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October 30, 2006, 6:34 PM CT

Breast Cancer Therapy In Which Order?

Breast Cancer Therapy In Which Order?
For women who have had surgery for early breast cancer, it may not matter whether they receive follow-up chemotherapy before, after or during radiation treatment, as per a new review of studies.

A woman's chances of survival or seeing the cancer return are similar in all three cases, if radiation treatment and chemotherapy begin within seven months after surgery, the review concludes.

However, the studies suggest that certain toxic side effects in the blood and esophagus -- common in chemotherapy and radiation patients -- may be up to 44 percent more likely when the two therapies are delivered at the same time, said Dr. Brigid Hickey and his colleagues at the Southern Zone Radiation Oncology Service in Brisbane, Australia.

The reviewers also note that most of the women in the studies were treated about 10 years ago. "As a result, the trials do not assess the modern types of radiotherapy and newer types of chemotherapy" and other anti-cancer drugs such as Herceptin, Hickey said.

Studies show that radiation treatment can reduce the risk of breast cancer returning in the treated breast and boost the likelihood of survival after breast cancer surgery. Doctors may also prescribe chemotherapy to women at high risk for having the cancer spread to other parts of the body after surgery, to reduce the risk of dying from breast cancer.........

Posted by: Janet      Permalink


October 30, 2006, 5:48 PM CT

Oral Contraceptives Increase Risk For Breast Cancer

Oral Contraceptives Increase Risk For Breast Cancer
A meta-analysis reported in the recent issue of Mayo Clinic Proceedings indicts oral contraceptives as putting premenopausal women at significantly increased risk for breast cancer, particularly women who use them previous to having a child.

The meta-analysis builds on a number of studies with similar findings. But even as the findings stack up, a number of women are unaware of the risks posed by oral contraceptive use previous to pregnancy, says lead study author Chris Kahlenborn, M.D., of Altoona Hospital in Altoona, Pa.

Dr. Kahlenborn says the discrepancy between risk and patient awareness prompted the meta-analysis, which involved extracting data from 34 studies on whether oral contraceptive (OC) use is linked to premenopausal breast cancer. Included in the studies were women who were premenopausal or younger than 50 and who had been, in most cases, diagnosed with breast cancer during or after 1980.

"As I studied the medical literature, I noticed that a trend appeared," says Dr. Kahlenborn. "Namely, OC use previous to first-term pregnancy seemed to consistently increase the risk of premenopausal breast cancer. Eventhough the trend was apparent, premenopausal women have continued to hear that OCs are basically safe".

Rather, patients should know that sustained oral contraceptive use previous to pregnancy increases a premenopausal woman's risk of developing breast cancer, saysDr. Kahlenborn. He says physicians should better inform their patients of the risks linked to oral contraceptives and calls it a "clear-cut informed consent issue".........

Posted by: Janet      Permalink


October 30, 2006, 5:31 PM CT

How Multiple Copies Of A Gene Affect Metastasis?

How Multiple Copies Of A Gene Affect Metastasis?
Scientists at UT Southwestern Medical Center have for the first time described how multiple copies of a gene are responsible for metastases in early-stage breast cancer and poor prognosis for patients.

As per a research findings published in this week's issue of the Proceedings of the National Academy of Sciences, the gene, called uPAR, offers a promising target for therapeutic drugs to stop or slow the progression of the disease and could serve as a screening tool for assessing which types of drugs a patient will respond to.

The gene launches a biochemical process in which a molecule called plasmin perforates the membranes of tissues, causing the membranes to break down and allowing the cancer cells to escape into the bloodstream and to adjacent tissues. The result is metastasizing breast cancer. About 20 percent to 25 percent of breast-cancer patients were shown to have uPAR gene amplification, which means they carry too a number of copies of the gene.

"The uPAR system probably plays a role in metastases in a number of of the common solid tumors," said Dr. Jonathan Uhr, professor in the Cancer Immunobiology Center and of microbiology and the study's senior author.

While analyzing slides of individual tumor cells - either from the primary tumor or circulating tumor cells - of 72 patients with advanced recurrent breast carcinoma, the UT Southwestern research team discovered how uPAR may work in concert with another known breast cancer gene, HER-2.........

Posted by: Janet      Permalink


October 30, 2006, 5:09 PM CT

Breast Cancer Survivors Face Higher Suicide Rates

Breast Cancer Survivors Face Higher Suicide Rates
The burden is not over for patients with breast cancer even after the battle with breast cancer is won. A new study suggests that breast cancer survivors have an increased risk committing suicide in comparison to women in the general population. Survivors of breast cancer have as much as 37 percent increased risk of committing suicide in comparison to other women and this increased risk of suicide persist for more than 25 years after the diagnosis of breast cancer.

