Health profiles of 996 melanoma survivors: the M. D. Anderson experience

BACKGROUND: The incidence and survival of melanoma are increasing, but little is known about its long-term health effects in adult survivors. METHODS: A health survey was available from 996 melanoma survivors (577 treated with surgery alone, and 391 with combined treatments). Their medical/physiologic and psychosocial responses were analyzed and compared with those of the survivors from other cancers. RESULTS: The melanoma survivors were 44.8 ± 12.8 years of age at diagnosis (significantly younger than the survivors of other cancers) and 63.7 ± 12.8 years at survey. Melanoma survivors were less likely to report that cancer had affected their health than survivors of other cancers (15.8% vs. 34.9%). The 577 individuals treated with surgery alone reported arthritis/osteoporosis, cataracts, and heart problems most frequently (less often than survivors of other cancers). The 391 individuals who had undergone combined treatments reported circulation problems and kidney problems generally as often as survivors of other cancers. Health problems were not associated with number of decades since diagnosis but with age at diagnosis, treatment modality, and family relationships. CONCLUSION: We present information from a large cohort of long-term survivors of melanoma. As a group, they were less likely to report that cancer had affected their overall health than survivors of other cancers; a number of disease related and psychosocial factors appear to influence their health profiles

G-protein signaling: back to the future

Heterotrimeric G-proteins are intracellular partners of G-protein-coupled receptors (GPCRs). GPCRs act on inactive Gα·GDP/Gβγ heterotrimers to promote GDP release and GTP binding, resulting in liberation of Gα from Gβγ. Gα·GTP and Gβγ target effectors including adenylyl cyclases, phospholipases and ion channels. Signaling is terminated by intrinsic GTPase activity of Gα and heterotrimer reformation — a cycle accelerated by ‘regulators of G-protein signaling’ (RGS proteins). Recent studies have identified several unconventional G-protein signaling pathways that diverge from this standard model. Whereas phospholipase C (PLC) β is activated by Gαq and Gβγ, novel PLC isoforms are regulated by both heterotrimeric and Ras-superfamily G-proteins. An Arabidopsis protein has been discovered containing both GPCR and RGS domains within the same protein. Most surprisingly, a receptor-independent Gα nucleotide cycle that regulates cell division has been delineated in both Caenorhabditis elegans and Drosophila melanogaster. Here, we revisit classical heterotrimeric G-protein signaling and explore these new, non-canonical G-protein signaling pathways

Equilibrium gas-phase structures of sodium fluoride, bromide, and iodide monomers and dimers

The alkali halides sodium fluoride, sodium bromide, and sodium iodide exist in the gas phase as both monomer and dimer species. A reanalysis of gas electron diffraction (GED) data collected earlier has been undertaken for each of these molecules using the EXPRESS method to yield experimental equilibrium structures. EXPRESS allows amplitudes of vibration to be estimated and correction terms to be applied to each pair of atoms in the refinement model. These quantities are calculated from the ab initio potential-energy surfaces corresponding to the vibrational modes of the monomer and dimer. Because they include many of the effects associated with large-amplitude modes of vibration and anharmonicity, we have been able to determine highly accurate experimental structures. These results are found to be in good agreement with those from high-level core-valence ab initio calculations and are substantially more precise than those obtained in previous structural studies

Beyond cancer: changes, problems and needs expressed by adult lymphoma survivors attending an out-patient clinic

Little is known about the impact of the cancer experience on people following the completion of treatment. Work has begun to outline such experiences primarily in the United States. The purpose of this study was to explore the 'survival'experience within a British context of care, outlining the changes, problems and needs expressed by adult cancer survivors.A convenience sample of 10 adult lymphoma patients from one large teaching hospital was interviewed a minimum of 18 months following the completion of successful treatment. Data were collected by means of tape-recorded semi-structured interviews, using a schedule based on the Cancer Survivorship Questionnaire (Loescher et al., 1990).Data were analysed using content analysis and this indicated that, whilst survival itself may be reward enough for some, others seek to improve or adjust their current status, physically, psychologically or socially. It was concluded that the British cancer survivors were affected in many ways, some having to adjust more than others to the consequences of cure. The preliminary findings pointed towards a notion of 'subtle survivorship'in the British survivors. While they reported many changes in their lives after treatment, many were typically accepting of these and successfully adjusted to their new lives

Surviving adult cancers. Part 1: Physiologic effects.

To provide an overview of the physiologic long-term and late effects of adult cancers and cancer treatments by a review of the medical and nursing literature.Primarily from an English-language literature search using MEDLINE (1980 to 1988) and Index Medicus (1980 to 1988).After a consensus review by four observers, 285 articles were selected that addressed the stated purpose.Four observers assessed the literature using predetermined criteria for eliciting information about long-term and late effects. RESULTS AND DATA SYNTHESIS: Much has been written about the acute phases of cancer and cancer treatments. In comparison, relatively few data are available that define physiologic long-term: and late effects of cancer treatments in adult survivors. Review of the existing data showed that these sequelae may affect virtually any body system months or years after treatment ends. In addition, few prospective studies dealing with physiologic survivorship issues have been done.Health care providers need to be aware of long-term or late complications that may affect the increasing number of adult cancer survivors. Attention to treatment regimens in the acute cancer phase and careful follow-up once the disease is eradicated may help to prevent or manage these complications. More prospective research should be done in this area

Surviving adult cancers. Part 2: Psychosocial implications.

To address the psychosocial implications of surviving adult cancers by a comprehensive review of the literature.An English-language literature search using MEDLINE (1970 to 1988). Index Medicus (1970 to 1988), and bibliographic reviews of textbooks and review articles.Of 103 originally identified articles, 58 that specifically addressed the stated purpose were selected.Four authors reviewed and critiqued the literature extrapolating the major themes on this topic.There is little information on the many psychosocial variables that affect an adult's long-term cancer survival trajectory. Collation of data identified the following significant psychosocial themes: fear of recurrence and death, relationships with the health care team, adjustment to physical compromise, alterations in customary social support, isolationism, psychosocial reorientation, and employment and insurance problems.The continuation of a rehabilitation effort begun around the initial diagnosis of cancer would be instrumental in providing post-therapy evaluation and guidance needed by adult long-term survivors of cancer. Education, research, and support interventions need to be mobilized for this population of adults with a history of cancer

Surviving adult cancers. Part 2: Psychosocial implications.

To address the psychosocial implications of surviving adult cancers by a comprehensive review of the literature.An English-language literature search using MEDLINE (1970 to 1988). Index Medicus (1970 to 1988), and bibliographic reviews of textbooks and review articles.Of 103 originally identified articles, 58 that specifically addressed the stated purpose were selected.Four authors reviewed and critiqued the literature extrapolating the major themes on this topic.There is little information on the many psychosocial variables that affect an adult's long-term cancer survival trajectory. Collation of data identified the following significant psychosocial themes: fear of recurrence and death, relationships with the health care team, adjustment to physical compromise, alterations in customary social support, isolationism, psychosocial reorientation, and employment and insurance problems.The continuation of a rehabilitation effort begun around the initial diagnosis of cancer would be instrumental in providing post-therapy evaluation and guidance needed by adult long-term survivors of cancer. Education, research, and support interventions need to be mobilized for this population of adults with a history of cancer