cancer update

HIV Patients More Prone to 7 Kinds of Cancer

2009-10-14T02:15:00.000-07:00

The weakened immune systems of people with HIV puts them at increased risk for at least seven types of cancer, but early diagnosis and treatment of HIV infection could help delay the onset of some of these cancers, a new study suggests.

French researchers examined the incidence of three AIDS-defining cancers (Kaposi's sarcoma, non-Hodgkin's lymphoma and cervical cancer) and four non-AIDS-defining cancers (Hodgkin's lymphoma, lung cancer, liver cancer and anal cancer) in 52,278 HIV-infected people.

The study authors also analyzed the association between immunodeficiency, viral load, antiretroviral treatment and the onset of the seven cancers. Overall, immunodeficiency increased the risk of all the cancers, and CD4 cell count was the most predictive risk factor for all the cancers except anal cancer. The cancer risk associated with viral load was lower than that associated with immunodeficiency, the researchers noted.

CD4 count was the only risk factor for Hodgkin's lymphoma, lung cancer and liver cancer, the study found. Increased risk of Kaposi's sarcoma and non-Hodgkin's lymphoma was associated with lower CD4 count, higher HIV viral load and a lack of combination antiretroviral therapy (cART).

A higher CD4 count was associated with a lower risk of cervical cancer, and patients taking cART were half as likely to develop cervical cancer. Anal cancer risk increased with the time during which CD4 count was less than 200 cells per microliter and viral load was greater than 100,000 copies per milliliter, according to the report.

The study appears online Oct. 7 in advance of publication in the November print issue of The Lancet Oncology.

"Our results suggest that cART would be most beneficial if it restores or maintains the CD4 count above 500 cells per microliter, thereby indicating an earlier diagnosis of HIV infection and earlier treatment initiation," the researchers wrote.

The study authors called for effective cancer-specific screening programs for HIV patients and said all HIV-positive women should be regularly offered cervical cancer screening.

Novel Breast Tissue Feature May Predict Woman's Cancer Risk

2009-10-06T01:13:00.000-07:00

The study shows that acini (AS-ih-nye), the small milk-producing elements in breast lobules, can be counted in sample biopsies. The percentage of acini present per lobule at a given age indicates cancer risk. Researchers say this method is more accurate in predicting risk for an individual than the Gail model (see National Cancer Institute).

"Aside from the predictors of heredity, there is no effective independent predictor of risk of breast cancer," says Lynn Hartmann, M.D., Mayo Clinic oncologist and senior author of the study. "This risk estimate model based on novel tissue in each individual may provide a reliable strategy."

Researchers studied the tissue structures in 85 patients with breast cancer and examined earlier, noncancerous breast biopsies from the same women. They compared them to 142 age-controlled samples from Mayo's Benign Breast Disease Cohort, a bio repository of benign biopsy tissues. Then, researchers developed the model and tested a risk prediction for each patient. For the same women, they used the existing Gail model to make five-year risk predictions for the same women. While helpful in determining increased risk in groups of women, the Gail model is only slightly better than a guess when it comes to predicting cancer for an individual, the researchers say.

"Women who were more likely to develop breast cancer had larger lobules with more acini," explains Dr. Hartmann.

Significance of the Findings

As women age, especially as they approach menopause, the risk of breast cancer declines because the lobules and acini disappear. This natural process, called involution, is at the core of this risk factor. Dr. Hartmann says if the lobules aren't largely gone by the time a woman is 55, her risk of breast cancer triples. By looking closely at the structures in a large sample of benign tissues, the researchers were able to note standard measurements for lobule size and number of acini in the lobules. This twofold approach led to development of accurate metrics on which to base individual risk. The team hopes this new model, combined with other patient information and assessments, will greatly improve a physician's ability to predict cancer risk for individual patients.

Others on the research team are Kevin McKian, M.D.; Carol Reynolds, M.D.; Daniel Visscher, M.D.; Aziza Nassar, M.D.; Derek Radisky, Ph.D.; Robert Vierkant; Amy Degnim, M.D.; Judy Boughey, M.D.; Karthik Ghosh, M.D.; Stephanie Anderson; Douglas Minot; Jill Caudill; Celine Vachon, Ph.D.; Marlene Frost, Ph.D.; and V. Shane Pankratz, Ph.D.; all of Mayo Clinic. The research was supported by the Department of Defense, Martha and Bruce Atwater, the National Institutes of Health, and the Katherine B. Anderson Foundation.

Loneliness could heighten risk of breast cancer, study finds

2009-10-01T11:24:00.001-07:00

Scientists in the United States who isolated cancer-prone mice found they developed larger tumours than animals with companions.

The socially deprived mice experienced gene activity changes in their mammary glands that were associated with cancer growth.

It is likely the findings have implications for human health – and not solely with regard to breast cancer, the researchers believe.

"This is a novel finding and may begin to explain how the environment affects human susceptibility to other chronic diseases such as central obesity, type 2 diabetes, hypertension (high blood pressure), etc," said study leader Dr Suzanne Conzen, from the University of Chicago.

The results suggest new targets for treatments that might reverse the effects.

Previous data from clinical trials have indicated that social support can improve the prospects of women with breast cancer.

Epidemiological studies suggest that social isolation increases death rates associated with several chronic diseases.

Dr Conzen's team took mice that were genetically predisposed to develop breast cancer and raised them in two different environments.

Mice from one group were kept on their own from the time they were first separated from their mothers. Those in the other group were allowed to mingle with other animals.

After the same amount of time, the isolated mice grew significantly larger mammary gland tumours.

They also showed signs of heightened stress, marked by raised levels of the stress hormone corticosterone.

"Despite the genetic similarity of the mice assigned to grouped versus isolated housing, living in the stressful environment was associated with greater tumour size, suggesting that the social environment may in fact alter the biology of cancer growth," said Dr Conzen.

Examination of DNA from the animals' mammary tissues revealed alterations in the activity of metabolism genes that were likely to fuel tumour growth.

