Symptoms cancer

MVP Does Not Provide Benefit in Mesothelioma Patients

2008-07-06T03:39:00.001-07:00

The chemotherapy agent Navelbine® (vinorelbine) may improve outcomes for patients with malignant pleural mesothelioma. However, the combination chemotherapy regimen referred to as MVP (mitoxantrone, vinblastine, and cisplatin) does not provide any benefit for patients with this disease. These results were published in The Lancet.

Malignant pleural mesothelioma (MPM) is a rare cancer that develops in the tissue that covers the lungs and lines the interior of the chest. It is often caused by chronic exposure to asbestos. The majority of patients are not diagnosed until the disease has progressed to an advanced stage; treatment with surgery or radiation is not an option at this stage. Patients with this disease often experience symptoms such as shortness of breath, cough, pain, fatigue, and an inability to eat, which lessen their quality of life.

Mesothelioma is fairly resistant to most therapies, including surgery, chemotherapy, and radiation therapy. Therefore, finding a chemotherapy regimen or new therapeutic approaches that can improve quality of life or survival is essential for improving care for patients with this disease. Prior results have indicated that the chemotherapy combination consisting of Alimta® (pemetrexed) plus a platinum compound provides significant anticancer activity in patients with newly diagnosed mesothelioma. Researchers continue to evaluate different chemotherapy agents for the treatment of this disease.

Researchers from England recently conducted a clinical trial to evaluate the effectiveness of MVP and vinorelbine in the treatment of MPM. This trial included 409 patients from 76 medical institutions in England and two in Australia. Patients were treated with either active symptom control (ASC), consisting of steroids, pain relievers, and agents to dilate lung passages; radiation therapy to relieve pain or pressure; ASC plus MVP; or ASC plus Navelbine.

• There was no evidence that the addition of MVP provided survival benefit compared to ASC alone.
• The addition of Navelbine to ASC provided a survival benefit compared with ASC alone, although this benefit was minimal.
• No benefit in terms of quality of life was achieved with the addition of chemotherapy to ASC.

The researchers concluded that the addition of MVP to ASC did not provide any benefit compared with ASC only for patients with MPM. However, results from the addition of Navelbine to ASC “suggested that vinorelbine merits further investigation.” Further evaluation of Navelbine is necessary to confirm these results. In addition, direct comparisons of Navelbine to Alimta are necessary to determine the potential clinical benefit of Navelbine among patients with MPM.

Patients with MPM may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating chemotherapy or other novel therapies. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.eCancerTrials.com.

Reference: Muers M, Stephens R, Fisher P, et al. active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial. The Lancet. 2008; 371:1685-1694.

Women&Cancer to Be Featured on NBC’s Today Show on Monday, June 23

2008-07-06T03:36:00.000-07:00

Women&Cancer Executive Editor Charles H. Weaver, MD to Appear on Today Show

Women&Cancer magazine’s executive editor Charles H. Weaver will appear on NBC’s Today Show on Monday, June 23rd to discuss the magazine’s mission of delivering information and inspiration to women affected by a cancer diagnosis with the show’s fourth-hour co-anchor Hoda Kotb. Dr. Weaver will emphasize the value of bringing issues related to wellness, prevention, treatment, and advocacy to a consumer audience, and will describe the importance for women of creating a dialog around these issues.

Kotb, who is featured on Women&Cancer’s summer 2008 cover, is a breast cancer survivor who brought her own story public in October, 2007. In the cover feature, Kotb discusses her difficult decision to go public with her story, the passion for breast cancer advocacy that she now embraces, and her determination to not waste another day: “If you survive breast cancer,” Kotb says, “it could be the best thing that happened to you because suddenly you are empowered; because you have strength now; because you realize that your life has margins—it’s to be valued and not wasted.”

In addition to Kotb’s feature, the summer issue also other important topics and features included in the summer issue include: new cancer vaccines; advances in breast reconstruction; reproductive concerns for women facing cancer treatment; an interview with Olympic figure skater and breast cancer survivor Peggy Fleming; and up-to-date information about the benefits of exercise during and after cancer treatment.

As always, the magazine also includes articles that span wellness, spiritual, and family issues related to a cancer diagnosis, highlighted in this issue by articles about, and many more.

About Women&Cancer
Women&Cancer is a quarterly women's health and lifestyle magazine that recognizes women are the main healthcare decision makers for themselves and their families. All women are impacted by cancer, whether they are concerned about screening and early detection, nutrition, environmental and genetic risk factors for themselves and their families, or are impacted by an actual diagnosis of cancer. Women want and need information on the wellness, prevention, diagnosis and management issues related to cancer, as well as inspirational and informative articles about support services that address the mind, body, and spirit of the individual. Women&Cancer offers all women a trusted resource dedicated to topics related to the prevention and management of cancer while emphasizing wellness, fostering community, and inspiring hope.

A one-year subscription to the English version of Women&Cancer is $24.95 and can be purchased online at www.WomenandCancermag.com. A subscription includes four quarterly issues of Women&Cancer

About Omni Health Media, LLC
Omni Health Media publishes Women&Cancer, and manages www.WomenandCancermag.com. Women&Cancer is a quarterly magazine offering all women a trusted resource dedicated to topics related to the prevention and management of cancer while emphasizing wellness, fostering community, and inspiring hope.

Women&Cancer magazine is available online at www.WomenandCancermag.com, where the site also offers additional daily content and community. Omni Health Media also provides print and Internet-based marketing solutions and publishing services to the oncology marketplace.

