New Guidelines Help Preserve Fertility After Cancer Treatment

Cancer and cancer treatment can make it difficult for cancer survivors to conceive a child or maintain a pregnancy. Both women and men can suffer temporary or permanent infertility due to treatments such as chemotherapy, radiation therapy to the pelvic area, or surgery.

The new American Society of Clinical Oncology guidelines make the following recommendations:

Discussion about infertility as a potential risk of cancer therapy should be initiated with patients of childbearing age as early as possible after diagnosis.
Physicians should identify whether the patient is at risk for treatment-induced infertility and should discuss with the patient their concerns about infertility and interest in fertility preservation, as well as available treatment options, and the best time to undergo fertility preservation measures, before beginning cancer treatment.
Patients interested and eligible for fertility preservation should be referred to reproductive specialists to facilitate decision-making and fertility treatment planning.
"It is important for doctors and cancer patients to determine the threat cancer treatment may have on reproduction as early as possible, since many of the fertility preservation options require time to perform before cancer therapy begins. An early discussion will give the patient the most fertility preservation options," guideline lead author Dr. Stephanie Lee, an associated member at the Fred Hutchinson Cancer Research Center in Seattle, said in a prepared statement.

She and her colleagues on the expert panel concluded the two methods of fertility preservation with the highest likelihood of success in cancer patients are embryo cryopreservation for women and sperm cryopreservation for men. Embryo cryopreservation involves the harvesting of eggs, followed by in vitro fertilization and freezing of embryos for later use. Sperm cryopreservation is the freezing and storing of sperm for later use.

The guidelines are to be published in the June 20 issue of the Journal of Clinical Oncology.

Black Women More Likely to Die From Breast Cancer

Black Women More Likely to Die From Breast Cancer
TUESDAY, March 21 (HealthDay News) -- Black American women are 19 percent more likely than white women to die of breast cancer, a new study finds.
And a second study in the March 20 issue of the Journal of Clinical Oncology found that minority women in the United States are half as likely as white women to receive recommended post-surgical drug treatment for breast cancer. This may partially explain why black women are more likely to die from breast cancer, the researchers said.
In the first study, researchers reviewed data from 20 previous breast cancer studies that included information on patient survival, ethnicity, and socioeconomic status.
"Even after controlling for socioeconomic status and disease stage, African-American women were 19 percent more likely to die from breast cancer than white women," study lead author Dr. Lisa A. Newman, director of the Breast Care Center at the University of Michigan, said in a prepared statement. "Our research underscores the need to investigate the role of biologic, genetic and sociocultural factors in breast cancer mortality among black women," she added.
In the second study, researchers at the Mount Sinai School of Medicine reviewed the medical records of 677 women who had surgery for early-stage breast cancer in six New York City-area hospitals in 1999 and 2000.
They found that minority women were only 50 percent as likely as white women to receive adjuvant treatment, even though they had similar rates of referrals to oncologists.
The likelihood of under-use of adjuvant treatment was 34 percent among black women, 23 percent among Hispanic women and 16 percent among white women.
"We found that one in three black women and nearly one in four Hispanic women fail to receive the necessary adjuvant therapy. Significant progress can be made toward reducing racial disparities in cancer death by eliminating the disparities in breast cancer treatment," study lead author Dr. Nina A. Bickell, associate professor of health policy and medicine at Mount Sinai, said in a prepared statement.
-- Robert Preidt
SOURCE: American Society of Clinical Oncology, news release, March 20, 2006
Copyright 2006 ScoutNews LLC. All rights reserved.

Two-Doctor Care Best for Breast Cancer Survivors

Two-Doctor Care Best for Breast Cancer Survivors
TUESDAY, March 21 (HealthDay News) -- Breast cancer survivors may get better follow-up care when they're looked after by both their primary-care doctor and a cancer specialist, compared to when they see just one physician, researchers report.
"Previous studies have shown that over one-third of breast cancer survivors do not receive adequate annual mammography after treatment, so we know that there are problems with the quality of follow-up care for survivors," study co-author Dr. Kenneth Schellhase, an assistant professor of family and community medicine at the Medical College of Wisconsin's Center for Patient Care and Outcomes Research, said in a prepared statement.
"However, the best approach for delivering such care remains unclear," he said. "We wondered whether the specialty of the physician made a difference, so we evaluated mammography use among survivors followed by primary-care physicians, cancer specialists or both."
In their study, Schellhase's team tracked three years of routine follow-up care for more than 3,800 women, age 66 or older, who'd been treated for breast cancer.
About two-thirds of the women received shared specialist/generalist physician care in the three years after treatment.
According to the researchers, that group experienced higher mammography rates in all three years (84 percent, 81 percent and 78.6 percent) than breast cancer survivors cared for by a specialist or generalist alone (76.3 percent, 70 percent and 66 percent).
The study also found that the underuse of mammography among the breast cancer survivors was most common among women with the greatest risk of recurrence -- those treated with breast-conserving surgery without radiation and those with stage II disease.
Screening mammography is believed to be critical for the early detection of either recurrent breast cancer or of new, primary tumors, the researchers noted.
"Our results are encouraging -- that primary care physicians and specialists who cooperate in the care of breast cancer survivors can deliver better quality care," Schellhase said.
The study was published online March 15 in Breast Cancer Research and Treatment.
-- Robert Preidt
SOURCE: Medical College of Wisconsin, news release, March 16, 2006
Copyright 2006 ScoutNews LLC. All rights reserved.

