Kill Cancer By New Tech

Scientists say drug delivery method improves cancer treatment

2011-12-01T09:27:00.000-08:00

Implantable, flexible LED detects cancer

2011-09-20T11:30:00.000-07:00

www.smartplanet.com By Tuan C. Nguyen | September 20, 2011, 7:10 AM PDT

In light of its viability as a replacement for soon-to-be-phased-out incandescent light bulbs, LEDs have become a controversial and much politicized area of innovation. It’s kind of a shame because beyond the contentious debates, the technology has the potential to revolutionize critical aspects of our day-to-day lives, such as health care.

The latest example of its game-changing application comes from researchers at the Korea Advanced Institute of Science and Technology, who recently demonstrated that a special type of flexible LED can, for instance, be surgically implanted unobtrusively inside the human body to detect cancer and possibly treat diseases.

The new concept, called GaN LED, is a highly efficient light emitting device that can be found in LED TVs and various lighting products. Until recently, it had been difficult to incorporate this semiconductor material into flexible electronic systems due to its brittleness. GaN LED is not only flexible, but also features a flexible LED biosensor to catch the appearance of prostate cancer cells.

Keon Jae Lee, a materials science and engineering professor, first hit upon the idea with his co-invention of “High Performance Flexible Single Crystal GaN,” developed during his PhD course at the University of Illinois at Urbana-Champaign (UIUC). His flexible GaN LED biosensor utilizes a similar method to transfer thin GaN LED films onto flexible substrates. This is followed up with a biocompatible packaging process that enables the technology to be used for implantable biomedical applications.

“Bio-integrated LEDs represent an exciting, new technology with strong potential to address important challenges in human health,” said Professor John Roger. “This present work represents a very nice contribution to this emerging field.”

Bold experimental treatment uses form of HIV to kill cancer

2011-09-14T12:26:00.000-07:00

By Laura Shin | September 14, 2011, 5:41 AM PDT SMARTPLANET.COM

A bold experimental treatment has finally succeeded in accomplishing a goal that has eluded doctors for decades: it has trained the immune systems of cancer patients to search out and kill cancer cells.

The New York Timesreports, in a novel twist, that the doctors used a disabled form of HIV-1, the virus that causes AIDS, to deliver the new genes that would program the person’s own cells to attack the cancer.

The University of Pennsylvania doctors have tried the experimental treatment in three leukemia patients, two of whom went into full remission and one of whom has had a partial remission in which his leukemia remains in lessened form.

They published the results of their experiment with the first patient, William Ludwig, in the New England Journal of Medicine and Science Translational Medicine.

Results in first patient

The doctors — Dr. Carl June of the Abramson Cancer Center at the University of Pennsylvaniaand colleagues Dr. David L. Porter, Bruce Levine and Michael Kalos — began by removing a billion of Ludwig’s T-cells, which are white blood cells that fight tumors and viruses.

They then altered the genes of the T-cells so they would attack cancer, and returned those modified T-cells to his bloodstream.

For the first ten days, nothing happened. But then, according to the Times, “hell broke loose in his hospital room. He began shaking with chills. His temperature shot up. His blood pressure shot down. He became so ill that doctors moved him into intensive care and warned that he might die. His family gathered at the hospital, fearing the worst.”

But within a few weeks, the fevers subsided, leaving no trace of cancer in their wake. No leukemic cells were found in his blood or bone marrow, and doctors calculated that two pounds of cancer cells had been killed off.

A year later, Ludwig’s remission remains complete. He has gained 40 pounds, plays golf, does yard work and travels with his wife in an R.V. Before the study, he sometimes could barely get out of bed and frequently suffered bouts of pneumonia. “I have my life back,” he told the Times.

How the therapy works and uses the HIV virus

In order for T-cells to kill cancer cells, they must be able to do several things: recognize the cancer, fight it, multiply and continue living inside the patient. Previous attempts to make T-cells do all these things failed, resulting in cells that, for instance, could only temporarily fight tumors.

However, this experiment enabled the modified T-cells to multiply to 1,000 to 10,000 times the amount originally altered by the researchers. In those numbers, they wiped out the cancer and then gradually diminished, but there remains a population of memory cells that could proliferate if needed.

The particular type of leukemia treated in this case was chronic lymphocytic leukemia, which afflicts B-cells. The doctors gave the T-cells genes that would make them find and attack a protein found on all B-cells, whether they are healthy or leukemic.

But it is not easy to decide which genes to insert and how to insert them. Viruses are natural delivery vehicles because they specialize in invading the genes of cells. In this case, because doctors wanted to modify T-cells, the AIDS virus was chosen because it naturally invades T-cells.

While other researchers have used HIV-1 to insert DNA into cells in gene therapy for other diseases, Dr. June and his colleagues were the first to use it in gene therapy for cancer patients.

This particular form of HIV-1 was no longer dangerous because other researchers had added DNA from humans, mice and cows and from a virus that infects woodchucks and another that infects cows.

But this type of therapy is not without risks. In other experiments, engineered T-cells have attacked the healthy tissue of patients. And, having been done in only three patients, the new T-cell treatment is not yet proven to work and has not yet been mass-produced by the drug industry.

Dr. June said his team’s next focus is using T-cells to attack solid tumors, such as mesothelioma and ovarian and pancreatic cancer.

Watch them discussing their method in this video:

via: The New York Times

photo: the engineered T-cells with magnetic beads attached to them; the beads are removed prior to infusion into the patient. (University of Pennsylvania)

PET/MRI creates diagnostic-quality images

2011-07-23T07:21:00.000-07:00

© This article copyright 2010 by AuntMinnie.com. Any copying, republication or redistribution of AuntMinnie.com content is expressly prohibited without the prior written consent ofAuntMinnie.com.

Structural, functional and molecular imaging of patients with brain tumours is feasible with diagnostic imaging quality using simultaneous hybrid PET/MR image acquisition, according to a study in the August issue of the Journal of Nuclear Medicine.

A pilot study in Germany of 10 patients with intracranial masses found no significant artefacts or distortions using a hybrid scanner configuration that features an MRI-compatible PET insert placed in the magnet bore. The lead author of the study was Andreas Boss, from the department of diagnostic and interventional radiology at Eberhard Karls University Tübingen in Germany (JNM 51 1198).

As the authors noted, previous studies have indicated that only half of low-grade gliomas can be correctly classified using conventional contrast-enhanced MRI. In addition, conventional MRI may be insensitive to post-therapy changes. With PET's ability to provide biochemical and metabolic information, researchers surmised that the two modalities together "may increase diagnostic accuracy over the single modalities."

Between August 2008 and November 2009, 10 patients with a median age of 51 years (range, 34 to 73 years) participated in the pilot study. All patients initially received a brain PET/CT scan, followed immediately by PET/MRI.

Patient diagnoses

At the time of the patient referrals, diagnoses included three cases of meningioma, two patients with low-grade astrocytoma, two cases of glioblastoma, and one case each of suspected low-grade astrocytoma, anaplastic astrocytoma, and atypical neurocytoma.

For the glial tumours, the radiotracer carbon-11 (C-11) methionine was used for PET imaging. In the cases of meningiomas, gallium-68 DOTA-tyr³-octreotide (Ga-68 DOTATOC) was administered.

Data acquisition from the PET scanner (Hi-Rez Biograph 16, Siemens Healthcare, Erlangen, Germany) started at 30 minutes after the injection of methionine and lasted for eight minutes. When DOTATOC was used, acquisition started at 20 minutes after injection and lasted for four minutes. A noncontrast-enhanced low-dose CT scan was used for attenuation correction in the glioma patients, while a contrast-enhanced CT scan was used for meningioma patients.

PET/MRI exams

All PET/MRI scans were performed with a hybrid PET/MRI system capable of simultaneous PET/MR imaging of the brain and skull base. The system consisted of an MRI-compatible PET scanner (BrainPET, Siemens), which was inserted into a modified 3-tesla whole-body MRI scanner (Magnetom Trio Tim, Siemens).

