The diagnosis in the same patient of the two diseases is very often delayed. Generally, tuberculosis is diagnosed first, and then cancer when the radiologic lesions extend despite of antituberculous treatment. In half of our cases, tuberculous lesions could not be individualized from cancer on the chest X-ray films. Antineoplastic chemotherapies may favour the development of tuberculosis, or atypical mycobacteriosis, in cancer patients, and it must be considered as an opportunistic infection in such patients. Clinicians should be aware of the possible coexistence of the two diseases and, in practice, ask for fiberoptic bronchoscopy and sputum cytology in tuberculous patients presenting atypical features, and for sputum examination in cancer patients.

A 25-year-old woman developed hot flushes due to the artificial menopause induced by cytotoxic chemotherapy (MOPP) during five years for Hodgkin's disease. Plasma FSH levels were found to be greatly elevated while those af 17 beta-oestradiol were markedly diminished. Veralipride was prescribed as one tablet (100 mg) daily for 20 days. Hot flushes disappeared completely, and no recurrence was observed during the 4-month follow-up period after discontinuation of treatment. Tolerance was excellent. This result is in agreement with those of studies reported in the published literature, relating to the treatment of hot flushes and psychofunctional disorders associated with both the natural and artificial menopause.

In a phase II trial 2 N-Methyl-9-Hydroxy-Ellipticine (NMHE) was administered in weekly infusions of 100mg/m2 over 1 hour to patients with malignant metastases. Prior to injection, the drug was dissolved in 250 ml isotonic glucose. The results were evaluated in 67 patients. Objective regression was observed in 23 (34%) and was superior to 50% in 10 cases. Patients showing signs of regression under treatment were mostly those with breast cancer (10/24 cases), soft tissue sarcoma (3/9 cases) and renal cancer (2/8 cases). The main toxic effect was haemolysis (2 cases), probably due to an immunoallergic mechanism. Attention is drawn to the lack of bone marrow toxicity.

A 60-year-old male patient with small carcinoma of the lung was treated with chemotherapy and radiotherapy. The tumour regressed, but two squamous cell carcinomas appeared in the contralateral lung. The first one was discovered after 3 months' treatment and developed slowly; the second one, diagnosed after 9 months' treatment, was rapidly progressive. The patient died 13 months after the beginning of treatment, and only the squamous cell carcinomas could be confirmed on autopsy. Such cases may reflect either selection of tumours that were present from the beginning of treatment, or development of other malignancies, or treatment-induced histological changes in the original tumour.

Although it is generally accepted that anti-cancer chemotherapy should be administered at the maximum tolerable dose, it is not clearly established that the therapeutic results at dosage levels involving maximum tolerable toxicity are really superior to those with lower, better tolerated doses. 392 patients with advanced primary lung cancer were treated with 5 chemotherapy regimens including cyclophosphamide, methotrexate, vincristine, procarbazine, hydroxyurea, adriamycin and CCNU, in combinations of 3 to 7 agents. Response rates of 50% and over were registered after 8 weeks of treatment. During the same time the intensity of leukopenia, thrombocytopenia, vomiting, other digestive toxicity, neurologic disorders and alopecia was graded according to the worst observation from 0 to 4. The results show that there is no correlation between the grade of toxicity and the rate of response either for the whole group or for subgroups of patients as defined by cell type, degree of dissemination, age, or performance status. They demonstrate that the search for maximum tolerable toxicity is not a sine qua non for the best possible response to chemotherapy in primary lung cancer.