Skin Care and Aging

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Skin Care and Aging
"Defy aging."
"Tone and firm sagging skin."
"Restore your skin's own wrinkle control."
Americans spend billions of dollars each year on skin care products that promise to erase wrinkles, lighten age spots, and eliminate itching, flaking, or redness. But the simplest and cheapest way to keep your skin healthy and young looking is to stay out of the sun.
Sunlight is a major cause of the skin changes we think of as aging ? changes such as wrinkles, dryness, and age spots. Your skin does change with age. For example, you sweat less, leading to increased dryness. As your skin ages, it becomes thinner and loses fat, so it looks less plump and smooth. Underlying structures ? veins and bones in particular ? become more prominent. Your skin can take longer to heal when injured.
You can delay these changes by staying out of the sun. Although nothing can completely undo sun damage, the skin sometimes can repair itself. So, it?s never too late to protect yourself from the harmful effects of the sun.
Wrinkles
Over time, the sun?s ultraviolet (UV) light damages the fibers in the skin called elastin. The breakdown of these fibers causes the skin to lose its ability to snap back after stretching. As a result, wrinkles form. Gravity also is at work, pulling at the skin and causing it to sag, most noticeably on the face, neck, and upper arms.
Cigarette smoking also contributes to wrinkles. People who smoke tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure. The reason for this difference is not clear. It may be because smoking also plays a role in damaging elastin. Facial wrinkling increases with the amount of cigarettes and number of years a person has smoked.
Many products currently on the market claim to ?revitalize aging skin.? According to the American Academy of Dermatology, over-the-counter ?wrinkle? creams and lotions may soothe dry skin, but they do little or nothing to reverse wrinkles. At this time, the only products that have been studied for safety and effectiveness and approved by the Food and Drug Administration (FDA) to treat signs of sun-damaged or aging skin are tretinoin cream and carbon dioxide (CO2) and erbium (Er:YAG) lasers.
Tretinoin cream (Renova), a vitamin A derivative available by prescription only, is approved for reducing the appearance of fine wrinkles, mottled darkened spots, and roughness in people whose skin doesn?t improve with regular skin care and use of sun protection. However, it doesn?t eliminate wrinkles, repair sun-damaged skin, or restore skin to its healthier, younger structure. It hasn?t been studied in people 50 and older or in people with moderately or darkly pigmented skin.
The CO2 and Er:YAG lasers are approved to treat wrinkles. The doctor uses the laser to remove skin one layer at a time. Laser therapy is performed under anesthesia in an outpatient surgical setting.
The FDA currently is studying the safety of alpha hydroxy acids (AHAs), which are widely promoted to reduce wrinkles, spots, and other signs of aging, sun-damaged skin. Some studies suggest that they may work, but there is concern about adverse reactions and long-term effects of their use. Because people who use AHA products have greater sensitivity to the sun, the FDA advises consumers to protect themselves from sun exposure by using sunscreen, wearing a hat, or avoiding mid-day sun. If you are interested in treatment for wrinkles, you should discuss treatment options with a dermatologist.
For more, please read the Wrinkles article.
Dry Skin and Itching
Many older people suffer from dry skin, particularly on their lower legs, elbows, and forearms. The skin feels rough and scaly and often is accompanied by a distressing, intense itchiness. Low humidity ? caused by overheating during the winter and air conditioning during the summer ? contributes to dryness and itching. The loss of sweat and oil glands as you age also may worsen dry skin. Anything that further dries your skin ? such as overuse of soaps, antiperspirants, perfumes, or hot baths ? will make the problem worse. Dehydration, sun exposure, smoking, and stress also may cause dry skin.
Dry skin itches because it is irritated easily. If your skin is very dry and itchy, see a doctor. Dry skin and itching can affect your sleep, cause irritability, or be a symptom of a disease. For example, diabetes and kidney disease can cause itching. Some medicines make the itchiness worse.
The most common treatment for dry skin is the use of moisturizers to reduce water loss and soothe the skin. Moisturizers come in several forms ? ointments, creams, and lotions.
Ointments are mixtures of water in oil, usually either lanolin or petrolatum.
Creams are preparations of oil in water, which is the main ingredient. Creams must be applied more often than ointments to be most effective.
Lotions contain powder crystals dissolved in water, again the main ingredient. Because of their high water content, they feel cool on the skin and don?t leave the skin feeling greasy. Although they are easy to apply and may be more pleasing than ointments and creams, lotions don?t have the same protective qualities. You may need to apply them frequently to relieve the signs and symptoms of dryness. Moisturizers should be used indefinitely to prevent recurrence of dry skin.

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Breast Asymmetry Points to Cancer Risk

Breast Asymmetry Points to Cancer Risk
Bigger Difference in Size Could Mean Bigger Risk
By?Salynn?Boyles
WebMD Medical News
Reviewed By?Louise?Chang,?MD
on Monday, March 20, 2006
March 20, 2006 -- The difference in the size of a woman's right and left breast may help predict her risk for developing breast cancer.
Few women have perfectly symmetrical breasts, but the intriguing early research from the U.K. suggests that larger difference in size is an independent risk factor for the disease.
In a study published Monday in the journal Breast Cancer Research, researchers reported that each 3.38 ounce increase in breast asymmetry, as measured by mammography, predicted a 50% increase in breast cancer risk.
The average breast size of the 504 women in the study was 16.9 ounces and the average asymmetry was 1.7 ounces to 2.03 ounces, says Diane Scutt, PhD, one of the study researchers.
Only one woman in the study had breasts that were exactly symmetrical.
"This early work is very encouraging," Scutt tells WebMD. "It certainly suggests that breast asymmetry could be a good independent predictor of breast cancer risk."
Balanced Evidence
Scutt and colleagues studied mammograms from 252 women free of breast cancer at the time of breast imaging but who developed the disease later on. An equal number of women with normal mammograms from women who did not develop breast cancer were also examined.
The finding that women who later developed breast cancer had more asymmetry than those who did not is consistent with previous studies by the same researchers comparing mammograms from breast cancer patients and nonpatients.
The researchers hope to confirm the findings by examining mammograms from 13,000 women who were free of breast cancer when they entered a study on menopause 25 years ago. Differences in breast size will be compared between women who later developed breast cancer and those who did not.
Even if those findings suggest a strong link between breast asymmetry and breast cancer, Scutt says it is just one of many traits that influence breast cancer risk.
More Study Needed
If breast asymmetry is a factor in risk then estrogen may explain why.
"Our previous work seems to indicate that estrogen plays a part in asymmetry," Scutt says, "But the short answer is that we need to do more work to figure this out."
American Cancer Society spokesman Len Lichtenfeld, MD, FACP, agrees. He adds that it isn't likely that breast asymmetry will be used to predict breast cancer risk anytime soon.
"We have identified a variety of characteristics that are known to influence risk," he tells WebMD. "Family history, a woman's age, her reproductive history, and other factors play a role. These new findings are interesting, but they are very preliminary."



