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July 25, 2007, 5:19 AM CT

Success rates for prostate cancer depend on experience of surgeon

Success rates for prostate cancer depend on experience of surgeon
Surgeons performing operations to remove patients prostate glandsthe primary therapy for prostate cancergo through a steep learning curve, as per a research studypublished online July 24 in the Journal of the National Cancer Institute As the surgeons gain more experience performing the operation, called a radical prostatectomy, the chance that patients prostate cancer will reoccur goes down.

The idea that more experienced surgeons perform more successful surgeries is a widely held belief. But there have been few data to support this idea, and it has not been previously shown whether a surgeons experience makes a large or small difference on their patients outcome.

Andrew Vickers, Ph.D., of Memorial Sloan-Kettering Cancer Center in New York and his colleagues analyzed data from 72 surgeons at four institutions and 7,765 of their patients with prostate cancer treated with radical prostatectomies between 1987 and 2003. They measured surgeons experience by the number of times they had performed the procedure before each operation.

More surgical experience was linked to a greater likelihood that the patients cancer would not return after their operation. The learning curve for this procedure was very steepthere was dramatic improvement in patient outcomes as surgeons experience increased up to 250 operations, after which increasing experience had little influence on cancer recurrence. Patients treated by inexperienced surgeons (for example, those with 10 previous operations) were nearly 70% more likely to have evidence of recurrence of their prostate cancer within five years than those whose surgeons had performed 250 operations (17.9% vs. 10.7%).........

Posted by: Mark      Read more         Source


July 23, 2007, 6:37 PM CT

Latest drugs improve survival for metastatic breast cancer

Latest drugs improve survival for metastatic breast cancer
Newer drug therapies available since the 1990s, in particular aromatase inhibitors, improve the survival of women with metastatic breast cancer in the general population, as per a new study. Reported in the September 1, 2007 issue of CANCER, a peer-evaluated journal of the American Cancer Society, the study is the first to demonstrate that drugs made available to the general public in the 1990s have had a significant impact on population-based metastatic breast cancer survival rates, confirming findings from earlier clinical trials. Survival improved by approximately 30 percent as systemic treatment, in particular aromatase inhibitors, became more widely used.

Currently, women with metastatic breast cancer survive an average of approximately 24 months. That marks a significant improvement from the estimated 18 month survival noted in the early part of 1980s. While popular opinion suggests that this improved survival rate is due to newly developed drugs, a direct link has not been clearly shown. A few studies suggest overall survival improvements are linked to the new therapies, but their conclusions are not necessarily generalizable to the general population or to specific new systemic therapies.

Dr. Stephen Chia of the University of British Columbia in Vancouver and co-researchers compared outcomes of 2150 women diagnosed with metastatic breast cancer in the Canadian province of British Columbia between 1991 and 2001. In analyzing temporal trends in outcome, the researchers primary goal was to evaluate whether new hormonal and chemotherapeutic drugs approved for public use actually had an impact on survival outside the clinical trial setting. In addition, because not all patients in the general population received any palliative systemic treatment, they were also able to make inferences about drug efficacy versus no therapy.........

Posted by: Janet      Read more         Source


July 23, 2007, 5:11 PM CT

NSAIDs treatment can reduce colorectal cancer risk

NSAIDs treatment can reduce colorectal cancer risk
A study of Medicare patients with osteoarthritis provides additional evidence that non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin reduce the risk of colorectal cancer. Earlier investigations of the drugs impact on tumor development could not rule out the possibility that an observed protective effect was caused by other preventive health care measures. The current study, led by a Massachusetts General Hospital (MGH) physician, appears in the August 2007 Journal of General Internal Medicine.

This is good news for people who take NSAIDs regularly for osteoarthritis, says Elizabeth Lamont, MD, MS, of the MGH Cancer Center, the studys lead author. Eventhough patients face risks such as bleeding or kidney damage from this treatment, they probably are at a lower risk of developing colorectal cancer. Because of the risks posed by the dosage used to treat osteoarthritis, she and her co-authors stress that currently available NSAIDs should not be used solely to prevent cancer.

Earlier randomized trials clearly showed that NSAID therapy can prevent the development of premalignant colorectal polyps, but whether or not such treatment also reduces the risk of invasive colorectal cancer has still not been confirmed. Those trials used relatively low doses of aspirin and showed no significant differences in colorectal cancer rates between the aspirin and placebo groups. While a number of findings based on observation have shown a protective effect of NSAIDs against colorectal cancer, interpretation of some of those results may have been clouded by other healthy behaviors of the participants.........

Posted by: Sue      Read more         Source


July 23, 2007, 4:45 PM CT

Smokers who see more ads for smoking-cessation products

Smokers who see more ads for smoking-cessation products
The more magazine ads smokers see for the nicotine patch and other quit-smoking aids, the more likely they are to try to quit smoking and be successful -- even without buying the products, finds a new Cornell study.

