February 16, 2009, 9:28 PM CT
Breast MRI to supplement standard imaging
Updated guidelines for physicians that represent best practices for using magnetic resonance imaging (MRI) to newly diagnose breast cancer and to make therapy decisions for breast cancer were published recently in the Journal of the National Comprehensive Cancer Network
Breast radiologists and surgeons at the Seattle Cancer Care Alliance (SCCA) and the Roswell Park Cancer Institute in Buffalo, N.Y. authored the paper upon which the guidelines are based.
The SCCA breast imaging program led by Connie Lehman, M.D., has established itself as a national leader in breast MRI based on pioneering research it has reported in the past few years. Lehman is corresponding author of today's journal paper, "Indications for Breast MRI in the Patient with Newly Diagnosed Breast Cancer." The study summarizes an extensive review of published, peer-evaluated studies.
Among the key recommendations:.
- MRI is not a substitute for screening or diagnostic mammography and, when indicated, diagnostic breast ultrasound. MRI supplements the use of these standard imaging tools in appropriately selected clinical situations.
- For women with diagnosed breast cancer, MRI provides enhanced detection in both the breast known to have cancer and the opposite, or "contralateral," breast.........
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February 16, 2009, 7:25 PM CT
Resources for off-label prescribing may be incomplete
The resources doctors use to get important information about indications and reimbursement for use of cancer drugs off-label appears to be out-of-date and incomplete, as per a research studyled by scientists in the Duke Comprehensive Cancer Center.
The study, which was funded by the Agency for Healthcare Research and Quality (AHRQ), examined compendia the online and hard copy resources that oncologists and pharmacists use when prescribing medications for diseases other than the ones for which they are FDA-approved and observed that they are sometimes unclear and do not appear to follow systematic methods to review or update evidence.
The scientists published their findings in the February 17, 2009 online issue of the journal Annals of Internal Medicine
"Oncologists and pharmacists use the compendia to guide choice of drugs for cancer patients that are not FDA-approved for use in that patient's disease an example would be bevacizumab or Avastin for brain cancer," said Amy Abernethy, M.D., an oncologist at Duke and lead investigator on the study. "Bevacizumab is approved for use in diseases such as colorectal and lung cancer; it is not FDA-approved for brain tumors, but we have evidence that suggests it could be effective in this population, including peer-evaluated studies".........
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February 16, 2009, 7:23 PM CT
Sun safety behaviors among pool staff
The social environment at swimming pools may be correlation to sun safety behaviors of outdoor pool staff, as per a report in the recent issue of Archives of Dermatology,
one of the JAMA/Archives journals.
"Skin cancer accounts for almost half of all cancers diagnosed in the United States, and there is both direct and indirect evidence that sun exposure can cause skin cancer," as per background information in the article. Outdoor lifeguards and aquatic instructors are especially at high risk for overexposure to the sun because they are young and because they work outdoors. Sunburn tends to be common among young adults in high school and college due to poor sun protection habits. "About 50 percent of aquatic staff had a history of severe sunburn and almost 80 percent had experienced sunburn the prior summer".
"Interventions in the workplace appears to be effective for reducing sun exposure and improving sun protective behaviors of outdoor workers, but there are few published reports of sun protection interventions in occupational settings and inconsistent findings across those reports," the authors note.
Dawn M. Hall, M.P.H., and his colleagues at the Rollins School of Public Health, Emory University, Atlanta, studied data collected from the Pool Cool skin cancer prevention program to analyze the associations among the pool environment, social norms and outdoor lifeguards' and aquatic instructors' sun protection habits and sunburns in 2001 and 2002. Demographic information was also noted.........
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February 12, 2009, 6:21 AM CT
Removing those skin wrinkles
As we get older, fat cells in the subcutaneous layer of the skin become smaller and fewer in number so that they are not longer able to "fill in" damage to the epidermal and dermal skin layers. The results are wrinkles and sagging.
Hollywood stars of a certain age take note: Research at Berkeley Lab suggests that a protein associated with the spread of several major human cancers may also hold great potential for the elimination of wrinkles and the rejuvenation of the skin. If this promise bears fruit, controlling concentrations of the RHAMM protein could one day replace surgical procedures or injections with neurotoxins that carry such unpleasant side-effects as muscle paralysis and loss of facial expressions.
