Chemo for Choriocarcinoma

Gestational trophoblastic disease comprises a spectrum of interrelated conditions originating from the placenta and includes teh msot agressive type, choriocarcinoma. Histologically distinct disease entities encompassed by this general terminology include complete and partial hydatidiform moles, invasive moles, gestational choriocarcinomas, and placental site trophoblastic tumors. Before the advent of sensitive assays for human chorionic gonadotropin (hCG) and efficacious chemotherapy, the morbidity and mortality from gestational trophoblastic disease were substantial. In agressive high-risk cases, aggressive multiagent chemotherapy and individualized multimodality therapy is warranted . At present, treatment with single-agent methotrexate or actinomycin D is recommended for low-risk disease, while intense combination regimens including EMACO (etoposide, methotrexate, actinomycin D, cyclosphosphamide and oncovin) are recommended for intermediate or high-risk disease.

Royal College of Obstetricians and Gynaecologists (RCOG). The management of gestational trophoblastic neoplasia. London (UK): Royal College of Obstetricians and Gyneacologists (RCOG); 2004 Feb. 7 p. (Guideline; no. 38). [16 references]

Kufe D (2000). Benedict RC, Holland JF. ed. Cancer medicine (5th ed. ed.). Hamilton, Ont: B.C. Decker. ISBN 1-55009-113-1.

^Rustin GJ, Newlands ES, Begent RH, Dent J, Bagshawe KD (1989). "Weekly alternating etoposide, methotrexate, and actinomycin/vincristine and cyclophosphamide chemotherapy for the treatment of CNS metastases of choriocarcinoma". J. Clin. Oncol. 7 (7): 900–3.

Adrenal cancer after resection: followup imaging

Adrenal cancer is not common and the clincial experience with it is limited. There is much information on how to follow it before resection but not as much on how to follow resected cancers. Many adrenocortical cancers are not particularly PET avid. A recent guideline says this: "An enhanced CT scan of chest and abdomen is recommended every 3 months for 1 year post-operatively, followed by repeat scans every 3–6 months for 5 years and at least annually thereafter if there is no evidence of tumor recurrence. Bone scans and brain MRI should be based on symptoms. PET is a promising tool that is currently under clinical investigation and should not yet be considered a standard of care in patient follow-up."

Fassnacht M, Allolio B. Clinical management of adrenocortical carcinoma. Best Pract Res Clin Endocrinol Metab. Apr 2009;23(2):273-89.

Schteingart, D E, Doherty, G M, Gauger, P G, Giordano, T J, Hammer, G D, Korobkin, M, Worden, F P Management of patients with adrenal cancer: recommendations of an international consensus conference Endocr Relat Cancer 2005 12: 667-680

Rankings Rankings…

In the latest FIFA rankings Japan have snuck back into the world’s top 40…joint 40th with Northern Ireland – yikes! It’s a far cry from 4 years ago at the equivalent time in the build up to the World Cup when Japan reached the giddy heights of 15th in January 2006.

It all went rather wrong as a result of the 2006 World Cup when the Blue Samurai plummeted to 49th…and we’re still trying to claw our way back. It’s not overly helped by the fact that most of Japan’s opposition is quite low ranked, so not many points are gained by beating them.

Japan are still the second ranked team in Asia, well behind Australia who are 23rd.

This isn’t hugely significant, but it backs up something I’ve been thinking for a while, that Japan rarely test themselves against decent opposition. Clearly Japan’s Asian matches are generally against weaker opposition, often significantly so, but when the opportunity arises for friendlies who do Japan play? Venezuela, South Africa, Togo and Scotland are the most recent examples. Only once in the last year have they played a top nation, which was the Netherlands and unsurprisingly Japan were given a footballing lesson by a less than full strength Dutch team.

If Japan are to progress again, and get back to where they were 8 years ago or better then surely they need to test themselves against top opposition more regularly. Ok, so some beatings may have to be taken, but it’s only by testing yourself against teams better than you that you can learn and develop and come back stronger.

I fear for the World Cup if Japan arrive untested by decent opposition.

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http://www.youtube.com/watch?v=KmQjBbhlUas&hl=en

FIFA World Cup 2011 Ticket Sales Kick-Off

The official online ticketing portal at FIFA.com/Germany2011 was
launched on Thursday, 29 October 2009 during the half-time break of the
women's international between Germany and USA (0:1).

Mia Hamm has been appointed international ambassador for the 2011 women's World Cup in Germany. The American soccer legend was officially presented by Steffi Jones
ahead of the women's friendly match between Germany and USA at the
Augsburg Arena on Thursday October 29, 2009.

Iran earn their ticket to Asian Cup 2011

Team Melli fans, I am finally glad to be the bearer of some good news for you! After over three years of mediocre soccer at best, and all sorts of record setting losses, we finally won one that mattered. Yes, we defeated Singapore to make it to Asian Cup 2011 tournament.

OK, fine; Singapore is not exactly an Asian powerhouse, but don’t tell me you were not starving for some good news.

With this win, Team Melli coaching staff can breathe somewhat comfortably and start preparing the team for the 2011 tournament. Perhaps they can start by watching tapes of 2010 World Cup ……. Zing!

Yep, I am still sour about not making it to South Africa, but hey at least we can look forward to Asia 2011.

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