Peter Daly - Academia.edu (original) (raw)
Papers by Peter Daly
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 20, 2012
59 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical bre... more 59 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical breast exam, mammography and MRI have sensitivities approaching 100%. Even with intensive screening BRCA mutation carriers can present with self-detected interval cancers. We investigate screening practices and presentation among a cohort of Irish BRCA1/2 mutation carriers. Females with breast cancer belonging to kindreds now known to harbour BRCA1/2 mutations were retrospectively identified. Records were reviewed for BRCA mutation, demographics, breast cancer diagnosis, stage, histology and screening. We assessed screening modalities and whether breast cancers were diagnosed at screening or as interval cancers. 53 cases of breast cancer were diagnosed from 1968-2010 among 53 Irish hereditary breast ovarian cancer kindreds. BRCA mutation status was unknown at time of diagnosis but subsequently confirmed. Detection method was identified in 50% of patients: 84% by clinical breast exam (CBE), ...
Surg J R Coll Surg Edinb Irel, 2008
The management of gastric lymphoma is controversial and a wide variety of unimodality or multimod... more The management of gastric lymphoma is controversial and a wide variety of unimodality or multimodality approaches have been used. The aim of this report is to highlight the variety of treatment regimens deployed, the outcomes achieved and to present a modern management approach for this enigmatic tumour. Results: 42 cases of primary gastric lymphoma managed at one centre over a 15year period were reviewed. Weight loss (52%), pain (41%) and anorexia (33%) were the most common presenting symptoms. Most patients (86%) had high-grade lymphoma. Primary treatment modalities included surgery (36%), chemotherapy (40%), supportive care only (22%) and Hpylori eradication (2%). Adjuvant therapies included chemotherapy (17%), radiotherapy (7%) and combined chemoradiotherapy (5%). The overall median survival was 53 months, with a Ý ve year survival of 46%. In the curative group, the median survival was 75 months and Ý ve year survival 58%. Curative surgery or chemotherapy +/-radiotherapy were similarly effective for stage IE and IIE disease. Conclusions: The prognosis for gastric lymphoma is grade-and stage-dependent. With equivalent outcomes for cure in localised gastric lymphoma for surgery and chemotherapy, the latter is preferred in this unit because of gastric preservation, with surgery being reserved for failed medical management or presentations with haemorrhage, perforation or obstruction refractive to steroid therapy.
Oncogene, Apr 1, 1995
A small proportion of breast cancer is attributable to the inheritance of dominant, high penetran... more A small proportion of breast cancer is attributable to the inheritance of dominant, high penetrance susceptibility genes. One of these genes, BRCA2, has recently been localised by genetic linkage analysis to chromosome 13q12-13. This is a region known to exhibit loss of heterozygosity in 20-40% sporadic breast cancers. In this study, we have examined cancers from a family showing strong evidence of linkage to BRCA2. LOH was seen in seven out of eight informative cancers. In all cases the allele lost was the wild type allele that does not segregate with the disease in the family. The data suggest that both alleles of BRCA2 are inactivated in cancers, the pattern expected of a recessive oncogene or tumour suppressor gene.
Cancer, Apr 1, 1988
A left breast mass developed in association with pulmonary tuberculosis in a woman 26 years of ag... more A left breast mass developed in association with pulmonary tuberculosis in a woman 26 years of age. Eight years later, rapidly fatal Hodgkin's Disease with chest wall erosion by involved mediastinal nodes simulating a breast lump developed. Subsequently, a discrete breast mass due to mammary Hodgkin's disease developed. Involvement of the breast by both tuberculosis and Hodgkin's disease, two diseases often associated with immune dysfunction, in a patient with dysmorphic features and a strong family history of tuberculosis, raises the possibility of an underlying genetic defect. This defect probably involves the immune system.
