20 patients with malignant ascites were treated with intraperitoneal(IP) cisplatin which included 16 cases of carcinoma ovary and one case each of cancer breast, colon, stomach and mesothelioma of peritoneum. Out of 20 patients, 16 patients had excellent local control of disease with absence of effusion and improving Karnofsky's scale upto 90 to 100 percent(14 cases of cancer ovary and one case each of carcinoma breast and mesothelioma of peritoneum). Two cases , one ach of carcinoma colon and stomach, and two cases of carcinoma ovary with advanced disease did not respond to intraperitoneal cisplatin. Infusions of cisplatin were generally well tolerated by the patients. No sign of myelosuppression, nephrotoxicity, neuropathy or ototoxicity was observed in the present study. Acute toxicity consisting of mild nausea, vomiting(Grade 1-2 according to WHO scale)and anorexia was observed in most of patients. The results obtained in the current study suggest that intraperitoneal cisplatin is an effective therapy for immediate control of malignant ascites with minimal side effects.

Paclitaxel is a new anti-tumour agent. The drug hs been found useful in advanced ovarian malignancies and various other malignancies. Phase II trial of this drug was conducted at Tata Memorial Hospital to study efficacy, safety and toxicity profile of this drug. The response rate was 18 percent for advanced ovarian carcinoma and partial response was seen in one case of choriocarcinoma. Acceptable degree of myelosuppression and alopecia were seen as side effect. No hypersensitivity reactions were noticed. We conclude that Paclitaxel is a reasonably safe drug with good efficacy in various malignancies.

Ovarian tumors are the second most common cause of gynecological malignancies in India. We undertook this study in 21 patients with clinical suspicion of ovarian neoplasm, all of whom were evaluated by Ultrasound(US) and Computed Tomography(CT). Each patient was evaluated for pelvic and extra pelvic disease. Sixteen of these patients underwent surgery while 5 were evaluated by fine needle aspiration biopsy. Nineteen of these finally proved to be primary ovarian tumors while 2 were non ovarian masses. Both these modalities had similar results for pelvic disease evaluation. CT proved to be superior for evaluating extra pelvic disease primarily because of its ability to detect omental/peritoneal deposits, gastrointestinal tract(GIT) involvement and liver deposits better than US. We recommend CT as the investigation of choice between these 2 modalities.

A case of 53 year old female patient who developed stage la, well differentiated endometrial carcinoma after taking adjuvant Tamoxifen for breast cancer is reported.

Small Cell Carcinoma of cervix is a rare entity. A 42 year old woman presented with stage Ib cervical cancer, biopsied specimen on light microscopy proved to be of small cell variety. Inspite of radical surgery and post operative adjuvant chemotherapy, she developed bilateral adrenal metastases. The patient was than given aggressive second line chemotherapy but the metastatic lesion was persistent. Excision of persistent adrenal metastases was planned after the metastatic work up. On CT scan, patient had multiple brain metastases. After three months she succumbed to the disease.

Modern day management of cancer patients very often requires administration of intravenous of combination chemotherapeutic agents. Peripheral venous access, may frequently become difficult necessitating reliable Central Venous access. This is a retrospective review of our experience with cancer patients who had completely implanted venous access ports. From 1991 to 1994 there were ten patients. The ports remained in situ for an average of 9 months. Two ports functioned for more than a year. Average of 6 chemotherapies were given through each port. Catheter performance in 50 percent of cases was excellent. The commonest complication was sepsis which required removal of two ports. Totally implantable ports are a relatively safe and reliable method of long term venous access in cancerr patients requiring chemotherapy.