These changes occurred even before tumour size differences were measurable.

The gene "expression patterns" indicated potential targets for preventive treatment.

"Given the increased knowledge of the human genome (genetic code map) we can begin to objectively identify and dissect the specific alterations that take place in cancer-prone tissues of individuals in at-risk environments and that will help us to better understand and implement cancer prevention strategies," said Dr Conzen.

Dr Caryn Lerman, deputy editor of the journal Cancer Prevention Research, which published the findings, said: "This study uses an elegant preclinical model and shows that social isolation alters expression of genes important in mammary gland tumour growth.

"It further elucidates the molecular mechanisms linking environmental stress with breast cancer development and progression."

Artist Luke Jerram's viral sculptures trap bacteria and viruses like Swine Flu, HIV and E-coli in glass
The artist with multiple personalities
Kindred Spirits

Cervical cancer vaccinations resume

2009-10-01T11:20:00.000-07:00

Family members confirmed the 14-year-old had been ill 'for some time' and said they were satisfied that the vaccine had not caused her death.

School and primary care trusts around the country had suspended their vaccination programmes while the batch involved was identified and sent back GlaxoSmithKline, the maker, for testing.
The recall was being carried out as a precaution, a spokesman for Glaxo said, and was instigated before results from the post mortem were available which showed the vaccine was 'unlikely' to have been related to the death.

Tens of thousands of doses of vaccine are involved in the recall and as a result some areas will not have had enough supplies to continue vaccinating, a spokesman for the Department of Health said.

Local arrangements were being put in place to share out batches of the vaccine unaffected by the recall and more stocks were being ordered.

Natalie Morton collapsed at Blue Coat School, in Coventry, on Monday hours after being given the Cervarix vaccine, against the humanpapilloma virus which causes 70 per cent of cervical cancers.

She died later in hospital and fears were prompted the vaccine may have been faulty or she may have suffered a reaction to it.

However last night a spokesman for Coventry PCT said post mortem results had found a 'serious underlying medical condition which was likely to have caused death'.

The vaccination programme there will resume on Monday and in other areas of the country the immunisations were being rescheduled.

A spokesman for Coventry PCT said: “It is an extremely rare health problem for a girl of Natalie’s age to suffer.”

Natalie’s stepfather, Andrew Bullock, said yesterday that she had been unwell for “some time” and that the family now believed the vaccine had not caused her death.

Mr Bullock said: “Natalie has been poorly for some time. She had not been to hospital but she was receiving medication and doctors have been involved.

“I don’t wish to say anything more about Natalie’s illness but let’s just say that sometimes things go on inside people’s bodies that we are not always aware of.

“We now believe that her death may not have been linked to the vaccine. We are waiting to hear the results of the post mortem to find out more.

“We are happy with the way the way that the school and the primary care trust have handled the situation. The school was not aware of Natalie's condition.

“We are now trying come to terms with our loss.”

A Department of Health spokesman said: "Preliminary results from the autopsy on Natalie Morton, who sadly died on Monday confirm that she had a rare and grave underlying medical condition that was likely to have caused her death.

"Before this was known, the vaccine manufacturer voluntarily initiated a recall of one batch of vaccine as a precautionary measure.

"We have been clear all along that there is no reason to suspend HPV immunisation - the programme against cervical cancer continues today.

"Some areas may have minor interruptions to the immunisation programme because they do not have sufficient stock of vaccine - this is a temporary situation following the precautionary batch recall by the manufacturer.

Others may have decided to pause to make sure parents and girls have all the facts they need, he added.

"We have one of the most successful immunisation programmes in the world

and have great confidence in the safety of them. Young girls can continue

to protect themselves against cervical cancer by having this vaccine.

"The Department of Health strongly recommends that local immunisation

continues as soon as possible

Regular exercise 'can cut chance of developing breast cancer

2009-10-01T11:11:00.000-07:00

Researchers found that older women who worked out for an hour a day, or just seven hours a week, could cut their chance of developing the disease by 16 per cent.

The exercise had to be of moderate to vigorous intensity but could include walking, hiking, swimming and some strenuous forms of gardening to have the protective effect.
The study looked at the exercise history of more than 110,000 women who had all who had gone through the menopause, the group most at risk of developing the disease.

They found that those who had exercised regularly for the last 10 years had cut their risk of developing breast cancer.

However, regular exercise at a younger age appeared to offer no protection from the disease.

The research team, from the American National Cancer Institute in Maryland, believe that the findings could indicate that exercise regulates sex hormones, which have been shown to drive growth in some cancers.

Breast cancer affects 37,000 women in Britain every year, and around 12,000 women die from the disease annually.

Mastectomies on increase

2009-09-28T08:01:00.000-07:00

In a stark reversal of a long-term trend, more early-stage breast cancer patients are choosing mastectomy, despite evidence that the aggressive, disfiguring surgery has the same survival rate as removing the malignant lump, new research shows.

The study by doctors at the Mayo Clinic in Rochester, Minn., suggests that a more detailed screening technique may have led additional women to have their breasts removed.But researchers also found a rise in mastectomies among women who weren't examined with the new magnetic resonance imaging technology. Some doctors say more women are opting to have their breasts removed because of an overwhelming fear the cancer will return.

"For some women, their quality of life is better with their breasts removed because you get rid of the concern, the anxiety" about recurrence, said Dr. Lisa Jacobs, a surgical oncologist with the Johns Hopkins Breast Center who was not affiliated with the study. "A lot of women come in and say, `I don't ever want to do this again.'"

Still, doctors worry that some patients are being treated too aggressively because many of the cancers spotted by ultra-sensitive MRI would never develop into dangerous tumors. There is also no research on whether the use of MRI improves overall survival.

The study found that 43 percent of breast cancer patients chose mastectomy at the Mayo Clinic in 2006 - up from 30 percent three years earlier. The 2006 rate was almost the same as the 45 percent of breast cancer patients who had mastectomies in 1997.

