Breast Cancer Blog: From Medicineworld.org
Do you read all of the blogs published by medicineworld.org? Many of our bloggers are busy keeping you updated on the various health related topics. We publish the following blogs at this time.
Cancer blog: I manage the cancer blog with lots of help and support form other bloggers. Through this cancer blog my friends and I try to bring stories of hope for patients with cancer. The cancer blog often republishes important blog posts from other cancer related blogs at Medicineworld.org. If you are searching for a blog that covers wide variety of cancer topics, this may be the one for you.
Breast cancer blog: Breast cancer blog is run by Emily and other bloggers and they bring you the latest stories, news and events that are related to breast cancer. Increasing awareness about breast cancer among women and in the general population is the main goal of this breast cancer blog.
Lung cancer blog: Lung cancer blog is managed by Scott with the help of other bloggers. Through this blog Scott and his friends constantly remind the readers about the dangers of smoking. It's a never-ending struggle against this miserable disease with which a social stigma of smoking is associated.
Colon cancer blog: Colon cancer blog is run by Sue and other bloggers. Sue brings a personal touch to the colon cancer blog since her mother died of colon cancer few years ago. She writes about stories, research news and advances in treatment related to colon cancer.
Prostate cancer blog: Prostate cancer is the most common cancer among American men. American Cancer Society estimates that over 230,000 new cases of prostate cancer occur in the United state every year. This important blog about prostate cancer is run by Mark and other bloggers. This blog brings news, stories, and other personal observations related to prostate cancer.
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Facts and figurers published today show the full extent of the problem facing Scottish women. The longest delay was at Aberdeen Royal Infirmary, where a woman referred for urgent care by her GP waited 276 days or nearly 40 weeks before treatment. At three other hospitals, patients waited for four months or more for starting treatment.
Charity Breast cancer organizations are expressing concern regarding this huge delay in starting breast cancer treatment. Lorraine Dallas, head of the charity Breast Cancer Care Scotland, said: "These apparently huge variations in the time that patients with urgent referrals are being forced to wait for treatment in Scotland are simply unacceptable.
The article does not give details to know that these patients had early stage breast cancer or metastatic breast cancer. While a delay of nine months of treatment for metastatic breast cancer could be criminal, a delay of nine months treatment in early stage breast cancer could be nothing less than gross neglect. Early stage breast cancer patients should be started on adjuvant treatment within one to two months of completing surgery.
While socialized medicine has its benefits, but it brings with it long and sometimes unacceptably prolonged waiting for essential medical treatment. The Scotland government has to wake up from slumber and act to lessen the miseries of these unfortunate women who have been diagnosed with breast cancer.
This morning I was reading a new study, which showed that persisting fatigue after chemotherapy is rare. In this study only one in five women showed persistent fatigue after chemotherapy, regardless of the type of chemotherapy used. Some of these women had received regular chemotherapy while some other had received high dose chemotherapy.
This study comes from Dr. Elisabeth G. E. de Vries and colleagues at University Medical Center Groningen, the Netherlands. They evaluated the effects of standard and high dose chemotherapy on factors such as fatigue, and hemoglobin level in 403 women who were disease free after treatment. These women were evaluated at four different time periods.
More than 60 percent of women did not complain of any fatigue during the four follow up points, while only 3 percent reported fatigue at all four points. Twenty percent of women have reported fatigue once during the follow up.
The mean hemoglobin level was slightly low in women who received high dose chemotherapy compared to women who received standard dose chemotherapy, but there was no correlation between hemoglobin level and fatigue.
The idea is this: you can download a small program and install it on your computer and then forget about it. The researchers would use that extra computing power on your computer, to expand the capabilities of their super computer.
The report says that, modern computers are incredibly powerful machines whose processing abilities are seldom used to their full abilities. Regardless of how hard you push it, you're probably not using as much of the computer's power as you think.
Is it safe, that's the next question?
