Cancer

HHS HealthBeat

(December 28, 2009)

Life, death and mammograms

Listen to Tip Interested? Take the Next Step

From the U.S. Department of Health and Human Services, I’m Jeff Levine with HHS HealthBeat.

The best way to treat breast cancer is to spot it early and remove it. The most effective way to spot it early in most women is the mammogram. And a look at breast cancer deaths has the numbers to back it up.

Blake Cady, an emeritus professor at Harvard Medical School who’s on the staff of Cambridge Breast Center, checked data on the outcomes of almost 7,000 cases of breast cancers that had not spread.

[Blake Cady speaks] ``Seventy-five percent of the deaths occurred in the 20 percent of women who were not in regular screening programs, while only 25 percent of the deaths occurred in women who were getting regularly screened.’’

Cady says it’s another argument for regular screening.

The study presented at the ASCO Breast Cancer Symposium was supported by the National Institutes of Health.

Learn more at hhs.gov.

HHS HealthBeat is a production of the U.S. Department of Health and Human Services. I’m Jeff Levine.

Last revised: December, 28 2009

http://regular screening-dobi.blogspot.com/cancer

Cancer

Gene Variation May Speed

Recurrence of Stomach Cancer

Disease returned three times sooner in study participants with inherited trait.

FRIDAY, Jan. 22 (HealthDay News) -- An inherited genetic trait may be linked to more aggressive cases of stomach cancer, researchers say.

The new findings don't prove that the gene variation actually causes stomach cancer, also known as gastric cancer, but those who have the variation, which is found on a gene called CD44, experienced recurrence of the disease more than three times sooner than others with the disease.

The findings are scheduled to be presented Friday at the Gastrointestinal Cancers Symposium in Orlando, Fla.

"If our findings are confirmed in larger, prospective clinical trials, testing for the CD44 variation could help us identify patients who would benefit from more aggressive treatment, as well as facilitate the development of therapies targeting this genetic variation," the study's lead author, Dr. Thomas Winder, a postdoctoral research fellow at the University of Southern California, said in a news release from the American Society of Clinical Oncology, which helped organize the meeting.

The gene in question plays a role in the production of a protein that's been connected to the spread of digestive cancers.

The researchers came to their conclusions after looking for links between the gene variation and time to recurrence of cancer in 104 people with localized gastric cancer. Those with the variation experienced recurrence at an average of 2.1 years, compared with an average of 7 years among those who didn't have it.

The study noted that it might be possible to develop a genetic test that would pinpoint a person's risk of developing gastric cancer.

http://genetic trait-dobi.blogspot.com/cancer

Cancer

Blood Test Spots Colon Cancer, Polyps

If validated, the screen could greatly boost detection rates, researchers say.

WEDNESDAY, Jan. 20 (HealthDay News) -- The first blood test to reliably detect early-stage colorectal cancer and polyps may help identify patients who would gain most from colonoscopy, say Israeli researchers who developed the screen.

The blood test checks for levels of CD24 protein, which is produced early in colorectal cancer development and may play a role in the spread of tumor cells, say the team, who will present their findings Sunday at the Gastrointestinal Cancers Symposium in Orlando, Fla.

"Screening is effective for early colorectal cancer detection and prevention, but for a range of reasons, many people are reluctant to undergo colonoscopy. Most people, however, are willing to have a blood test," lead author Sarah Kraus, head of a research laboratory at Tel Aviv Souraski Medical Center, said in a news release from the American Society of Clinical Oncology (ASCO), which helped organize the meeting.

"The CD24 blood test holds promise for identifying the patients at risk for colorectal cancer and could help guide the best use of colonoscopy resources," she said.

Kraus and her colleagues tested the new blood test in 150 patients undergoing colonoscopy. They found that the test was 92.3 percent sensitive (accurate detection of an abnormality) and specific (able to differentiate certain diseases from other diseases) for detecting colorectal cancer, and 84.2 percent sensitive and 89.2 percent specific for detecting polyps that may develop into cancer.

Additional, larger studies to confirm the findings are needed before the new blood test could be used for colorectal cancer screening, Kraus cautioned.

Another study to be presented at the meeting found that post-surgical (adjuvant) treatment with XELOX -- a combination of capecitabine and oxaliplatin -- was more effective than standard 5-fluorouracil and leucovorin (5-FU/LV) therapy for slowing progression of stage III colon cancer in patients of all ages, including those 70 and older.

The phase III study included almost 1,900 patients. After three years, there was no disease progression in 71 percent of patients who received XELOX and 67 percent of patients who received 5-FU/LV, a statistically significant difference, according to the researchers.

Among patients younger than 70, there was no disease progression in 72 percent of the XELOX group and in 69 percent of the 5-FU/LV group. Among patients older than 70, the figures were 66 percent and 60 percent, respectively, the researchers found.

"These findings indicate that patients with stage III colon cancer benefit more from the newer, XELOX adjuvant treatment regimen than from the traditional adjuvant chemotherapy, and that this benefit persists among older patients," lead author Dr. Daniel G. Haller, professor of medicine and of gastrointestinal oncology at the Abramson Cancer Center, University of Pennsylvania, said in an ASCO news release.

"While treatment decisions should be made on an individual basis, these findings shed important new light on how we can best treat otherwise healthy patients age 70 and older," Haller added.

http://blood test-dobi.blogspot.com/search/label/cancer

Cancer

Current Smoking Can

Worsen Lung Cancer

Cigarette fumes not only cause tumors, but promote growth, mouse study finds.

TUESDAY, Jan. 19 (HealthDay News) -- Not only does cigarette smoke cause lung cancer, it worsens the disease by increasing lung inflammation, U.S. researchers have found.

