October 17, 2006, 5:03 AM CT

Older Breast Cancer Patients May Be Under-treated

Elderly patients with breast cancer who received care in a community hospital setting may have been under-diagnosed, under-staged and under-treated, according to a report in the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

The number of older breast cancer patients has increased along with overall elderly population, according to background information in the article. About half of breast cancer patients are older than 65 years and 35 percent are older than 70; 77 percent of breast cancer deaths occur in women older than 55. Choosing the appropriate treatment for older patients is a challenge, because many have other serious illnesses in addition to their cancer that may threaten their health and shorten their lives. Questions remain about the best screening protocols for elderly women, as well. Some current guidelines suggest that women stop having mammograms at age 70, while others provide no upper limit.

David A. Litvak, M.D., then of Michigan State University, Lansing, and now at Kaiser Permanente Medical Center, Orange County, Calif., and Rajeev Arora, M.D., used a tumor registry database to identify 354 women age 70 or older who were diagnosed with breast cancer between 1992 and 2002 at a community hospital. The researchers studied the group of women as a whole and also divided them into three age groups for analysis: ages 70 to 74 (136 patients), 75 to 79 (115 patients) and 80 or older (103 patients).........

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October 17, 2006, 4:54 AM CT

Listening To The Sound Of Skin Cancer

Researchers at the University of Missouri-Columbia can now detect the spread of skin cancer cells through the blood by literally listening to their sound. The unprecedented, minimally invasive technique causes melanoma cells to emit noise, and could let oncologists spot early signs of metastases -- as few as 10 cancer cells in a blood sample -- before they even settle in other organs. The results of the successful experimental tests appear in the Oct. 15 issue of the journal Optics Letters, published by the Optical Society of America.

The team's method, called photoacoustic detection, combines laser techniques from optics and ultrasound techniques from acoustics, using a laser to make cells vibrate and then picking up the characteristic sound of melanoma cells. In a clinical test, doctors would take a patient's blood sample and separate the red blood cells and the plasma. In a healthy person, the remaining cells would be white blood cells, but in a melanoma patient the sample may contain cancer cells. To find out, doctors would put the sample in saline solution and expose it to rapid-fire sequences of brief but intense blue-laser pulses, each lasting just five billionths of a second.

In lab tests, the Missouri-Columbia team was able to detect melanoma cells obtained from actual patients, showing that the method can spot as few as 10 cells in saline solution. The dark, microscopic granules of melanin contained in the cancer cells absorb the energy bursts from the blue-laser light, going through rapid cycles of expanding as they heat up and shrinking as they cool down. These sudden changes generate loud cracks -- relative to the granules' size -- which propagate in the solution like tiny tsunamis.........

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October 17, 2006, 4:44 AM CT

New Hope For Children With Leukemia

Clinicians at St. Jude Children's Research Hospital have successfully demonstrated an improved technique for blood stem cell transplantations in children that shows promise for those most likely to fail standard therapy for leukemia.

The St. Jude technique allows blood stem cells to come from parents or unmatched adult siblings; and it avoids the aggressive, toxic therapys that commonly must accompany the transplant. This allows the majority of patients with leukemia or non-malignant blood disorders to receive a transplant, as per Gregory Hale, M.D., St. Jude Bone Marrow Transplantation Division interim chief. A report on this work appears in the prepublication edition of the British Journal of Haematology.

A clinical trial of this technique demonstrated that it accelerated recovery of the immune system in recipients and shortened the duration of immune deficiency during the early post-transplant period, reducing the risk of infections. The immune system recovery included not only T and B lymphocytes, the major cells genetically programmed to attack specific targets, but also natural killer cells, a critical first-response army of cells that acts as a quick-strike force against a wide variety of targets.

"The overall success of this procedure suggests it holds promise for children who are likely to fail standard therapy for leukemia because they have therapy-resistant disease and no matched donor," Hale said.........

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October 12, 2006, 10:12 PM CT

Algae Provide Clues To Cancer

A microscopic green alga helped scientists at the Salk Institute for Biological Studies identify a novel function for the retinoblastoma protein (RB), which is known for its role as a tumor suppressor in mammalian cells. By coupling cell size with cell division, RB ensures that cells stay within an optimal size range.

