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Objectives: The menopause is attaining greater significance as symptoms and long-term sequelae are amenable to hormone replacement treatment. However, hormone replacement treatment is no panacea and all women undergoing the menopause need to make informed decisions about its use. The aim of this study was to assess the effects of a series of group sessions for women aged 45–55 years, dealing with physical, social, emotional and medical aspects of the climacteric. Methods: All women registered at the Roborough surgery were invited to join a group for four sessions, led by the health visitor and counsellor, with a doctor leading one session on hormone replacement treatment. Women’s views on the group were obtained by questionnaire. Prescribing data on hormone replacement treatment and antidepressants were analysed for attenders and a matched group of those invited who did not attend. Results: Twelve percent of invited women attended. All stated that sessions helped an understanding of the physical and emotional changes at this time. No significant differences were found in the use of hormone replacement treatment, antidepressants or in subsequent use of the counsellor’s services between the attenders and a matched group of non-attenders. Conclusions: This group offered all women at risk the opportunity to discuss, share and learn about all aspects of the menopause. It was well received and made no major differences to the uptake of hormone replacement treatment.

The results of several clinical trials support the hypothesis that biochemical modulation may enhance the antitumor activity of 5-Fluorouracil (5-FU). We have performed a phase I trial using a combination of three different biochemical modulators at the optimal dose established in previous clinical trials. The modulators include: phosphonacetyl-l-aspartate (PALA), which may increase 5-FU incorporation into RNA; leucovorin, which potentiates thymidylate synthase inhibition; and 6-methylmercaptopurine riboside (MMPR), which promotes the intracellular retention of fluorinated nucleotides. The treatment regimen consisted of PALA 250 mg/m2 day 1, followed 24 h later by MMPR 150 mg/m2 as an iv bolus, and the initiation of a 24-hour infusion of 5-FU along with leucovorin 50 mg/m2. This regimen was repeated weekly. Doses of 5-FU were escalated in cohorts of four or more patients from 2,000 to 2,600 mg/m2. Among 20 patients entered, the majority had colorectal cancer, and most had received prior 5-FU treatment. Toxicity was predominantly gastrointestinal, and diarrhea was dose-limiting at a 5-FU dose of 2600 mg/m2. There were three partial remissions observed, two of whom had colorectal cancer. Emerging data that casts doubt on the modulation value of PALA at this dose and schedule suggests that revision of this regimen be considered before Phase II trial.