Hi, my name is Lori Ann Blakeley.

Welcome to my Web site developed and maintained on my behalf by my father, Larry Blakeley. http://www.royblakeley.name/larry_blakeley/larryblakeley_photos_jpeg.htm

My father also manages the following Web sites:

Larry Blakeley (Contact Info: larry at larryblakeley.com)

Major Roy James Blakeley (USAF - KIA) (December 10, 1928 - July 22, 1965) - my grandfather

Leslie Blakeley Adkins - my older sister

Evan Blakeley- my younger brother 

A Web page for giving notices of interest to visitors here. http://www.loriblakeley.name/notices_of_interest.htm

Various letters and notes here. http://www.loriblakeley.name/various_notes_letters.htm

What my brother, Evan Blakeley is up to with his baseball. http://www.evanblakeley.name

My mother's walking club for the students at Cockrell Hill Elementary School, DeSoto, Texas http://www.loriblakeley.name/article_dallas_morning_news_jackie_blakeley20070601.htm

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- "Treatment of Adrenocortical Carcinoma: Contemporary Outcomes," David Y. T. Chen, MD, R. Ernest Sosa, MD, and Douglas S. Scherr, MD, Current Urology Reports 2004, Volume 5, Issue 1, http://www.biomedcentral.com/1527-2737/5?issue=1 Pages 65-72, February, 2004, Current Science, Inc. http://www.current-science.com/inc/, a subsidiary of The Current Science Group, head office in United Kingdom: Middlesex House, 34-42 Cleveland Street, London, W1T 4LBLondon (UK), with additional offices in Philadelphia, Hoboken and Tel Aviv http://www.current-science-group.com/,

This article was accessed through the Open Access Web site of BioMed Central at the location http://www.biomedcentral.com/1527-2737/5/65#IDARFKRD

See the Web page for Open Access Publishers http://www.larryblakeley.com/library_research_commercial/commercial_publishers_elibraries/open_access.htm for further information on Open Access Publishers like BioMed Central (including the Web page to register as a user).

This article can also be accessed at:

(DjVu version 100 KB here http://www.lori.blakeley.name/treatment_acc_contemporary_outcomes_200402.djvu)
(PDF version 421 KB here http://www.lori.blakeley.name/treatment_acc_contemporary_outcomes_200402.pdf)

Post Date: February 13, 2005 at 12:30 PM CST; 1830 GMT

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- "Collaborative group for Adrenocortical Carcinoma Therapy (COACT): Clinical Study Protocol," First International Randomized trial in locally advanced and Metastatic Adrenocortical Carcinoma Treatment (FIRM-ACT) http://www.firm-act.org/, Etoposide, Doxorubicin, Cisplatin and Mitotane vs. Streptozotocin and Mitotane, April 24, 2004,

Study Protocol: http://www.firm-act.org/documents/FIRM_ACT_protocol_final.pdf

Synopsis: http://www.firm-act.org/documents/FIRM_ACT_Synopsis.pdf

Objective: To compare the efficacy of etoposide, doxorubicin and cisplatin plus mitotane (EDP/M) as first line treatment versus streptozotocin plus mitotane (Sz/M) as first line treatment

Steering Committee: http://www.lori.blakeley.name/FIRM_ACT_steering_committee_20040424.htm

Post Date: February 13, 2005 at 10:00 AM CST; 1600 GMT

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The following articles (a 15 page version and a 47 page version) were accessed from the Web site of Offizielle Homepage des deutschen Nebennnieren-Karzinom-Registers (NKR) http://www.nebennierenkarzinom.de from the Web page here http://www.nebennierenkarzinom.de/Downloads/

- "Management of Adrenocortical Carcinoma," Bruno Allolio*, Stefanie Hahner, Dirk Weismann, Martin Fassnacht* Endocrinology and Diabetes Unit, Dept of Medicine, University of Wuerzburg, Germany http://www.nebennierenkarzinom.de/Downloads/Allolio-ACC-ClinEndo2003.pdf (47 page version)

