Racial differences in quality of life and employment outcomes in insured women with breast cancer

Purpose

Prior studies indicate that racial disparities are not only present in cancer survival, but also in the quality of cancer survivorship. We estimated the effect of cancer and its treatment on two measures of survivorship quality as follows: health-related quality of life and employment and hours worked for initially employed and insured women newly diagnosed with breast cancer.

Methods

We collected employment data from 548 women from 2007 to 2011; 22 % were African-American. The outcomes were responses to the SF-36, CES-D, employment, and change in weekly hours worked from pre-diagnosis to 2 and 9 months following treatment initiation.

Results

African-American women reported a 2.77 (0.94) and 1.96 (0.92) higher score on the mental component summary score at the 2 and 9 month interviews, respectively. They also report fewer depression symptoms at the 2-month interview, but were over half as likely to be employed as non-Hispanic white women (OR?=?0.43; 95 % CI?=?0.26 to 0.71). At the 9-month interview, African-American women had 2.33 (1.06) lower scores on the physical component summary score.

Conclusions

Differences in health-related quality of life were small and, although statistically significant, were most likely clinically insignificant between African-American and non-Hispanic white women. Differences in employment were substantial, suggesting the need for future research to identify reasons for disparities and interventions to reduce the employment effects of breast cancer and its treatment on African-American women.

Implications for cancer survivors

African-American breast cancer survivors are more likely to stop working during the early phases of their treatment. These women and their treating physicians need to be aware of options to reduce work loss and take steps to minimize long-term employment consequences.     

The impact of cancer diagnosis on employment: is there a difference between rural and urban populations?

Purpose

To determine if living in a rural or urban area influences the impact of cancer diagnosis on employment.

Method

Surveys that asked about changes in employment status related to a cancer diagnosis or treatment were sent to 2,005 cancer survivors enrolled in the Vermont Cancer Survivor Surveillance Registry. Data on cancers were obtained from hospital cancer registries. Respondents indicating that they were working at the time of diagnosis were included in this study for a total of 1,155 participants. Associations between rural or urban residence and changes in employment were assessed by chi-square tests and logistic regression.

Results

There were no statistically significant differences in the proportions of rural and urban survivors working fewer hours, experiencing a career change or unable to work. However, a larger proportion of rural than urban patients retired early after their diagnosis (11.1 vs. 7.2 %, p?=?0.031). There were also fewer rural patients that reported that they went on paid disability during cancer treatment (12.3 vs. 17.0 %, p?=?0.030).

Conclusions

While many patients will return to work after treatment for a cancer diagnosis, it appears that rural patients may be less likely to receive paid disability and more likely to retire early. It is possible that rural populations engage in more physically demanding jobs that they are unable to continue after their cancer treatment. Additionally the types of manual labor available in rural areas rarely offer disability benefits, increasing the impact of cancer diagnosis for this population.

Implications for Cancer Survivors

A cancer diagnosis may have a greater impact on employment among rural residents. Cancer programs should recognize this disparity and enhance return to work and disability counseling in patients from rural areas.     

Cancer’s impact on employment and earnings—a population-based study from Norway

Introduction

Increased attention is being paid to the long-term health and well-being of people living with a history of cancer. Of particular concern is cancer’s effect on productivity and work ability, which in turn is important for persons’ financial situation, life satisfaction, and social relationships. We explored the extent to which Norwegian cancer survivors stay affiliated to working life compared to the cancer-free population, and quantified cancer-associated earning declines.

Methods and results

Logistic regression models were estimated to explore the impact of cancer on employment using register data covering the entire Norwegian population in 2001, 567,000 men and 549,300 women 40–59 years old, of whom 34,000 were diagnosed with cancer. These analyses revealed that a cancer diagnosis was strongly associated with not being employed. Log-linear regression models were used to estimate the effect of cancer on labor earnings in 2001 for those employed. Cancer was associated with a 12% decline in earnings overall. Leukemia, lymphomas, lung, brain, bone, colorectal, and head-and-neck cancer resulted in the largest reductions in employment and earnings. Earning declines were strongly associated with educational level. In addition, linear regression models were used to estimate differentials in earnings before and after cancer. These results accorded well with those from cross-sectional models.

Conclusion and implications for cancer survivors

Cancer survivors are less likely to be employed than the cancer-free population, and undertake modifications in their employment, e.g. reduce work-hours or hold lower-wage jobs, which result in reduced earnings. A social class gradient is present and must be addressed to accommodate appropriate intervention from welfare societies.     

