Anastrozole: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

ANASTROZOLE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N...

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ANASTROZOLE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Anastrozole: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84330-9 1. Anastrozole-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on anastrozole. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ANASTROZOLE.......................................................................................... 3 Overview........................................................................................................................................ 3 Federally Funded Research on Anastrozole ................................................................................... 3 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. NUTRITION AND ANASTROZOLE ................................................................................ 21 Overview...................................................................................................................................... 21 Finding Nutrition Studies on Anastrozole .................................................................................. 21 Federal Resources on Nutrition ................................................................................................... 23 Additional Web Resources ........................................................................................................... 23 CHAPTER 3. CLINICAL TRIALS AND ANASTROZOLE ...................................................................... 25 Overview...................................................................................................................................... 25 Recent Trials on Anastrozole ....................................................................................................... 25 Keeping Current on Clinical Trials ............................................................................................. 30 CHAPTER 4. PATENTS ON ANASTROZOLE ...................................................................................... 33 Overview...................................................................................................................................... 33 Patent Applications on Anastrozole ............................................................................................ 33 Keeping Current .......................................................................................................................... 35 CHAPTER 5. BOOKS ON ANASTROZOLE .......................................................................................... 37 Overview...................................................................................................................................... 37 Book Summaries: Online Booksellers........................................................................................... 37 Chapters on Anastrozole .............................................................................................................. 37 CHAPTER 6. PERIODICALS AND NEWS ON ANASTROZOLE ............................................................ 39 Overview...................................................................................................................................... 39 News Services and Press Releases................................................................................................ 39 Academic Periodicals covering Anastrozole................................................................................. 42 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 45 Overview...................................................................................................................................... 45 U.S. Pharmacopeia....................................................................................................................... 45 Commercial Databases ................................................................................................................. 46 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 49 Overview...................................................................................................................................... 49 NIH Guidelines............................................................................................................................ 49 NIH Databases............................................................................................................................. 51 Other Commercial Databases....................................................................................................... 53 APPENDIX B. PATIENT RESOURCES ................................................................................................. 55 Overview...................................................................................................................................... 55 Patient Guideline Sources............................................................................................................ 55 Finding Associations.................................................................................................................... 57 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 59 Overview...................................................................................................................................... 59 Preparation................................................................................................................................... 59 Finding a Local Medical Library.................................................................................................. 59 Medical Libraries in the U.S. and Canada ................................................................................... 59 ONLINE GLOSSARIES.................................................................................................................. 65 Online Dictionary Directories ..................................................................................................... 65 ANASTROZOLE DICTIONARY.................................................................................................. 67 INDEX ................................................................................................................................................ 85

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with anastrozole is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about anastrozole, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to anastrozole, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on anastrozole. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to anastrozole, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on anastrozole. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON ANASTROZOLE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on anastrozole.

Federally Funded Research on Anastrozole The U.S. Government supports a variety of research studies relating to anastrozole. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to anastrozole. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore anastrozole. The following is typical of the type of information found when searching the CRISP database for anastrozole: •

Project Title: ESTROGEN SUPPRESSION IN MALES--METABOLIC & LINEAR Principal Investigator & Institution: Mauras, Nelly; Chief; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: The specific and important role of estrogens in promoting epiphyseal closure, even in males, has been recently characterized. However, the metabolic impact of

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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estrogen's effect in the male has not been properly studied in humans. These studies were therefore designed to address the role of estrogen on both whole body protein metabolism and epiphyseal closure in males, through the use of an aromatase inihibitor (Anastrozole). Data generated from these studies may provide important information in the treatment of young males with growth hormone deficiency. These studies are conducted at the Nemours Children's Clinic in Jacksonville, Florida. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FEMALE HORMONES AND VISION Principal Investigator & Institution: Eisner, Alvin; Senior Scientist; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 28-FEB-2007 Summary: (provided by applicant): The long-term goal is to elucidate the roles that female hormones have on the eye and vision. The information gained is expected to provide quantitative means of assessing duration-dependent effects of medications that affect estrogen receptors or that alter estrogen levels. The clinical emphasis will be on 2 types of medications - selective estrogen receptor modulators (SERMS) and aromatase inhibitors. Both are used as adjuvant therapy for early-stage breast cancer, or are likely to be used for this purpose or for breast cancer prophylaxis. SERMS can act either as estrogen agonists or antagonists depending on the target tissue. Aromatase inhibitors block the production of estrogen. The main objective is to identify the functional and anatomical changes that occur in the eye and visual system as a result of estrogenreceptor action and to elucidate the effects of 2 SERMS, tamoxifen and raloxifene, as functions of their durations of use. Because tamoxifen has long been the medication of choice for adjuvant breast cancer therapy and has been shown to affect the eye and vision, it will serve as the focus. In this way, potential side effects of newer medications can be compared against those of the standard of care. The main use of raloxifene at present is to prevent osteoporosis. The aromatase inhibitor to be evaluated, anastrozole, currently is used for treating advanced breast cancer. There are 4 specific aims: (1) To define the changes of visual function that occur during the 5-year period of tamoxifen use. A longitudinal design will be used to test 2 hypotheses: a) that tamoxifen alters the adaptation properties of SWS-cone pathways in the visual-field periphery, and b) that 2 distinct tamoxifen-user response groups can be defined on the basis of visual changes that occur after several years. Psychophysical measures will be compared with results of automated perimetry. (2) To determine the time course of tamoxifen-induced changes of ocular anatomy. A longitudinal design will be used to test the hypothesis that the retinal nerve fiber layer often thickens during year 1 of tamoxifen use but later thins. Anatomical measures will be made using the Heidelberg Retina Tomograph and the Zeiss Ocular Coherence Tomograher. (3) To distinguish the effects of raloxifene and anastrozole from those of tamoxifen. The same techniques will be used as for Specific Aims 1 and 2. (4) To determine the prevalence of cyclic changes of SWS-cone-mediated sensitivity across the menstrual cycle. Data from healthy women who are identified as having large cyclic sensitivity changes will be obtained from high and low estrogenresponse portions of the menstrual cycle, and the visual changes that occur over weeks will be used to help interpret effects of prolonged exposure to SERMS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies

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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with anastrozole, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “anastrozole” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for anastrozole (hyperlinks lead to article summaries): •

A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: a Gynecologic Oncology Group study. Author(s): Rose PG, Brunetto VL, VanLe L, Bell J, Walker JL, Lee RB. Source: Gynecologic Oncology. 2000 August; 78(2): 212-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10926805&dopt=Abstract

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A phase III trial comparing anastrozole (1 and 10 milligrams), a potent and selective aromatase inhibitor, with megestrol acetate in postmenopausal women with advanced breast carcinoma. Arimidex Study Group. Author(s): Buzdar AU, Jones SE, Vogel CL, Wolter J, Plourde P, Webster A. Source: Cancer. 1997 February 15; 79(4): 730-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9024711&dopt=Abstract

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A randomised comparison of oestrogen suppression with anastrozole and formestane in postmenopausal patients with advanced breast cancer. Author(s): Kleeberg UR, Dowsett M, Carrion RP, Dodwell DJ, Vorobiof DA, Aparicio LA, Robertson JF. Source: Oncology. 1997; 54 Suppl 2: 19-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394856&dopt=Abstract

3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A randomised trial comparing two doses of the new selective aromatase inhibitor anastrozole (Arimidex) with megestrol acetate in postmenopausal patients with advanced breast cancer. Author(s): Jonat W, Howell A, Blomqvist C, Eiermann W, Winblad G, Tyrrell C, Mauriac L, Roche H, Lundgren S, Hellmund R, Azab M. Source: European Journal of Cancer (Oxford, England : 1990). 1996 March; 32A(3): 40412. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8814682&dopt=Abstract

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A randomized, open, parallel-group trial to compare the endocrine effects of oral anastrozole (Arimidex) with intramuscular formestane in postmenopausal women with advanced breast cancer. Author(s): Vorobiof DA, Kleeberg UR, Perez-Carrion R, Dodwell DJ, Robertson JF, Calvo L, Dowsett M, Clack G. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 1999 October; 10(10): 1219-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10586340&dopt=Abstract

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Advanced breast cancer updates on anastrozole versus tamoxifen. Author(s): Nabholtz JM; Arimidex Study Group. Source: The Journal of Steroid Biochemistry and Molecular Biology. 2003 September; 86(3-5): 321-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14623528&dopt=Abstract

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An open randomised trial of second-line endocrine therapy in advanced breast cancer. comparison of the aromatase inhibitors letrozole and anastrozole. Author(s): Rose C, Vtoraya O, Pluzanska A, Davidson N, Gershanovich M, Thomas R, Johnson S, Caicedo JJ, Gervasio H, Manikhas G, Ben Ayed F, Burdette-Radoux S, Chaudri-Ross HA, Lang R. Source: European Journal of Cancer (Oxford, England : 1990). 2003 November; 39(16): 2318-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14556923&dopt=Abstract

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An overview of the pharmacology and pharmacokinetics of the newer generation aromatase inhibitors anastrozole, letrozole, and exemestane. Author(s): Buzdar AU, Robertson JF, Eiermann W, Nabholtz JM. Source: Cancer. 2002 November 1; 95(9): 2006-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404296&dopt=Abstract

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Anastrozole ('Arimidex') blocks oestrogen synthesis both peripherally and within the breast in postmenopausal women with large operable breast cancer. Author(s): Miller WR, Stuart M, Sahmoud T, Dixon JM. Source: British Journal of Cancer. 2002 October 21; 87(9): 950-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434282&dopt=Abstract

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Anastrozole (Arimidex) in clinical practice versus the old 'gold standard', tamoxifen. Author(s): Buzdar AU. Source: Expert Review of Anticancer Therapy. 2002 December; 2(6): 623-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503208&dopt=Abstract