Their findings, which would be published in the October 13 online edition of PLoS Genetics, show that RB blocks cells from dividing before they reach a minimum size and could provide new insights into the origins of cancer.

"Being the right size is very important for cells because their physiology changes quite dramatically when the surface-to-volume ratio changes," explains senior author James Umen, Ph.D., an assistant professor and Hearst Endowment Chair in Salk's Plant Biology Laboratory. "The human body is composed of trillions of cells, each of which must coordinate its growth and division in order to maintain size equilibrium," he adds.

This process is very tightly regulated and any given cell type will always stay within a very narrow size range, but the means by which cell size is determined remain mysterious. In proliferating cells, control mechanisms termed checkpoints are thought to prevent cells from dividing until they reach a specific size, but the nature of the checkpoints has proved difficult to dissect.........

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October 11, 2006, 9:00 PM CT

Test To Predict Response In Pancreatic Cancer

By slicing up bits of patient tumors and grafting them into mice, Johns Hopkins Kimmel Cancer Center specialists have figured out how to accurately "test drive" chemotherapy drugs to learn in advance which drug treatments offer each individual pancreatic cancer patient the best therapeutic journey.

Although "xenografting" with either cells or fresh tissue is already used widely to test cancer therapies, the Hopkins design is personalized to each patient who has relapsed after an initial course of chemotherapy. "Eventually our approach offers a promising way to individualize therapy earlier in treatment instead of first giving everyone the standard drug gemcitabine, which has a success rate of less than 10 percent," says Antonio Jimeno, M.D., instructor in oncology at the Johns Hopkins Kimmel Cancer Center.

Results of preliminary tests of the Hopkins method in 14 patient samples taken after surgery shows that each xenografts' genetic profile remained stable through three and four generations of mice so that "test drives" would accurately represent a patient's tumor. The scientists also found they could build xenografts in 80 percent of their pancreatic patients, a success rate higher than efforts with colon cancer patients, for which rates are typically less at about 50 percent.........

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October 9, 2006, 10:04 PM CT

Target For Leukemia Treatment

Cincinnati Children's Hospital Medical Center today announced the publication of pioneering research identifying the crucial role and novel mechanism of action of the protein RhoH GTPase in the development and activation of cells critical to the immune system. The findings, along with other studies, suggest that RhoH GTPase may provide a target for therapeutic intervention in some types of leukemia. The paper is due to appear in an upcoming edition of the journal Nature Immunology and was recently posted in the advance online publication section of the journal's website, http://www.nature.com/ni/index.html.

The paper describes detailed genetic and biochemical studies undertaken by scientists in the Division of Experimental Hematology and the Division of Immunobiology. The researchers succeeded in identifying a crucial role for RhoH GTPase in the development of thymocytes and activation of T-lymphocytes, both key processes in immune cell development. In addition, the scientists uncovered a novel mechanism for regulating RhoH activity, which may have broad implications in improving researchers' understanding of the mechanism of action of the Rho GTPase protein family and provide a potential target for leukemia drug development.

"We continue to make important progress in deciphering the molecular processes involved in the development and maintenance of the immune and blood system and how disruption of key proteins may contribute to leukemia," said David A Williams, M.D., Director of Experimental Hematology, Cincinnati Children's. "Through a collaboration with Ohio State University Comprehensive Cancer Center, we are now focused on translating these findings into developing new ways to target the protein as a novel approach to treating hematological malignancy".........

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October 9, 2006, 8:50 PM CT

Genome Id Method Against Cancer

A mathematical discovery has extended the reach of a novel genome mapping method to humans, potentially giving cancer biology a faster and more cost-effective tool than traditional DNA sequencing.

A student-led group from the laboratory of Michael Waterman, USC University Professor in molecular and computational biology, has developed an algorithm to handle the massive amounts of data created by a restriction mapping technology known as "optical mapping." Restriction maps provide coordinates on chromosomes analogous to mile markers on freeways.

Lead author Anton Valouev, a recent graduate of Waterman's lab and now a postdoctoral fellow at Stanford University, said the algorithm makes it possible to optically map the human genome.