With widespread reports of Internet virus attacks, worms, Trojan horses, spyware and identity theft, some might fear that participating in a grid will make them more vulnerable to becoming a virtual victim.
"We are comfortable saying that on any computer you're willing to browse, you should be comfortable putting our client on," said Armentrout of his company's grid software. "We say it's safer than surfing."
Litow said that IBM is also committed to keeping participants safe, and that in the year IBM's World Community Grid has been in existence - a network of humanitarian grid projects - there hasn't been a single problem.
You may read the whole story here
To come to this conclusion, researchers analyzed 78 clinical trials in a process called meta-analysis and showed that use of post-operative radiation therapy decreases five year recurrence rate of breast cancer from 26 percent to 7 percent. The researchers also demonstrated for the first time a survival advantage with post-operative radiation therapy by showing the odds of dying from the disease decreases from 36 percent to 31 percent with the use of radiation therapy.
Patients who had mastectomy, also benefited from post-operative radiation therapy. Radiation therapy is usually given to patients with mastectomy only if they are high risk of recurrence of breast cancer due to involvement of multiple lymph nodes.
"This study provides the first really definite evidence that, for women who've had breast-conserving surgery and for women whose cancer has spread to the armpit, radiotherapy reduces the long-term risk of dying from the disease," said Dr Richard Peto, a co-author of the report.
These research findings appeared in the latest issue of the medical journal Lancet.
Researchers reviewed data from more than 68,000 women to come to this conclusion. The found that those who consumed at least two servings of mostly low-fat dairy products a day had up to a 20 percent less risk of postmenopausal breast cancer than women who ate the least amount of dairy products.
"Our findings suggest that dairy products, composed mainly of low-fat sources, or some component within these foods are associated with a small but significantly lower risk of breast cancer in postmenopausal women," study leader Marji McCullough, a senior epidemiologist with the American Cancer Society, said in a prepared statement.
"Work is still needed to more clearly identify what may be the responsible factors. And while we controlled to the best of our ability for other possible explanations, it's certainly possible women who consume low-fat dairy products have other health-related behaviors that could also lower the risk," McCullough said.
She also cautioned women to be careful about how they interpret the study's findings.
"It is important to keep in mind that some dairy products, like whole milk and many types of cheese, have a lot of saturated fat, which we know can increase the risk of heart disease and possibly other cancers. Also, many diary products have growth factors such as insulin-like growth factor I, which have been shown to promote breast cancer cell growth," McCullough said.
This result came as a part of a new analysis of the placebo arm of the MA-17 trial, which was designed to see if women benefits from additional 5 years of treatment after completion of 5 years of tamoxifen. As a part of the study about half of patients received placebo and other half received the drug Femara.
In 2003, results of an interim analysis showed that Femara reduced the risk of breast cancer recurrence by 42 per cent compared to placebo. These data prompted unblinding of the study. Since then, approximately 1,655 women talking placebo have chosen to switch to Femara, while another 613 women did not pursue further treatment.
These women with hormone-sensitive early breast cancer who switched to Femara (letrozole) from placebo as discussed above experienced a 69 per cent reduction in the risk of recurrence. There also was a 72 per cent reduction in the risk of developing metastatic disease. This was also associated with a A 47 per cent reduction in the risk of dying from breast cancer.
The analysis represents the first time that an aromatase inhibitor has demonstrated a benefit in starting therapy up to five years after the end of a patient taking tamoxifen, another medicine used in the treatment of hormone-related breast cancers, claims a Novartis release.
This data provides evidence for the first time that women with breast cancer can benefit from Femara even years after the completion of tamoxifen therapy. This finding may have significant impact on the overall treatment outcomes for postmenopausal women with early breast cancer.
Introgen Therapeutics updated its phase 2 trial evaluating Advexin combined with neoadjuvant (pre-operative) chemotherapy and surgery in women with locally advanced breast cancer. After 35 months of follow-up, 92 per cent of the treated patients are alive and 83 per cent have survived without evidence of disease recurrence.
