45.10 20.38
29.6 20.26
35.90.47
05.5=0.70
aij
4.25 40.45
2§.88=0 47
41.60.70
67.6 20.82
1960
38.0680.49
28. b1=0. $u
42 250 o9
al
.
40.55
. %5.11
yO Ol
35. wont‘a
.
0 4033
37.3@1)
é seinomeofng
a3
39.02 =0.85
as.See 93
41.Joh 25
07 Ow &4
Hedgule's disease
1900
33.1963.21
24. soat-8
44.101 97
68.743 12
Totnontbertoutg
P value*
Extensive
P value
i
Nonmetastacic
{
.
ns
P value
Leukemia
P value
Carcinome of stomach ond eonpingut
caren a
colon
’
<0.01
is
28.4%3.29
23. ser 38
13
=§.27
40,77
T7m§
Ohi
26. fer"Ns
05 » 1.56
28.26 =1 62
4l.de=l
0.20
<0.01
:
Waarnea F. Baweks, COLONEL, M.c., THeopore H, NicHo1.as, MAJON, M. c,* AND JOHN }:
Kovanic, CAPTAIN, Ma.
<i 01
4
68 Oeu96
He PRRSENT clinical investipation at Brooke
Army Hospital was originally stipulated
of YI
63.081
<0 O01
50.403 ,!
.
46.602
<i.19
wo
'
<0 Oi
76
by the work on bilateral adrenalectomy in
advanced carcinoma ot the breast perlormed
by Huggins in Chicago and at Memorial Cen-
ter for Cancer and Allied Diseases jin New, ,
u 26
74 oie!
.
623.41
72 coun
York City. Previous efforts to palliate this
tlivease have led to the recoguitian of the in.
OY 4422.74
mary camer, and the elfitct of castration and
Huence of hormones an the prowth of mam-
<0 Ul
acdhninistration ot cnc and androgens
*P value represents statistical cpesparisan with corresponding normal value.
confirm those reported earlier by Kelly et al.,
who used T1824tagged plasma and |)*!labeled albumin in similar atudies.
SUMMARY
eters ot
“OSSe eee
To determine whether anemia observed in
cancer results from excessive red-blood-cell
destruction or from an expansion of plasina
volume, the whole-blood volume and hematocrit were wieasured in tumor-bearing rats and
in patients with various types of cancer,
The whole-blood volume of twenty-nine
Aa
Slonaker rate bearing 4 transmissible tibie-
barcoma was found to be greater than aerial.
Yhis was the result of an inctease in plasina
volume; the red-cell iiss was -bscieased
slightly.
Similar determinations in 175 paticuts with
various types ul cancer and eighty seven nur
mal control subjects showed no signiheant
expansion of whole-hload volume int cancer,
but did demonstrate a sipnitic ant ea pagiaiad|
of plasma volume and a decreased in ‘veel
Hass, especially wheu the cancer wus wide
spread.
REFERENCES
i
“4
.
|
Changes in petdangion)
uf copper and irom it tives acd
Tumors, ia ed.
ladetpbie.weB. Saunders Co. apleea in chroidid dictecs acccinpanicd by secondary
aneuia. Arch. Path. $7) 894-644, 144u.
1940, p. 5
2. bon §. J. and Stuminc, K.: Determination et 7. Scdre, KG; Bost, WoL; saisinen, MLB, aid
~ HAsiLion, f. G.: Distribution at globulin boutd thy
circulating red cell volume by radioactive chromiu
row fractions uf wading i martial dick lumeous ani
Science 1 2: 2: 179-180. 1950.
tials after inteavenous adounisitation using radtioiodiar
§. Gaar, §. J, and Stamuine K.; arte
red
usu tracer. Cancer 2: 692 600, 1949.
cells and plasma proteins with rad
iv
aes,
t. Ewin, J: neha
lastic
a Treatise on
J. Clin, Ingestigation 2B: 1604-1615, [1
4. Kerry, KH; Bacaman, ne
Ke
af
B.:
reulation lime in
Blood volume, body water; and
dlecases.
Cancer
tients with advan}
esearch 12: €14-817,
a ing
;
MM; Lau, F. ¥. K
Scott, K. G., and WH
. Es: Whole blood volume
by radiochromiuns-tagged red cells; com-
parative studies on normal snd con sive heart failure
patients. Circulation 9: 571-580, 1
6. Sanvasag, M.; Gaoss. H.
sel Wousy, Oo. M:
8. Simone, 1. C., aint Feancis, F202. dhe bhood of
female mice (Uieeders) uf caticcs suaccpuble (A) and
gatcer resistant (CHA) ettaina. Arch. Path, 2: dks 20s,
1957.
