Anal squamous cell carcinoma

There is wide geographical variation in the incidence of anal cancers around the world. Areas of high incidence include Recife in Brazil and the Philippines. Interestingly, those areas with a high incidence of anal cancer also tend to have a high incidence of cervical, vulval, and penile tumours. Epidemiological evidence has suggested that anal cancer may be associated with anal sexual activity. Male homosexual activity and HIV infection are strongly associated with the incidence of anal...

Ablation of endocrine glands

In men and premenopausal women the major sites of steroid hormone synthesis are the gonads. Castration decreases circulating testosterone in males by over 95 and oestrogens in premenopausal women by 60 (relative to follicular phase levels).These endocrine effects produce benefits in about 80 of men with metastatic prostate cancer and in 30-40 of unselected premenopausal women with advanced breast cancer. Oophorectomy is rarely beneficial in postmenopausal women because the postmenopausal ovary...

Adjuvant chemotherapy of colorectal cancer

Nearly half the patients undergoing apparently curative resection of bowel cancer are destined to relapse and eventually die with either locally recurrent or distant metastatic disease. This is due to the presence of residual micro-metastases invisible at the time of surgery. The aim of adjuvant chemotherapy is to eradicate these micro-metastases and thereby prevent future relapse. Current available chemotherapy does not completely eradicate bulky, advanced metastatic bowel cancer. It does...

Effective use of morphine

The keystone to using morphine for moderate to severe pain is in proper prescribing, patient reassessment, patient information, and prevention of side-effects. Ideally start with a quick-acting morphine preparation. This has onset of analgesia in 20-30 minutes, which peaks at 60 minutes, and, when the required dose for the individual's pain is reached, will last four hours. This information should be given to the patient. Morphine may relieve pain completely, partially, or not at all. It was...

Small cell lung cancerradiotherapy

Patients with small cell lung cancer (SCLC) are usually treated by primary chemotherapy because of its chemo-responsiveness and frequent dissemination at time of diagnosis. SCLC is, however, also the most radio-responsive variety of bronchial carcinoma and radiotherapy has an important role in its management. In patients with a localized tumour, thoracic irradiation (TI) and prophylactic cranial irradiation (PCI) improve disease control at these sites and lead to prolongation of survival when...

List of contributors

Ahmed Aberdeen Royal Infirmary, Aberdeen, UK J. W. Arndt Department of Diagnostic Radiology, Leiden University Hospital, Leiden, The Netherlands Dr Ahmed Awada Chemotherapy Unit, Jules Bardet Institute, Brussels, Belgium Professor Anne Barrett Professor of Radiation Oncology, Glasgow University and Beatson Oncology Centre, Western Infirmary, Glasgow, UK Professor H. Bartelink The Netherlands Cancer Institute, The Netherlands Professor H. Bismuth University of South Paris, Paris, France Dr...