The oncologist, 1999
The National Cancer Institute (NCI) has recently decided to embark on an international partnershi... more The National Cancer Institute (NCI) has recently decided to embark on an international partnership with the developing cancer programs on the Island of Ireland (Northern Ireland and the Republic of Ireland) in an attempt to further improve the quality and range of cancer services available for patients. This Transatlantic Partnership called the All Ireland-NCI Cancer Consortium offers exciting opportunities in cancer treatment, education and research as the cancer-caring communities from both the Republic of Ireland and Northern Ireland prepare to join with the U.S. NCI in this major endeavor. The inaugural event of the partnership will be the NCI All Ireland Cancer Conference to be held in Belfast, October 3-6, 1999. (See www.allirelandcancer.com, for information on the conference.) Cancer is a significant cause of mortality and morbidity on the Island of Ireland. There are approximately 28,000 new cases and approximately 11,000 deaths from cancer each year. Therefore, Northern Ire...
Blood, 1983
111In-labeled granulocytes were used to study the effects of histocompatibility factors on the mi... more 111In-labeled granulocytes were used to study the effects of histocompatibility factors on the migration of transfused granulocytes to infected sites. Fourteen alloimmunized and 20 nonalloimmunized patients received approximately 10(8) 111In-labeled granulocytes from ABO-compatible, non-HLA-matched donors, and scans were performed over known infected sites. All 14 alloimmunized patients had lymphocytotoxic antibody (LCTAb) and required HLA-matched platelet transfusions. Of the nonalloimmunized patients, 20/20 had positive scans at sites of infection. None of the 20 had LCTAb, 0/17 had a positive lymphocytotoxic crossmatch (LCTXM) with the donor, and 3/18 had a positive leukoagglutinin crossmatch (LAXM). Thus, histocompatibility testing was not found to be important in nonalloimmunized patients. In contrast, only 3/14 alloimmunized patients had positive scans at sites of infection (p = 0.00001 compared to nonalloimmunized patients). One of 3 had a positive LCTXM and 2/3 had a positiv...
British journal of cancer, 1989
Blood, 1979
Nineteen noninfected adults receiving initial induction chemotherapy for acute nonlymphocytic leu... more Nineteen noninfected adults receiving initial induction chemotherapy for acute nonlymphocytic leukemia (ANLL) were randomized to receive either prophylactic granulocyte transfusion or platelet transfusion alone on an alternate-day schedule. An average of 11 granulocyte transfusions (range 3--19) were administered/patient with a mean dose of 11.5 X 10(9) granulocytes/transfusion. The groups were identical with respect to age, sex, number of days on study, granulocytopenic days, percent of days receiving systemic antibiotics, febrile days, complete remission rate, and incidence of minor infection. Significant transfusion reactions were much increased in the granulocyte transfusion group (7/10 versus 1/9 in controls) and were associated with the development of lymphocytotoxic antibodies (7/10 versus 4/9 controls), refractoriness to platelet transfusion, repeated fevers, and a pulmonary infiltrate in one patient. Alloimmunization to granulocytes occurred as early as the second week in s...
Blood, 1979
Platelet function and the interaction of platelets with human fibrinogen have been studied follow... more Platelet function and the interaction of platelets with human fibrinogen have been studied following degradation of membrane glycoproteins by chymotrypsin. Washed human and rabbit platelets were treated with a-chymotrypsin (1-50 U/mI), which cleaved glycopeptides from membrane glycoproteins without causing aggregation or release of granule contents. Chymotrypsin removed a large percentage of the sialic acid and periodic acid Schiff (PAS) staining material from the platelet membrane, but glycoprotein IV (of human platelets) or Ill (of rabbit platelets) were not affected. Chymotrypsin-treated platelets were either less responsive or unresponsive to aggregation induced by adenosine diphosphate (ADP) and aggregation and release induced by thrombin or collagen, depending on the concentration of chymotrypsin with which the platelets had been incubated. Unlike untreated platelets, chymotrypsin-treated platelets aggregated in response to human fibrinogen. This was not an agglutination reaction, since it was prevented by EDTA or EGTA or (with rabbit platelets) by the omission of calcium from the suspending medium. ADP enhanced fibrinogen-induced aggregation of these platelets. Fibrinogen becomes associated with untreated human or rabbit platelets during ADP-induced aggregation. 125l-fibrinogen became associated with the chymotrypsin-treated platelets during fibrinogen-induced aggregation, and more '25l-fibrinogen associated with them upon the addition of ADP than became associated with untreated control platelets during ADP-induced aggregation. Normal, untreated, disc-shaped platelets do not seem to have available fibrinogen-binding sites. It may be that when they are induced to change shape by ADP, such sites are revealed so that fibrinogen can form bridges between adjacent platelets. It appears that treatment of platelets with chymotrypsin, which removes glycopeptides from membrane glycoproteins, also causes rearrangement of platelet membrane components so that fibrinogen-binding sites become available. These observations support the concept that fibrinogen has a major role in platelet aggregation.