Gemzar® plus Second Chemotherapy Agent Provides Small Survival Benefits in Advanced Pancreatic Cancer

2007-10-06T18:10:00.000-07:00

Gemzar® plus Second Chemotherapy Agent Provides Small Survival Benefits in Advanced Pancreatic Cancer

According to results recently published in the journal Drugs and Aging, the combination of Gemzar® (gemcitabine) with a second chemotherapy agent provides small but significant improvements in survival compared with Gemzar only in the treatment of metastatic pancreatic cancer.

The pancreas is an organ surrounded by the stomach, small intestine, bile ducts (tubes that connect the liver to the small intestine), gallbladder, liver, and spleen. The pancreas helps the body break down food and also produces hormones, such as insulin, to regulate the body’s storage and use of food.

Pancreatic cancer has one of the highest mortality rates of all cancers. Pancreatic cancer is often called a “silent killer” because its symptoms are usually not recognizable until it has advanced and spread outside the pancreas. As a result the majority of pancreatic cancers are not diagnosed until they have reached advanced stages and are considered incurable. Researchers continue to evaluate novel ways to treat pancreatic cancer in order to extend survival for these patients.

The chemotherapy agent Gemzar is commonly used as treatment for pancreatic cancer. The addition of a second chemotherapy agent to Gemzar, referred to as a Gemzar-based doublet, is also a common therapeutic approach for this disease. Researchers from France recently evaluated the true benefit of adding a second chemotherapy agent to Gemzar for the treatment of pancreatic cancer. The researchers conducted a study that reviewed 23 clinical trials, which included 5,886 patients with advanced pancreatic cancer; these patients had been treated with either a Gemzar-based doublet or Gemzar alone.

At six months patients treated with Gemzar-based doublets had an 8% reduced risk of death compared with patients treated with Gemzar alone.
At 12 months patients treated with Gemzar-based doublets had a 4% reduced risk of death compared with patients treated with Gemzar alone.
At 18 months patients treated with Gemzar-based doublets had a 3% reduced risk of death compared with patients treated with Gemzar alone.
The researchers concluded that the addition of a second chemotherapy agent to Gemzar provides small but significant improvement in survival compared with Gemzar alone in the treatment of advanced pancreatic cancer. Patients with advanced pancreatic cancer may wish to speak with their physician regarding their individual risks and benefits of all available therapies.

Reference: Banu E, Banu A, Fodor A, et al. Meta-analysis of randomised trials comparing gemcitabine-based doublets versus gemcitabine alone in patients with advanced and metastatic pancreatic cancer. Drugs and Aging. 2007;24:865-879.

Avastin® May Provide Benefit in Recurrent Ovarian Cancer

2007-10-05T18:06:00.000-07:00

Avastin® May Provide Benefit in Recurrent Ovarian Cancer

According to an article recently published in the International Journal of Gynecological Cancer, the targeted agent Avastin® (bevacizumab) plus chemotherapy may provide anticancer activity in patients with recurrent ovarian cancer.

Ovarian cancer is the most deadly of gynecologic cancers. A main reason that survival rates for ovarian cancer are so low is that the majority of patients are not diagnosed until the disease has already spread from its site of origin.

Recurrent ovarian cancer refers to cancer that has progressed or returned following prior therapy. Standard treatment options for recurrent ovarian cancer are limited, with chemotherapy remaining the cornerstone of therapy for this group of patients.

Avastin is an agent that is targeted against the vascular endothelial growth factor receptor (VEGF). VEGF is involved in the growth and replication of cancer cells. Avastin binds to VEGF, resulting in a reduction or prevention of cellular growth. Avastin tends to have fewer overall side effects than chemotherapy.

Researchers involved in a multicenter trial recently conducted a clinical trial to evaluate Avastin in the treatment of recurrent ovarian cancer. This trial included 62 patients with recurrent ovarian cancer; 12 patients were treated with Avastin only, and the remaining 50 were treated with Avastin plus chemotherapy.

Anticancer responses were achieved in 36% of patients overall.
Anticancer responses were achieved in 40% of patients treated with Avastin plus chemotherapy compared with only 10% treated with Avastin only.
Side effects were significantly increased with the addition of chemotherapy.
The researchers concluded that a combination of chemotherapy plus Avastin provides anticancer activity in recurrent ovarian cancer. Longer follow-up is necessary to determine if this combination can improve long-term outcomes for these patients. Furthermore, researchers are evaluating a potential connection between certain variables and the risk of gastrointestinal perforation (hole in the gastrointestinal track), which occurred in 7% of patients in this trial.

Patients with recurrent ovarian cancer may wish to speak with their physician regarding their individual risks and benefits of participation in a clinical trial further evaluating Avastin or other promising therapeutic agents. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.eCancerTrials.com.

Reference: Wright JD, Secord AA, Numnum TM, et al. A multi-institutional evaluation of factors predictive of toxicity and efficacy of bevacizumab for recurrent ovarian cancer. International Journal of Gynecological Cancer [early online publication]. July 21, 2007.

Virtual Colonoscopy Suggested as Initial Screening for Colorectal Cancer

2007-10-05T18:04:00.000-07:00

Virtual Colonoscopy Suggested as Initial Screening for Colorectal Cancer

According to an article recently published in the New England Journal of Medicine, virtual colonoscopy, also referred to as computed tomographic colonography (CTC), is an effective initial screening measure for the detection of colorectal cancer.