RHAMM stands for Receptor for Hyaluronan Mediated Motility. Mina Bissell, a cell biologist with Berkeley Lab's Life Sciences Division and a leading authority on breast cancer, was collaborating with Eva Turley, an oncology professor at the University of Western Ontario and leading authority on tissue polysaccharides, on a study of the role that RHAMM plays in regulating the signaling of adipocytes (fat cells) during the repairing of tissue wounds from injuries such as skin cuts, heart attacks and stroke. Earlier research by Turley, who discovered RHAMM, had shown that over-expression of this protein points to a poor patient outcome for such human cancers as breast, colon, rectal and stomach.
In the course of their collaborative study, Bissell and Turley, working with mice, discovered that blocking the expression of the RHAMM protein - either by deleting its gene, or through the introduction of a blocking reagent - can be used to selectively induce the generation of fat cells to replace those lost in the aging process. At the same time blocking RHAMM expression also reduces deposits of unhealthy visceral fat.........
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February 12, 2009, 6:16 AM CT
New platinum compound to combat cancer
Scientists in the Department of Chemistry at Wake Forest University in collaboration with colleagues at the Wake Forest University Health Sciences Comprehensive Cancer Center have developed a new class of platinum-based anti-tumor drugs that animal studies have shown to be 10 times more effective than current therapys in destroying certain types of lung cancer cells.
The results were reported in the December 11 issue of the Journal of Medicinal Chemistry and highlighted in Science-Business eXchange (SciBX), produced by the publisher of the journal Nature. They suggest a new approach to fighting non-small cell lung cancer, which accounts for more than three-quarters of all lung cancers. Lung cancer is the leading cause of cancer-related deaths in both men and women. Less than a third of non-small cell patients with lung cancer respond to traditional platinum-based therapies, and those who do respond have a median survival of less than a year.
"We are able to slow the growth of this cancer substantially in mice," said principal investigator Ulrich Bierbach, Z. Smith Reynolds Foundation Fellow and associate professor of chemistry at Wake Forest. "That is very good news, since this is such a rapidly growing, intractable type of cancer".
The new compound's potency derives from its ability to rapidly bind with and disable a tumor cell's DNA before the cell's natural repair mechanisms are activated. That repair process causes drug resistance, which reduces the effectiveness of currently used platinum-based drugs.........
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February 12, 2009, 6:14 AM CT
Regular exercise to prevent colon cancer
An ambitious newly released study has added considerable weight to the claim that exercise can lower the risk for colon cancer. Scientists at Washington University School of Medicine in St. Louis and Harvard University combined and analyzed several decades worth of data from past studies on how exercise affects colon cancer risk. They observed that people who exercised the most were 24 percent less likely to develop the disease than those who exercised the least.
"What's really compelling is that we see the association between exercise and lower colon cancer risk regardless of how physical activity was measured in the studies," says lead study author Kathleen Y. Wolin, Sc.D., a cancer prevention and control expert with the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University. "That indicates that this is a robust association and gives all the more evidence that physical activity is truly protective against colon cancer".
Colorectal cancer is the third most common type of cancer. Each year more than 100,000 people in the United States are diagnosed with colon cancer and about 40,000 are diagnosed with rectal cancer. The study suggests that if the American population became significantly more physically active, up to 24 percent, or more than 24,000, fewer cases of colon cancer would occur each year.........
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February 12, 2009, 6:08 AM CT
Your brain is working hard even when you are sleeping
New research provides strong support for the idea that one of the key functions of sleep is the consolidation of memories. The study, published by Cell Press in the February 12th issue of the journal Neuron
, provides fascinating insight into the cellular mechanisms that govern the sleep-dependent consolidation of experiences that occur while we are awake.
Eventhough sleep is thought to facilitate memory and learning, the molecular links between sleep and synaptic plasticity are not well understood. Ocular dominance plasticity (ODP) is a classic model of experience-dependent cortical plasticity that allows researchers to follow specific changes in the visual cortex in response to the occlusion of one eye.
"We have shown that ODP is consolidated by sleep," says senior study author Dr. Marcos G. Frank from the Department of Neuroscience at the University of Pennsylvania School of Medicine. "Our prior studies indicate that the underlying mechanisms, though still unknown, may involve N-methyl D-aspartate receptors (NMDARs) and intracellular kinases." Dr. Frank and his colleagues performed a series of experiments designed to test this hypothesis.