The team at the University of California, San Diego School of Medicine conducted tests on mice with early lung cancer lesions and found that those repeatedly exposed to tobacco smoke developed larger tumors -- and developed tumors more quickly -- than those that weren't exposed to tobacco smoke. Lung tissue inflammation was the major contributing factor.

The findings, published Jan. 19 in the journal Cancer Cell, offer definitive proof that lung inflammation caused by chronic exposure to tobacco smoke promotes lung cancer growth, the researchers said.

In addition, the study results establish new lung cancer models, provide new information about the development and growth of lung cancer, and suggest that anti-inflammatory drugs may prevent or slow lung cancer progression.

"We've shown for the first time that tobacco smoke is a tumor promoter -- not only a tumor initiator -- and that it works through inflammation," study leader Michael Karin, professor of pharmacology and pathology, said in a university news release

http://cigarette smoke -dobi.blogspot.com/cancer

Cancer

Therapy May Relieve

Breast Cancer

Surgery Complication

Early physical therapy prevented or reduced secondary lymphedema in study patients.

WEDNESDAY, Jan. 13 (HealthDay News) -- A common complication of breast cancer surgery can be prevented or reduced if patients receive physical therapy, including massage and shoulder exercises, soon after their operation, a new study suggests.

Secondary lymphedema -- caused by damage to the lymphatic system during treatment -- results in fluid retention and arm swelling. It affects 71 percent of patients within 12 months of breast cancer surgery and can cause disfigurement, anxiety, depression and emotional distress.

Maria Torres Lacomba, a professor of physiotherapy at Alcala de Henares University in Madrid, Spain, and colleagues selected 120 women who had breast cancer surgery involving removal of lymph nodes and divided them into two groups -- an intervention group that received early physiotherapy and education, and a control group that received education only. Both programs lasted three weeks and the patients were followed up four weeks after surgery and again three, six and 12 months after surgery.

The therapy included lymph drainage, scar tissue massage and shoulder exercises supervised by a physiotherapist. The education program included materials about the lymphatic system and advice on how to avoid injury and prevent infection.

After one year, 7 percent of women in the intervention group and 25 percent of those in the control group developed secondary lymphedema. The researchers also found that secondary lymphedema was diagnosed four times earlier in the control group than in the intervention group, according to the report published online Jan. 12 in the BMJ.

Further research is needed to determine whether early physical therapy after breast cancer surgery offers longer-term protection against secondary lymphedema, the researchers said.

http://physical therapy-dobi.blogspot.com/cancer

Cancer

Combo PET-CT Scans

Can Spot Hidden Cancers

Whole-body screening might work when unexplained neurologic symptoms occur, researchers say.

TUESDAY, Jan. 12 (HealthDay News) -- A combination whole-body PET-CT scan is more accurate than some other commonly used tests in detecting cancer in patients with neurologic symptoms, according to U.S. researchers.

So-called "paraneoplastic neurologic disorders" can occur in people with lung, breast, ovarian and other types of cancer when cancer-fighting antibodies mistakenly attack nervous system cells. Cancers that cause neurological symptoms are often small, restricted to one site and not detected until autopsy, the Mayo Clinic researchers explained.

Routine non-invasive cancer examinations may prove inconclusive in such cases. "These standard evaluations include physical examination; computed tomography of the chest, abdomen and pelvis; mammography in women; and testicular ultrasonography and prostate-specific antigen testing in men," wrote Andrew McKeon and colleagues.

They analyzed the medical records of 56 patients with suspected paraneoplastic neurologic disorders who underwent standard evaluations that did not detect cancer. The patients then underwent whole-body PET-CT, a combination of positron emission tomography (PET) and computed tomography (CT) .

Those scans detected abnormalities suggestive of cancer in 22 patients. Of those, 10 had cancer diagnoses confirmed by biopsy or another method. Of these cancers, two were in the thyroid, one in the tonsil, three in the lungs, one in the colon and three were cancerous lymph nodes with unknown primary cancer sites.

Nine of the 10 cancers were early-stage, and the patients underwent early treatment. After a median follow-up of 11 months, seven patients had cancer remission and five had improvement in neurologic symptoms.

The study was published online Jan. 11 in advance of the March print issue of the journal Archives of Neurology.

http://detecting cancer-dobi.blogspot.com/cancer

cancer

Marijuana Compounds

Could Beat Back Brain

Cancer

Preliminary lab research suggests they could kill tumor cells.

By Randy Dotinga
HealthDay Reporter

MONDAY, Jan. 11 (HealthDay News) -- Preliminary research suggests that a combination of compounds in marijuana could help fight off a particularly deadly form of brain cancer.

But the findings shouldn't send patients rushing to buy pot: the levels used in the research appear to be too high to obtain through smoking. And there's no sign yet that the approach works in laboratory animals, let alone people.

Still, the finding does suggest that more than one compound in marijuana might boost cancer treatment, said study author Sean McAllister, an associate scientist at California Pacific Medical Center Research Institute in San Francisco. "Combination therapies might be more appropriate," McAllister said.

Researchers have long studied the compounds in marijuana known as cannabinoids, which are thought to hold possible health benefits. One, known as THC, is well known for its role in making people high when they smoke or eat pot. Researchers have been testing it as a treatment for the brain tumors known as glioblastomas.

In the new study, researchers tested THC and cannabidiol, another compound from marijuana, on brain cancer cells. The findings appear in the January issue of Molecular Cancer Therapeutics.

The study authors found that the combination treatment seemed to work better at killing the cancerous cells and preventing them from growing back.

About 9,000 people in the United States develop glioblastomas each year, said Dr. Paul Graham Fisher, chief of the Division of Child Neurology at Stanford University and Lucile Packard Children's Hospital. The most famous patient was the late U.S. Senator Ted Kennedy.