European Journal of Cancer Supplements, 2004
Familial Cancer Control, 1992
Objectives-Familial aggregation of testicular germ cell tumor (TGCT) has been reported, but it is... more Objectives-Familial aggregation of testicular germ cell tumor (TGCT) has been reported, but it is unclear if familial TGCT represents a unique entity with distinct clinicopathologic characteristics.
Transfusion, 1979
Platelet concentrates were prepared using the hemonetics Model 30 (M-30) and a multiunit bag pher... more Platelet concentrates were prepared using the hemonetics Model 30 (M-30) and a multiunit bag pheresls method. Comparisons of collection efficiency uaIng paired donor collections and posttransfusion recovery using the stune donor-recipient pairs were made for the two methods. The M-30 proved consistently superior as a method of collection in terms of efficiency and yield per hour (p < .001). When the platelets obtained were transfused to HL-A matched, clinically stable, thromhocytopenic patients with acute leukemia simllnr increments within the expected range were obtained at 1 hour and 18 hours posttransfusion. While the M-30 is a more efficient collection method, the bag method is still relatively eflicient and may be more suitable for smder centers and specialized uses.
The Surgeon, 2008
The management of gastric lymphoma is controversial and a wide variety of unimodality or multimod... more The management of gastric lymphoma is controversial and a wide variety of unimodality or multimodality approaches have been used. The aim of this report is to highlight the variety of treatment regimens deployed, the outcomes achieved and to present a modern management approach for this enigmatic tumour. Results: 42 cases of primary gastric lymphoma managed at one centre over a 15year period were reviewed. Weight loss (52%), pain (41%) and anorexia (33%) were the most common presenting symptoms. Most patients (86%) had high-grade lymphoma. Primary treatment modalities included surgery (36%), chemotherapy (40%), supportive care only (22%) and Hpylori eradication (2%). Adjuvant therapies included chemotherapy (17%), radiotherapy (7%) and combined chemoradiotherapy (5%). The overall median survival was 53 months, with a Ý ve year survival of 46%. In the curative group, the median survival was 75 months and Ý ve year survival 58%. Curative surgery or chemotherapy +/-radiotherapy were similarly effective for stage IE and IIE disease. Conclusions: The prognosis for gastric lymphoma is grade-and stage-dependent. With equivalent outcomes for cure in localised gastric lymphoma for surgery and chemotherapy, the latter is preferred in this unit because of gastric preservation, with surgery being reserved for failed medical management or presentations with haemorrhage, perforation or obstruction refractive to steroid therapy.
The Oncologist, 2001
The Ireland-Northern Ireland-National Cancer Institute Cancer Consortium was launched in October ... more The Ireland-Northern Ireland-National Cancer Institute Cancer Consortium was launched in October of 1999, at a conference in Belfast, Northern Ireland, for the development of cancer programs in Ireland and Northern Ireland, where cancer is a significant cause of mortality and morbidity. Cancer services there have undergone major restructuring as a result of several government reports. Specifically, the National Strategy Document for Cancer proposed that cancer treatment services should be centered around primary care services, regional services, and a national coordinating structure where supra-regional centers would deliver specialist surgery, medical and radiation oncology, rehabilitation, and specialist palliative care. Therefore, this was an opportune time to bring the National Cancer Institute (NCI) on board in a determined effort to redevelop and significantly improve services and outcomes for cancer patients throughout the island. During the NCI All Ireland Cancer Consortium, initial major goals were established as follows: A) To share best available technology and enhance clinical research; B) conduct joint clinical research studies involving people from all jurisdictions; C) sponsor formal training exchanges for Irish and American scholars in cancer programs in partner institutions; D) implement the use of teleconferencing, telesynergy, and other information technology capabilities to facilitate education, and E) consolidate the Cancer Registries of Ireland and Northern Ireland and learn more about cancer incidence and trends on the entire island. In the past year, significant advances have been made in all these areas. Plans are already under way for the second NCI All Ireland Cancer Conference which will be held in late 2002 and feature speakers from Ireland, Northern Ireland, the U.S., and other areas. It will be open to all oncologists, researchers, nurses, students, and other health care professionals interested in learning and enhancing cancer care and research.