All the patients participated in the study showed an average 80 per cent reduction in tumor size. Following tumor shrinkage, complete tumor removal by subsequent surgery was achieved in 100 per cent of the patients. The results of the therapy with the addition of Advexin are better than what would be expected from neoadjuvant chemotherapy treatment alone, claims a company release.
Neoadjuvant treatments are administered prior to surgery and represent a novel and increasingly applied approach to make surgical tumour resections either more complete improving outcomes or less invasive facilitating breast conservation.
The company says the data is very encouraging, and suggest that Advexin may be combined with neoadjuvant chemotherapy to improve patient outcomes by reducing tumor size thereby permitting complete surgical tumor removal. The results of this study indicate that Advexin may enhance the clinical benefit of chemotherapies without increasing their toxicity and support clinical applications of Advexin in earlier phases of cancer treatment.
Company representatives state that prior preclinical and clinical studies indicate that Advexin interacts synergistically with many standard anti-cancer therapies and it is not surprising to find that the combination of Advexin with chemotherapy in these patients is generating encouraging results.
Introgen has received FDA fast track designation for Advexin therapy and Advexin has been designated as an orphan drug for the treatment of head and neck cancer under the Orphan Drug Act.
The main concern with the herceptin treatment is the heart muscle toxicity, inherent to herceptin, with about 5 to 10 percent of patients receiving herceptin developing heart muscle problems. This has triggered an FDA warning regarding the use of caution with this drug.
Herceptin is a wonderful drug, but it has to be handled with care. The recent San Antonio Breast Cancer Symposium (SABCS) has given a boost to the drug, by demonstrating that, giving a shorter duration of herceptin can maintain benefits but minimizes toxicity to heart muscle. Shorter duration of herceptin would also drastically cut down the huge amount of dollar price tag associated with herceptin treatment.
This new research finding is from Finland researchers, who said that nine weeks of Herceptin instead of the usual year prevented recurrences and didn't raise the risk of heart failure.
They make a convincing case for using Herceptin earlier in breast cancer treatment, said Dr. Robert Carlson, a Stanford University breast cancer expert who had no role in the studies.
''The jury is in and the jury has a very strong verdict'' - that virtually all women whose tumors are the type targeted by Herceptin should get the drug, he said.
I don't know how much these four treatments of chemotherapy may have helped her. When you are having a tumor size of 1 centimeter, your risk of return of cancer in the next 10 years is only about 15 percent. Hormonal therapy gives very good protection in this setting and may cut down your risk of recurrence of breast cancer to about 10 percent. If you use chemotherapy and hormonal therapy combined, your may expect the risk of recurrence may be reduced to about 8 percent. (These values were calculated using an online breast cancer risk calculator). So my question is what are you gaining with addition of chemotherapy? Just a 2 percent reduction of recurrence of breast cancer? What about the risks and hassles associated with the chemotherapy? What about 1 in 500 chance of developing leukemia after the chemotherapy?
Don't quote me wrong, women with larger tumors, and or lymph node involvement would definitely benefit from chemotherapy. Also women who have hormone negative tumor may not have the luxury of hormonal treatment and may best undergo chemotherapy.
These thoughts were reflected in the recent San Antonio Breast Cancer Symposium (SABCS). Guidelines recently adopted in Europe and similar ones unveiled this weekend at SABCS will result in far fewer women getting chemotherapy in the future.
The new advice calls for choosing a treatment based on each woman's particular type of tumor. Under these new rules, hormone status becomes the single most important factor in choosing treatment.
New research has found that tamoxifen, which is usually used for the treatment of breast cancer, decreases the rate of skeletal maturation in boys giving them time to attain higher final body height. These research findings were reported in the in a recent issue of the medical journal Pediatrics.
The lead investigator of the study Dr. Nerissa C. Kreher spoke about the potential uses of this new finding, and suggested that this new finding may lead to more investigations in this regard and may finally lead to use of tamoxifen to actually treat young boys, who have short stature.
