Search

The aim of this study was to determine in healthy consultees attending cancer genetics clinics their risk status, their pathways leading to the clinics, their expectations and perception of cancer risk. In 1994, the consultees at six French centres completed a questionnaire before their first oncogenetic consultation. The oncogeneticists subsequently filled in a standardised form giving their risk assessment. Among the 206 healthy consultees, 91.3% were women, 92.2% had at least one cancer-affected first-degree relative and 73% had a “cancer family risk” as assessed by the oncogeneticist. Sixty-nine per cent of the consultees were referred to the clinics by a physician, 10.4% by their family and 18.8% on their own initiative: 83.5% of the sample perceived their family risk of cancer as being high and this belief was confirmed in 74.3% of the cases studied by the oncogeneticist. The families of self-referred consultees were less often at risk than those of consultees referred by a physician or by their family ( P = 0.012). The majority (78%) expected to be informed about cancer prevention and screening, and this expectation depended on the consultee's level of education ( P = 0.001). This study shows that medical pathways are more effective than the media as a means of reaching the members of the general population who are genuinely at risk, and shows that fuller information about prevention needs to be provided at cancer genetic consultations.

D, belonging to the taxoid class of anticancer agents, enhances microtubule assembly and inhibits the depolymerization of tubulin. The cytotoxic activity of V is through inhibition of the microtubule assembly. D and V have both shown clinical activity in advanced breast cancer as single agent. Additionally, therapeutic synergism has been observed in preclinical studies when the two drugs are combined simultaneously. Thus, a phase I study of a combination of these 2 drugs commenced in patients with metastatic breast cancer. However, as D. and V. induce mild neurotoxicity, neurological effects of this combination were evaluated. Neurological function at baseline, during (every 2 cycles and at the end of the study), and following treatment, in 13 metastatic breast cancer patients treated with docetaxel (60–85 mg/m2) and vinorelbine (20–22.5 mg/m2—D1–D5), none of them treated with vinca-alcaloids and/or CDDP, were prospectively evaluated. Deep tendon reflexes decrease was the most frequent abnormal finding, which occurred in 10 patients (77%). Mild, temporary and reversible grade 1 asymptomatic paresthesia were seen in 4 patients (31%). Pin sensibility, vibration sensation and muscular strength were always normal. Median and peroneal motor nerve conduction velocities, as well as median sensitive nerve conduction velocity, remained in the normal ranges. Peripheral neurotoxicity induced by the docetaxel-vinorelbine combination therapy appears to be mild (grade 1 according to NCI toxicity criteria).