Cancer incidence in a cohort with high fish consumption

Purpose

Evidence suggests that fish-derived omega-3 polyunsaturated fatty acids inhibit cancer promotion and progression. On the other hand, fish may contain endocrine-disrupting and potentially carcinogenic environmental contaminants. Our objective was to describe cancer incidence among the Finnish professional fishermen and their wives who are presumed to eat a lot of fish, partly from the contaminated Baltic Sea. Additionally, we wanted to see whether occupational characteristics are reflected in the fishermen’s cancer pattern.

Methods

All Finnish fishermen during 1980–2002 were identified from the Professional Fishermen Register (n = 6,410) and their wives from the National Population Information System (n = 4,260). The cohort was linked with the Finnish Cancer Registry data until 2011, and the standardized incidence ratios (SIR) were calculated based on national incidence rates.

Results

The total cancer incidence among the fishermen and their wives was the same as in the Finnish general population. Among the fishermen, the incidence was increased for lip (SIR 2.17, 95 % confidence interval 1.26–3.47) and testis (2.51, 1.15–4.75) and decreased for colon (0.72, 0.52–0.98) cancers.

Conclusions

We cannot exclude the possibility that the observed excess in testis cancer among the fishermen could reflect life-long high exposure to environmental contaminants. An excess in lip cancer has been repeatedly observed among outdoor workers due to high exposure to ultraviolet radiation, whereas high physical activity during fishing is the most likely explanation for the deficit in colon cancer.     

Chronic neuropathic pain negatively associated with employment retention of cancer survivors: evidence from a national French survey

Purpose

Chronic neuropathic pain (CNP) is more prevalent among cancer survivors than among the general population. This study aims to investigate the role of CNP on job retention among cancer survivors, 5 years after diagnosis.

Methods

In 2015, 2009 individuals diagnosed with cancer in 2010 were interviewed in the French national survey VIe après le CANcer. Logistic regression investigated the relationship between CNP—measured using the seven-item Douleur Neuropathique 4 (DN4) questionnaire—and employment.

Results

Nine hundred sixty-nine individuals were aged 18–54 and employed at diagnosis and therefore were included. Eighty-two percent were still employed in 2015, 26% had fewer working hours than before diagnosis, and 55% had the same working hours. Thirty percent reported CNP 5 years after diagnosis. These cancer survivors were less likely to be employed in 2015 than those without CNP and, if employed, were more likely to work fewer hours. After adjustment for gender, medical variables (adverse cancer event, prognosis, chemotherapy, and comorbidities) were found to still significantly affect employment retention in cancer survivors, as well as reporting CNP.

Conclusion

Improving CNP screening and management is necessary to reduce its impact on cancer survivors’ professional lives.

Implications for cancer survivors

Healthcare policy and medical cancer survivor’s follow-up must take into account the importance of the substantial impact of CNP on cancer survivors’ daily lives. Therefore, in order to ensure greater employment retention for cancer survivors, raising awareness of care providers about diagnosis and management of CNP is needed.

     

Long working hours and cancer risk: a multi-cohort study

Background:

Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear.

Methods:

This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cancer at baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers; weekly working hours were self-reported.

Results:

During median follow-up of 10.8 years, 4371 participants developed cancer (n colorectal cancer: 393; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working ⩾55 h per week was associated with 1.60-fold (95% confidence interval 1.12–2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift- and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity.

Conclusions:

Our findings suggest that working long hours is unrelated to the overall cancer risk or the risk of lung, colorectal or prostate cancers. The observed association with breast cancer would warrant further research.     

Nutritional supplements, COX-2 and IGF-1 expression in men on active surveillance for prostate cancer

Background

Nutritional factors are associated with reduced risk of prostate cancer progression, yet mechanisms remain unclear. We examined the effects of lycopene and fish oil supplements versus placebo on the normal prostate microenvironment, among men pursuing active surveillance for low-burden prostate cancer. We hypothesized that lycopene or fish oil supplements would down-regulate insulin-like growth factor-1 (IGF-1) and cyclooxygenase 2 (COX-2) gene expression, respectively, reflecting putative proliferation (IGF-1) and inflammatory (COX-2) pathways relevant to carcinogenesis.

Methods

We conducted a 3-month randomized, double-blinded, clinical trial comparing prostate tissue gene expression profiles (assessed by qRT?CPCR) among men with favorable-risk prostate cancer receiving either 30 mg/day lycopene, 3 g/day fish oil (including 1,098 mg eicosapentaenoic and 549 mg docosahexaenoic fatty acids) or placebo.