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. If detected and treated early, colorectal cancer is highly curable. Thus screening for colorectal cancer is recommended starting at the age of 50 for individuals with a normal risk of developing the disease and earlier for those at higher risk.

Historically, optical colonoscopy (OC) has been the mainstay of screening for colorectal cancer. An OC is a procedure in which a lighted tube with an attached camera is inserted into the rectum and through the colon. During the colonoscopy the physician is able to view the colon on a screen and is able to remove abnormal-looking areas or growths. Unfortunately, patients often view an OC as invasive and time-consuming, which results in a low compliance rate.

CTC is another screening procedure for colorectal cancer. CTC uses computed tomography to scan the colon. Results from research have been conflicting about the effectiveness of CTC in detecting colorectal cancer compared to OC. However, physicians are optimistic that compliance rates may increase with CTC because it is not as invasive as OC.

Researchers from the University of Wisconsin recently conducted a clinical trial to compare OC to CTC for the detection of colorectal cancer. This trial included approximately 3,300 adults with an average age of 57–58 years. Patients underwent either initial screening with CTC or initial screening with OC. Patients initially screened with CTC in whom polyps (small growths) at least 6 millimeters in size were detected were offered a polypectomy (removal of polyps) with OC. As well, patients with one or two polyps between 6 and 9 millimeters were offered the option of CTC surveillance (repeated scans at specified intervals to detect growth).

Among patients initially receiving CTC, nearly 8% were referred to undergo a subsequent OC.
Advanced neoplasia (abnormal cellular growth often preceding cancer) was detected in 3.2% of patients who underwent an initial CTC and 3.4% of patients who underwent an initial OC.
Approximately one-quarter of the polyps were removed among patients who underwent a CTC compared with those who underwent an initial OC.
The researchers concluded: “Primary CTC and OC screening strategies resulted in similar detection rates for advanced neoplasia, although the numbers of polypectomies and complications were considerably smaller in the CTC group. These findings support the use of CTC as a primary screening test before therapeutic OC.” Individuals may wish speak with their healthcare provider about screening schedules for colorectal cancer.

Reference: Kim D, Pickhardt P, Taylor A, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. The New England Journal of Medicine. 2007;357:1403-1412.

Taxotere® Approved for Head and Neck Cancer

2007-10-03T01:48:00.000-07:00

Taxotere® Approved for Head and Neck Cancer
The United States Food and Drug Administration (FDA) recently approved the chemotherapy agent Taxotere® (docetaxel), in combination with Platinol® (cisplatin) and 5-fluorouracil, for use prior to surgery and chemoradiation therapy for the treatment of locally advanced squamous cell head and neck cancer. Taxotere is also approved for breast, lung, gastric, and prostate cancers.
Head and neck cancers originate in the oral cavity (lip, mouth, tongue), salivary glands, paranasal sinuses, and nasal cavity, pharynx (upper back part of the throat), larynx (voice box), and lymph nodes in the upper part of the neck. Worldwide, head and neck cancer is diagnosed in approximately 640,000 people and is responsible for approximately 350,000 deaths annually.

Locally advanced head and neck cancer refers to cancer that has spread from its site of origin to nearby tissues in the head and/or neck, but not to distant sites in the body. Patients are often treated with several different treatment modalities, including chemotherapy, radiation therapy, and/or surgery.

Pre-operative therapy including chemotherapy and/or radiation therapy is referred to as neoadjuvant therapy. Neoadjuvant therapy is often used to shrink the size of the cancer prior to the surgical removal, both to allow for a greater chance of complete removal and to provide initial systemic (full-body) therapy to kill cancer cells that may have already spread. If treatment is not administered until after surgery, the patient must wait until he/she has healed from surgery; this waiting period may allow cancer cells to grow and spread further.

The trial that prompted FDA approval of Taxotere for head and neck cancer is referred to as the TAX 324 trial. This international trial included patients with head and neck cancer that was considered potentially operable though not likely to be cured with surgery. Patients were treated with either Taxotere/Platinol/5-fluorouracil (TPF) or Platinol/5-fluorouracil (PF) as initial (induction) therapy. All patients were then treated with Paraplatin® (carboplatin) plus radiation therapy followed by surgery, for those eligible at that point.

Overall survival was significantly improved for patients treated with TPF compared with those treated with PF.
Overall median survival was 70.6 months for patients treated with TPF compared with only 30.1 months for those treated with PF.
At three years survival was 62% for those treated with TPF compared with only 48% for those treated with PF.
Severe side effects occurred in 65% of patients treated with TPF and 62% of patients treated with PF.
Patients diagnosed with locally advanced head and neck cancer may wish to speak with their physician regarding their individual risks and benefits of treatment with Taxotere.

Reference: Sanofi-Aventis. Taoxtere® (docetaxel) Granted FDA Approval to Treat Locally Advanced Head and Neck Cancer Prior to Chemoradiotherapy and Surgery. Available at: http://en.sanofi-aventis.com/Images/071001_taxotere__fda_en_tcm24-19038.pdf. Accessed October 2007.

Neulasta® Reduces Hospitalizations for Febrile Neutropenia in Women with Breast Cancer

2007-10-03T01:43:00.000-07:00

Neulasta® Reduces Hospitalizations for Febrile Neutropenia in Women with Breast Cancer

According to results presented at the European Cancer Conference (ECCO 14), preventive treatment with Neulasta® (pegfilgastim) improved chemotherapy delivery and reduced the risk of febrile neutropenia (low white blood cell levels accompanied by fever) among women with breast cancer.

