Cancer
Penn studies point to strategies for reducing painful breast cancer drug side effects
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Aromatase inhibitors, the same drugs that have buoyed long-term survival rates among breast cancer patients, also carry side effects including joint pain so severe that many patients discontinue these lifesaving medicines. New University of Pennsylvania School of Medicine research, however, has uncovered patterns that may help clinicians identify and help women at risk of these symptoms sooner in order to increase their chances of sticking with their treatment regimen. In a study published recently in the journal Cancer, researchers at Penn’s Abramson Cancer Center found that estrogen withdrawal may play a role in the onset of joint pain, also known as arthralgia, during treatment: Women who stopped getting their menstrual periods less than five years before starting breast cancer treatment were three times more likely to experience these pains than those who reached menopause more than a decade earlier. In a separate study published in the journal Integrative Cancer Therapies, the Penn researchers found that among women experiencing these symptoms during treatment with aromatase inhibitors (AI), those who received electro-acupuncture – a technique that combines traditional acupuncture with electric stimulation – reported a reduction in joint pain severity and stiffness. Those women also said they suffered less fatigue and anxiety.
“We are fortunate today to have many effective treatments for breast cancer. Unfortunately, many of these treatments have troublesome and debilitating side effects that can last for months or years after treatment, and really harm the quality of life and productivity of women who receive them,” says lead author Jun J. Mao, MD, MSCE, an assistant Professor of Family Medicine and Community Health. “These findings are just a first step in our comprehensive research program aimed at understanding the nature of treatment-related symptoms, who is likely to get them, the mechanisms by which they occur, and how best to treat them.”
Toxicity issues and side effects among patients taking aromatase inhibitors – drugs used in post-menopausal women to prevent recurrence of breast cancer following initial treatment, by reducing the amount of estrogen the body makes – lead as many as 20 percent of patients to miss prescription refills or discontinue their therapy altogether. Patients in the new study were taking aromatase inhibitors including Arimidex, Femara or Aromasin.
NewYork-Presbyterian/Weill Cornell Establishes Prostate Cancer Institute
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NewYork-Presbyterian Hospital/Weill Cornell Medical Center has established a new Prostate Cancer Institute, dedicated to pursuing aggressive and innovative prostate cancer treatments while providing patient care in a comfortable and compassionate setting. Dr. Ashutosh Tewari, a leading robotic urologic surgeon, has been appointed as its director.
Dr. Tewari is an internationally acclaimed expert on robotic prostatectomy and other minimally invasive robotic surgeries, of which he has performed more than 2,000 in New York. A prolific researcher, he has also written upwards of 200 scientific articles. His clinical interests involve urologic oncology with special emphasis on the care of patients with prostate, bladder and other urological cancers.
“I am proud to have Dr. Tewari lead the Prostate Cancer Institute,” says Dr. Peter Schlegel, professor and chairman of urology at Weill Cornell Medical College, and urologist-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Cost-savings of colorectal cancer screening as treatment costs increase
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Investing in some colorectal cancer screening programs could cut future, more expensive treatment costs in half, according to a new study published online September 24 in the Journal of the National Cancer Institute. The only screening program found not to be cost-saving was colonoscopy.
Governments and insurance companies may invest more in colorectal cancer screening programs—some of which have proven to reduce colorectal cancer mortality—if the cost-savings were known, especially as more expensive cancer drugs continue to hit the market.
Iris Lansdorp-Vogelaar, Ph.D., of the Department of Public Health, Eramus MC, University Medical Center Rotterdam in the Netherlands, and colleagues used a microsimulation model, known as the MISCAN-Colon model, to assess whether the increasing use of new, very costly drugs would affect treatment savings of colorectal cancer screening.
Certain cancers more common among HIV patients than non-HIV patients
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Researchers at UT Southwestern Medical Center have found that non-AIDS-defining malignancies such as anal and lung cancer have become more prevalent among HIV-infected patients than non-HIV patients since the introduction of anti-retroviral therapies in the mid-1990s.
AIDS patients with suppressed immune systems are at higher risk for so-called AIDS-defining malignancies – cancers such as non-Hodgkin’s lymphoma, Kaposi’s sarcoma and cervical carcinoma. Some researchers have speculated, however, that HIV patients are diagnosed with more non-AIDS-defining malignancies simply because anti-retroviral drugs now used enable them to live longer, but the results of the UT Southwestern study suggest that other factors may be at work.