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Anastrozole (Arimidex) versus tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: survival analysis and updated safety results. Author(s): Nabholtz JM, Bonneterre J, Buzdar A, Robertson JF, Thurlimann B. Source: European Journal of Cancer (Oxford, England : 1990). 2003 August; 39(12): 16849. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12888362&dopt=Abstract

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Anastrozole (Arimidex), a new aromatase inhibitor for advanced breast cancer: mechanism of action and role in management. Author(s): Hortobagyi GN, Buzdar AU. Source: Cancer Investigation. 1998; 16(6): 385-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9679529&dopt=Abstract

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Anastrozole (Arimidex)--an aromatase inhibitor for the adjuvant setting? Author(s): Buzdar AU. Source: British Journal of Cancer. 2001 November; 85 Suppl 2: 6-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11900212&dopt=Abstract

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Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Author(s): Baum M, Budzar AU, Cuzick J, Forbes J, Houghton JH, Klijn JG, Sahmoud T; ATAC Trialists' Group. Source: Lancet. 2002 June 22; 359(9324): 2131-9. Erratum In: Lancet 2002 November 9; 360(9344): 1520. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090977&dopt=Abstract

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Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses. Author(s): Baum M, Buzdar A, Cuzick J, Forbes J, Houghton J, Howell A, Sahmoud T; The ATAC (Arimidex, Tamoxifen Alone or in Combination) Trialists' Group. Source: Cancer. 2003 November 1; 98(9): 1802-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14584060&dopt=Abstract

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Anastrozole as a preventive agent in breast cancer. Author(s): Thornton H. Source: Lancet. 2003 May 31; 361(9372): 1911-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12788605&dopt=Abstract

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Anastrozole for ductal carcinoma in situ. Author(s): Cuzick J, O'Neill C, Howell T, Forbes J. Source: Lancet. 2003 September 6; 362(9386): 832-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13678886&dopt=Abstract

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Anastrozole in the management of breast cancer. Author(s): Nabholtz JM, Reese D. Source: Expert Opinion on Pharmacotherapy. 2002 September; 3(9): 1329-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186625&dopt=Abstract

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Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: results of a North American multicenter randomized trial. Arimidex Study Group. Author(s): Nabholtz JM, Buzdar A, Pollak M, Harwin W, Burton G, Mangalik A, Steinberg M, Webster A, von Euler M. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2000 November 15; 18(22): 3758-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11078488&dopt=Abstract

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Anastrozole is superior to tamoxifen as first-line therapy in hormone receptor positive advanced breast carcinoma. Author(s): Bonneterre J, Buzdar A, Nabholtz JM, Robertson JF, Thurlimann B, von Euler M, Sahmoud T, Webster A, Steinberg M; Arimidex Writing Committee; Investigators Committee Members. Source: Cancer. 2001 November 1; 92(9): 2247-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11745278&dopt=Abstract

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Anastrozole is superior to tamoxifen as first-line therapy in hormone receptorpositive advanced breast carcinoma. Author(s): Gluck S. Source: Cancer. 2002 December 1; 95(11): 2442-3; Author Reply 2443-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436453&dopt=Abstract

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Anastrozole shows evidence of activity in postmenopausal patients who have responded or stabilised on formestane therapy. Author(s): Harper-Wynne C, Coombes RC. Source: European Journal of Cancer (Oxford, England : 1990). 1999 May; 35(5): 744-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10505035&dopt=Abstract

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Anastrozole versus megestrol acetate in the treatment of postmenopausal women with advanced breast carcinoma: results of a survival update based on a combined analysis of data from two mature phase III trials. Arimidex Study Group. Author(s): Buzdar AU, Jonat W, Howell A, Jones SE, Blomqvist CP, Vogel CL, Eiermann W, Wolter JM, Steinberg M, Webster A, Lee D. Source: Cancer. 1998 September 15; 83(6): 1142-52. Erratum In: Cancer 1999 February 15; 85(4): 1010. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9740079&dopt=Abstract

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Anastrozole versus progestins/tamoxifen. Author(s): Beat T. Source: European Journal of Cancer (Oxford, England : 1990). 2002 November; 38 Suppl 6: S49-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409073&dopt=Abstract

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Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in 668 postmenopausal women: results of the Tamoxifen or Arimidex Randomized Group Efficacy and Tolerability study. Author(s): Bonneterre J, Thurlimann B, Robertson JF, Krzakowski M, Mauriac L, Koralewski P, Vergote I, Webster A, Steinberg M, von Euler M. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2000 November 15; 18(22): 3748-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11078487&dopt=Abstract

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Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer: methodologic issues. Author(s): Winquist E, Bramwell V, Vandenberg T. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 September 1; 20(17): 3748-9; Author Reply 3749-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12202679&dopt=Abstract

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Anastrozole versus tamoxifen as first-line therapy in postmenopausal patients with hormone-dependent advanced breast cancer: a prospective, randomized, phase III study. Author(s): Milla-Santos A, Milla L, Portella J, Rallo L, Pons M, Rodes E, Casanovas J, Puig-Gali M. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 2003 June; 26(3): 317-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796608&dopt=Abstract

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Anastrozole, a potent and selective aromatase inhibitor, versus megestrol acetate in postmenopausal women with advanced breast cancer: results of overview analysis of two phase III trials. Arimidex Study Group. Author(s): Buzdar A, Jonat W, Howell A, Jones SE, Blomqvist C, Vogel CL, Eiermann W, Wolter JM, Azab M, Webster A, Plourde PV. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1996 July; 14(7): 2000-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8683230&dopt=Abstract

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Anastrozole. A review of its use in the management of postmenopausal women with advanced breast cancer. Author(s): Wiseman LR, Adkins JC. Source: Drugs & Aging. 1998 October; 13(4): 321-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9805213&dopt=Abstract

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Anastrozole. An effective, second-line hormonal treatment for advanced breast cancer. Author(s): Camp-Sorrell D. Source: Cancer Practice. 1997 November-December; 5(6): 391-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9397709&dopt=Abstract

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Anastrozole: a new addition to the armamentarium against advanced breast cancer. Author(s): Buzdar AU. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 1998 April; 21(2): 161-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9537204&dopt=Abstract

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Anastrozole: a new selective nonsteroidal aromatase inhibitor. Author(s): Goss PE, Tye LM. Source: Oncology (Huntingt). 1997 November; 11(11): 1697-703; Discussion 1707-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394367&dopt=Abstract

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Anastrozole: a selective aromatase inhibitor for the treatment of breast cancer. Author(s): Higa GM, alKhouri N. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 1998 March 1; 55(5): 445-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9522927&dopt=Abstract

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Anastrozole: in early breast cancer. Author(s): Wellington K, Faulds DM. Source: Drugs. 2002; 62(17): 2483-90; Discussion 2491-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12421108&dopt=Abstract

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Anastrozole: pharmacological and clinical profile in postmenopausal women with breast cancer. Author(s): Koberle D, Thurlimann B. Source: Expert Review of Anticancer Therapy. 2001 August; 1(2): 169-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12113022&dopt=Abstract

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Anastrozole--a new generation in aromatase inhibition: clinical pharmacology. Author(s): Dowsett M, Lonning PE. Source: Oncology. 1997; 54 Suppl 2: 11-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394854&dopt=Abstract

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Anastrozole-induced remission of diaphragmatic paralysis from metastatic breast cancer treated with multiple prior therapies. Author(s): Suzuma T, Sakurai T, Yoshimura G, Umemura T, Shimizu Y, Yang QF, Okamura Y. Source: Breast Cancer. 2003; 10(2): 153-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12736569&dopt=Abstract

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'Arimidex' (anastrozole) versus tamoxifen as adjuvant therapy in postmenopausal women with early breast cancer--efficacy overview. Author(s): Buzdar AU; ATAC trialists' group. Source: The Journal of Steroid Biochemistry and Molecular Biology. 2003 September; 86(3-5): 399-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14623537&dopt=Abstract

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Arimidex (ZD1033): a selective, potent inhibitor of aromatase in postmenopausal female volunteers. Author(s): Yates RA, Dowsett M, Fisher GV, Selen A, Wyld PJ. Source: British Journal of Cancer. 1996 February; 73(4): 543-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8595172&dopt=Abstract

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ARIMIDEX: a new oral, once-a-day aromatase inhibitor. Author(s): Plourde PV, Dyroff M, Dowsett M, Demers L, Yates R, Webster A. Source: The Journal of Steroid Biochemistry and Molecular Biology. 1995 June; 53(1-6): 175-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7626450&dopt=Abstract

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ARIMIDEX: a potent and selective aromatase inhibitor for the treatment of advanced breast cancer. Author(s): Buzdar AU, Jonat W, Howell A, Plourde PV. Source: The Journal of Steroid Biochemistry and Molecular Biology. 1997 April; 61(3-6): 145-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9365184&dopt=Abstract

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Anastrozole

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Aromatase inhibitors in prevention--data from the ATAC (arimidex, tamoxifen alone or in combination) trial and the design of IBIS-II (the second International Breast Cancer Intervention Study). Author(s): Cuzick J. Source: Recent Results Cancer Res. 2003; 163: 96-103; Discussion 264-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12903846&dopt=Abstract

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Biological activity of anastrozole in postmenopausal patients with advanced breast cancer: effects on estrogens and bone metabolism. Author(s): Bajetta E, Martinetti A, Zilembo N, Pozzi P, La Torre I, Ferrari L, Seregni E, Longarini R, Salvucci G, Bombardieri E. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2002 July; 13(7): 1059-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12176784&dopt=Abstract

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Clarification of anastrozole/megestrol acetate trial program design. Author(s): Howell A. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2000 December 15; 18(24): 4109. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11118472&dopt=Abstract

