Quotes of the Month

Fall 2004

     I don't know about your area of the country but we have had a delightfully moderate and unusually wet summer. A cool fall seems to be in the forecast and the combined moderate seasons are most unusual for North Texas - I'll take it any time. This Webletter will cover some advances in cancer therapy as reported at the recent meeting of the American Society of Clinical Oncology (ASCO) which was held in New Orleans, LA.


     Stig Holmberg M.D. of Gothenberg, Sweden, principal investigator for the International Breast Cancer Study Group Trial 93, gave the first preliminary study report. He said older breast cancer patients who are clinically node negative (no palpable nodes in the axilla) can avoid axillary dissection and still have the same survival outcome as those women who underwent the surgical procedure. This information was outlined in the Aug 2004 issue of Oncology News International.

     ED: By avoiding an axillary dissection, patients are spared the uncomfortable side effects of the procedure such as pain, numbness, swelling, and restricted motion. Oncologists had wondered if skipping a surgical dissection of the axilla, which risks leaving microscopic cancer cells behind, impacted the patient's survival chances. If these results hold up until the completion of the study it will be a major advance in breast cancer surgical therapy. I might add that all of the patients were placed on Tamoxifen so it's not like there was no treatment at all.

     Teen age girls copy their favorite movie stars when it comes to smoking. The results of a three year study were reported in the American Journal of Public Health. Researchers interviewed 3000 teenage (12-15 yrs) girls and determined that if their favorite movie stars smoked on screen the teens were 80% more likely to smoke after 3 years than those whose favorite stars did not smoke on screen.

     ED: Lifestyle emulation plus peer pressure-powerful stimulants.

     A recent report from the Agency for Healthcare Research and Quality indicated that exercise programs can improve functional capacity and cardiopulmonary fitness, reduce symptoms of fatigue, and improve quality of life during and after cancer treatment. Exercise can also reduce cancer patients' symptoms of anxiety and depression during treatment.

     ED: This is a good reason for oncologists to treat anemia in cancer patients so they can participate in exercise programs.

     Also another exercise related study revealed that exercise, in addition to weight control, reduced cancer risks in women. Dr. James R. Cerhan, associate professor of epidemiology at the Mayo Clinic College of Medicine, studied 29,838 women in the Iowa Women's Health Study and found that data supported making the following guidelines to lower cancer risk in post-menopausal women:
  1. Have a maximum BMI < 25.
  2. Engage in daily moderate and weekly vigorous physical activity.
  3. Gain no more than 11 lbs. since age 18.
  4. Eat 5 or more servings of fruit and vegetables daily.
  5. Consume > 400g. of complex carbohydrates daily.
  6. Limit alcohol intake to < 14g./day.
  7. Limit red meat consumption to < 80g./day.
  8. Limit daily consumption of fat < 30% of total caloric intake.
  9. Limit use of sodium to < 2,400 mg/day.
     ED: The above guidelines were reported in HEM/ONC NEWS. How can you go wrong?

     A study from Brigham and Women's Hospital in Boston shoots down the perception that women with the same smoking history as men were more likely to develop lung cancer. The group from Brigham studied 60,296 women from the Nurses Health Study and 25,397 men from the Health Professionals Follow-up Study and concluded there was no difference in overall lung cancer susceptibility.

     ED: Because of the perception stated above, researchers have tried to find a biological reason for the difference. This study suggests there is really no difference.

     ONI interviewed John M. Jessup, M.D., professor of oncology at Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC. He has studied the data base of 150,000 patients with colon cancer treated between 1985 and 200 and determined that adjuvant chemotherapy has improved survival in stage III colon cancer but he thought more women and older patients should also receive as much treatment as male patients and younger patients. This would perhaps improve the underserved group's survival rate.

     ED: Adjuvant chemotherapy is being used more in advanced colon cancer but I agree with Dr. Jessup. It is not offered to the elderly especially women as much as it should if co-morbid medical conditions do not prohibit its use.

Doctors are always working to preserve our health and cooks to destroy it, but the latter are the more often successful.
     - Denis Diderot (1713-84) French philosopher and writer

Give me health and a day, and I will make the pomp of emperors ridiculous.
     - Ralph Waldo Emerson (1803-82) poet and essayist

To avoid sickness, eat less, to prolong life, worry less.
     - Chu Hui Weng, Bulletin of the New York Academy of Medicine, 4:985,1928


As I wandered on the Trinity Trails
Abutting the river and verdant dales,
I had time to mentally pause, gently think
About the past that to now did link.

When I could not meet my patients' wills
I thought I should leave my surgical skills.

But something else must duplicate the loss
Or my brain would vegetate, as with moss.

"Do I miss it?" Many so inquire.

The negative denotes no lack of fire,
Rather two score plus years of joy,
A career earned, owned, caressed-not a ploy.

I'm mightily striving to fill the lack
So my mind's satiety will again come back.

A new calling is certainly needed
To replace that, formerly ceded.

What endeavor would satisfy my desires,
A mental stimulant, not one that tires?

Would it be golf, tennis, card games- a greeter?

No, my psyche's taste required something sweeter.

So I chose to pursue the world of words,
Organized and concise, not like curds.

Poetry, essays, stories, other prose,
Verily brought my gap to a close.

     - The above poem was composed while I was
        walking a segment of the Trinity Trails in Fort Worth, Texas.

Take care until next time,
Richard J. Turner, III, M.D., F.A.C.S.

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     Summer Trip to Russia
     Miscellaneous Medical One Liners
     Trip to Ireland
     Texas Surgical Society Meeting Notes
     The Malpractice Crisis
     Treatment and Prevention of Malignant Disease
     West Nile/Cancers/Discontent with American Healthcare/Prescriptions
     History of Preventive Medicine
     Smoking Risks/Depression/The Western Diet
     Food Consumption/Cancer and Treatment Relationships
     Notes from the Spring Texas Surgical Society Meeting
     Alternative Medicine