The researchers, using data from more than 100,000 patient records in the U.S. Veterans Affairs Healthcare System, found that when the statistics were adjusted for gender, race/ethnicity and age, HIV-infected patients were 60 percent more likely to have anal, lung, Hodgkin’s, melanoma or liver cancer than patients without HIV. The rate of prostate cancer was similar between the two groups, according to the report.
Prostate cancer patients on hormone therapy at increased risk for various heart diseases
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Berlin, Germany: New research has found that hormone therapy used to treat men with advanced prostate cancer is associated with an increased chance of developing various heart problems. Some choices of therapy appear, however, to be less risky than others.
Researchers told Europe’s biggest cancer congress, ECCO 15 – ESMO 34 [1], in Berlin today (Tuesday 22 September) that the findings of their study, the largest and most comprehensive to date on the issue, indicate that doctors need to start considering heart-related side effects when they prescribe endocrine therapy for prostate cancer and might want to refer patients to a cardiologist before starting treatment.
A few smaller studies have indicated that some types of hormone therapy increase the risk of coronary heart disease and heart attacks in prostate cancer patients, but others have found no increased risk. This is the first large study to investigate how the broader range of hormone therapies affect a wider range of heart problems and provides for the first time a detailed picture of the impact of each sort of hormone therapy on individual types of heart trouble.
Inflammatory Breast Cancer: Why You Need to Know the Signs of This Deadly Disease
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It’s one of the most aggressive forms of breast cancer, but most women have never heard about it. Inflammatory breast cancer or IBC, is a silent killer because unlike many other cancers, patients often don’t recognize the symptoms.
According to the National Cancer Institute, approximately 200,000 new cases of inflammatory breast cancer will be diagnosed this year and more than 40,000 people will die from the disease. Though it occurs in both men and women, it is largely a disease that affects women.
“Inflammatory breast cancer accounts for one-to-five-percent of all breast cancers diagnosed and because it is uncommon, you don’t necessarily jump to that as a first diagnosis,” says Beth Overmoyer, MD, an IBC expert at Dana-Farber Cancer Institute. “In traditional breast cancers, a patient can feel a lump or we can see a mass on a mammogram. Inflammatory breast cancer is often not a lump or mass, but a rash or bruise and can be misdiagnosed as an infection.”
New Surgical Procedure Improves Quality of Life for Breast Cancer Patients
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Toronto Western Hospital has pioneered a new procedure - minimally invasive, outpatient spine surgery for cancer that has spread to the spine. Approximately, 40-50 percent of metastic cancers end up in the spine. The most common primary cancers to spread to the bones of the spine are breast and lung cancer. Spinal tumours can drastically affect a patient’s quality of life and result in pain and reduced mobility. A spinal tumour or a growth of any kind can impinge on nerves, leading to pain, neurological problems and sometimes paralysis.
SNPs linked with prostate cancer confirmed in Japanese men too
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A third of the previously identified single-nucleotide polymorphisms, or SNPs, associated with prostate cancer in men of European or African ancestry were also associated with prostate cancer in a Japanese population, according to a new study published online September 2 in the Journal of the National Cancer Institute.
Genome-wide association studies have primarily been performed in populations of European ancestry, but little is known if the associations discovered in one population are relevant for other populations.
In this study, Matthew L. Freedman, M.D., of the Department of Medical Oncology at the Dana-Farber Cancer Institute in Boston, and colleagues evaluated 23 SNPs previously reported to be associated with prostate cancer risk and clinical covariates (tumor aggressiveness and age at diagnosis, for example) in almost 1350 Japanese men (311 case subjects and 1035 control subjects).
New hope for deadly childhood bone cancer
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Researchers at Huntsman Cancer Institute (HCI) at the University of Utah have shed new light on Ewing’s sarcoma, an often deadly bone cancer that typically afflicts children and young adults. Their research shows that patients with poor outcomes have tumors with high levels of a protein known as GSTM4, which may suppress the effects of chemotherapy. The research is published online today in the journal Oncogene.
“Doctors and researchers have long known that certain Ewing’s sarcoma patients respond to chemotherapy, but others don’t even though they have the same form of cancer,” says HCI Investigator Stephen Lessnick, M.D., Ph.D. “Our research shows that GSTM4 is found in high levels among those patients where chemotherapy doesn’t seem to work. It’s found in low levels in patients where chemotherapy is having a more positive effect.”
The research could lead to drugs that can suppress GSTM4 in certain patients. It also could lead to a screening test that could reveal which therapies will be most effective for patients. “GSTM4 doesn’t seem to suppress the benefits of all chemotherapy drugs, just certain ones. A GSTM4-based test could help to identify the best therapy for each individual patient,” Lessnick says.
