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Emotional Recovery From Breast Cancer
"We thought we'd find that women do worse psychologically after therapy," says Washington University psychology expert, Teresa L. Deshields, Ph.D., assistant professor of medicine. "That's the clinical lore. After all, a number of of the patients referred to us are the ones struggling at the end of therapy. But our study shows that within two weeks most women adjust very well to survivorship".
The research team surveyed 94 women drawn from patients of the radiation oncology practice at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. The women, averaging 55 years of age, had stage 0, I, II or III breast cancer and at the start of the study were completing the last of a six- to seven-week course of daily radiation therapys.
The women were surveyed five times: on their last day of radiation therapy, two weeks later, several days before their first follow-up appointment (four to six weeks post-treatment) and at three and six months. The survey measured patients' depressive symptoms and quality of life (the quality of life measurement quantifies a set of attributes that include physical, social/family, emotional and functional well-being, and breast-cancer-specific concerns). For the group of breast-cancer survivors, the average score for indications of depression was heightened at the end of therapy compared to a group of healthy men and women. A higher score on the depression index indicates more severe depressive symptoms.........
December 20, 2005
Expanding Mammography's Power
A team of researchers, including Bradley J. Lucier, has found that digitized mammograms, the X-ray cross sections of breast tissue that doctors use to search for cancer, are actually interpreted more accurately by radiologists once they have been "compressed" using techniques similar to those used to lessen the memory demand of images in digital cameras. Though compression strips away much of the original data, it still leaves intact those features that physicians need most to diagnose cancer effectively. Perhaps equally important, digitization could bring mammography to a number of outlying communities via mobile equipment and dial-up Internet connections.
"Any technique that improves the performance of radiologists is helpful, but this also means that mammograms can be taken in remote places that are underserved by the medical community," said Lucier, who is a professor of mathematics and computer science in Purdue's College of Science. "The mammograms can then be sent electronically to radiologists, who can read the digitized versions knowing they will do at least as well as the original mammograms".
The research paper will appear in today's (Dec. 20) issue of Radiology, the journal of the Radiological Society of North America. Lucier developed the file-compression method used in the study, which was run at the Moffitt Cancer Center at the University of South Florida in Tampa.
Discerning the potential seeds of cancer within the chaff of extraneous detail present in a mammogram requires the expert eye of a radiologist, who must pick out salient features at a number of different scales within the image. Clues can be very small clusters of tiny calcium deposits, each less than one-hundredth of an inch in diameter. Clues also can range up through the edges of medium-sized objects - which could be non-malignant cysts with smooth edges, for example, or malignant tumors with rough edges - up to large-scale patterns in tissue fiber.........
December 19, 2005
Immunotherapy for precancerous changes of the cervix
Dr. Daron G. FerrisImmunotherapy for premalignant changes of the cervix.
Whether young women with premalignant changes of the cervix can avoid surgery by using an agent that helps the immune system target the virus responsible is under study at the Medical College of Georgia.
"Infection with human papillomavirus initiates these premalignant changes and this treatment uses that fact to target the lesions," says Dr. Daron G. Ferris, family medicine physician, colposcopist and director of the Gynecologic Cancer Prevention Center at the Medical College of Georgia. "We are telling the immune system to go find HPV and eliminate it. When the immune system attacks the HPV, it also attacks the premalignant changes".
Human papillomavirus is the most common sexually transmitted disease in the country and the major cause of cervical cancer, Dr. Ferris says. Strains that cause cervical cancer get inside cells in the cervix and slowly change them. "In the beginning, women commonly have mild premalignant changes. The good news is, most of the time, these mild changes go away on their own. About 70 percent of the time, we don't have to do any therapy other than following patients closely," Dr. Ferris says.
Unfortunately, cells may also develop moderate to severe changes called cervical dysplasia. "These are true cancer precursors. There is a 30 to 50 percent chance that severe dysplasia will progress to cancer if they are not treated," Dr. Ferris says.
An abnormal Pap smear detects such abnormalities and colposcopy, a technique for examining the cervix for signs of premalignant or malignant cellular changes, typically is performed in follow up. Tests also may be performed to detect the 13 oncogenic strains of HPV.
Patients who have cervical dysplasia may get one of several surgical approaches to remove affected cells and adjacent tissue. "We want to make sure there is only normal, healthy, unexposed skin left after surgery so that when the woman heals, there is no disease left behind," Dr. Ferris says. These approaches, which are 90 percent to 95 percent effective, require removing some of the cervix's mucus-secreting tissue, which can reduce fertility and increase chances of premature delivery.........
December 17, 2005
Cancer Support Cells May Evolve
Dr. Terry Van DykeUniversity of North Carolina at Chapel Hill researchers have demonstrated in a living organism that cancers may cause surrounding supportive cells to evolve and ultimately promote cancer growth.