The prognosis for people with the condition is grim because tumors spread throughout the brain. It can be impossible for treatments to remove the entire tumor, Fisher said.

"No matter what you do, this tumor has a larger border than you ever think," he said. "We know there are microscopic satellites all throughout one side of the brain and pretty soon in the other side of the brain. The only thing that will fix this disease is something that provides a more blanket approach."

Instead of targeting the tumors itself, he explained, treatments need to do something like disrupt the pathways that cancer cells use to communicate.

In the big picture, "you're seeing a lot more thinking outside the box about trying to treat glioblastoma," he said. "I think in the next 10 to 15 years we're going to start seeing progress forward."

For now, he said, there's no evidence that marijuana is good or bad for glioblastoma tumors.

Back in the laboratory, McAllister said the next step is to test the combination treatment on laboratory animals and then on people. The treatment may be given to people directly through the brain, which could be expensive. But the compounds themselves may not be expensive, McAllister said.

As for the idea of getting the same effect through a couple of marijuana joints, he had this to say: "It's unlikely that you could reach effective concentrations by smoking the plant."

http://compounds in marijuana-dobi.blogspot.com/cancer

Cancer

Childhood Cancer

Survivors Targets for

Heart Disease

Study finds higher risk for diabetes, high cholesterol and blood pressure.

THURSDAY, Jan. 7 (HealthDay News) -- Childhood cancer survivors are at increased risk for diabetes, high cholesterol and high blood pressure, all of which predispose them to heart disease, say U.S. researchers.

They analyzed data on almost 8,600 survivors and close to 3,000 of their siblings who took part in the Childhood Cancer Survivor Study.

"In data previously published from the Childhood Cancer Survivor Study, pediatric cancer survivors were found to be at almost 10-fold greater risk for cardiovascular disease than their non-survivor counterparts," Dr. Lillian R. Meacham, medical director of the Cancer Survivor Program and professor of pediatrics at Emory University, said in a news release.

"In this study, we identified whether the predisposing risk factors for cardiovascular disease -- obesity, hypertension, hyperlipidemia [high cholesterol] and diabetes -- were present at higher rates compared to siblings. If the risk factors could be recognized and treated early it is hoped some of the long-term cardiac side effects could be averted," she said.

Meacham and her colleagues found that childhood cancer survivors were nearly twice as likely as their siblings to take medication for high blood pressure, 70 percent more likely to have diabetes and 60 percent more likely to take cholesterol medication. The cancer survivors were not more likely than their siblings to be obese.

The study was published Jan. 7 in the journal Cancer Epidemiology, Biomarkers & Prevention.

Meacham said radiation treatment may play a role in the development of cardiovascular disease risk factors. Total body radiation was associated with a 5.5-fold increased risk of cardiovascular risk factor clustering, while chest and abdomen radiation was associated with a 2.2-fold increased risk.

"Mechanistically, we are not yet sure why this is, but the association is definitely there," Meacham said.

http://diabetes high cholesterol -dobi.blogspot.com/cancer

Cancer

Alzheimer's May Stave

Off Cancer, and Vice Versa

Biological factors that lead to one seem to protect against the other, expert says.

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, Dec. 23 (HealthDay News) -- Researchers have uncovered a bittersweet relationship between two major illnesses: cancer and Alzheimer's disease.

People who have had cancer are less likely to get Alzheimer's disease, just as having Alzheimer's disease reduces the risk for cancer, their study found.

"Alzheimer's was associated with a rather dramatic reduction in cancer risk," said Dr. Richard Lipton, an attending neurologist at Montefiore Medical Center and professor of neurology at Albert Einstein College of Medicine in New York City. "From my perspective, the strengths of the findings are very striking and somewhat unexpected."

There was no link between Alzheimer's and vascular dementia, however, suggesting that the association has to do with neurodegenerative factors. Vascular dementia is attributed to damage to the brain's blood supply.

"Parkinson's and Alzheimer's are both neurodegenerative diseases, where specific populations of cells die without clear reason," Lipton said. "In cancer, specific populations of cells begin dividing wildly and out of control so, very broadly, it makes sense that a condition associated with selective cell death may be associated with a condition associated with proliferation. The biological factors that predispose one to neurodegenerative disease may protect against wild division."

A number of previous studies had hinted at a similar relationship but were subject to the usual limitations of early research.

For example, said Catherine M. Roe, lead author of the new study, published Dec. 23 in Neurology, earlier research could not pinpoint whether cancer patients died before they had a chance to be diagnosed with Alzheimer's. Roe is an instructor in neurology at Washington University in St. Louis School of Medicine.

As the accompanying editorial pointed out, the main reason older people with advanced brain tumors don't get Alzheimer's is that they just don't live long enough.

In Roe's study, 3,020 people 65 and older enrolled in a cognition sub-study of the large Cardiovascular Health Study were followed for an average of five years for dementia and eight years for cancer.

Among white participants, those who had Alzheimer's at the start of the study were 69 percent less likely to be hospitalized for cancer. Having cancer meant a 43 percent reduced risk for Alzheimer's.

Among minority participants, the researchers found an opposite trend, but it was not statistically significant, they noted.

There appeared to be no link either way between vascular dementia and cancer.

Next, Roe said, the research team would like to see whether there's an association between Alzheimer's disease and specific types of cancer.

http://research-dobi.blogspot.com/cancer

Cancer

Many High-Risk Women Refuse Breast MRI

Though it helps ID early breast cancer, 42 percent in study declined free test.

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Dec. 22 (HealthDay News) -- For women at high risk of breast cancer, an MRI can help detect malignancies early and is often suggested in addition to annual mammograms. Yet, 42 percent of such women in a new study said no to the test.

