---

News from the cancer side, January 30

Good morning, everyone. Here is our latest news roundup for this weekend. Happy reading.

News from the experts

February Is National Cancer Prevention Awareness Month
Oncologists and researchers at University of Texas M. D. Anderson Cancer Center are encouraging people to participate in cancer prevention studies to help researchers learn more about the causes of cancer and how to prevent the disease. “Prevention studies offer participants the best options for individual care, improving one’s overall health and well-being,” says Ernest T. Hawk, M.D., M.P.H, vice president of M. D. Anderson’s Division of Cancer Prevention and Population Sciences. “These studies also offer the best chance for reducing the number of future cancer cases.”

News from health care

Medicare Widens Drugs It Accepts for Cancer
Some good news from Medicare. It has expanded its coverage of cancer drugs and treatments, even beyond those approved by the US FDA. It is especially good to know that off-label uses may now be covered. Off-label drugs are those “prescribed for uses other than those for which they have been specifically approved.” While many doctors and patients are happy about this decision, there are others who express concerns about abuse of this ruling resulting in overspending, and worse, using patients as guinea pigs for treatments not approved for their conditions.

News from the pharma industry

In Wyeth, Pfizer Sees a Drug Pipeline
The biggest merger/acquisition news of the month. Pfizer buys Wyeth, and in doing so, it might become a major player in biologics and other biotech products.

News from the innovators

OncoVue offers improved estimation of risk for breast cancer
This new predictive model – OncoVue® – seems to give a more accurate estimation of breast cancer than the one currently used – the Gail Model. OncoVue is a new genetic-based breast cancer risk test that uses a combination of a questionnaire and a saliva test in order to assess risk.

News from the critics

America’s Best Hospitals
This 2008 survey by the US News and World Report gives us the list America’s top medical facilities, in general as well as for specific specialty areas. The top five on overall rankings are:

1. Johns Hopkins Hospital, Baltimore
2. Mayo Clinic, Rochester, Minn.
3. Ronald Reagan UCLA Medical Center, Los Angeles
4. Cleveland Clinic
5. Massachusetts General Hospital, Boston

For the specialty field of cancer/oncology, the following institutions were ranked top 5:

1. University of Texas M.D. Anderson Cancer Center, Houston
2. Memorial Sloan-Kettering Cancer Center, New York
3. Johns Hopkins Hospital, Baltimore
4. Mayo Clinic, Rochester, Minn.
5. Dana-Farber Cancer Institute, Boston

Photo credit: stock.xchng

---

Preview into heart(y) events in February

Instead of our usual Friday heart(y) news roundup, let’s have a peek into our schedule for February.

Upcoming heart(y) awarenesss events for February

February is a special month because it has been designated as THE MONTH of many things, especially on heart(y) and healthy issues. Most important for us here at Battling Heart and Stroke, February is the American Heart Month and the National Women’s Healthy Heart Campaign. As part of the American Heart Month, Friday, Feb. 6, 2009 has been designated as National Wear Red Day. Stay tuned for more details next week.

From February 7 to 14, we will be observing the Congenital Heart Defect Awareness Week. In the same week from February 8 to 14 is Heart Failure Awareness Week.

Don’t forget to be good to your heart on Valentine’s Day, February 14, which by the way, is also designated as National Organ Donor Day to honor those with hearts so big they even share their blood and organs.

Now, February also honors healthy lifestyle and nutritious food by being the

• National Grapefruit Month
• National Cherry Month
• National Wise Health Consumers Month
• National Eating Disorders Awareness Week (22 to 28 February)
• National Pistachio Day (February 26)
• National Sweet Potato Month

Of course, we shouldn’t forget that our dental health is closely related to our heart health. That’s why we shouldn’t forget that February is National Children’s Dental Health Month.

Finally, let us all be friends and be nice to each other next month because February is the International Friendship Month.

Heart(y) Online Webchats with Cleveland Clinic Experts for February
Once again, the country’s number one heart clinic is organizing live webchats wherein the public can ask the top heart experts questions close to their hearts. Below is February’s schedule:

• Carotid Artery Disease Wednesday, February 18, 2009 – 12 noon (EST), to be presented by Dr. Daniel Clair, Chairman, Department of Vascular Surgery.
• Cardiac Conditions & Concerns in the Student Athlete Thursday, February 19, 2009 – 12 noon (EST), will be presented by pediatric cardiologist Dr.Richard Sterba of Pediatric Institute & Children’s Hospital and Heart and Vascular Institute.
• Ask the Heart Doctor, Friday, February 20, 2009 – 12 noon (EST), to be presented by Dr. Michael Faulx, staff cardiologist at Cleveland Clinic Heart & Vascular Institute.
• Treating and Preventing Adolescent Obesity, Wednesday, February 25, 2009 – 12 noon (EST), to be presented by Dr. Ellen Rome of the Department of Adolescent Medicine Pediatric Institute and Children’s Hospital.

Photo credit: stock.xchng

---

A database of breast cancer carcinogens

Breast cancer is easily the most well-studied of all cancers. Hundreds, if not thousands of research studies have identified the many risk factors that makes a woman susceptible to breast cancer. These risks are now available in a database, with links to the supporting evidence.