PET/MR images

The researchers acquired PET and MRI data simultaneously, starting 30 to 60 minutes after PET/CT acquisition. The PET scan was conducted for 30 minutes, producing approximately 5 GB of raw data. The PET datasets then were reconstructed by 3D algorithm. Attenuation maps were computed from 3D MRI datasets using an algorithm combining pattern recognition and atlas registration.

Upon review of the resulting images, the researchers determined that the MRI datasets acquired during simultaneous PET acquisition "showed diagnostic image quality, without apparent artefacts or distortions."

The one exception was when a 4 mm Gaussian filter was not used and the PET datasets from concurrent PET/MRI scans "exhibited slight streak artefacts, which were best visible in the sagittal and coronal reformations," the researchers noted. "After filtering, these artefacts were hardly visible."

PET/CT vs PET/MRI

The group also found that radiotracer decay between the PET/CT and PET/MRI acquisitions was effectively compensated by the longer scanning duration and better scanner sensitivity.

"Our study indicates that hybrid PET/MRI of intracranial tumours using C-11 methionine or Ga-68 DOTATOC can be reliably performed," Boss and his colleagues wrote. "The image quality and quantitative data achieved using PET/MRI is similar to that using PET/CT."

In addition, the authors noted that the combination of PET with MRI, instead of CT, "offers many advantages, such as higher soft-tissue contrast; reduced radiation exposure; and advanced MRI techniques such as perfusion imaging, diffusion imaging, and MR spectroscopy."

Additional clinical benefits are that PET with MRI can reduce a patient's exposure to ionizing radiation, which is present with CT.

About the author

Wayne Forrest is an AuntMinnie.com staff writer.

Combination radiation and hormone therapy shown to be effective in early-stage prostate cancer treatment

2011-07-16T11:06:00.000-07:00

By: www.privatemdlabs.com

For men who have received positive PSA tests, a combination of androgen deprivation therapy and radiation may significantly improve their chances of beating the disease, according to a new study published in the New England Journal of Medicine.

The researchers who conducted the study said that PSA testing has drastically improved doctors' ability to detect prostate cancer early. While this is an important breakthrough, it has raised the question of how best to treat men with early-stage prostate cancer.

For the study, researchers from Radiation Therapy Oncology Group followed the medical records of just under 2,000 men with low- to intermediate-risk prostate cancer for a period of nine years. The results showed that individuals who received short-term hormone therapy followed by a lengthier treatment of radiation were significantly less likely to die from prostate cancer.

The researchers said that their findings could play an important role in guiding the direction of early-stage prostate cancer treatments. In addition to improving outcomes, this could help make sure that healthcare resources are distributed in the most effective way possible.

Insulin Potentiation Therapy ....Great Article to read

2011-07-01T05:03:00.000-07:00

One of the main detriments of having cancer is not the cancer itself, but its treatment. Chemotherapeutic drugs are toxic not only to cancer, but to normal body tissue as well. Reducing the collateral damage caused by traditional medicine is posited to help the body be stronger to fight off the disease. Doctors have been experimenting with a treatment that allows for smaller doses of chemo drugs, called Insulin Potentiation Therapy (IPT).

Developing this technology first required looking to the physiological differences between a cancer cell and a normal body cell, in order to attack a cancer cell in ways that would not affect body cells as much. IPT acts on the principle that all cells need glucose for energy, and while body cells utilize a combination of glucose, fats, and proteins for energy, cancer cells rely solely on glucose. In fact, a typical cancer cell membrane contains up to fifteen times more glucose receptors than a normal cell, allowing them to thrive and starve healthy cells of nutrition. These glucose receptors open up when insulin is introduced, making the cell more vulnerable to chemotherapeutic drugs.

As well as opening the cancer cells up for attack, insulin also stimulates cell division. It is during this period that the part of the cell responsible for replication is most exposed. Chemotherapy drugs administered during this time have a far greater chance of taking out a cancer’s ability to spread and grow. These two actions in combination force the cancer to expose itself to attack, allowing for a lower dose of chemotherapeutic drugs to effectively neutralize malignancy and kill the cells.

Clinical studies at Georgetown University show that isolated cancer cells absorbed chemo drugs at 15,000 times the normal rate when first exposed to insulin. In practical applications, a variety of different cancers have been treated with only 5-10% of typical chemotherapy doses required to achieve cell death. This equates to a 90-95% drop in chemo drugs and the side effects they incur. They also inhibit or destroy much of the body’s natural defense network. IPT aims to make chemo drugs more of a smart bomb, having them “aim” and do more damage to the cancer than healthy tissue.

This variety of treatment is still in its early developmental stages and is not widely accepted or utilized in hospitals. It is showing great promise, however, having been effective against cancers of the mesothelium (mesothelioma), prostate, lung, breast, pancreas, ovary, colon, and lymphatic system. Given the especially pessimistic prostate malignancy and mesothelioma prognosis, this new form of treatment could offer hope to those with particularly difficult struggles.

By: David Haas

TrueBeam™ System for Non-Invasive Image-Guided Cancer Treatment Receives Shonin Approval

2011-06-17T11:02:00.000-07:00

Advanced technology from Varian Medical Systems for fast, accurate tumor targeting now available to cancer treatment centers in Japan

TOKYO, June 15, 2011 /PRNewswire/ -- Varian Medical Systems, Inc. (NYSE: VAR), the world's leading manufacturer of medical technology for treating cancer with radiotherapy, announced today it has received Shonin approval from the Japanese Ministry of Health, Labor and Welfare (MHLW) to market the TrueBeam™ system for image-guided radiotherapy and radiosurgery inJapan. Designed for the treatment of lung, breast, prostate, head and neck, and other types of cancer, Varian's TrueBeam system was engineered from the ground up to treat tumors with great speed and accuracy — including tumors that move during treatment as the patient breathes in and out.

TrueBeam features a multitude of technical innovations that dynamically synchronize imaging, patient positioning, motion management, and treatment delivery. Applicable for all forms of advanced external-beam radiotherapy including image-guided radiotherapy and radiosurgery, intensity-modulated radiotherapy (IMRT), stereotactic body radiotherapy (SBRT) and RapidArc® radiotherapy, TrueBeam can deliver treatments with a dose delivery rate that is roughly twice the maximum output of conventional systems. This makes it possible to offer shorter treatment times for patients, potentially enabling clinics to treat more patients each day and to improve precision by leaving less time for tumor motion during dose delivery.

"Intelligent" automation further speeds treatments and makes the technology easier for clinicians to use, with an up to five-fold reduction in the number of steps needed for imaging, positioning and treating patients. A standard intensity-modulated treatment that would typically take ten minutes can be completed in less than two minutes.

More than 220 TrueBeam systems have now been ordered by treatment centers around the world, and more than 65 installations are completed or in process.

Varian also offers the Trilogy® and Clinac® systems for image-guided radiotherapy, which have been approved for sale inJapan since 1995. There are now over 360 Varian treatment machines operating at cancer treatment centers across Japan.

"TrueBeam is Varian's most advanced cancer treatment system. It combines high dose delivery rates, image-guidance, RapidArc, and motion management capabilities, making it particularly well-suited for treating cancer of the lung and liver, two of the five most prevalent forms of cancer in Japan," said Makoto Yamada, sales manager for Varian in Japan. "We are pleased to be able to add the new TrueBeam system to the full line of cancer treatment technologies Varian can offer to our clinical partners in Japan.

BY: www.prnewswire.com

Ibuprofen to be used in cancer treatment?

2011-05-30T06:01:00.000-07:00

27th May 2011-www.spirehealthcare.com

The painkiller ibuprofen could become a part of cancer treatment after a study found that it stifles cancer growth.

A team of Cancer Research UK scientists based at the University of Bath found that a class of common painkillers, which includes ibuprofen, could interact with a protein which fuels cancer growth.

Non steroidal anti-inflammatory drugs are all processed by the body through the protein AMACR, which is overactive in prostate, bowel and various others types of cancer.