Predicting cancer prognosis
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Researchers led by Dr. Soheil Dadras at the Stanford University Medical Center have developed a novel methodology to extract microRNAs from cancer tissues. The related report by Ma et al, “Profiling and discovery of novel miRNAs from formalin-fixed paraffin-embedded melanoma and nodal specimens,” appears in the September 2009 issue of the Journal of Molecular Diagnostics.
Cancer tissues from patients are often stored by a method that involves formalin fixation and paraffin embedding to retain morphological definition for identification; however, this method frequently prevents further molecular analysis of the tissue because of mRNA degradation. Even so, these tissues contain high numbers of microRNAs (miRNAs), which are short enough (~22 nucleotides) to not be broken down during the fixation process.
In this study, Dr. Dadras and colleagues optimized a new protocol for extracting miRNAs from formalin-fixed paraffin-embedded tissues. Using their new procedure, they identified 17 new and 53 known miRNAs from normal skin, melanoma, and sentinel lymph nodes. These miRNAs were well-preserved in a 10-year-old specimen.
September is National Childhood Cancer Awareness Month
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While rare, pediatric cancer is the leading cause of death by disease in children younger than 15, according to the American Cancer Society. More than 10,700 children nationwide will be diagnosed with cancer this year. However the prognosis for these youngsters is not as poor as it used to be. The five-year survival rate for children with cancer is 80 percent, which is up from 50 percent in the early 1970s. The Cancer Institute of New Jersey (CINJ) is making experts available to discuss the latest in comprehensive treatment, research, and service offerings for this unique population during the month of September, which is National Childhood Cancer Awareness Month. CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School.
Along with cutting-edge treatment, pediatric cancer patients at CINJ have access to unique services. For instance, a state-accredited classroom setting is available, providing educational support to children from pre-school through high school.
Cancer Researchers, IT Specialists Win Bioinformatics Award
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A team of researchers and information technology specialists at the University of Alabama at Birmingham (UAB) Comprehensive Cancer Center has won the caBIG® 2009 Deployment Award from the National Cancer Institute (NCI).
The award honors the university’s progress towards adopting the cancer Biomedical Informatics Grid®, or caBIG®. The project is a NCI-led, secure online resource of shared data and software used to improve and boost cancer-research collaboration. Today, more than 1,500 individuals from more than 450 research centers and organizations worldwide use caBIG and contribute to its projects.
“This team from the University of Alabama at Birmingham undertook a major initiative to adapt its existing data-entry system to work with caBIG tools and within the caBIG infrastructure,” NCI officials said at an award ceremony in July in Washington, D.C. “The pioneering efforts of the team have resulted in a tremendous amount of institutional knowledge about the adaptation process.
Obesity increases risk of prostate cancer recurrence for both blacks and whites
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A new look at a large database of prostate cancer patients shows that obesity plays no favorites when it comes to increasing the risk of recurrence after surgery: Being way overweight is equally bad for blacks and whites, say researchers at Duke University Medical Center.
Studies have shown that obesity is linked to generally worse outcomes in many cancers, including prostate cancer. Because blacks are more likely than whites to develop and die from prostate cancer – and because there is a higher prevalence of obesity among black men with prostate cancer, compared to whites – some studies have suggested that obesity might be a more ominous risk factor for blacks than whites.
“Not so,” says Stephen Freedland, M.D., an associate professor of urology and pathology in the Duke Prostate Center and the senior author of the study appearing in the journal Cancer. “Obesity leads to worse cancer in both groups.”
Study traces steady declines in U.S. cancer deaths
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Improvements in cancer screening and better treatments have resulted in steady declines in cancer death rates over the past three decades, U.S. researchers said on Thursday.
They said younger adults—those aged 35 to 45 years old—have experienced the steepest declines in cancer death rates, but all age groups have shown some improvement.
“Essentially, the younger you are, the faster your rates are declining,” said Dr. Eric Kort of the Helen DeVos Children’s Hospital in Grand Rapids, Michigan, whose study appears in the journal Cancer Research.
Childhood cancer treatment may raise diabetes risk
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Cancer survivors who got radiation treatments as children have nearly twice the risk of developing diabetes as adults, U.S. researchers said on Monday.
They said children who were treated with total body radiation or abdominal radiation to fight off cancer appear to have higher diabetes risks later in life, regardless of whether they exercise regularly or maintain a normal weight.
The odds of surviving childhood cancer have improved with better therapies but several research teams have found that some treatments pose health risks later in life.