The Science Review Database is a joint project of Susan G. Komen for the Cure, the Environmental Factors and Breast Cancer Science Review, and the Silent Spring Institute. It includes information on breast cancer risk factors such as diet, obesity, smoking, physical activity, and more than 216 carcinogenic chemicals. The database only takes into account environmental factors but not the genetic factors.

The carcinogens included in the database were those that were tested in animal studies and exhibited induction of tumors in the mammary glands of these animals. The current database pooled together data from other databases which are not specific for breast cancer, namely

• US National Toxicology Program (NTP)
• International Agency for Research on Cancer (IARC) Monographs
• 11th Report on Carcinogens (11th ROC)
• Carcinogenic Potency Database (CPDB)
• Chemical Carcinogenesis Research Information System (CCRIS) database

Included in the database are besides the identity and the characteristics of the chemicals are:

carcinogenic potential

ability to cause gene mutations

exposure in the general population and for women at work

other characteristics of chemical use, sources, and regulation

According to Dr. Robert Schneider, co-director of breast cancer research at New York University School of Medicine, the top three risk factors he thinks most associated with breast cancer are bisphenol A (BPA), radiation exposure from CT scans and delayed first pregnancy. Other experts would probably have other opinions on this.

However, we cannot deny that we live in an environment full of chemicals. According to the database, approximately 80,000 chemicals have been registered for commercial use in the US. So far, only about 100 of these have been identified as human carcinogens by the IARC.

Although many factors have been associated with breast cancer, Schneider said his top three would include the

The mammary carcinogen database is far from complete and data development is still ongoing.

According to Dr. Schneider

“Breast cancer is multifactorial. It would be rare for there to be a single environmental chemical that alone would be sufficient to cause an increase in breast cancer…In many cases, an increased risk of breast cancer is quite small, and we don’t yet know how each factor affects the risk of breast cancer. [Similar to a puzzle] we need to know how all of the pieces fit together, and this database begins to help us start assessing some of that.”

Photo credit: stock. xchng

---

Weight loss pills: useless or even outright dangerous

Not only are we wasting billions of dollars on “quack” weight loss products, we are actually endangering our health each time we take them. This is according to a report by a nutritional expert published in the British Journal of Medicine.

“Globally every year, obese people waste billions of pounds on food products that ‘imply’ that they aid weight loss, but are totally ineffective,” according to Professor Lean from the University of Glasgow. It is estimated that Americans spent more than $35 billion dollars on weight loss products in 2000.

However, most diet pills may not only be useless, they may actually be dangerous. This latest report warns American consumers against illegal weight loss pills coming from South America. These pills may actually contain active ingredients not declared on the labels. These ingredients, which may include amphetamines, benzodiazepines, selective serotonin reuptake inhibitors, diuretics, laxatives, thyroid hormones and other unidentified substances, may dampen the appetite but can have some serious adverse side effects. The report cites two cases of patients who learned this the hard way:

Case #1:

A 26 year-old woman suffered from intermittent chest pains, palpitations, headaches and insomnia for two years. She consulted her doctor numerous times over the two-year period for these unexplained symptoms. Her urine tested positive for amphetamines and benzodiazepines, and both fenproporex and chlordiazepoxide were present in her pills. Her symptoms disappeared after she stopped taking the imported pills.

Case #2:

A 38 year-old man tested positive for amphetamines after an occupational urine screening test and was suspended from work. Both fenproporex and fluoxetine were detected in his imported pills. While he was taking the pills he also experienced insomnia and palpitations, symptoms which disappeared after he stopped taking the pills.

In the US, amphetamine-based appetite suppressants have been banned by the FDA. However, they are easily available in many parts of the world and are sold over the Internet. Sometimes they are sold under different names, e.g. as dietary or nutritional supplements or performance enhancers.

Just this week, the US FDA warned against the use of Venom HYPERDRIVE 3.0, a dietary supplement which contains sibutramine, a compound that “can substantially increase blood pressure and heart rate (pulse), and may present a significant risk for people with a history of heart disease, heart failure, irregular heart beats or stroke.”

This is so unfair because many people are taking diet pills to loose weight in their quest to reduce their cardiovascular risks and improve their quality of life. Unfortunately, these pills actually present serious dangers to people’s cardiovascular health.

In the European Union, a new EU Directive on Unfair Commercial Practices will finally protect consumers from being tricked this way.

Photo credit: stock.xchng

---

Your marriage and your breast cancer recovery

Being diagnosed with breast cancer is one of the most devastating experiences that women may have to go through. Cancer treatment will further put them through physical and emotional distress so that these women need all the emotional support they can get to battle this deadly disease. That is why it is no surprise to know about the latest study in the US shows that marital distress may affect the chances of women of recovering from breast cancer.

This latest research shows that marriage problems may result in lower survival rate in women with breast cancer. This report was based on data from 100 breast cancer patients who were married or living with a partner at the beginning of the study and remained in the relationship for the next five years. All of these women had high and almost equal levels of cancer-related stress at the start of the study. Seventy-two of them claimed their marriages are good while 28 claimed they’re having marriage problems. The results showed women with good marriages have lesser cancer-related stress compared to women with marital problems. Women with marital problems are found to have higher stress levels, slower recovery, lesser physical activity and more symptoms and signs of illness compared to those women with good marriages. The positive effect for women with good marriages still holds true even after the researchers adjusted the participant’s cancer stage, depression levels, cancer treatments and other factors that may influence the results. This shows that improving the quality of a relationship may also improve not only the emotional well-being but also one’s health.