The Breast, 2011
Little information is available regarding the management of BRCA-related breast cancer in Ireland... more Little information is available regarding the management of BRCA-related breast cancer in Ireland. A cancer genetics programme was initiated in 1992 at our institution to provide counselling and expert management for those with cancers resulting from inherited predisposition. We examined a cohort of BRCA mutation-carriers treated at a single institution over 16 years. A total of 107 women from 57 families were found to be carriers of mutations in BRCA1/2. Bilateral salpingo-oophorectomy was the most common prophylactic surgery performed. Overall survival between BRCA-related and sporadic breast cancer was equivalent. This is the first publication on surgical management of BRCA-mutation carriers in Ireland. It is imperative that those considered likely to harbour a mutation are referred early to a dedicated clinic so that appropriate counselling, testing and subsequent management to reduce the risk of dying from cancer can be undertaken.
Supportive Care in Cancer, 1993
Four-hourly temperature charts relating to 63 febrile neutropenic episodes in 32 patients were as... more Four-hourly temperature charts relating to 63 febrile neutropenic episodes in 32 patients were assessed for a circadian distribution to the onset of fever (> 37.5 degrees C) using the Edward's test. A highly significant distribution was found with the maximum incidence of febrile events between the hours of 5 p.m. and midnight (acrophase 9.30 p.m.). Patients were 5.53 times more likely to develop fever at 9.30 p.m. that 9.30 a.m.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 20, 2012
59 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical bre... more 59 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical breast exam, mammography and MRI have sensitivities approaching 100%. Even with intensive screening BRCA mutation carriers can present with self-detected interval cancers. We investigate screening practices and presentation among a cohort of Irish BRCA1/2 mutation carriers. Females with breast cancer belonging to kindreds now known to harbour BRCA1/2 mutations were retrospectively identified. Records were reviewed for BRCA mutation, demographics, breast cancer diagnosis, stage, histology and screening. We assessed screening modalities and whether breast cancers were diagnosed at screening or as interval cancers. 53 cases of breast cancer were diagnosed from 1968-2010 among 53 Irish hereditary breast ovarian cancer kindreds. BRCA mutation status was unknown at time of diagnosis but subsequently confirmed. Detection method was identified in 50% of patients: 84% by clinical breast exam (CBE), ...
Surg J R Coll Surg Edinb Irel, 2008
The management of gastric lymphoma is controversial and a wide variety of unimodality or multimod... more The management of gastric lymphoma is controversial and a wide variety of unimodality or multimodality approaches have been used. The aim of this report is to highlight the variety of treatment regimens deployed, the outcomes achieved and to present a modern management approach for this enigmatic tumour. Results: 42 cases of primary gastric lymphoma managed at one centre over a 15year period were reviewed. Weight loss (52%), pain (41%) and anorexia (33%) were the most common presenting symptoms. Most patients (86%) had high-grade lymphoma. Primary treatment modalities included surgery (36%), chemotherapy (40%), supportive care only (22%) and Hpylori eradication (2%). Adjuvant therapies included chemotherapy (17%), radiotherapy (7%) and combined chemoradiotherapy (5%). The overall median survival was 53 months, with a Ý ve year survival of 46%. In the curative group, the median survival was 75 months and Ý ve year survival 58%. Curative surgery or chemotherapy +/-radiotherapy were similarly effective for stage IE and IIE disease. Conclusions: The prognosis for gastric lymphoma is grade-and stage-dependent. With equivalent outcomes for cure in localised gastric lymphoma for surgery and chemotherapy, the latter is preferred in this unit because of gastric preservation, with surgery being reserved for failed medical management or presentations with haemorrhage, perforation or obstruction refractive to steroid therapy.