"We were surprised that so few women wanted to have MRI, even though it was no cost to them," said study author Dr. Wendie A. Berg, a breast imaging specialist at Johns Hopkins' Green Spring Station in Lutherville, Md.

Berg and her colleagues offered 1,215 women at high or intermediate risk of breast cancer an MRI for screening, but 512 women refused the test. They cited claustrophobia, time problems and reluctance to have the contrast medium injected as some of their reasons. They also mentioned financial concerns and the need to travel to get the test.

In an MRI, a powerful magnetic field, radio frequency pulses and a computer produce detailed pictures of organs, soft tissues, bone and other structures. MRI is often used to evaluate the heart, liver, kidney, spleen, pelvic organs, blood vessels and breasts.

Contrast material may be swallowed or injected to produce a better image. The patient is rolled into a cylindrical machine, and some have problems because of claustrophobia.

In the Berg study, the acceptability of the test was lower than expected, said Robert Smith, director of cancer screening for the American Cancer Society (ACS). "I would think most women would accept the test if their doctor suggested it," he said.

The study is published in the January issue of Radiology.

Smith said he was surprised that claustrophobia was cited more often -- by 25.4 percent of the women -- than reluctance to inject the contrast material -- 5.3 percent.

The ACS recommends MRI plus mammograms annually beginning at age 30 for certain groups of women with a high risk of getting breast cancer, which is defined as more than a 20 percent lifetime risk. For instance, those with the genetic mutation known as BRCA1 or 2 would be candidates for getting both.

In the study, some of the women were at intermediate, not high risk, of breast cancer, Smith noted.

But Berg said that there is a gray area about what to do with intermediate-risk women as far as adding MRI to their screening program. "There is some evidence that it's of value for intermediate-risk women," she explained.

Berg said genetic counseling would be of benefit for some women who are unsure if they are at very high risk of breast cancer. For instance, women who may benefit from genetic counseling and possibly testing for the BRCA1 or 2 mutations include those who are first-degree relatives of a known BRCA mutation carrier and those who have a male family member with breast cancer.

"I think the researchers need to understand a little better what is behind the rejection, and how it might be overcome," Smith said.

Berg suspects that once awareness of the value of MRI is raised and more women know it increases cancer detection, there will be a greater interest in getting the test.
http://breast cancer-dobi.blogspot.com/cancer

Cancer

Chemo With Herceptin May Be Best for Some Breast Cancers

Taking the drug during chemotherapy, rather than after, improves survival, study finds.

SATURDAY, Dec. 12 (HealthDay News) -- New research suggests that certain breast cancer patients who take the drug Herceptin during chemotherapy, instead of taking it afterward, fare better, leading one of the study authors to say patients should routinely take the drug with chemo.

The patients at issue are those with HER2-positive breast cancer, which accounts for 20 percent to 25 percent of all cases of the disease.

Researchers looked at the outcomes for hundreds of women who underwent different treatment regimens. Their findings were to be released at the San Antonio Breast Cancer Symposium, sponsored by the Cancer Therapy & Research Center of the University of Texas, the American Association for Cancer Research and Baylor College of Medicine.

The study found that patients who used Herceptin (also known by the generic name trastuzumab) and chemotherapy together were 25 percent less likely to experience a cancer recurrence or death than those who used the drug after chemotherapy.

"The results of this trial have been eagerly awaited in the U.S. and in many nations as this is the only trial developed to define the optimal way to incorporate Herceptin in the context of adjuvant chemotherapy," Dr. Edith Perez, a breast cancer researcher at the Mayo Clinic in Jacksonville, Fla., said in a news release. "This could mean that up to 10,000 women around the world each year may have a better outcome if Herceptin is used along with chemotherapy. Given that, I believe this study will lead to a global re-evaluation of how Herceptin is used."

http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

Tweaks to Breast

Cancer Treatments

Boost Outcomes

In one study, longer Herceptin use helped beat back the disease.

By Kathleen Doheny
HealthDay Reporter

FRIDAY, Dec. 11 (HealthDay News) -- With a growing array of choices for breast cancer treatment, researchers are now trying to pinpoint the best combination of therapies or the best order in which to give cancer drugs to patients.

In some cases, combination therapies will improve survival and sometimes the order in which therapies are given does not matter, said experts presenting new data at a Friday press briefing at the San Antonio Breast Cancer Symposium.

"The most dramatic finding [presented at the briefing] is that continuing Herceptin therapy after tumor progression improves survival," said moderator Dr. Edith Perez, director of the Breast Cancer Program at the Mayo Clinic in Jacksonville, Fla. "It is the first time this has been shown."

In that study, Dr. Kimberly Blackwell, director of the Clinical Trials Program in Breast Cancer at Duke University Medical Center, reported that combining the drug lapatinib (Tykerb) with trastuzumab (Herceptin) was better than single-drug therapy in women who have HER2-positive breast cancer that has spread.

Cancers that are HER2-positive test positive for a protein called human epidermal growth factor receptor 2, which fuels cancer cell growth.

Tykerb inhibits HER2 and the receptor, while Herceptin binds to the ER2 protein -- a kind of double-punch, the researcher explained.

Blackwell reported on 296 women with breast cancer that had spread. Half got the drug Tykerb, 1,500 milligrams a day; the other half got 1,000 milligrams of Tykerb a day plus the Herceptin at a dose geared to their body weight.

The women's tumors had already progressed while on a number of other treatments, so they were running out of options.

The findings? "There was significant improvement in overall survival in favor of the combination of lapatinib and trastuzumab compared to the single agent lapatinib," Blackwell said. There was a 26 percent reduction in the risk of death if both agents were used.