Lead author Dr Matthew Lloyd, said: "Some early laboratory studies have suggested that high doses of ibuprofen can halt the growth of prostate cancer cells, but the reasons for this aren't well understood."

He added that understanding more about how this protein acts and what molecules it interacts with could provide vital clues about future treatments for prostate cancer.

According to figures from Cancer Research UK, prostate cancer affects over 37,000 men in the UK. Around a quarter of all new cases of cancer diagnosed in men are prostate cancers.

Posted by Jeanette Royston

1 - Woodman et al, Chiral inversion of 2-arylpropional-CoA esters by human alpha-methyylacyl-CoA racemase 1A (P504S) - a potential mechanism for the anti-cancer effects of ibuprofen (2011), Chemical Communications.

Health News is provided by Adfero in collaboration with Spire Healthcare. Please note that all copy above is ©Adfero Ltd. and does not reflect views or opinions of Spire Healthcare unless explicitly stated. Additional comments on the page from individual Spire consultants do not necessarily reflect the views or opinions of other consultants or Spire Healthcare.

New machine provides fast, accurate radiation

2011-05-25T12:08:00.000-07:00

Written by

ESTELA VILLANUEVA-WHITMAN- www.desmoinesregister.com

Debra Douglas diagnoses cancer for a living, but when she learned she had a benign brain tumor, she said she came unglued.

"I couldn't breathe. It was frightening," said Douglas, 56, of Urbandale.

Problems with double vision sent her to the eye doctor, and an MRI showed a benign tumor on the third cranial nerve on her brain stem. For treatment, she was able to take advantage of TrueBeam STx technology, which has been available at John Stoddard Cancer Center since March.

Douglas's treatment included a series of radiation treatments over five days. Each treatment lasted roughly two minutes and her appointment ran a little more than a half hour, which meant she could return to work as a cytologist at The Iowa Clinic after each appointment. Previously, the process would have involved hour-long treatments spread over six weeks.

Douglas said her tumor is small, about five millimeters, which made TrueBeam a good choice for treatment.

"I can come here and finish out my routine like normal. It's been great," she said.

TrueBeam is a major advancement for cancer patients and John Stoddard is one of the few centers in the country to use it.

The technology allows for more accuracy, comfort and speed, said Dr. Robert Isaak, radiation oncologist at the cancer center. The equipment includes a mini CAT scan that revolves in a circular fashion around the patient, and delivers a higher dose output in the targeted area.

The machine uses an infrared camera to position patients and performs a CAT scan to ensure accuracy down to the millimeter. Images taken before and during the procedure are used by technicians for comparison using a split computer screen.

Isaak said Douglas's tumor is located in a tight spot that also controls much of the eye movement. Because it is benign, it won't spread or infiltrate other structures. Instead, it grows and can pinch and squeeze the nerve.

Dr. Robert Kerr, a neuro surgeon with The Iowa Clinic and the Neuroscience Institute, said treating while the tumor is smaller and in a minimally invasive manner is a huge benefit, compared to months of recovery from cranial surgery that also carries higher risks.

"The options are really to watch and to wait, versus waiting until this becomes much, much bigger and it becomes an absolute necessity to treat. When you do that in these deep and very critically located tumors, your chances of damaging or giving her permanent deficits at that point is much, much higher," he said.

Dr. Robert Goebel, medical director of radiation oncology at John Stoddard, added that comfort and accuracy are the key features of TrueBeam.

"The faster the treatment, the less of a chance you have that there is going to be any patient movement. It's extremely accurate and extremely fast," he said.

Kerr added that TrueBeam is helping John Stoddard build a neuro-oncology program. The equipment allows for more effective, less-invasive treatment, which can more easily treat spinal cord cases, difficult focused brain tumors and skull-based tumors.

"These are things we wouldn't have been able to do before, and now we can," he said.

Douglas' treatment took one week to complete and she will return in three months to monitor the progress of the tumor.

Heat may improve some cancer therapies

2011-05-11T10:53:00.000-07:00

Genelle Weule
ABC www.abc.net

Stem cell culture (iStockphoto)

Ramping up the heat on tumour cells could potentially boost the effectiveness of cancer treatments, say Dutch researchers.

The study by researchers based in The Netherlands, suggests that heating cancer cells between 41°C and 42°C may block a key DNA pathway and allow radiation and chemotherapy to more effectively thwart tumour growth.

But critics debate whether this heat level will work in the clinical setting.

Heating tumours a few degrees above body temperature in the lab breaks down a protein called BRCA2, which is essential for repairing double strands of DNA by a process known as homologous recombination, the researchers report in this week's Proceedings of the National Academy of Science.

This means the cells are less efficient at repairing damage caused by radiotherapy, chemotherapy or a new type of trial drug known as a PARP-1. The latter is used to treat rare cancers caused by defective BRCA genes such as some types of breast and ovarian cancer.

The researchers say their results, based on a range of cell cultures and animal models, shows that heat knocks out this DNA repair pathway in cancers with normal BRCA genes.

"We found that hyperthermia inhibits homologous recombination irrespective of the rare genetic BRCA2 mutation," says study co-author Dr Roland Kanaar from the Erasmus Medical Centre in Rotterdam.

This finding could potentially pave the way for the use of PARP-1 inibitors in combination with radio- or chemotherapy for a wider group of people, Kanaar says.

"While PARP inhibitors are now used in clinical trials for relatively rare tumours [caused by defective BRCA genes], our results suggest that tumours that can be efficiently heated should respond well to PARP inhibitors.

"So a drug developed for a small group of tumours with a specific genetic mutation, might now be useful for a larger group of tumours," he says.

Early days

Dr Gillian Mitchell, a clinical oncologist and director of the Familial Cancer Centre at the Peter McCallum Cancer Centre in Melbourne is trialling PARP-1 drugs in patients with breast cancer caused by defective BRCA genes.

While the Dutch research is "very early days from the petri dish to the person", Mitchell says it offers a new way of thinking for researchers working in the field.

"The big question in clinical trials is whether you can expand PARP inhibitors out to people that don't have the [BRCA] gene mutation," says Mitchell.

"At the moment we've been struggling with just how to identify tumours with this pathway and bashing our heads trying to identify them, whereas this [research] is suggesting … that you don't need to try to find them, you can make them susceptible," says Mitchell.

She says the technique may be useful for the treatment of localised tumours, but a lot more research is needed to get the concept into the clinic.

"We need to understand a lot more about what heating the cells means and the potential ramifications of that."

She says there are a number of questions that need to be answered to ensure the treatment actually works and doesn't cause side-effects.

"There are a lot of technical problems between now and using it in the clinic if the specific areas you want have to be heated to a specific temperature."

Heating not easy in reality

Professor Kum Kum Khanna from the Queensland Institute of Medical Research , says the concept of using hyperthermia to sensitise cancer cells isn't new.

"[This study] has potential based on laboratory-based evidence, but I would await positive outcomes from clinical trials whether this would be accepted as a treatment," says Khanna, who studies DNA damage and repair pathways and their impact on cancer.

Khanna says heating tumour cells in the clinical setting is a major hurdle.

"Systemic tumours are very difficult because you can't reach 43°C without having an outside temperature of 54° or above, which would burn the patient," she says.

Tej Pandita, Professor of Radiation Oncology at South Western Medical Center in Dallas, also urges caution about the study results.

Pandita says the paper's finding that a temperature of 42°C sensitises cancer cells is "inconsistent with existing literature."

He says previous research on animal studies published by his team in 2005 showed that temperatures of 42°C did not degrade proteins.

All clinical trials to heat tumours using electrodes or other methods have failed, he adds.

One of the researchers in the Dutch study is an employee of AstraZenica, which contributed the drugs and analytic tools used in the research.

Words of inspiration in fight against breast cancer

2011-05-02T14:08:00.000-07:00

No two breast cancer patients handle the disease in quite the same way. Nonetheless, one thing is certain: A positive attitude is good medicine. We asked breast cancer survivors to share what helped or helps them endure the fear and treatment. From inspiration drawn from a famous poet to advice from a cherished friend or trusted physician, each of these individuals has words they've held onto in the worst of times. And in the tradition of passing on the help, they are sharing them with us. Here are their words of advice.