Fifty-two percent of women who had an MRI in 2006 had mastectomies, but so did 41 percent of women who didn't have an MRI.

Anecdotal evidence - and a recent study showing more breast cancer patients choosing prophylactic mastectomy in the cancer-free breast - suggests that the trend extends beyond the Mayo Clinic.

"Are we doing the right thing for women? Is converting a woman to mastectomy ... will that lead to a better clinical outcome?" said Matthew P. Goetz, assistant professor of oncology at the Mayo Clinic and one author of the study.

Goetz, who spoke to reporters yesterday, will present the paper May 31 at the American Society of Clinical Oncology's annual meeting in Chicago. The work was released yesterday along with nearly 5,000 other abstracts in advance of the conference.

The unusual data release occurred because some drug company stock prices fluctuated suddenly in past years between the time ASCO members got copies of the abstracts and the time they were publicly released. Some of the research papers involve trials of cancer drugs. To prevent a repeat, ASCO decided to release nearly all of the material at once this year.

Mastectomy rates began to decline nationwide soon after a 1990 National Institutes of Health Consensus Panel reported that breast conservation surgery - lumpectomy plus radiation therapy - was as effective as mastectomy for overall survival of most women with early-stage breast cancer. There was some increased risk of cancer recurrence when a breast was left behind, the group said.

The medical community began to view high mastectomy rates as a negative, counting against hospital rating scores, with the implication that a center with high rates wasn't up on new techniques and treatments.

There was a sense that paternalistic doctors were encouraging women to undergo major surgery when it wasn't necessary. But Jacobs said she thinks today's return to mastectomies is about something else.

"Before, it was felt the physicians were pushing it," she said. "It's the patients pushing it now."

Jacobs and other physicians also cited a new feeling of empowerment on the part of patients - mixed with more available treatment information, genetic testing and better breast reconstruction surgery.

"People want to have their breast cancer treated and reduce the chances that they'll have to face it again," said Dr. Stephen Grobmyer, a surgical oncologist at the University of Florida's Shands Cancer Center in Gainesville. "We see patients every week that are very educated and in many cases know what they want: It's mastectomy."

Jacobs said she always explains all of the options to her patients. Whenever appropriate, she starts the conversation with, "You are a perfect candidate for lumpectomy."

But a patient's concerns may go beyond that. Many women who get mastectomies don't need chemotherapy or radiation, eliminating the side effects and hardships of five-day-a-week radiation for six weeks after a lumpectomy.

An MRI does help find more cancers - about 3 percent in one study. But it is also associated with a high number of false-positive results - 75 percent in another study.

Doctors recommend an MRI for women who have a genetic trait associated with breast cancer or a family history of the disease. An MRI, which uses powerful magnetic fields, radio waves and a computer to produce detailed pictures, tends to work better than mammograms in detecting abnormalities in women with dense breast tissue.

More women with breast cancer opt to remove healthy breast

2009-09-28T07:58:00.000-07:00

A rising number of women are choosing to remove a healthy breast after being diagnosed with breast cancer -- even though there is little evidence that doing so improves survival, a new study found.

The research, which appears in Cancer, the journal of the American Cancer Society, examined data from 6,275 New York state women, who had prophylactic mastectomies -- removal of a non-cancerous breast as a preventive measure.

Researchers looked at women who had a healthy breast removed after the discovery of cancer in the other breast as well as woman without cancer who had both breasts removed, but had a strong family history of the disease or a gene making them more susceptible to it.

From 1995 to 2005, the number of women who had cancer in one breast and choose to have the other breast removed more than doubled. Those with no personal history of breast cancer who had both breasts removed also increased, but slightly.

While the number of these kinds of mastectomies remains small, they're rising and such surgery comes with risks. Other studies reveal increases in overal mastectomies, raising concerns that some women are being treated too aggressively and whether doctors are doing the right thing for patients.

FDA committee recommends approval of GlaxoSmithKline cervical cancer vaccine Cervarix

2009-09-09T22:47:00.000-07:00

A U.S. Food and Drug Administration committee voted Wednesday to recommend approval for Cervarix, the cervical cancer vaccine developed by GlaxoSmithKline.

Cervarix is designed for girls and young women ages 10 to 25 to prevent cervical pre-cancers and cervical cancer related to human papillomavirus types 16 and 18, the two most common virus types that cause the disease.

The FDA generally follows the recommendations of its committees. The FDA’s Vaccines and Related Biological Products Advisory Committee was the panel that voted on Cervarix.

If Cervarix is approved, the drug will compete in the United States against Merck & Co. Inc.’s cervical cancer vaccine Gardasil, which was approved by the FDA in 2006. Merck (NYSE:MRK) is looking to expand the use of Gardasil to include preventing genital warts in men and boys.

Cervarix is approved in about 100 countries outside the United States.

London-based GlaxoSmithKline (NYSE: GSK) bases in North American operations in Research Triangle Park and has about 6,000 employees in the Raleigh-Durham area. Whitehouse Station, N.J.-based Merck employs several hundred people at its vaccine-production facility in Durham.

search bar

2009-08-31T01:42:00.000-07:00

Custom Search

103-yr-old undergoes beast cancerr surgery in Mumbai

2009-08-27T11:55:00.000-07:00

MUMBAI: A 103-year-old woman has undergone breast cancer surgery at a hospital here, a senior doctor
said.

Sagarbai Bakshi, a resident of Thakurdwar in Girgaum area of south Mumbai, underwent mastectomy on July 25 at the Bombay Hospital here. After the surgery on her right breast, she was discharged within three days, Dr Sanjay Sharma, who performed the surgery, said.

Bakshi, who is one of the oldest patients to have undergone the surgery, had complained of a lump in her breast and a biopsy was performed after which it was decided to undertake the surgery, Dr Sharma said.

Bakshi, a retired teacher, had undergone mastectomy for left breast five years ago, he said.