SOURCES: Scutt, D. Breast Cancer Research, March 20, 2006; vol 8: online edition. Diane Scutt, PhD, director, research in health sciences, division of medical imaging, University of Liverpool, Liverpool, England. Len Lichtenfeld, MD, FACP, deputy chief medical officer, American Cancer Society.
? 2006 WebMD Inc. All rights reserved

Virus May Raise Skin Cancer Risk

Virus May Raise Skin Cancer Risk
WEDNESDAY, March 15 (HealthDay News) -- A subtype of the virus best known for its links to cervical cancer may also raise the risk for a form of skin cancer, researchers report.
A human papillomavirus (HPV) subtype called beta HPV may be associated with increased risk of squamous cell carcinoma skin cancer , according to a study in the March 15 issue of the Journal of the National Cancer Institute.
"Although sun exposure and sun sensitivity are the major risk factors for (skin) cancers, our data support a role of HPV, particularly beta HPV, in the development of squamous cell carcinoma," write researchers at Dartmouth Medical School in Hanover, N.H.
Beta HPVs, which include HPV types 5 and 8, have been detected in skin tumors and previous research has suggested they may play a role in skin cancer.
In this study, researchers looked for antibodies to 16 different HPV types in samples collected from 252 people with squamous cell carcinoma, 525 people with basal cell carcinomas, and 461 cancer-free people in a control group.
Beta type HPV antibodies were detected in squamous cell carcinoma patients more often than in people in the control group. Basal cell carcinoma patients and control group volunteers showed no difference in the presence of HPV antibodies.
-- Robert Preidt
SOURCE: Journal of the National Cancer Institute, news release, March 14, 2006
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Genes May Help Guide Lung Cancer Care

Genes May Help Guide Lung Cancer Care
By Amanda Gardner
HealthDay Reporter
WEDNESDAY, March 15 (HealthDay News) -- Specific genetic patterns may predict the course of lung cancer, researchers report.
The new patterns could help with the diagnosis, prognosis and, eventually, treatment of the disease as the information gleaned is used in drug development.
"Anything that can give us a clue about survival is important," explained Dr. Norman Edelman, chief medical officer of the American Lung Association. "Like many other things of this kind, we hope it just opens the door to new research."
Lung cancer remains the number one cancer killer in the world. Currently, about half of all people with early, stage-1 lung cancer who undergo surgery will see their cancer spread within five years. The problem is that physicians cannot yet predict who will recover and who will not.
While scientists have untangled some of the genetic intricacies of lung cancer, they are still far from having the full picture.
Enter microRNAs or miRNAs, small pieces of genetic material called ribonucleic acid (RNA) that are thought to control gene expression.
"This is a relatively new class of molecules that regulate cells and may be very much involved in the process of normal cells becoming cancer cells," explained co-senior author Dr. Curtis C. Harris, chief of the Laboratory of Human Carcinogenesis at the U.S. National Cancer Institute.
As reported in the March 13 issue of Cancer Cell, Harris' team compared samples of lung cancer tissue and noncancerous lung tissue from 104 patients. The focus was on adenocarcinomas and squamous cell carcinomas -- non-small cell lung cancers that represent about 85 percent of all lung cancers and are notoriously difficult to treat.
About two-thirds of the tumors were adenocarcinomas, and the remainder squamous cell carcinomas.
"We wanted to see if these miRNAs, which regulate other signaling molecules, might have a different and a unique profile in cancer vs. non-cancer, and whether it relates to clinical disease in terms of prognosis or stage," Harris said.
Microarray analysis was used to detect patterns of miRNA expression in each tumor and normal tissue pair. Ultimately, five miRNAs displayed different expression levels in tumor tissues vs. the normal tissues.
Further study revealed that two miRNAs -- has-mir-155 and has-let-7a-2 -- could predict survival. Specifically, lung cancer patients with high levels of has-mir-155 or low levels of has-let-7a-2 had worse survival outcomes than patients with low has-mir-155 or high has-let-7a-2 expression.
Based on these genetic clues, doctors could identify patients with a worse prognosis who may need more aggressive treatment, the authors stated. "More sensitive and specific tests allow you to differentiate the people who have a better prognosis vs. those who don't. It's the idea of personalized medicine," Harris said.
The findings need to be replicated in other studies before they are used in real-life situations, the researcher said. "This is not ready yet for routine clinical practice," Harris said.
That process has already begun, however. Harris was co-senior author of a paper appearing in the Feb. 14 issue of the Proceedings of the National Academy of Sciences. That study found that miRNAs were also involved in the progress of lung, breast, stomach, prostate, colon and pancreatic cancer.
"What we really hope with genetic profiles is that we will be able to say, 'Aha! This profile says that these are the drugs that work best,'" Edelman said. "It's another good step in working through the genetic variations of lung cancer."
SOURCES: Curtis C. Harris, M.D., chief, laboratory of human carcinogenesis, National Cancer Institute; Norman Edelman, M.D., chief medical officer, American Lung Association; March 13, 2006, Cancer Cell; Feb. 14, 2006, Proceedings of the National Academy of Sciences
Copyright ? 2006 ScoutNews, LLC. All rights reserved.