Kreher and colleagues at Indiana University School of Medicine, Indianapolis, have previously noted that, the use of tamoxifen leads to considerable decrease in skeletal maturation in girls with certain conditions affecting their growth. However, no reports have been made if it works in short boys as well.
In order to investigate this, the researchers reviewed medical charts of seven boys with an average age of 15 years. The rate of skeletal maturation was determined by dividing the change in bone age by the change in chronological age. It was found that the rate of skeletal maturation was significantly decreased and the predicted adult height was increased by the use of tamoxifen.
I was wondering when does the bonding with the baby occur? Is it at the time of conception or more closer to the birth of the baby? I don't know the answer to this question.
I was thinking all about these when I was reading a remarkable piece of news form Britain. A British-based Filipina mother who found out she had cancer after becoming pregnant sacrificed her life for her unborn baby by refusing an abortion and chemotherapy as per reports.
Bernadette Mimura - known as Milai - sacrificed her own precious life avoiding the potentially life-saving treatment for breast cancer because doctors told her it would kill the child.
The 37-year-old, who lived near Stockton-on-Tees, northeast England, with her British partner, Adam Taylor, survived long enough to see the birth of their son, Nathan.
But soon after seeing him baptised, she was transferred to a hospice and died about a week later.
Priest Alan Sheridan, who performed the baptism, told, "Bernadette said the most important thing was the birth of her baby and she would not do anything to harm him".
Aromatase inhibitors like Arimidex is superior to tamoxifen and more women are taking aromatase inhibitors compared to tamoxifen, but if you are on tamoxifen for any reason then switching to arimidex may improve your chance of living longer.
This is the first study that showed aromatase inhibitors could save lives, not just delay the recurrence of disease. Women in the study were switched to arimidex after two to three years of tamoxifen and this has resulted significant improvement in lives of these women.
Researcher Dr. Walter Jonat and colleagues of the University of Kiel in Germany combined information from three large European studies on Arimidex and found that women who were switched to it after several years of tamoxifen were 29 percent more likely to be alive 2 1/2 years later.
About 4.5 percent of women who continued on tamoxifen died, compared with only 3.3 percent of those who switched to Arimidex. More than 3,800 women were included in the analysis. Women who switched from tamoxifen to arimidex also had a 41 percent lower risk of having cancer again.
Aromatase inhibitors are useful only in post-menopausal women.
A researcher from Israel has developed a technology, using which you can turn your mobile phone to a breast cancer detection tool. This is done by simply installing a new software and adding an inexpensive infrared camera. The developer of this new technique says that this is highly effective technique to detect breast tumors, and claim that this is much superior to the routine self-breast examination women usually perform monthly.
The image obtained from the breast scan can be immediately transferred to a medical facility, where it can be analyzed for presence of abnormalities.
The infrared cameras used for this technique uses two techniques, one is to compare the temperature of the breast tissue at different parts of the breast and the other is to analyze the oxygen flow to different areas of the breast.
Israeli mobile phone company, Cellcom, is currently working to integrate the infrared sensor technology into the cameras currently built into many mobile handsets.
An Israeli psychologist has reportedly developed a radical new technology which would enable an ordinary mobile phone to diagnose breast cancer and various type of heart disease.
I agree that it is far away for this technology to replace the routine mammograms, but judging by the pace at which technology is growing, it won't be too much time before this or a similar convenient technology would replace the painful mammogram.
This is actually a new approach to chemotherapy called the metronomic delivery of chemotherapy. In fact I was not familiar with this term and had to do a little research to find out what exactly is metronomic delivery.
In an article published a recent issue of the Journal of National Cancer Institute the authors call this approach as "Less is more" and go on to say that the harsh side effects and the ultimate failures of most chemotherapies have fueled broad investigation of alternatives. Dictionary meaning for the term metronomic is: "mechanically or unvaryingly regular in rhythm".
This is what I learned about metronomic delivery: when some of the chemotherapy drugs are given in frequent low doses they can exert significant lethal effects on the tumor cells by inhibiting new blood vessel formation, known as angiogenesis. Needless to say that this is an experimental approach to chemotherapy.