Oncogene, Apr 1, 1995
A small proportion of breast cancer is attributable to the inheritance of dominant, high penetran... more A small proportion of breast cancer is attributable to the inheritance of dominant, high penetrance susceptibility genes. One of these genes, BRCA2, has recently been localised by genetic linkage analysis to chromosome 13q12-13. This is a region known to exhibit loss of heterozygosity in 20-40% sporadic breast cancers. In this study, we have examined cancers from a family showing strong evidence of linkage to BRCA2. LOH was seen in seven out of eight informative cancers. In all cases the allele lost was the wild type allele that does not segregate with the disease in the family. The data suggest that both alleles of BRCA2 are inactivated in cancers, the pattern expected of a recessive oncogene or tumour suppressor gene.
Cancer, Apr 1, 1988
A left breast mass developed in association with pulmonary tuberculosis in a woman 26 years of ag... more A left breast mass developed in association with pulmonary tuberculosis in a woman 26 years of age. Eight years later, rapidly fatal Hodgkin's Disease with chest wall erosion by involved mediastinal nodes simulating a breast lump developed. Subsequently, a discrete breast mass due to mammary Hodgkin's disease developed. Involvement of the breast by both tuberculosis and Hodgkin's disease, two diseases often associated with immune dysfunction, in a patient with dysmorphic features and a strong family history of tuberculosis, raises the possibility of an underlying genetic defect. This defect probably involves the immune system.
The oncologist, 1999
The National Cancer Institute (NCI) has recently decided to embark on an international partnershi... more The National Cancer Institute (NCI) has recently decided to embark on an international partnership with the developing cancer programs on the Island of Ireland (Northern Ireland and the Republic of Ireland) in an attempt to further improve the quality and range of cancer services available for patients. This Transatlantic Partnership called the All Ireland-NCI Cancer Consortium offers exciting opportunities in cancer treatment, education and research as the cancer-caring communities from both the Republic of Ireland and Northern Ireland prepare to join with the U.S. NCI in this major endeavor. The inaugural event of the partnership will be the NCI All Ireland Cancer Conference to be held in Belfast, October 3-6, 1999. (See www.allirelandcancer.com, for information on the conference.) Cancer is a significant cause of mortality and morbidity on the Island of Ireland. There are approximately 28,000 new cases and approximately 11,000 deaths from cancer each year. Therefore, Northern Ire...
Blood, 1983
111In-labeled granulocytes were used to study the effects of histocompatibility factors on the mi... more 111In-labeled granulocytes were used to study the effects of histocompatibility factors on the migration of transfused granulocytes to infected sites. Fourteen alloimmunized and 20 nonalloimmunized patients received approximately 10(8) 111In-labeled granulocytes from ABO-compatible, non-HLA-matched donors, and scans were performed over known infected sites. All 14 alloimmunized patients had lymphocytotoxic antibody (LCTAb) and required HLA-matched platelet transfusions. Of the nonalloimmunized patients, 20/20 had positive scans at sites of infection. None of the 20 had LCTAb, 0/17 had a positive lymphocytotoxic crossmatch (LCTXM) with the donor, and 3/18 had a positive leukoagglutinin crossmatch (LAXM). Thus, histocompatibility testing was not found to be important in nonalloimmunized patients. In contrast, only 3/14 alloimmunized patients had positive scans at sites of infection (p = 0.00001 compared to nonalloimmunized patients). One of 3 had a positive LCTXM and 2/3 had a positiv...