Although chemotherapy improves outcomes for many cancer patients, it is associated with unpleasant and sometimes life-threatening side effects. Chemotherapy destroys not only cancer cells, but also normal cells that grow rapidly. These include blood cells forming in the bone marrow, cells in the hair follicles, and cells in the mouth and intestines.

Neutropenia, one of the most common side effects of chemotherapy, occurs when white blood cells (immune cells) are destroyed by chemotherapy, leaving the immune system unable to fight infections.

Chemotherapy-induced neutropenia can become a serious condition for several reasons: many patients who develop neutropenia will require a delay in treatment or a dose reduction, which can prevent them from receiving full benefits of treatment; patients who develop neutropenia may require hospitalization; and even minor infections can become life-threatening. For patients at high risk of developing neutropenia, blood cell growth factors such as Neulasta® can be used to reduce the risk.

To evaluate the effects of Neulasta among patients receiving chemotherapy regimens with a moderate (15-20%) or high (20% or greater) risk of febrile neutropenia, researchers combined information from 11 previous studies. These studies enrolled a total of 2,282 women with breast cancer.

Hospitalizations for febrile neutropenia occurred in 4% of women who received preventive treatment with Neulasta and 10% of other women.
Chemotherapy dose reductions were required in 9% of women who received preventive treatment with Neulasta and 24% of other women.
This study suggests that breast cancer patients at moderate or high risk of febrile neutropenia benefit from preventive treatment with Neulasta. Preventive treatment with Neulasta reduced the risk of hospitalization for febrile neutropenia and supported a higher level of chemotherapy delivery.

Reference: Aapro M, Schwenkglenks M, Lyman G et al. Improved chemotherapy delivery in breast cancer patients receiving pegfilgrastim primary prophylaxis compared with current practice neutropenia management – results from an integrated analysis (NeuCuP). Presented at ECCO-14 – The European Cancer Conference. Barcelona, Spain, September 23-27, 2007. Abstract O#2033.

Surgery Reduces Recurrence Risk in Patients with Nodular Basal Cell Carcinoma

2007-10-01T03:31:00.000-07:00

Surgery Reduces Recurrence Risk in Patients with Nodular Basal Cell Carcinoma

Among patients with nodular basal cell carcinoma of the skin, surgery results in a lower risk of recurrence, but also a worse cosmetic result, than photodynamic therapy. These results were published in the Archives of Dermatology.

Each year, more than one million new cases of skin cancer are diagnosed in the United States.[1] Skin cancer is often divided into two broad categories: melanoma and non-melanoma. Non-melanoma skin cancer refers to several different types of skin cancer, but the most common types are basal cell carcinoma and squamous cell carcinoma.

Basal cell carcinoma accounts for roughly 80% of all cases of non-melanoma skin cancer.[2] Basal cell carcinoma most commonly develops on sun-exposed skin, with the head (particularly the nose) and neck being the most common sites. The appearance of basal cell carcinoma varies. It often appears as a raised bump with a smooth, pearly or waxy appearance. It may also look like a firm, flat scar.[3] Basal cell carcinoma very rarely metastasizes (spreads beyond the skin), but it can cause extensive local damage to the skin and surrounding tissues. Nodular basal cell carcinoma is the most common type of basal cell carcinoma.

Surgery is the mainstay of treatment for non-melanoma skin cancer, and several different types of surgery are available. Certain patients, however, may be candidates for non-surgical treatments, such as radiation therapy, topical therapy (application of medications to the skin), or photodynamic therapy. Photodynamic therapy involves the use of an agent that collects in cancer cells and makes them sensitive to light. Light is then applied to the area in order to destroy the cancer cells.

To compare surgical excision to photodynamic therapy in the treatment of nodular basal cell carcinoma, researchers conducted a clinical trial among 97 patients.[4]

During five years of follow-up, 4% of patients treated with surgery and 14% of patients treated with photodynamic therapy experienced a recurrence of basal cell carcinoma.
A good or excellent cosmetic result was achieved in 54% of patients treated with surgery and 87% of patients treated with photodynamic therapy.
These results indicate that in the treatment of nodular basal cell carcinoma, surgical excision results in a lower risk of recurrence, but also a worse cosmetic result, than photodynamic therapy. The researchers conclude that while surgical excision is likely to remain a standard treatment for nodular basal cell carcinoma, consideration of photodynamic therapy may be appropriate when cosmetic outcome is important. The researchers note that photodynamic therapy “is also an effective treatment.”

References:

[1]American Cancer Society. Cancer Facts and Figures 2007. Available at http://www.cancer.org/docroot/stt/stt_0.asp (Accessed September 25, 2007)

[2] Rubin AI, Chen EH, Ratner D. Basal-Cell Carcinoma. New England Journal of Medicine. 2005;353:2262-2269.

[3] National Cancer Institute. Skin Cancer (PDQ®): Treatment. Patient Version. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/skin/patient (accessed September 25, 2007)

[4] Rhodes LE, de Rie MA, Leifsdottir R et al. Five-year follow-up of a randomized, prospective trial of topical methyl aminolevulinate photodynamic therapy vs surgery for nodular basal cell carcinoma. Archives of Dermatology. 2007;143:1131-1136.