"It carries tremendous benefits for medical applications, specifically for finding genomic abnormalities," he said.

The algorithm appears in this week's PNAS Early Edition.

Optical mapping was developed at New York University in the late 1990s by David Schwartz, now a professor of chemistry and genetics at the University of Wisconsin-Madison. Schwartz and a collaborator at Wisconsin, Shiguo Zhou, co-authored the PNAS paper.

The power of optical mapping lies in its ability to reveal the size and large-scale structure of a genome. The method uses fluorescence microscopy to image individual DNA molecules that have been divided into orderly fragments by so-called restriction enzymes.........

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October 8, 2006, 6:15 PM CT

Some Breast Cancer Patients Unhappy With Lumpectomy

[imgl]/images/blog/lumpectomy.jpg[/imgl]Women with breast cancer often undergo a lumpectomy and radiation to save their breasts and avoid the need for additional reconstructive surgery. However, approximately one-third of all patients are unhappy with how their breasts look after undergoing breast conservation treatment and a number of would consider reconstruction, as per a research studypresented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2006 conference in San Francisco.

"I have patients walking into my office saying lumpectomy was supposed to save their breast but what's left doesn't look like a breast to them," said Howard Wang, ASPS Member Surgeon and co-author of the study. "Conservation is thought to bean acceptable way of saving a woman's breast. But a number of of these women are coming to plastic surgeons for help, saying it isn't so".

In the study, 28 percent of the patients with breast cancer stated they were dissatisfied with the cosmetic result of their lumpectomy. Of those patients, 46 percent stated their physical appearance was worse or much worse after the surgery and were considering reconstruction. Only nine percent of patients who were satisfied with the outcome, however, would consider reconstruction if it were offered.........

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October 2, 2006, 9:17 PM CT

Dissolving Jaw Syndrome

Drugs belonging to the group of bisphosphonates like aredia are good in strengthening the bone in cancer patients including breast cancer. There is a downside to this group of drugs. These drugs can erode the jaw bone and literally dissolve the jaw bone.

This condition, called osteonecrosis of the jaw, is marked by exposed bone in the jaw and can lead to infection, inflammation and pain.

While scientists do not fully understand the condition or what causes it, osteonecrosis of the jaw, or ONJ, appears to occur in individuals who have been treated with drugs called bisphosphonates, which are used to improve bone strength. When treating bone affected by cancer, the bisphosphonates are given intravenously and have been shown to decrease the risk of skeletal complications such as fracture.

"Osteonecrosis of the jaw is not a common condition. It appears to occur in 1 percent to 10 percent of patients with advanced cancer who are on intravenous bisphosphonate treatment a number significant enough that most medical oncologists will see patients with this condition. It is important that scientists learn why it occurs and how best to prevent or treat it," says Catherine Van Poznak, M.D., assistant professor of internal medicine at the University of Michigan Medical School.........

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October 1, 2006, 8:05 PM CT

Researchers Stop Colon Cancer

Scientists from Texas were able to stop the growth of colon cancer in mice by blocking just one enzyme. They say that this is a big step against conquering cancer. Even though this was an experiment on mice, these scientists hope that their findings might soon find its way to human cancers including colon cancer.

In cell culture experiments, researchers from the University of Texas Medical Branch at Galveston (UTMB) and the University of Texas at Arlington determined that stopping the activity of a single enzyme called aldose reductase could shut down the toxic network of biochemical signals that promotes inflammation and colon cancer cell growth.

In a dramatic demonstration of the potential of this discovery, they followed up this work with animal studies showing that blocking the production of aldose reductase halted the growth of human colon cancer cells implanted in laboratory mice.

"By inhibiting aldose reductase we were able to completely stop the further growth of colorectal cancer tumor cells," said UTMB professor Satish K. Srivastava, senior author of a paper about the discovery would be published Oct. 1 in the journal Cancer Research.

As per the federal Centers for Disease Control and Prevention, colon cancer is the country's second leading cancer killer. In 2002, the most recent year for which statistics are available, 70,651 men and 68,883 women were diagnosed with colon cancer in the United States; 28,471 men and 28,132 women died from the disease.........

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