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Clinical efficacy of the aromatase inhibitor anastrozole in relation to prolactin secretion in heavily pretreated metastatic breast cancer. Author(s): Barni S, Lissoni P, Meregalli S, Ardizzoia A, Mengo S, Musco F, Merlini D, Tancini G. Source: Tumori. 1998 January-February; 84(1): 45-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9619713&dopt=Abstract

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Clinical overview of anastrozole--a new selective oral aromatase inhibitor. Author(s): Jonat W. Source: Oncology. 1997; 54 Suppl 2: 15-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9394855&dopt=Abstract

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Could exemestane affect insulin-like growth factors, interleukin 6 and bone metabolism in postmenopausal advanced breast cancer patients after failure on aminoglutethimide, anastrozole or letrozole? Author(s): Ferrari L, Bajetta E, Martinetti A, Celio L, Longarini R, La Torre I, Buzzoni R, Gattinoni L, Seregni E, Bombardieri E. Source: International Journal of Oncology. 2003 May; 22(5): 1081-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684675&dopt=Abstract

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Critique of survival update analysis from two phase III anastrozole clinical trials. Author(s): Buzdar AU. Source: Annals of Surgical Oncology : the Official Journal of the Society of Surgical Oncology. 1999 December; 6(8 Suppl): 8S-11S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619453&dopt=Abstract

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Delayed closure of epiphyseal cartilages induced by the aromatase inhibitor anastrozole. Would it help short children grow up? Author(s): Faglia G, Arosio M, Porretti S. Source: J Endocrinol Invest. 2000 December; 23(11): 721-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11194703&dopt=Abstract

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Double-blind, randomized trial comparing the efficacy and tolerability of fulvestrant versus anastrozole in postmenopausal women with advanced breast cancer progressing on prior endocrine therapy: results of a North American trial. Author(s): Osborne CK, Pippen J, Jones SE, Parker LM, Ellis M, Come S, Gertler SZ, May JT, Burton G, Dimery I, Webster A, Morris C, Elledge R, Buzdar A. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 August 15; 20(16): 3386-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12177098&dopt=Abstract

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Effect of neoadjuvant treatment with anastrozole on tumour histology in postmenopausal women with large operable breast cancer. Author(s): Anderson TJ, Dixon JM, Stuart M, Sahmoud T, Miller WR. Source: British Journal of Cancer. 2002 July 29; 87(3): 334-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12177804&dopt=Abstract

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Effective aromatase inhibition by anastrozole in a patient with gonadotropinindependent precocious puberty in McCune-Albright syndrome. Author(s): Roth C, Freiberg C, Zappel H, Albers N. Source: J Pediatr Endocrinol Metab. 2002; 15 Suppl 3: 945-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12199354&dopt=Abstract

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Effects of the aromatase inhibitor anastrozole on serum oestrogens in Japanese and Caucasian women. Author(s): Dowsett M, Donaldson K, Tsuboi M, Wong J, Yates R. Source: Cancer Chemotherapy and Pharmacology. 2000; 46(1): 35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10912575&dopt=Abstract

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Efficacy of anastrozole in male breast cancer. Author(s): Giordano SH, Valero V, Buzdar AU, Hortobagyi GN. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 2002 June; 25(3): 235-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12040279&dopt=Abstract

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Efficacy of tamoxifen following anastrozole ('Arimidex') compared with anastrozole following tamoxifen as first-line treatment for advanced breast cancer in postmenopausal women. Author(s): Thurlimann B, Robertson JF, Nabholtz JM, Buzdar A, Bonneterre J; Arimidex Study Group. Source: European Journal of Cancer (Oxford, England : 1990). 2003 November; 39(16): 2310-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14556922&dopt=Abstract

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Experience of hormonal therapy with anastrozole for previously treated metastatic breast cancer. Author(s): Lavrenkov K, Man S, Geffen DB, Cohen Y. Source: Isr Med Assoc J. 2002 March; 4(3): 176-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11908256&dopt=Abstract

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Formestane, a steroidal aromatase inhibitor after failure of non-steroidal aromatase inhibitors (anastrozole and letrozole): is a clinical benefit still achievable? Author(s): Carlini P, Frassoldati A, De Marco S, Casali A, Ruggeri EM, Nardi M, Papaldo P, Fabi A, Paoloni F, Cognetti F. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2001 November; 12(11): 1539-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11822752&dopt=Abstract

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Fulvestrant (Faslodex) versus anastrozole for the second-line treatment of advanced breast cancer in subgroups of postmenopausal women with visceral and non-visceral metastases: combined results from two multicentre trials. Author(s): Mauriac L, Pippen JE, Quaresma Albano J, Gertler SZ, Osborne CK. Source: European Journal of Cancer (Oxford, England : 1990). 2003 June; 39(9): 1228-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763210&dopt=Abstract

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Fulvestrant versus anastrozole as second-line treatment of advanced breast cancer in postmenopausal women. Author(s): Vergote I; Faslodex 0020 and 0021 Investigators. Source: European Journal of Cancer (Oxford, England : 1990). 2002 November; 38 Suppl 6: S57-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409076&dopt=Abstract

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Fulvestrant versus anastrozole for the treatment of advanced breast carcinoma in postmenopausal women: a prospective combined analysis of two multicenter trials. Author(s): Robertson JF, Osborne CK, Howell A, Jones SE, Mauriac L, Ellis M, Kleeberg UR, Come SE, Vergote I, Gertler S, Buzdar A, Webster A, Morris C. Source: Cancer. 2003 July 15; 98(2): 229-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12872340&dopt=Abstract

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Fulvestrant, formerly ICI 182,780, is as effective as anastrozole in postmenopausal women with advanced breast cancer progressing after prior endocrine treatment. Author(s): Howell A, Robertson JF, Quaresma Albano J, Aschermannova A, Mauriac L, Kleeberg UR, Vergote I, Erikstein B, Webster A, Morris C. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 August 15; 20(16): 3396-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12177099&dopt=Abstract

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Influence of anastrozole (Arimidex), a selective, non-steroidal aromatase inhibitor, on in vivo aromatisation and plasma oestrogen levels in postmenopausal women with breast cancer. Author(s): Geisler J, King N, Dowsett M, Ottestad L, Lundgren S, Walton P, Kormeset PO, Lonning PE. Source: British Journal of Cancer. 1996 October; 74(8): 1286-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8883419&dopt=Abstract

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Influence of letrozole and anastrozole on total body aromatization and plasma estrogen levels in postmenopausal breast cancer patients evaluated in a randomized, cross-over study. Author(s): Geisler J, Haynes B, Anker G, Dowsett M, Lonning PE. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 February 1; 20(3): 751-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821457&dopt=Abstract

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Influence of neoadjuvant anastrozole (Arimidex) on intratumoral estrogen levels and proliferation markers in patients with locally advanced breast cancer. Author(s): Geisler J, Detre S, Berntsen H, Ottestad L, Lindtjorn B, Dowsett M, Einstein Lonning P. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 2001 May; 7(5): 1230-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11350888&dopt=Abstract

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Inhibition of human drug metabolizing cytochromes P450 by anastrozole, a potent and selective inhibitor of aromatase. Author(s): Grimm SW, Dyroff MC. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1997 May; 25(5): 598-602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9152599&dopt=Abstract

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Is anastrozole superior to tamoxifen as first-line therapy for advanced breast cancer? Author(s): Costa SD, Kaufmann M. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 May 1; 19(9): 2580; Author Reply 2580-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331346&dopt=Abstract

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Is anastrozole superior to tamoxifen as first-line therapy for advanced breast cancer? Author(s): Tonkin K. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 May 1; 19(9): 2579-80; Author Reply 2580-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331344&dopt=Abstract

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Is anastrozole superior to tamoxifen as first-line therapy for advanced breast cancer? Author(s): Copur MS, Ledakis P, Bolton M, Norvell M, Muhvic J. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 May 1; 19(9): 2578; Author Reply 2580-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331343&dopt=Abstract

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Is anastrozole superior to tamoxifen as first-line therapy for advanced breast cancer? Author(s): Bagley CM Jr, Rowbotham RK. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 May 1; 19(9): 2578-9; Author Reply 2580-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331342&dopt=Abstract

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Is anastrozole superior to tamoxifen as first-line therapy for advanced breast cancer? Author(s): Panasci LC. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 May 1; 19(9): 2578; Author Reply 2580-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331341&dopt=Abstract

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Is there a benefit by the sequence anastrozole-formestane for postmenopausal metastatic breast cancer women? Author(s): Carlini P, Ferretti G, Di Cosimo S, Colella E, Tonachella R, Romiti A, Tomao S, Frassoldati A, Papaldo P, Fabi A, Ruggeri EM, Cognetti F. Source: The Journal of Steroid Biochemistry and Molecular Biology. 2003 July; 86(1): 1079. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943750&dopt=Abstract

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Pharmacokinetics of anastrozole and tamoxifen alone, and in combination, during adjuvant endocrine therapy for early breast cancer in postmenopausal women: a subprotocol of the 'Arimidex and tamoxifen alone or in combination' (ATAC) trial. Author(s): Dowsett M, Cuzick J, Howell A, Jackson I; ATAC Trialists' Group. Source: British Journal of Cancer. 2001 August 3; 85(3): 317-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11487258&dopt=Abstract

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Pharmacokinetics of anastrozole in Chinese male volunteers. Author(s): Yuan J, Wang PQ, Ge SR, An FR, Shi AG, Chen J, Liang JY. Source: Acta Pharmacologica Sinica. 2001 June; 22(6): 573-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11747767&dopt=Abstract

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Pharmacological and clinical profile of anastrozole. Author(s): Lonning PE, Geisler J, Dowsett M. Source: Breast Cancer Research and Treatment. 1998; 49 Suppl 1: S53-7; Discussion S737. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9797018&dopt=Abstract

