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A Multidisciplinary Analysis of Controversies in the by H. Ballentine Carter M.D., Donald S. Coffey Ph.D. (auth.),

By H. Ballentine Carter M.D., Donald S. Coffey Ph.D. (auth.), Donald S. Coffey, Martin I. Resnick, F. Andrew Dorr, James P. Karr (eds.)

These complaints emanate from the second one Prouts Neck convention on prostate melanoma hung on October 17-19, 1986, the subject of which was once deal with­ ment, with specialise in present matters and destiny learn that's had to resolution serious questions with regards to optimum administration of many of the levels of prostate melanoma. the target was once to bare the main the most important difficulties impeding growth and to crystallize the mixed multidisci­ plinary enter generated by way of the convention into centred thoughts or suggestions for presentation to the nationwide melanoma Institute (NCI) , with the final word cause of concentrating on learn to handle the concern concerns pointed out. In organizing the workshop, each attempt was once made to take care of a multidisciplinary stability between nationally well known specialists on prostate melanoma. hence, top surgeons, radiation and clinical onco­ logists and biostatisticians have been in equivalent presence. whereas there have been lively exchanges with cautious scrutiny and critique of all information pre­ sented, there has been a standard trust that the problem of prostate melanoma will be most sensible approached during this multidisciplinary Organ Systems-oriented model. through the process the convention, it turned obvious to all current that significant nomenclature and procedural obstacles have made it ordinarily tricky, and often very unlikely, to check result of medical research.

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6 (1966-1967). Japanese Cancer Society, p. 81, 1972. 11. D. Epidemiologic factors associated with prostatic cancer, in: "Prostate Cancer. S. T. 9, UICC Technical Report Series, 48:56-80, 1979. 12. Haenszel, W. and Kurihara, M. Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J. Natl. Cancer Inst. 40:43-68, 1965. 13. Staszewski, J. and Haenszel, W. Cancer mortality among the Polish-born in the United States. J. Natl. Cancer Inst. 35:291-297, 1965.

Migrant studies have demonstrated that environmental, not simply genetic factors, are critically involved in the progression of microscopic to clinically manifest prostatic cancer (32). If such environmental factors could be identified, it is possible that effective therapeutic measures could be developed to minimize this progression thereby reducing by over 10-fold the high incidence rate of clinical prostatic cancer among American males to at least as low a rate as that found for Japanese men in Japan.

If prostatic carcinogenesis occurs as a single step process, then once this single malignant event has occurred within an individual prostatic cell, then a clinically manifest cancer should develop directly via its continuous clonal growth with no morphological indication of any intervening pre-malignant stage of development. Alternatively, if prostatic carcinogenesis occurs as a multiple-step process, then cells which have undergone some but not all of the transformation steps should be present within the gland and the clonal growth of these partially transformed cells should produce morphologically identifiable pre-malignant lesions.

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