Cancer blog

July 22, 2008, 7:40 PM CT

End of life physician-patient communication

Eventhough a growing body of research supports a link between effective communication and patient, family and doctor satisfaction, doctors, including oncologists and other specialists who frequently care for terminal patients, do not routinely receive training in end-of-life conversations during medical school, residency training, or after they start to practice medicine.

A study published in recent issue of the Journal of Psychosocial Oncology measured changes in physician's attitudes and knowledge after training in end-of-life communication using an innovative educational approach entitled "The Four Habits of Highly Successful Clinicians." The scientists observed that participation in a program that fosters communication skills can have a positive and lasting effect on the physician's delivery of end-of-life care.

"We observed that doctors are actually eager to improve their skills in end-of-life communication but don't often have the opportunity to do so. With a framework that makes sense to them, their confidence and competence increases," said study senior author Richard M. Frankel, Ph.D., professor of medicine at the Indiana University School of Medicine and a Regenstrief Institute research scientist.

"Anecdotally we learned from family members that they appreciated it greatly when compassionate end-of-life counsel was given to their loved ones," said Dr. Frankel......... Posted by: Jessica      Read more         Source

July 10, 2008, 8:16 PM CT

Cancer drug against graft vs. host disease

A new University of Michigan study in mice suggests that a drug recently approved to fight cancer tumors is also able to reduce the effects of graft-versus-host disease, a common and sometimes fatal complication for people who have had bone marrow transplants.

Plans are under way at U-M for an initial trial of the drug in people as a new way to prevent graft-versus-host disease. Scientists expect to begin a trial within a year.

The U-M researchers tested the effects of the drug SAHA, as well as another member of a group of drugs known as HDAC inhibitors, on key immune system cells called dendritic cells. In mice, both drugs were able to significantly diminish the destructive inflammatory effects that these cells cause in graft-versus-host disease.

Graft-versus-host disease occurs when immune cells in the transplanted bone marrow mount a misguided attack on body tissues. If HDAC inhibitors turn out to be safe and effective in people, they might offer a therapy option preferable to the immunosuppressant drugs used now to treat the disease. These leave people vulnerable to infection and have other significant side effects.

"To make bone marrow transplants more effective, we need better control of the very powerful reactions between the immune systems of the donor and recipient. This study shows how drugs like SAHA regulate those reactions, and takes us a major step closer to bringing this new approach to patients who need transplants," says James L.M. Ferrara, M.D., director of the U-M Combined Bone Marrow Transplant Program and a senior author on the study. Ferrara is also professor of internal medicine and pediatric and communicable diseases at U-M......... Posted by: Jessica      Read more         Source

Sat, 24 May 2008 22:23:18 GMT

Perspectives In Brain Cancer

The other day, news broke out that doctors found malignant brain tumor in Senator Edward Kennedy.

From The Washington Post:

Edward M. Kennedy (D-Mass.), the liberal icon who has spent more than four decades at the forefront of social-change efforts in Congress, has a cancerous brain tumor, physicians at Boston's Massachusetts General Hospital said yesterday.

A biopsy of a portion of Kennedy's brain identified a malignant glioma as the cause of the seizure that hospitalized him Saturday, according to a statement by Lee H. Schwamm, the hospital's vice chairman of neurology, and Larry Ronan, the 76-year-old senator's primary-care physician.

A glioma is the most common type of brain tumor, accounting for more than half of the 20,000 or so diagnosed in the United States each year. The prognosis for patients is poor, according to the National Institutes of Health.

Though his tumor cannot be removed he's back home from the hospital and that there is hope even how life sentencing brain cancer sound. The Senator is reportedly in high spirits, however grim the news can be.



On the happier front, David Cook is the newly-crowned American Idol. Yey! What has he got to do with brain cancer? Read on, from The Associated Press:

Or maybe being rebellious turned out to be worth the gamble for Cook; it's been suggested that a poor showing with the judges can drum up support from indignant or sympathetic voters.

Cook was overcome with emotion when he won, bending down toward the stage, his eyes filled with tears when he stood back up. It was the second time in as many nights that the scruffy, grainy-voiced belter had broken down.