The new research offers what is believed to be the first evidence that mutations within cancer cells can signal surrounding tissue cells to alter their molecular composition in ways that promote tumor growth and proliferation.
Moreover, the findings also suggest that cell mutations that promote cancer progression may arise in cells other than the predominant cancer cell.
The new findings are published as the cover story in today's (Dec. 16) issue of the journal Cell.
While not offering immediate application to the therapy of human cancers, the research indicates that new anti-tumor therapies may be more effective if their targets are broadened to include molecules within supporting cells of the cancer.
These additional target cells are in the tumor's surrounding "microenvironment," or stroma, including the supporting connective tissue that forms the framework of organs such as the breast, colon and prostate. They also are found in the tumor's blood vessels, or its vasculature.
"Basically, virtually all the studies on genetic changes or changes in gene expression have focused on the cancer cell, on events within the cancer cell itself," said Dr. Terry Van Dyke, professor of genetics and biochemistry and biophysics in the School of Medicine, member of the UNC Lineberger Comprehensive Cancer Center and the study's senior author.
Thus, research focused solely on the predominant cancer cell, such as epithelial cells that form the bulk of a number of tumors including breast cancer, would be on the accumulated mutations that have allowed the cell to survive and grow unchecked.........
December 16, 2005
Strategy To Knock Out Cancer
These images of cell nuclei treated with damaging radiation show that in the absence of MDC1, repair proteins (bright green areas) are inhibited from gathering at the sites of DNA damage.To remain healthy, all cells must quickly mend any breaks that arise in their DNA strands. But cancer cells are especially dependent on a process called homologous recombination to repair DNA and stay alive.
Now scientists at Washington University School of Medicine in St. Louis have found that a protein known as MDC1 has a role in homologous recombination. This discovery could be exploited in a two-pronged therapy strategy to eliminate cancer cells' ability to repair DNA.
"Frequently cancer cells are more efficient at DNA repair than normal cells," says Simon Powell, M.D., Ph.D., head of the Department of Radiation Oncology and a researcher with the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. "That's what makes them resistant to drugs or radiation therapys that physicians use in an effort to damage cancer cells' DNA and destroy them."
But in light of their findings, Powell and colleagues believe MDC1 - along with other proteins involved this repair pathway - may be good targets for dual-drug chemotherapeutic approaches that can completely knock out tumor cells' ability to cope with DNA damage. Their study appears in the recent issue of Nature Structural and Molecular Biology.
The research group discovered that MDC1, a protein previously recognized only for its function in sensing DNA damage and signaling its presence, also transports DNA-repair proteins to the site of DNA strand breaks. Without MDC1 to pave the way, repair happens slowly because the fix-it proteins have a hard time reaching damaged areas, which are buried in the tightly packed chromosomal material of the cell's nucleus.
"MDC1 can bind to chromatin, the complex mixture of DNA and proteins that holds the genetic material," Powell says. "Because of chromatin's properties, getting into it to reach the DNA strand requires the right 'passwords.' MDC1 provides the DNA-repair proteins with this privileged access, and efficiently transports them to the site of damage so they can do their jobs."........
December 16, 2005
New Recommendations for Use of Artificial Nutrition and Hydration
In response to such challenges, scientists from the University of Pennsylvania's Institute on Aging and Center for Bioethics, and the Philadelphia VA's Center for Health Equity Research and Promotion review and clarify ethical principles regarding the use of ANH. According to the authors, the five ethical principles that should guide decisions about ANH are: .
These recommendations are the result of a national conference held at the University of Pennsylvania in early 2005, and appear in the December 15th, 2005 issue of the New England Journal of Medicine.........
December 15, 2005
New Model Of Prostate Cancer
Thomas J. RosolScientists have developed a new line of prostate cancer cells that they hope will provide a better model to study the disease.
This new cancer-cell line has already provided some help. One new study in mice identified a promising possible treatment to reduce skeletal pain that accompanies prostate cancer. Researchers found that a substance called anti-nerve growth factor appeared to be more effective in controlling pain in mice than even morphine.
But the work would not have been possible without the new cell line, said Tom Rosol , a co-author of study and a professor of veterinary medicine at Ohio State University.
Armed with this new cell line, researchers will be able to more directly study how prostate cancer affects the body, said Rosol, whose laboratory developed the cell line.
Metastatic bone tumors are a common manifestation in patients with late-stage breast cancer or prostate cancer. "Metastasis" means that cancer has spread from its original site to other areas of the body. But breast cancer typically destroys bone at tumor sites, whereas prostate cancer tumors that spread to bone induce abnormal bone growth.