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Phase II trial of anastrozole in women with asymptomatic mullerian cancer. Author(s): del Carmen MG, Fuller AF, Matulonis U, Horick NK, Goodman A, Duska LR, Penson R, Campos S, Roche M, Seiden MV. Source: Gynecologic Oncology. 2003 December; 91(3): 596-602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14675683&dopt=Abstract

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Questions about anastrozole for early breast cancer. Author(s): Thornton H. Source: Lancet. 2002 December 7; 360(9348): 1890; Author Reply 1890-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480405&dopt=Abstract

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Questions about anastrozole for early breast cancer. Author(s): Stasi R, Terzoli E. Source: Lancet. 2002 December 7; 360(9348): 1890; Author Reply 1890-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480404&dopt=Abstract

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Randomised study of anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women. Author(s): Vergote I, Bonneterre J, Thurlimann B, Robertson J, Krzakowski M, Mauriac L, Koralewski L, Webster A, Steinberg M, von Euler M. Source: European Journal of Cancer (Oxford, England : 1990). 2000 September; 36 Suppl 4: S84-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11056332&dopt=Abstract

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Rapid determination of anastrozole in plasma by gas chromatography with electron capture detection and its application to an oral pharmacokinetic study in healthy volunteers. Author(s): Duan G, Liang J, Zuo M. Source: Biomedical Chromatography : Bmc. 2002 September; 16(6): 400-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12228897&dopt=Abstract

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Role of anastrozole in adjuvant therapy for postmenopausal patients. Author(s): Buzdar AU. Source: Seminars in Oncology. 2003 October; 30(5 Suppl 16): 21-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14613023&dopt=Abstract

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Sequential hormonal therapy for metastatic breast cancer after adjuvant tamoxifen or anastrozole. Author(s): Carlson RW, Henderson IC. Source: Breast Cancer Research and Treatment. 2003; 80 Suppl 1: S19-26; Discussion S278. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14535531&dopt=Abstract

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Short-term effects of anastrozole treatment on insulin-like growth factor system in postmenopausal advanced breast cancer patients. Author(s): Ferrari L, Martinetti A, Zilembo N, Pozzi P, Buzzoni R, La Torre I, Gattinoni L, Catena L, Vitali M, Celio L, Seregni E, Bombardieri E, Bajetta E. Source: The Journal of Steroid Biochemistry and Molecular Biology. 2002 April; 80(4-5): 411-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11983488&dopt=Abstract

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Static disease on anastrozole provides similar benefit as objective response in patients with advanced breast cancer. Author(s): Robertson JF, Howell A, Buzdar A, von Euler M, Lee D. Source: Breast Cancer Research and Treatment. 1999 November; 58(2): 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10674881&dopt=Abstract

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The ATAC (Arimidex, Tamoxifen, Alone or in Combination) adjuvant breast cancer trial in postmenopausal patients: factors influencing the success of patient recruitment. Author(s): Baum M. Source: European Journal of Cancer (Oxford, England : 1990). 2002 October; 38(15): 19846. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376201&dopt=Abstract

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The effect of anastrozole on the pharmacokinetics of tamoxifen in post-menopausal women with early breast cancer. Author(s): Dowsett M, Tobias JS, Howell A, Blackman GM, Welch H, King N, Ponzone R, von Euler M, Baum M. Source: British Journal of Cancer. 1999 January; 79(2): 311-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9888474&dopt=Abstract

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The effect of anastrozole on the single-dose pharmacokinetics and anticoagulant activity of warfarin in healthy volunteers. Author(s): Yates RA, Wong J, Seiberling M, Merz M, Marz W, Nauck M. Source: British Journal of Clinical Pharmacology. 2001 May; 51(5): 429-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422000&dopt=Abstract

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The effects of neoadjuvant anastrozole (Arimidex) on tumor volume in postmenopausal women with breast cancer: a randomized, double-blind, singlecenter study. Author(s): Dixon JM, Renshaw L, Bellamy C, Stuart M, Hoctin-Boes G, Miller WR. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 2000 June; 6(6): 2229-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10873072&dopt=Abstract

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The preclinical pharmacology of “Arimidex” (anastrozole; ZD1033)--a potent, selective aromatase inhibitor. Author(s): Dukes M, Edwards PN, Large M, Smith IK, Boyle T. Source: The Journal of Steroid Biochemistry and Molecular Biology. 1996 July; 58(4): 43945. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8903429&dopt=Abstract

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Use of the aromatase inhibitor anastrozole in the treatment of patients with advanced prostate carcinoma. Author(s): Santen RJ, Petroni GR, Fisch MJ, Myers CE, Theodorescu D, Cohen RB. Source: Cancer. 2001 October 15; 92(8): 2095-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11596025&dopt=Abstract

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Validated assay for the quantification of anastrozole in human plasma by capillary gas chromatography-63Ni electron capture detection. Author(s): Bock MJ, Bara I, LeDonne N, Martz A, Dyroff M. Source: J Chromatogr B Biomed Sci Appl. 1997 October 24; 700(1-2): 131-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9390722&dopt=Abstract

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CHAPTER 2. NUTRITION AND ANASTROZOLE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and anastrozole.

Finding Nutrition Studies on Anastrozole The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “anastrozole” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

22

Anastrozole

The following information is typical of that found when using the “Full IBIDS Database” to search for “anastrozole” (or a synonym): •

A randomized, open, parallel-group trial to compare the endocrine effects of oral anastrozole (Arimidex) with intramuscular formestane in postmenopausal women with advanced breast cancer. Author(s): Sandton Oncology Centre, South Africa. Source: Vorobiof, D A Kleeberg, U R Perez Carrion, R Dodwell, D J Robertson, J F Calvo, L Dowsett, M Clack, G Ann-Oncol. 1999 October; 10(10): 1219-25 0923-7534

•

Anastrozole ('Arimidex') blocks oestrogen synthesis both peripherally and within the breast in postmenopausal women with large operable breast cancer. Author(s): Breast Unit, Western General Hospital, Edinburgh EH4 2XU, Scotland, UK. [email protected] Source: Miller, W R Stuart, M Sahmoud, T Dixon, J M Br-J-Cancer. 2002 October 21; 87(9): 950-5 0007-0920

•

Anastrozole shows evidence of activity in postmenopausal patients who have responded or stabilised on formestane therapy. Author(s): Department of Cancer Medicine, Imperial College School of Medicine, Charing Cross Hospital, London, U.K. Source: Harper Wynne, C Coombes, R C Eur-J-Cancer. 1999 May; 35(5): 744-6 0959-8049

•

Delayed closure of epiphyseal cartilages induced by the aromatase inhibitor anastrozole. Would it help short children grow up? Author(s): Institute of Endocrine Sciences, Ospedale Maggiore IRCCS, University of Milan, Italy. [email protected] Source: Faglia, G Arosio, M Porretti, S J-Endocrinol-Invest. 2000 December; 23(11): 721-3 0391-4097

•

Double-blind, randomized trial comparing the efficacy and tolerability of fulvestrant versus anastrozole in postmenopausal women with advanced breast cancer progressing on prior endocrine therapy: results of a North American trial. Author(s): Breast Center at Baylor College of Medicine, 1 Baylor Plaza, MS 600, Houston, TX 77030, USA. [email protected] Source: Osborne, C K Pippen, J Jones, S E Parker, L M Ellis, M Come, S Gertler, S Z May, J T Burton, G Dimery, I Webster, A Morris, C Elledge, R Buzdar, A J-Clin-Oncol. 2002 August 15; 20(16): 3386-95 0732-183X

•

Formestane, a steroidal aromatase inhibitor after failure of non-steroidal aromatase inhibitors (anastrozole and letrozole): is a clinical benefit still achievable? Author(s): Department of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy. [email protected] Source: Carlini, P Frassoldati, A De Marco, S Casali, A Ruggeri, E M Nardi, M Papaldo, P Fabi, A Paoloni, F Cognetti, F Ann-Oncol. 2001 November; 12(11): 1539-43 0923-7534

•

Fulvestrant, formerly ICI 182,780, is as effective as anastrozole in postmenopausal women with advanced breast cancer progressing after prior endocrine treatment. Author(s): Department of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom. [email protected] Source: Howell, A Robertson, J F R Quaresma Albano, J Aschermannova, A Mauriac, L Kleeberg, U R Vergote, I Erikstein, B Webster, A Morris, C J-Clin-Oncol. 2002 August 15; 20(16): 3396-403 0732-183X

•

The effect of anastrozole on the single-dose pharmacokinetics and anticoagulant activity of warfarin in healthy volunteers. Author(s): AstraZeneca, Alderley Park, Macclesfield, Cheshire, UK.

Nutrition

23

Source: Yates, R A Wong, J Seiberling, M Merz, M Marz, W Nauck, M Br-J-ClinPharmacol. 2001 May; 51(5): 429-35 0306-5251

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMD®Health: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. CLINICAL TRIALS AND ANASTROZOLE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning anastrozole.

Recent Trials on Anastrozole The following is a list of recent trials dedicated to anastrozole.5 Further information on a trial is available at the Web site indicated. •

Adjuvant Tamoxifen Compared With Anastrozole in Treating Postmenopausal Women With Ductal Carcinoma In Situ Condition(s): intraductal breast carcinoma; breast cancer in situ Study Status: This study is currently recruiting patients. Sponsor(s): Cancer Research UK Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using either tamoxifen or anastrozole may fight breast cancer by blocking the uptake of estrogen. It is not yet known whether tamoxifen is more effective than anastrozole in preventing breast cancer after surgery for ductal carcinoma in situ. PURPOSE: Randomizedphase III trial to compare the effectiveness of adjuvant tamoxifen with that of anastrozole in treating postmenopausal women who have undergone surgery to remove ductal carcinoma in situ. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00072462

5

These are listed at www.ClinicalTrials.gov.

