Prophets of the beast: the modernist esotericism of D.H. Lawrence and W.B. Yeats

This thesis analyses the influence of the esoteric tradition on D.H. Lawrence and W.B. Yeats’ thought and examines both authors’ writings in light of the antidemocratic political religions that emerged during and after their respective careers. While a number of extant studies investigate the connection between modernism and the occult and a number of critics have discussed the importance of antidemocratic politics to modernism, this study is unique in its emphasis on the relationship between modernist esotericism and antidemocratic politics, and in its insistence that the interconnection between the two constitutes a fundamental part of both authors’ world-views. This study calls for the development of a multivalent understanding of modernism, which appears as neither a “cultural movement identifiable with bourgeois, capitalist, paternalist, ethnocentrist, phallocentrist, and logocentrist ideologies” (Surette 5) nor entirely the opposite; Romantic, feministic, primitivistic and countercultural. Rather, modernism will be shown to have encompassed both of these ideological orientations, effectively operating on a double front in its crusade to establish a new age. This complexity is visible in both Lawrence and Yeats’ work, as both authors advocate a return to traditional structures while simultaneously endeavouring to usher Western civilisation into a new modern paradigm. Although they primarily grounded their writings in a mythico-pastoral discourse that masked the practical implications of their revolutionary agendas, both authors possessed an attraction to Futurist thought and, albeit rarely, showed an awareness that the change they envisioned could not be brought about without a radical intervention in the political and economic sectors – an intervention that would necessarily take place through the medium of the “machine” from which they were often so adamant to distance themselves. This fusion of technophilic and Arcadian thought-currents – dubbed “archeofuturism” by the French right-wing intellectual Guillaume Faye – constitutes the central focus of this discussion of Lawrentian and Yeatsian thought.

Cancer associated malnutrition: prevalence of cachexia, sarcopenia and impact on treatment outcomes, survival and health related quality of life

Malnutrition, sarcopenia and cancer cachexia (CC) are prevalent among cancer patients and can have detrimental effects on clinical outcomes such as quality of life (QoL) and overall survival. Cachexia is associated with lower tolerance for chemotherapy, which limits the total dose that can be delivered, the number of symptomatic responses and any survival advantage that might be accrued. Moreover, for the majority who do not respond, cachexia may be exacerbated by systemic chemotherapy, thus increasing the net symptom burden experienced by patients. The multitude of interactions between cancer location, treatments, nutritional status and QoL has never been thoroughly explored in an Irish cancer cohort. The objectives of this thesis were to further understand nutritional status, especially body composition in ambulatory cancer patients and determine the relationship between nutritional status using different assessment criteria and QoL, chemotherapy toxicity and survival among cancer patients undergoing chemotherapy. Results aimed to identify baseline factors that may be predictive of poor outcome, toxicities to chemotherapy and disease-free and overall survival. This thesis broadly divides into two sections. The first section (Chapters 3 & 4) focuses on improving our knowledge of the nutritional status of Irish cancer outpatients using a cross sectional study design. A study of 517 patients referred for chemotherapy was conducted using computed tomography (CT) imaging (body composition) and a survey that documented oncologic data, weight loss (WL) data and QoL data. We revealed that a significant proportion of Irish cancer patients undergoing chemotherapy experience unintentional WL over the previous 6 months (62%), sarcopenia (45%) and CC (43%), and the distribution of WL and nutritional risk were associated with site of primary tumour and treatment intent. Patients that had sarcopenia, nutritional risk, or CC had significantly reduced functional abilities, more symptoms and adverse global QoL. In the second section of this thesis (Chapters 5 & 6) the potential link between developing toxicity to antineoplastic regimens in patients with sarcopenia was conducted by way of retrospective studies. A retrospective serial CT analysis defined the prevalence of sarcopenia in patients with metastatic renal cell carcinoma (mRCC) and metastatic castrate resistant prostate cancer (mCRPC), which was then correlated with dose limiting toxicities of sunitinib and docetaxel respectively. Sarcopenia was prevalent in patients with mRCC and mCRPC, was an occult condition in patients with normal/high BMI, was associated with less treatment days, was a significant predictor of DLT in patients receiving sunitinib and a significant predictor of neutropenia and neurosensory toxicities in patients receiving docetaxel. This thesis attempted to address the underlying research deficiencies in Irish oncology nutritional data at national level. The findings from this thesis have implications for the planning of cancer care interventions and indicate that further research is required to improve nutritional screening, in particular for CC and sarcopenia, in the hope that timely intervention can improve both patient-centered and oncologic outcomes.

The use of PET-CT in the assessment of patients with colorectal carcinoma.

Colorectal cancer is the third most commonly diagnosed cancer, accounting for 53,219 deaths in 2007 and an estimated 146,970 new cases in the USA during 2009. The combination of FDG PET and CT has proven to be of great benefit for the assessment of colorectal cancer. This is most evident in the detection of occult metastases, particularly intra- or extrahepatic sites of disease, that would preclude a curative procedure or in the detection of local recurrence. FDG PET is generally not used for the diagnosis of colorectal cancer although there are circumstances where PET-CT may make the initial diagnosis, particularly with its more widespread use. In addition, precancerous adenomatous polyps can also be detected incidentally on whole-body images performed for other indications; sensitivity increases with increasing polyp size. False-negative FDG PET findings have been reported with mucinous adenocarcinoma, and false-positive findings have been reported due to inflammatory conditions such as diverticulitis, colitis, and postoperative scarring. Therefore, detailed evaluation of the CT component of a PET/CT exam, including assessment of the entire colon, is essential.