“The quality of the marital relationship may not be the first thing women worry about when they get a cancer diagnosis. But it may have a significant impact on how they cope physically and emotionally,” study co-author Hae-Chung Yang, a research associate in psychology at Ohio State University, said in a university news release. “Our results suggest that the increases in stress and other problems that come with a distressed marital relationship can have real health consequences and lead to poorer recovery from cancer.”

To be fair, partners-caregivers of cancer patients are also subjected to a lot of stress in taking care of their loved ones. Depending on their coping skills, this stress can cause the strain in a relationship. That is why there are support groups out there, not only for patients but for the partners as well.

Following the saying “it takes two to tango”, it takes two to make a relationship and cancer recovery within the relationship a success.

 

Photo credit: stock.xchng

---

Bleeding hearts

Have you ever seen a bleeding heart? Literary, I mean? Up till now, many of us use the term “bleeding heart” figuratively to mean “a person who is excessively sympathetic towards other people.” A real softie, in other words. It could also refer to a plant (Dicentra sp. ) with heart-shaped white flowers with a red center

But hearts really do bleed and the amount of bleeding can indicate the extent of heart damage after a heart attack.

Heart attacks or myocardial infarction in doctor speak occurs when a blood vessel (an artery) transporting blood to the heart gets blocked, cutting off blood supply to the heart muscles. The clear the blockage, metal implants called stents are inserted into the artery. However, it has been observed that bleeding in the heart muscles can occur once the heart start pumping again.

Researchers at the Medical Research Council (MRC) Clinical Sciences Centre at Imperial College London have captured images of bleeding hearts. Using magnetic resonance imaging (MRI) technology, they took images of hearts of 15 patients who suffered from heart attacks of different severity.

“Analysis of the MRI scans revealed that the amount of bleeding correlated with how much damage the heart muscle had sustained. Patients who had suffered a large heart attack, where a lot of the heart muscle was damaged, had a lot of bleeding into the heart muscle compared with those whose heart attack was relatively small.”

The significance of heart bleeding has been poorly understood. These recent findings can help doctors and researchers in figuring out the bleeding, how it can be prevented and minimize the damage to the heart muscles.

According to Medline Plus

Magnetic resonance imaging (MRI) is a non-invasive method of taking pictures of the body and the internal organs. Unlike x-rays and computed tomographic (CT) scans, which use radiation, MRI scans use magnetic fields and radio waves. Each single MRI image is called a slice. One MRI test can produce many different slices. The researchers were able to view the area of bleeding in the heart because of the magnetic effects of iron, a metal which is present in the blood.

“The researchers hope that this kind of imaging will be used alongside other tests to create a fuller picture of a patient’s condition and their chances of recovery. The research was funded by the Medical Research Council, the British Heart Foundation and the Department of Health, UK.“

Photo credit: MRC Clinical Sciences Centre at Imperial College London

---

John Updike succumbs to cancer at age 76

The two-time Pulitzer Prize winner for Fiction John Updike died on Tuesday, January 27, 2009 from lung cancer, according to Associated Press. He was 76. He is described as a “prolific man of letters and erudite chronicler of sex, divorce and other adventures in the postwar prime of the American empire.” His most famous works were the Rabbit series (Rabbit Run, Rabbit Redux, Rabbit is Rich, and Rabbit at Rest) and The Witches of Eastwick which was made into a movie and a musical play.

---

Heart drugs found in the waters of St. Lawrence River

The use of pharmacological agents has increased rapidly during the last decades. Cardiovascular diseases and cancers are the most prevalent chronic conditions in developed countries. Large amounts of chemotherapeutic drugs and medications to manage high blood pressure and elevated cholesterol levels are being used to treat patients everyday. These drugs make us feel better and keep ailments at bay but have we ever wondered where do they end up after being excreted from the body? Although drugs are taken up and metabolized by the human body, a large amount of these are excreted through the urine and the feces.And they eventually end up in our waste water that goes to the water treatment plants.

So far so good. However, how efficient is our water treatment system in filtering out these chemicals?

This was the question that researchers from the University of Montreal wanted to answer. The researchers sampled water in the St. Lawrence River downstream and upstream of the wastewater treatment plant of the city of Montreal. They checked for the presence of chemotherapy products and certain hypertension and cholesterol medications using the “rapid detection method On-line SPE-LC-MS/MS (On-line solid-phase extraction liquid chromatography coupled to polarity-switching electrospray tandem mass spectometry).” The compounds they specifically check for were

• Bezafibrate, a cholesterol-lowering rug
• Enalapril, a drug against hypertension
• Methotrexate, a chemotherapy agent
• Cyclophosphamide, also a chemotherapy agent

These four drugs are routinely prescribed in large amounts by doctors in the area.

The results of the study show that all four drugs were detected in the untreated waters upstream of the water treatment plant. However, only bezafibrate and enalapril were detected downstream in the treated waters leaving the plant. The results indicate the following:

• Large amounts of pharmacological products enter the St. Lawrence River.
• The water treatment system is efficient enough to get rid of the chemotherapy drugs but not the anti-cholesterol or anti-hypertension drugs.

