Question:
I hope that someone can help me by pointing me in the right direction
regarding information on skin cancer. I've searched the net and all I've
been able to find thus far is general information on this topic. I would
like to get more detailed information. Perhaps some studies or papers. My
wife is a 4th year pharmacy student and needs information for a talk she is
supposed to do. Thanks in advance for any help and please e-mail me directly
with your suggestions as I do not regularly read this group.
Answer:
What kind of skin cancer are you interested in? Your question is so general it
is impossible to answer. If she is a pharmacy student, I suppose you are
thinking of skin cancers that could be treated medically rather than surgically
or by radiotherapy. Adjuvant chemotherapy is sometimes used for melanoma.
Chemotherapy is also used for cutaneous T-cell lymphomas including mycosis
fungoides. The more common kinds of skin cancer such as squamous cell carcinoma
and basal cell carcinoma are better treated surgically, in fact topical chemo is
contraindicated in basal cell carcinoma because it seems to cure the surface
cancer while encouraging underlying spread.
Did you look in PDQ? This is a database updated monthly by the NCI. It has
descriptions of the various kinds, stages, and treatments of most cancers and it
is easy to use. Find it at http://cancernet.nci.nih.gov/pdq.htm. Get the
summary on skin cancer for doctors, rather than the one for patients. This
should have lots of good stuff, and it is accompanied by many refs she can look
up.
You can also look for refs to articles in MEDLINE at PubMed at
www.ncbi.nlm.nih.gov. Go to the Advanced Search screen for doing Medline
searches. Select "MeSH Terms" from the pull-down over the Enter Query box. In
the box, type terms you are interested in. These must be from our controlled
vocabulary (MeSH) and this is the most efficient way to search, though you can
add in textword terms to narrow the search down by using the Add Terms box set
on All Fields or Text Word. Some terms that I guess would be useful for her, not
knowing at all what you are looking for, are
skin neoplasms
head neoplasms
facial neoplasms
antineoplastic agents
administration, cutaneous
administration, topical
treatment outcome
multimodal treatment
drug evaluation
clinical trial
randomized controlled trial
double blind method
drug screening assays, antitumor
photodynamic therapy
mycosis fungoides
lymphoma, t-cell
melanoma
carcinoma, squamous cell
carcinoma, basal cell
lymphatic metastasis
metastasis
survival rate
survival analysis
neoplasms, radiation induced (this is used for those caused by sun exposure,
too)
sunlight
ultraviolet rays
cocarcinogenesis
environmental exposure
occupational exposure
bioavailability
biotransformation
half life
metabolic activation
metabolic detoxification, drug
structure activity relation
dose response relation, drug
biological transport
active transport
drug resistance, antineoplastic
multidrug resistance
P-glycoprotein
calcium channel blockers (sometimes used to avoid drug resistance)
biological response modifiers
recombinant proteins
recombinant fusion proteins
immunomodulators
tissue distribution
intestinal absorption
blood brain barrier
drug synergism
drug interactions
drug utilization
drug costs
prescription
physicians practice patterns (for habits of prescribing, etc.)
photochemistry
dermatitis medicamentosa
drug administration schedule
drug administration routes
tumor cells, cultured
enzyme inhibitors
alkylating agents, antineoplastic
dna damage
dna, neoplasm
apoptosis
neoplasm proteins
organ culture
keratinocytes
epidermis
skin
angiogenesis, pathologic
There are many more (about 20,000 in all) MeSH Terms, so play around with the
concept and don't get discouraged. It is annoying to try to learn them all
suddenly, but it saves tons of time because otherwise you have to think of every
trade name, chemical name, variant spelling, etc. for each drug and AND them all
together to be sure of getting what you want. The same with the disease--you'd
have to AND together all the possible ways they could have said skin cancer:
skin cancer, skin tumors, skin carcinoma, cutaneous neoplasms, cutaneous tumor,
skin neoplasia, cutaneous melanoma, etc. We've done all that work already and
indexed them all as skin neoplasms plus the histological type if given (also a
very hairy field in terms of nomenclature).
You can use subheadings with the above diseases by adding them after a slash
(eg. melanoma/etiology). Some useful subheadings might be:
/etiology
/drug therapy
/chemically induced
/surgery
/radiotherapy
/epidemiology
/mortality
/pathology
/metabolism
/genetics
/supply and distribution
/economics
You can use subheadings on the drugs too. Each drug should be indexed by its
chemical name and by its pharmacological action, so in addition to the very
general term "antineoplastic agents" given above (which should be added to all
anticancer drugs, or at least one of the specifics like "antineoplastic agents,
phytogenic" will be added and the search picks up all the specifics filed under
the general term), she can try the names of particular drugs she is interested
in. If they don't exist as MeSH Terms, she should try setting the box on
Substance Name because we have about 200,000 drugs listed there which do not
appear often enough in the literature to merit their own headings in MeSH.
Trying different spellings may help. As a last resort, use the drug name as a
Textword search and scan titles for it; then select Medline rather than Citation
as an output format and see what term was used. This will be the MeSH Term to
try. Useful subheadings with drugs are:
/pharmacology
/pharmacokinetics
/adverse effects
/therapeutic use
/tox
/poisoning
/metab
/agonists
/antagonists
/contraindications
For things involving the behavior of the drug in the body, /pharmacokinetics is
used rather than /metab. If it is in cultured cells or organ culture, /metab is
used. For the drug's effect on a process or another chemical, /pharmacology is
used, eg. verapamil/pharmacology AND calcium channels/drug effects AND calcium
channel blockers/pharmacology would be the way to search for verapamil's action
as a calcium channel antagonist.
Hopefully once she gets all the refs, she can find them at the library
associated with the pharmacy school or a nearby med school. As you can see it is
a huge topic, and I just gave you a few ideas off the top of my head. (Also, if
some of the terms don't work, I may have misremembered their correct form
because for indexing we use a lot of abbreviations that can't be used for
searching on PubMed. Try changing them a bit, eg. if
"angiogenesis, pathologic" doesn't work, try "angiogenesis, pathological". We
just use "pathol.") Good luck to her!---Helen S.