Fecal Immunochemical Test Detects High Percentage of Colon Cancers

2007-09-29T20:37:00.000-07:00

Fecal Immunochemical Test Detects High Percentage of Colon Cancers

According to the results of a study published in the Journal of the National Cancer Institute, use of a newer type of fecal occult blood test known as a fecal immunochemical test detected a high percentage of left-sided colorectal cancers (cancers that develop in the last part of the colon or the rectum).

Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. The disease develops in the large intestine, which includes the colon (the longest part of the large intestine) and the rectum (the last several inches).

Because cure rates are high when colorectal cancer is detected and treated early and fall dramatically once the cancer has spread, researchers have been evaluating novel screening methods that will offer higher accuracy and encourage more patient compliance. Currently, it is recommended that people 50 years of age or older and those at a high risk for colorectal cancer are screened for the disease. Screening methods include testing for blood in the stool (fecal occult blood test [FOBT]), sigmoidoscopy, and colonoscopy.

While colonoscopy allows for the most complete detection of colorectal cancers and precancerous colorectal polyps, the test is invasive and may discourage some individuals from being screened for colorectal cancer. On the other hand, the traditional guaiac FOBT provides a simple and inexpensive screening test but has limited accuracy.

In response to the limitations of the guaiac FOBT, researchers have developed a newer type of FOBT known as a fecal immunochemical test. This test is more specific than the guaiac test (it produces fewer false-positive results), and certain types of fecal immunochemical tests may also be more sensitive (better able to detect cancers and advanced polyps).

To evaluate the performance of two types of FOBT—a sensitive guaiac test and a fecal immunochemical test—researchers conducted a study among 5,841 people at average risk of colorectal cancer. Study participants who tested positive on either FOBT received a colonoscopy. Study participants who tested negative received a sigmoidoscopy. Because a sigmoidoscopy only evaluates the last part of the colon (the part of the colon on the left side of the body) the researchers were only able to draw conclusions about the ability of the tests to detect left-sided colorectal cancer.

The fecal immunochemical test detected 82% of the left-sided colorectal cancers and the sensitive guaiac FOBT detected 64%.
The fecal immunochemical test detected 30% of advanced adenomas (a precancerous growth) and the sensitive guaiac FOBT detected 41%. It’s unclear why the guaiac test was better able to detect advanced adenomas than the FIT.
The fecal immunochemical test had higher specificity than the sensitive guaiac FOBT. This means that the fecal immunochemical test produced fewer false-positive test results.
The researchers concluded that the fecal immunochemical test performed well in detecting left-sided colorectal cancer, and may be a useful replacement for the guaiac fecal occult blood test.

Reference: Allison JE, Sakoda LC, Levin TR et al. Screening for colorectal neoplasms with new fecal occult blood tests: update on performance characteristics. Journal of the National Cancer Institute. 2007;99:1462-70.

All Types of Alcohol Increase Breast Cancer Risk

2007-09-28T18:04:00.001-07:00

All Types of Alcohol Increase Breast Cancer Risk

According to the results of a study presented at the European Cancer Conference (ECCO 14), women who consume three or more alcoholic beverages per day (beer, wine, or spirits) are 30% more likely to develop breast cancer than women who consume less than one alcoholic beverage per day.

Breast cancer is the most commonly diagnosed cancer (other than non-melanoma skin cancer) in U.S. women. The American Cancer Society estimates that there will be over 178,000 new breast cancer diagnoses in U.S. women in 2007 and roughly 40,000 breast cancer deaths.

The identification of modifiable risk factors for breast cancer has been an important focus of breast cancer research. While we can’t change our family history, we can choose to engage in healthy behaviors such as regular physical activity.

Several studies have linked moderate to high alcohol consumption to an increased risk of breast cancer. It’s remained uncertain, however, whether risk varies by type of alcohol.

To further explore the link between alcohol and breast cancer, researchers in California conducted a study among more than 70,000 women (59% white, 26% African-American, and 10% Asian-American).

Study participants provided information about alcohol intake and other health behaviors and characteristics during health exams conducted between 1978 and 1985. The women were then followed through 2004. During this time, 2,829 women developed breast cancer.

Compared to women who consumed less than one drink per day, risk of breast cancer was increased by 10% among women who consumed one to two drinks per day, and by 30% among women who consumed three or more drinks per day.
Each type of alcohol (beer, wine, or spirits) appeared to have a similar effect on breast cancer risk.
The link between alcohol and breast cancer did not appear to vary by age or ethnicity.
This large study provides further evidence that alcohol increases the risk of breast cancer, and suggests that all types of alcohol contribute to this risk.

Reference: Li Y, Baer D, Friedman GD, Udaltsova N, Klatsky AL. Wine, liquor, beer, and risk of breast cancer. Presented at ECCO-14 – The European Cancer Conference. Barcelona, Spain, September 23-27, 2007. Abstract P#1201.

No Clear Link between Fruit and Vegetable Intake and Colon Cancer

2007-09-28T18:01:00.000-07:00

No Clear Link between Fruit and Vegetable Intake and Colon Cancer Risk

According to the results of a study published in the Journal of the National Cancer Institute, higher intake of fruits and vegetables does not appear to reduce the risk of colon cancer.

Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. The disease develops in the colon (the longest part of the large intestine) or the rectum (the last several inches of the large intestine). It may start as a precancerous growth known as an adenomatous polyp or adenoma.

Researchers have long hypothesized that dietary factors may contribute to the development of colon cancer. Studies have generally reported that high intake of red meat increases colon cancer risk, but the relationship with fruit and vegetable intake is less clear.

