Charles D. Sherman

International union against cancer

Abstract This article describes progressive interest in cancer education on three continents with an increasing number of national and multinational groups having a formalized role in cancer. A great deal of this activity has been stimulated by the International Union Against Cancer (UICC) through surveys, regional conferences, courses, etc. Further action at the continental, national, and local level will be strengthened considerably with the formation of new “coordinating councils”; for cancer education in Europe, Latin America, and the Asian‐Pacific region. These “coordinating councils”; include representatives of most organizations with an interest in cancer education. A long list of projects for possible consideration by these councils is noted.

CLINICAL AND METABOLIC STUDIES FOLLOWING BOWEL BY‐PASSING FOR OBESITY*

Some six years ago we examined the possibility of by-passing most of the small bowel in an effort to control massive obesity. We had had clinical experience and had done metabolic studies on several patients who had had most of their bowel resected for gangrene secondary to volvulus or embolism. We felt we understood and could control the potential problems of patients with extensive by-passing since the amount of bowel remaining in circuit would be about the same as that remaining after resection for extensive gangrene. Two other factors played a major role in our final decision to pursue this clinical investigation: First, excessive obesity (200 per cent or more of normal weight) is a serious health hazard and carries a significantly increased mortality and morbidity. Second, no matter how many specialists are involved in caring for these excessively obese patients, over three-fourths of these patients do not maintain any significant weight reduction for a prolonged period. We felt that if a safe surgical procedure could be developed that would bring about and maintain significant weight reduction without serious side effects, it might be reasonable to use it in selected patients.

Assessment of jejunoileostomy for obesity— some observations since 1976

In this review, which only partially covers the data available, it is pointed out that the evaluation of the results of jejunoileostomy may depend upon the criteria used by the observers, and disclosure of the true effects of the operation may depend upon the long-term follow-up of the patients. With increasing length of observation, it has become apparent that problems such as vitamin D deficiency, renal stone formation, continued steatorrhea, gallstones, zinc and copper deficiency, and even renal failure may be seen with disturbing frequency. Some of these may be preventable, others may be correctable and, indeed, the overall incidence of genuinely severe problems may, in the long run, be sufficiently low so as to make the benefits of jejunoileostomy outweigh the hazards. The rate of patient satisfaction is high, quality of life is generally improved and psychosocial and economic benefits of jejunoileostomy are apparent. The operation may also be a better alternative than the physical hazards of continuing obesity. Whether or not gastric bypass represents a true improvement over jejunoileostomy will depend upon the conclusions reached after applying to it the same searching scrutiny that is being used to examine the long-term results of jejunoileostomy.

Response and survival in advanced carcinoma without severe antitumor drug toxicity.

Summary5-FU is a useful, fairly predictable drug for the palliation of advanced colonic carcinoma. When used with caution, subjective improvement can be expected in more than half the patients and objective remissions in a sixth to a quarter. Toxic side-effects can be kept to a minimum by evaluating the patient carefully before each dose of the drug.

The international union against cancer (UICC) and its professional education program

The International Union Against Cancer (UICC) is a world federation composed of 242 member organizations. One of its functions is organizing a quadrennial international cancer congress. The next congress will be held in Budapest in August, 1986. Other UICC programs include a Detection and Diagnosis Program, a Tumor Biology Program, a Public Education Campaign, Fellowships and Awards Program, Epidemiology and Prevention Program, Smoking and Cancer Program, Treatment and Rehabilitation Program, and the Professional Education Program. The latter produces a UICC Manual of Clinical Oncology, sponsors regional education meetings, offers consultation visits on request, and offers courses and training programs. The American activities are coordinated by the USA National Committee on the UICC, comprised of representatives of the United States members of the UICC.

International union against cancer: The development of “coordinating councils”; for cancer education in Europe, Latin America, and the Asian‐Pacific region

Abstract This article describes progressive interest in cancer education on three continents with an increasing number of national and multinational groups having a formalized role in cancer. A great deal of this activity has been stimulated by the International Union Against Cancer (UICC) through surveys, regional conferences, courses, etc. Further action at the continental, national, and local level will be strengthened considerably with the formation of new “coordinating councils”; for cancer education in Europe, Latin America, and the Asian‐Pacific region. These “coordinating councils”; include representatives of most organizations with an interest in cancer education. A long list of projects for possible consideration by these councils is noted.