Outlook Improving for Heart, Lung Transplant Recipients

Outlook Improving for Heart, Lung Transplant Recipients
WEDNESDAY, March 15 (HealthDay News) -- The number of heart- and lung-transplant patients surviving three years or more after transplant continues to rise, according to a new global report.
More than 64 percent of patients who had heart and lung transplants between 2000 and 2003 survived for at least three years, compared to 55 percent of patients who had transplants between 1988 and 1994, according to data from the Registry of the International Society for Heart and Lung Transplantation
Key factors increased the risk of death following transplants, the report found. One of these factors is "primary grant dysfunction" -- a severe, acute lung injury that can occur in the first 72 hours after transplantation. One study found the 30-day death rate for transplant patients with primary grant dysfunction to be 42 percent, compared to six percent for patients without the complication.
Another problem linked to increased death rates among lung-transplant patients is a rejection-linked process called bronchiolitis obliterans syndrome (BOS). According to a University of Pittsburgh study, about 30 percent of lung-transplant patients develop BOS late in the first year after their transplant. About two-thirds of these patients suffer a steady decline of pulmonary function over several years.
A recent workshop on lung transplantation sponsored by the U.S. National Heart, Lung, and Blood Institute concluded that a few key priorities could improve post-transplant survival and care. These included an expansion of the donor pool; accurate prediction of and effective treatment for primary graft dysfunction and BOS; and the development of strategies to facilitate induction of immune tolerance.
The findings appear in the March issue of the American Journal of Respiratory and Critical Care Medicine.
-- Robert Preidt
SOURCE: American Thoracic Society, news release, March 2006
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Longer Drug Therapy Helps Bone Marrow Disease Patients

Longer Drug Therapy Helps Bone Marrow Disease Patients
FRIDAY, March 17 (HealthDay News) -- Longer courses of treatment with decitabine -- a drug currently undergoing clinical trials -- may help patients with a form of bone marrow disease called myelodysplastic syndrome (MDS), German researchers report.
MDS is a pre-leukemic bone marrow disorder most commonly found in elderly patients.
The study included 22 patients with relapsing MDS at high risk of developing leukemia who had received initial treatment with decitabine. The patients were retreated with a median of three courses of dectabine.
According to the study, to be published in the April 15 issue of Cancer, 10 (45 percent) of the patients showed some form of response to the retreatment.
Researchers at the University of Freiburg Medical Center say the median survival time for all patients from the start of the first treatment with decitabine was 28 months. Retreated patients had a median survival time of 13 months post-relapse.
Among the 45 percent of patients who showed a response to retreatment, the quality and duration of the second response was still inferior to their response to the initial treatment. This suggests that longer initial treatments may be more beneficial to patient outcome, the researchers said.
They concluded that, "results of the present analysis point to the importance of extending therapy with low-dose decitabine beyond the point of first response, and strongly support institution of a maintenance treatment."
This extended approach is currently being studied in a multi-center clinical trial with older MDS patients.
-- Robert Preidt
SOURCE: John Wiley & Sons Inc., news release, March 13, 2006
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Implanted Wafer Helps Fight Brain Cancer

Implanted Wafer Helps Fight Brain Cancer
FRIDAY, March 17 (HealthDay News) -- An implantable, biodegradable wafer that releases chemotherapy close to brain tumors offers long-term survival benefit for people with high-grade malignant gliomas, researchers report.
In the United States, the "Gliadel Wafer" is currently approved for treatment of patients with newly-diagnosed high-grade malignant gliomas as an adjunct to surgery and radiation. It's also indicated to treat a particularly deadly brain cancer , recurrent glioblastoma multiforme, when used in addition to surgery.
The newly published data reports long-term survival results on 59 of 240 patients with high-grade malignant gliomas who took part in a previously published study. That study found that patients treated with Gliadel Wafer in combination with radiation therapy had a three-year survival rate of 9.2 percent, compared to 1.7 percent for patients who received a placebo.
The latest data shows that, of the 59 patients available for long-term follow-up, 11 were alive after 56 months. Of those 11 patients, nine had received Gliadel Wafer and two had received placebo wafers. The researchers concluded that treatment with Gliadel Wafer was associated with a 27 percent reduction in risk of death over the study period.
"We feel that the publication of this important data contributes significantly to the result of the randomized, placebo-controlled study, showing that patients with high-grade malignant gliomas have a better chance of long-term survival when treated with Gliadel Wafer," lead investigator Dr. Manfred Westphal, of the University Hospital Eppendorf in Hamburg, said in a prepared statement.
The findings are published in the March issue of the European Journal of Neurosurgery.
-- Robert Preidt
SOURCE: MGI Pharma Inc., news release, March 8, 2006
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Non-Smokers Get Lung Cancer, Too

Health Tip: Non-Smokers Get Lung Cancer, Too
(HealthDay News) -- The disturbing truth about lung cancer is that while smoking is a primary avoidable cause, non-smokers can contract lung cancer , too.
Besides smoking, risk factors may include environmental exposure to such carcinogens as radon in the home or workplace, or a family history of the disease, according to the U.S. Centers for Disease Control and Prevention.
Lung cancer is the second-leading cancer killer of men, and the second for white and Native American women in the United States. It is the third most common cancer killer of black, Asian, and Hispanic women.
Symptoms of the disease include shortness of breath, coughing that doesn't go away, chest pain, coughing up blood, wheezing, fever, and weight loss.
If you have these symptoms, talk with your doctor immediately, even if you've never smoked.
-- Deborah DiSesa Hirsch
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Imaging System Helps Detect Cervical Pre-Cancer

Imaging System Helps Detect Cervical Pre-Cancer
FRIDAY, March 17 (HealthDay News) -- A new system to help doctors identify pre-cancerous cells on a woman's cervix has been approved by the U.S. Food and Drug Administration.
MediSpectra's LUMA Cervical Imaging System can detect pre-cancerous cells missed by colposcopy, a diagnostic tool used on women with an abnormal Pap smear. In 50 cases of pre-cancer detected during a clinical study of 193 women, nine were caught by the LUMA system after being missed by colposcopy, the FDA said in a news release.
LUMA shines a light on the cervix and evaluates how different portions of cervical tissue respond to that light, the agency said. This and colposcopy results help doctors decide where to biopsy.
"Use of the LUMA device is not a substitute for a thorough colposcopic exam," the agency stressed.
If detected early, cervical cancer is "highly preventable," the FDA said. The American Cancer Society estimates that in 2006, about 9,710 cases of invasive cervical cancer will be diagnosed in the United States, and about 3,700 U.S. women will die from the disease.
-- Scott Roberts
Copyright 2006 ScoutNews, LLC. All rights reserved.