To summarize available information about the link between fruit and vegetable intake and risk of colon cancer, researchers combined information from 14 prospective studies. In a prospective study of diet and cancer incidence, all study participants are free of cancer at the time the study begins and diet is assessed. Study participants are then followed forward in time to see who develops cancer.

The combined analysis included information from 756,217 men and women, 5,838 of whom developed colon cancer.

Overall, higher intake of fruits and/or vegetables was not linked with a reduced risk of colon cancer.
There was a suggestion that fruit and vegetable intake may reduce the risk of distal colon cancer (cancer in the part of the colon above the rectum).
Results were generally similar for men and women.
Although this study suggests that higher fruit and vegetable intake does not significantly reduce overall colon cancer risk, fruits and vegetables have other health benefits and remain an important part of a healthy diet.

Reference: Koushik A, Hunter DJ, Spiegelman D et al. Fruits, vegetables, and colon cancer risk in a pooled analysis of 14 cohort studies. Journal of the National Cancer Institute [early online publication]. September 25, 2007.

High Intake of Vegetables and Fruit Reduces Risk of Lung Cancer

2007-09-26T21:39:00.000-07:00

High Intake of Vegetables and Fruit Reduces Risk of Lung Cancer

According to an article recently published in the Annals of Oncology, a high intake of vegetables and fruit drastically reduces the risk of lung cancer. The reduced risk is particularly evident in smokers but is also apparent in non-smokers.

Lung cancer remains the leading cause of cancer-related deaths in the world. Although smoking is largely attributed to the prevalence of lung cancer, a significant portion of lung cancer patients have never smoked. Given the prevalence of this disease, researchers continue to evaluate ways to prevent or reduce the risk of the developing of lung cancer among both smokers and non-smokers. Diet has become an intense focus of such research in terms of its association with the risk of developing various types of cancers. In particular, studies have indicated that consumption of fruit and/or vegetables may significantly reduce an individual’s risk of developing or dying from some types of cancers.

Researchers from China recently conducted a clinical study to evaluate a possible relationship between fruit and vegetable consumption and the risk of developing lung cancer. This study included 218 individuals with lung cancer and 436 individuals who did not have lung cancer or other smoking-related disease.

Individuals consuming the largest amount of vegetables had an approximate 60% reduced risk of developing lung cancer compared with individuals consuming the lowest amount of vegetables.
Individuals consuming the highest amount of fruits had an approximate 25% reduced risk of developing lung cancer compared with individuals consuming the lowest amount of fruit.
Smokers derived greater benefit from high vegetable and fruit consumption in terms of a reduction in the risk of developing lung cancer compared to non-smokers; however, non-smokers who consumed a large amount of vegetables and fruit also had a significantly reduced risk of lung cancer.
The researchers concluded that consumption of fruit and vegetables may significantly reduce the risk of the development of lung cancer, particularly among smokers. These data add to the growing body of evidence indicating the importance of fruits and vegetables in an individual’s diet.

Reference: Galeone C, Negri E, Pelucchi C, et al. Dietary intake of fruit and vegetable and lung cancer risk: a case-control study in harbin, northeast china. Annals of Oncology. 2007; 18: 388-392.

Higher Rates of Colorectal Cancer in Patients with Coronary Artery

2007-09-26T21:33:00.000-07:00

Higher Rates of Colorectal Cancer in Patients with Coronary Artery Disease

According to the results of a study conducted in Hong Kong, patients with coronary artery disease have a higher rate of colorectal polyps and colorectal cancer than individuals without coronary artery disease. These results were published in the Journal of the American Medical Association.

Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. The disease develops in the large intestine, which includes the colon (the longest part of the large intestine) and the rectum (the last several inches).

Coronary artery disease refers to the hardening and narrowing of arteries that supply blood to the heart. It is the leading cause of death among both men and women in the United States.

Factors that may increase the risk of both colorectal cancer and coronary artery disease include obesity, physical inactivity, diabetes, and smoking. These and other shared risk factors may explain previously reported links between the two conditions.

To further evaluate the link between coronary artery disease and colorectal cancer, researchers in Hong Kong conducted a study among three groups of people: 1) patients who had a coronary angiogram and were found to have coronary artery disease; 2) patients who had a coronary angiogram and were found not to have coronary artery disease; and 3) a sample of individuals from the general population.

The study excluded patients who had taken aspirin or a statin for more than one year, as well as patients who had a history of colorectal polyps, colorectal cancer, or other colon problems.

All patients in the study received a colonoscopy.

Colorectal growths (polyps or cancer) were detected in 34% of patients with coronary artery disease, 18.8% of patients without coronary artery disease, and 20.8% of individuals in the general population sample.
Colorectal cancer was detected in 4.4% of patients with coronary artery disease, 0.5% of patients without coronary artery disease, and 1.4% of individuals in the general population sample.
The link between coronary artery disease and colorectal cancer was particularly strong for smokers and individuals with the metabolic syndrome. The metabolic syndrome involves a combination of conditions such as abdominal obesity, insulin resistance, high blood pressure, and abnormal cholesterol and triglyceride levels.
This study supports previous reports that colorectal cancer is more common in patients with coronary artery disease than in the general population. Smokers and patients with the metabolic syndrome have an increased risk of developing both conditions.

Reference: Chan AOO, Jim MH, Lam KF et al. Prevalence of colorectal neoplasm among patients with newly diagnosed coronary artery disease. JAMA. 2007;298:1412-1419.