And a few weeks earlier, when he seemed edgy and distracted, he acknowledged that he had "things going on," perhaps a vague reference to the struggles of his older brother, Adam, who is battling advanced brain cancer.

That's right, David Cook's older brother is battling advanced brain cancer.

Brain cancer sounds scary, indeed. But there is always hope, right? So we keep hoping. As long as treatments are available, there is always hope of surviving.

[In Photo: Damn The Statistics, I Have a Life to Live!: Coping with a Brain Tumor My Personal Story (Paperback) by Charles Wolf from Amazon] Posted by: Gloria Gamat      Read more     Source

May 22, 2008, 10:27 PM CT

U of T research supports Ontario ban on cigarette displays

Toronto, ON. Just weeks before Ontario implements a ban on the retail display of all tobacco products, new research from the Ontario Tobacco Research Unit at the University of Toronto shows that consumers have been bombarded by extensive tobacco promotion at point of sale.

Places where tobacco is sold have become important environments for the tobacco industry to communicate with current, former and potential smokers through large tobacco product displays, countertop displays and signs advertising tobacco.

The research conducted by Joanna Cohen, a professor in the Department of Public Health Sciences at the University of Toronto and Principal Investigator with the Ontario Tobacco Research Unit, involved an examination of over 480 establishments including convenience stores, gas stations and grocery stores in 20 Ontario cities.

The provinces upcoming ban on displaying tobacco products couldnt come sooner, says Cohen. Our research shows tobacco promotions were extensive in stores across Ontario. The vast majority of chain convenience stores had large displays of cigarettes with shelf gliders (98%), shelf liners (97%), and a top display panel (89%) colour-coded to complement various cigarette brands, and 89% had tobacco products placed within one foot of candy......... Posted by: Jessica      Read more         Source

May 19, 2008, 8:30 PM CT

New guidelines for hypertension treatment

A study based at The University of Texas Health Science Center at Houston provides added justification that a thiazide-type diuretic is the best first-choice drug for hypertensive patients. The findings, reported in the American Heart Associations Circulation, Volume 117, Issue 20, evaluate the results of a prior trial coordinated by scientists at The University of Texas School of Public Health, along with other recent studies.

As per the American Heart Association, about one in three U.S. adults has high blood pressure. Uncontrolled hypertension can lead to stroke, heart attack, heart failure or kidney failure. A joint national committee (JNC) on the prevention, detection and evaluation of hypertension meets on a regular basis to summarize suggested guidelines for doctors on treating high blood pressure based on medical research. The study, titled Thiazide-type diuretics and beta-adrenergic blockers as first-line drug therapys for hypertension, analyzes the guidelines of the committee based on prior and recent research.

The findings of the JNC are based on information stemming from a landmark investigation at the UT School of Public Health, which in 2002 established that diuretics were as good or better than three other classes of medications for high blood pressure. The original investigation was called ALLHAT - Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial......... Posted by: Jessica      Read more         Source

April 22, 2008, 9:09 PM CT

Mechanism of Epigenetic Inheritance

Eventhough letters representing the three billion pairs of molecules that form the "rungs" of the helical DNA "ladder" are routinely called the human "genetic code," the DNA they comprise transmits traits across generations in a variety of ways, not all of which depend on the sequence of letters in the code.

In some cases, rather than the sequence of "letters," it is the physical manner in which DNA is spun around protein spools called histones and tightly packed into chromosomes that determines whether or with what intensity specific genes are expressed. A team of researchers at Cold Spring Harbor Laboratory (CSHL) has solved another in a series of mysteries about this critical mechanism of gene expression, described in a paper in the April 8 issue of Current Biology.

Inherited Clumping

As per CSHL professor Rob Martienssen, Ph.D., who led the research team, about a tenth of our DNA stands aloof, spending its time in tightly packed clumps called heterochromatin, and unwinding only to replicate when a cell divides. After copying, both of the resulting DNA molecules - to the surprise of a number of - have been observed to form reclusive clumps in the same places as the original one did.