Alzheimer's Drug Helps Brain Tumor Patients

Alzheimer's Drug Helps Brain Tumor Patients
FRIDAY, March 17 (HealthDay News) -- Six months of treatment with the Alzheimer's drug Aricept significantly improved cognitive function, mood and quality of life in brain tumor patients after radiation therapy, U.S. researchers report.
Aricept (donepezil) belongs to a class of drugs called acetylcholinesterase (AChE) inhibitors.
"To our knowledge, this is the first study of an AChE inhibitor or any other drug administered to long-term survivors of partial or whole brain radiation therapy in an attempt to reduce the symptoms associated with a brain tumor and its treatments," study co-author Dr. Edward G. Shaw, chairman of the department of radiation oncology at Wake Forest University Baptist Medical Center, said in a prepared statement.
Reporting in the March 17 issue of the Journal of Clinical Oncology, Shaw's team decided to try Aricept on this group of patients after noticing that radiation-induced brain injury resembles Alzheimer's and other forms of dementia, both in terms of symptoms and what's seen with brain-imaging technology.
"Each year, more than 15,000 Americans are diagnosed with primary brain tumors, and as many as 200,000 with metastatic brain tumors, nearly all of whom receive radiation therapy," Shaw said. "For survivors of brain tumor radiation, symptoms of short-term memory loss and mood changes similar to those seen in Alzheimer's disease, as well as fatigue, frequently occur, leading to a poor quality of life."
The researchers are now planning a clinical trial to compare brain tumor patients treated with Aricept to those treated with a placebo.
-- Robert Preidt
SOURCE: Wake Forest University Baptist Medical Center, news release, March 17, 2006
Copyright 2006 ScoutNews LLC. All rights reserved.

Preventive Mastectomy Offers Women Relief

Preventive Mastectomy Offers Women Relief
By Kathleen Doheny
HealthDay Reporter
FRIDAY, March 17 (HealthDay News) -- Most women diagnosed with breast cancer who choose to have their unaffected breast removed along with the diseased one say they don't regret their decision, a new study finds.
Furthermore, their quality of life equals that of women who chose not to have a preventive mastectomy, say researchers reporting in the March 20 issue of the Journal of Clinical Oncology.
Those who chose the preventive mastectomy were also a little less concerned about cancer recurring, the study found.
"Overall, we think these are reassuring results, in that women who have preventive mastectomy don't appear to suffer any ill psychological effects compared to those who [just] had the breast cancer treated," said Ann Geiger, lead author of the study and an associate professor of public health sciences at the Wake Forest University Baptist Medical Center School of Medicine in Winston-Salem, N.C.
Her team surveyed 580 women: 519 underwent a preventive mastectomy on the unaffected breast after learning they had cancer; 61 did not.
Women answered questions about their quality of life, body image, sexual satisfaction, concern about breast cancer recurrence, depression and their perception of their health.
Respondents to the survey received care from six healthcare systems within the National Cancer Institute-funded Cancer Research Network. They had been diagnosed between the years of 1979 to 1999. Of the 519 who chose preventive mastectomy, 86.5 percent said they were satisfied with their decision, and 76.3 percent reported "high contentment" with their quality of life.
Of the 61 who did not undergo the preventive mastectomy, a similar number (75.4 percent) reported high contentment with their quality of life.
This latest study adds to a body of knowledge about preventive mastectomies, an area that has garnered little research, Geiger said. Some preventive mastectomies are done bilaterally if a woman is at high risk of breast cancer due to strong family history; other studies have involved the unaffected breast when breast cancer is diagnosed in the other breast. "Most research has been done on bilateral preventive mastectomy -- when no cancer is present," she said.
The study results came as no surprise to Dr. Julia Smith, director of the New York University Cancer Institute's Breast Cancer Screening and Prevention Program and director of the Lynne Cohen Breast Cancer Preventive Care Program at the NYU Cancer Institute and Bellevue Hospital in New York City. "It's totally consistent with our experience with patients," she said of the survey findings.
Making the decision is not easy, she added, whatever the woman's medical history.
"These are very important decisions," Smith said. She said it's crucial that women head to a center known for its skill in high-risk assessment. This may be a university center or a center that does research and is known for its high-risk management programs, she said. "If women go to these programs, and they get their own individual risk profile assessed, then they can understand, with the help of a good medical oncologist and his or her team, what the risks and benefits for this preventive surgery are for them," she added.
The key to making this decision is, "given the risks and the benefits, what will allow this woman to live her life fully?" Smith said.
Whatever the decision, Geiger said, concern about recurrent cancer remains, although it may be lessened.
In the study, "about half of those who had the prophylactic [preventive] mastectomy on the other breast that wasn't cancerous still remained concerned about the possibility of recurrent cancer, compared to 75 percent of those who left the healthy breast alone," the Wake Forest researcher said. While preventive procedures reduce the risk of recurrent cancer by up to about 95 percent, Geiger said, a risk always remains, because it is impossible to remove all breast tissue.
SOURCES: Ann Geiger, Ph.D., associate professor, public health sciences, Wake Forest University Baptist Medical Center School of Medicine, Winston-Salem, N.C; Julia Smith, M.D., Ph.D., director, New York University Cancer Institute's Breast Cancer Screening and Prevention Program, and director, Lynne Cohen Breast Cancer Preventive Care Program, NYU Cancer Institute and Bellevue Hospital, New York City; March 20, 2006, Journal of Clinical Oncology
Copyright 2006 ScoutNews LLC. All rights reserved.

Urban Air Clean-Ups Save Lives

Urban Air Clean-Ups Save Lives
WEDNESDAY, March 15 (HealthDay News) -- Cutting down on fine particulate matter in city air can be a real lifesaver, a new study finds.
"This reduction was observed specifically for deaths due to cardiovascular and respiratory disease and not from lung cancer," researcher Francine Laden, of Channing Laboratory in Boston, said in a prepared statement.
The original study -- called the Harvard Six Cities study -- was conducted from 1979 to 1990. It identified an association between fine particulate air pollution and death risk. This new study extended that work to the years 1990 to 1998.
The study participants included nearly 8,100 residents of a number of American towns, including Watertown, Mass.; Kingston and Harriman, Tenn.; St. Louis, Mo.; Steubenville, Ohio; Portage, Wyocena and Pardeeville, Wisc.; and Topeka, Kan. The participants averaged 50 years of age at the start of the original study.
The new study found that the largest drops in adjusted death rates were in cities with the greatest reductions in fine particulate matter air pollution.
While deaths linked to heart disease and respiratory illness dropped along with pollutant levels, lung cancer deaths did not, probably because lung cancer is "a disease with a longer latency period and less reversibility," according to Laden.
During the eight-year study period, the annual mean concentration of fine particulates declined by 7 micrograms per cubic meter of air per decade in Steubenville; by 5 micrograms in St. Louis; by 3 micrograms in Watertown; by 2 micrograms in Harriman; by 1 milligram in Portage; and by less than a microgram in Topeka.
The findings appear in the March issue of the American Journal of Respiratory and Critical Care Medicine.
-- Robert Preidt
SOURCE: American Thoracic Society, news release, March 15, 2006
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Whites Have Higher Blood Levels Cancer-Linked PFCs