26

•

Anastrozole

Anastrozole and Gefitinib Compared With Fulvestrant and Gefitinib in Treating Postmenopausal Women With Recurrent or Metastatic Breast Cancer Condition(s): recurrent breast cancer; stage IV breast cancer Study Status: This study is currently recruiting patients. Sponsor(s): Eastern Cooperative Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using anastrozole and fulvestrant may fight breast cancer by blocking the uptake of estrogen. Gefitinib may stop the growth of cancer cells by blocking the enzymes necessary for cancer cell growth. It is not yet known whether gefitinib is more effective when combined with anastrozole or fulvestrant in treating breast cancer. PURPOSE: Randomizedphase II trial to study the effectiveness of anastrozole and gefitinib compared with fulvestrant and gefitinib in treating postmenopausal women who have recurrent or metastatic breast cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057941

•

Anastrozole and ZD 1839 in Treating Postmenopausal Women With Metastatic Breast Cancer Condition(s): recurrent breast cancer; stage IIIB breast cancer; stage IIIC breast cancer; stage IV breast cancer Study Status: This study is currently recruiting patients. Sponsor(s): Institute for Drug Development Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Anastrozole may fight breast cancer by blocking the production of estrogen by the tumor cells. Biological therapies such as ZD 1839 may interfere with the growth of the tumor cells and slow the growth of advanced solid tumors. Combining anastrozole with ZD 1839 may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining anastrozole with ZD 1839 in treating postmenopausal women who have metastatic breast cancer that has not responded to hormone therapy. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00049062

•

Anastrozole Compared With Tamoxifen After Lumpectomy Postmenopausal Women With Ductal Carcinoma in Situ

in

Treating

Condition(s): breast cancer in situ; intraductal breast carcinoma Study Status: This study is currently recruiting patients. Sponsor(s): National Surgical Adjuvant Breast and Bowel Project (NSABP); National Cancer Institute (NCI); North Central Cancer Treatment Group; Southwest Oncology Group; American College of Surgeons

Clinical Trials 27

Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Tamoxifen may fight breast cancer by blocking the uptake of estrogen. Anastrozole may fight breast cancer by decreasing estrogen production. It is not yet known whether anastrozole is more effective than tamoxifen in preventing the recurrence of breast cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of anastrozole to that of tamoxifen after lumpectomy in preventing the recurrence of breast cancer in postmenopausal women who have ductal carcinoma in situ and are undergoing radiation therapy. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00053898 •

Anastrozole With or Without Gefitinib in Treating Postmenopausal Women With Metastatic or Locally Recurrent Breast Cancer Condition(s): recurrent breast cancer; stage IIIA breast cancer; stage IIIB breast cancer; stage IIIC breast cancer; stage IV breast cancer Study Status: This study is currently recruiting patients. Sponsor(s): EORTC Breast Cancer Cooperative Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using anastrozole may fight breast cancer by reducing the production of estrogen. Gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Combining anastrozole with gefitinib may kill more tumor cells. PURPOSE: Randomizedphase II trial to compare the effectiveness of anastrozole with or without gefitinib in treating postmenopausal women who have metastatic or locallyrecurrent breast cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00066378

•

Anastrozole With or Without Trastuzumab in Treating Postmenopausal Women With Metastatic Breast Cancer Condition(s): stage IV breast cancer; recurrent breast cancer Study Status: This study is currently recruiting patients. Sponsor(s): Hoffmann-La Roche Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Anastrozole may fight breast cancer by blocking the production of estrogen by the tumor cells. Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. It is not yet known whether anastrozole is more effective with or without trastuzumab in treating metastatic breast cancer. PURPOSE: Randomizedphase II/III trial to compare the effectiveness of anastrozole plus trastuzumab with that of anastrozole alone in treating postmenopausal women who have metastatic breast cancer.

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Anastrozole

Phase(s): Phase II; Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00022672 •

Arimidex in McCune Albright Syndrome Condition(s): McCune-Albright Syndrome Study Status: This study is currently recruiting patients. Sponsor(s): AstraZeneca Purpose - Excerpt: The primary objective of this study is to evaluate the safety and efficacy of anastrozole 1 mg given once daily in subjects with McCune-Albright Syndrome. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00055302

•

Exemestane Compared With Anastrozole, With or Without Celecoxib, in Treating Postmenopausal Women After Surgery for Primary Breast Cancer Condition(s): stage IIIA breast cancer; stage I breast cancer; stage II breast cancer Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute of Canada; North Central Cancer Treatment Group; Cancer and Leukemia Group B Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using exemestane or anastrozole may fight breast cancer by reducing the production of estrogen. It is not yet known whether exemestane is more effective than anastrozole, with or without celecoxib, in preventing the recurrence of breast cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of exemestane with that of anastrozole, with or without celecoxib, in preventing cancer recurrence in postmenopausal women who have undergone surgery for primary breast cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00066573

•

Trial Comparing Anastrozole-Placebo to the Combination Anastrozole-ZD1839 in Postmenopausal Patients with Estrogen Receptor (ER) and/or Progesterone Receptor (PgR) Metastatic Breast Cancer Condition(s): Breast Cancer Study Status: This study is currently recruiting patients. Sponsor(s): AstraZeneca

Clinical Trials 29

Purpose - Excerpt: This study is being carried out to see if treatment with ZD1839 (Gefitinib) combined with Arimidex (Anastrozole) has improved efficacy over Arimidex alone in preventing progression of metastatic breast cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00077025 •

Adjuvant Radiation Therapy After Surgery Compared With Observation in Treating Women With Estrogen Receptor Positive or Progesterone Receptor Positive Ductal Carcinoma In Situ of the Breast Who Are Receiving Tamoxifen or Anastrozole Condition(s): intraductal breast carcinoma; breast cancer in situ Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Cancer Research Institute (NCRI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known whether radiation therapy after surgery is effective in preventing a recurrence of ductal carcinoma in situ. PURPOSE: Randomizedphase II trial to compare the effectiveness of adjuvant radiation therapy after surgery with that of observation in treating women with estrogen receptor positive or progesterone receptor positive ductal carcinoma in situ who are also receiving tamoxifen or anastrozole. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00077168

•

Anastrozole With or Without Fulvestrant as First-Line Therapy in Treating Postmenopausal Women With Metastatic Breast Cancer Condition(s): stage IV breast cancer; recurrent breast cancer Study Status: This study is not yet open for patient recruitment. Sponsor(s): Southwest Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using drugs such as anastrozole and fulvestrant may fight breast cancer by blocking the uptake of estrogen. It is not yet known whether anastrozole is more effective with or without fulvestrant in treating breast cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of anastrozole with or without fulvestrant as first-line therapy in treating postmenopausal women who have metastatic breast cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00075764

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Anastrozole

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “anastrozole” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

Clinical Trials 31

•

For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 4. PATENTS ON ANASTROZOLE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.6 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “anastrozole” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on anastrozole, we have not necessarily excluded nonmedical patents in this bibliography.

Patent Applications on Anastrozole As of December 2000, U.S. patent applications are open to public viewing.7 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to anastrozole:

6Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 7 This has been a common practice outside the United States prior to December 2000.

34

•

Anastrozole

Pharmaceutical combination of bicalutamide and anastrozole for providing an antiandrogenic effect and aromatase inhibition Inventor(s): Cockshott, Ian; (Macclesfield Cheshire, GB), Furr, Barrington; (Macclesfield Cheshire, GB) Correspondence: Ropes & Gray; One International Place; Boston; MA; 02110-2624; US Patent Application Number: 20030114519 Date filed: October 22, 2002 Abstract: The present invention relates to a pharmaceutical product, daily dose or dose regimen comprising 4'-cyano-.alpha.',.alpha.',.alpha.'-trifluoro-3-(4fluorophenylsulphonyl)-2-hydroxy-2-methylpropriono-m-toluidide (compound I) and anastrozole. The invention also relates to a method of providing an anti-anrogenic effect and aromatase inhibition in a patient, wherein the aromatase inhibition is provided substantially without causing an additional increase in the levels of circulating androgens. Excerpt(s): The present invention relates to a pharmaceutical product, daily dose or dose regimen comprising 4'-cyano-.alpha.',.alpha.',.alpha.'-trifluoro-3-(4fluorophenylsulphonyl)-2-hydroxy-2-methylpropiono-m-toluidide and anastrozole. The invention also relates to a method of providing an anti-androgenic effect and aromatase inhibition in a patient, wherein the aromatase inhibition is provided substantially without causing an additional increase in the levels of circulating androgens. Furthermore, the invention relates to the use of 4'-cyano-.alpha.',.alpha.',.alpha.'trifluoro-3-(4-fluorophenylsulphonyl)-2-hydroxy-2-methy- lpropiono-m-toluidide and anastrozole in the manufacture of a pharmaceutical product for this purpose. 4'-cyano.alpha.',.alpha.',.alpha.'-trifluoro-3-(4-fluorophenylsulphonyl)-2-hydroxy-2methylpropiono-m-toluidide can exist in distinct R- and S-enantiomeric forms. The Renantiomer is the (-) isomer and is the pharmacologically active compound in vivo. For further details of the enantiomers, reference is made to Tucker and Chesterton, J. Med. Chem. 31, pp 885-887 (1988). EP-100172 provides a disclosure (without supporting examples) of a pharmaceutical composition comprising 4-cyano-3-trifluoromethyl-N-(3p-fluorophenylsulphonyl-2-hydroxy-2-methyl- propionyl)aniline in combination with "one or more drugs selected from anti-oestrogens, for example tamoxifen; aromatase inhibitors, for example testolactone or aminoglutethamide; progestins, for example medroxyprogesterone acetate; inhibitors of gonadotrophin secretion, for example danazol; LH-RH-analogues, for example buserelin; cytotoxic agents, for example cyclophosphamide; antibiotics, for example penicillin or oxytetracyclin; and antiinflammatory agents, for example, especially for topical use, fluocinolone acetonide". Bicalutamide can be used for the treatment of prostate cancer in combination with an inhibitor of gonadotrophin secretion, for example a luteinising hormone releasing hormone (LHRH) agonist such as goserelin, buserelin, leuprorelin or triptorelin. The properties and usefulness of bicalutamide as an anti-androgen have been reviewed in B J A Furr et al., Urology, 1996, 47 (Suppl. 1A), 13-25, and G J C Kolvenbag et al., Urology, 1996, 47 (Suppl. 1A), 70-79. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 35