(The above PDF version (1,031 KB) also available here http://www.lori.blakeley.name/Allolio-ACC-ClinEndo2003.pdf (47 page version)

(Also, a DjVu version (271 KB) available here http://www.lori.blakeley.name/Allolio-ACC-ClinEndo2003.djvu (47 page version)

- "Management of adrenocortical carcinoma,"
Clinical Endocrinology (2004) Volume 60, Pages 273–287 doi: 10.1046/j.0300-0664.2003.01881.x http://www.nebennierenkarzinom.de/Downloads/management%20of%20ACC.pdf, accepted on June 5, 2003 by the Clinical Endocrinology Journal (2004) published by Blackwell Publishing Ltd. (15 page version)

For futher information on Blackwell Publishing and other commercial publishers go here http://www.larryblakeley.com/library_research_commercial/commercial_publishers_elibraries/comercial_publishers.htm

Post Date: February 13, 2005 at 10:00 AM CST; 1600 GMT

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- "Toxic Treatment Without Effect," German News Magazine "Der Spiegel", October, 2004

Directory: http://www.royblakeley.name/larryblakeley/articles/monthly_articles/

Abstract: http://www.royblakeley.name/larryblakeley/articles/monthly_articles/der_spiegel200410_abstract.htm

File Name: der_spiegel200410 (1,854 words)

Post Date: February 1, 2005 at 2:30 AM CST; 0830 GMT

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- "The Great Chemotherapy Myth," Dr. Robert H. Sorge, New Life Magazine, September/October 2004 Issue

Directory: http://www.royblakeley.name/larryblakeley/articles/monthly_articles/

Abstract: http://www.royblakeley.name/larryblakeley/articles/monthly_articles/robert_sorge200409_abstract.htm

File Name: robert_sorge200409 (3,329 words)

Post Date: February 1, 2005 at 1:45 AM CST; 0745 GMT

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- "Nutrition and cancer: A review of the evidence for an anti-cancer diet," Michael S Donaldson, Director of Research, Hallelujah Acres Foundation, Nutrition Journal 2004, 3:19, http://www.nutritionj.com/home/ doi:10.1186/1475-2891-3-19 http://www.nutritionj.com/content/3/1/19

© 2004 Donaldson; licensee BioMed Central Ltd.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Directory: http://www.royblakeley.name/larryblakeley/articles/monthly_articles/

Abstract: http://www.royblakeley.name/larryblakeley/articles/monthly_articles/michael_donaldson20041020_abstract.htm

File Name: michael_donaldson20041020.pdf

Note: This article is being provided on this Web site to teach you the importance of the Open Access movement and the importance of free access by the public of these types of research reports. It is highly recommended that you view the Web page for this article, "Nutrition and cancer: A review of the evidence for an anti-cancer diet" at the URL http://www.nutritionj.com/content/3/1/19

See the Web page for Open Access Publishers http://www.larryblakeley.com/library_research_commercial/commercial_publishers_elibraries/open_access.htm for further information on Open Access Publishers like BioMed Central.

Post Date: January 26, 2005 at 2:15 AM CST; 0815 GMT

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- "Amplification of the Steroidogenic Factor 1 (SF-1) Gene in Childhood Adrenocortical Tumors," http://www.lori.blakeley.name/amplication_SF1_20041116.pdf

The Endocrine Society http://www.endo-society.org/, Journal of Clinical Endocrinology & Metabolism. First published November 16, 2004 as doi:10.1210/jc.2004-0942 http://jcem.endojournals.org/cgi/rapidpdf/jc.2004-0942v1.pdf

Authors here. http://www.lori.blakeley.name/amplication_SF1_20041116_authors.htm

Important Note: This article is applicable to children only - not to Lori's circumstances.