British journal of cancer, 1989
Blood, 1979
Nineteen noninfected adults receiving initial induction chemotherapy for acute nonlymphocytic leu... more Nineteen noninfected adults receiving initial induction chemotherapy for acute nonlymphocytic leukemia (ANLL) were randomized to receive either prophylactic granulocyte transfusion or platelet transfusion alone on an alternate-day schedule. An average of 11 granulocyte transfusions (range 3--19) were administered/patient with a mean dose of 11.5 X 10(9) granulocytes/transfusion. The groups were identical with respect to age, sex, number of days on study, granulocytopenic days, percent of days receiving systemic antibiotics, febrile days, complete remission rate, and incidence of minor infection. Significant transfusion reactions were much increased in the granulocyte transfusion group (7/10 versus 1/9 in controls) and were associated with the development of lymphocytotoxic antibodies (7/10 versus 4/9 controls), refractoriness to platelet transfusion, repeated fevers, and a pulmonary infiltrate in one patient. Alloimmunization to granulocytes occurred as early as the second week in s...
Blood, 1979
Platelet function and the interaction of platelets with human fibrinogen have been studied follow... more Platelet function and the interaction of platelets with human fibrinogen have been studied following degradation of membrane glycoproteins by chymotrypsin. Washed human and rabbit platelets were treated with a-chymotrypsin (1-50 U/mI), which cleaved glycopeptides from membrane glycoproteins without causing aggregation or release of granule contents. Chymotrypsin removed a large percentage of the sialic acid and periodic acid Schiff (PAS) staining material from the platelet membrane, but glycoprotein IV (of human platelets) or Ill (of rabbit platelets) were not affected. Chymotrypsin-treated platelets were either less responsive or unresponsive to aggregation induced by adenosine diphosphate (ADP) and aggregation and release induced by thrombin or collagen, depending on the concentration of chymotrypsin with which the platelets had been incubated. Unlike untreated platelets, chymotrypsin-treated platelets aggregated in response to human fibrinogen. This was not an agglutination reaction, since it was prevented by EDTA or EGTA or (with rabbit platelets) by the omission of calcium from the suspending medium. ADP enhanced fibrinogen-induced aggregation of these platelets. Fibrinogen becomes associated with untreated human or rabbit platelets during ADP-induced aggregation. 125l-fibrinogen became associated with the chymotrypsin-treated platelets during fibrinogen-induced aggregation, and more '25l-fibrinogen associated with them upon the addition of ADP than became associated with untreated control platelets during ADP-induced aggregation. Normal, untreated, disc-shaped platelets do not seem to have available fibrinogen-binding sites. It may be that when they are induced to change shape by ADP, such sites are revealed so that fibrinogen can form bridges between adjacent platelets. It appears that treatment of platelets with chymotrypsin, which removes glycopeptides from membrane glycoproteins, also causes rearrangement of platelet membrane components so that fibrinogen-binding sites become available. These observations support the concept that fibrinogen has a major role in platelet aggregation.
European Journal of Cancer Supplements, 2004
Familial Cancer Control, 1992
Objectives-Familial aggregation of testicular germ cell tumor (TGCT) has been reported, but it is... more Objectives-Familial aggregation of testicular germ cell tumor (TGCT) has been reported, but it is unclear if familial TGCT represents a unique entity with distinct clinicopathologic characteristics.
Transfusion, 1979
Platelet concentrates were prepared using the hemonetics Model 30 (M-30) and a multiunit bag pher... more Platelet concentrates were prepared using the hemonetics Model 30 (M-30) and a multiunit bag pheresls method. Comparisons of collection efficiency uaIng paired donor collections and posttransfusion recovery using the stune donor-recipient pairs were made for the two methods. The M-30 proved consistently superior as a method of collection in terms of efficiency and yield per hour (p < .001). When the platelets obtained were transfused to HL-A matched, clinically stable, thromhocytopenic patients with acute leukemia simllnr increments within the expected range were obtained at 1 hour and 18 hours posttransfusion. While the M-30 is a more efficient collection method, the bag method is still relatively eflicient and may be more suitable for smder centers and specialized uses.
