Dr Ou of the UCI Medical Center

Last night I attended a meeting near the UCI Medical Center. The speaker, Doctor Ou, is an Associate Clinical Professor at the school. He brought up some interesting facts.

• There are more deaths among women from lung cancer (70,490) than from breast cancer, ovarian cancer, cervical cancer, uterine cancer, vulva cancer, and vaginal cancer combined (68,290).

• There are tests for early detection of many forms of cancer (i.e. mamograms for breast cancer and PAP smears for cervical cancer), but there is no test for early detection of lung cancer.

• Because of the difficulty in detecting lung cancer at an early stage, it generally takes 25 years to manifest itself. Almost half of all new patients diagnosed are in the late stage (IIIB and IV) of the disease, making treatment unlikely to be successful.

• Those who smoke but quit at the age of 30 have more than double the chance of dying from lung cancer than those who have never smoked. Those who quit at age 50 have more than a six-fold lung cancer mortality rate.

• Women who never smoke are much more likely than men who have never smoked to develop lung cancer. This is more pronounced in the Asian countries than in Europe and the US, although it holds true in all geographic areas studied.

• Radon gas is the second leading cause of lung cancer. Produced by decaying uranium-238 in the soil, it is estimated that 8 million homes in the US have elevated levels of radon, primarily in Northern states.

• As with most diseases, genetic mutations have been identified as being involved with the development of lung cancer. Epidermal growth factor receptor (EGFR), when mutated, can cause the uncontrolled cell division known as cancer.

• A drug under study, Gefitinib, shows great promise in stopping some forms of lung cancer, but while it works extremely well in some patients, it does not work at all in others. Its effectiveness depends on the specific mutations in the EFGR gene. I will write more about Gefitinib in a future post.

Chao Cancer Center

The cancer prevention research office at the Chao Family Comprehensive Cancer Center at the University of California, Irvine Medical Center is looking for participants for a Melanoma prevention trial.

Participants must be at least 18 years of age with 2 or more easily-biopsied abnormal moles and/or a history of melanoma.

Of the three main forms of skin cancer, melanoma is the least common but the most deadly, accounting for about 79% of skin cancer related deaths. This equates to approximately 8000 deaths a year. According to the American Cancer Society, the incidence rate for melanoma has more than doubled since 1973.

Those with a history of melanoma or who exhibit abnormal moles have an increased risk of developing skin cancer.

Lovastatin is an investigational drug for use in skin cancer prevention.

In a randomized, double-blind, placebo-controlled phase II clinical trial, Lovistatin will be tested in an effort to develop a safe, effective method to halt and/or reverse the progression of abnormal moles, also known as atypical nevi, into melanoma.

Participants will be asked to take the medication once daily by mouth, for six months. They will also be asked to return to the clinic at scheduled intervals for follow-up examinations.

Those who qualify will receive a free screening and evaluation of their abnormal moles. Lab work, the study medication, and follow-ups during the study will also be free.

The research project is sponsored by the National Cancer Institute.

For more information and to see if you qualify for this melanoma prevention trial, contact Vanessa Wong or Rachel Gonzalez at 1-888-456-7067 or (714) 456-6210.

Ripe Mango

In 2001, a study at the University of Florida indicated that Mangoes contain several cancer fighting components including carotinoids and phenolic compounds called polyphenols, both powerful antioxidants.

A more recent study funded by the National Mango Board and done at Texas A&M University’s AgriLife Research department determined that one class of these phenolic compounds, known as gallotannins, is particularly effective in killing breast cancer and colon cancer cells under laboratory conditions.

In the earlier study, mangoes were pureed and separated into a carotinoid portion and a portion heavy in phenolics.  While both portions inhibited cancer formation, the phenolic portion was shown to be more effective.  Some of the compounds were suspected of being unique to Mangoes and the results suggested that further studies were warranted.

This brings up the later study.  The husband and wife team of Dr. Susanne and Dr. Steve Talcott at Agrilife Research found that gallotannins were effective in slowing the growth of lung, prostate, and leukemia cancer cells, but were even more effective against breast and colon cancer.  The compounds actually caused the breast and colon cancer cells to stop multiplying and die in a form of cell suicide called apoptosis.

The gallotannins also prevented damaged cells, those showing precancerous signs, from developing further.  When the compounds were administered to normal, healthy cells, no harm was done.

Although the research was funded by the National Mango Board, there appears to be no reason to question the findings.

Of course, not all experiments performed in the laboratory pan out when used on human subjects.  But the results give hope that another, more natural alternative to widely prescribed cancer drugs may soon be offered to cancer victims.  Clinical trials may begin soon to determine the efficacy on human subjects.

In the meantime, eat more mangoes and drink tea, which is also high in gallotannins.

Breast cancer self-examination

A year ago I reported on findings which indicated that bisphosphonate drugs might be a contributor to esophageal cancer. Now I have to report new research which indicates that bisphosphonate drugs such as Fosamax may be effective in reducing the risk of breast cancer.

