Minerva

As the incidence of malignant melanoma continues to rise throughout the world at a rate close to 5% a year the gloomy news is that the survival of patients with metastatic lesions has not improved (Journal of the American College of Surgeons 1995;181:193-201). Follow up of 1521 patients treated in California showed that those with distant metastases had a mean survival of only 7.5 months, a figure that had not changed during the previous 22 years. Melanomas on the head, neck, and trunk carried the worst prognosis.

Aspirin is nowadays recommended as a preventive treatment for patients who have had strokes, heart attacks, or transient ischaemic attacks. How many of them bleed? A report in “Gut” (1995;37:509-11) from the UK transient ischaemic attack trial followed up 2435 patients given either aspirin or placebo. There were 52 confirmed episodes of symptomatic upper gastrointestinal bleeding--all except five in patients taking aspirin. The relative risk was 3.3 for patients taking 300 mg of aspirin and 6.4 for those taking 1200 mg.

Surgeons in Japan report far higher survival rates for the patients they treat for stomach cancer than are reported for patients treated in the West. A report from Austria (Cancer 1995;76:1302-12) suggests that …