Sen. Edward M. Kennedy Loses Cancer Battle

2009-08-27T11:53:00.000-07:00

Sen. Edward M. Kennedy of Massachusetts, the last surviving brother in an enduring political dynasty and one of the most influential senators in history, died Tuesday night at his home on Cape Cod after a yearlong struggle with brain cancer. He was 77.

In nearly 50 years in the Senate, Kennedy, a liberal Democrat, served alongside 10 presidents - his brother John Fitzgerald Kennedy among them - compiling an impressive list of legislative achievements on health care, civil rights, education, immigration and more.

In a brief statement to reporters at his rented vacation home on Martha's Vineyard, Mass., President Barack Obama eulogized Kennedy as one of the "most accomplished Americans" in history - and a man whose work in Congress helped give millions new opportunities.

"Including myself," added the nation's first black president.

CBS News has learned that Kennedy will be buried at Arlington National Cemetery. At the eternal flame rests four Kennedy family members, including the former president, Jacqueline Kennedy, their baby son, Patrick, who died after two days, and a still-born child. Former Sen. Robert Kennedy F. Kennedy is buried a short distance away.

Summit told stigma around cancer must be addressed

2009-08-27T11:48:00.000-07:00

THERE IS still a huge stigma attached to a cancer diagnosis in many countries, and much more needs to be done to address this, the third and final day of a global cancer summit in Dublin heard yesterday.

Dr John Seffrin, chief executive of the American Cancer Society, said the stigma was different in different places. In some places it meant people were discriminated against by employers; in others women were afraid to tell their husbands in case they would leave them.

“The key point is we need to destigmatise cancer, saying it is a disease process, we know a great deal about how to prevent it, we know a great deal about how to detect it early, and we know a great deal about how to reduce human suffering from it.”

In the US, he said, there was a notion that if you had cancer you were somehow compromised for the rest of your life and not going to be able to achieve as much as you otherwise would.

He added that we know how to prevent 60 per cent of cancer. It was now known, for example, that the cervical cancer vaccination worked and there was “a moral imperative” to use it. Ireland should introduce it as soon as it could. “Obviously tough decisions have to be made, but it should be high on the list and as soon as it is affordable it should be done.”

Minister for Health Mary Harney has postponed the introduction of the vaccine for 12-year-old Irish girls due to the costs involved.

Dr Seffrin added that the cost of cancer was a huge issue for families, with 100,000 families going bankrupt in one year in the US as a direct result of a cancer diagnosis.

Cancer survivor and seven times Tour de France champion Lance Armstrong said there was a stigma associated with testicular cancer when he was diagnosed with it in Texas in 1996. “The state government had taken out testicular self-exams out of text books... That’s because of stigma, its because they considered that to be offensive, so I suffered a little bit from that.”

He added that the impression that cancer was a death sentence was incorrect. “We can change that, and we can encourage people to get treatment earlier and believe that they will live.”

However, he stressed that people had to also take personal responsibility and go to the doctor if things were not right.

He was speaking at the close of the Livestrong Cancer Summit at the RDS organised by the Lance Armstrong Foundation, which was set up in the US over a decade ago to raise awareness around cancer.

Two Proteins May Be Key to Screening for Early-Stage Liver Cancer

2009-08-11T04:00:00.000-07:00

Researchers have identified an improved method of screening high-risk patients for one of the most common types of liver cancer, hepatocellular carcinoma
(HCC), particularly if the patient has a history of hepatitis. By changing the threshold of one commonly used screening test and adding a second, complementary test, researchers were able to accurately identify more early stage HCC cases. There is currently no standard or routine screening test for HCC, but high-risk patients (i.e. those with a history of hepatitis infection or cirrhosis) are often tested for high levels of Alpha-fetoprotein (AFP), a protein which is usually produced by a fetus, and in adults can indicate the presence of HCC. Blood levels of AFP can be elevated for other reasons, however, such as pregnancy, hepatitis, and other forms of cancer.

A multi-institutional team of researchers from the NCI's Early Detection Research Network (EDRN) compared the efficacy of AFP with two other proteins, des-gamma carboxyprothrombin (DCP) and lectin-bound alpha-fetoprotein (AFP-L3), which are also associated with liver cancer. They found that AFP was the best choice for finding early stage HCC. In addition, they found that screening for the presence of both AFP and DCP together was best when screening for early stage HCC that is associated with hepatitis infection. The results of this study were published July 1, 2009, in the journal Gastroenterology. The abstract of the article, α-Fetoprotein, Des-γ Carboxyprothrombin, and Lectin-Bound α-Fetoprotein in Early Hepatocellular Carcinoma can be viewed online.

Risk of Pancreatic Cancer Linked to Variation in Gene that Determines Blood Type

2009-08-11T03:56:00.001-07:00

Common variants of the gene that determines human blood type are associated with an increased risk of pancreatic cancer, according to a study by scientists at the National Cancer Institute (NCI), part of the National Institutes of Health, and colleagues from many universities and research institutions. The study, published online Aug. 2, 2009, in Nature Genetics, is consistent with an observation first made more than 50 years ago.

In the study, the researchers discovered that genetic variation in a region of chromosome 9 that contains the gene for ABO blood type was associated with pancreatic cancer risk. Individuals with the variant that results in blood types A, B, or AB were at an increased risk of pancreatic cancer, compared to those with the variant for blood type O. This finding is consistent with previous research, some of it dating back to the 1950s and 1960s, that had shown increased risks of gastric and pancreatic cancer among individuals of the A and B blood groups (i.e., blood types A, B, and AB). The latest results provide a genetic basis for those earlier observations.

A person's blood type depends on which form or forms of the ABO gene they inherit from their parents. The protein produced by the ABO gene determines the type of carbohydrates (complex sugars) that are present on the surface of red blood cells and other cells, including cells of the pancreas. The proteins encoded by the A and B forms of the gene transfer different carbohydrates onto the cell surfaces to make A and B blood types. The O form encodes a protein that is unable to transfer carbohydrates. Studies by other researchers have shown that ABO protein encoding in pancreatic tumor cells is different than in normal pancreatic cells.