These study findings were published in a recent issue of the Journal of the National Cancer Institute. There have been prior studies on this topic but none have undertaken such a long-term study of the subject and none of the studies included women from the United States of America.

This conclusion is from analysis of a large pool of data involving 723,810 breast cancer survivors who were diagnosed between 1953 and 2001 and were included in population-based cancer registries in the United States and Scandinavia.

The scientists have observed that during follow-up through 2002, a total of 836 women committed suicide. Compared with the general population the women with breast cancer had a suicide rate of 4.1 per 100,000 women per year.

Even after a period of 25 years, breast cancer survivors still had a 35 percent increased risk of committing suicide. Suicide rates were higher among African American women, with a 2.88-fold elevated risk. Scientists noted that the risk of committing suicide increases with increasing stage of breast cancer.........

Posted by: Janet      Permalink


October 27, 2006, 5:15 AM CT

linking ethnic identity to breast cancer genes

linking ethnic identity to breast cancer genes BRCA
Genetic research over the past decade has linked Ashkenazi Jewish ethnicity to an increased risk for hereditary breast cancer, so much so that certain gene mutations have become known as "Jewish ancestral mutations." But a new study released in the recent issue of The American Journal of Public Health challenges this approach, warning that disparities in access to care and other unintended consequences can, and have, resulted.

The study, by Columbia University College of Physicians & Surgeons researchers, notes that while three recognized breast cancer mutations are present in 2-3 percent of the Ashkenazi Jewish population, similar prevalence studies have not been carried out in other ethnic groups. In addition, the study finds that research linking the breast cancer mutations with Ashkenazi Jews has been beset by methodological problems that cast doubt on the use of ethnicity as the basis for genetic research on disease.

"The linking of Ashkenazi Jews to a deadly disease raises serious scientific and social concerns," said co-author Sheila M. Rothman, PhD, Professor of Sociomedical Sciences at the Center for the Study of Society and Medicine. "Focusing genetic studies on a specific ethnic group confers disadvantages to that group and others. For Ashkenazi Jews it raises the risk of stigmatization and insurance or job discrimination. For other groups, it introduces a gap in access to testing and therapy".........

Posted by: Janet      Permalink         Source


October 27, 2006, 5:11 AM CT

Women With Mental Disorders And Mammograms

Women With Mental Disorders And Mammograms
Women with mental disorders are less likely to have screening mammograms than women without mental illness, although.

the nature of the mental illness does play a role, as per a large study published by Indiana University School of Medicine and Richard Roudebush VA Health Services Center for Excellence scientists in the recent issue of Journal of General Internal Medicine. Previous to this study, little was known about whether the type or severity of mental illness influences receipt of preventive services such as mammograms.

"Eventhough women with mental disorders are less likely to receive mammography than women who do not have mental disorders, we observed that both the type and severity of mental illness does influence the receipt of mammograms. Women with psychotic disorders such as schizophrenia are significantly less likely to receive mammograms than women in the general population. However, women with mild depression do not differ markedly. But, as depression severity increases, so does the likelihood that women will not receive needed screening," said senior author Caroline Carney Doebbeling, M.D., M.Sc., associate professor of psychiatry and medicine at the I.U. School of Medicine. She is also a Regenstrief Institute, Inc. research scientist and director of the IU.........

Posted by: Janet      Permalink         Source


October 27, 2006, 5:08 AM CT

Videoconferencing In Pediatric Oncology

Videoconferencing In Pediatric Oncology
An article in the January 2007 issue of the Pediatric Blood & Cancer examines the use of videoconferencing between industrialized and developing countries as a way of improving patient care. The journal is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/pbc.

Pediatric oncology has seen vast improvements in survival rates in industrialized countries over the last several decades, but developing nations are still lagging behind, despite the fact that up to 85 percent of childhood malignancies occur in these countries. Obstacles to advances in the development of pediatric oncology programs include poverty, malnutrition, lack of education, and compliance. Additional factors are a shortage of pediatric oncologist specialists, a lack of cross communication between different disciplines, which leads to delayed and improper referrals, and the tendency to seek multiple second opinions due to a distrust of the quality of available medical care.

Efforts to improve medical care in developing countries include twinning programs that involve the exchange of personnel between participating institutions, a practice that is time consuming and expensive. Telemedicine, another way of communicating and distributing information, is already being used in industrialized countries for educational purposes, second opinions and quality assurance in many fields, but there are few reports of its impact in developing countries.........

Posted by: Janet      Permalink         Source


October 24, 2006, 8:55 PM CT

Genetic Variations Aspirin And Colon Cancer

Genetic Variations Aspirin And  Colon Cancer
Dartmouth scientists are among a team of doctors that have learned more about how people may or may not benefit from taking aspirin in the effort to curb colon cancer. Their study, which appears in the Oct. 18 issue of the Journal of the National Cancer Institute, finds that the beneficial effect of aspirin may be limited to individuals who have a specific genetic variation in their ODC gene.