Results

Among 69 men (22 assigned to lycopene, 21 to fish, and 26 to placebo), there was no difference in the change from baseline to the 3 months in IGF-1 expression level between the placebo and lycopene arms (p = 0.93) nor in COX-2 expression between the placebo and fish arms (p = 0.99).

Conclusion

Compared to placebo, 3-month intervention with lycopene or fish oil did not significantly change IGF-1 and COX-2 gene expression in the normal prostate microenvironment in men with low-burden prostate cancer. Further analysis of global gene expression profiles may shed light on the bioactivity and relevance of these nutrients in prostate cancer.     

Vocational services associated with competitive employment in 18–25 year old cancer survivors

Background

Young adult cancer survivors report difficulties related to employment. This study investigated the association of vocational services on work in young cancer survivors unemployed prior to receipt of services.

Methods

Administrative data obtained for years 2004 and 2005 from the Rehabilitation Services Administration (RSA) database was used in the analyses. A total of 368 cases aged 18–25 who were closed during the 2 years with a diagnosis of cancer were identified. All cancer survivors were unemployed at the time of application. Data on demographic characteristics, employment and vocational services were extracted and analyzed in relation to employment. Multivariate logistic regression was used to examine the relationship among services provided and work outcomes accounting for demographic characteristics.

Results

Cancer survivors represented 0.4% of the total population that received vocational services in the state-federal vocational rehabilitation system. Of the unemployed cancer survivors who received services, 190 (51.6%) achieved successful employment while 178 (48.4%) were not employed following receipt of vocational rehabilitation services. Gender (woman) (OR = 1.79; 95% CI: 1.16 to 2.76), vocational training (OR = 2.03; 95% CI: 1.03 to 4.00), miscellaneous training (OR = 4.01; 95% CI: 1.80 to 8.97), job search assistance (OR = 4.01; 95% CI: 1.80 to 8.97), job placement services (OR = 2.24; 95% CI: 1.11 to 4.52), on-the-job support (OR = 4.20; 95% CI: 1.66 to 10.63), and maintenance services (OR = 2.85; 95% CI: 1.38 to 5.90) were all related to an increased odds for employment. Provision of cash or medical benefits (e.g., Social Security Disability Insurance benefits) (OR = 0.43; 95% CI: 0.28 to 0.67) was associated with lower employment following vocational services.

Conclusion

Very few young adult cancer survivors were involved in the state-federal rehabilitation program. Despite this, the provision of certain vocational rehabilitation services was related to increased employment in this group. Those who received job search assistance and on the job support were four times more likely to be employed following such services. While those in receipt of benefits were less likely to be employed, it is very likely that those receiving such benefits are the more severe cases. It is worth noting that the exact direction of these relationships can not be determined with the current design.

Implications for cancer survivors

Young adult cancer survivors who are seeking employment and can qualify for such services may benefit from certain services offered by state vocational rehabilitation agencies. This represents another service to consider when employment is a goal.     

Concurrent chemoradiotherapy with low dose weekly gemcitabine in medically inoperable muscle-invasive bladder cancer patients

Purpose

We aimed to determine the efficacy and the toxicity of low dose weekly gemcitabine with radiation therapy in medically unfit muscle-invasive bladder cancer patients.

Methods

Twenty-six patients were included into the retrospective analysis. Weekly gemcitabine was administered 75 mg/m² with a median dose of 63 Gy radiation therapy. Clinical target volume was defined as the urinary bladder only in conformal treatment planning.

Results

Median follow-up was 51 months (range 14–118 months). Complete response rate was 62.5 %. The 5-year local progression-free survival, disease-specific survival and overall survival rates were 40.6, 59.5 and 58.5 %, respectively. Concurrent chemotherapy was continued in 80.7 % of patients without any interruption. Gemcitabine was stopped due to grade 3 thrombocytopenia (n = 1), cardiac angina (n = 1), chronic obstructive pulmonary disease exacerbation (n = 1) or patients’ reluctance (n = 2).

Conclusions

Low dose weekly gemcitabine with concurrent radiotherapy is a tolerable regimen and have comparable outcomes with platinum-based combined treatments in muscle-invasive bladder cancer. Prospective randomized trials can help in understanding the safety and efficacy of this treatment specially in medically unfit patients.     