"We believe that the reason may be that important 'spillover effects' from advertising may be occurring, which has important implications for advertising for a wide range of health products," said Alan Mathios, professor of policy analysis and management at Cornell and a co-author of the study, published in an upcoming issue of the Journal of Political Economy and winner of best conference paper at the 2007 American Marketing Association's Public Policy and Marketing Conference, May 31-June 2, in Washington, D.C.

Mathios noted that the results of this study may also apply to other types of pharmaceutical advertising. For example, when patients discuss with their physicians an advertised drug that lowers cholesterol, physicians will often recommend such health behavior changes as diet and exercise, creating a positive spillover effect from the advertising.

Using databases on the consumer behavior and magazine-reading habits of 28,303 current or former smokers and advertising data in 26 consumer magazines, Mathios and three Cornell colleagues explored the impact of advertising of smoking-cessation products on quitting decisions.........

Posted by: Janet      Read more         Source


July 19, 2007, 10:28 PM CT

Obesity a risk factor for multiple myeloma

Obesity a risk factor for multiple myeloma
An obese person is more likely than a lean person to develop multiple myeloma, as per scientists from Brigham and Womens Hospital, Harvard Medical School, and Harvard School of Public Health. Their findings indicate that Body Mass Index (BMI) a statistical measure that scales weight to height provides an indicator for ones risk of developing multiple myeloma, a cancer of the blood cells that produce antibodies. Multiple myeloma currently affects more than 50,000 people in the U.S., and the five-year survival rates of the cancer are below 40 percent.

The study, reported in the recent issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, takes its data from over 100,000 participants in the on-going Nurses Health Study and Health Professionals Follow-up Study, two similar large-scale studies. The study findings were similar to those from previously published studies that included smaller numbers of multiple myeloma patients, and/or were based on a one-time recording of height and weight.

I find the results of these studies encouraging, since they show consistent results about the first risk factor for multiple myeloma that people can actually modify, said the studys lead author Brenda M. Birmann, Sc.D., a researcher in the Department of Medicine at Brigham and Womens Hospital and Harvard Medical School. Treatment options for this disease are improving, but it is also important to identify risk factors that could be modified. We would like to learn how to prevent its occurrence.........

Posted by: Janet      Read more         Source


July 17, 2007, 10:52 PM CT

Nonsmall cell lung cancer: chemotherapy before surgery

Nonsmall cell lung cancer: chemotherapy before surgery
Combining pre-operative chemotherapy and surgery increases the average chance of survival at five years by approximately 6% compared with surgery alone.

This conclusion was drawn by a team of Cochrane Scientists from the MRC Clinical Trials Unit in London after they identified 12 eligible randomised controlled trials. Data from seven of these trials were available from trial reports and were combined in a meta-analysis. The seven trials involved a total of 988 patients.

This is currently the best estimate of the effectiveness of this treatment, but is based on a relatively small number of trials and patients, says lead researcher Sarah Burdett.

There was, however, insufficient data to break the patients down into sub-groups and see whether the effectiveness varies for different types of patients or stages of the disease.

This research is important because around the world more than a million new cases of lung cancer are diagnosed each year, around 80% of which are non-small cell lung cancer. In addition, a number of patients are only diagnosed after the disease has progressed, so survival rates across all stages of disease tend to be fairly low at around 14%, with only a quarter of patients being suitable for surgery.

The Cochrane Systematic Review observed that using chemotherapy before surgery can reduce the size of tumours making the surgery simpler, and increasing the number of patients who may be candidates for surgery. The worry is, however, that having a course of chemotherapy delays the operation, and could therefore leave patients at risk of allowing the tumour to spread.........

Posted by: Scott      Read more         Source


July 17, 2007, 10:13 PM CT

Food-cancer Drug Interactions

Food-cancer Drug Interactions
Tykerb tablets
Alexandria, Va. A commentary in the Journal of Clinical Oncology (JCO) urges scientists to explore an intriguing approach to reduce the dose, and therefore the cost, of oral targeted cancer therapies. The commentary, by Mark Ratain, MD and Ezra Cohen, MD of the University of Chicago, examines recent pharmacologic research which observed that taking the targeted treatment lapatinib (Tykerb) with food significantly increased the concentration of the drug in the body. The commentary suggests that taking lapatinib with food instead of on an empty stomach, as currently indicated, could cut the needed dose by at least 60 percent, reducing the cost accordingly. The authors stress that formal studies are needed to determine the effectiveness of this approach. The article is being published online July 16.

The commentary focuses on a study presented at the March 2007 meeting of the American Society for Clinical Pharmacology and Therapeutics, which observed that lapatinib is more readily absorbed by the body when taken with food, especially a high-fat meal. As a result, 500 mg of lapatinib taken with food may be as effective as taking the currently approved 1,250 mg without food.