Two different studies have come up with similar results, one resulting from the Woman’s Health Initiative (WHI) and another from a controlled case study in Israel. Both showed a sharply lowered cancer incidence in women who had been prescribed bisphosphonates to prevent bone loss.

The WHI study was led by Dr, Rowan Chlebowski, chief oncologist from the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center.

Of the 2816 women having taken bisphosphonates at the beginning of the WHI study, only 64 women developed breast cancer. This was a 32 percent reduction in incidence compared to those women who were not taking the drug.

It should be noted that women taking the drugs were slightly more likely to develop DCIS, or ductal carcinoma in situ, than those who did not. DCIS is a very early form of breast cancer confined to the milk ducts where it is formed and is nearly 100 percent curable when found.

The other study, led by Dr. Gad Rennert, chairman of community medicine and epidemiology at the Clalit National Cancer Control Center in Haifa Israel looked at 4575 women who took bisphosphonates for at least a year. The results indicated a 34 percent reduced rate of breast cancer diagnosis. Even after controlling for other risk factors, the reduction remained at 29 percent.

Where tumors did occur in the women who took the drugs, the tumors were more estrogen-receptor positive and differentiated. These factors are associated with better response to treatment and better prognoses.

Breast cancer ribbon

The study found that protection from the drug was most pronounced after taking it for a year. Less than a year offered little or no protective benefit and after more than a year, the benefit did not increase.

Over 30 million patients are prescribed bisphosphonates for the reduction of osteoporosis.

So there you have it. If you take bisphosphonates you may increase the risk of developing esophageal cancer, and your risk of developing breast cancer may increase if you don’t.

President Roosevelt

It was recently revealed that President Franklin Delano Roosevelt died as a result of melanoma, a cancer noted for its ability to spread or metastasize throughout the body.  A tumor in his brain from the metastasized cancer caused the previously reported stroke.

In a study done at the University of Queensland in Brisbane, Australia and in a second study done at the University of California, Los Angeles. research indicated that family history may be more important in gauging melanoma risk than the amount of sun exposure or other factors.

While our knowledge of melanoma has come a long way since the 1940s, it is still one of the deadliest forms of cancer.  This is because it can be influenced by several different genetic factors each of which must be dealt with by a different treatment.  Unless one knows the genetic code involved, one can’t know which treatment will be effective, assuming there is a treatment for a particular genetic mutation.

In a test of a new drug, PLX4032, 20 of 22 patients with a common form of melanoma, associated with a mutation of the BRAF gene, experienced a reduction of their tumors.  It is believed that about half of all melanomas are associated with this genetic mutation.

Administered twice a day by researchers at the Memorial Sloan-Kettering Cancer Center in New York, PLX4032 blocked the activity of the gene.  All of the patients in the study had the mutated gene and all had failed to respond to other treatments.

As this treatment addresses the genetic code which causes the cells to divide uncontrollably and not the cell division itself, it does not result in the devastating side effects of chemotherapy.

While the report was promising, the therapy is not yet viewed as a cure.  It did, however, focus on the importance of addressing the genetic programming which causes the disease rather than the symptoms of the disease.

In the future, it is likely that new therapies focusing on genetics will be the answer to beating various forms of cancer, including melanoma.

If FDR had lived in the early decades of the 21st century and had the mutated BRAF gene form of melanoma, he might have stood a chance of surviving the disease.

Rapidly growing solid tumors create pockets without sufficient blood vessels. This makes them difficult to treat with chemotherapeutic drugs. The drugs, carried by blood, cannot get to the cells and resulting dead material cannot be removed by the body.

Cells in these pockets are deprived of oxygen and nutrients. This is known as Hypoxia. As there is an absense of oxygen, hypoxic pockets in tumors create a unique niche in which anaerobic bacteria can grow.

The oxygen deficient pockets can create an environment for dangerous bacteria such as staphylococcus, but they can also be used for a focused therapy to reduce tumors.

Shibin Zhou, M.D., of Johns Hopkins Ludwig Center for Cancer Genetics has developed an attenuated strain of Clostridium novi, an anaerobic bacteria, the spores of which can be injected intravenously.

These spores, which germinate and thrive in the oxygen deprived environment of the middle of the tumor, cause massive death of cancer cells leading to tumor regression.

The bacteria cannot grow in the presence of oxygen, so there is no toxic effect on healthy tissue. In addition to the destruction of the tumor, the bacterial infection elicits a potent antitumor immune response in the host, leading to possible long-term cures.

Dr. Zhou’s laboratory is working on next generation anaerobic bacterial agents to increase potency and combine them with other types of therapies used to kill cancer.

For non-small cell lung cancer, specific genetic factors have been determined to be the cause in about 5% of cases.  Recent advances in genetic research, combined with a new treatment, may turn a virtual death sentence into a manageable condition for those with this genetic characteristic.