The prognostic role of cancer-specific beliefs among prostate cancer survivors

Objective

The objective of this study is to evaluate the association between cancer-specific beliefs and survival among men newly diagnosed with prostate cancer.

Methods

Based on data from a biracial cohort monitored for mortality for up to 15 years, we investigated the association between beliefs and survival among 251 men newly diagnosed with prostate cancer between 1987 and 1990. We examined patients?? beliefs related to efficacy of regular checkups for detection, potential negative treatment effects, and perceived curability of cancer. Cox proportional hazards models were adjusted for sociodemographic variables, medical care measures, clinical factors, and lifestyle.

Results

In a fully adjusted model, not believing that most cancers can be cured was associated with an increased risk of death from any cause (Hazard Ratio = 1.62; 95% confidence interval = 1.11, 2.38). Beliefs regarding the efficacy of checkups or potential negative treatment effects were not associated with survival.

Conclusions

Prostate cancer patients who reported not believing that most cancers are curable experienced poorer survival after adjusting for a wide array of prognostic factors and potential confounders. Future research to identify underlying behavioral (medical protocol adherence, lifestyle) and physiological (immune and endocrine regulation) mechanisms of this association would translate into improved intervention strategies for cancer survivors.     

Comparison of efficacy and safety of 1- and 3-month luteinizing hormone-releasing hormone agonist depots as initial therapies for prostate cancer

Background

We compared the efficacy and safety of 1- and 3-month depots of the luteinizing hormone-releasing hormone (LH-RH) agonist goserelin acetate in prostate cancer patients.

Methods

Patients were randomly assigned to the Direct Group that received the goserelin 3-month depot or the Switch Group that began with the 1-month depot for the first 3 months and then switched to the 3-month depot. All patients were co-administered the antiandrogen agent bicalutamide. Serum testosterone and prostate-specific antigen (PSA) levels and adverse events were recorded at weeks 4, 8, 12, and 24.

Results

Baseline testosterone levels in the Direct and Switch Groups were 4.98 and 5.07 ng/mL, respectively (P = 0.798). At each week, the levels in both groups were ≤0.50 ng/mL (castration level) with no significant differences between them. All of the patients in the Switch Group and 98.1 % in the Direct Group had achieved castration levels at week 12, and 100 % had achieved such levels at week 24. Baseline PSA levels in the Direct and Switch Groups were 52.37 and 46.72 ng/mL, respectively (P = 0.793). Levels in both groups dropped continuously, to about 1.0 ng/mL at week 24, with no significant differences between the groups at any time. Three patients in the Direct Group experienced adverse events that were attributed to the co-administered bicalutamide.

Conclusions

There was no difference in the efficacy or safety between the 1- and 3-month depots of goserelin when given as initial prostate cancer treatment in combination with bicalutamide. Patients must be monitored for adverse events associated with bicalutamide.     

Sperm banking and assisted reproductive outcome in men with cancer: a 10 years’ experience

Background

As cancer therapy can be harmful to spermatogenesis, men are generally advised to cryopreserve sperm before gonadotoxic treatment. Here, we compared fresh and frozen-thawed sperm quality in patients according to cancer type, and reported use rate in subsequent assisted reproductive technology (ART) cycles.

Methods

This retrospective analysis of a sperm cryopreservation program in all men suffering from cancer was conducted at the University Hospital of Nantes between 1997 and 2007.

Results

A total of 1042 men were referred for sperm cryopreservation during this period (438 testicular cancer, 184 other solid cancers, 278 lymphoma and 142 other haematological malignancies). A total of 2577 ejaculates from 1009 men were studied. Sperm characteristics and sperm sensitivity to the freezing process varied according to the cancer type. Frozen sperm was used in 82 patients, with 112 in vitro fertilization and 66 intrauterine insemination cycles performed, leading to a clinical pregnancy rate per cycle of 23.2 and 12%, respectively.

Conclusion

Sperm quality and motility alteration during the freezing process can differ according to the type of cancer, but sperm frozen before gonadotoxic treatment in cancer patients can be successfully used in ART.     

Comparison of chemotherapy regimens for concurrent chemoradiotherapy in unresectable stage III non-small cell lung cancer

Background

The purpose of this study was to retrospectively compare the survival and toxicities associated with chemoradiotherapy using full-dose and weekly regimens in patients with stage III non-small cell lung cancer.

Methods

Consecutive patients who received concurrent chemoradiotherapy between October 2002 and June 2006 at our institution were enrolled. The prescribed dose for thoracic radiotherapy was 60 Gy in 30 fractions for all the patients.

