Salomon J C
Institut de Recherches Scientifiques sur le Cancer, C.N.R.S., Villejuif, France.
Med Hypotheses. 1990 May;32(1):29-32. doi: 10.1016/0306-9877(90)90063-k.
A given cancer is a disease which combines a paraneoplastic syndrome with an invasive tumour capable of giving rise to metastases. Surgeons, radiotherapists, medical oncologists and experimental scientists are primarily interested in the tumour. Tumours of tissues and organs which do not normally produce hormones might, during the neoplastic transformation, begin to secrete hormones or substances able to mimic hormones in their effects on other tissues in the organism. The number of known hormones has increased considerably in the last 20 years. It has been found that even in the absence of clinical signs there are often secretory abnormalities and changes in the hormone balance in cancer. The tumour-paraneoplastic syndrome interaction is bidirectional. That paraneoplastic syndromes are dependent upon the tumour, is universally accepted; the reverse, that the tumour might depend on the paraneoplastic syndrome is not part of the current way of thinking. To treat cancer patients, instead of debating the cause and effect in the tumour-paraneoplastic syndrome pair with the classical idea of acting as close to the cause as possible, it seems better, in all circumstances, to treat both the tumour and the paraneoplastic syndrome, even if only subclinical.
特定的癌症是一种将副肿瘤综合征与能够发生转移的侵袭性肿瘤相结合的疾病。外科医生、放射肿瘤学家、医学肿瘤学家和实验科学家主要关注肿瘤。通常不产生激素的组织和器官的肿瘤，在肿瘤转化过程中，可能会开始分泌激素或分泌在对机体其他组织的作用上能够模拟激素的物质。在过去20年里，已知激素的数量大幅增加。人们发现，即使没有临床症状，癌症患者也常常存在分泌异常和激素平衡变化。肿瘤与副肿瘤综合征之间的相互作用是双向的。副肿瘤综合征依赖于肿瘤，这一点已被普遍接受；而肿瘤可能依赖于副肿瘤综合征这一相反观点，并非当前的思维方式。为了治疗癌症患者，与其按照尽可能接近病因的传统观念去争论肿瘤与副肿瘤综合征之间的因果关系，在所有情况下，似乎更好的做法是同时治疗肿瘤和副肿瘤综合征，即使只是亚临床的。