- Jennifer Towery

Get mad, and don't give up
My wife was a 16-year survivor who passed away in May 2010. For advice to other survivors, as I told my "darlin' bride" - get mad! If you lay down and give up, the disease wins. Fight, be mean, and don't ever forget: You can fight this. You can overcome this. And as my wife proved for years, you can lead a good, long productive life.
To all the ladies out there fighting this mean, nasty killer, don't give up. Fight, lead a full, wonderful life, and embrace all who will be with you on your journey. You are not alone, and you are loved. God bless you all.
Ron Kingsley
Sparland
Husband of the late Dixie Kingsley
Don't stop living your life
We never expect to hear "Your biopsy results have come back, and you have cancer," but that is exactly what I heard on Jan. 14, 2011, and my world was turned upside down.
I had my surgery on Feb. 14, and am currently undergoing 33 radiation treatments. To date I have completed seven of them.
There were several things that got me through the month from diagnosis to surgery. Among them, a strong faith and a loving and supportive family unit and fantastic friends, surgeons, physicians and medical personnel.
I think it's very important to try and stay as normal as you can in your daily life and be informed about your condition and options for treatment. When my mind began to wander off, I would journal daily. This helped me to face my fears. I tried to keep focused on the present, and take one day at a time. I also tried to recognize those things that I could change and accept the things that I could not do anything about. It put the situation somewhat into perspective for me.
I am so very blessed and thankful for two of my dearest friends who kept me busy. They did not allow me to wallow or feel like I have been going through this journey alone. Their constant phone calls, visits and weekly "girls day out" truly kept me from losing my grip, and I am grateful to them.
Please ladies, get your regular mammograms. Because I did this, my cancer was caught very early, and my outcome looks very positive.
It's a dreadful disease, and I hope and pray that we find a cure.
Cheri Jacobson, 60, Brimfield

Surround yourself with people you love
I am an eight-year breast cancer survivor. My advice to anyone diagnosed is to stay positive and always surround yourself with the people you love - they will help keep your spirits up when you need it the most. Don't ever give up. Continue living life as normally as possible, and love life.
Melinda Bohls
Age 52
Peoria

Strength from determination
Often, people don't know what to say, so they say things like "you'll be fine," or "I don't know how you're doing this; I could never go through this." Believe me, that is NOT the advice a cancer patient wants to hear. Does anyone really know I'll be fine? What other choice do we have than to go through it?
The best piece of advice I got was, "Chin up, shoulders back, you WILL do this." I took that advice and made it my mantra. On days when I felt consumed by worry, I made an effort to put my chin up and shoulders back. I faced each day with the determination that I would beat breast cancer. Cancer can take so much from us; it took my breast. However, cancer gave me a strength I didn't know I had, courage I didn't know I'd need and a deep appreciation for friends, family and health care professionals who I may have taken for granted before I began my fight against cancer.
When you first discover you may have cancer, your life is filled with so many frightening things. You need an ultrasound; you need an MRI; we have to biopsy ... we found cancer. I am very grateful to my plastic surgeon, Dr, Glyn Jones, who told me on my first visit, "We can put Humpty back together again!" I held on to that as well, remembering that there would be an end to treatments and surgery.
Cancer is a lifelong journey. Even when treatment is over, there is still that worry every time you have a mammogram or feel what you think might be a lump. My advice to women facing a breast cancer diagnosis is to reach out. Talk to friends, join a support group, read books. I have been able to reach out to other breast cancer patients, and I always tell them, "Chin up, shoulders back, you WILL do this." Women are strong beyond our appearance. Together, we can fight cancer and win!
Tammy Bishop
Age 49
Mackinaw

Don't just survive - thrive
"Surviving is important. Thriving is elegant." - Maya Angelou
After surviving my diagnosis, during treatment and even now, as an eight-year survivor of breast cancer, I did and still do use this saying as my mantra.
The words have provided me with strength, hope and inspiration.
Strength to persevere through challenges.
Hope to heal physically, emotionally and spiritually.
Inspiration to love life.
I am surviving, and, I dare say, thriving.
Joan McNamara
Age 56
Peoria

'You need to fight this'
I am the mother of three beautiful girls. After finalizing the divorce of my 15-year marriage, I met someone. He became a friend, a confidant and someone I spent a lot of time with.
As we sat watching a movie one night, he put his arm around my back and under my arm to pull me closer to him. As he did he felt a lump, I assured him it was just a gland. But after three weeks of him telling me I needed to get it checked out, I went to my doctor, who sent me to the Susan G. Komen Center for a mammogram.
I had the biopsy done on a Friday and returned on Monday, July 14, 2008, alone for the results. When they gave me that diagnosis - "It's breast cancer, either Stage 2 or 3" - I wanted to run away, scream, cry, laugh, tell them they were wrong. Most of all, I wanted to fight someone. I calmly put on a brave face and walked myself to my vehicle where I sat alone. I screamed, I cried and I laughed and said, "They must be wrong." Then I had a conversation with my mom.
My mom was my best friend. She had passed away May 11, 2002, the day of the Race for the Cure that year. I told her I wanted to see her, but it was just too soon. I wasn't ready to die. I needed to be here for my girls, and I know this life has so much more planned for me. The sun shone brightly in my face and this warmth came over me. I'm not sure if it was because it was July, and I was sitting in a vehicle with the windows up and the car wasn't running, but I want to believe it was my mom and my two aunts, who passed away from breast cancer, giving me a big hug telling me I need to fight. I can fight!
Two days later, I sat in front of my surgeon, who gave me the best advice: "Breast cancer is not a death sentence. You need to fight this."
She trained me for my fight, and fight I did. After a partial mastectomy, chemo, radiation, hair loss and the worse pain I have ever felt from the onset neuropathy, my fight was over.
As I look back, I realize that through it all, I wasn't alone. My girls, my family, my dad, my friends, my doctors, and most of all that guy - they were all there for me.
I told that guy he could walk away from our relationship with no hurt feelings because I knew that this would be too much for anyone to take. He stayed in my life. He reminded me every day that I wasn't dead. My guy and my dad were the two best coaches any fighter could ever have. They let me cry on their shoulders and then would push me back out to fight, reminding me all the time, "This is not a death sentence, and you can win this fight!"
And I did. I'm cancer free, and I've celebrated two birthdays since that diagnosis. It feels good to know I'm not alone.
I was 36 when I was diagnosed. Insurance standards say that women shouldn't have mammograms until age 40. They are wrong. I remind people that they should check themselves regardless of age.
Kandace Johnson
Age 38
Pekin

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Carbon nanotubes capture cancer cells

2011-04-13T10:10:00.000-07:00

www.medicalphysicsweb.org

Researchers in the US have made a new device capable of detecting cancer cells and viruses. The device could eventually be developed into low-cost tests for doctors to use in developing countries where expensive diagnostic equipment is hard to come by, says team leader Mehmet Toner at Massachusetts General Hospital (Small doi: 10.1002/smll.201002076).

Carbon nanotube posts

It is usually a challenge to detect single cancer cells in a blood sample because they are present in very small amounts – just a few cells per millilitre of sample. These "circulating" cancer cells, as they are known, are those that have broken away from the original tumour site and indicate that a cancer has metastasized, decreasing a patient's chance of survival. It is thus crucial to be able to detect them. "Of all deaths from cancer, 90% are not the result of cancer at the primary site but from tumours that have spread from the original site," explained team member Brian Wardle at Massachusetts Institute of Technology (MIT).

Toner and colleagues had made an earlier version of their device four years ago that consisted of thousands of nanometre-sized silicon "posts" confined inside microfluidic channels. The posts were coated (or "functionalized") with antibodies that preferentially stick to certain types of tumour cell. When a blood sample was passed through the device (at around 2 ml per hour), tumor cells in the sample that came into contact with the posts became trapped.