The researchers, however, think that it is too early to conclude about the efficiency of water treatment in taking out chemotherapeutic compounds. It is possible that they might still be there but in very minute amounts undetectable by the current analytical methods used.

According the university press release

“This study was conducted due to the sharp rise in drug consumption over the past few years. In 1999, according to a study by IMS Health Global Services, world drug consumption amounted to $342 billion. In 2006 that figure doubled to $643 billion.”

The next questions to be answered are:

• How do these chemicals affect the aquatic environment and the plants and animals living in it?
• How much of these chemicals are present in our drinking water?

---

Thyroid cancer

In honor of the Thyroid Awareness Month of January, I’d like to touch on thyroid cancer.

About 60 million Americans are suffering from some form of thyroid disorders. Thyroid disorders are difficult to diagnose but once identified, are usually easy to manage and treat.

However, a thyroid disorder that is potentially life-threatening is thyroid cancer. Thyroid cancer is not as common as breast and lung cancers but it nevertheless presents risks especially to women older than 30 and its aggressiveness increases with age.

According to the American Thyroid Association, “thyroid cancer is the most common endocrine-related cancer… with about 20,000 new patients [diagnosed annually] annually.”

There are several types of thyroid cancers (source: American Thyroid Association), namely.

Papillary carcinoma

This is the most common type of thyroid cancer, accounting for 70 to 80% of all thyroid cancer cases. This cancer is relatively less aggressive compared to other cancer types, with prognosis as high as 100 % cure rates and long life expectancy. Metastasis is very unlikely, recurrence is common but mortality rates are very low.

Follicular carcinoma

This is the second most common cancer of the thyroid accounting for 10 to 15% of all cases. This type is more malignant than papillary carcinoma, with a higher tendency to metastasize. However, prognosis is generally good and cure rates are generally high.

Medullary thyroid cancer

This is a rare form of thyroid cancer and accounts for 5 to 10% of all cases. This type of cancer runs in families and can be diagnosed by genetic testing,

Anaplastic thyroid cancer

This is the rarest but the deadliest of all thyroid cancer types, and accounts for less than 5% of all cases. It is aggressive and doesn’t respond well to treatment. While most thyroid cancers are prevalent among women, this type occurs equally in men and women. This is the type of thyroid cancer that caused the death of U.S. Supreme Court Chief Justice William Rehnquist in 2005.

What causes thyroid cancer?

Two main causes of thyroid cancer have been identified

• Exposure to radiation
• Genetics

In many cases, however, the real cause is not well understood.

What are the symptoms of thyroid cancer?

Like most thyroid disorders, the overt symptoms of thyroid cancer are difficult to identify because of their resemblance to other disorders. However, the presence of a lump or a nodule in the thyroid should ring some alarm bells.

The initiative of the Thyroid Awareness campaign Mary Shomon of the New York Times recommends the following steps for thyroid self-examination:

• Stand in front of a mirror
• Stretch your neck back
• Swallow water
• Look for enlargement in your neck (below the Adam’s Apple, above the collar bone)
• Feel the area to confirm enlargement or bump
• If any problem is detected, see a doctor.

---

January is Thyroid Awareness Month

Millions people in the US and worldwide are suffering from one form or another of thyroid disease. And many are not even aware of it. January has been designated the Thyroid Awareness Month.

According to patient advocate Mary Shomon and New York Times author, initiator of this awareness campaign

“Millions of people have an undiagnosed thyroid problem, and don’t realize that it is the source of the other health challenges they face. Obesity, depression, fatigue, high cholesterol, infertility, low sex drive, and many other conditions are often the direct result of undiagnosed and untreated thyroid conditions.”

Thyroid disorders are very difficult to diagnose. It took months and many different tests before my doctor could diagnose my hyperthyroidism a couple of years back. The celebrity Ophra Winfrey herself suffered from thyroid problems that led her to gain 40 pounds before it was diagnosed.

For the occasion of Thyroid Awareness Month, Mary Shomon has come up with a downloadable (FREE!) e-book “Check your neck, change your life” available at the campaign site.

Women are especially at risk of having thyroid disease and it is a heritable disease. It runs in my family and has affected my mom, a niece, and recently, a nephew was even suspected (still to be confirmed) to have it.

So what does thyroid awareness have to do with heart disease and stroke?

The signs and symptoms of thyroid disorders are varied and many and can be confused with those of other diseases. However, they affect the pulse rate, blood pressure, and heart rate and can lead to heart palpitations and abnormal heart rhythms. Thyroid health is therefore closely linked to cardiovascular health. A 2008 study by researchers at the University of Pennsylvania found a link between low thyroid function and heart failure risk

Mary Shomon recommends checking your neck regularly for signs of abnormality:

1. Stand in front of a mirror
2. Stretch your neck back
3. Swallow water
4. Look for enlargement in your neck (below the Adam’s Apple, above the collar bone)
5. Feel the area to confirm enlargement or bump
6. If any problem is detected, see a doctor.

