By David Kerr, Annie Young, Richard Hobbs
(BMJ Books) Univ. of Birmingham, united kingdom. Covers key parts of sufferer care and offers debate round the quite a few uncertanties concerning the sickness. colour illustrations. Softcover.
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Extra resources for FD Richard Hobbs, ABC of Colorectal Cancer
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Investigations included chest x ray and colonoscopy; no routine liver imaging was performed. Recurrence rates were similar (26%) in both groups, but the recurrences in the intensive group were detected on average nine months earlier, often at an asymptomatic stage. More patients with local recurrence underwent repeat surgery with curative intent. No difference existed, however, in overall survival (68% v 70%) or cancer related survival. More recently, Schoemaker and his colleagues evaluated the addition of annual chest radiography, colonoscopy, and computed tomography of the liver to a standard follow up based on clinical examination, faecal occult blood testing, liver function tests, and measurement of the carcinoembyronic antigen, with further investigations as clinically indicated.
Br J Surg 1997;87:657-63. x McArdle CS, Hole D. Impact of variability among surgeons on post-operative morbidity and mortality and ultimate survival. BMJ 1991;302:1501-5. x Parry JM, Collins S, Mathers J, Scott NA, Woodman CBJ. Influence of volume of work on the outcome of treatment for patients with colorectal cancer. Br J Surg 1998;86:475-81. x Porter GA, Soskolne CL, Yakimets WW, Newman SC. Surgeon-related factors and outcome in rectal cancer. Ann Surg 1998;227:157-67. 3 Outcome seems to differ substantially among surgeons performing colorectal surgery—specialisation rather than volume of work might be a way of improving overall outcome 21 7 Adjuvant therapy Rachel S J Midgley, D J Kerr Despite substantial improvements in surgical technique and postoperative care, colorectal cancer continues to kill 95 000 people in Europe alone each year.
X What is the optimum combination and sequence for fluorouracil based therapies and the new chemotherapy drugs? x Is home chemotherapy viable? x How are the new, more expensive drug therapies to be funded? Treatment of advanced disease New thymidylate synthase inhibitors Raltitrexed is a quinazoline analogue antifolate that gains entry to cells via the reduced folate carrier and is polyglutamated to a potent, long acting, specific inhibitor of thymidylate synthase. Its regimen—a short intravenous infusion every three weeks—has similar efficacy to that of fluorouracil plus folinic acid and is clearly more convenient, although potentially more toxic.