A gene called Anaplastic Lymphoma kinase, more commonly known as the ALK gene, can combine with another gene or form a duplicate copy of itself.  When this happens, a relatively rare type of tumor can appear.

Presence of the ALK gene is determined by FISH testing which is also sometimes used to detect copies of the HER2 gene in breast cancer patients.

By administering a new oral drug called an “ALK inhibitor”, this type of lung cancer is not only stopped from growing, but appears to melt away.  The drug does not rid the body of the gene, so tumors can reappear, requiring additional future treatments… but the disease becomes manageable.

Five cancer centers worldwide participated in the first two trials of the drug, including the University of Colorado Cancer Center, one of the few places where the related FISH test can be performed.

23 people were treated in the initial studies and almost all of them had dramatic responses within short periods of time.

Ila Hegland, diagnosed nine years ago with stage 4 non-small cell lung cancer, was told she only had two years to live. After six weeks of treatment with the ALK inhibiting drug, no signs of the cancer could be found.

Third stage trials are now being performed and it is hoped that the treatment will be generally available in the near future.

Other forms of cancer are also tied to the ALK gene, including 10 to 15 percent of childhood non-hodgekin lymphomas and myofibroblastic tumors (sarcoma).  With further studies, perhaps the drug can be applied to these types of conditions as well.

A tall person

Several studies have shown a relationship between a person’s height and the risk of developing various forms of cancer.

A study from Seoul National University in Korea following 788,789 people between the ages of 40 and 64 determined that for every 5 centimeters in additional height, men’s cancer risk increased by 5% and women’s cancer risk increased by 7%.

The study was adjusted for relevant factors such as age and socioeconomic status. A positive association was found for colon, breast, thyroid, ovarian, and prostate cancer.

A review study of literature done at John Hopkins University , which also found links between height and cancer, found the most consistent associations were for breast cancer. While the links found were relatively weak, they were still conclusive.

Several of the studies have suggested that increased levels of an insulin-like growth factor known as IGF-1 may be involved. Cancer and natural growth have factors in common – namely, division and increases in cells. More IGF-1 causes more growth, often leading to greater height.

IGF-1 protects new cells from being attacked by the body, a necessary function when growing. But raised levels of IGF-1 may also diminish the ability of the body to rid itself of abnormal cells such as cancer.

Caloric intake during early years may also be related to the height versus cancer risk. A study done in Norway comparing historic periods where food was less abundant, suggested that reduced nutrition leading to reduced adult height could be linked to fewer cases of breast cancer.

With regard to prostate cancer, it has been found that the more aggressive the cancer, the better the correlation to height. This was noted in an article in Cancer Epidemiology Biomarkers & Prevention

We tall people sometimes seem to be at an advantage, but where cancer is involved, it might be better to be short.

The relationship between migraines and breast cancer had previously only been looked at in a single relatively small study that was unable to assess the effect of migraine triggers, such as alcohol consumption and hormone therapy, which are also well-established breast cancer risk factors.

The more recent study compared data from 4568 women with breast cancer and 4678 healthy women using in-person interviews.  Women with histories of migraines were found to have a 26% lower risk of breast cancer, taking other factors into account such as migraine triggers, menopause, and prescription drugs.

Estrogen may be a key factor as low levels of the hormone seem to increase the severity and frequency of migraines and higher levels are known to raise breast cancer risk.

The results of the study were published in Cancer Epidemiology, Biomarkers & Prevention, a publication of the American Association for Cancer Research.

Chemotherapy acts on rapidly dividing cells

As stated in previous posts, I have not been enthusiastic about the use of chemotherapy against cancer. Too much damage is done to other tissues and the patient may die from the treatment. That opinion may be about to change due to a report from researchers based in Sydney, Australia.

According to the report, non-reproducing bacterial cells can be produced and modified to target receptors specific to cancer cells. Different types of cancer have different types of receptors, so the bacterial cells must be specific for a given type of cancer.

These bacterial cells, not actually alive as they have no chromosomes, are known as minicells and can be “loaded” with various chemicals. Minicells are about 1/5 the size of normal cells and are capable of transporting highly toxic substances.

In a first round of treatment, minicells are infused with materials which reduce cancer cells’ resistance to chemo drugs. Injected into the body, these cells seek out the cancer cells and pretreat them. This step can be repeated as many times as necessary.

A second “wave” of minicells are infused with chemo drugs. When one of these minicells reaches a cancer cell, it attaches to the receptors on that cell and releases the toxin into the cell, causing the cancer cell to die.

As the mini-cells only attach to the cancer cells, the rest of the body is essentially unaffected. This means no damage is done to other tissues and the side effects experienced with systemic chemotherapy administration methods are absent.

By only delivering the chemo drugs to where they are needed, this delivery method reduces the amount of chemo needed, lowering the cost and the need for hospitalization in many cases.

Developed by EnGeneIC and applied to mice and dogs so far, human trials will be started shortly. If all goes well, this will be a huge and exciting advance in the fight against cancer.