Intravenous treosulfan versus intravenous treosulfan plus cisplatinum in advanced ovarian carcinoma

Article Abstract:

The long-term survival of patients diagnosed with advanced ovarian cancer is poor. Ovarian cancer is treated with surgery and chemotherapy. Treosulfan is an oral chemotherapeutic agent which has recently demonstrated a good therapeutic response rate. Pulsed intravenous administration of treosulfan has been useful in maintaining treatment effectiveness and reducing bone marrow suppression, a common side effect of chemotherapy. Cisplatinum is another chemotherapeutic agent that is used when patients do not respond well to other treatments. However, because cisplatinum is highly toxic and very expensive its use is restricted to special treatment centers. Low doses of cisplatinum are more easily managed and tolerated. The treatment effects of intravenous treosulfan alone and in combination with cisplatinum were studied among 135 women with advanced ovarian cancer. All the patients had either advanced or recurrent disease that had spread, but were expected to live longer than two months and had good kidney functioning. Of the 69 patients receiving treosulfan alone, 20 ( 29.0 percent) showed no response compared with nine out of 66 women (13.6 percent) receiving treosulfan plus cisplatinum. Patients with stage III and IV disease (more advanced disease) responded less well to treosulfan alone than to the combination regimen. Both treatment regimens had similar response rates in the patients with stage I and II disease. Treosulfan produced a response in 19 of the 38 patients (50 percent) and treosulfan plus cisplatinum produced a response in 27 out of 35 (77 percent). The two treatment regimens produced similar average survival rates in the two groups. Side effects such as bone marrow suppression were experienced more often by patients receiving treosulfan plus cisplatinum. It is suggested that women with stage I and II disease receive treosulfan alone. Patients who are unresponsive to treosulfan alone, or who have greater residual disease (stage III and IV) should receive the combined treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Chemotherapy, Cisplatin

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The effects of oral contraceptives and parity on ovarian cancer trends in women under 55 years of age

Article Abstract:

The survival rate of women with ovarian cancer remains low. The lack of early detection methods and ineffective treatment protocols have contributed to the poor survival rate. Identifying risk factors is a primary focus in the prevention of ovarian cancer. Studies have shown that the risk of ovarian cancer decreases in women as the number of children they give birth to increases; women with two children have a 40 percent reduction in risk. Oral contraceptive use is thought to protect women from ovarian cancer; a 50 percent reduction in risk was observed in one study, depending on duration of use. Furthermore, the risk continues to be reduced even after the pill is no longer being used. When increased parity (completion of full-term pregnancy) and oral contraceptive use are combined, the risk is reduced further. To see if oral contraceptives reduce the risk of ovarian cancer, trends in ovarian cancer were studied using vital statistics reported between 1950 and 1986. A substantial decline in the death rate of women under the age of 55 years was seen in the United Kingdom. An increase in family size corresponded to a decrease in deaths from ovarian cancer. A relationship between oral contraceptives and ovarian cancer became evident in women who were exposed to birth control pills by 29 years of age. As the number of pill users increased, the death rate from ovarian cancer decreased. The number of new cases of ovarian cancer increased in women over 55 years, but not in younger women. There was no striking relationship between family size and cancer death rates. The decreasing trend in ovarian cancer deaths was strongly associated with increasing use of oral contraceptives. Oral contraceptive use may be the only known protection against ovarian cancer. However, the role of oral contraceptives in causing breast cancer needs to be better understood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Prevention, Risk factors, Demographic aspects, Cancer, Oral contraceptives

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The Stamey endoscopic bladder neck suspension: a clinical and urodynamic investigation, including actuarial follow-up over four years

Article Abstract:

Although many cases of genuine stress incontinence (GSI), involuntary escape of small amounts of urine during coughing, sneezing, or other stressful events, are successfully treated by colposuspension, a surgical procedure involving shifting the position of the vagina, many women are not cured by the procedure. This study evaluated a modification of the Stamey endoscopic bladder neck suspension in 100 women with GSI, many of whom had undergone prior surgery. The procedure is described. Three months post-surgery, 83 percent of the subjects were cured according to objective criteria. Subjectively, four years later, 53 percent of the patients under 65 years old were cured, as were 76 percent of the older patients. Surgery caused a decrease in bladder capacity and in the average peak urine flow rate. The approach used here is well suited for women with complex histories of GSI, particularly older patients. Colposuspension remains the optimal approach for uncomplicated GSI at early stages. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Urinary stress incontinence, Urologic surgery, Bladder

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