Results

Fifty-nine patients were enrolled; 36% of the patients were treated with full-dose regimens and 64% with weekly regimens. The patient characteristics were similar in the two groups. In both univariate and multivariate analyses, treatment with weekly regimens was associated with a better overall survival than that with full-dose regimens (2-year survival rates: 75% for weekly regimens vs 41% for full-dose regimens). The toxicities and compliance in the two groups were comparable.

Conclusion

Weekly regimens exhibited more favorable overall survival as compared to full-dose regimens in this retrospective study. Confirmation of the results by a randomized phase III trial is warranted.     

Patient and provider communication about employment following a cancer diagnosis

Purpose

Cancer treatment can precipitate functional limitations that restrict survivors’ ability to work. Yet, it is unclear whether healthcare providers discuss the potential for employment limitations with their patients. We assessed the frequency of patient-provider communication about employment, from the perspectives of survivors, and examined whether receiving a treatment summary was associated with employment communication.

Methods

Cancer survivors who were working at diagnosis were identified from the Health Information National Trends Survey-4, conducted in 2014 (n?=?290). Separate multivariable regression analyses examined the associations between survivor characteristics and employment communication and receipt of a treatment summary and employment communication.

Results

Among cancer survivors who were working at diagnosis, 62.69% (95% CI 54.42–70.95) reported discussing employment with any healthcare provider at any time since diagnosis. Younger cancer survivors and those more recently treated were more likely to ever have employment discussions. Survivors who received a treatment summary were also more likely to ever discuss employment with any healthcare provider than survivors who did not receive a treatment summary (OR?=?3.47, 95% CI 1.02–11.84).

Conclusions

Approximately two thirds of cancer survivors who were working at diagnosis ever discussed employment with a healthcare provider. Thus, for a sizable portion of cancer survivors, the potential impact of cancer on employment is never discussed with any healthcare provider.

Implications for Cancer Survivors

Efforts are needed to proactively screen patients for cancer-related work limitations, empower patients to discuss employment concerns with their healthcare providers, and develop interventions that support survivors’ goals for working throughout treatment and recovery.

     

Associations of adiponectin and leptin with stage and grade of PSA-detected prostate cancer: the ProtecT study

Purpose

Obesity has been associated with an increased risk of advanced and fatal prostate cancer; adipokines may mediate this association. We examined associations of the adipokines leptin and adiponectin with the stage and grade of PSA-detected prostate cancer.

Methods

We conducted a nested case–control study comparing 311 men with mainly locally advanced (≥T3, N1, or M1 cases) vs. 413 men with localized (T ≤2 & NX-0 & M0 controls) PSA-detected prostate cancer, recruited 2001–2009 from 9 UK regions to the ProtecT study. Associations of body mass index and adipokine levels with prostate cancer stage were determined by conditional logistic regression and with grade (Gleason score ≥7 vs. ≤6) by unconditional logistic regression.

Results

Adiponectin was inversely associated with prostate cancer stage in overweight and obese men (OR 0.62; 95 % CI 0.42–0.90; p = 0.01), but not in normal weight men (OR 1.48; 0.77–2.82; p = 0.24) (p for interaction 0.007), or all men (OR 0.86; 0.66–1.11; p = 0.24). There was no compelling evidence of associations between leptin or leptin to adiponectin ratio and prostate cancer stage. No strong associations of adiponectin, leptin, or leptin:adiponectin ratio with grade were seen.

Conclusions

This study provides some evidence that adiponectin levels may be associated with prostate cancer stage, dependent on the degree of adiposity of the man. Our results are consistent with adiponectin countering the adverse effects of obesity on prostate cancer progression.     

Cohort study of workers employed in an Italian tire manufacturing plant, 1962–2004

Purpose

To investigate mortality and bladder cancer incidence among workers of a tire manufacturing plant where antioxidants severely contaminated by beta-naphthylamine were never used.

Methods

Mortality follow-up was performed of 9,501 workers first hired between 1962 when the plant started operations and 2000. Person-years of observation from 1962 to 2004, expected deaths, and standardized mortality ratios (SMR) were calculated. Follow-up for bladder cancer incidence from 1988 to 2003 was carried out, and standardized incidence ratios (SIR) were calculated. Multivariable (Poisson) analyses of bladder cancer incidence and mortality by duration of employment (DOE) and time since first employment (TSFE) were performed.

