European Stars And Stripes (Newspaper) - September 20, 1986, Darmstadt, Hesse Ail her or the future health of the patient or Lor the Way she tests about herself and it remains a primary motto i of treatment surgery i3 far less drastic Loday. The two leading categories of Mastectomy Are the modified Radical in which the Brosl. Some or most Lymph nodes and lining Over the Chest muscle Are removed and he simple or total Mastectomy in which Only the breast and if necessary a Low nodes Are taken. Among operations that remove the tumor but not the breast there Ore several procedures that vary mainly in the amount of tissue they excise. They Range irom the quadrant Ecloy in which a Quarter of the breast it removed to the Lumpectomy in which Only the tumor and a Small margin of adjoining Lissue Are removed. In Small breasted woman this can amount to a quadrant Lockomy White the debate Over surgery has commanded much of the Public attention in is systemic i Crapy that has the most Promise and is the most controversial Hal Wilt to lilo saving asked or. Marc e. Lippman Chiel of the medical breast cancer Section of the National cancer Institute. Only Ono thing and that is adjuvant chemotherapy " adjuvant therapy is the use of drug or endocrine therapy alter surgery to destroy hidden Micro metastatic disease there is no Lippman said that there have been highly significant advances in this area ii it were widely applied with what to know now thousands of women would be alive " a recent National cancer Institute study showed less than one thud of american women who would Benefit Are gelling any chemotherapy and Many who do gel it Don l get it adequately. Lippman said that chemotherapy ought to be considered for at least half of the women following. Local treatment of their breast that Means essentially All the women with positive Lymph nodes and in a Citrin cases those with negative nodes As Well he said other authorities Are no so certain that the use of chemotherapy in the forms now available ought be so widespread or thai it helps Many patients. Despite Iho Confidence expressed in chemotherapy in is agreed that a great Deal More research is needed new drugs and new ways of using them must be developed questions abound. Do the drugs simply delay recurrence or can they truly prevent in do the pole Lial bin Ellis prolongation of Lite Lor some patients outweigh the harsh Side Ello cts and possible risks does Homol Horary Woik Tor some patients and nol others and what combinations of drugs on what Limel Ables work Best in addition to the presence of malignant cells in Lymph nodes the primary considerations for prescribing adjuvant therapy Are whether the patient is menstruating or menopausal and a nether Ner tumor is dependent on hormones for ils growth. Chemotherapy is Lor premenopausal women than it s Tor Posl menopausal love and other experts said oestrogen and or progesterone can stimulate inc growth of Somo tutors known As hormone receptor positive a hormone receptor negative tumor grows Independent of hormonal influences a positive Reading is considered to offer a better prognosis though the reasons Are not entirely Clear. A National institutes of health consensus panel on breast cancer therapy that met last fall made the following treatment recommendations. For premenopausal women who comprise Between one Quarter and one third of breast cancer patients chemotherapy using combo Lions of drugs for women Over 50 whose Lymph nodes contain hormone positive receptors hormone therapy using tamoxifen an Antie Strogen agent. Tamoxifen which has minimal Side effects is believed to Otter such women a significant period of disease free survival though it is too new to assess its ability to save lives. For postmenopausal women whose cancers were nol inked oestrogen or progesterone chemotherapy especially it they had Lour or More positive Lymph nodes. For women of All Ages whose cancer was confined to the breast and had not spread to the Lymph nodes no Tollow up treatment was recommended unless they 1 Ell into other High risk categories. However there is " some belief that prescribing treatment or them could. Reduce the number of recurrences. The goal in breast cancer As in other forms of the disease is to prevent. Forms of prevention remain elusive. Perhaps in diet Way of he or environmental changes perhaps in genetic intervention or immunology perhaps in scientific disciplines yet to be developed. F3 As Lippman put it we Ara doing he Best we can Fly with the tools we have bul we need to have new an a Ray machine makes mammon us at the univ Unity of Kansas medical Center. Silence is not Golden for tinnitus sufferers by Gayle Young United press International or some the still of inc night or a quiet moment of Solitude is an exercise in agony. The silence Only exacerbates a persistent ringing in the ears a condition called tinnitus that affects an estimated 36 million people. The noise can Range in Pilch irom a Low Roar to a High squeal doctors say but it is always relentless and rarely heard by anyone but the sufferer it can interfere with everyday enjoyment o life if the degree is Sevare enough said or. Joseph Touma an otolaryngologist in Huntington. W. A. They become irritated because the noise interferes with their concentration or their ability to sleep " Moat people Suiter periodic episodes of tinnitus alter lengthy exposure to loud noise. Doctors say they receive dozens o Telephone Calls Tho morning after Rock concerts from people who Are suffering a bout with the disorder a concert of loud music will produce tinnitus that will last or an hour to a few Days Touma said. Out the real problem is when tinnitus is doctors say dozens of medical conditions can cause tinnitus including allergies diabetes High blood pressure and Wax buildup. Some of the causes such As brain tutors arts head trauma can be serious. Tinnitus runs the whole spectrum irom ear Wax to tumor said or. David Redelstein an otolaryngologist at Tho Manhattan Eye ear and Throat Hospital. Even medications can cause ringing As a Side effect. If someone were to take aspirin every Day Over a prolonged period of time they would suffer a reversible form of but doctors said the most common causes of tinnitus Arnold age and repeated exposure to Joud noises. The disorder is common among people Over age 65 or who work in factories airports and As Rock musicians. Tinnitus occurs when microscopic nerve endings in the inner ear Are damaged according to a report from the american Academy of . The damaged nerves no longer Able to pick up the Correct sound cues crease the ringing noise and often result in an accompanying loss of hearing. It s sort of a Paradox that a person suffers hearing loss yet hears this ringing noise Edelstein said. Doctors shall Aren t completely sure a rare form of tha disorder called objective tinnitus is caused by abnormal Hes in blood vessels around the ear. The reselling muscle spasms cause clicking a and crackling sounds within the Middle ear that can he Hoard by o Hor people. Is ill another form of tinnitus is caused when Wax buildup temporarily irritates the sensitive car nerve endings. This form of Iho disorder can be eliminated by removing the Wax doctors said bul most other lorry Are incurable. Doctors estimate that out of Tho 30 million people who have tinnitus 7 million have cases so severe they need help living with the disorder. Most people ignore it since it usually has Lobo very quiet to hear the tinnitus anyway Touma said the others have to avoid Complete silence so the innit us in t As obvious and this technique called masking can Range from sleeping next to inc steady lick lock of a clock to expensive gadgets that Are inserted into the ear and Pio Ducc a White noise designed to counter the ringing. Hearing aids can also help mask tinnitus and Are especially helpful to people who also suffer hearing loss the aids pick up room sounds that counter the Slady noise of the disorder they said doctors advise tinnitus patients to avoid Salty foods and to exercise both ways to keep blood pressure Down and prevent blood vessels in lha car from damaging nearby nerve endings sufferers should also avoid stimulants such As Ca Teine. Nicotine and marijuana doctors said. The stimulants Causa sensitive nerves such As those in the ear to Over act making tinnitus More pronounced. And finally tinnitus sufferers Are told to relax. Nervous tension and stress Only put More Strain on the det Icale nerves and heighten Awa eness of the problem. Many doctors encourage their patients to try biofeedback an exercise process thai is designed to teach voluntary control Over certain Muscles and blood flow. In a Way we All have tinnitus Edelstein said. The major blood vessel irom the heart to the bum runs near the ear. If it s very very quiet you can sort of hear the sounds of your body Al the stars and stripes Page is