Porosity is the key

However, the problem with this configuration was that some cancer cells passed through the device without contacting the posts at all. Toner's team has now overcome this problem by making the posts porous instead of solid. In this way, the cells flow through the posts as well as around them. This means the cells have a greater chance of touching the posts and sticking to them.

The new porous posts were designed by Wardle, who is an aeronautics engineer. Such nano-engineered structures are usually studied with the goal of making advanced composite material for stronger aircraft parts.

The posts in the new device are made of vertically aligned carbon nanotubes instead of silicon and can collect cancer cells eight times better than the solid posts, say the researchers. Carbon nanotubes are rolled up sheets of carbon atoms and assemblies of the tubes are highly porous. Indeed, an array of carbon nanotubes – which can contain up to 100 billion carbon nanotubes per square centimetre – is 99% air.

As in the original device, the researchers functionalize the surface of each nanotube with different antibodies that stick to a particular type of cancer cell. But that's not all: changing the configuration of the nanotubes also allows them to capture different sized objects – for example, cells that are around 10 µm in diameter, all the way down to viruses, which can be as small as just 40 nm.

Coated in antibodies

Toner and Wardle's team has proved that its device works by detecting a variety of bacteria and viruses, including fluorescent labelled Streptococcus pneumoniae bacteria. The researchers did this by coating the micofluidic device with anti-S. Pneumoniae antibody. They also succeeded in detecting human leukocytes, taken from healthy volunteers, and coating the devices with anti-CD4 antibodies.

"Sample preparation and filtering is crucial when working directly with complex biological samples, such as blood," commented Hatice Altug of Boston University, who was not involved in the work. "In this respect, it is very exciting to see that this device can very effectively capture and separate target bioparticles across multiple size scales, ranging from viruses to bacteria and cells."

And, since the technology is also compatible with large-area and low-cost manufacturing, it could find a wide range of applications in diagnostics, she added. The MIT team is now working on tailoring the device so that it can detect HIV, the virus that causes AIDS.

About the author

Belle Dumé is a contributing editor to nanotechweb.org.

Oncologists use robots to fight cancer

2011-03-22T11:33:00.000-07:00

by: www.smartplanet.com

year, Jean Stuetzle, 92, learned she had lung cancer and was given few options to make her well again. Then, she visited radiation oncologist Robert Sinha at El Camino Hospital in Silicon Valley. He told Jean about CyberKnife, a non-invasive procedure that uses a robot and targeted radiation to eliminate cancerous tumors. SmartPlanet looks at the new technology and how it's working on cancer patients like Stuetzle.

Surgery helps men regain fertility after cancer

2011-03-15T11:50:00.000-07:00

WASHINGTON (AP) — New research shows a painstaking surgical technique can help some men deemed infertile because of childhood cancer treatment to become fathers after all.

Many of the cancer treatments that can save lives also leave survivors infertile. Young men can bank sperm if they're told in time, but many aren't. And experiments to find options for children diagnosed before puberty are only now beginning.

Researchers at New York-Presbyterian Hospital and Weill Cornell Medical Center pioneered an option a decade ago for men deemed sterile for a number of reasons.

Now they have long-term data showing the technique can work in some childhood cancer survivors whose only other options would have been adoption or using donor sperm.

Surgeons essentially perform tiny biopsies of testicular tissue to hunt any pockets of hidden sperm, which then are used in standard in vitro fertilization to attempt a partner's pregnancy.

In cancer survivors, they were able to extract small amounts of sperm from more than a third of the men — 27 of 73. Doctors then attempted injecting the sperm into a partner's eggs in hopes of pregnancy. The result: 20 children were born, including five pairs of twins, the researchers reported Monday in the Journal of Clinical Oncology.

Being able to find what are essentially stray sperm cells is dramatic but doesn't mean the technique will help everyone, cautions Dr. Peter Schlegel, urology chairman at NY-Presbyterian/Weill Cornell.

"Chances of successful treatment before were thought to be zero. So yes, we're far better than zero but certainly it's not absolute that if you go in for treatment, that you're going to be successful," he said.

The new study found that the best chance for sperm retrieval was among men who'd been treated for testicular cancer, while survivors of sarcoma had the lowest chance. That's because of varying treatments for different types of cancer.

Sperm is made in tiny tubes inside the testicles, which can be seen under an operating-room microscope, Schlegel explained. Flat tubes probably contain no sperm, while larger ones are removed to see if they do.

The surgery costs about $10,000 to $12,000, in addition to the costs of IVF, he said. It's already offered at various medical centers around the country.

"This study gives men a new way to achieve fertility and the potential of parenthood," Dr. Lisa Diller of the American Society of Clinical Oncology said in a statement.

by www.google.com/hostednews

Intraoperative Radiation Therapy (IORT)

2011-03-10T10:35:00.000-08:00

Intraoperative radiation therapy (IORT) is an intensive radiation treatment that delivers a concentrated beam of radiation to tumors as they are located during surgery. IORT allows direct radiation to the tumor while sparing normal surrounding tissue. The type of IORT most commonly used at Mayo Clinic is also called intraoperative electron radiation therapy, or IOERT.

Thousands of people have received IORT treatment at Mayo Clinic. The IORT team at Mayo Clinic includes specialists in radiation oncology who perform the procedure, surgery,anesthesiology and pathology. In Arizona, Mayo Clinic is one of only a few institutions in the United States that uses a Mobetron, a mobile device that can provide radiation therapy in the operating room.

Conditions treated with IORT

IORT is used for cancer that cannot be cured with surgery alone and for tumors that are either attached or close to vital tissues. Recurrent rectal cancer is the most common condition treated with IORT at Mayo Clinic. IORT is also used to treat:

Cervical, uterine and ovarian cancers
Prostate, bladder and kidney cancers
Stomach, pancreatic, colon, rectal and anal cancers
Soft tissue sarcoma

For people who have recurring cancer and people who have locally advanced cancers, IORT can be an effective therapy in achieving long-term tumor control.

How it works

IORT is almost always used along with external radiation prior to surgery. During surgery, after the surgeon removes as much of the tumor as possible, a machine called a linear accelerator delivers a concentrated beam of electron radiation directly to the tumors. The surgeon moves healthy organs out of the radiation field to prevent damage, and special tubes are used to focus the beams safely on the tumor(s).

IORT also may be used when the remaining tumor is too small to see.

Advantages of IORT

IORT allows doctors to administer high doses of radiation to tumors without exposing nearby healthy organs to radiation. A single dose of intraoperative radiation may have as much effect on the tumor as 10 to 20 daily radiation treatments. IORT offers the following benefits:

Higher radiation dosage to cancer cells
Faster radiation delivery during surgery
Decreased radiation exposure to normal surrounding tissue
Safer application compared with traditional radiation treatments

Like other treatments, IORT carries some risks. Mayo Clinic doctors discuss the benefits and risks with people to help them decide on a treatment.

by:www.mayoclinic.org

NewGen radiation treatment effective in advanced head and neck cancer

2011-03-06T12:30:00.000-08:00

Clinical trials at Helsinki University Central Hospital in Finland to assess the efficacy and safety of boron neutron capture therapy (BNCT) indicate that it has the potential to treat patients with advanced head and neck cancer who have not responded to previous treatments.

BNCT treatment produces radiation inside a tumor using boron-10 and thermal neutrons. Boron-10 is introduced into cancer cells with the help of phenylalanine, a special carrier substance. The tumor is then irradiated with low-energy neutrons.

The neutrons react with the boron to generate high-LET radiation, which can destroy the cancer cells. One to two BNCT treatment sessions may be sufficient to destroy a tumor, while keeping the impact of radiation on surrounding healthy tissue to a minimum.

Prof Heikki Joensuu and his team looked at 30 patients referred to HUCH's Department of Oncology from hospitals around Finland.

Apart from palliative chemotherapy, conventional treatment was no longer considered possible for the patients treated in the BNCT trial.