The scientists observed that sleep consolidates ODP primarily by strengthening cortical responses to stimulation of the nondeprived eye. NMDAR- and protein kinase A-mediated intracellular cascades were critical components of the cellular machinery mandatory for sleep-dependent consolidation of ODP, and their activation during sleep promoted synaptic strengthening.........
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February 12, 2009, 6:01 AM CT
Are you in control of your own actions?
The underlying sense of being in control of our own actions is challenged by new research from UCL (University College London) which demonstrates that the choices we make internally are weak and easily overridden in comparison to when we are told which choice to make.
The research, which is published recently in Cerebral Cortex
, is one of the first neuroscientific studies to look at changing one's mind in situations where the initial decision was one's own 'free choice'. Free choices can be defined as actions occurring when external cues are largely absent for example, deciding which dish to choose from a restaurant menu.
The scientists asked study participants to choose which of two buttons they would press in response to a subsequent signal, while their brain activity was recorded using EEG (electroencephalogram). Some choices were made freely by the volunteers and other choices were instructed by arrows on a screen in front of them. The volunteers' choices were occasionally interrupted by a symbol asking them to change their mind, after they had made their choice, but before they had actually pressed the button.
First author Stephen Fleming, UCL Institute of Neurology, said: "When people had chosen for themselves which action to make, we observed that the brain activity involved in changing one's mind, or reprogramming these 'free' choices was weak, relative to reprogramming of choices that were dictated by an external stimulus. This suggests that the brain is very flexible when changing a free choice rather like a spinning coin, a small nudge can push it one way or the other very easily.........
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February 12, 2009, 5:44 AM CT
Why put your loved ones at risk of heart attack?
Scientists at University College London and St George's, University of London measured recent exposure to tobacco smoke in non-smoking middle-aged men taking part in the British Regional Heart Study by measuring the levels of cotinine - a compound carried in the blood - at two time points 20 years apart. A blood cotinine level above 0.7ng/mL is linked to a 40% increase in the risk of a heart attack (2), and other studies have suggested that even a level of 0.2ng/mL may increase the risk (3). The scientists observed that while in 1978-80, 73% of men had a cotinine level above 0.7ng/mL, by 1998-2000 that proportion had fallen to 17%.
However, despite the number of non-smoking men at risk having fallen, half of those who still had a high cotinine level (above 0.7 ng/ml) in 1998-2000 lived with a partner who smoked. Non-smoking men who had a partner who smoked had average cotinine levels of 1.39ng/mL, almost twice the level linked to an increased risk of a heart attack. Their cotinine levels were nearly eight times higher than the cotinine levels of men whose partner did not smoke.
During the period the study looked at, national data shows that the prevalence of smoking amongst adults across the UK declined from 40% to 27% and the number of cigarettes consumed by smokers fell from 114 to 97 per week. Restrictions on smoking in public spaces and workplaces were also introduced, eventhough the study period was before the national legislative bans on smoking in public places introduced between 2006 and 2007.........
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February 12, 2009, 5:42 AM CT
Avoid pregnancy rather than go through hazels of testing
Parents of children with genetic conditions may avoid the need to choose whether to undergo pre-natal testing or to abort future pregnancies by simply avoiding subsequent pregnancy altogether, a study has observed.
Parents are 'choosing not to choose', researcher Dr Susan Kelly, who is based at the Egenis research centre at the University of Exeter, suggests, in a 'reflection of deep-seated ambivalence' about the options and the limitations of new reproductive technologies.
As per 'Choosing not to choose: reproductive responses of parents of children with genetic conditions or impairments' reported in the journal Sociology of Health and Illness
, more than two-thirds of parents in the USA-based study chose not to have any more children rather than accepting tests to identify or avoid the birth of an affected child. Of the parents who did have further children, a majority chose not to make use of prenatal screening or testing.
"Prenatal testing procedures (to detect genetic conditions or fetal anomalies) were perceived by a number of parents as presenting rather than resolving risks," says Dr Kelly. "A number of parents rejected the possibility of being confronted with the choice of termination or continuation of an affected pregnancy".
The parents studied had children who were clients of a state-wide rural genetic outreach programme in the USA. A majority of parents still of childbearing age chose to avoid future pregnancies, or to decline prenatal testing for subsequent pregnancies. "These decisions do not reflect simple rejection of medical intervention, opposition to abortion, and/or affirmation of a positive parenting experience with an affected child," says Dr Kelly. "Rather, choosing to avoid the condition of choice may be a strategy of responsible parenting that emerges from ambivalence towards the options presented by reproductive technologies".........
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