Currently, most models used to study prostate cancer do not mimic the human condition and the resulting bone metastases. Most of these models really mimic the spread of breast cancer since the bone metastases in that disease are associated with bone loss rather than bone growth.
"Even though there is more bone at the sites of prostate cancer tumors, this formation still damages the bone," said Rosol, who is also dean of the College of Veterinary Medicine at Ohio State . "The new growth compresses nerves, making it terribly painful for the patient".
The results appear in a January issue of the journal Cancer Research. The study was led by Patrick Mantyh, a professor of preventive sciences at the University of Minnesota.........
December 15, 2005
New Microchip Technology Assembles FDG
The design is the result of a collaboration between academic and industrial scientists at CalTech, the David Geffen School of Medicine at the University of California at Los Angeles (UCLA), Howard Hughes Medical Institute in Los Angeles, Stanford University School of Medicine (Stanford, CA), Siemens, and Fluidigm Corporation.
"Multistep Synthesis of a Radiolabeled Imaging Probe Using Integrated Microfluidics," by Chung-Chen Lee, et al., was published in the December 16 issue of the journal Science (2005;310:1793-1797). As a proof of principle, the group of academic and commercial researchers demonstrated that FDG could be synthesized by the stamp-size chip. These chips are similar in design to integrated electronic circuits, except that they are made of fluid channels, chambers, and valves that allow them to perform multiple chemical operations, synthesizing molecules and labeling them with radioisotopes. All the operations of the chip are controlled and executed by a standard office computer.
The chips use microfluid circuitry to integrate many chemical processes in a small space with no opportunity for cross-contamination, and it is possible to design and build circuits to synthesize new compounds in about two days, according to Hsian-Rong Tseng, PhD, coauthor and assistant professor of molecular and medical pharmacology, Crump Institute for Molecular Imaging, UCLA.........
December 15, 2005
Pretreating Rogue Cancer Cells With Aspirin
"When cancers recur after initial treatment, they tend to be extremely aggressive and patient prognosis is poor," said Yong J. Lee, Ph.D., professor in the departments of surgery and pharmacology, University of Pittsburgh School of Medicine, and lead author of the study. "If we could find ways to prevent these secondary cancers from occurring, we could save a number of lives. Aspirin is a low-cost medicine that, in our studies, appears to have great potential for helping to prevent such cancer recurrences".
TRAIL is a protein that is expressed by cells of the immune system. Numerous studies have shown that TRAIL induces programmed cell death, or apoptosis, in cancer cells while having little or no effect in normal healthy cells. Apoptosis is one of several mechanisms by which damaged cells self-destruct and is the body's way of ensuring that only healthy cells reproduce. Most often, apoptosis eliminates rogue cells with damaged DNA or cells growing too quickly, but it also eliminates normal cells that have simply become obsolete as an organism grows and develops. Because cancer cells have lost their ability to undergo apoptosis, they continue to reproduce and spread their damaged progeny throughout the body.........
December 15, 2005
Can most types of cancers be prevented?
And finding answers is one of the top goals of The University of Texas M. D. Anderson Cancer Center, which has one of the largest cancer prevention research programs in the world.
M. D. Anderson was among the first to begin dedicated prevention research efforts in the late 1970s. A decade ago, nine faculty were working on 23 projects -- a pursuit that was regarded as trend-setting at the time. The cancer center's focus on prevention has grown so much in recent years that the 48 faculty, involved in 140-plus research projects and clinical programs valued at more than $20 million in 2005 alone, just moved into the new Cancer Prevention Building.
In addition to housing faculty offices, the building's Cancer Prevention Center and new Behavioral Research and Treatment Center provide advanced early detection and risk-reduction services and state-of-the-art biobehavioral and psychosocial research venues.
These two centers involve only a sliver of the basic and applied research under way. In short, the researchers, physicians, nurses, employees and volunteers that staff this building aim to bring about a future that may some day be free of cancer.
They also are the first to say that attaining this goal will not be easy; that prevention will require developing a wide variety of strategies and associated tactics to curtail the variety of different diseases, all called cancer, that have now emerged as the number one killer of Americans under age 85.
"Prevention is very broad," says Bernard Levin, M.D., vice president and head of the Division of Cancer Prevention and Population Sciences. "It is not just prevention of cancer development, but includes advances in diagnosis and therapy that reduce suffering and mortality from the disease".........
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Did you know?
Studies in monkeys and women suggest that unlike traditional estrogen therapy, a diet high in the natural plant estrogens found in soy does not increase the risk of uterine cancer in postmenopausal women, according to Mark Cline, D.V.M., Ph.D., an associate professor of comparative medicine at Wake Forest University Baptist Medical Center.
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