Whites Have Higher Blood Levels of Cancer-Linked PFCs
THURSDAY, March 16 (HealthDay News) -- Blood levels of cancer-linked industrial pollutants called perfluorochemicals (PFCs) vary by race and ethnicity, a new U.S. study shows.
Researchers at the U.S. Centers for Disease Control and Prevention analyzed blood samples collected in 2001 and 2002 as part of the National Health and Nutrition Examination Survey. They found that whites had three times higher blood serum levels of PFCs than Hispanics, and two times higher levels than blacks.
Men in all three racial groups had slighter higher PFC levels than women. The researchers concluded that age had no influence on blood concentrations of PFCs.
The researchers don't know why whites have high blood levels of PFCs, but noted the differences may be a reflection of greater exposure to PFCs among whites than among other racial/ethnic groups.
In addition to environmental exposure, PFC levels in certain groups of people may be linked to diet, lifestyle and genetic factors, the CDC team said.
PFCs were introduced in the 1950s and have been used to make insecticides, non-stick coatings and stain-resistant fabric and carpet. These compounds accumulate in the environment. While the human health effects of PFCs aren't yet known, laboratory studies have linked PFCs to cancer and developmental problems in animals.
The findings will be published in the April 1 issue of Environmental Science & Technology.
-- Robert Preidt
SOURCE: American Chemical Society, news release, March 8, 2006
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Chili's Heat Kills Prostate Cancer Cells

Chili's Heat Kills Prostate Cancer Cells
By Steven Reinberg
HealthDay Reporter
THURSDAY, March 16 (HealthDay News) -- Capsaicin, the component that gives jalapeno peppers their heat, may also kill prostate cancer cells, a new study suggests.
Initial experiments in cancer cells and mice show that capsaicin causes prostate cancer cells to undergo a kind of suicide. Researchers speculate that, in the future, pills containing capsaicin might be used as therapy to prevent prostate cancer's return.
According to their report, capsaicin caused almost 80 percent of prostate cancer cells in the mice to die. In addition, prostate cancer tumors treated with capsaicin were about one-fifth the size of tumors in untreated mice.
"Capsaicin inhibits the growth of human prostate cancer cell in Petri dishes and mice," said lead researcher Dr. H. Phillip Koeffler, director of hematology and oncology at Cedars-Sinai Medical Center and a professor of medicine at the University of California, Los Angeles. Based on the findings, Koeffler believe the next step is a trial to see if it works in patients with prostate cancer.
The report appears in the March 15 issue of Cancer Research.
Capsaicin probably has several effects, Koeffler said. Most noticeable is its effect in blocking NF-kappa Beta, a molecular mechanism that promotes cancer cell growth, he noted.
In addition, capsaicin also was effective against leukemia, and might be effective in slowing or preventing the growth of other cancers as well, he added.
But it's still too early to reach for the chili sauce, Koeffler said.
"I am not recommending that people increase their consumption of peppers," he said. "Our calculation is that you would have to eat 10 habanera peppers three times a week, which would be equivalent to the amount of capsaicin we gave to the mice."
The researcher believes capsaicin could someday gain a place in adjuvant prostate cancer therapy. For example, it might be used after prostate surgery to kill cancer cells in patients whose blood PSA levels start to rise, indicating the presence of tumors too small to be seen, he said.
The study does highlight the crossover that can occur between conventional and alternative therapies. "We should take note of herbal medicines and then use modern-day techniques to find what the active compounds are and bring them into clinical trials," Koeffler said.
One expert thinks it's too early to know if capsaicin will ever be an effective prostate cancer treatment, however.
"Since large amounts of capsaicin have never been given to people, we don't know what the side effects might be," cautioned Dr. Len Lichtenfeld, deputy chief medical officer at the American Cancer Society. "We don't know about the right dose or anything."
Lichtenfeld believes that any trial should be done in patients who are not responsive to other standard therapies. "We are ways away from a clinical trial," he said. "We need more basic research before we start treating patients."
Another expert concurred.
"This study does not prove that capsaicin will prove effective in the treatment of prostate cancer in humans," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "Nor does it tell us that eating peppers rich in the substance will help prevent such cancer, or forestall its growth. But it provides a compelling argument for clinical study of capsaicin in human prostate cancer to put these questions to the test."
"This paper should serve to remind us that herbal remedies and pharmacotherapy are often of common origins, differing only in our capacity to identify, purify and package the active ingredients," Katz said. "This work suggests that the conventional medical community should turn a discriminating eye, rather than a jaded eye, toward time-honored herbal treatments. Many will doubtless prove ineffective when put to the test of high-quality research. But some will pass that test, and we must meticulously distinguish between them."
SOURCES: H. Phillip Koeffler, M.D., director, hematology and oncology, Cedars-Sinai Medical Center, and professor, medicine, University of California, Los Angeles; Len Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society, Atlanta; David L. Katz, M.D., associate professor, public health, and director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; March 15, 2006, Cancer Research
Copyright ? 2006 ScoutNews LLC. All rights reserved.

Genes May Help Guide Lung Cancer Care

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, March 15 (HealthDay News) -- Specific genetic patterns may predict the course of lung cancer, researchers report.

The new patterns could help with the diagnosis, prognosis and, eventually, treatment of the disease as the information gleaned is used in drug development.

"Anything that can give us a clue about survival is important," explained Dr. Norman Edelman, chief medical officer of the American Lung Association. "Like many other things of this kind, we hope it just opens the door to new research."