This inherited clumping of DNA, which causes genes to be expressed in distinctive ways, is one of a series of phenomena that researchers call epigenetic. The same sequence of nucleotides in two people can produce different patterns of gene expression if the way the DNA is clumped happens to be different......... Posted by: Jessica      Read more         Source

April 17, 2008, 8:11 PM CT

Ovarian cancer stem cells identified

Researchers at Yale School of Medicine have identified, characterized and cloned ovarian cancer stem cells and have shown that these stem cells may be the source of ovarian cancers recurrence and its resistance to chemotherapy.

These results bring us closer to more effective and targeted treatment for epithelial ovarian cancer, one of the most lethal forms of cancer, said Gil Mor, M.D., associate professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine.

Mor presented his findings recently at the annual meeting of the American Association for Cancer Research (AACR) Meeting in San Diego, California.

Cancerous tumors are made up of cells that are both cancerous and non-cancerous. Within cancerous cells, there is a further subclass referred to as cancer stem cells, which can replicate indefinitely.

Present chemotherapy modalities eliminate the bulk of the tumor cells, but cannot eliminate a core of these cancer stem cells that have a high capacity for renewal, said Mor, who is also a member of the Yale Cancer Center. Identification of these cells, as we have done here, is the first step in the development of therapeutic modalities.

Mor and colleagues isolated cells from 80 human samples of either peritoneal fluid or solid tumors. The cancer stem cells that were identified were positive for traditional cancer stem cell markers including CD44 and MyD88. These cells also showed a high capacity for repair and self-renewal......... Posted by: Jessica      Read more         Source

April 13, 2008, 9:40 PM CT

MRI to detect prostate cancer

The use of MRI without endorectal coil can detect prostate cancer and provide undistorted images with diagnostic image quality and accurate tumor localization, as per a recent study conducted by scientists from The Ohio State University in Columbus, OH.

The 3T MRI datasets were acquired without an endorectal coil and were used during robotic surgery, said Steffen Sammet, MD, PhD, lead author of the study. Since the use of an endorectal coil leads to deformation of the prostate and potentially altered microcirculation, our goal was to assess the capability of detecting prostate cancer areas by dynamic contrast enhanced MRI without endorectal coil at 3T validated by correlation with surgical pathology, he said.

The study included 13 prostate cancer patients who were scheduled for prostatectomy and were imaged on a 3T MRI. The scientists noted suspicious areas, tumor location, extracapsulation (the extent of the tumor outside the capsule of the prostate and is a linked to a unfavorable prognosis), and seminal vesicle involvement. Once this was complete, 3D reconstruction of the prostate, tumor neurovascular bundle and surrounding tissue waccording toformed and used as an intra-operative roadmap.

As per the study, cancer was correctly localized in 11 of the 13 patients. There was an agreement with pathology in 10 of the 13 patients regarding extracapsulation and 11 of 13 regarding seminal vesicle involvement. The study showed that 3D reconstruction was useful for the surgical roadmap in all 13 cases......... Posted by: Jessica      Read more         Source

March 4, 2008, 6:16 PM CT

Unexpected Increase In Cancer Risk

An increased cancer risk in post-menopausal women after they stopped taking combined hormone treatment was an unexpected finding in a study that will be published in the March 5 edition of the Journal of the American Medical Association (JAMA), said Rowan T. Chlebowski, M.D., Ph.D., a Los Angeles Biomedical Research Institute (LA BioMed) lead investigator who contributed to the study.

This latest study reinforces the original finding that combined hormone treatment of estrogen plus progestin should not be taken for the purpose of reducing disease in post-menopausal women, Chlebowski said. These findings also reinforce the need for monitoring for cancer in women who have taken the combination of estrogen plus progestin.

