October 30, 2006, 5:23 PM CT

Breast Cancer Survivors Face Higher Suicide Rates

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

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

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

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

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

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October 27, 2006, 5:16 AM CT

linking ethnic identity to breast cancer genes

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

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

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

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October 27, 2006, 5:09 AM CT

Videoconferencing In Pediatric Oncology

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

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

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

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October 22, 2006, 11:23 PM CT

Choosing Chemotherapy Using Genomics

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

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

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

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

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

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October 22, 2006, 8:40 PM CT

How To Seal DNA Breaks

Researchers investigating an important DNA-repair enzyme now have a better picture of the final steps of a process that glues together, or ligates, the ends of DNA strands to restore the double helix.

The enzyme, DNA ligase, repairs the millions of DNA breaks generated during the normal course of a cell's life, for example, linking together the abundant DNA fragments formed during replication of the genetic material in dividing cells.

"Our study shows that DNA ligase switches from an open, extended shape to a closed, circular shape as it joins DNA strands together," says the study's senior author Tom Ellenberger, D.V.M, Ph.D., the Raymond H. Wittcoff Professor and head of the Department of Biochemistry and Molecular Biophysics at Washington University School of Medicine in St. Louis. "The ligase resembles a wristwatch that latches around the DNA ends that are being joined".

DNA is surprisingly reactive and under continuous assault from environmental toxins and reactive cellular metabolites. A means of repairing DNA damage is vital to maintaining the integrity of the genetic blueprint.

When these repair processes go awry, cells can malfunction, die or become malignant, so scientists would like to know how "DNA mechanics" do their jobs. DNA ligases are attractive targets for the chemotherapy of cancer and other diseases.........

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October 19, 2006, 8:47 PM CT

Targeted Tumor Therapy

Targeted tumor treatment lobs toxic payloads directly into tumors to destroy cancer cells while leaving normal cells unharmed. In the case of radiotherapy, these missiles, which should unerringly home in on the target and make it implode, consist of radioactive bullets guided by small molecules--known as agonists--that recognize and then activate specific receptors over-expressed on the surface of tumor cells.

But a team including scientists at the Salk Institute for Biological Studies and collaborators in Switzerland now shows that it may be better to exploit small molecules that antagonize rather than activate receptors. Those findings are published in this week's Early Online Edition of the Proceedings of the National Academy of Sciences.

"Our findings mark a paradigm shift," says Jean Rivier, a professor in the Clayton Foundation Laboratories for Peptide Biology at the Salk. "In the past, radiolabeled antagonists were never considered for targeted cancer treatment since they don't trigger the internalization of the receptor/ligand complex, which was believed to be the critical step towards accumulation of the payload. But we observed that antagonists have other properties that may considerably improve the sensitivity of diagnostic procedures and improve the efficacy of receptor-mediated radiotherapy," he adds.........

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October 18, 2006, 10:39 PM CT

Cancer Stem Cells Linked To Radiation Resistance

Certain types of brain cancer cells, called cancer stem cells, help brain tumors to buffer themselves against radiation therapy by activating a "repair switch" that enables them to continue to grow unchecked, scientists at Duke University Medical Center have found.

The scientists also identified a method that appears to block the cells' ability to activate the repair switch following radiation therapy. This finding may lead to the development of therapies for overcoming radiation resistance in brain cancer as well as other types of cancer, the scientists said.

Working with animal and cell culture models, the scientists observed that a specific cellular process called the "DNA damage checkpoint response" appears to enable cancer stem cells to survive exposure to radiation and to switch on a signal to automatically repair any damage caused to their DNA.

"In recent years, people have hypothesized that cancer stem cells are responsible for the resistance of cancerous tumors to radiation therapy," said Jeremy Rich, M.D., senior investigator of the study and an associate professor of neurology at Duke. "We have shown, for the first time, that this is indeed the case".

The findings appear Oct. 18, 2006, in the advance online edition of the journal Nature. The research was supported by the National Institutes of Health and many philanthropic organizations [complete list below].........

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October 17, 2006, 9:49 PM CT

Regular Exercise Keeps Breast-cancer Away

Postmenopausal women who want to significantly decrease their breast-cancer risk would be wise to exercise regularly and keep their weight within a normal range for their height, according to new findings from the Women's Health Initiative would be published in the journal Obesity.

The multicenter team of researchers, led by Anne McTiernan, M.D., Ph.D., of Fred Hutchinson Cancer Research Center, found that women who had the lowest body-mass index, or BMI, and the highest physical-activity levels had the lowest levels of circulating estrogens, sex hormones that can fuel breast-cancer growth.

Specifically, they found a significant decrease in the two most common, biologically active forms of estrogen, estrone and estradiol, among the most active, lean women studied. The researchers found that women with high BMI and low physical-activity had mean estrogen concentrations that were 50 percent to 100 percent higher than that of women with low BMI and high activity levels.

"Women with high levels of estrogens have a two-to-four-times-higher risk of breast cancer than women with very low levels," said McTiernan, a member of the Hutchinson Center's Public Health Sciences Division and co-investigator of the Women's Health Initiative Clinical Coordinating Center, which is based at the Center. "If a woman can keep her own natural estrogens lower after menopause, it is probably going to be beneficial in terms of reducing her risk of breast cancer".........

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October 17, 2006, 4:43 AM CT

New Hope For Children With Leukemia

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

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

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

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

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October 15, 2006, 7:32 PM CT

Novel Therapy For Prostate Cancer

A team of University of Iowa Health Care scientists has launched an important clinical trial of a novel therapeutic that may eventually lead to new therapys for men diagnosed with prostate cancer.

The Ad5-TRAIL gene treatment for prostate cancer research trial is a Phase I study designed to test the optimal dosage at which the therapeutic agent can safely be given to patients.

The clinical study is being co-led by Thomas Griffith, Ph.D., (photo, left) an associate professor in the Department of Urology, and Richard Williams, M.D., the Rubin H. Flocks Chair in Urology and professor and head of the UI Department of Urology.

"This is the first use of this type of anti-cancer agent which was developed at the University of Iowa. This new gene treatment may help us successfully manage patients with high-risk prostate cancer," Griffith said. "Ideally, we hope to be able to say at the conclusion of this trial that this novel agent is safe and performs as intended by causing the death of prostate tumor cells with no harm to normal cells. However, being at the initial stages of the trial, it is premature to make any claims until the data is analyzed".

Scientists injected the investigational therapeutic into the malignant prostates of three patients. Then, following a 10-day waiting period, surgeons removed the prostates and are evaluating the results.........

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