The Surgeon, 2008
The management of gastric lymphoma is controversial and a wide variety of unimodality or multimod... more The management of gastric lymphoma is controversial and a wide variety of unimodality or multimodality approaches have been used. The aim of this report is to highlight the variety of treatment regimens deployed, the outcomes achieved and to present a modern management approach for this enigmatic tumour. Results: 42 cases of primary gastric lymphoma managed at one centre over a 15year period were reviewed. Weight loss (52%), pain (41%) and anorexia (33%) were the most common presenting symptoms. Most patients (86%) had high-grade lymphoma. Primary treatment modalities included surgery (36%), chemotherapy (40%), supportive care only (22%) and Hpylori eradication (2%). Adjuvant therapies included chemotherapy (17%), radiotherapy (7%) and combined chemoradiotherapy (5%). The overall median survival was 53 months, with a Ý ve year survival of 46%. In the curative group, the median survival was 75 months and Ý ve year survival 58%. Curative surgery or chemotherapy +/-radiotherapy were similarly effective for stage IE and IIE disease. Conclusions: The prognosis for gastric lymphoma is grade-and stage-dependent. With equivalent outcomes for cure in localised gastric lymphoma for surgery and chemotherapy, the latter is preferred in this unit because of gastric preservation, with surgery being reserved for failed medical management or presentations with haemorrhage, perforation or obstruction refractive to steroid therapy.
The Oncologist, 2001
The Ireland-Northern Ireland-National Cancer Institute Cancer Consortium was launched in October ... more The Ireland-Northern Ireland-National Cancer Institute Cancer Consortium was launched in October of 1999, at a conference in Belfast, Northern Ireland, for the development of cancer programs in Ireland and Northern Ireland, where cancer is a significant cause of mortality and morbidity. Cancer services there have undergone major restructuring as a result of several government reports. Specifically, the National Strategy Document for Cancer proposed that cancer treatment services should be centered around primary care services, regional services, and a national coordinating structure where supra-regional centers would deliver specialist surgery, medical and radiation oncology, rehabilitation, and specialist palliative care. Therefore, this was an opportune time to bring the National Cancer Institute (NCI) on board in a determined effort to redevelop and significantly improve services and outcomes for cancer patients throughout the island. During the NCI All Ireland Cancer Consortium, initial major goals were established as follows: A) To share best available technology and enhance clinical research; B) conduct joint clinical research studies involving people from all jurisdictions; C) sponsor formal training exchanges for Irish and American scholars in cancer programs in partner institutions; D) implement the use of teleconferencing, telesynergy, and other information technology capabilities to facilitate education, and E) consolidate the Cancer Registries of Ireland and Northern Ireland and learn more about cancer incidence and trends on the entire island. In the past year, significant advances have been made in all these areas. Plans are already under way for the second NCI All Ireland Cancer Conference which will be held in late 2002 and feature speakers from Ireland, Northern Ireland, the U.S., and other areas. It will be open to all oncologists, researchers, nurses, students, and other health care professionals interested in learning and enhancing cancer care and research.
The Breast, 2011
Little information is available regarding the management of BRCA-related breast cancer in Ireland... more Little information is available regarding the management of BRCA-related breast cancer in Ireland. A cancer genetics programme was initiated in 1992 at our institution to provide counselling and expert management for those with cancers resulting from inherited predisposition. We examined a cohort of BRCA mutation-carriers treated at a single institution over 16 years. A total of 107 women from 57 families were found to be carriers of mutations in BRCA1/2. Bilateral salpingo-oophorectomy was the most common prophylactic surgery performed. Overall survival between BRCA-related and sporadic breast cancer was equivalent. This is the first publication on surgical management of BRCA-mutation carriers in Ireland. It is imperative that those considered likely to harbour a mutation are referred early to a dedicated clinic so that appropriate counselling, testing and subsequent management to reduce the risk of dying from cancer can be undertaken.
Supportive Care in Cancer, 1993
Four-hourly temperature charts relating to 63 febrile neutropenic episodes in 32 patients were as... more Four-hourly temperature charts relating to 63 febrile neutropenic episodes in 32 patients were assessed for a circadian distribution to the onset of fever (> 37.5 degrees C) using the Edward's test. A highly significant distribution was found with the maximum incidence of febrile events between the hours of 5 p.m. and midnight (acrophase 9.30 p.m.). Patients were 5.53 times more likely to develop fever at 9.30 p.m. that 9.30 a.m.