Results

Among men, SMRs were significantly reduced for all causes, all cancers, lung cancer, cardiovascular, and ischemic heart diseases. Bladder cancer mortality and leukemia mortality were close to expectation but increased with TSFE. Seventy-two incident cases of bladder cancer were observed (SIR?=?1.15; 95?% confidence interval 0.90–1.44), and multivariable analysis suggested a possible increase in rate ratios with DOE. Among women, mortality was close to expectation, but the limited number of observed deaths prevented detailed analyses.

Conclusions

No significant cancer excess was observed. A suggestion of increased risks of bladder cancer and leukemias after extended TSFE was present in men, deserving consideration as exposure to carcinogens possibly occurred early in plant operation. Furthermore, this cohort of workers is still relatively young and less than 10?% have died. There was, thus, limited power to detect small increases in risk at rare cancer sites. Further epidemiological surveillance of this cohort is planned.     

Nachsorge beim Vulva- und Vaginalkarzinom

Background

Women with vaginal or vulvar cancer require posttreatment surveillance that aims to detect possible recurrences earlier and ascertain adequate support with regard to treatment-induced somatic or psychological challenges. This article focuses on specific follow-up measures and intervals.

Objective

The goal of the present work is to provide consensus-based recommendations for the posttreatment surveillance of women with vulvar or vaginal cancer.

Material and method

Selective literature search with special attention to studies of large groups and national and international recommendations.

Results

Vulvar and vaginal cancer surveillance consists primarily of a thorough review of symptoms and of physical examinations. Within the first 3 years after primary treatment, follow-up appointments should be scheduled at 3-month intervals, in the years 4 and 5 at 6-month intervals, and thereafter on a yearly basis. Further investigations (imaging, histopathology) are indicated when recurrence is suspected.

Conclusion

Routine cancer surveillance after primary treatment of women with vulvar and vaginal cancer helps to identify local recurrence that may be salvageable often with relatively good prognosis. However, it has never been demonstrated that any of the follow-up measures have an impact on morbidity or mortality.     

Assessing clinical benefit response in the treatment of gastric malignant ascites with non-measurable lesions: a multicenter phase II trial of paclitaxel for malignant ascites secondary to advanced/recurrent gastric cancer

Background

Paclitaxel has shown promise against advanced gastric cancer and associated malignant ascites with non-measurable lesions. In order to evaluate the therapeutic effect of paclitaxel against malignant gastric ascites, a prospective phase II clinical trial was designed according to our previously proposed criteria represented by the clinical benefit response in gastric cancer (CBR-GC) criteria and the five-point method (5PM).

Methods

Patients with advanced gastric cancer with malignant ascites were treated with 1-h intravenous (i.v.) infusions of 80?mg/m² of paclitaxel weekly over a 3-week cycle on days 1, 8, and 15, followed by 1?week of rest. Therapeutic responses were measured according to the CBR-GC criteria and the 5PM.

Results

The CBR-GC criteria showed improved ascites volume and functional status in 39.1% of patients. A positive CBR-GC response in abdominal girth was seen in 31.3% of patients, and this was significantly correlated with the 5PM-estimated change in ascites volume (p?<?0.001). The median number of treatment cycles was 3 (range 1?C12). The most common non-hematological toxicity was anorexia, in 22.2% of patients.

Conclusion

Weekly i.v. paclitaxel is a safe and effective chemotherapeutic regimen based on validated CBR-CG criteria.     

Prospective study of cytomegalovirus serostatus and prostate cancer risk in the Prostate Cancer Prevention Trial

Purpose

To investigate serologic evidence of infection by cytomegalovirus (CMV), a herpesvirus with known oncogenic potential that has been detected in malignant prostate tissue, in relation to prostate cancer (PCa) risk in a large case–control study nested in the Prostate Cancer Prevention Trial (PCPT).

Methods

Cases were men with a confirmed diagnosis of PCa after visit 2 (n?=?614), and controls were men not diagnosed with PCa during the trial who also had a negative end-of-study biopsy (n?=?616). Controls were frequency-matched to cases by age, treatment arm, and family history of PCa. Sera from visit 2 were tested for CMV IgG antibodies.

Results

No association was observed between CMV serostatus and PCa risk (adjusted CMV seroprevalence?=?67.9?% for cases and 65.2?% for controls, odds ratio?=?1.13, 95?% CI 0.89–1.45).

Conclusions

Considering our null findings in the context of the full CMV literature, CMV infection, as measured by serostatus, does not appear to increase PCa risk.