Small Cell Carcinoma of the Prostate

An 82-year-old man, who 7 years previously had been treated for adenocarcinoma of the prostate, was found to have developed a small cell (oat cell) carcinoma of prostate, which presented with liver metastases. The expression of different neuroendo crine markers in these carcinomas is presented, the histogenesis of small cell carcinoma is discussed, and the relevant literature is reviewed. The importance of the recognition of small cell carcinoma of the prostate is emphasized because of the influence of small cell carcinoma on the prognosis. Int J Surg Pathol 2(3):237-244, 1995

Popularity of less frequent follow up for breast cancer in randomised study: initial findings from the hotline study

OBJECTIVE

To compare the experiences of patients with breast cancer who were conventionally monitored with those in whom routine follow up was restricted to the time of mammography.

DESIGN

Randomisation to conventional schedule of clinic visits or to visits only after mammography. Both cohorts received identical mammography and were invited to telephone for immediate appointments if they detected symptoms.

SETTING

Combined breast clinic, Chelsea and Westminster Hospital.

SUBJECTS

211 eligible outpatients with a history of breast cancer.

MAIN OUTCOME MEASURES

Acceptability of randomisation, interim use of telephone and general practitioner, satisfaction with allocation to follow up.

RESULTS

Of 211 eligible patients, 196 (93%) opted for randomisation in the study. Of these, 55 were under 50 years, 78 were diagnosed fewer than five years before, 90 had stage T2-4 tumours, and 71 had involved axillary nodes. Patients who did not participate were more likely to be under 50 years, to be two to five years after diagnosis, and to have had aggressive primary disease. Twice as many patients in both groups expressed a preference for reducing rather than increasing follow up. No increased use of local practitioner services or telephone triage was apparent in the cohort randomised to less frequent follow up by specialists.

CONCLUSIONS

Reducing the frequency of routine follow up has so far proved popular among patients with breast cancer at standard risk in this cohort. A multicentre study is needed to determine the effectiveness and cost-effectiveness of routine follow up with respect to disease outcomes.