There are definitely people who have discovered their own thyroid problems after noticing a lump or swelling in the neck area. But remember that checking your neck is similar to breast self-exams, in that it’s not conclusive. So a thorough examination by a physician is always needed to diagnose or rule out thyroid disease.

Supermodel Kim Alexis is one of the many celebrities who are helping promote thyroid health awareness as you can see in this YouTube video.

So take good of your thyroid, and take good care of your heart!

---

Lymphedema: life after breast cancer

The prognosis for breast cancer treatment is getting better these days. What was once a fatal disease can now be curable. In Germany, the survival rate for breast cancer is more than 80%. But while the survival rate increases, the survivors still have to battle the side effects of the treatments. One side effect that these women have to face is “lymphedema”. Lymphedema is a condition where the lymph system is damaged due to breast cancer treatment. This is characterized by the accumulation of fluid around the breast and arms because the lymph system cannot properly regulate it. This condition can restrict movement and cause a lot of pain. This can become a chronic problem and difficult to treat. The risk of lymphedema is higher if the breast cancer treatment is more aggressive. In Germany alone, an estimated 400,000 women have lymphedema after breast cancer treatment.

“Even with many women having less aggressive breast cancer treatments, around 10 to 20% will develop lymphedema,” according to Professor Peter Sawicki, Director of German Institute for Quality and Efficiency in Health Care (IQWiG). “We doctors still underestimate the impact on patients’ quality of life of treatment adverse effects like lymphedema. The first step to prevention is using therapies that limit the damage to the woman’s lymph system.”

Lymphedema, however, can be prevented and cancer patients can have a better quality of life. The first step to avoid this is to choose less damaging treatments. This problem can be further avoided if the patients maintain an active life. It was always believed that women have to limit the use of their arm and to reduce their activity after breast cancer treatment.

Professor Sawicki said, “While women who are developing lymphedema have to protect their arms more, the blanket warnings from the past to all women with breast cancer were never based on strong scientific evidence. In fact, trials of exercise in women with breast cancer have shown that it can improve quality of life without increasing the risk of lymphedema.”

It is also important that women should know the early warning signs of lymphedema so that it can be treated early. Women who has undergone breast cancer treatment should act early if they experience the feeling of heaviness, heat and swelling in the arm in the years after treatment. Other ways of easing the discomfort of lymphedema are:

• Compression therapy with bandages or compression sleeves has also been found found to be effective in treating this problem.
•  A special massage technique called lymphatic drainage as well as physiotherapy might be able to help, but this has not been so well-studied.

---

January is US National Radon Action Month

In honor of the National Radon Action Month, I will be writing an in-depth resource post on this beginning of February. Stay tuned!

---

CVD Newswatch, January 23

Good morning. Here is your news round up for this weekend and it doesn’t include any peanut butter recalls. Happy reading.

CVD innovation watch

Sensor in artery measures blood pressure
No more 24-hour blood pressure readings with electrodes attached all over your torso. The German applied research company Fraunhofer-Gesellschaft announced an innovative technique of monitoring blood pressure. A microimplant with a diameter of 1mm is inserted into the femoral artery. The microsensor “measures the patient’s blood pressure 30 times per second. It is connected via a flexible micro-cable to a transponder unit, which is likewise implanted in the groin under the skin. This unit digitizes and encodes the data coming from the micro-sensor and transmits them to an external reading device that patients can wear like a cell phone on their belt. From there, the readings can be forwarded to a monitoring station and analyzed by the doctor.”

CVD legislation watch

Obesity tax proposal gets mixed reaction
New York State Health Commissioner Richard Daines makes his own YouTube video to campaign for the obesity tax which would place an 18% sales tax on top of prices of fattening drinks such as non-diet cola and sweetened drinks with <70% fruit juice content. The tax will supposedly help curb obesity and raise $400 million that can help out the state deficit. Another supporter is New York Governor Paterson himself. Other leglislators, however, are not as keen.

CVD employment watch

Health care among few bright spots in us employment picture
Unemployment is up, very high up, in fact. But where can we find jobs these days? The health care industry is the way to go, according to the Wall Street Journal. It seems there is a constant shortage of medical professionals especially nurses.

CVD diagnostics watch

New tool could prevent needless stents and save money
We haven’t heard the end of the stents controversy. This study published in the15 January issue of the New England Journal of Medicine says that doctors may be using too many unnecessary stents to open arteries. By using new diagnostic tool called ‘fractional flow reserve,’ or FFR, “which involves inserting a coronary pressure guidewire into the artery, doctors can measure whether blood flow is actually reduced to a dangerous level beyond any apparent narrowing.” In many cases, medication may actually be a better option than the rather invasive stent.

CVD regulatory watch

FDA issues update to safety review on cholesterol-lowering drugs
The US FDA reaffirms its recommendation of cholesterol-lowering drugs and “its position that elevated amounts of low-density lipoprotein (LDL), or “bad cholesterol,” are a risk factor for cardiovascular diseases such as heart attack, stroke and sudden death and that lowering LDL cholesterol reduces the risk of these diseases.” This comes after the regulatory body’s evaluation of the results of the ENHANCE trial.

Photo credit: stock. xchng

---

News from the cancer side, January 23

This week has been a funny combination of presidential inauguration euphoria and peanut butter alarm. Let’s hope that next week will be quieter one. Here is your cancer news for the weekend.

