The oncologist
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If instead of the title "Prophylactic Oophorectomy: Reducing the U. S. Death Rate from Epithelial Ovarian Cancer," the title were "Drug X Reducing the U. ⋯ Whether the inherited BRCA1 and BRCA2 mutations that result in familial ovarian cancer also cause primary peritoneal carcinoma is as yet unknown. All such women are followed closely post prophylactic oophorectomy by physical examination and CA125 blood testing. In conclusion, it is posited that prophylactic oophorectomy in women with a history of familial ovarian cancer who have completed their family by age 35 and desire prophylactic oophorectomy and in women age 40 or older who undergo hysterectomy for benign uterine conditions may result in a significant decrease in the death rate from ovarian cancer - a disease in search of a highly sensitive screening test(s) and improved therapy.
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WHAT IS HYPOPLASTIC ANEMIA? Aplastic anemia is a hematological disease characterized by pancytopenia and bone marrow hypoplasia. Acquired cases of aplastic anemia are almost all idiopathic and arise from unknown causes. Other cases of aplastic anemia are secondary and are caused by radiation, chemicals or viruses. ⋯ TREATMENT:Aplastic anemia is treated with androgens, high-dose methylprednisolone, cyclosporin A (CyA), antithymocyte globulin (ATG), antilymphocyte globulin (ALG), hematopoietic growth factors such as G-CSF, and bone marrow transplantation. Interestingly, patients who require continuous CyA administration to maintain stable hematopoiesis have a specific HLA class II haplotype (DRB1*1501-DQA1*0102-DQB1*0602) [6]. Recent reports from EBMT SAA Working Party showed the excellent therapeutic result (response rate 82%) when severe cases were treated with ALG, CyA and G-CSF in combination [7].
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COMMENTS FOR PROFESSOR BARRIE R. CASSILETH: I have enjoyed reading the two issues of The Oncologist I've received so far. I would like to make some comments on Dr. ⋯ But most oncologists, like Dr. Quah, indeed are faced with trying to advise patients about therapies for which there is little hard evidence. The best guiding principles at this point are to discourage remedies that promise cancer cure or are promoted for use instead of mainstream treatment, encourage non-invasive, comforting, complementary (adjunctive) therapies such as massage, green tea and qi gong, and check medical journals and newspapers for warnings such as those issued recently for Ma Huang (ephedrine), a still-common ingredient in herbal remedies widely available through catalogs and in health food stores.
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". we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military industrial complex." Dwight D. Eisenhower, 34th President of the United States (1953-1961). Farewell Address, January 17, 1961. ⋯ It is our responsibility to tout our accomplishments, admit our failures, and provide progressively better basic and clinical research with an eye toward future improvements in outcome. We must not be seen as yet another special interest come to drink at the well of public spending, but as advocates for the public good. If we fail to become important to those who control medical spending, we will be unable to make any important long-term contribution to those who matter most - our patients.