Put in more human terms, that means that "15 more out of 100 women are alive at a year because of combination therapy."

In another report, Dr. Daniel Rea, senior lecturer in medical oncology at the University of Birmingham in the UK, compared two approaches for postmenopausal women with early stage hormone-sensitive breast cancer. In the trial, 9,775 postmenopausal women with hormone-positive (the most common type) early breast cancer were assigned to get the drug exemestane (Aromasin) at 25 milligrams a day or tamoxifen at 20 milligrams a day. That was in 2001, and in 2004 the researchers assigned all the women who were getting tamoxifen to switch to Aromasin after 2.5 or three years.

Another 2,500 patients were enrolled and assigned to get either Aromasin or tamoxifen followed by Aromasin.

"The outcome is identical," Rea said. At five years, there was 85 percent disease-free survival in both groups.

"Both of these strategies appear to be reasonable approaches for those with early cancer," he said.

Perez said the additional option to choose between the drugs may be of special interest to patients because of the cost savings. Aromasin typically costs more than tamoxifen, she said. Tamoxifen is now available as a generic drug.

Blackwell received honorariums from GlaxoSmithKline (which makes Tykerb) and Genentech (which makes Aromasin) to conduct the study; Rea reports research funding from Novartis and Pfizer.

http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

New Drugs,

New Combinations

Fight Breast Cancer

Targeted therapies could make inroads against metastatic disease, researchers say.

By Amanda Gardner
HealthDay Reporter

FRIDAY, Dec. 11 (HealthDay News) -- New therapies and new spins on existing treatments are offering hope for patients with breast cancer, especially those with metastatic disease, according to research being presented this week at the annual San Antonio Breast Cancer Symposium in San Antonio, Texas.

One study found that a higher (500-milligram) dose of Faslodex (fulvestrant) works better than the currently approved 250-milligram dose in hormone receptor-positive breast tumors that had already spread to other parts of the body. There was no difference in the severity of side effects between the two doses, researchers added.

Many breast cancer cells are sensitive to circulating estrogen because they carry receptors on their surface that link up with the hormone, helping malignant cells to spread and grow. Faslodex targets this critical link-up.

"This drug is different from other hormonal agents. It can actually destroy the estrogen receptor," explained study lead author Dr. Angelo Di Leo, director of the department of oncology at the Hospital of Prato in Italy. "Evidence from past clinical trials suggests that if you increase the dose of the drug you can induce a more profound down-regulation of the estrogen receptor."

And, in the new trial, that turned out to be the case.

"It was clear that 500 milligrams was more effective than 250 in prolonging time to disease progression and the median time to progression, which was 6.5 months for those in the 500-milligram group versus 5.5 months in the 250-milligram group," she said.

There was no evidence of tumor shrinkage but there was a hint that survival was also improved, but this was not statistically significant.

Dr. C. Kent Osborne, president of the symposium and moderator of a Friday teleconference detailing these and other findings, and director of the Dan L. Duncan Cancer Center and the Lester and Sue Smith Breast Center at Baylor College of Medicine in Houston, expressed hope that the dosing changes may also help women with early breast cancer.

A second study found that adding Nexavar (sorafenib) -- a drug already used to treat liver and kidney cancer -- to chemotherapy in advanced breast cancer patients with HER2-negative tumors extended the time to disease progression, another hint of increased survival.

"The drug has multiple targets including some in the angiogenic pathway [the pathway that controls blood flow to the tumor]," explained study lead author Dr. William Gradishar, professor of medicine at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University in Chicago. Gradishar consults to Onyx Pharmaceuticals, which makes Nexavar, as does Osborne.

The median time to disease progression was 8.1 months for those taking the combination therapy versus 5.6 months for those in the control group.

One troubling trend did emerge, however: a larger number of deaths in participants from India who took Nexavar plus chemo. "At first blush, that's troubling but when we looked closer we identified that the patients were dying from adverse events not related to the study, things we don't typically see in the West, such as malaria and meningitis," Gradishar said.

Osborne stated he does not think that oncologists will start using Nexavar off-label to treat breast cancer.

A third study gives added credibility to the stem cell theory of cancer that is currently gaining prominence in the medical community.

The hypothesis holds that tumors are propelled forward by a small group of stem cells or "mother" cells that are resistant to existing therapies, explained Dr. Jenny Chang, lead author of this study and professor of medicine at Baylor College of Medicine in Houston.

In fact, studies have suggested that chemotherapy can actually increase the number of these stem cells, Chang said.

Investigating further, Chang said she and her colleagues "isolated these cells and found that the [molecular] pathway that regulated cancer stem cells was the 'Notch' pathway."

So called gamma-secretase inhibitor drugs, which activate the Notch pathway, succeeded in rendering cancer stem cells vulnerable to chemotherapy in an animal model.

And in one human patient, the drug managed to shrink a tumor in a woman who had failed all attempts at chemotherapy.

"She is now about to go for surgery," Chang reported. "Previously, a patient like this is inoperable."

A final study found that treating estrogen receptor-positive breast cancer tumors with a combination of an experimental drug called fidarestat and Femara (the aromatase inhibitor letrozole) either delayed or eliminated tumors that had developed a resistance to hormone therapy.

Researchers at the University of Texas Health Science Center, San Antonio, found that fidarestat affects cellular metabolism of glucose, which provides energy for cells, sustaining tumor growth.

http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

New Field of

'Cardio-oncology' Suggested

Heart, cancer specialists should collaborate to protect chemo patients, researchers say.

THURSDAY, Dec. 10 (HealthDay News) -- Certain types of chemotherapy can cause heart problems, and cardiologists and oncologists need to work together to protect patients, especially those at greatest risk, say Italian researchers who reviewed available scientific literature.