News from the outpatient clinics

Medication errors among adults and children with cancer in the outpatient setting.
This is definitely not the best of news but it has to be mentioned anyhow. It seems that medication errors are quite common among adult and pediatric outpatients suffering from cancer. According to a new study supported in part by AHRQ’s Centers for Education and Research on Therapeutics (CERTs) program, 7%of adults and 19% of children on chemotherapy drugs were given the wrong dosage or experienced other medication errors in outpatient clinics or at home. Talk about adding insult to injury.

News from the epidemiologists

UC Davis study links smoking with most male cancer deaths
An epidemiological analysis by researchers at the University of California Davis reported that more than 70% of the cancer death burden among the male population of the state of Massachusetts in 2003 is linked to tobacco smoking. This is much higher than the previous estimate of 34% in 2001. The new estimate takes second hand smoke into account as well. According to lead author Bruce Leistikow
“This study provides support for the growing understanding among researchers that smoking is a cause of many more cancer deaths besides lung cancer…The full impacts of tobacco smoke, including secondhand smoke, have been overlooked in the rush to examine such potential cancer factors as diet and environmental contaminants. As it turns out, much of the answer was probably smoking all along.”

News from the consumers

More americans skipping necessary prescriptions, group says
These are tough times and many people really have it hard. The New York Times report that more and more Americans are going without prescription drugs for lack of funds. The article was based on a survey by the Center for Studying Health System Change in Washington, D.C., which reported that “since 2003…one in 10 people under 65 went without a prescription drug because they couldn’t afford it.” Many people are on prescription drugs because of chronic conditions. Without these drugs, their health will deteriorate. These troubling findings clearly show a need for reforms in the US healthcare systems.

News from the regulators

FDA not effectively monitoring investigator conflicts of interest, HHS watchdog says
One government health agency reprimanding another. A report from the Department of Health and Human Services (HHS) accuses the US FDA of not effectively regulating conflicts of interests in relation to clinical trials of drugs. There have been several scandals in relation to monetary compensation of clinical trial investigators by pharmaceutical companies, a fact which can bias study results.

Photo credit: stock.xchng

---

Heart disease among Indian Asians: it’s in their genes

Several previous posts have tackled about the increased incidence of CVD in people of Indian Asian origin.

Heart disease is globally, the number one cause of mortality. However, the incidence of CVD in India has been observed to be even higher than the rest of the world. It is predicted that 60% of heart disease cases in 2010 will be diagnosed in India alone.

Indian geneticists have now found the most likely reason for this and it is called genetic mutation.  According to the study published in Nature Genetics, “1% of the world’s population carries a mutation almost guaranteed to lead to heart problems and most of these come from the Indian subcontinent, where the mutation reaches a frequency of 4%.”

The genetic mutation is a deletion of 25 letters representing amino acids in the genetic code of the heart protein gene MYBPC3. It supposedly started in the Indian subcontinent 30,000 years ago. This genetic aberration seems to be unique to people from and is found in 1 out of five member of the population. In such a culturally varied and very large population such as India’s, the mutation does not recognize caste, ethnic or religious differences. It is estimated that 60 million people in India have the mutation.

According to study leader, Kumarasamy Thangaraj from the Centre for Cellular and Molecular Biology, Hyderabad, India

“The mutation leads to the formation of an abnormal protein…Young people can degrade the abnormal protein and remain healthy, but as they get older it builds up and eventually results in the symptoms we see.”

Usually, genetic mutations which lead to death eventually “die out.” However, the MYBPC3 mutation managed to persist over thousands of years because of the late onset of symptoms, usually beyond the middle age. By the time heart disease develops overt symptoms and causes mortality, the affected individuals have already reproduced and have passed on the mutation to the next generation.

It is only very recently, with the advancement of the field of genomics that identification of genetic aberrations such as reported here is made possible.

So now that the culprit has been identified, what is the next step?

Well, that the cause is know, screening for the genetic aberration can be identified early in life so that management strategies such as a lifestyle designed to mitigate the risks, symptoms and complications can be also implemented early.

The lifetime risk of developing heart failure is roughly one in five for a person aged 40 years. Now that this mutation has been identified, there is a new glimmer of hope for some of them. The mutation’s effects vary a lot from person to person. Carriers could be identified at a young age by genetic screening and adopt a healthier lifestyle.

 

 Phot credit: stock.xchng

---

Is skin cancer on the rise?

The incidence of skin cancer is increasing. And this increase is not only due to better screening and diagnostic techniques. The threat is real and not just an artefact of better technology, according to researchers at the Stanford University Medical Center in California.

This rise of skin cancer incidence has been reported both in the US and Europe. In the US, the increase is on average, 3.1% each year, from 1992 to 2004.

The Stanford researchers argue that improved screening methods will detect more skin tumors which are thinner and most likely to be benign, the kind that were easily missed before the new methods were introduced. However,

“after assessing 70,596 previously documented cases of cancer diagnosed between 1992 and 2004 in the United States, they found that there were significantly more cases of tumours of all thicknesses”.

Another indication of skin cancer increase is the fact that the rise is evident in all socioeconomic groups, not only among those who belong to higher income groups in the US and therefore have better access to health care and insurance coverage.