Dr. Chlebowski is a medical oncologist who has led several previous reports focusing on hormone effects on malignancies, including breast and colorectal cancer. He was a member of the team of researchers, led by Gerardo Heiss, M.D., of the University of North Carolina, Chapel Hill, N.C., who authored the March 5 JAMA report on a follow-up study of post-menopausal women enrolled in the Womens Health Initiative. Dr. Chlebowski is available for comment for reporters seeking further insight into the studys findings......... Posted by: Jessica      Read more         Source

February 25, 2008, 9:28 PM CT

Link Between Obesity, Carbs and Esophageal Cancer

Cases of esophageal cancer (adenocarcinoma) in the U.S. have risen in recent decades from 300,000 cases in 1973 to 2.1 million in 2001 at age-adjusted rates. A new study published in The American Journal of Gastroenterology shows that these rates in the U.S. closely mirrored trends of increased carbohydrate intake and obesity from 1973-2001.

The study illustrates what may be a public heath concern as the composition of U.S. diets changes and total carbohydrate and refined carbohydrate intakes increase. Obesity is a risk factor for many types of cancer, and a diet that includes a high percentage of calories from refined carbohydrates is a common contributor to obesity. Carbohydrates were also unique in that no other studied nutrients were found to correlate with esophageal cancer rates.

The causes of esophageal cancer remain largely unknown. Despite recent advances in treatment, esophageal cancer has a poor prognosis. The five-year rate of survival for esophageal cancer remains below 20 percent and is the eighth-leading cause of cancer related death in American men.

"If we can reverse the trends in refined carbohydrate intake and obesity in the U.S., we may be able to reduce the incidence of esophageal cancer," says Dr. Li Li, senior author of the study......... Posted by: Jessica      Read more         Source

February 14, 2008, 10:26 PM CT

Insight into possible cause of lymphoma

The immune system's powerful cellular mutation and repair processes appear to offer important clues as to how lymphatic cancer develops, Yale School of Medicine scientists report this week in Nature.

"The implications of these findings are considerable," said David Schatz, a Howard Hughes Medical Institute investigator, professor of immunobiology at Yale, and senior author of the study. "It now seems likely that anything that compromises the function of these DNA repair processes could lead to widespread mutations and an increased risk of cancer".

The lymph system is made up of infection-fighting B cells. Schatz and colleagues examined the somatic hypermutation (SHM) process, which introduces random mutations in B cells' antibody genes to make them more effective in fighting infection.

SHM occurs in two steps: First, a mutation initiator, or activation-induced deaminase (AID), causes genetic mutations. Second, DNA repair enzymes spot the changes and begin making "sloppy" repairs, which lead to yet more mutations. The two steps combined, Schatz said, present a major risk to genomic stability.

Interestingly, these same repair enzymes recognize mutations in a number of other types of genes in the B cells, but they fix the genes in a precise, or, "high fidelity," manner......... Posted by: Jessica      Read more         Source

February 14, 2008, 10:12 PM CT

New Drug Targets for Cancer and Other Diseases

If the genome is the parts list of the human cell, certain proteins are the production managers, activating and deactivating genes as needed. Researchers funded by the National Institute of General Medical Sciences (NIGMS), part of the National Institutes of Health, now have a clearer understanding of how a key protein controls gene activity and how mutations in the protein may cause disease. The work could provide new avenues to design drugs aimed at cancer, diabetes, HIV, and heart disease.

The research appears in the Feb. 14, 2008, issue of the journal Nature. The lead authors include Philip Cole, M.D., Ph.D., of the Johns Hopkins University School of Medicine in Baltimore, Md., and Ronen Marmorstein, Ph.D., of the Wistar Institute in Philadelphia, Pa.

The researchers focused on a protein called p300/CBP that belongs to a family of enzymes known as histone acetyltransferases, or HATs. These enzymes activate genes by attaching chemicals called acetyl groups to histones, the spool-like proteins that hold DNA in a tightly wound form.

Mutations in p300/CBP are associated with a variety of cancers, including those of the colon, breast, pancreas, and prostate. Scientists think that a substance that selectively inhibits p300/CBP might be the basis for an anticancer agent......... Posted by: Jessica      Read more         Source

January 17, 2008, 10:12 PM CT

New gene test for prostate cancer

Men with susceptibility for prostate cancer will soon be identifiable through a simple DNA test. So hope researchers at the Swedish medical university Karolinska Institutet, who have shown that men carrying a combination of known risk genes run a four to five times higher risk of developing prostate cancer.