Radiation Therapy May Increase Diabetes Risk In Childhood Cancer Survivors

2009-08-11T03:40:00.000-07:00

ScienceDaily (Aug. 11, 2009) — Childhood cancer survivors treated with total body or abdominal radiation may have an increased risk of diabetes, according to a report in the August 10/24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. This correlation does not appear to be related to patients' body mass index or physical inactivity.
As a result of their curative therapies, childhood cancer survivors face an increased risk of morbidity and mortality," with almost 75 percent of survivors developing a chronic health condition and 42.4 percent developing a severe, disabling or life-threatening condition 30 years after diagnosis, according to background information in the article. Cardiovascular disease, in particular, is a significant cause of deaths in this group. "In the general population, diabetes mellitus is strongly associated with an increased risk of cardiovascular disease and all-cause death."

Lillian R. Meacham, M.D., of Emory University and AFLAC Cancer Center and Blood Disorders Service, Atlanta, and colleagues compared the prevalence of diabetes in a sample of 8,599 childhood cancer survivors (diagnosed before age 21 between 1970 and 1986) and 2,936 randomly selected siblings of the survivors (average ages 31.5 and 33.4 at follow-up in 2003, respectively). Medication use, treatment exposures (including irradiation, or exposure to radiation treatments) and factors that may have modified the risk of diabetes were noted.

Of the survivors, 218 (2.5 percent) reported having diabetes, while 49 (1.7 percent) of siblings reported having the condition. "After adjustment for body mass index, age, sex, race/ethnicity, household income and insurance, the survivors were 1.8 times more likely than the siblings to report diabetes mellitus, with survivors who received total body irradiation, abdominal irradiation and cranial irradiation at increased risk," the authors write. "Survivors who were treated with abdominal irradiation were 2.7 times as likely to report diabetes mellitus as those who were not treated with abdominal irradiation or total body irradiation; those treated with total body irradiation were 7.2 times as likely to report diabetes mellitus."

Survivors diagnosed with cancer before age 5 were 2.4 times more likely to report diabetes than those diagnosed in late adolescence (from ages 15 to 20). "As in the general population, older age, black or Hispanic/Latino background, lower household income, physical inactivity and increased BMI were associated with an increased risk of diabetes mellitus," they note.

"It is likely that this additional chronic disease in childhood cancer survivors, who frequently also sustain damage to the heart, kidneys and endocrine system, will lead to further morbidity and premature mortality," the authors conclude. "Therefore, it is imperative that clinicians recognize this risk, screen for diabetes and prediabetes when appropriate and approach survivors with aggressive risk-reducing strategies. Moreover, further research is warranted to understand the pathways by which these two modes of radiation therapy lead to diabetes."

This work was supported by a grant from the Department of Health and Human Services, by funding to the University of Minnesota from the Children's Cancer Research Fund and by funding to St. Jude Children's Research Hospital from the American Lebanese Syrian Associated Charities (ALSAC).

Nanosignals Of Trouble From 'Normal' Cells Far From Cancer

2009-07-14T11:00:00.000-07:00

A new Northwestern University-led study of human colon, pancreatic and lung cells is the first to report that cancer cells and their non-cancerous cell neighbors, although quite different under the microscope, share very similar structural abnormalities on the nanoscale level.

The findings, obtained using an optical technique that can detect features as small as 20 nanometers, validate the "field effect," a biological phenomenon in which cells located some distance from a malignant or premalignant tumor undergo molecular and other kinds of abnormal changes.

The most striking findings were that these nanoscale alterations occurred at some distance from the tumor and, importantly, could be identified by assessing more easily accessible tissue, such as the cheek for lung cancer detection.

The partial wave spectroscopy (PWS) technique, once optimized, could be used to detect cell abnormalities early and help physicians assess who might be at risk for developing cancer. Like a pap smear of the cervix, a simple brushing of cells is all that is needed to get the specimen required for testing.

Using PWS, the researchers made another important discovery: the abnormalities found in the nanoarchitecture of the colon cells are the same abnormalities as those found in the pancreas and lung, illustrating commonality across three very different organs.

The results are published online by the journal Cancer Research. Authors of the paper include researchers from Northwestern and NorthShore University HealthSystem.

"Our data provide a strong argument that these nanoscale changes are general phenomena in carcinogenesis and occur early in the process," says Vadim Backman, professor of biomedical engineering at the McCormick School of Engineering and Applied Science and the paper's senior author. "These changes occur not only in cancer cells but in cells far from the tumor site and are the same in at least three different types of cancer. Given its ability to detect these changes, PWS could be used in the early screening of a variety of cancers."

Backman and his Northwestern colleagues recently developed PWS, which provides researchers with unprecedented information on the health of cells by measuring the increase in disorder -- the structural variations -- within the cell. PWS quantifies the statistical properties of cell nanoscale architecture by using the signal generated by light waves striking the complex structure of the cell.

A cell's nanoarchitecture includes the fundamental "building blocks" of the cell, which drive the molecular processes that allow a cell to function. These structures are most likely to be altered with the onset of cancer formation, says Backman, who is a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Backman's colleague and co-author, Hemant Roy, M.D., agrees. "While very preliminary, if validated, this approach may be of great clinical and biological value," says Roy, director of gastroenterology research at NorthShore. "Indeed, the ability to determine cancer risk by interrogating readily accessible tissue may provide an important step forward in cancer screening."

"Partial wave spectroscopy is a paradigm shift from conventional diagnostic techniques, which involve interrogating the actual tumor region," adds the paper's first author, Hariharan Subramanian, a postdoctoral fellow in Backman's research group.

PWS can look inside the cell and see those critical building blocks, which include proteins, nucleosomes and intracellular membranes, and detect changes to this nanoarchitecture. Conventional microscopy cannot do this, and other techniques that can (to some degree) are expensive and complex. PWS is simple, inexpensive and minimally invasive.