Because many nations have aging populations, a growing number of people have both cancer and cardiovascular disease, the researchers said.

The review summarized the potential toxic effects of chemotherapeutic and chemopreventive drugs on the cardiovascular system. The researchers also stressed the importance of evaluating people's cardiovascular risk before they have chemotherapy, called for new chemotherapy guidelines that include collateral effects on the cardiovascular system and recommended creation of a new interdisciplinary field of "cardio-oncology."

Led by Adriana Albini, chief of oncology research at the Clinical and Research Institute Multimedica in Milan, the researchers said that using imaging techniques and biomarkers to identify high-risk patients would play an important role in reducing cardiovascular harm and death.

They also called for assessment of cardiotoxicity in phase 1 trials of new chemotherapy drugs that pose less heart risk.

"Today's oncologists must be fully aware of cardiovascular risks to avoid or prevent adverse cardiovascular effects, and cardiologists must now be ready to assist oncologists by performing evaluations relevant to the choice of therapy," the authors of the review wrote.

The article was published online Dec. 10 in the Journal of the National Cancer Institute.

http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

Too Much Drinking, Eating Tied to Breast Cancer Recurrence

Prognosis is also worse for overweight women, researchers find.

By Kathleen Doheny
HealthDay Reporter

THURSDAY, Dec. 10 (HealthDay News) -- Overeating and drinking even moderate amounts of alcohol may be bad news for women with breast cancer, new research suggests.

Drinking alcohol is already known to boost breast cancer risk, and a new study finds even moderate drinking may increase the odds of breast cancer recurrence. Another study confirms that overweight or obese women with breast cancer have a worse prognosis over time than thinner patients.

In the alcohol study, women who drank six grams or more of alcohol a day -- about half a drink -- had a 34 percent increased risk of recurrence compared to those who drank less, said Marilyn Kwan, staff scientist in the division of research at Kaiser Permanente, Oakland, Calif. She is scheduled to present her findings Thursday at the San Antonio Breast Cancer Symposium.

"Women who drank less than six grams a day had no increased risk of recurrence," Kwan said.

Kwan evaluated data from 1,897 early-stage breast cancer survivors who were diagnosed between 1997 and 2000. They all submitted information on alcohol consumption.

After eight years of follow-up, the researchers found 349 breast cancer recurrences and 332 deaths. For the study, they defined recurrence as including a new cancer in the opposite breast. When they took out the 32 of the 349 recurrences that occurred in the opposite breast, they found the risk slightly lower -- 31 percent, compared to 34 percent, with that finding not reaching statistical significance.

Susan Gapstur, vice president for epidemiology for the American Cancer Society, took issue with the definition of recurrence used for the study.

"With the inclusion of women who experience a new contralateral [opposite breast] cancer, the results of the study do not provide a clear picture of the risk of breast cancer recurrence associated with alcohol consumption," she said. "Therefore, more research studies are needed with larger numbers of women who experience a recurrence -- omitting those who have a new cancer in the opposite breast -- to better clarify how strong the association is."

In the obesity study, also scheduled for presentation Thursday at the symposium, Danish researchers looked at the effect of body-mass index (BMI) on the outcomes of breast cancer patients.

From a database of nearly 54,000 women, they had information on BMI for 35 percent of the women, or nearly 19,000 patients.

Breast cancer patients with a higher than normal BMI -- more than 25 -- had a higher risk of death from breast cancer than leaner patients, they found. Cancers were likely to be detected later in the heavier women, and positive treatment effects were shorter among that group of women as well.

Within the first 10 years of follow-up, which spanned 30 years for some, chemo and hormone treatments were equally effective for lean and obese women. But after a decade, the treatments were less effective in the obese women.

Gapstur, who reviewed the study, said the women diagnosed longer ago may have gotten different treatments, which could have affected the results.

"The overall take-home message of this research is that obesity contributes to a poorer overall survival, which is consistent with research published previously," she said.

As for what to do about alcohol consumption, Kwan agreed more study is needed to better define the link between alcohol consumption and recurrence risk. Meanwhile, what should breast cancer survivors do? "I would say that I think they should, given the results of our study, consider possibly minimizing their consumption of alcohol.
http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

Selenium, Omega-3s

May Stave Off Colorectal

Cancer

Studies find benefits, but others question validity of the link

By Jennifer Thomas
HealthDay Reporter

TUESDAY, Dec. 8 (HealthDay News) -- Certain dietary supplements appear to affect the development of colorectal cancer or its recurrence, two new studies suggest.

In one study, researchers from the U.S. National Institute for Environmental Health Sciences found that eating a diet high in omega-3 fatty acids cut the risk of developing colorectal cancer by nearly 40 percent. In the other study, from cancer researchers in Italy, consumption of a dietary supplement containing selenium was found to reduce the chances of having polyps recur by a similar amount.

Both studies were to be presented Dec. 7 in Houston at a conference on cancer prevention sponsored by the American Association for Cancer Research.

In the selenium study, 411 people, 25 to 75 years old, who'd had one or more colorectal polyps removed took either a supplement or a placebo. The supplement, described as an antioxidant compound, contained 200 micrograms of selenomethionnine (a combination of selenium and methionnine), 30 milligrams of zinc, 6,000 international units of vitamin A, 180 milligrams of vitamin C and 30 milligrams of vitamin E.

Participants had a colonoscopy one year, three years and five years after starting the regimen.

Polyps recurred in 4.2 percent of those taking the supplement, compared with 7.2 percent of the placebo group. Overall, the study found, people taking the supplement had about a 40 percent reduction in risk for a return of polyps.

The researchers estimated that, after 15 years, about 48 percent of those taking the supplement would still be free of polyps, versus about 30 percent of those not taking the supplement.