9. Simone, C.. ve wal Francis, $b: Dallereanes 10
hav previously been fowud to be benetiial.
The similarity of adrenal hormones to those
of the gonads has led investiguturs to pustulate that the Might also intiueme these par-
ticular neoplasins. lt was belicved that removal
-pl thee hormones with resultant ableraon
ul ahe physiological cuvironment ol the lunar
nigh bawe Cinical remission. “Whe lack of
whom had advanced mammary cances, with
clinical and laboratory evidence of distany
IneLggenses, *
;
METHOD
'
The adrenal glands were removed in al]
patients though the posterolateral approach,
through the bed of the twelfth rib oa either
side, both glands being renioved at the same
uperative procedure. In all instances, there
had been previous surgical or roentgen-ray
castratian, The present replacement therapy
fur the adrenal glands is as follows: one day
pleapératively, 50 ing. cortisane inuramuscularly every four hours, operative day, 60 mg,
coltpone intramuscularly every four hours
and 100 ing. orally at 6:00 a.n; first postuperalive day, 50 mg. cortisone intramuscularly
every 61x hours; second and third postoperative
. ately late Yeplacemene therapy lor the lile- days, cortivone 50 mp. intramuscularly every
supporting acdbenal glauds, however, prevented twelve hows; Jowth, hich, and sixth pose
the use ol bilateral adbenalectomy until the operative days, 25 mg. cortisone orally every
development of contione. bia about MSE Hag: eight hours; seventh postoperative day, and
Kis tast employed! bilateral adienalectomy i thereafter, 25 mg. cortisone orally every
twelve
hiviudvanced caminama ol the breat and hours. The maintenance dose of oral tyrtisone
prostate, as dll a proup ta Memorial Center, - is 50 mp. a day in two divided doses.
Prior to the begining of aur investigation,
kn the early pare of our investigation, it
each group had reported a small series of
tases indicia Het Wigst parents achieved
wibjective benehits lor weeks to months, while
Wout 50 per cent al patients abo denon:
ated obyccuve provement, as mantlested
hy shirinkape of tumiar tuitoses, new bone fornition in osteolytic lesions, deciewe in pleural
clusion, and gains in weight and) strength.
‘The same investigators also sied the operaWun in other cancers but townd no evidence
al benefit.
hemuglubin values in the blood of bieceder Fenuale mice,
The clinical experience at Brooke Army
Hospital trom January §, 154, through July
1, 1955, is limited to eleven patients, all of
level and tumor growth. Camer Hescarih 2: we3-22],
From the Departinent of Suagery, Brooke Army Hostal, Fort dant Hotton, Penas.
“Pisent ashe, UL § Aimy Hospital Berlin,
Germany.
.
a compativon between cancer-susceprible and cancer
reaintant atiains. Am. J. Cancer $6. S!H)-4u%, HHU.
10. ‘Taynos, A. and Poupaca, MAS Heimaglubin
1942,
_
Recelved fur publication, July 29, 1955.
F
277
4
j
a
3
vhete
wis our custam to administer intramuscular
deoxycorticasterune acetate (bOcA)
prior to
und on the day of surgery, along with sodium
chloride; however, these procedures have been
lound to be unnecessary and have contributed
to the accumulation of excessive body Huid
insnifested by ascites and peripheral edema.
We till advocate the use of boca and intravenous sodium chluride in the operative or
postoperative coune in patients having diffi.
culty with maintenance of bloud pressure;
however, in properly prepared patients, we
have had no diffiulty to date in supporting
the blood pressure. Other drugs that have
Leen recommended are nor-epinephrine, adrenccortical extract, and intravenous hydro.
cortisone. All eleven patients in this eries
tolerated the adrenal surgery well and their
ce te ee
ELERCOPhan ge ON AETg
7Se TTae a Eperes SL
1
a7
Neralcats)
Au Concert
A Report of Eleven Cases
774 oe ae ee
Whuole-Lloud
volume
Hematocrit
Diagnostic categories
BILATERAL ADRENALECTOMY FOR ADVANCED BREAST
CANCER
;
Plasma
volunse
Red-cell
mass
No. af
teats
4
t:
-™
a
oo
er
—~
Taare 4
OMPARISON OF DATA ON THE BLOOD VOLUME OF NORMAL SUBJECTS
“ND PATIENTS WITH CANCER, USING Cr AS A RED-BLOOD-CELL TAG
Values Presented ‘Are Means #@ Standard Error
——
BA te ee aeeer, “Soest
a
= coe
Vol. 9
Cancun March-April 1956
276
|