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Das Buch enthält die Vorträge des XVIII. Seminarkongresses 1989 für Psychosomatische Gynäkologie und Geburtshilfe. Die Beiträge behandeln u. a. Bilder der Weiblichkeit, Schwangerschaftskonflikt, Pubertät und Adoleszenz sowie aktuelle Themen aus Forschung und Praxis. Der neue Band dieser Fortbildungsreihe vermittelt Gynäkologen, interessierten Ärzten anderer medizinischer Fachdisziplinen sowie klinisch tätigen Psychologen das relevante notwendige Wissen über psychosomatische Zusammenhänge und Störungen. Es enthält praxisnahe Hinweise für eine erfolgreiche Behandlung auf diesem für Arzt und Patientin problematischen Gebiet.

The growth and function of many tissues are influenced by hormones. Therefore it is quite understandable that hormones play a role in the development and treatment of malignant tumors. Numerous publications address this topic; however, the results of many studies are controversial and have not been unequivocally accepted. For nearly 50 years the carcinogenic effect of steroid hormones has been under debate, and their therapeutic value a matter of discussion for equally as long. The present volume concentrates on substantiated data first obtained from the study of tumors developing from hormone­ regulated or hormone-producing tissue, e.g., the thyroid, adrenal glands, prostate, and the female genital tract. Through a joint approach from the field of molecular biology, biochemistry, and histopathology, advances in the management of these tumors have been elaborated. Another exciting example is the endo­ nuclear diagnosis of adrenal tumors. Antihormones, i.e. antian­ drogens or GnRH analogues have proved to be important indeed since they exhibit a destructive effect on prostate carcinomas and breast cancer. Further improvements can be expected in the localization of hormones in tumor tissue by specific antibodies. A special chapter is dedicated to the diffuse endocrine cell system (DECS), the clinical significance of which has mainly become obvious in the gastroenteropancreatic tract.

Minimal neoplasia may be defined as a small cancer that has progressed beyond its site of primary origin into the surrounding tissue, but that has not yet reached the stage of deeper invasion or metastasization. The basic principles of this minimal cancer are presented in chapters on molecular, biological and experimental aspects, and, in particular, on the clinical manifestations in various organs: preleukemia, incipient lymphoma, and minimal carcinomas of the uterine cervix, breast, thyroid, larynx, lung, prostate, stomach and colon. A separate chapter is devoted to cryptic gliomas. The latest morphological methods including cytology, early clinical diagnostics and, in particular, radiodiagnostics, are considered. The reader can expect up-to-date information about prompt diagnosis of the very early manifestations of cancer, together with inferences on therapy, which, especially in tumors of the uterine cervix, breast and thyroid, differs considerably from the treatment of advanced neoplasia.

In the past, research in cancer immunology has produced informa­ tion important for other medical disciplines. It helped, for example, in formulating the laws of immunogenetics and in achieving a better understanding of the mechanism governing the fate of allotrans­ planted tissue. Cancer has often been considered a foreign body, and therefore many attempts have been made to cure it on the basis of the immunological principles applicable to parasitic, bacterial, or viral diseases. Vaccination has been investigated clinically for its po­ tential to prevent cancer [1], and clinical research into the cure of cancer has included active immunization [2], nonspecific stimulation of defense mechanisms [3], and transfer of passive immunity by cells [4] or by antibodies [5]. These experiments have been of limited value and in some cases have even had an adverse effect. The reputation of cancer immunology has suffered, and the concept has often been severely criticized. However, the basic postulate that cancer must originate from the body's own cells, and that the immune system belongs to the principal regulatory mechanisms, remains valid. In recent years new research into clinical cancer immunotherapy has included critical appraisal of all its potential benefits, and also of the risks and limitations. It is dangerous to make unrealistic promises or to speak or think in terms of'miracle weapons'or a'magic bul­ let.