© 2004 by Oxford University Press
© 2004 Oxford University Press
IN THIS ISSUE |
Quality-of-Life Outcomes 5 Years After Prostate Cancer Treatment
Men treated for clinically localized prostate cancer with either radical prostatectomy or external beam radiotherapy usually survive many years with the side effects of these treatments. Potosky et al. (p. 1358) examined quality-of-life outcomes for 901 prostate cancer patients treated with radical prostatectomy and 286 prostate cancer patients treated with external beam radiotherapy 5 years after their initial diagnoses. They found that at 5 years after diagnosis, overall sexual function in both groups was approximately the same and lower than that at diagnosis, but erectile dysfunction was more prevalent in the radical prostatectomy group than in the external beam radiotherapy group. In addition, men treated with radical prostatectomy for localized prostate cancer experienced worse urinary incontinence than men treated with external beam radiotherapy, whereas bowel urgency and painful hemorrhoids were more common in the external beam radiotherapy group than in the radical prostatectomy group.
In an accompanying editorial, Bermejo et al. (p. 1348) discuss the decision-making dilemma faced by patients and their doctors regarding appropriate and necessary treatment after a prostate cancer diagnosis. The authors consider the study by Potosky et al. a clarion call for a concerted nationwide study to address questions regarding prostate cancer detection and treatment.
Simian Virus 40 Infection and Non-Hodgkin Lymphoma
Simian virus 40 (SV40), a macaque polyomavirus, was an accidental contaminant of poliovirus vaccine used in 1955–1962. Although it has been suggested that SV40 infection may be associated with the development of several different human cancers, this association is controversial. Several groups have detected SV40 DNA in tumor tissue from patients with non-Hodgkin lymphoma (NHL) by using polymerase chain reaction–based assays, but epidemiologic evidence that would support such an association is lacking. In this issue (p. 1368), Engels et al. report the results of a case–control study of the association between SV40 serostatus and NHL. Using two similar immunoassays that detect antibodies to virus-like particles (VLPs), carried out independently in two different laboratories, the authors found no association between SV40 seropositivity and NHL, either overall or for specific histologies or sites. The authors note that VLP-based antibody assays are a valuable new tool for epidemiologic studies of SV40 infection and cancer.
Atrazine Exposure and Cancer Incidence
Human and animal studies have suggested that atrazine, the most commonly used pesticide in the United States, is possibly carcinogenic. Rusiecki et al. (p. 1375) measured cancer incidence among 53 943 licensed pesticide applicators in North Carolina and Iowa, who were followed from enrollment (1993–1997) through December 31, 2001. Using detailed exposure information obtained from the enrollment questionnaire, the authors grouped participants into quartiles of lifetime days of atrazine exposure and into quartiles of intensity-weighted lifetime days of atrazine exposure. Rate ratios of multiple cancer types among those in the various quartiles were calculated using Poisson regression. The authors found no association between atrazine exposure and cancer risk. They conclude, however, that further studies should be performed for cancers that revealed a suggested—although not statistically significant—association with atrazine exposure.
Site Classification and Gastric Cardia Cancer Incidence
The incidence of some gastric cancers appears to have increased over the last decade. To examine whether improvements in cancer site classification may have contributed to these increases, Corley and Kubo (p. 1383) compared gastric cancer incidence rates that were adjusted for improvements in site classification with the unadjusted incidence rates obtained from data reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) cancer registries from 1974 through 1998. The authors conclude, based on their results, that improved specification of gastric cancer sites may largely account for the purported increase in cardia cancer incidence in recent decades and that noncardia gastric cancer incidence may be decreasing more rapidly than previously appreciated. These results, the authors say, illustrate the potentially large influence of changes in site classification on some cancer incidence rates.
Mammaglobin-A Vaccination and Breast Cancer
Mammaglobin-A is a breast cancer–associated antigen that has been found in 80% of primary breast tumors but not in normal breast cells. To determine if mammaglobin-A may be a successful target for immunotherapy in breast cancer, Narayanan et al. (p. 1388) identified mammaglobin-A peptides that bind to cytotoxic T lymphocytes (CTLs). The authors then showed that the CTLs of mice immunized with mammaglobin-A cDNA reversed tumor growth of mammaglobin-A–expressing breast tumors in a mouse model of human breast cancer they developed for the study. They also found that CTLs of breast cancer patients could recognize five of the seven mammaglobin-A peptides developed in the study. The authors conclude that their data demonstrate the immunotherapeutic potential of mammaglobin-A in breast cancer.
Alcohol and Bladder Cancer
Epidemiologic data, mostly derived from case–control studies, regarding whether alcohol consumption increases the risk of bladder cancer are equivocal. Using data from 10 125 participants in the Framingham Heart Study, a population-based prospective study, Djoussé et al. (p. 1397) assessed whether there was an association between total and beverage-specific alcohol consumption and the risk of bladder cancer. The authors found that, during a mean follow-up of more than 25 years, there were 126 incident cases of bladder cancer, but no statistically significant association between alcohol consumption and the risk of bladder cancer. In beverage-specific analyses, beer consumption was associated with a reduced risk of bladder cancer, whereas wine or spirit consumption was not. The authors conclude that total and beverage-specific alcohol consumption are not associated with an increased risk of bladder cancer.
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