Stomach cancer symptoms

2007-09-26T05:26:00.000-07:00

Stomach cancer symptoms & Signs of stomach cancer

People with stomach cancer may experience the following symptoms. Sometimes, people with stomach cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

Stomach cancer is usually not found at an early stage because it often does not cause specific symptoms. When symptoms do occur, they may be vague and can include:

Indigestion or heartburn

Pain or discomfort in the abdomen

Nausea and vomiting

Diarrhea or constipation

Bloating of the stomach after meals

Loss of appetite

Symptoms of advanced stomach cancer may include:

Weakness and fatigue

Vomiting blood or having blood in the stool

Unexplained weight loss

It is important to remember that these symptoms can also be caused by many other illnesses, such as a stomach virus or an ulcer. People with the symptoms listed above should talk with their doctor.

Skin cancer symptoms

2007-09-26T05:21:00.000-07:00

Skin cancer Symptoms & Sign of Skin cancer

The skin features that frequently occur in basal or squamous cell carcinoma are listed below. If you are concerned about a symptom or a feature on this list, please talk with your doctor.

Changes in the skin are the main warning sign for skin cancer. Each type of skin cancer can appear differently, and an accurate diagnosis by a doctor or other health-care professional is essential.

For basal cell cancer, two or more of the following features may be present:

An open sore that bleeds, oozes, or crusts, and remains open for several weeks

A reddish, raised patch or irritated area that may crust or itch, but rarely hurts

A shiny pink, red, pearly white or translucent bump

A pink growth with an elevated border and crusted central indentation

A scar-like, white, yellow, or waxy area, often with a poorly defined border

Squamous cell cancer can often crust and bleed and appears as:

A wart-like growth

A persistent, scaly red patch with irregular borders that may bleed easily

An open sore that persists for weeks

An elevated growth with a rough surface and a central depression

Early detection: Finding skin cancer early

Regular self-examinations may help find skin cancer early. Examinations should be performed in front of a full-length mirror in a brightly lit room. It helps to have another person check the scalp and back of the neck. Non-melanoma skin cancer most often begins on skin that has frequently been exposed to the sun.

A doctor should be consulted for:

Growths on the skin that match any symptoms on either of the above lists

New growth on the skin

Suspicious changes in an existing mole or spot

A sore that doesn't heal within two weeks

Surgery Reduces Recurrence Risk in Patients with Nodular Basal Cell Carcinoma

2007-09-26T05:18:00.000-07:00

Vitamin D Linked with Reduced Risk of Death

2007-09-26T05:14:00.000-07:00

Vitamin D Linked with Reduced Risk of Death

According to a combined analysis of 18 clinical trials, intake of ordinary doses of vitamin D supplements was linked with 7% reduction in overall risk of death. These results were published in the Archives of Internal Medicine.

Vitamin D is a fat-soluble vitamin that comes from dietary supplements, foods such as fortified milk and cereal, certain kinds of fish (including salmon, mackerel, and tuna), and exposure to sunlight. Vitamin D is hypothesized to play a role in the prevention of some types of cancer.

To explore the relationship between use of vitamin D supplements and risk of death from any cause, researchers combined information from 18 vitamin D clinical trials. These trials included a total of 57,311 study participants.

The dose of vitamin D given in the trials ranged from 300 to 2,000 IU per day, with an average dose of 528 IU per day.

Patients were followed for an average of 5.7 years. During this time, 4,777 deaths occurred among study participants.

Overall risk of death was 7% lower in individuals who were assigned to receive vitamin D supplements than in individuals in the comparison group. The link between vitamin D and specific causes of death was not assessed.

The researchers conclude that vitamin D supplements appear to reduce overall risk of death. Additional research is needed to explore the relationships among an individual’s baseline vitamin D status, dose of the vitamin D supplement, and risk of death.

Reference: Autier P, Gandini S. Vitamin D supplementation and total mortality: A meta-analysis of randomized controlled trials. Archives of Internal Medicine. 2007;167:1730-1737.

Better Quality of Life with Vaginal Brachytherapy for Endometrial

2007-09-24T16:46:00.000-07:00

Better Quality of Life with Vaginal Brachytherapy for Endometrial Cancer

Among women who received post-surgery radiation therapy for endometrial cancer, vaginal brachytherapy (a type of internal radiation therapy) resulted in better quality of life than external beam radiation therapy. These results were presented at the European Cancer Conference (ECCO 14).

Some patients with endometrial cancer receive adjuvant (post-surgery) treatment with radiation therapy. Two different approaches to delivering radiation therapy for endometrial cancer are external beam radiation therapy and vaginal brachytherapy. Vaginal brachytherapy is a type of internal radiation therapy in which radioactive material is placed within the vagina.

To compare vaginal brachytherapy to external beam radiation therapy, researchers in The Netherlands conducted a clinical trial among 427 women with endometrial cancer. The trial was restricted to selected patients with Stage IB, IC, or IIA cancer. All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (surgical removal of the uterus, the ovaries, and the fallopian tubes).

The study was designed to address both treatment effectiveness and impact on quality of life. The presentation at the European Cancer Conference focused on the quality of life results; effectiveness results are not yet available.

In both groups of patients, quality of life was lowest after surgery and then gradually improved.
From six months onwards, patients who had received vaginal brachytherapy reported better overall quality of life than patients who received external beam radiation therapy.
Patients who had received vaginal brachytherapy reported fewer bowel symptoms (such as diarrhea) and less fatigue than patients who received external beam radiation therapy.
There was no significant different between the groups in sexual symptoms (such as vaginal dryness) or sexual interest.
While these results suggest that vaginal brachytherapy results in better quality of life than external beam radiation therapy, effectiveness information is not yet available from this study. This information will be available in the future, and will help guide treatment decisions for women with intermediate-risk endometrial cancer.