•

Product for treating gynecomastia Inventor(s): Massimini, Giorgio; (Abbiategrasso, IT), Piscitelli, Gabriella; (Milano, IT) Correspondence: Oblon Spivak Mcclelland Maier & Neustadt PC; Fourth Floor; 1755 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20020183291 Date filed: June 19, 2002 Abstract: The invention provides a method of treating gynecomastia in a patient being treated with an antiandrogen, which method comprises administering to a patient in need thereof a therapeutically effective amount of an aromatase inhibitor selected from exemestane, formestane, anastrozole, letrozole and fadrozole, or a pharmaceutical composition comprising a said aromatase inhibitor. The use of a said aromatase inhibitor in the preparation of a pharmaceutical composition for treating gynecomastia induced by antiandrogen therapy and a kit containing the said aromatase inhibitor and an antiandrogen are also provided. Excerpt(s): This invention relates to a method of treating gynecomastia in patients being treated with an antiandrogen, who are in need of such treatment. This invention more particularly relates to a method of treating gynecomastia in prostatic cancer and in benign prostatic hypertrophy patients being treated with an antiandrogen, who are in need of such treating, comprising administering to such patients in association with therapeutically effective amounts of the antiandrogen, an aromatase inhibitor selected from exemestane, formestane, anastrozole, letrozole and fadrozole, or pharmaceutical compositions thereof. Prostatic cancer has been treated with antiandrogens. Benign prostatic hypertrophy, a particularly common problem in older men, has been treated with antiandrogens and by use of estrogenic substances. The use of estrogenic substances has undesirable, life-threatening side effects due to the inherent properties of the estrogenic substances. The use of antiandrogens, e.g. bicalutamide, flutamide, nilutamide and cyproterone acetate, while devoid of life-threatening side effects associated with treatment with estrogenic substances, produces gynecomastia in up to 40% of non-castrated males studied, including normal subjects and advanced prostate cancer patients. Gynecomastia interferes with continued patient compliance with the antiandrogen therapy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with anastrozole, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “anastrozole” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on anastrozole. You can also use this procedure to view pending patent applications concerning anastrozole. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON ANASTROZOLE Overview This chapter provides bibliographic book references relating to anastrozole. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on anastrozole include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “anastrozole” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “anastrozole” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “anastrozole” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Anastrozole (Arimidex) Realising the Need for an Oral Selective Aromatase Inhibitor (Oncology) by W. Jonat (Editor), M. Kaufmann (Editor); ISBN: 380556595X; http://www.amazon.com/exec/obidos/ASIN/380556595X/icongroupinterna

•

History and Advancement of Anastrozole in the Treatment of Breast Cancer by Aman Buzdar (Editor), Michael Baum (Editor); ISBN: 1853155578; http://www.amazon.com/exec/obidos/ASIN/1853155578/icongroupinterna

Chapters on Anastrozole In order to find chapters that specifically relate to anastrozole, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and anastrozole using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes

38

Anastrozole

at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “anastrozole” (or synonyms) into the “For these words:” box.

39

CHAPTER 6. PERIODICALS AND NEWS ON ANASTROZOLE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover anastrozole.

News Services and Press Releases One of the simplest ways of tracking press releases on anastrozole is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “anastrozole” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to anastrozole. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “anastrozole” (or synonyms). The following was recently listed in this archive for anastrozole: •

Neoadjuvant anastrozole increases feasibility of breast conservation Source: Reuters Industry Breifing Date: December 03, 2003

•

Anastrozole bests tamoxifen as adjuvant treatment for early-stage breast cancer Source: Reuters Industry Breifing Date: November 27, 2003

40

Anastrozole

•

Advanced breast cancer more responsive to letrozole than anastrozole Source: Reuters Industry Breifing Date: November 11, 2003

•

Anastrozole still superior to tamoxifen after nearly 4 years Source: Reuters Industry Breifing Date: October 10, 2003

•

Anastrozole's fracture risk peaks after two years Source: Reuters Medical News Date: September 24, 2003

•

Anastrozole side effect lessens over time Source: Reuters Health eLine Date: September 24, 2003

•

AstraZeneca begins broad trials of Arimidex in early breast cancer Source: Reuters Industry Breifing Date: May 28, 2003

•

Anastrozole effective, well tolerated adjuvant therapy for breast cancer Source: Reuters Industry Breifing Date: June 20, 2002

•

More women respond to Femara than Arimidex in advanced breast cancer study Source: Reuters Industry Breifing Date: May 20, 2002

•

AstraZeneca's Arimidex to get FDA priority review Source: Reuters Industry Breifing Date: April 15, 2002

•

AstraZeneca seeks wider use of anastrozole in breast cancer Source: Reuters Industry Breifing Date: April 08, 2002

•

Anastrozole treatment effective in treating some male infertility Source: Reuters Medical News Date: February 11, 2002

•

AstraZeneca gets fast track designation for Arimidex Source: Reuters Industry Breifing Date: January 15, 2002

•

Trial backs AstraZeneca's Arimidex for breast cancer Source: Reuters Industry Breifing Date: December 10, 2001

•

Anastrozole seen as more effective than tamoxifen for breast cancer Source: Reuters Medical News Date: December 10, 2001

•

Anastrozole improves survival in advanced breast cancer Source: Reuters Medical News Date: September 19, 2001

•

Safety committee approves continued study of anastrozole plus tamoxifen Source: Reuters Medical News Date: February 22, 2001

Periodicals and News

41

•

AstraZeneca's Arimidex approved in Sweden Source: Reuters Industry Breifing Date: January 29, 2001

•

Anastrozole recommended as first-line therapy for advanced breast cancer Source: Reuters Industry Breifing Date: December 05, 2000

•

Anastrozole called first-line therapy for postmenopausal women with advanced breast cancer Source: Reuters Industry Breifing Date: November 14, 2000

•

FDA approves AstraZeneca's Arimidex as first-line therapy for advanced breast cancer Source: Reuters Industry Breifing Date: September 06, 2000

•

AstraZeneca's Arimidex Approved for First Line Use in Europe Source: Reuters Industry Breifing Date: April 14, 2000

•

Postmenopausal breast cancer progression slowed with anastrozole Source: Reuters Medical News Date: December 16, 1999

•

Anastrozole superior to tamoxifen for advanced breast cancer in postmenopausal wome Source: Reuters Medical News Date: September 16, 1999

•

Anastrozole superior to megestrol acetate as second-line breast cancer therapy Source: Reuters Medical News Date: September 17, 1998

•

Anastrozole Effective In Subset Of Advanced Breast Cancer Patients Source: Reuters Medical News Date: February 18, 1997

•

Anastrozole: As Effective As Megestrol For Breast Cancer, But With Less Weight Gain Source: Reuters Medical News Date: July 16, 1996 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine.

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Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “anastrozole” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “anastrozole” (or synonyms). If you know the name of a company that is relevant to anastrozole, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “anastrozole” (or synonyms).

Academic Periodicals covering Anastrozole Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to anastrozole. In addition to these sources, you can search for articles covering anastrozole that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical

Periodicals and News

43

periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

45

CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for anastrozole. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with anastrozole. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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Anastrozole

following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to anastrozole: Anastrozole •

Systemic - U.S. Brands: Arimidex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203659.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

47

APPENDICES

49

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

8

These publications are typically written by one or more of the various NIH Institutes.

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Anastrozole

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

51

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:10 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

9

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 10 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “anastrozole” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 397 0 15 1 0 413

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.15 Simply search by “anastrozole” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

11

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

12

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

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Coffee Break: Tutorials for Biologists16 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.17 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

16 Adapted 17

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

55

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on anastrozole can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to anastrozole. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to anastrozole. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “anastrozole”:

56

•

Anastrozole

Other guides Cancer http://www.nlm.nih.gov/medlineplus/cancer.html Clinical Trials http://www.nlm.nih.gov/medlineplus/clinicaltrials.html Financial Assistance http://www.nlm.nih.gov/medlineplus/financialassistance.html Head and Neck Cancer http://www.nlm.nih.gov/medlineplus/headandneckcancer.html Liver Cancer http://www.nlm.nih.gov/medlineplus/livercancer.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to anastrozole. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

Patient Resources

•

57

WebMD®Health: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to anastrozole. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with anastrozole. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about anastrozole. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “anastrozole” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “anastrozole”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “anastrozole” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “anastrozole” (or a synonym) into the search box, and click “Submit Query.”