I had a reason to research on this new term. I was reading about a new study from Dana-Farber Cancer Center in Boston in which a combination of metronomic doses of chemotherapy and avastin (a new drug that blocks the formation of new blood vessels) showed some promising results in patients with advanced breast cancer. This combination looks very rational because both are targeting the tumor angiogenesis.
This was a small pilot study in which 55 women participated. In this new strategy, avastin plus metronomic delivery of chemotherapy delayed breast cancer progression by an average of 5.5 months, compared to two months in those who received only the metronomic chemotherapy.
I am not suggesting this is a ground breaking study, but it illuminates the point that researchers are working hard to bring innovations to the treatment approach to breast cancer.
As I was taking my breakfast this morning, thinking about the topic for today, this news item about increased risk of other cancers in women who have been diagnosed with breast cancer came to my attention. It is not a surprising finding, given the fact that these women are subjected to the double torments of chemotherapy and radiation. Also it is possible that these women are genetically susceptible to other cancers in addition to breast cancer. Women who are carriers of BRCA mutations have increased risk of a host of other cancers including ovarian cancer. As I have written in one of my previous blogs, one in about 500 women who received chemotherapy for breast cancer may develop leukemia.
The study I am talking about is a huge Danish study, involving 525,527 patients with breast cancer in 13 cancer registries in Europe, Canada, Australia and Singapore.
This study found an almost 6-fold increase in the risk of developing cancers of the connective tissue of the thorax and upper limbs, suggesting toxic effects from past radiation. Incidence of leukemia was higher, and so was the risk of endometrial cancer. While it is known that tamoxifen increases risk of endometrial cancer, the current study suggests that the increased incidence may not be entirely related to tamoxifen, because this risk was high even before 1975, when tamoxifen was rarely used.
Colorectal, kidney and postmenopausal breast cancer appear to share obesity as a risk factor, while ovarian cancer and breast cancer seem to have a genetic predisposition in common. The study found an excess of ovarian cancer already within one year of breast cancer diagnosis, along with an increased risk of breast cancer after ovarian cancer.
A little while ago some smart researchers like Larry Norton from Memorial Sloan-Kettering Cancer Center in New York and his colleagues developed a strategy to reduce the frequency of treatment from once in three weeks to once in two weeks. They thought, if the patient is subjected to chemotherapy once in two weeks this would probably mean hitting the cancer cells harder when they are more vulnerable. These researchers developed a clinical trial in which the chemotherapy was administered once every two weeks instead of three weeks. They used white cell growth factor known as neupogen (filgrastim) to stimulate the white cells so that they recover in two weeks leaving the cancer cells susceptible to the effects of chemotherapy. What a smart idea?
These researchers used three drugs for the treatment (adriamycin, cyclophosphamide, and taxol) and this regimen is now known as dose dense chemotherapy. After all, the gut feeling of these researchers proved to be right. The dose dense regimen showed improved survival. More surprising was the finding that once in two weeks chemotherapy caused fewer side effects compared to once in three weeks chemotherapy. Do you know why? Use of the white cell growth factor decreased the risks associated with low white cell count. The rest is history, dose dense chemotherapy has become a standard practice in the United States for patients with node positive breast cancer.
This is past story, now a group of Italian researchers were trying to duplicate the results of this study, and found no improvement in survival for dose dense regimen. However they found that once in two weeks chemotherapy was associated with minimal side effects.
There were some limitations in direct comparison of these two studies. The Italian researches used a different chemotherapy combination. The study was designed to look for 32 percent or more improvement in survival, and trial did not attain its planned enrolment and was stopped prematurely. These factors make the direct comparison of these two studies difficult, but I would agree that more studies are needed to resolve the issue.
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Image of MRI courtesy of UC San FranciscoThis morning I was reading a news story from the Duke Medical center. The writer was talking about a 56-year-old woman. She had a mammogram and passed with flying colors. Just two weeks later she noticed a lump in her breast and undergone an MRI of the breast, which demonstrated glaring mass the size of a walnut and it was cancer.
