deffense

Retrospective and prospective biobehavioral cancer studies have revealed that psychosocial stressors may play a pivotal role in the initiation and progression of malignant neoplasia. In recent research, a pattern has emerged, which in analogy to the coronary prone pattern (type A) has been labelled type C, encompassing suppression of emotional responses, such as anger and hostility, rationality and antiemotionality, as well as high social conformity and a lack of self-assertiveness. There is growing evidence in both infrahuman and human research that specific coping styles (repressive coping) with stress may be associated with specific biologic responses, including neuroendocrine, immunologic and other bodily functions. The application of this model appears to be of importance for further research, as well as for the detection of high risk individuals, but also in regard to therapy, rehabilitation, early detection and possibly also prevention of malignant disease. This concept suggests also new directions and modifications of stress research, as stressors are to be viewed not necessarily as pathological, but in some instances as quite possibly salutary, depending on the nature of the stressor, the psychophysiologic state of the individual and his or her ability to cope with adverse life situations. Quite naturally, the development of this concept is still in its initial stages, there remain a number of open questions, and it needs hardly to be pointed out in this connection that further and painstaking clinical and laboratory work is warranted in order to clarify the role of stressors, life and coping styles and its biological concomitants in neoplastic disease.

A study on the relationship between the pineal gland and the opioid system in patients with cancer. Preliminary considerations.

Recent studies showed that both the pineal gland and the endogenous opioid system are involved in the modulation of the immune system and in the regulation of tumor growth. Moreover, a relationship between pineal and opioid system has been demonstrated. In order get an overall view of the psychoneuroendocrine interactions in cancer patients, the levels of melatonin, the most important pineal hormone, and of beta-endorphin have been measured on blood samples collected during the morning. The study was carried out on 54 patients, 42 healthy subjects, and in 34 patients having illnesses other than cancer. Breast cancer, lung carcinoma, and colorectum cancer were the three neoplasms detected in the patients investigated. Growth hormone (GH), somatomedin-C and prolactin (PRL) levels were also determined. beta-endorphin levels were found to be substantially within the normal range in patients with cancer, whereas those of melatonin were raised in several cases. The beta-endorphin/melatonin ratio was higher than 2 in normal subjects, in non-neoplastic patients and in most cancer patients without metastases, whereas this ratio was lower than 2 in almost all patients in a metastatic stage of the disease. Neither melatonin levels nor those of beta-endorphin appeared to be significantly correlated with GH, somatomedin-C, and PRL concentrations. The low beta-endorphin/melatonin ratio observed in metastatic patients suggests the presence of an unbalanced relation between the pineal and the opioid system in those subjects. Therefore, an anomalous relationship between pineal function and opioid activity might play a role in the clinical course of neoplastic disease.

The unique nutritional needs of the elderly patient with cancer

E PIDEMIOLOGICAL evidence indicates that cancer is a disease of older people; the mean age of people who have cancer is 67.5 years. It can be expected, based on population projections, that in the future an even larger segment of cancer patients will have attained advanced age. ’ In fact, the prevalence of cancers in 80-year-old people is twice that of 60-year-olds.’ Cancer may be more prevalent in the older age groups for several reasons: (1) length of time between exposure to carcinogens and development of the disease, (2) decreased efficiency of the immune system to deter proliferation of errant cells, and (3) advances in medical science that have led to eradication of many communicable diseases and to effective treatment of chronic disease.2 Cancer, in addition to other chronic problems found in older individuals, contributes to the unique needs and health problems of this population. In addition to pharmacological, physiological, psychosocial, and physical changes that occur with aging, nutritional needs are also altered. In the presence of cancer, the unique nutritional needs of the elderly become particularly important. Nutrition may interact with cancer as an etiologic factor: nutritional status may be affected by the course of neoplastic disease, and nutrition may be a factor of cancer therapy. The practicing oncology nurse frequently confronts all of these nutritionally related aspects of cancer care when dealing with elderly patients. The revised 1987 Standards of Oncology Nursing Practice specifically cite nutrition as one of 11 areas of responsibility during the diagnosis, planning, and treatment of nursing problems of the patient with cancer. 3

The Psychological Aspects of Cancer in Man

• A better understanding of the psychiatric aspects of work with cancer patients and their relatives can enable the profession to more effectively deal with the emotional turm­ oil and the dire anticipations of the afflicted and their families. 1 shall concentrate on exploring the effects of physical illness and its consequences upon the previously healthy or upon the sick mind. 1 shall not attempt to deal with the question: Can emotional disturbances or grave psycho­ logical shocks-such as the loss of a beloved spouse, for instance-cause cancer, predispose towards cancer, or even influence the clinical course of neoplastic disease. To my knowl­ edge, this has never been adequately proven as yet-nor, for that matter-has it been scientifically refuted. More, truly scientific work is needed in this area. What does illness, especially chronic, de­ bilitating, life-endangering illness, mean to the patient? It interferes with his daily activities, earning capacity, his social and familial rela­ tionships and his sexual activities. It makes him unable to take care of himself and, there­ fore, delivers him to the mercy of an often merciless environment; it wracks his body with pain, a body he is compelled to watch wasting away and, ultimately, it delivers him to helpless agony and to death. And the pic­ ture is in no way overdrawn. How does the patient react to all of this special and severe form of stress? Such stress does threaten or disrupt important defense mechanisms which the patient has evolved to bring his physical and emotional needs into harmony with the demands of his environ­ ment. It follows that, whenever such defense mechanisms are threatened or disrupted, a

The homograft reaction in cancer immunology: Clinical applications

To summarize the past attempts to apply immunology to cancer therapy, we can safely say that they have contributed little to the understanding of a cancer-specific antigen, and that there is no proof that they have ever influenced the course of cancer in any patient. The fact that these past attempts have been disappointing, should not discourage scientists from continuing their search for a cancer-specific antigen and its application to both therapy and prophylaxis. The works of Rapport and Graf [10], Nairn et al. [42] strongly suggest the presence of cancer-specific antigens. It is with this assumption that we believe that an effective therapeutic tumor vaccine will soon evolve out of the mass of research devoted to this subject. The evidence that the host responds to its own tumor antigen has been adequately shown [28–31]. Assuming that a specific cancer antigen is isolated, it is not too farfetched to speculate that a prophylactic vaccine similar to smallpox or poliomyelitis will alter the course of neoplastic disease.

Ineffectiveness of Chymotrypsin Therapy in Malignancy.

SummaryTreatment with crystalline chymotrypsin did not influence the course of neoplastic disease in experimental animals or in fifteen selected cancer patients.