At present, men with suspected prostate cancer are identified mainly using what are known as PSA tests. However, the test has a relatively low sensitivity and better methods are needed.

"In the near future, it will be possible to combine PSA tests with simple genetic tests," says Professor Henrik Gronberg at Karolinska Institutet. "This means that fewer men will have to undergo unnecessary biopsies and that more prostate cancer diagnoses can be made."

It has long been known that prostate cancer is partly caused by inherited factors, which makes some men more likely to develop the disease than others. Five relatively common gene variants that affect this risk have so far been identified. However, each of these variants affects the risk only marginally, and knowledge of them has been of no real benefit to individual patients.

Now, however, a research group at Karolinska Institutet and their American colleagues have analysed for the first time the cumulative effect of these gene variants. The results, which are reported in the prestigious scientific periodical The New England Journal (NEJM), shows that men who carry four or more risk variants run a four to five times greater risk of developing prostate cancer. This risk is increased even more if they also had close relatives with the disease......... Posted by: Jessica      Read more         Source

January 7, 2008, 10:48 PM CT

High-energy ultrasound sharpens view of liver tumors

A high-energy form of ultrasound imaging developed by scientists at Duke University's Pratt School of Engineering produces pictures of liver tumors that are better than those made with traditional ultrasound, as per results of a clinical study.

The study suggests that the imaging method known as Acoustic Radiation Force Impulse (ARFI) ultrasound might offer a new tool for screening patients at increased risk for liver cancers, as per the researchers. They say it might also play a useful role in guiding biopsy procedures and minimally invasive therapies aimed at destroying malignant tissues found deep in the abdomen.

The scientists reported their findings Jan. 7 in the journal Physics in Medicine and Biology. The work was funded by the National Institutes of Health with system support from Siemens Medical Solutions.

First developed six years ago by Duke biomedical engineers Gregg Trahey and Kathy Nightingale, ARFI uses high-energy sound waves to push on tissues like sonic fingers. A tracking beam then captures the movement of the tissue, providing a measure of its elasticity or stiffness.

"To our knowledge, these are the first images of abdominal malignancies in humans that show tissue elasticity," said Trahey, professor of biomedical engineering, radiology and medical physics at Duke. The preliminary findings, which represent the Ph.D. thesis work of Trahey's former graduate student Brian Fahey, have already led Siemens to pursue a product prototype that will combine traditional ultrasound with ARFI, he added......... Posted by: Jessica      Read more         Source

December 13, 2007, 9:04 PM CT

Sutent can have toxic effects on the heart

Another FDA-approved targeted cancer drug, sunitinib (SutentTM, Pfizer), may be linked to cardiac toxicity, report scientists at Childrens Hospital Boston, Dana-Farber Cancer Institute (Boston), and Thomas Jefferson University (Philadelphia). Their collaborative study, led by Ming Hui Chen, MD, MMSc, a heart specialist at Childrens who specializes in the cardiac health of cancer patients, appears in the December 15 issue of The Lancet, accompanied by an editorial.

Sunitinib is one of several new smart cancer drugs called tyrosine kinase inhibitors that targets specific signaling molecules inside cancer cells that aid cancer spread. Another targeted cancer treatment, imatinib (GleevecTM, Novartis Pharmaceuticals), was reported last year in Nature Medicine to be linked to heart failure in patients with chronic myelogenous leukemia.

Sunitinib was originally believed to be relatively free of cardiac side effects. However, a new retrospective analysis, focused on cardiovascular events, revealed a risk for heart failure, myocardial infarction and high blood pressure in 75 adult patients with imatinib-resistant, gastrointestinal stromal tumor (GIST) receiving multiple cycles of sunitinib in a phase I/II trial at Dana-Farber.