Polyps, or adenoma, are benign growths on the large bowel. Though only a small proportion progress to become cancer, about 70 to 80 percent of colorectal cancer cases begin as polyps, according to the American Association for Cancer Research. About one in four people, most older than 60, will have at least one adenoma.

Selenium is found in soil, and human consumption comes by eating plants that have absorbed the nutrient or fish or animals that have eaten plants as part of their diet. "The content of selenium in the food depends on the soil content of this trace element, and in the same country there are areas at high, adequate or low content of selenium in the soil," said the study's lead author, Dr. Luigina Bonelli, head of the unit of secondary prevention and screening at the National Institute for Cancer Research in Genoa, Italy.

Earlier research had suggested that selenium can inhibit cell proliferation in the colon and rectum, Bonelli said.

Michele Forman, a professor of epidemiology at the M.D. Anderson Cancer Center in Houston, said that, though the findings are interesting, it's impossible to tell if the benefit was attributable to the selenium or to the other vitamins and minerals included in the supplement.

"You really don't know if it's the selenium or some combination that reduces risk of recurrence," Forman said.

In addition, the daily dosages of vitamins A and E taken by the participants were higher than the recommended daily allowances, Forman added. High levels of such vitamins can be detrimental, she said.

In the omega-3 study, U.S. researchers surveyed 1,509 whites and 369 blacks about their dietary habits in the past year. About half of the participants had colorectal cancer.

Among the white participants, those whose diets were in the highest fourth of omega-3 fatty acid consumption were 39 percent less likely to have colorectal cancer than those in the lowest fourth. However, for reasons the authors said they did not know, no association was noted between omega-3s and a reduction of colorectal cancer risk among black participants. The disease occurs at a higher rate among blacks than whites.

"Our finding clearly supports the evidence from previous experimental and clinical studies showing that long-chain omega-3 fatty acids inhibit tumor growth," said the study's lead author, Sangmi Kim, a postdoctoral fellow at the U.S. National Institute of Environmental Health Sciences in Research Triangle Park, N.C.

Kim said the research supports boosting omega-3 intake through diet or perhaps by taking an omega-3 supplement. Omega-3 fatty acids are found in fish, especially oily fish such as salmon, mackerel, herring, anchovies, sardines and tuna. Plant-based sources include flax and flaxseed oil, Brussels sprouts, soybeans and soybean oil, canola oil, spinach, walnuts and kiwi.

Previous studies have suggested that omega-3 fatty acids act as anti-inflammatory agents and help prevent cancer. But in the new study, Forman noted, participants were asked about their diets after they had been diagnosed with colorectal cancer so it's possible that their recollections were not fully accurate.

In addition, she said, it's possible that the benefit was not the result of omega-3s. Those who ate more fish might have had a healthier diet overall, she said.

"Were they eating a salmon-and-broccoli diet or a hamburger-and-french-fry diet?" Forman asked. "We don't know enough to say that it's truly the effect of the omega-3s."

http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

Breast Cancer Decline

Only Partly Due to HRT

Drop in hormone replacement therapy doesn't fully explain the 7% falloff, researchers say.

TUESDAY, Dec. 8 (HealthDay News) -- The incidence of breast cancer in the United States declined 7 percent between 2002 and 2003, but only part of that decrease can be attributed to reduced use of hormone replacement therapy (HRT) by menopausal women, researchers say.

HRT use declined after the 2002 release of The Women's Health Initiative study, which concluded that hormone therapy increases the risk of breast cancer. Other studies have confirmed the link.

"We found that the change in hormone therapy use only accounted for a decline (in breast cancer) of about 3 percent, so there's another 4 percent that is being caused by something we do not yet know," study leader Brian Sprague said in a news release.

He and his colleagues reviewed studies that looked at the decline of HRT use and the decline in breast cancer incidence. Based on the available literature, Sprague and colleagues estimated that reduced use of HRT accounted for 42 percent of the decline in breast cancer incidence.

Further research is needed to identify the other reasons for the decrease in breast cancer cases, Sprague said.

"This does not mean that women should start taking hormones again, but there appear to be additional factors that have contributed to the decline in breast cancer," he noted.

The study was to be presented at an American Association for Cancer Research conference on cancer prevention, held Dec. 6 to 9.

http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

No Increase in Brain Tumors Seen From Cell Phones

Despite new findings, doubts linger about whether they cause brain cancer

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_92606.html (*this news item will not be available after 03/03/2010)

HealthDayThursday, December 3, 2009

THURSDAY, Dec. 3 (HealthDay News) -- Whether cell phones cause brain cancer has been a subject of ongoing debate, but a new study confirms previous evidence suggesting that they don't.

A 30-year examination of the incidents of brain tumors in Scandinavia found no substantial change in prevalence even after cell phone use became widespread, according to the report in the Dec. 3 online edition of the Journal of the National Cancer Institute.

"If mobile phones were to cause brain tumors we would expect to see a sudden rise in the number of brain tumors at some point in time, and we don't see it," said lead researcher Isabelle Deltour, from the Institute of Cancer Epidemiology at the Danish Cancer Society in Copenhagen.

However, Deltour leaves the door open to the possibility that widespread cell phone use hasn't been around long enough to see an increase in brain tumors.

"Either it means that mobile phones don't cause brain tumors or it means that we don't see it yet or we don't see it because the increase is too small to be observed in this population, or it is a risk that is limited to a small subgroup of the population," she said.

Deltour's team will continue to look at the rates of brain tumors in the study group, she added.

For the study, Deltour's team collected data on 60,000 people diagnosed with glioma and meningioma in Denmark, Finland, Norway and Sweden between 1974 and 2003.

The researchers found that the incidence of brain tumors over this 30-year period were stable, decreased or gradually increased, starting before cell phones became popular.