In the studies, cells were collected by brushing the rectum (for the colon), the duodenum (for the pancreas) and the cheek (for the lungs). The PWS technique was able to distinguish between the patients with cancer and those without. The cancer cells showed an increase in structural disorder on the nanoscale.

For each organ, the researchers next studied non-cancerous cells that neighbored tumors. When viewed using microscopy, all three cell types looked normal. PWS, however, detected a level of disorder in the cell architecture that was much closer to that of cancer cells than it was to normal cells.

The paper is titled "Nanoscale Cellular Changes in Field Carcinogenesis Detected by Partial Wave Spectroscopy." In addition to Backman, Roy and Subramanian, the paper's other authors are Prabhakar Pradhan, of Northwestern University; Michael J. Goldberg, Joseph Muldoon, Charles Sturgis, Thomas Hensing, Daniel Ray, Andrej Bogojevic, Jameel Mohammed and Jeen-Soo Chang, of NorthShore University HealthSystem; and Randall E. Brand, formerly with NorthShore, now with the University of Pittsburgh.

Lung Cancer: Radiofrequency Ablation (RFA) of Lung Tumors

2009-07-13T00:39:00.000-07:00

Lung Cancer: Radiofrequency Ablation (RFA) of Lung Tumors
RFA is a promising local therapy that has evolved rapidly in recent years for the treatment of primary and secondary cancers in the lung. The feasibility and safety profile in humans are well established. Complications following RFA are similar to those of CT-guided lung biopsies. However, sufficient long term results beyond 5 years are not yet available due to the relatively short time that this technology has been in use. Patients with smaller tumors (less than or equal to 3 cm) and fewer tumor nodules (less than or equal to 5 lesions) who are considered poor surgical candidates or who develop residual or recurrent disease despite maximal conventional therapy, and have tumors that are away from vital structures are the best candidates for RFA. Hence, RFA can be safely offered to patients who cannot undergo surgical resection. However the role of RFA in patients who are candidates for surgical resection is unproven, and there is no evidence on whether RFA is more or less effective that focused radiation (sterotactic body radiation therapy). Overall, RFA is a highly promising modality that may be used to our patients' advantage either as a solitary treatment or in combination with conventional therapy.

Not all breast cancer patients need surgery

2009-07-13T00:37:00.000-07:00

Breast Feeding
Cancer
Child Development
Children
Diabetes
Drugs
Ear
Emotions
Eyes
Fitness/Lifestyle
Health Insurance
Heart
HIV/AIDS
Infection
Injuries/FirstAid
Liver
Men's Health
Nutrition
Pregnancy
Rehabilitation Medicine
Sex
Skin
Surgery
Teeth
Tobacco Control
Travel and Health
Tuberculosis
Women's Health
Women diagnosed with breast cancer may be undergoing surgery or gruelling treatment they do not need, according to a study. Researchers say as many as one in three cases of breast cancer detected by screening prove harmless.

Karsten Jorgensen and Peter Gotzsche of the Nordic Cochrane Centre in Copenhagen analyzed breast cancer trends at least seven years before and after government-run screening programs for breast cancer started in parts of Australia, Britain, Canada, Norway and Sweden.

The research was published Friday in the BMJ, formerly known as the British Medical Journal.

Researchers said that screening for cancer may lead to earlier detection of lethal cancers but also detects harmless ones that will not cause death or symptoms.

“The detection of such cancers, which would not have been identified clinically in someone’s remaining lifetime, is called overdiagnosis and can only be harmful to those who experience it,” the researchers said.

“As it is not possible to distinguish between lethal and harmless cancers, all detected cancers are treated. Overdiagnosis and overtreatment are therefore inevitable.”

The authors pointed to post-mortem data that has shown that about 37 per cent of women aged 40 to 54 “who died from causes other than breast cancer, had lesions of . . . cancer at autopsy”. About half of these lesions would have been picked up in screening and some would have been treated, they said.

"This information needs to get to women so they can make an informed choice," Jorgensen said. "There is a significant harm in making women cancer patients without good reason."

Jorgensen said that for years, women were urged to undergo breast cancer screening without them being informed of the risks involved, such as having to endure unnecessary treatment if a cancer was identified, even if it might never threaten their health.

Breast cancer risk and migraine

2009-07-13T00:34:00.000-07:00

For women there may be one good thing about having migraines - a reduced risk of breast cancer.

Both migraine and breast cancer are hormonally mediated diseases, and it is biologically plausible that woman with a history of migraine may have a reduced breast cancer risk. Low oestrogen levels appear to increase the severity and frequency of migraines in women, while increased levels of the hormones are known to boost breast cancer risk.

Previous study, which included around 2,000 women, found a 33% lower breast cancer risk among women with migraines. To confirm the relationship between breast cancer and migraine, researchers studied 4,568 American women with breast cancer (aged between 34 and 64 years) and 4,678 healthy controls. They accounted the effects of migraine triggers such as alcohol, smoking or hormone use.

It was found that those women who had a history of migraines were 26 per cent less likely to develop breast cancer, which did not change with migraine triggers or whether or not a woman was menopausal. Similarly, use of prescription drugs for migraine did not change the risk.

The researchers concluded that a history of migraine may reduce the breast cancer risk, however, further research is required to resolve reasons for this relationship.

Metabolic syndrome linked to breast cancer

2009-07-06T03:54:00.000-07:00

New research suggests that a set of risk factors for heart disease and type 2 diabetes, known as the metabolic syndrome, could be related to the risk of breast cancer in post-menopausal women.

People with the syndrome have excess fat around their middle, high levels of glucose in their blood, resistance to the blood-glucose-lowering hormone insulin, high cholesterol, and high blood pressure, Dr. Geoffrey C. Kabat of the Albert Einstein College of Medicine in Bronx, New York and his colleagues note in their report.