Lapatinib was approved by the U.S. Food and Drug Administration (FDA) in March of this year for women with advanced HER2-positive breast cancer. The FDA approved the 1,250 mg dose of lapatinib based on a large phase III clinical trial demonstrating its effectiveness and safety at that dose without food. It is taken as five 250 mg tablets on an empty stomach and costs $2,900 per month.........

Posted by: Janet      Read more         Source


July 16, 2007, 10:29 PM CT

Would you like fries with that?

Would you like fries with that?
Exploiting interactions between food and drugs could dramatically lower the rapidly rising costs of several anticancer drugs, and perhaps a number of other medications, two cancer-pharmacology specialists suggest in a commentary in the July 16, 2007, issue of the Journal of Clinical Oncology.

University of Chicago oncologists Mark Ratain, MD, and Ezra Cohen, MD, call attention to the flip side of recent studies showing how certain foods can alter absorption or delay breakdown of precisely targeted anti-cancer drugs.

Instead of seeing such studies as highlighting a dosing problem, Ratain and Cohen argue that results like this one should point scientists toward a partial solution, a novel way to decrease medicine costs while increasing benefits from these effective but expensive drugs.

The commentary was inspired by a study presented in June at the American Society for Clinical Oncology. Scientists from Dartmouth showed that taking the breast cancer drug lapatinib (TYKERB) with foodinstead of on an empty stomach as suggested on the labelresulted in more of the drug being absorbed and available to treat the cancer.

Patients currently take five 250 mg lapatinib tablets on an empty stomach. The study observed that taking the drug with a meal increased the bioavailability of the drug by 167 percent. Taking the drug with a high-fat meal boosted levels by 325 percent.........

Posted by: Janet      Read more         Source


July 15, 2007, 9:29 PM CT

Potential new target for cancer

Potential new target for cancer
By bypassing a well-known gene implicated in almost one-third of all cancers and instead focusing on the protein activated by the gene, Duke University Medical Center scientists believe they may have found a new target for anti-cancer drugs.

In experiments with human cells and animal models, the scientists studied the gene known as Ras, which is integral in normal cell growth. When this gene is mutated and becomes overactive, it can lead to the unregulated proliferation of cells that is the hallmark of tumor formation.

The ras gene, known as an oncogene when it is in this mutated state, has been implicated in several different cancers, including those of the pancreas and lungs. To date, efforts at blocking or turning off ras have proven ineffective. Pancreas cancer has been shown to have the strongest link to the ras oncogene, and it is also one of the hardest cancers to treat, with few patients alive five years after diagnosis, scientists said.

Since it has been so difficult to target the ras gene itself with drugs, we tried to determine if something that ras activates could be a possible target for a drug or treatment, said Christopher Counter, Ph.D., associate professor of pharmacology and cancer biology and senior member of the research team. We found a specific target that could be susceptible to drugs, and if these findings are proven true in human trials, we could have a new way of treating ras-dependent cancers.........

Posted by: Janet      Read more         Source


July 12, 2007, 10:24 PM CT

The '2-week wait rule' is failing breast cancer patients

The '2-week wait rule' is failing breast cancer patients
The two week wait rule is failing patients with breast cancer and needs to be evaluated urgently say the authors of a seven year study examining the impact of the target, published recently on bmj.com.

At the end of the last century death rates from breast cancer in the UK were among the highest in Europe. Long waiting lists, resulting in delayed diagnosis and therapy, were believed to be partly responsible. In 1998 the Department of Health brought in the 2 week wait rule which stipulated that by April 1999 all patients with suspected breast cancer should be seen by a specialist within two weeks of referral by a GP.

A number of studies have questioned the validity of the 2 week wait rule, but this is the first to assess the long term impact. Dr Shelley Potter and her colleagues gathered data on the number, route and outcome of Primary Care referrals to the Frenchay Brest Care Centre in Bristol between 1999 and 2005.

There were 24,999 referrals to the centre during this period, with GPs classifying each patient as being either urgent as per 2 week wait criteria or routine. Between 1999 and 2005 the number of annual referrals to the centre increased by 9%.

Routine referrals decreased by 24% but 2-week wait referrals increased by 42%. Despite the changes in referral patterns the total number of cancers remained constant over the 7 year period.........

Posted by: Janet      Read more         Source



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Cancer
Cancer is a very common disease, approximately one out of every two American men and one out of every three American women will have some type of cancer at some point during the course of their life. Cancer is more common in the elderly and 77 percent of cancers occur in people above age 55 or older. Cancer is also common in children. Cancer incidence is said to have two peaks once during early childhood and then during late years in life. No age period is completely exempted from development of cancers. Some cancers occur predominantly in the elderly, other types occur in children, Cancer occurs in all ethnic races, however the cancer rates and rates of specific cancer types may vary from group to group. Late stages of cancer may be incurable in most cases, but with the advancement of medicine, more and more cancers are becoming curable.

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