59

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.19

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

19

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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Anastrozole

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)20: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

20

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

61

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

65

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

67

ANASTROZOLE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adjuvant Therapy: Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, or hormone therapy. [NIH]

Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and

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herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Aminoglutethimide: An anticancer drug that belongs to the family of drugs called nonsteroidal aromatase inhibitors. Aminoglutethimide is used to decrease the production of sex hormones (estrogen or testosterone) and suppress the growth of tumors that need sex hormones to grow. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anastrozole: An anticancer drug that belongs to the family of drugs called nonsteroidal aromatase inhibitors. Anastrozole is used to decrease estrogen production and suppress the growth of tumors that need estrogen to grow. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Antiandrogen therapy: Treatment with drugs used to block production or interfere with the action of male sex hormones. [NIH] Antiandrogens: Drugs used to block the production or interfere with the action of male sex hormones. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU]

Dictionary 69

Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] Aromatase inhibition: Prevention of the formation of estradiol, a female hormone, by interfering with an aromatase enzyme. Aromatase inhibition is a type of hormone therapy used in postmenopausal women who have hormone-dependent breast cancer. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bicalutamide: An anticancer drug that belongs to the family of drugs called antiandrogens. [NIH]

Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and

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is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Buserelin: A potent and durable analog of naturally occurring gonadotropin-releasing hormone (GnRH). [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Carcinoma in Situ: A malignant tumor that has not yet invaded the basement membrane of the epithelial cell of origin and has not spread to other tissues. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Celecoxib: A drug that reduces pain. Celecoxib belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is being studied for cancer prevention. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA

Dictionary 71

molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyproterone: An anti-androgen that, in the form of its acetate, also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females. [NIH] Cyproterone Acetate: An agent with anti-androgen and progestational properties. It shows competitive binding with dihydrotestosterone at androgen receptor sites. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein,

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cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytotoxic: Cell-killing. [NIH] Danazol: A synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Ductal carcinoma in situ: DCIS. Abnormal cells that involve only the lining of a duct. The cells have not spread outside the duct to other tissues in the breast. Also called intraductal carcinoma. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid

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morphological changes and the differentiation of basic structures. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epiphyseal: Pertaining to or of the nature of an epiphysis. [EU] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Estrogen receptor positive: ER+. Breast cancer cells that have a protein (receptor molecule) to which estrogen will attach. Breast cancer cells that are ER+ need the hormone estrogen to grow and will usually respond to hormone (antiestrogen) therapy that blocks these receptor sites. [NIH] Exemestane: An anticancer drug used to decrease estrogen production and suppress the growth of estrogen-dependent tumors. [NIH] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Fadrozole: A selective aromatase inhibitor effective in the treatment of estrogen-dependent disease including breast cancer. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Flatus: Gas passed through the rectum. [NIH] Flutamide: An antiandrogen with about the same potency as cyproterone in rodent and canine species. [NIH] Foetoplacental: Pertaining to the fetus and placenta. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid.

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[NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Goserelin: 6-(O-(1,1-Dimethylethyl)-D-serine)-10-deglycinamideluteinizing hormonereleasing factor (pig) 2-(aminocarbonyl)hydrazide. A long-acting gonadorelin agonist. It is used in the treatment of malignant neoplasms of the prostate, uterine fibromas, and metastatic breast cancer. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Histology: The study of tissues and cells under a microscope. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

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Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Intraductal carcinoma: Abnormal cells that involve only the lining of a duct. The cells have not spread outside the duct to other tissues in the breast. Also called ductal carcinoma in

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situ. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Letrozole: An anticancer drug that belongs to the family of drugs called nonsteroidal aromatase inhibitors. Letrozole is used to decrease estrogen production and suppress the growth of estrogen-dependent tumors. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lumpectomy: Surgery to remove the tumor and a small amount of normal tissue around it. [NIH]

Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Mammary: Pertaining to the mamma, or breast. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medroxyprogesterone: (6 alpha)-17-Hydroxy-6-methylpregn-4-ene-3,20-dione. A synthetic progestational hormone used in veterinary practice as an estrus regulator. [NIH] Medroxyprogesterone Acetate: An injectable contraceptive, generally marketed under the name Depo-Provera. [NIH] Megestrol: 17-Hydroxy-6-methylpregna-3,6-diene-3,20-dione. A progestational hormone

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used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer. [NIH] Megestrol Acetate: A drug that belongs to the group of hormones called progestins, used as hormone therapy to block estrogen and to suppress the effects of estrogen and androgens. [NIH]

Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]

Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis,

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prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nilutamide: A drug that blocks the effects of male hormones in the body. It belongs to the family of drugs called antiandrogens. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oestrogen: A generic term for oestrus-producing steroid compounds; the female sex hormones. In humans, oestrogen is formed in the ovary, possibly the adrenal cortex, the testis, and the foetoplacental unit; it has various functions in both sexes. It is responsible for the development of the female secondary sex characteristics, and during the menstrual cycle it acts on the female genitalia to produce an environment suitable for the fertilization, implantation, and nutrition of the early embryo. Oestrogen is used in oral contraceptives and as a palliative in cancer of the breast after menopause and cancer of the prostate; other uses include the relief of the discomforts of menopause, inhibition of lactation, and treatment of osteoporosis, threatened abortion, and various functional ovarian disorders. [EU]

Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU]

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Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Parturition: The act or process of given birth to a child. [EU] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perimetry: Determination of the extent of the visual field for various types and intensities of stimuli. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH]

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Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progesterone receptor positive: Breast cancer cells that have a protein (receptor molecule) to which progesterone will attach. Breast cancer cells that are PR+ need the hormone progesterone to grow and will usually respond to hormonal therapy. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from

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radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Raloxifene: A second generation selective estrogen receptor modulator (SERM) used to prevent osteoporosis in postmenopausal women. It has estrogen agonist effects on bone and cholesterol metabolism but behaves as a complete estrogen antagonist on mammary gland and uterine tissue. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Rods: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide side vision and the ability to see objects in dim light (night vision). [NIH]

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Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Sperm: The fecundating fluid of the male. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic

Dictionary 83

hydrocarbons. [EU] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testolactone: An antineoplastic agent that is a derivative of progesterone and used to treat advanced breast cancer. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is

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analogous to bacterial transformation. [NIH] Trastuzumab: A type of monoclonal antibody used in cancer detection or therapy. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. Trastuzumab blocks the effects of the growth factor protein HER2, which transmits growth signals to breast cancer cells. [NIH] Triptorelin: A long-acting gonadorelin analog agonist. It has been used in the treatment of prostatic cancer, ovarian cancer, precocious puberty, endometriosis, and to induce ovulation for in vitro fertilization. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

85

INDEX A Adaptation, 4, 67 Adjustment, 67 Adjuvant, 4, 7, 11, 17, 18, 25, 26, 29, 39, 40, 67 Adjuvant Therapy, 4, 11, 18, 40, 67 Adrenal Cortex, 67, 73, 78, 80 Adverse Effect, 67, 82 Affinity, 67 Agonist, 34, 67, 74, 81, 83, 84 Algorithms, 67, 69 Alopecia, 67, 71 Alpha Particles, 67, 80 Alternative medicine, 42, 67 Amino Acid Sequence, 68 Aminoglutethimide, 12, 68 Analog, 68, 70, 84 Anatomical, 4, 68, 75 Androgenic, 34, 68, 72 Androgens, 34, 67, 68, 69, 77 Antiandrogen therapy, 35, 68 Antiandrogens, 35, 68, 69, 78 Antibiotic, 68, 79 Antibodies, 27, 68, 79, 84 Antibody, 67, 68, 75, 77, 81, 84 Anticoagulant, 19, 22, 68, 84 Antigen, 67, 68, 75 Anti-inflammatory, 34, 68, 70 Anti-Inflammatory Agents, 34, 68, 70 Antineoplastic, 68, 71, 83 Aromatase, 4, 5, 6, 7, 10, 11, 12, 13, 14, 15, 19, 22, 34, 35, 37, 68, 69, 73, 76 Aromatase inhibition, 11, 13, 34, 69 Arteries, 69, 71, 77 Arterioles, 69, 70 Assay, 19, 69 Asymptomatic, 17, 69 Atrial, 69, 84 Atrial Fibrillation, 69, 84 B Bacterial Physiology, 67, 69 Base, 69, 76 Basement Membrane, 69, 70 Benign, 35, 69, 72, 78, 81 Bicalutamide, 34, 35, 69 Biological therapy, 69, 74 Biotechnology, 5, 42, 51, 69 Bladder, 69, 80, 84

Blood vessel, 69, 72, 76, 83 Bone Marrow, 69, 76, 82 Bowel, 26, 70, 72 Bowel Movement, 70, 72 Brachytherapy, 70, 75, 81 Branch, 63, 70, 76, 82, 83 Breakdown, 70, 73, 78 Buserelin, 34, 70 C Capillary, 19, 70, 84 Carcinoma, 5, 8, 9, 15, 19, 25, 26, 29, 70, 71 Carcinoma in Situ, 25, 26, 29, 70 Carotene, 70, 81 Celecoxib, 28, 70 Cell, 26, 67, 69, 70, 72, 74, 76, 77, 78, 79, 81 Cell Division, 70, 74 Cell Survival, 70, 74 Chemotherapy, 13, 67, 70 Cholesterol, 70, 81, 82, 83 CIS, 70, 81 Clinical trial, 3, 13, 25, 30, 51, 70, 80, 81 Cloning, 69, 70 Coagulation, 71, 84 Complete remission, 71, 81 Computational Biology, 51, 71 Cone, 4, 71 Contraceptive, 71, 76 Contraindications, ii, 71 Coronary, 71, 77 Coronary Thrombosis, 71, 77 Corpus, 71, 76, 80 Corpus Luteum, 71, 76, 80 Curative, 71, 83 Cyclic, 4, 71 Cyclophosphamide, 34, 71 Cyproterone, 35, 71, 73 Cyproterone Acetate, 35, 71 Cytochrome, 69, 71 Cytotoxic, 34, 72, 81 D Danazol, 34, 72 Databases, Bibliographic, 51, 72 Diagnostic procedure, 33, 42, 72 Digestive system, 30, 72 Dihydrotestosterone, 71, 72, 81 Direct, iii, 45, 72, 81 Drug Interactions, 46, 72 Duct, 72, 75, 82