"There is evidence that aspirin and related anti-inflammatory drugs can reduce the risk of colorectal adenomas [polyps] and cancer," says Elizabeth Barry, a research assistant professor of community and family medicine at Dartmouth Medical School, and one the authors of the study. "And with this study, we looked closer at the impact of aspirin in people who have a higher risk of developing colorectal adenomas, which lead to cancer, by examining their ODC genotype. So now we know that aspirin appears to work better in people who have this slight genetic variation, and this finding could potentially be clinically useful in the future by allowing physicians to predict which individuals are likely to benefit from aspirin use for colorectal cancer chemoprevention".

The scientists studied 973 subjects over three years as part of the Aspirin/Folate Polyp Prevention Study. In a randomized manner, some were given aspirin and some were given placebos. Almost half of the participants carried one or two copies of the ODC genetic variation. The study observed that there was no association between carrying the genetic variation and the occurrence or new adenomas, but the genotype did influence the effect of aspirin on adenoma development. Those with the ODC genetic variation were 23 percent less likely to develop new adenomas and 49 percent less likely to develop more advanced lesions, which also lead to cancer.........

Posted by: Sue      Permalink         Source


October 24, 2006, 5:48 PM CT

Virtual Colonoscopy More Expensive

Virtual Colonoscopy More Expensive Image courtesy of Mayo clinic
Wake Forest University Baptist Medical Center scientists have observed that "virtual" colonoscopy using a computer tomography (CT) scanner is considerably more expensive than the traditional procedure due to the detection of suspicious images outside of the colon.

"Virtual colonoscopy will certainly play a role in the future of colon cancer screening," said gastroenterologist Richard S. Bloomfeld, M.S., M.D., assistant professor of medicine at Wake Forest Baptist and a member of the research team. "It is important to understand the implications of findings outside the colon before we advocate wide-spread use of this technology".

Virtual colonoscopy, also known as CT-colonography (CTC), was developed at Wake Forest Baptist. It allows doctors to use Computerized axial tomography scanners to look at the colon to detect polyps (small growths in the colon that may become malignant if they are not removed) and cancers. Virtual reality software allows them to look inside the body without having to insert a long tube (conventional colonoscopy) into the colon or without having to fill the colon with liquid barium (barium enema).

Research performed at Wake Forest Baptist and elsewhere has shown that CTC is better able to see polyps than barium enemas and is nearly as accurate as conventional colonoscopy. Most patients report that CTC is more comfortable than either procedure.........

Posted by: Sue      Permalink         Source


October 22, 2006, 11:22 PM CT

Choosing Chemotherapy Using Genomics

Choosing Chemotherapy Using Genomics
Researchers at Duke University's Institute for Genome Sciences & Policy have developed a panel of genomic tests that analyzes the unique molecular traits of a malignant tumor and determines which chemotherapy will most aggressively attack that patient's cancer.

In experiments published in the November 2006 issue of the journal Nature Medicine, the scientists applied the genomic tests to cells derived from tumors of cancer patients. They observed that the tests were 80 percent accurate in predicting which drugs would be most effective in killing the tumor.

The Duke team plans to begin a clinical trial of the genomic tests in patients with breast cancer next year.

The new tests have the potential to save lives and reduce patients' exposure to the toxic side effects of chemotherapy, said Anil Potti, M.D., the study's lead investigator and an assistant professor of medicine in the Duke Institute for Genome Sciences & Policy. The tests are designed to help doctors select and initiate therapy with the best drug for a patient's tumor instead of trying various drugs in succession until the right one is found, Potti said.

"Over 400,000 patients in the United States are treated with chemotherapy each year, without a firm basis for which drug they receive," said Joseph Nevins, Ph.D., the study's senior investigator and a professor of genetics at the Duke Institute for Genome Sciences & Policy. "We believe these genomic tests have the potential to revolutionize cancer care by identifying the right drug for each individual patient".........

Posted by: Janet      Permalink         Source



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Cancer
Cancer is a very common disease, approximately one out of every two American men and one out of every three American women will have some type of cancer at some point during the course of their life. Cancer is more common in the elderly and 77 percent of cancers occur in people above age 55 or older. Cancer is also common in children. Cancer incidence is said to have two peaks once during early childhood and then during late years in life. No age period is completely exempted from development of cancers. Some cancers occur predominantly in the elderly, other types occur in children, Cancer occurs in all ethnic races, however the cancer rates and rates of specific cancer types may vary from group to group. Late stages of cancer may be incurable in most cases, but with the advancement of medicine, more and more cancers are becoming curable.

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