While researchers have looked at separate components of the syndrome and breast cancer risk, Kabat and his team add, results of these studies have been "inconclusive," and no one has investigated the syndrome as a whole in relation to risk of breast cancer.

They looked at a subset of 4,396 women participating in a large study of postmenopausal women's health called the Women's Health Initiative.

Women who had metabolic syndrome at the study's outset were at no greater risk of developing breast cancer during follow-up, which averaged about 8 years.

But individual components of the syndrome -- especially high blood glucose, high levels of triglycerides, and high diastolic blood pressure -- were linked to increased risk when the researchers looked at these variables 1 year before the breast cancer diagnosis.

Well Water Might Raise Bladder Cancer Risk

2009-07-03T23:57:00.000-07:00

New Tests Spot Tough-to-Detect Cancers Sooner
Sun exposure, smoking and the source of water used for drinking may each play a role in whether someone develops and dies from bladder cancer, according to a new study.

Researchers from the University of Alabama at Birmingham found that well water consumption was linked to a higher incidence of bladder cancer in women and death from the disease in men and women alike. They speculated that this might be from pesticides leeching into unmonitored wells.

However, the amount of ultraviolet (UV) radiation a person is exposed to from the sun was found to be inversely linked to the chance of developing or dying from bladder cancer.

The study also confirmed previous research that smoking cigarettes is directly tied to developing and dying from bladder cancer.

About 69,000 cases of bladder cancer were diagnosed in the United States last year, with the disease claiming about 14,000 lives, according to the American Cancer Society. Men are about three times more likely than women to develop bladder cancer, and incidence of the disease varies widely among states.

The study was to be presented this week in Chicago at the annual scientific meeting of the American Urological Association.

"Cigarette smoking is a well-known risk factor associated with bladder cancer, but sources such as the patient's water supply are coming to light as potential unmonitored risk factors," Dr. J. Brantley Thrasher, an association spokesman, said in a news release from the group.

New Tests Spot Tough-to-Detect Cancers Sooner

2009-07-03T23:53:00.000-07:00

Mayo Clinic researchers say they have developed new tests that make it easier to diagnose cancers of the pancreas and bile ducts.

In a study, the new tests more than doubled the detection rate of these cancers, which frequently are fatal because they often are not discovered until their later stages.

"The earlier we can diagnose a patient, the better the types of treatment we can offer, and the more likely they are to have long-term survival after treatment," study senior author Lewis Roberts, a Mayo Clinic gastroenterologist, said in a news release.

The results appear in the June issue of Gastroenterology.

Doctors typically look for tumors in the bile duct and pancreas region by snaking an endoscope down a patient's throat and into those areas of the body. But because the bile duct is narrow, it is hard for medical personnel to determine what is normal and what is a further stricture -- or narrowing -- caused by a tumor.

The new testing procedure starts with an endoscopic procedure in which the doctors brush off cells from the duct for study. Traditional cytology is then performed to look for abnormally shaped cells, a search repeated with the additional use of digital image analysis and fluorescence in situ hybridization (FISH). The latter procedure uses colored probes visible with a fluorescence microscope to seek abnormal cells.

In the study, nearly 500 people known to have narrowing of the pancreatobiliary duct underwent the new testing procedures. The combination of cytology and FISH increased the bile duct and pancreatic cancer detection rate from 20 percent to 43 percent.

About 5,000 cases of bile duct cancer are diagnosed every year, mostly in people between ages 50 and 70, making it rare, although reported cases are on the rise. In the United States, doctors annually diagnose more than 35,000 cases of pancreatic cancer.

Pesticides Linked to Precancerous Blood Disorder

2009-07-03T23:41:00.000-07:00

Individuals who apply pesticides to crops are twice as likely as the general population to develop a precancerous blood disorder called MGUS (monoclonal gammopathy of undetermined significance), which can lead to multiple myeloma, according to the results of a study published in Blood.[1]

Multiple myeloma is a cancer of the blood that affects the plasma cells, which are an important part of the immune system that produce antibodies to help fight infection and disease. Multiple myeloma is characterized by an excess production of abnormal plasma cells. Symptoms include increased risk of bacterial infections and impaired immune responses. Almost all patients with multiple myeloma experience the plasma disorder MGUS before developing myeloma.

Previous studies have indicated that pesticides may be associated with an increased risk of multiple myeloma. This more recent study included a cohort of 678 men ages 30-94 from the Agricultural Health Study (which included over 57,000 subjects). The men work as pesticide applicators in North Carolina and Iowa and were enrolled in the study between 1993 and 1997. They provided blood samples that were analyzed for MGUS and then compared with samples from 9,469 men from the general population in Minnesota.

The incidence of MGUS among pesticide workers over age 50 was 6.8%. (There were no cases of MGUS among pesticide workers under age 50.) The rate of MGUS was 1.9 times higher among the pesticide workers than among the control subjects from Minnesota. Furthermore, the researchers identified an increased risk of MGUS associated with different types of pesticides: the risk of MGUS was 5.6 times higher for those who worked with the insecticide dieldrin, 3.9 times higher for the fumigant mixture carbon-tetrachloride/carbon disulfide, and 2.4 times higher for the fungicide chlorothalonil.

The researchers concluded that “specific pesticides are causatively linked to myelomagenesis” and that further study is warranted in order to understand the link between pesticide use and the subsequent development of cancer.

Marijuana Damages DNA And May Cause Cancer, New Test Reveals Detecting Prostate Cancer Earlier

2009-07-03T03:54:00.000-07:00

A new blood test is more reliable at finding prostate cancer in its early stages by detecting a protein marker in blood plasma. Doctors say the new test, now in clinical trials, will have an accuracy of 95 percent, better than the commonly used PSA, which signals abnormal prostate conditions rather than cancer.
BALTIMORE--Most men over age 50 are familiar with PSA testing, used to detect prostate cancer. But the test can sometimes miss cancer cases. Now a new test can find cancer earlier.