Then naturally we all may think, why don't everyone get screening with MRI of the breast rather than with mammogram. There are several reasons why this is not a good idea.
Both mammogram and MRI may have its strengths and weakness. Where one fail the other prevails. Thinking about the cost involved, MRI is ten times more costly compared to the regular mammogram. Even with this high price tag it may fail to show those tiny specs of calcifications, which may be the harbingers of breast cancer.
Mammogram may fail in some women, especially in cases where the woman have dense breasts. Dense breasts with tightly packed cells can block the X-rays from distinguishing a cancer mass from other packed cells.
Given the pluses and minuses associated with these two modalities of breast cancer screening, the task is to determine who will benefit from mammogram and who will need an MRI of the breast. It is best to use these techniques complimenting each other.
African American women tend to have denser breasts and may be best screened using MRI, but doctors say there is not much information available from clinical trials to prove this fact. All African American women who have high risk factors for breast cancer should have access to MRI of the breast. Given this fact, insurance companies may not be willing to pay for an MRI citing lack of evidence to the added benefit of MRI screening.
Now researchers from Fox Chase Cancer Center In Philadelphia say that the same estrogen, which may be responsible for initiation of breast cancer, can be used to kill the breast cancer cells. These researchers uncovered new details about how estrogen can activate natural pathways. that kill certain breast cancer cells or tumors. The results raise the possibility that estrogen therapy may overcome resistance to certain breast cancer hormonal therapies. The study appears in the December 7 issue of the Journal of the National Cancer Institute.
Many breast cancer cells require estrogen for survival, and death of such cells can be induced with treatments that block estrogen, such as tamoxifen, fulvestrant, or aromatase inhibitors. When such treatments drain even the last drop of estrogen some of the breast cancer cells adapt to survival in an environment that is lacking estrogen. To best adapt to the environment these cells may lose its ability to live in the presence of estrogen. Paradoxically these cells may undergo rapid death when exposed to estrogen.
This new finding has important implications to breast cancer patients. When a woman who is using aromatase inhibitors like arimidex or femara fail on these drugs due to development of resistance, a strategy of treatment with estrogen may be developed to overcome the resistance and to kill these resistant breast cancer cells.
Many of the important developments in the breast cancer are first presented in this meeting. Superiority of arimidex over tamoxifen was first presented in this meeting about five years ago. This meeting continues to attract national and international breast cancer researchers.
I do not know what's the breaking news in breast cancer from this conference this year. More information would be available in the next few days as we move along the meeting and the plenary session.
I was reading about this gene therapy related study that would be presented in the San Antonio Breast Cancer Symposium and it discusses the benefits of a new gene based drug called Advexin. Researchers say that this drug reduces the breast cancer tumor size by 80 percent. The drug was used prior to surgery in combination with chemotherapy. This treatment has given the option of lumpectomy for many patients with large tumors, for whom lumpectomy was not possible prior to the treatment with the drug Advexin. Patients who had large tumors with an average size of 8 centimeters showed shrinkage to an average size of 1.78 centimeters. The tumor in the lymph nodes also decreased with the treatment.
Advexin uses a viral agent to supply p53 genes in very high concentrations to kill cancer cells. These exciting findings will be presented by Dr. Massimo Cristofanilli, from M. D. Anderson Cancer Center.
"We have a clear evidence of a double-acting mechanism of gene therapy, something that has not been seen before in patients treated with only chemotherapy," Cristofanilli comments.
Every year, more than 200,000 women are diagnosed with breast cancer in the United States. Breast cancer ranks second as the leading cause of cancer deaths in American women. Until recently breast cancer topped the list of leading causes of cancer deaths in women, but lately lung cancer has claimed the top position. If skin cancer is excluded, breast cancer is the commonest cancer among American women.
Breast Cancer Blog: From Medicineworld.org
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