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Ductal carcinoma in situ, 8, 25, 27, 29, 72, 76 E Efficacy, 7, 9, 11, 12, 13, 14, 22, 28, 29, 72 Electrons, 69, 72, 80, 81 Emboli, 72, 84 Embolism, 72, 80, 84 Embolization, 72, 84 Embryo, 72, 75, 78 Endometrial, 5, 73 Endometriosis, 72, 73, 84 Endometrium, 73, 77 Environmental Health, 50, 52, 73 Enzymatic, 70, 73, 81 Enzyme, 69, 73, 81 Epiphyseal, 3, 13, 22, 73 Epithelial, 70, 73 Esophagus, 72, 73, 83 Estradiol, 69, 73 Estrogen, 4, 15, 25, 26, 27, 28, 29, 68, 69, 71, 73, 76, 77, 80, 81, 82, 83 Estrogen receptor, 4, 29, 73 Estrogen receptor positive, 29, 73 Exemestane, 6, 12, 28, 35, 73 External-beam radiation, 73, 80 F Fadrozole, 35, 73 Family Planning, 51, 73 Flatus, 73 Flutamide, 35, 73 Foetoplacental, 73, 78 G Gallbladder, 72, 73 Gamma Rays, 73, 80, 81 Gas, 18, 19, 73, 78 Gastrin, 73, 74 Gene, 69, 74 Gland, 67, 74, 79, 80, 81, 82 Glucose, 74, 75 Gonadorelin, 74, 84 Gonadotropin, 13, 70, 74 Goserelin, 34, 74 Governing Board, 74, 79 Growth, 4, 12, 18, 25, 26, 27, 28, 29, 68, 70, 73, 74, 75, 76, 78, 84 Growth factors, 12, 74 H Hemorrhage, 74, 83 Hirsutism, 71, 74 Histology, 13, 74 Hormonal, 10, 14, 18, 74, 80 Hormonal therapy, 14, 18, 74, 80

Hormone, 4, 8, 9, 25, 26, 27, 28, 29, 34, 67, 69, 70, 73, 74, 75, 76, 77, 80, 83 Hormone therapy, 25, 26, 27, 28, 29, 67, 69, 74, 77 Hypertrophy, 35, 74 I Id, 23, 56, 62, 64, 74 Immune response, 67, 68, 74, 83 Immunology, 67, 75 Immunosuppressive, 71, 75 Impairment, 75, 77 Implant radiation, 75, 81 Implantation, 75, 78 In situ, 25, 26, 29, 75 In vitro, 75, 84 In vivo, 15, 34, 75 Indicative, 37, 75 Induction, 68, 75, 80 Infarction, 75 Infection, 69, 75, 76, 79 Infertility, 40, 75 Inflammation, 68, 75 Insulin, 12, 18, 75 Insulin-dependent diabetes mellitus, 75 Insulin-like, 12, 18, 75 Internal radiation, 75, 81 Intraductal carcinoma, 72, 75 Intramuscular, 6, 22, 76 K Kb, 50, 76 L Lactation, 76, 78, 80 Large Intestine, 72, 76, 81, 82 Letrozole, 6, 12, 14, 15, 22, 35, 40, 76 Libido, 68, 76 Library Services, 62, 76 Ligament, 76, 80 Lipid, 75, 76 Liver, 56, 71, 72, 73, 76 Lumpectomy, 26, 27, 76 Lutein Cells, 76, 80 Lymphatic, 75, 76, 82 Lymphatic system, 76, 82 Lymphoid, 68, 76 M Malignant, 68, 70, 74, 76, 78, 81 Malignant tumor, 70, 76 Mammary, 76, 81, 83 MEDLINE, 51, 76 Medroxyprogesterone, 34, 76 Medroxyprogesterone Acetate, 34, 76 Megestrol, 5, 6, 9, 10, 12, 41, 76, 77

Index 87

Megestrol Acetate, 5, 6, 9, 10, 12, 41, 77 Membranes, 70, 77, 81 Menopause, 77, 78, 79 Menstrual Cycle, 4, 77, 78, 80 Menstruation, 77 Mental Disorders, 31, 77 Metastasis, 77 Metastatic, 11, 12, 14, 16, 18, 26, 27, 28, 29, 74, 77 MI, 65, 77 Microbiology, 67, 77 Modulator, 77 Molecular, 6, 11, 16, 18, 19, 51, 53, 69, 71, 77, 80 Molecule, 68, 69, 73, 77, 80, 81 Monoclonal, 27, 77, 81, 84 Mucosa, 77, 80 Myocardial infarction, 71, 77, 84 Myocardium, 77 N NCI, 1, 26, 27, 29, 30, 49, 70, 77 Necrosis, 75, 77, 78 Need, 35, 37, 57, 68, 73, 78, 80 Neoplasm, 78, 84 Nerve, 4, 78, 81 Nervous System, 78, 83 Neutrons, 67, 78, 80 Nilutamide, 35, 78 Nitrogen, 68, 71, 78 Nucleus, 71, 73, 78, 80 O Ocular, 4, 78 Oestrogen, 5, 6, 15, 22, 78 Opsin, 78, 81 Osteoporosis, 4, 78, 81 Ovaries, 69, 78, 82 Ovary, 71, 73, 78 Ovulation, 77, 78, 84 Ovum, 71, 78, 80 P Palliative, 71, 77, 78, 83 Pancreas, 72, 75, 79 Paralysis, 11, 79 Partial remission, 79, 81 Parturition, 79, 80 Patient Compliance, 35, 79 Pelvic, 73, 79, 80 Penicillin, 34, 79 Perception, 71, 79 Perimetry, 4, 79 Pharmacokinetic, 18, 79 Pharmacologic, 79, 83

Physiologic, 67, 77, 79, 81 Pigments, 70, 79, 81 Placenta, 69, 73, 79, 80 Plasma, 15, 18, 19, 68, 79, 82 Plasma cells, 68, 79 Polypeptide, 68, 79, 80 Practice Guidelines, 52, 79 Preclinical, 19, 79 Prevalence, 4, 79 Progesterone, 28, 29, 77, 80, 82, 83 Progesterone receptor positive, 29, 80 Prognostic factor, 80, 83 Progression, 29, 41, 80 Progressive, 74, 78, 80, 84 Prolactin, 12, 80 Prophylaxis, 4, 80, 84 Prostate, 19, 34, 35, 74, 78, 80 Protein S, 69, 80 Proteins, 68, 77, 78, 79, 80, 82 Protocol, 17, 80 Protons, 67, 80 Puberty, 13, 80, 84 Public Policy, 51, 80 Pulmonary, 80, 84 Pulmonary Embolism, 80, 84 R Radiation, 27, 29, 67, 73, 75, 80, 81, 84 Radiation therapy, 27, 29, 67, 73, 75, 80 Radioactive, 75, 81 Radiolabeled, 81 Radiotherapy, 70, 81 Raloxifene, 4, 81, 82 Randomized, 6, 8, 9, 13, 15, 19, 22, 72, 81 Receptor, 4, 8, 28, 29, 67, 68, 71, 73, 80, 81 Rectum, 70, 72, 73, 76, 80, 81 Recurrence, 27, 28, 29, 81 Reductase, 69, 81 Refer, 1, 78, 81 Regimen, 34, 72, 79, 81 Remission, 11, 81 Retina, 4, 81 Retinal, 4, 71, 81 Retinol, 81 Rods, 81 S Salivary, 72, 82 Salivary glands, 72, 82 Screening, 70, 82 Secretion, 12, 34, 74, 75, 76, 82 Selective estrogen receptor modulator, 4, 81, 82, 83 Semen, 80, 82

88

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Senile, 78, 82 Serine, 74, 82 Serum, 13, 74, 82 Sex Characteristics, 68, 78, 80, 82, 83 Side effect, 4, 35, 40, 45, 67, 69, 71, 82, 83 Signs and Symptoms, 81, 82 Skeletal, 68, 82 Small intestine, 74, 82 Solid tumor, 26, 82 Specialist, 57, 82 Species, 73, 77, 82 Sperm, 68, 82 Sterility, 71, 75, 82 Steroid, 6, 11, 16, 18, 19, 69, 72, 78, 82 Stomach, 72, 73, 74, 82, 83 Stroke, 31, 50, 83 Substance P, 82, 83 Suppression, 5, 83 Survival Analysis, 7, 83 Symphysis, 80, 83 Synergistic, 80, 83 Systemic, 46, 75, 81, 83, 84 T Tamoxifen, 4, 6, 7, 8, 9, 11, 12, 14, 16, 17, 18, 19, 25, 26, 27, 29, 34, 39, 40, 41, 82, 83 Testicular, 69, 83 Testis, 73, 78, 83 Testolactone, 34, 83 Testosterone, 68, 81, 83 Therapeutics, 46, 83

Thrombosis, 80, 83 Tissue, 4, 68, 69, 70, 71, 72, 73, 74, 76, 77, 78, 81, 82, 83, 84 Tooth Preparation, 67, 83 Topical, 34, 83 Toxic, iv, 83 Toxicity, 72, 83 Toxicology, 52, 83 Transfection, 69, 83 Trastuzumab, 27, 84 Triptorelin, 34, 84 Tumour, 13, 84 U Unconscious, 74, 84 Urethra, 80, 84 Uterus, 71, 73, 77, 78, 80, 84 V Vaccine, 67, 80, 84 Venous, 80, 84 Venous Thrombosis, 84 Venules, 69, 70, 84 Veterinary Medicine, 51, 84 Visceral, 14, 84 Visual field, 79, 84 Vivo, 84 W Warfarin, 19, 22, 84 X X-ray, 29, 73, 80, 81, 84

Index 89

90

Anastrozole

Index 91

92

Anastrozole

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