Seventy six percent of patients responded well to the treatment and 30 percent were still alive two years after treatment; although only one patient has survived 55 months.

"The positive results that we have achieved in treating head and neck tumours have convinced us of the benefits of further developing BNCT treatment and the services needed to administer it," said Boneca's Board of Directors chairman Seppo Pakkala.

"As BNCT saves healthy tissue, this promises to make it a good choice as a first-line therapy for patients with large head and neck tumours, avoiding the need for extensive surgery," he said.

"Additional studies will be needed, however, before BNCT can be adopted for this use. We would also like to extend the use of BNCT to treating tumours in other anatomical areas for which there are no forms of treatment currently available," he added.

The results of the study have recently been published in the International Journal of Radiation Oncology, Biology, Physics. (ANI)

by: www.sify.com

Breast cancer: Symptoms, treatment & prevention

2011-03-01T12:26:00.000-08:00

The chance of developing breast cancer for a woman in the United States over the course of her lifetime is about 1 in 8. However, the death rates from this much-publicized disease continue to drop with better early detection and constant advancements in treatment.

More than 261,000 women are diagnosed with breast cancer each year, according to the American Cancer Society, making it the second most common malignancy in women after skin cancer.

While all cancers arise from an uncontrolled growth of abnormal cells, each patient’s treatment and prognosis can differ radically depending on her type of breast cancer, how advanced it is and a variety of other factors.

- Symptoms & Types

All breast cancers are not created equal, either in symptoms or category. Though some cases emerge without any noticeable symptoms, breast changes that warrant a doctor’s attention include a lump, swelling or thickening; dimpling or skin irritation; breast pain; nipple pain or an inverted nipple; red or flaky nipple or surrounding skin; or a discharge other than breast milk, according to the National Breast Cancer Foundation.

It's important to note that even these symptoms don’t necessarily mean a malignancy is present and often signal a benign condition, such as a cyst or infection.

Just as breast cancer has many symptoms, the disease is comprised of many specific types. Defined by whether it begins in the lobules or ducts, the parts of the breast responsible for milk production, these types include:

- DCIS, or Ductal Carcinoma in Situ. This non-invasive malignancy is the earliest and most curable form of the disease because is confined to the duct and rarely spreads. DCIS comprises about 20 percent of all breast cancers, invasive and non-invasive, diagnosed annually.

- IDC, or Infiltrating Ductal Carcinoma, is an invasive malignancy because it has spread beyond the ducts. It accounts for almost 80 percent of all invasive breast cancers. IDC appears as rounded or star-shaped areas on mammograms, with the star-like lesions signaling a poorer prognosis.

The remaining five types of invasive breast cancer comprise about 20 percent of all total cases. According to the National Breast Cancer Foundation, they include the rare and aggressive Inflammatory Breast Cancer, or IBC, which unlike other forms is often visible on the outside of the breast. IBC causes the breast to look red or inflamed due to blocked lymph vessels in the skin and mimics certain breast infections such as mastitis.

Diagnosis & Tests

Breast cancer screening tests, which are done on symptom-free women, can help to diagnose early cases. Early detection methods include clinical exams by medical professionals, self breast exams and screening mammograms, which are recommended for women age 40 and over, according to the American Cancer Society. Women with a family history of the disease can also undergo genetic testing to determine if they are at increased risk of developing it.

If a screening method reveals possible breast cancer, several tests can help confirm or disprove the diagnosis. These include:

- Imaging tests such as mammograms, MRI scans or breast ultrasound. Each of these methods produces internal pictures of the breast that help doctors see a potential mass.

- Biopsies, which take cells from suspicious lumps to study in a pathology lab to determine if they are malignant. Cells are extracted through special needles or during surgery.

If cancer is confirmed, doctors will assess the cells to determine key information such as the type of cancer and its grade, which signals how fast it is growing. They will also learn if the tumor is caused by a genetic mutation passed through families or is hormone receptive.

According to the American Cancer Society, the presence of hormone receptors on breast cancer cells usually indicates a better prognosis because certain drugs can prevent estrogen or progesterone from promoting cancer growth.

Typically, women with a positive breast cancer diagnosis will also undergo a battery of tests to determine if the cancer has spread to surrounding tissues, organs or bone. Common sites for breast cancer metastases are the bones, lungs or liver.

Treatments & Medications

With more than 2.5 million breast cancer survivors in the United States, it's clear that researchers have developed effective treatments and drugs that can either cure the disease or prevent it from quickly recurring. Treatments either target the cancer locally or systemically, depending on the location of the breast tumor, its size and the extent of the disease.

Local treatments include surgery and radiation, which attempt to remove or destroy the cancer in the breast without affecting the rest of the body. Surgery can include a breast-sparing lumpectomy or the more aggressive mastectomy, which removes the entire breast and is usually done in more advanced cases, according to the National Breast Cancer Foundation.

Systemic treatments are given by mouth or through the bloodstream and target cancer cells throughout the body.

These include chemotherapy, which uses toxic drugs such as cyclophoshamide (sometimes referred to by its brand name, Cytoxan) or methotrexate. Cancer fueled by the hormones estrogen or progesterone can be treated with hormone suppressors such as tamoxifen or raloxifene (Evista).

More recent systemic treatments include biological therapy, which use the immune system to fight the cancer and targets breast cancer cells containing high levels of a certain protein. Commonly used biologics are bevacizumab (Avastin) or trastuzumab (Herceptin).

Depending on a variety of factors, including a patient’s age, type and stage of cancer, her care regimen might include only one of these treatments or a combination of several.

Prevention

Some breast cancer risks, such as age and heredity, can’t be controlled. But as with so many other diseases, eating right and exercising can help lower the chances of developing breast cancer. According to the Mayo Clinic, other risk-reducing tips include:

- Limiting dietary fat - Maintaining a health weight - Foregoing hormone therapy at menopause - Limiting exposure to pesticides and antibiotics.

(Source: myhealthnewsdaily.com)

Dual-energy CT images cancer biomarkers

2011-02-28T10:52:00.000-08:00

by : medicalphysicsweb

Spectral CT, an emerging technique that images using X-rays of more than one energy, can differentiate multiple tissue types or contrast agents within the body. At the SPIE Medical Imaging conference, held last week in Lake Buena Vista, FL, Cristian Badea from Duke University Medical Center (Durham, NC) described the application of dual-energy microCT to simultaneously image iodine and gold probes in vivo.

Badea and colleagues examined two nanoprobes: liposomal iodine (Lip-I) and gold nanoparticles. The Lip-I probes comprised an aqueous iohexol core surrounded by a lipid bilayer and PEGylated to ensure retention in the blood. The gold probe was AuroVist, a commercial contrast agent comprising 15 nm nanoparticles. Both probes are cleared from the body via the liver and spleen.

As gold and iodine exhibit different attenuation coefficient profiles, with K-edges at different energies (81 and 33 keV, respectively), it should be possible to distinguish the two by comparing X-ray images at different energies. To determine the optimal imaging parameters, Badea's team built a dual-energy microCT system, containing two X-ray tubes and two detectors.

First, the researchers used the Spektr computational tool to model the microCT system's performance, using a phantom containing varying volumes of the two probes and imaging at voltages from 40 to 150 kVp. Plots of contrast versus voltage revealed that at 40 kVp, signals from regions containing gold nanoparticles were brightest, while iodine provided maximum enhancement at around 70 and 80 kVp.

They then performed phantom experiments to measure CT enhancement for the probes across the same voltage range. The measured images agreed with the simulated results, showing maximum CT enhancement at 40 kVp for the gold nanoparticles and 80 kVp for the Lip-I. On a mass-concentration basis, the relative average enhancement of gold to iodine was 2.75 at 40 kVp and 1.58 at 80 kVp.

The team also used the phantom images to determine the limits of detectability of the two probes. Calculating the contrast-to-noise ratio at different concentrations revealed a limit of 20 mg/ml for the Lip-I probes and 10 mg/ml for gold nanoparticles. The use of averaging to reduce the noise improved these values to 15 and 6 mg/ml for Lip-I, and gold respectively.

