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E. GRUNDMANN The question as to whether cytostatic drugs might be
carcinogenic has been presented and discussed in three experimental
studies. The most extensive in- vestigations were by J. H.
WEISBURGER and coll. (New York, Alabama, Bethesda). They started
with an exact determination of rate and localization for spon- .
taneous tumors in their animal strains. Thirteen cytostatic
compounds current- ly in clinical use were then given in the
maximally tolerated dose (MTD) to groups of 25 male and 25 female
animals (rats and mice) three times weekly, in most assays over a
period of 6 months. Other identical groups of animals received 0. 5
of the MTD. Each test involved 50 male and 50 female mice and the
same number of rats. As positive controls, identical groups were
given diethylnitrosamine, which induced tumors of liver, lungs and
kidneys in the expected rates. The direct alkylating agents
(Actinomycin 0, Melphalan, Mito- mycin 0, Uracil mustard,
Dibromomannitol and Dibromodulcitol) induced cancer in the
peritoneal cavity, the site of the injections. Rats appeared to be
more susceptible than mice. Other drugs (e. g. the cyclohexamide
salt of phos- phorodiamidic acid derivative, Natulan, DIC and
streptozotocin) had a broad spectrum of carcinogenicity affecting a
variety of organs. Several agents led to tumors in the
hematopoietic and lymphatic systems in mice or rats or both. The
correlation to the general immunosuppressive action is not quite
clear. 6-Mercaptopurine induces lymphosarcomas in mice.
The growth and function of many tissues are influenced by hormones.
Therefore it is quite understandable that hormones play a role in
the development and treatment of malignant tumors. Numerous
publications address this topic; however, the results of many
studies are controversial and have not been unequivocally accepted.
For nearly 50 years the carcinogenic effect of steroid hormones has
been under debate, and their therapeutic value a matter of
discussion for equally as long. The present volume concentrates on
substantiated data first obtained from the study of tumors
developing from hormone regulated or hormone-producing tissue,
e.g., the thyroid, adrenal glands, prostate, and the female genital
tract. Through a joint approach from the field of molecular
biology, biochemistry, and histopathology, advances in the
management of these tumors have been elaborated. Another exciting
example is the endo nuclear diagnosis of adrenal tumors.
Antihormones, i.e. antian drogens or GnRH analogues have proved to
be important indeed since they exhibit a destructive effect on
prostate carcinomas and breast cancer. Further improvements can be
expected in the localization of hormones in tumor tissue by
specific antibodies. A special chapter is dedicated to the diffuse
endocrine cell system (DECS), the clinical significance of which
has mainly become obvious in the gastroenteropancreatic tract.
Minimal neoplasia may be defined as a small cancer that has
progressed beyond its site of primary origin into the surrounding
tissue, but that has not yet reached the stage of deeper invasion
or metastasization. The basic principles of this minimal cancer are
presented in chapters on molecular, biological and experimental
aspects, and, in particular, on the clinical manifestations in
various organs: preleukemia, incipient lymphoma, and minimal
carcinomas of the uterine cervix, breast, thyroid, larynx, lung,
prostate, stomach and colon. A separate chapter is devoted to
cryptic gliomas. The latest morphological methods including
cytology, early clinical diagnostics and, in particular,
radiodiagnostics, are considered. The reader can expect up-to-date
information about prompt diagnosis of the very early manifestations
of cancer, together with inferences on therapy, which, especially
in tumors of the uterine cervix, breast and thyroid, differs
considerably from the treatment of advanced neoplasia.
The preceding decade has seen the production of many cancer at
lases. As with other techniques of descriptive epidemiology, these
atlases have proved valuable in identifying areas for further re
sear~h employing the methods of analytical epidemiology. How ever,
the various cancer atlases produceq to date have failed to pro vide
a common format of presentation, which has limited their
comparability and frustrated in a large measure any attempt to
compare risks across national boundaries, boundaries which in terms
of environmental exposures may have little meaning. In this volume,
many features of cancer atlases are presented and there are
discussions on the areas where moves towards standardization could
greatly increase the utility of the finished product. In contrast
to topographic maps, i. e., representations of natural and man-made
features on the surface of the earth, thematic maps concentrate on
displaying the geographical occurrence and varia tion of a single
phenomenon - the "theme" of the map. The link between thematic and
base mapping is rather strong as the themat ic information to be
depicted is of greater value if displayed on an accurate base map.
Further, the thematic map generally uses statis tical data which
are frequently related to internal administrative boundaries for
enumeration. The major reason for constructing a thematic map is to
discover the spatial structure of the theme of the map and to then
relate the structure to some aspects of the under lying
environment.
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