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- "Adrenal Cancer: A Rare but Challenging Disease," David E. Schteingart M.D., University of Michigan http://csrf.net/ADRENAL_CANCER_Steingart.htm

Dr. David Schteingart is Professor of Internal Medicine in the Division of Metabolism, Endocrinology and Diabetes at the University of Michigan in Ann Arbor, MI. Dr. Schteingart has long standing experience in adrenal cancer and served as Program Chair for the September, 2003 International Consensus Conference on the Treatment of Adrenal Cancer.

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Medical Care:

- Medical care is supportive or adjuvant to surgical resection.

- Chemotherapy is discussed as follows:

- When metastatic disease cannot be removed or if biochemical evidence of tumor secretion persists after surgical removal, chemotherapy is often considered. Currently, no studies suggest that chemotherapy can fulfill a truly adjuvant role that improves patient survival and prevents relapse following incomplete resection or total resection.

- Nonetheless, anecdotal data exist that at least 2 drugs have activity that may prolong survival. If these drugs are thoroughly studied, they may ultimately demonstrate the possibility of an adjuvant role. The 2 drugs are mitotane (o,p'-DDD, Lysodren) and cisplatin (CDDP, Platinol). For a long time, researchers have known that mitotane dramatically decreases adrenal cortical hormone production and ultimately ablates the cortical part of the adrenal gland.

- In the absence of ongoing clinical trials, these drugs are most commonly used for palliation. Mitotane is used to decrease residual cortical hormonal production, and cisplatin is used to shrink metastases in the lung and elsewhere in order to prolong survival once the disease becomes unresectable.

- Radiation therapy may be helpful in palliation of unresectable disease that is unresponsive to medical therapy.

Surgical Care:

- Treatment of adrenal cortical carcinoma begins with surgical care. Surgery is the mainstay of treatment and currently appears to be the only hope of cure. Every reasonable attempt should be made to render the patient disease-free at the primary site, at sites of local invasion, and at sites of metastatic disease.

- In this author's experience, aggressive surgical care has led to survival longer than 10 years in 2 patients, one of whom was concurrently treated with medical therapy. This patient had a large bulky tumor with no local invasion; the other patient had a stage II tumor with several follow-up thoracotomies.

- In addition, some case reports indicate that multiple thoracotomies can allow more than 10 years of high-quality survival despite recurring crops of metastatic disease. In a recent study from Sloan-Kettering analyzing patients with adrenal cortical carcinoma regardless of age, aggressive primary surgical removal and aggressive surgical treatment of local or distant relapse led to far superior long-term survival rates than reported in previous studies. One important feature of this article was that patients who had a complete second resection had a median survival time of 74 months (5-y survival rate, 57%). The current role of surgical resection in the treatment adrenal cortical carcinoma cannot be overemphasized.

- Patients with symptoms of hormone overproduction and biochemical evidence of adrenal cortical hormone overproduction should be supported in the postoperative period following a major resection. These patients have suppressed their own endogenous adrenal cortical hormone production. Stress doses of hydrocortisone that ultimately lead to maintenance doses and tapering (should the patient not be placed on any further therapy) are indicated.

- "Adrenal Carcinoma," Lawrence C. Wolfe, MD, eMedicine.com http://www.emedicine.com/, March 9, 2004 http://www.emedicine.com/ped/topic41.htm

Lawrence C Wolfe, MD, Chief, Division of Pediatric Hematology-Oncology, Floating Hospital for Children; Associate Professor, Department of Pediatrics, Tufts University School of Medicine

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- "Adrenal Carcinoma," eMedicine.com http://www.emedicine.com, http://www.emedicine.com/med/topic63.htm, Last Updated: November 8, 2001.

Author: Gabriel I Uwaifo, MBBS, Clinical and Research Attending, Assistant Professor of Medicine and Endocrinology, MedStar Clinical Research Center, The MedStar Research Institute and the Washington Hospital Center http://www.medstarresearch.org/

Coauthor(s): Antonio Tito Fojo, MD, http://ccr.cancer.gov/staff/staff.asp?profileid=5729, Senior Clinical Investigator, Medicine Branch, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health