In vivo assessment

The researchers also used the dual-energy microCT system to perform in vivo imaging of mice with colon cancer tumours. Mice were injected with 0.1 ml gold nanoparticles (with a gold concentration of 200 mg/ml) and then imaged 72 hours later at 40 and 80 kVp. The mice were then injected with 0.4 ml of the Lip-I probe and rescanned.

Maximum intensity projection images showed that Lip-I probes visualized the blood vessels, while gold probes revealed the liver, spleen and some enhancement into the tumour due to extravasation of the nanoparticles.

"This dual-energy microCT provides a way to image 3D vasculature and permeability in tumours," concluded Badea, associate professor of radiology at Duke's Center for In Vivo Microscopy. "These are both important biomarkers in cancer studies."

Mammograms, now in 3D!

2011-02-23T10:37:00.000-08:00

Hologic, Inc. just received approval from the Food and Drug Administration for the first ever 3-D digital mammography system for screening breast cancer.

Current mammograms – with 2-D X-ray breast pictures – are limited because tissues overlapping tissues could be hiding lesions or, on the other hand, make benign areas look suspect. (About 10% of women undergo additional testing for abnormalities that are later determined to be noncancerous.)

The Selenia Dimensions digital breast tomosynthesis system (pictured at right) reveals the inner architecture of the breast, free from the distortion typically caused by tissue shadowing or density, according to Hologic.

In studies where radiologists viewed 300 mammography exams, the 3-D system “could significantly enhance existing diagnosis and treatment approaches,”says FDA’s Jeffrey Shuren. The system had better accuracy and detection, visibility and sensitivity – a 7% improvement over 2-D.

The breast is briefly compressed during the exam, which combines 3-D and 2-D imaging – resulting in a stack of thin high-resolution image slices that provide a clear rendition of the structures within the breast and the surrounding tissue.

The combination of 2-D and 3-D images about doubled the radiation dose the patient received. However, the increase in cancer risk from having both a 2-D and 3-D exam is expected to be less than 1.5% compared to natural cancer incidence, and less than 1% compared to the risk from conventional 2-D imaging, according to the FDA.

Nearly 40 million mammograms are performed each year in the US. In 2009, there were 192,370 new cases of invasive breast cancer diagnosed, and over 40,000 American women died from it in that same year. If detected early, the 5-year survival rate is 98%, according to the American Cancer Society.

“We believe tomosynthesis has the potential to change how screening and diagnostic mammography is performed, and over time will prove invaluable to the earliest possible detection of breast cancer and in the reduction of unnecessary diagnostic interventions,” says Hologic president and CEO, Rob Cascella.

Dimensions 3-D, which is an add-on to Hologic’s 2-D system, has already been commercially available in more than 40 countries. The National Cancer Institute recommends women ages 40 and older have a mammogram every one to two years.

by: www.Smartplanet.com

Images: Hologic

What can PDT does for cancer treatment?

2011-02-19T08:38:00.000-08:00

Metastasis is the main cause of death in cancer patients. One route for the spread of metastatic cells is through tumour-associated lymphatic vessels into the lymph nodes. Affected nodes can be removed surgically along with the primary tumour, but tumour cells inside the lymphatic vessels are left behind. Now, researchers from Finland have shown how using photodynamic therapy (PDT) to destroy lymphatic vessels and the tumour cells lodged within can halt the spread of cancer (Sci. Transl. Med. 3 69ra11).

The research team – headed up by Tuomas Tammela of the University of Helsinki – used animal studies to observe the tumour metastasis process in more detail. They implanted mouse melanoma cells into mouse ears and waited up to two weeks for the tumours to reach 1–2 mm in diameter and lymphangiogenesis (the tumour-induced formation of new lymphatic vessels) to set in.

Lymphatic vessel

Immunohistochemistry revealed that the newly formed lymphatic vessels did indeed contain in-transit tumour cells, as well as small tumour nodules. Analysis of tissue sections from a patient with recurrent melanoma demonstrated that lymphatic vessels of cancer patients also contain in-transit tumour cells and nodules.

Tammela and co-workers then investigated whether PDT could selectively destroy lymphatic vessels without affecting surrounding tissue. They injected verteporfin, a photosensitive drug that's used clinically to treat macular degeneration, into the mouse ear. Fluorescence imaging revealed that the drug accumulated preferentially within the lymphatic vessels. Illumination with 689 nm laser light activated the verteporfin, causing the vessels to shrink, fragment and become leaky.

Next, the researchers examined the combination of surgery and PDT. They implanted mouse melanoma cells into the flanks of mice, and waited two weeks for the tumour cells to become established and metastasize to the axillary lymph nodes. They then injected verteporfin into the primary tumour and surrounding tissue and illuminated the entire flank with infrared laser light before surgically removing the primary tumour and lymph nodes. A control group of mice only received the surgical treatment.

Targeting intralymphatic cells

Mice that underwent surgery plus PDT showed a tumour relapse rate of around 10%, compared with 65% for mice receiving surgery alone. This finding indicates that tumour nodules in the lymphatic vessels are a source of relapse, and suggests that targeting in-transit cells may reduce the rate of cancer recurrence in human patients.

"We do not expect PDT to replace current surgical techniques, which comprise removal of the primary tumour and metastatic lymph nodes," Tammela explained. "However, PDT could easily be combined with existing surgical techniques to destroy the lymphatic vessels draining from the tumour, as well as the tumour cell aggregates residing within them." He noted that, as both and PDT are already in use in patients, they are more likely to be approved for targeting tumour-associated lymphatic vessels than drugs in earlier phases of development.

Deep treatment
One limitation of PDT is that it's constrained by the penetration of light into tissue. To evaluate the feasibility of using PDT to destroy lymphatic vessels in humans, the team examined a pig model. To reach the deeper lymphatic vessels, they injected verteporfin into the pig's hoof, and then applied laser light using a "side-fire" laser catheter inserted at the knee. Following irradiation, the pig's lymphatic vessels fragmented and became clogged, indicating that PDT can target vessels deep within the body.

"We have demonstrated that photodynamic targeting of tumour-associated lymphatic vessels and intralymphatic tumour cells prevents locoregional metastasis and eradicates routes of tumour cell dissemination via the lymphatic system," the authors conclude. "Our approach may help to eradicate microscopic tumour cell aggregates in cancer patients and should render anti-lymphangiogenic therapies more feasible for clinical application.

By: Medicalphysicsweb.org - Research Articles

Gold seeds with IGRT >>> better cancer treatment

2011-02-15T12:36:00.000-08:00

Proton bombardment

2011-02-14T12:59:00.000-08:00

As written in the last article, the government of Canada has invested $35 million in four development programs, and the projects are headed up by: TRIUMF (Vancouver, BC); Canadian Light Source (Saskatoon, SK); Advanced Cyclotron Systems (Richmond, BC); and Prairie Isotope Production Enterprise (Winnipeg, MB). So,TRIUMF and Advanced Cyclotron Systems (ACSI) are both working on the cyclotron-based approach, which exploits the direct transmutation of Mo-100 into Tc-99m.

The process works as follows: the cyclotron accelerates hydrogen ions to a prerequisite energy, strips off the electrons to create a proton beam, and then directs this beam onto a thin target of enriched Mo-100. The protons collide with molybdenum nuclei and some of them cause it to transmute into Tc-99m (the proton beam energy is selected to optimize Tc-99m creation and minimize creation of other nuclides). Finally, the Tc-99m is extracted by dissolving the target and passing the solution through an ion-exchange column.

It's not a new idea – this method has been known for over 40 years – but, according to TRIUMF's Timothy Meyer, scaling up to efficient high-volume production requires the development and validation of several key processes.

"You need to show that the fabrication of the Mo-100 target is economical and reproducible, and that the accelerator can deliver sustained power levels in a reliable and efficient manner," he explained. "You also want to show that the separation and purification technologies meet regulatory guidelines for purity and clinical performance."