In addition, there was no change in the incidence of brain tumors between 1998 and 2003, during a period of rapid increase in cell phone usage, the researchers noted.

Dr. Paul Graham Fisher, an associate professor of neurology, pediatrics, and neurosurgery and human biology and the Beirne Family Director of Neuro-Oncology at Stanford University, said that "this topic won't go away."

Fisher thinks that like so many irrational fears, such as harm from radiation from electric wires, the connection between cell phones and brain tumors will persist even though there is no scientific evidence for such a connection.

"This is sort of the high-tension wires of our time," Fisher said. "This is an issue that is probably not going to go away, because people have this suspicion and it's fueled by some public paranoia and by people who make very provocative statements, and that is enough to make it not go away, despite very good science."

However, a review of existing research on the topic, published online Oct. 13 in the Journal of Clinical Oncology, did find a slight, potentially harmful association between cell phone use and brain tumors.

Commenting on that study, Dr. Deepa Subramaniam, director of the Brain Tumor Center at Georgetown Lombardi Comprehensive Cancer Center in Washington, D.C., said at the time that "we cannot make any definitive conclusions about this. But this study, in addition to all the previous studies, continues to leave lingering doubt as to the potential for increased risk. So, one more time, after all these years, we don't have a clear-cut answer."

SOURCES: Isabelle Deltour, Ph.D., Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen; Paul Graham Fisher, M.D., associate professor, neurology, pediatrics, and neurosurgery and human biology, and the Beirne Family Director of Neuro-Oncology, Stanford University, Palo Alto, Calif.; Dec. 3, 2009, Journal of the National Cancer Institute, online

HealthDay
http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

Certain Childhood Cancers

More Likely to Recur

Research and surveillance urged for at-risk patient groups.

FRIDAY, Dec. 4 (HealthDay News) -- Some childhood cancers, particularly Ewing sarcomas and central nervous system tumors, carry the risk of late recurrence, U.S. researchers have found.

The study authors analyzed data from 12,795 five-year survivors of the most common pediatric cancers who were enrolled in the Childhood Cancer Survivor Study.

The researchers found that the overall cancer recurrence rate was 4.4 percent at 10 years and 6.2 percent at 20 years. But the recurrence rate at 20 years was much higher for astrocytomas (14.4 percent) and for Ewing sarcomas (13 percent), and much lower for kidney tumors (0.9 percent), non-Hodgkin lymphomas (2.4 percent) and neuroblastomas (2.6 percent).

"Future research is needed to determine the risk of recurrence in subgroups of survivors and the cost-effectiveness of long-term disease surveillance in at-risk patient groups because these factors need to be considered in long-term follow-up and transitional care plans," wrote Dr. Karen Wasilewski-Masker, of the Aflac Cancer Center and Blood Disorders Service, Children's Healthcare of Atlanta at Scottish Rite, and colleagues.

The study appears online Dec. 4 in the Journal of the National Cancer Institute.

http://healthcareman-dobi.blogspot.com/search/label/cancer

Cancer

Mammograms May Boost Cancer Risk in High-Risk Women

Radiation exposures in younger women may up chances of disease, study finds.

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Dec. 1 (HealthDay News) -- Mammograms may actually boost the risk of breast cancer in some high-risk women, a new study suggests.

Dutch researchers analyzed six previously published studies, four examining the effect of low-dose radiation exposure from mammography among women with the genetic mutation boosting breast cancer risk and two looking at the effect of radiation from screening in women with a family history of breast cancer.

"Women who were exposed before the age of 20 had a 2.5 times increased risk of breast cancer," said Martine Jansen-van der Weide, an epidemiologist and researcher at the University Medical Center Groningen, in the Netherlands. So did women with five or more exposures.

She was to present the findings Monday at the Radiological Society of North America's annual meeting in Chicago.

No information was available from the studies about the time period, said Jansen-van der Weide. The studies did control for different factors that affect breast cancer risk, such as age, breast-feeding and age at first menstruation.

These new findings come in the wake of a controversial recommendation made in mid-November by the U.S. Preventive Services Task Force for the general public, that women delay routine screening mammograms from age 40 to 50, asking their doctor the best time to begin, and that older women switch to every-other-year mammograms.

Currently, the American Cancer Society and other organizations advise yearly mammograms for women beginning at age 40. For high-risk women, the ACS recommends a mammogram and MRI every year.

Overall, the Dutch researchers also found, the average risk of breast cancer from radiation exposure was 1.5 times greater among the high-risk women studied than the high-risk women not exposed.

The study is important, as it provides the ''first direct piece of evidence on whether high-risk women have an increased risk due to radiation exposure," said Edward Hendrick, a member of the American College of Radiology Commission, a medical physicist and clinical professor at the University of Colorado at Denver.

In the United States, women under 30 don't routinely get mammograms, however, he said. It's known that young women are more radiation-sensitive.

Young women who are deemed high-risk can, if they choose, turn to an MRI breast exam instead, he said. MRIs use magnetic or radio waves, not radiation.

"Screening is very important," Jansen-van der Weide said. "However, for young, high-risk women, a careful approach is advised when considering mammography for screening."

More information

To learn more about guidelines for early detection of cancer, visit the American Cancer Society. External Links Disclaimer Logo

(SOURCES: Martine C. Jansen-van der Weide, Ph.D., epidemiologist, University Medical Center Groningen, Netherlands; Edward Hendrick, Ph.D., member, American College of Radiology Breast Imaging Commission, and clinical professor, University of Colorado at Denver; Nov. 30, 2009, presentation, Radiological Society of North America annual meeting, Chicago)
http://healthcareman-dobi.blogspot.com/search/label/cancer