When James Foster discovered he had prostate cancer, his life barely missed a beat. Now a prostate cancer survivor, Foster says, "I don't think I was shocked. I truly was almost preparing for it." But finding out he had the disease wasn't easy or quick. Like many men his age, he experienced the problem of having elevated PSA test results that could mean any number of things.

Robert Getzenberg, a cancer biologist at Johns Hopkins School of Medicine in Baltimore, says, "A blood test of PSA is not really an accurate marker of prostate cancer, but really a marker of abnormal prostate conditions."

Cancer biologists now have a new blood test, currently in clinical trials, that's more reliable and accurate at finding the disease in its earliest stages. The new test identifies a protein marker in blood plasma, called early prostate cancer antigen -- or EPCA. When the marker appears in a blood test, it indicates a high probability of cancer, not just that something is wrong. Doctors say it's the best indicator yet of prostate cancer.

"If you have the EPCA marker in your blood, you almost certainly, higher than 95-percent chance, have prostate cancer," Getzenberg says -- promising new number that might help reduce the amount of prostate biopsies, a painful, invasive procedure to confirm cancer, and focus on men who are truly at risk.

The new blood test is currently in clinical trials, and doctors will be recruiting new patients this fall. For trial information, visit www.tesserainc.com.

BACKGROUND: In the first clinical study of a new blood protein associated with prostate cancer, researchers have found that the marker EPCA, or early prostate cancer antigen, can successfully detect prostate cancer in its earliest stages. The current technique for detecting prostate cancer prostate-specific antigen (PSA) testing, can sometimes indicate cancer when none is there. Prostate cancer is the most common type affecting American men, with about 232,090 new cases diagnosed in 2005.

WHAT IS THE PROSTATE: The prostate is a walnut-sized gland, located between the bladder and the penis and in front of the rectum. Its primary function is the production of seminal fluid, the milky substance that nourishes sperm.

WHAT IS PSA TESTING: PSA testing is one step in early identification of prostate tumors, combined with digital rectal examination. But PSA testing can miss some cancers, or produce a false positive (indicate a cancer that doesn't exist). Furthermore, a prostate biopsy is a very painful and unpleasant procedure, with 12 separate tissue extractions followed by a month of pain. The biopsy usually needs to be repeated each year after the first positive PSA result, even if the initial biopsy comes out negative. Of the 1.8 million biopsies performed annually, only 15 percent come out negative. Reducing the number of biopsies requires for an accurate diagnosis would bring welcome relief to many patients.

NEW BLOOD TEST: Researchers at Johns Hopkins measured the ECPA levels in 46 patients, including those with prostate cancer, bladder, colon and kidney cancer, spinal cord injury, and noncancerous prostate inflammation, as well as 16 healthy individuals. They found that EPCA levels were high in 11 of the 12 prostate cancer patients and low in all the healthy individuals. They estimate an accurate diagnosis rate of 94 percent. When coupled with standard PSA screening, the new blood test could help reduce the number of unnecessary biopsies and undetected prostate tumors. The ECPA test very specific to prostate cancer; it doesn't indicate other types of cancer or benign prostate conditions.

WHEN AVAILABLE: Larger clinical trials will be starting soon, and it is believed that the blood test will be generally available to medical practitioners in 2006.

Marijuana Damages DNA And May Cause Cancer, New Test Reveals

2009-07-03T03:51:00.000-07:00

Using a highly sensitive new test, scientists in Europe are reporting "convincing evidence" that marijuana smoke damages the genetic material DNA in ways that could increase the risk of cancer.
Researchers note that toxic substances in tobacco smoke can damage DNA and increase the risk of lung and other cancers. However, there has been uncertainty over whether marijuana smoke has the same effect. Scientists are especially concerned about the toxicity of acetaldehyde, present in both tobacco and marijuana. However, it has been difficult to measure DNA damage from acetaldehyde with conventional tests.

The research was carried out by Rajinder Singh, Jatinderpal Sandhu, Balvinder Kaur, Tina Juren, William P. Steward, Dan Segerback and Peter B. Farmer from the Cancer Biomarkers and Prevention Group, Department of Cancer Studies and Molecular Medicine and Karolinska Institute, Sweden.

Raj Singh said: “Parts of the plant Cannabis sativa, also known as marijuana, ganja, and various street names, are commonly smoked as a recreational drug, although its use for such purposes is illegal in many countries.

The scientists describe development and use of a modified mass spectrometry method that showed clear indications that marijuana smoke damages DNA.

“There have been many studies on the toxicity of tobacco smoke. It is known that tobacco smoke contains 4000 chemicals of which 60 are classed as carcinogens. Cannabis in contrast has not been so well studied. It is less combustible than tobacco and is often mixed with tobacco in use. Cannabis smoke contains 400 compounds including 60 cannabinoids. However, because of its lower combustibility it contains 50% more carcinogenic polycyclic aromatic hydrocarbons including naphthalene, benzanthracene, and benzopyrene, than tobacco smoke.”

The authors added: “It is well known that toxic substances in tobacco smoke can damage DNA and increase the risk of lung and other cancers. Scientists were unsure though whether cannabis smoke would have the same effect. Our research has focused on the toxicity of acetaldehyde, which is present in both tobacco and cannabis.”

The researchers add that the ability of cannabis smoke to damage DNA has significant human health implications especially as users tend to inhale more deeply than cigarette smokers, which increases respiratory burden. "The smoking of 3-4 cannabis cigarettes a day is associated with the same degree of damage to bronchial mucus membranes as 20 or more tobacco cigarettes a day," the team adds.

"In conclusion, these results provide evidence for the DNA damaging potential of cannabis [marijuana] smoke, implying that the consumption of cannabis cigarettes may be detrimental to human health with the possibility to initiate cancer development," the article states. "The data obtained from this study suggesting the DNA damaging potential of cannabis smoke highlight the need for stringent regulation of the consumption of cannabis cigarettes, thus limiting the development of adverse health effects such as cancer."