The TRIUMF team – known as CycloTech⁹⁹ – is investigating Tc-99m production on three different types of cyclotron. The idea is to use existing hospital cyclotrons, which currently produce other medical isotopes, to produce Tc-99m and distribute it to local clinics. Such cyclotrons will need to be upgraded, in particular by adding a beamline that's capable of irradiating solid targets. "We're going to benchmark the price and performance of that upgrade process and how it varies on different cyclotrons," Meyer said.

Myocardial perfusion imaging

Importantly, says Meyer, the upgrade won't impinge upon the normal cyclotron operating cycle. "Most medial isotope cyclotrons don't run 24 hours a day, they produce PET isotopes with short half-lives at certain schedules during the day," he explained. "The strategy would be to irradiate Mo-100 overnight, and then transfer it to the laboratory in the morning to process the Tc-99m shipment for the day."

Cyclotron manufacturer ACSI is also working to optimize this method of Tc-99m production, and has teamed up with the Centre Hospitalier Universitaire de Sherbrooke in Quebec and the University of Alberta. The collaboration has already made progress in target and process development, with Curie amounts of Tc-99m created using existing cyclotrons at the two facilities.

Quality control tests have shown that the cyclotrons can produce clinical-grade Tc-99m. Research will now focus on developing cost-efficient production using ACSI's high-current 24 MeV cyclotrons. Similarly to TRIUMF, the ultimate aim is to establish a decentralized network of medium-energy cyclotrons capable of producing large quantities of Tc-99m.

Photoneutron focus

The other two teams - Prairie Isotope Production Enterprise (PIPE) and Canadian Light Source – are developing production methods based around an electron accelerator. Again, Mo-100 is used as the target, but in this case, photoneutron reactions create Mo-99 as the end product.

High-energy electrons from a linear accelerator are incident upon the Mo-100 target, usually via a metal filter that helps dissipate the heat from the electron beam and creates a beam of intense X-rays. The X-rays remove a single neutron from some of the Mo-100 atoms in the target – turning them into Mo-99.

"Right now, we're using a water-cooled tungsten converter in front of natural molybdenum samples," PIPE's Jeff Martin explained. He noted that the team is also considering direct electron-beam irradiation, but that this can create problems with heating. PIPE is also looking at a range of methods for extracting the radioisotopes from the irradiated target.

"The idea we're working the hardest on involves dissolving the molybdenum target in solution. The solution will also contain Tc-99m, which can then be separated via a solvent extraction technique," said Martin. "The advantage of this method is you get very little breakthrough of non-radioactive molybdenum, a heavy metal that you don't want to give to the patient."

Martin pointed out that PIPE plans to speed its production process to market by basing it mostly on commercially available technologies. The collaboration has already shipped Mo-99 twice to the Health Sciences Centre in Winnipeg. "They've dissolved and extracted Tc-99m and it looks like it works," added John Barnard, Acsion Industries' director of research and technology.

One challenge associated with both the accelerator- and cyclotron-based approaches is the cost of the Mo-100 targets. Mo-100 comprises less than 10% of naturally occurring molybdenum and currently costs over $1000 per gram. Thus Tc-99m manufacture must also involve reprocessing of the irradiated targets.

"Because you only activate a small part of the Mo-100 in each cycle, it has to be recovered and integrated into a recovery process, which is an added complication to the whole isotope use in hospitals," explained Barnard. "That is going to be challenging - whether you use cyclotron or accelerator."

Looking ahead

The teams now have 15 months to prove themselves. After that, successful technologies could be rolled out across Canada and then marketed worldwide, possibly exploiting industry partnerships private to help with licensing and commercialization. Time will tell which will scale the fastest and prove the most reliable and economical. Either approach would create a more distributed supply network that overcomes the vulnerabilities of the current supply chain.

In terms of practical implementation, the cyclotron-based method produces Tc-99m, which has a half-life of just six hours and must therefore be manufactured at or very near to clinical sites. This approach can, however, take advantage of a wide network of existing medical cyclotrons.

The electron accelerator approach creates Mo-99, which has a half-life of 66 hours and, as such, can be shipped. "One or two linacs could probably supply most of Canada," Barnard said. This method also benefits from being more similar to, and thus able to exploit, the existing Tc-99m supply chain based on shipping of Mo-99.

"The decision by the government of Canada to invest public funds in a technology development programme is quite bold," Meyer told medicalphysicsweb. "If it's successful, with a few of these technologies at scale within about 15 months, the government's strategy and its faith in the technical community will be validated."

Kill Cancer By New Tech: Tc-99m production: losing the reactor

2011-02-13T13:28:00.000-08:00

Kill Cancer By New Tech: Tc-99m production: losing the reactor

Tc-99m production: losing the reactor

2011-02-13T08:35:00.000-08:00

Medical Cyclotron

Technetium-99m (Tc-99m) is the most widely used medical imaging isotope, employed in more than 30 million procedures worldwide each year. The isotope is created via decay of molybdenum-99 (Mo-99), which itself is produced in nuclear reactors. And herein lies the problem.

The nuclear reactor is needed to generate neutrons that bombard uranium-235 targets, with the resulting fission reaction producing Mo-99 around 6% of the time. This Mo-99 then decays into Tc-99m. Unfortunately, over 90% of the world's Mo-99 is produced by just five ageing reactors, resulting in an extremely fragile supply chain - the vulnerability of which was highlighted recently when unexpected shutdowns and routine maintenance closures combined to create serious shortages. But there are other ways to create Tc-99m, and ways that don't require nuclear reactors or a uranium target – itself a cause for concern as most facilities currently process highly-enriched (weapons-grade) uranium. Instead, researchers are investigating production methods based on cyclotrons and linear accelerators. Such processes exploit nuclear reactions within targets of Mo-100, bypassing the need for uranium completely.

In a bid to advance such technologies, the government of Canada has invested $35 million in four development programmes. The projects are headed up by: TRIUMF (Vancouver, BC); Canadian Light Source (Saskatoon, SK); Advanced Cyclotron Systems (Richmond, BC); and Prairie Isotope Production Enterprise (Winnipeg, MB) – a partnership between the University of Winnipeg, Acsion Industries and Health Sciences Centre Winnipeg.

"If Canada was going to build a new nuclear reactor, it'd cost a billion dollars," said Jeff Martin, professor of physics at the University of Winnipeg. "But with these proposed electron accelerators and cyclotrons, you have a smaller capital investment and can be up and running fast."

Read about Proton bombardment in the next article.

About the author

Tami Freeman is editor of medicalphysicsweb.

New breast cancer treatment SLND to replace ALND

2011-02-11T04:43:00.000-08:00

A study for a new cancer treatment procedure called sentinel lymph node dissection (SLND) that may take the place of axillary lymph node dissection (ALND) has been published in the Journal of American Medical Association (JAMA).

The common procedure ALND is an important and effective cancer treatment for more advanced breast cancer, but it is also a very painful early breast cancer treatment which involves removing multiple lymph nodes from the armpit. It not only removes the cancerous nodes, but it also removes surrounding nodes that could be cancerous as well. This method is not only painful, but can come with very disturbing side effects such as numbness, shoulder pain, limitation of motion, infection and lymphedema when the arm swells. This swelling can often times be permanent.

The new method SLND could save approximately twenty percent of breast cancer sufferers from having to undergo ALND, according the JAMA study. The study for SLND involved approximately 900 women who were being treated for breast cancer through the processes of lumpectomies and radiation therapy. The women were being treated at 115 different centers in the United States. According to the study, approximately half of the women also received ALND which showed to not significantly prevent recurrence of breast cancer or increase the survival rate of these women.

The co-author of the study and head of surgical breast oncology at M.D. Anderson Center, Dr. Kelly Hunt stated, “As we've learned more about biology of breast cancer we don't need these radical surgeries. [We do] not [need to] create all this collateral damageby removing normal uninvolved lymph nodes."

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by KC kelly- mind and body examiner