Of the 75, six (8 percent) developed symptoms consistent with moderate-to-severe congestive heart failure, and two had heart attacks. In all, eight (11 percent) had some kind of cardiovascular event while receiving sunitinib at FDA-approved or lower doses. Patients with preexisting coronary artery disease were more likely to develop cardiac problems. Nineteen percent of the 36 patients receiving the FDA-approved dose had decreases in left ventricular ejection fraction, a measure of the hearts pumping ability......... Posted by: Jessica      Read more         Source

December 11, 2007, 10:41 PM CT

Bosutinib safe, effective for CML

A new drug for chronic myelogenous leukemia works for patients who have developed resistance to frontline treatment and causes fewer side effects than other medications in its class, a research team led by researchers at The University of Texas M. D. Anderson Cancer Center reports at the 49th annual meeting of the American Society of Hematology.

"Bosutinib has shown good efficacy and very little toxicity in comparison to other tyrosine kinase inhibitors at this stage of the clinical trial," says lead researcher Jorge Cortes, M.D., professor in M. D. Anderson's Department of Leukemia.

Bosutinib, developed by Wyeth Pharmaceuticals, is being tested in patients in the early or chronic phase of CML whose disease has become resistant to imatinib or who have become intolerant of imatinib's side effects.

So far, 98 patients have enrolled in the relatively new clinical trial, with median duration of therapy at 5.1 months.

Among 23 evaluable patients who had become resistant to imatinib, 17 (74 percent) achieved a complete hematological response - normal blood counts. Of 36 evaluable for cytogenetic response - reduction of the abnormal chromosome that causes the disease - 15 had a major response and 12 of those had a complete response, or absence, of the chromosome......... Posted by: Jessica      Read more         Source

December 11, 2007, 10:37 PM CT

Gene linked to aggressive prostate cancer

Results from two genome-wide association studies have identified a genetic variant of the DAB2IP gene that is linked to the risk of aggressive prostate cancer. Research teams from the Translational Genomics Research Institute (TGen), Wake Forest University School of Medicine, the Karolinska Institute in Stockholm, Sweden, and Johns Hopkins Medical Institutions made the discovery jointly.

Scientists suspect that the DAB2IP gene is involved in tumor suppression, suggesting that this protective mechanism goes awry in men with the variant form. The finding, reported today in the Journal of the National Cancer Institute, might one day help doctors tailor therapy based on a patients genetic makeup.

Both genetic and environmental factors are important in the development of prostate cancer, and it is only recently that some of the consistent genetic factors have been identified. It is not clear at present whether men who are genetically prone to the disease tend to have more aggressive disease than men who are not.

Because there is no way to tell whether a person has or will have the aggressive version versus the mild version of prostate cancer, both forms are treated the samewith radiotherapy or surgery to remove the prostate gland. The identification of this genetic variant could lead to better risk assessment for aggressive disease, providing doctors with more information on how to best treat men who may be diagnosed with prostate cancer, said John Carpten, Ph.D., director of TGens Division of Integrated Cancer Genomics and senior author of the paper......... Posted by: Jessica      Read more         Source

December 10, 2007, 10:49 PM CT

Depression screening for cancer patients

Depression is known to be linked to cancer yet too a number of cancer patients are not screened for this mental disorder, as per scientists from the Indiana University School of Medicine, the Regenstrief Institute and the Roudebush VA Medical Center.

As per a research findings reported in the November-recent issue of General Hospital Psychiatry, Caroline Carney Doebbeling, M.D., M.Sc. and Laura Jones, Ph.D., looked at data from the Roudebush VA Medical Center, where 95 percent of veterans in primary care are screened for depression.

They report that depression screening in cancer patients was not done nearly as frequently with, for example, only slightly over half of veterans with lung cancer receiving screening. In places without integrated care and mandated primary care depression screening like the VA, we speculate that screening rates are even worse, said Dr. Carney Doebbeling, associate professor of medicine and of psychiatry at the Indiana University School of Medicine and a Regenstrief Institute research scientist.

Lung cancer has one of the highest associations with depression of any cancer, as per Dr. Doebbeling, who is an internist and a psychiatry expert. A number of patients with lung cancer have a history of smoking which has a strong association with depression and anxiety disorders......... Posted by: Jessica      Read more         Source