The findings of the two studies indicate that skin cancer is indeed on the rise.

Skin cancer incidence reports are quite controversial, because the disease is closely associated to exposure to the sun. In recent years, there is a rapid increase in vitamin D deficiency the world over because people tend to avoid sun exposure for fear of skin cancer. However, vitamin D deficiency has been linked to a variety to chronic conditions, including cardiovascular problems, osteoporosis, neurodegenerative disorders, as well as pregnancy complications.

According to lead researcher Eleni Linos

“Over the past 100 years, people are really changing the amount of time they spend in the sun, the clothes they wear, and whether their hobbies and work are indoor or outdoor.” This has been confounded by the thinning of the ozone layer which led to “increased exposure to ultraviolet light or a longer-term increase in the genetic susceptibility to cancer.”

According to the Medline Medical Encyclopedia,

Skin cancer is the most common form of cancer in the United States. The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, neck, hands and arms. Another type of skin cancer, melanoma, is more dangerous but less common.

• skin cancer commonly occurs in people who
• have light-colored skin, hair and eyes
• are older than 50 years old
• family history of skin cancer
• spend a lot of time outdoors in the sun.

Photo credit: stock. xchng

---

Information On Rheumatoid Arthritis Focuses On Treatment

One of the causes of arthritis is an autoimmune disease that causes the body to go into a self-preservation mode and attack healthy tissues, believing they are a threat to its well-being. While there is no known exact cause of autoimmune deficiencies, information on rheumatoid arthritis points out that some environmental factors may be involved. It is also thought that viruses, bacteria or fungus has some role in its development, information on rheumatoid arthritis targets the treatment more than the cause.

Unlike osteoarthritis, which generally affects older people as a degenerative disease, information on rheumatoid arthritis points out this disease can attack not only the cartilage in the joints, but also the bone structure. When pain usually associated with arthritis is experienced, it is sometimes difficult to pinpoint the exact cause of the pain, but thorough diagnosis by the doctor can determine if is a natural progression of cartilage loss or an internal strike by the body’s immune system that is causing the problem.

The repeated inflammation of bone tissue cause the pain to come and go, making diagnosis difficult. Exploratory x-rays and CAT-scans can help determine the cause. Additionally, information on rheumatoid arthritis suggests that the degeneration it causes is symmetrical, meaning if one hand is affected, the same effect will be experienced in the other hand as well.

No Known Cure For Rheumatoid Arthritis

There is no known treatment to totally stop the progression of this type of infection, but many drug therapies used in the initial stages have been shown to help reduce the frequency of inflammation as well as damage to the joints and other organs. Most of the information on rheumatoid arthritis is aimed at treating the pain and stopping the spread of the inflammation and two different classes of drugs are most often used.

Anti-inflammatory drugs are often used to help reduce the pain in affected joints and to help reduce swelling. Non-steroidal Anti-inflammatory drugs are often used in place of regular aspirin due to the lower dosage requirement to achieve the same effects. Additional information on rheumatoid arthritis accepts the idea that long-term use of long-acting drugs to prevent bone deformity may also be needed.

While the first line drugs work against the inflammation and pain, these second line drugs, which can take months to show signs of working, are the prevent the crippling effects of bone deformity. Newer drug therapies work biologically to halt the progression of inflammation, and are many of the same drugs used to fight the effects of cancer.

---

Stem cell trial to treat stroke approved for start

This is the first clinical trial of its kind. And everybody is hopeful that the trial will mark a new era in stroke treatment.

British clinical researchers have just received regulatory approval and will soon be able start the first ever clinical investigation that will use brain-derived stem cells in the treatment of stroke. The treatment will involve grafting

“different doses of cultured human neural stem cells grafted into the brains of patients who have had a stroke.” It is hoped that the stem cell transplant can repair or regenerate brain cells damaged during a stroke.

The Phase I trial will initially investigate the safety of the treatment, which is normal for the different steps of conducting clinical trials. Only when the treatment has been proven to be safe, can its efficacy for the indication involved be investigated. Previous studies using stem cells didn’t have any promising results. Previously, stem cells transplants used were derived from an embryonic tumor, which raised concerns about induction of tumor development in the human brain.

The currently tested treatment uses “expanded neural stem cells” developed by the UK biotech company ReNeuron. The ReN00a stem cell therapy has been developed specifically for transplant. The cells have been isolated from human embryonic cells, and then modified by the addition of a gene that promotes cell growth. This helps them to divide in culture in the lab so they can be grown up into the vast numbers required for the trial.

According the ReNeuron:

“The trial is designed primarily to test the safety profile of ReN001 in ischaemic stroke patients at a range of cell doses, but a number of efficacy measures will also be evaluated over the course of the trial. The ReN001 cells will be administered by direct injection into the affected region of the brain in a straightforward surgical procedure. Importantly, the nature of the procedure and the characteristics of the ReN001 cells mean that the patients will not require immunosuppression following treatment, thus eliminating the safety risks typically associated with immunosuppression regimens. Patients in the trial will be monitored for one year, with longer term follow-up procedures in place thereafter.”

The trial will be conducted at the Institute of Neurological Sciences, Southern General Hospital in Glasgow and will be coordinated by the neurologist Dr. Keith Muir of the University of Glasgow. Twelve stroke patients will be the first to be enrolled in the study.