Lung cancer remains the number one cancer killer in the world. Currently, about half of all people with early, stage-1 lung cancer who undergo surgery will see their cancer spread within five years. The problem is that physicians cannot yet predict who will recover and who will not.

While scientists have untangled some of the genetic intricacies of lung cancer, they are still far from having the full picture.

Enter microRNAs or miRNAs, small pieces of genetic material called ribonucleic acid (RNA) that are thought to control gene expression.

"This is a relatively new class of molecules that regulate cells and may be very much involved in the process of normal cells becoming cancer cells," explained co-senior author Dr. Curtis C. Harris, chief of the Laboratory of Human Carcinogenesis at the U.S. National Cancer Institute.

As reported in the March 13 issue of Cancer Cell, Harris' team compared samples of lung cancer tissue and noncancerous lung tissue from 104 patients. The focus was on adenocarcinomas and squamous cell carcinomas -- non-small cell lung cancers that represent about 85 percent of all lung cancers and are notoriously difficult to treat.

About two-thirds of the tumors were adenocarcinomas, and the remainder squamous cell carcinomas.

"We wanted to see if these miRNAs, which regulate other signaling molecules, might have a different and a unique profile in cancer vs. non-cancer, and whether it relates to clinical disease in terms of prognosis or stage," Harris said.

Microarray analysis was used to detect patterns of miRNA expression in each tumor and normal tissue pair. Ultimately, five miRNAs displayed different expression levels in tumor tissues vs. the normal tissues.

Further study revealed that two miRNAs -- has-mir-155 and has-let-7a-2 -- could predict survival. Specifically, lung cancer patients with high levels of has-mir-155 or low levels of has-let-7a-2 had worse survival outcomes than patients with low has-mir-155 or high has-let-7a-2 expression.

Based on these genetic clues, doctors could identify patients with a worse prognosis who may need more aggressive treatment, the authors stated. "More sensitive and specific tests allow you to differentiate the people who have a better prognosis vs. those who don't. It's the idea of personalized medicine," Harris said.

The findings need to be replicated in other studies before they are used in real-life situations, the researcher said. "This is not ready yet for routine clinical practice," Harris said.

That process has already begun, however. Harris was co-senior author of a paper appearing in the Feb. 14 issue of the Proceedings of the National Academy of Sciences. That study found that miRNAs were also involved in the progress of lung, breast, stomach, prostate, colon and pancreatic cancer.

"What we really hope with genetic profiles is that we will be able to say, 'Aha! This profile says that these are the drugs that work best,'" Edelman said. "It's another good step in working through the genetic variations of lung cancer."

SOURCES: Curtis C. Harris, M.D., chief, laboratory of human carcinogenesis, National Cancer Institute; Norman Edelman, M.D., chief medical officer, American Lung Association; March 13, 2006, Cancer Cell; Feb. 14, 2006, Proceedings of the National Academy of Sciences

Copyright © 2006 ScoutNews, LLC. All rights reserved.

Drug Eases Bone Marrow Cancer Burden

MONDAY, March 13 (HealthDay News) -- A new drug may improve the quality of life for patients with a bone marrow cancer called myelodysplastic syndrome (MDS), U.S. researchers report.

However, decitabine -- currently undergoing Phase III efficacy trials -- may not extend the survival of patients with this disease, experts say.

MDS is one of the most common geriatric blood-related cancers. It can be a chronic progressive disease with median survival over five years, or it can be a rapidly progressive disease complicated by acute myeloid lekemia (AML), with a median survival of less than five years.

According to researchers at the University of Texas M.D. Anderson Cancer Center in Houston, decitabine provided longer disease-free responses than supportive care alone for people with MDS.

Reporting in the April 15 issue of the journal Cancer, Dr. Hagop Kantarjian and colleagues found that MDS patients treated with decitabine had longer disease-free periods and a longer time to progression of AML or death than patients who received supportive care.

Patients treated with decitabine were also more likely to have immediate disease improvements and a better quality of life.

Decitabine is one of a number of new drugs currently being tested to treat MDS.

An accompanying editorial in the same issue of Cancer cautioned that these new drugs may help improve quality of life for MDS patients, but will have little impact on patients' length of survival.


SOURCE: John Wiley & Sons, Inc., news release, March 13, 2006

Patients in cancer drug plea

Cancer patients are campaigning to stop a promising new drug from being denied to most NHS patients.

They have a week to persuade the body that makes decisions on the cost effectiveness of medicines to change its mind.

What Nice are saying is that you have to start dying before you get the treatment that may keep you alive

Elizabeth Rees, support group

The drug, Glivec, has gone through trials for treating a rare form of leukaemia.

The drug's manufacturer, Novartis, says it can offer "substantial improvements" to patients with chronic myeloid leukaemia (CML).

But the National Institute for Clinical Excellence (Nice) said in a preliminary report this month that NHS patients should only get the drug if they are in the late stages of the illness.

The final deadline for receiving new evidence that might alter this position is 4 June.

'Immoral'

Elizabeth Rees, a CML sufferer who runs a support group, is urging patients to sign a petition to secure NHS funding of the drug for all patients.

"Without Glivec I wouldn't be here today," she told BBC News Online.

"What Nice are saying is that you have to start dying before you get the treatment that may keep you alive.

"The thought that this CML drug is going to be denied to patients is so shocking, I find it immoral."

Ms Rees, aged 49, who runs the internet-based CML support, took part in clinical trials of the drug.

She was offered it after suffering side effects from the only other available treatment, a type of interferon.

Patients who took part in the trials will be able to keep taking Glivec without having to pay under a special agreement.

My view is that Nice have got to reconsider and listen to the real experts

Prof Gordon McVie, Cancer Research UK

But many future patients in England and Wales will be denied the treatment if the provisional assessment by Nice is not overturned.

The situation is different in Scotland, as Ms Rees, of west London, pointed out.

"I am funded but if my neighbour got CML and was interferon tolerant they would have to move to Scotland to get it," she told BBC News Online.

'Listen to patients'

The watchdog body the Scottish Medicines Consortium has supported the use of Glivec at all stages of CML, said manufacturer Novartis.

