Open radical prostatectomy and the combined high-dose rate brachytherapy with external beam radiation appeared to be comparable in the measured outcomes. It was not possible to draw any conclusion on the efficacy of the two treatments due to insufficient power of the study.

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Abstract. To avoid pubic arch interference, prostate cancer patients are treated with neoadjuvant androgen deprivation therapy (ADT) to achieve prostate volume (PV) reduction prior to radiation treatment. The aim of the present randomised study was to compare the effects on PV of two regimens of ADT, an androgen receptor inhibitor monotherapy vs. castration plus an androgen receptor inhibitor. Consecutive patients with non-metastatic prostate cancer were included in a randomised neoadjuvant study, comparing an androgen receptor inhibitor monotherapy vs. castration plus an androgen receptor inhibitor. PV was assessed prior to the start of endocrine neoadjuvant treatment and prior to the start of radiation therapy (RT). PV assessment was performed by transrectal ultrasound. A total of 110 patients were included. Final sample constituted 88 (80%) patients due to lack of PV information. Castration plus an androgen receptor inhibitor was more effective in PV reduction compared with an androgen receptor inhibitor alone (P<0.001). Planning target volume decreased in the combination arm. There was no significant difference in clinical or demographic or length of neoadjuvant hormonal treatment between the groups. Overall, a significantly larger PV reduction was achieved by castration plus androgen receptor inhibitor, as compared with androgen receptor inhibitor monotherapy. The PV reduction, however, appeared not to translate into better health associated quality of life during the subsequently given curative intended combined EBRT and HDR-brachytherapy. Potential differences between these two treatments regarding anti-tumor effects on micro metastatic disease and radiation potentiating effect remains to be addressed in future prospective trials.

Introduction.Despite new treatments replacing tamoxifen in breast cancer management, menopausal symptoms remain a problem in women undergoing treatment. We aimed to ascertain the prevalence of menopausal symptoms and the effects of these symptoms on quality of life (QoL). Method. Women previously treated for breast cancer were asked to complete a questionnaire about their experience of menopausal symptoms (Menopause Rating Scale), any treatments tried for hot flushes (HF) and the effects of their symptoms on different aspects of Qol, including their partner's QoL. 285 women aged 65 years or less were asked to participate. Results. 174 women (61%) completed the questionnaires. 96% were Caucasian with mean age of 54 years (range 29-65). 66% women had received some education, 56% were currently employed and 76% were in a relationship. The majority were non-smokers and were taking some regular exercise.All except one reported at least one symptom related to menopause (86% HF, 92% urogenital, 59% sexual and 92% psychological). Only 15% of the symptomatic women were receiving any treatment for HF with most describing their treatment as ineffective or only partly effective. 80% of women described their knowledge of the treatment options for menopausal symptoms as none or poor. A statistically significant correlation was found between the severity of HF and self assessed effects on overall QoL. 65% of the eligible women believed that menopausal symptoms had affected their partner's QoL. Correlation was found between their partner's QoL, sexual symptoms and vaginal dryness (p<0.05).Conclusion. The majority of women receiving treatment for breast cancer experience menopausal symptoms, which negatively correlates with not only their own but their partner's QoL. Many women tolerate their symptoms due to the absence of safe and effective treatment, compounded by the lack of safety information and confidence in the available treatments.ability of the procedure were documented. Those with a localised lesion of the endometrium had a hysteroscopically directed biopsy under general anaesthetic.Results. The majority of asymptomatic women who underwent further investigations for abnormal ultrasound scan findings had benign pathology. Most women considered outpatient hysteroscopy an acceptable investigation. A minority required analgesia after the procedure. There were few complications. Conclusion. Outpatient hysteroscopy is acceptable to the patient; however the majority of asymptomatic women had benign pathology. Hysteroscopy has risks. In our opinion, therefore, further investigation is not justified in all asymptomatic women found to have a thickened or irregular endometrium; rather, there may be a place for a select group of women deemed to be at higher risk of endometrial cancer.

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