According to Dr. Muir:

“Stem cell treatment offers the potential to repair brain tissue lost as a result of stroke. We are very excited at the opportunity to undertake this, the first clinical trial involving neural stem cell therapy in stroke. At this stage, we are primarily seeking to establish the safety and feasibility of this form of treatment, and if successful, we hope that it will lead on to larger studies looking at the effects of the treatment on patient recovery.”

We are definitely crossing our fingers.

 

Photo credit: wikipedia

---

Study shows how cancer spreads

It is a common knowledge that cancer kills millions of people each year. In 2007, the American Cancer Society reported that 7.6 million people around the world died from cancer. While it is a known fact that cancer is a deadly disease, many of us do not really understand how this disease spreads inside the body leading to death.

Metastasis is a process by which cancer spreads. This involves the movement of cancer cells from the initial tumor to other parts of the body. This movement of cancer cells was initially thought to be a passive and random process. A recent study by researchers at Stanford University School of Medicine has shed some light on how cancer spreads.

Senior author Dr Amato Giaccia, professor of radiation oncology at Stanford, revealed: “Metastasis is not a passive process. Cells don’t just break off the primary tumour and lodge someplace else. Instead the cells actually secrete substances to precondition target tissue and make it more amenable to subsequent invasion.”

The report of Dr. Giccia and his colleagues is based on the series of experiments on mice to understand how cancer spreads. These researchers discovered that a protein called lysyl oxidase (LOX) which normally helps to strengthen connective tissues is involved in metastasis. It seems that the tumors are using LOX to help prepare other parts of the body to be invaded by cancer cells. They found that when LOX is absent in the body, bone-marrow derived cells that is involved in metastasis are prevented from moving to a site where cancer can spread. When LOX is present, however, specialized white blood cells accumulated in the lungs of the mice and a protein that breaks down collagen is produced so that cancer cells can invade the normal tissue. Therefore, if LOX production in mice is prevented, the spread of cancer is also reduced.

The researchers hope that if these series of events are blocked, it may be possible to stop cancer cells from migrating to other parts of the body and prevent metastatic cancer.

Dr Julie Sharp, Cancer Research UK’s science information manager, said: “A better understanding of how cancer spreads is crucial to improving the treatment of the disease. This research takes scientists a step closer to understanding this major problem – the next stage will be to find out if the LOX protein can be switched off to stop cancer spreading.”

According to a recent World Health Organization (WHO) report, cancer will soon overtake cardiovascular disease as the world’s top killer. While cancer rates are down in developing countries like the US, global death rate due to cancer is on the rise. This year, the number of cancer cases is expected to reach 12 million and 7 million of these will result in death. By 2010, it will be the world’s leading cause of death. By 2030, the number of cases may be almost triple.

Photo credit: stock. xchng

---

The anti-cancer properties of black raspberry

We eat different kinds of fruits and vegetables everyday but we don’t realize that some of these actually contain special compounds that can potentially cure deadly diseases like cancer. A paper in the recent issue of Cancer Prevention Research, a journal of the American Association for Cancer Research just reported that anthocyanins from black raspberries have anticancer properties. Anthocyanins are flavonoid compounds that are responsible for dark (red, purple or blue pigments) in the leaves, stems, roots, flowers and fruits of plants.

The report is based on the research from Ohio State Comprehensive Cancer Center where they have been testing the effects of anthocyanins from black raspberries on lab rats. The research was led by Dr. Gary Stoner, a professor in the department of internal medicine at Ohio State University. Stoner and his colleagues fed whole black raspberries and the fruit extracts containing high amount of anthocyanins on rats with esophageal cancer. The results showed that both the anthocynanin-rich extracts and the whole raspberry fruits containing similar amount of anthocyanins are effective in preventing esophageal cancer in rats. They discovered that these anthocyanins can inhibit the growth of cancer cells as well as make the cancer cells commit suicide.

Aside from the fruit extracts, Stoner and his colleagues also conducted clinical trials using whole berry powder. These trials also gave promising results but patients are required to take up to 60 grams of powder per day.

“Now that we know the anthocyanins in berries are almost as active as whole berries themselves, we hope to be able to prevent cancer in humans using a standardized mixture of anthocyanins. The goal is to potentially replace whole berry powder with its active components and then figure out better ways to deliver these components to tissues, to increase their uptake and effectiveness. Ultimately, we hope to test the anthocyanins for effectiveness in multiple organ sites in humans,” said Stoner.

Black raspberries belong to the rose family, genus Rubus. Two species, R. leucodermis and R. occidentalis are commonly known as black raspberries. They are said to be one of the richest berries in terms of anthocyanin content. Previous studies have already indicated the potential of black raspberries in cancer therapy. A 2006 trial reported positive effects in patients with Barrett’s esophagus, a pre-malignant for of esophageal cancer.

According to Dr. Stoner

“The National Cancer Institute recommends that every American eat at least four to six helpings of fruit and vegetables each day. We suggest that one of these helpings be berries of some sort… a daily diet of about 1.4 to 2 cups of fresh berries may be ideal for staving off certain types of cancer.”

Photo credit: oregonberry.com

Next Page »