The Swiss-based pharmaceutical company said in a statement that Nice's decision to limit Glivec use to the accelerated phase of the illness contradicted expert opinion.

The view is shared by some doctors. A group of specialists, led by Professor John Goldman, from the Hammersmith Hospital, London, has written to the medical journal The Lancet in protest at Nice's recommendation.

The cancer research charity Cancer Research UK is also urging Nice to change its mind.

Director Professor Gordon McVie told BBC News Online: "My view is that Nice have got to reconsider and listen to the real experts who are writing to the Lancet and writing to them and listen to patients who have had the drug."

from BBC News

Cancer rates rising

Better screening is helping cut down on cancer deaths


Cancer experts say more people than ever before are now likely to develop the disease at some time, but the chances of survival are also increasing.

Figures highlighted by the Cancer Research Campaign show that the proportion of the population suffering from cancer has risen significantly over the past 20 years.

Four in ten people are now expected to develop cancer, say experts at the charity.

However, they add that new treatments are likely to mean the disease may well become controllable within 50 years.



Many people will have cancer but it will be under control in the way diabetes is now
Dr Lesley Walker


Latest statistics for England and Wales show that in 1996, 41 per cent of men and 38 per cent of women were at risk of developing cancer in their lifetime.

In 1981 the statistics were 32 per cent of men and 31 per cent of women.

The projected increase is partly due to the fact people are living longer, with most cancer patients developing the disease over the age of 65.

Some older patients who have slowly progressing cancers are likely to die of other causes.

Better detection methods, including an increase in screening, mean that more cancers are found early and the survival rate is now better than ever.

The Cancer Research Campaign said advances in treatment could lead to the disease becoming a controllable condition like diabetes.

But it said a chronic shortage of cancer doctors and the rising cost of treatments meant its predictions might have to be reviewed unless current levels of government financial support are maintained.

The campaign's head of scientific information, Dr Lesley Walker, said the outlook for those developing the disease was improving all the time.

She told BBC Radio 5 Live: "The most exciting drop in death rates has been seen in breast cancer, and the reason why that's so exciting is because deaths really were increasing year on year until the late 80s, and now we've seen a big drop right the way through the last decade.

New treatments


Cancer survival rates
A third of cancer patients are now completely cured
By 2010 this figure could rise to 50%
By 2020 up to 80% of cancer patients could live a normal lifespan
"One of the main reasons for that is better treatment of early breast cancer.

"We'll expect to see an even further decrease due to the impact of the breast-screening programme."

She said the organisation was confident cancer would be largely beaten by the second half of the century.

"That's not to say everyone will be cured of cancer, but that many people will have cancer but it will be under control in the way diabetes is now," she said.

"There's been huge progress in the laboratories in terms of understanding the genes which control cancer

"And a whole raft of new treatment strategies are being developed."



Cancer will be controlled, people will live longer and live with their cancer
Professor Karol Sikora, World Health Organisation
Professor Karol Sikora, of the World Health Organisation said by 2020 it may be possible that 80% of people with cancer would not die from the disease - provided sufficient resources were made available.

At present, about one third of cancer patients are completely cured.

He said: "Cancer will be controlled, people will live longer and live with their cancer.

"At the moment we tend to treat cancer with blitz therapy - one big bang over six months. That is going to change over the next ten years, it will be treated slowly, gently with much less side effects from the treatment, but it will be more complicated, it will require better healthcare facilities than we have got at the moment.

"There will be a gradual transformation as there has been over the last 20 years."

A survivor's story: lung cancer

Lung cancer may be one of the most common cancers in the UK - but it is also one of the hardest to treat.

Leslie Ableson is one of the lucky few - his cancer was caught early enough to make treatment a possibility.

Cancer specialists are optimistic that the numbers of those who will beat the disease in the future will increase as drugs become more advanced.

He tells his story to BBC News Online.

"I gave up smoking when I was 56 or 57 for social reasons. Then, at 60, I was out of breath, had a pulsating sensation in my throat."

Leslie also found some blood in his spit: "Being in touch with my own body, I immediately went to my GP and had some x-rays taken."

I am living proof that that isn't true, that there is life after cancer - even lung cancer.
Leslie Ableson
A subsequent biopsy revealed the cancer.

"The following day I was rather brutally told that I had no expectancy at all and not to buy any long-playing records.

"Total, utter, complete shock. A total sense of disbelief - you just go totally frozen, the mind refuses to operate, you can't take anything in.

"The next day was acceptance. I came to terms very quickly with it."

Then a stroke of good fortune - the opportunity to take part in a clinical research trial testing out the latest chemotherapy drugs.

His cancer was localised and hadn't spread beyond the lung.

"It gave me expectation, I really didn't have hope. I was conditioned that once you had lung cancer or any form of cancer you're going to die.

"I am living proof that that isn't true, that there is life after cancer - even lung cancer."

Extensive chemotherapy followed, then strong radiotherapy.

"The chemo was tough, but I was fortunate. I got through the treatment because getting through the treatment was what mattered.

"I kept going because there was nowhere else to go."

As time progressed, it became apparent that Leslie's condition was improving.


The tragedy of course it's the young people who are smoking - it looks like we've lost the battle with the young people at the moment
Leslie Ableson

Lung Cancer: The facts
He said:"At one stage in my chemo my consultant told me I was a 'star', which evidently is an in-house expression meaning that things are looking up, things are improving."

The treatment carried on throughout the cricket season of that year.

"I was concentrating mainly on the fortunes of Middlesex, who were doing exceptionally well - and not only did I have a successful season in terms of beating cancer, but Middlesex won the county championship!"

He said that any patients offered the chance to take part in a clinical trial should grab the opportunity with both hands.

"In the end, I owe everything to Cancer Research," he said.

'No running'

"My health today is perfect. I'm able to do everything with the exception of running up inclines or running up hills, because there is some lung damage because of the chemo.

"But I can walk 10 miles without any problem at all."

Another change is his attitude to the tobacco companies.

He said: "I have become vehemently anti-smoking - blaming to tobacco companies after they discovered and were fully aware that cigarettes carried health problems and didn't tell the public what they were.

"The tragedy of course it's the young people who are smoking - it looks like we've lost the battle with the young people at the moment."