Reference: Putter H, Schultz IM, Jobsen JJ et al. Quality of life after radiotherapy for endometrial cancer: first results from the randomized PORTEC2 trial. Presented at ECCO-14 – The European Cancer Conference. Barcelona, Spain, September 23-27, 2007. Abstract O#5000.

Circulating Tumor Cells May Provide Information about Breast Cancer

2007-09-24T16:44:00.000-07:00

Circulating Tumor Cells May Provide Information about Breast Cancer Prognosis

According to the results of a study presented at the European Cancer Conference (ECCO 14), measurement of circulating tumor cells in the blood of breast cancer patients may provide information about risk of cancer recurrence.

Treatment of breast cancer often involves local therapy, such as surgery and radiation, as well as systemic (whole-body) therapy such as chemotherapy, hormonal therapy, and targeted therapy.

Decisions about the need for systemic therapy, and about the most appropriate types of systemic therapy, depend on many factors, including tumor size, whether cancer has spread to nearby lymph nodes, hormone receptor status, and HER2 status.

Another factor that may eventually guide treatment decisions is the presence of circulating tumor cells in the blood. Circulating tumor cells have been linked with a worse prognosis in women with metastatic breast cancer, but less is known about the importance of circulating tumor cells in women with earlier-stage breast cancer.

To evaluate circulating tumor cells in women with node-positive and high-risk node-negative breast cancer, researchers conducted a study among 1,767 women. For 852 of these women, blood samples were available both before and after chemotherapy.

Before treatment, 10% of the women were found to have more than one circulating tumor cell in their blood sample.
Of the patients who initially had evidence of circulating tumor cells, 90% were free of circulating tumor cells after completion of chemotherapy.
Of the patients who were initially free of circulating tumor cells, 93% remained free of circulating tumor cells.
The researchers hypothesize that the presence of circulating tumor cells after chemotherapy will be linked with a higher risk of cancer recurrence. Results about the link between circulating tumor cells and outcome of adjuvant therapy will be available in the future. If a link is demonstrated, a simple blood test may provide important information about a woman’s risk of breast cancer recurrence, and about the optimal approach to treatment.

Reference: Jueckstock J, Rack B, Thurner-Hermanns E et al. Detection of minimal residual disease (MRD) in peripheral blood of primary breast cancer patients – Translational research in the SUCCESS Study. Presented at ECCO-14 – The European Cancer Conference. Barcelona, Spain, September 23-27, 2007. Abstract O#2032.

Alimta®/Platinum-compound Combination Confirmed Active in Mesothelioma

2007-09-24T07:03:00.000-07:00

Alimta®/Platinum-compound Combination Confirmed Active in Mesothelioma

According to results recently presented at the 2007 annual meeting of the American Society of Clinical Oncology, the chemotherapy combination consisting of Alimta® (pemetrexed) plus a platinum compound (Platinol® [cisplatin] or Paraplatin® [carboplatin]) has been confirmed as an active therapeutic regimen in the treatment of patients with previously untreated malignant pleural mesothelioma.

Malignant pleural mesothelioma is a rare cancer that develops in the tissue that covers the lungs and lines the interior of the chest. It is often caused by chronic exposure to asbestos. The majority of patients are not diagnosed until the disease has progressed to an advanced stage; treatment with surgery or radiation is not an option at this stage. Patients with this disease often experience symptoms, such as shortness of breath, cough, pain, fatigue, and an inability to eat, which lessen their quality of life.

Mesothelioma is fairly resistant to most therapies, including surgery, chemotherapy, and radiation therapy. Therefore, finding a chemotherapy regimen or new therapeutic approaches that can improve quality of life or survival is essential for improving care for patients with this disease. Prior results have indicated that the chemotherapy combination consisting of Alimta plus a platinum compound provides significant anticancer activity in patients with newly diagnosed mesothelioma.

Researchers from Italy recently conducted a clinical trial further evaluating Alimta/Platinum compound in 745 patients with previously untreated mesothelioma. Patients in this trial were not eligible for surgery and were treated with Alimta plus Platinol or Alimta plus Paraplatin.

At one year survival was approximately 64% for both treatment groups.
The median time to cancer progression was approximately seven months for both treatment groups.
Overall anticancer responses were achieved in 26.3% of patients treated with Alimta/Platinol and 21.6% for those treated with Alimta/Paraplatin.
Severe low levels of blood cells occurred more frequently among patients treated with Alimta/Platinol than those treated with Alimta/Paraplatin.
The researchers concluded that the combination of Alimta plus a platinum compound provides significant activity among patients with previously untreated mesothelioma. These results confirm earlier results providing the same information.

Patients with mesothelioma may wish to speak with their physician regarding their individual risks and benefits of treatment with Alimta and a platinum compound.

Reference: Santoro A et al. Pemetrexed plus cisplatin or pemetrexed plus carboplatin for chemonaive patients with malignant pleural mesothelioma: results for the international expanded access program. Proceedings from the 2007 annual meeting of the American Society of Clinical Oncology. Abstract 7562.

Study Explores Detection of Prostate Cancer by Prostate Biopsy

2007-09-24T06:58:00.000-07:00

Study Explores Detection of Prostate Cancer by Prostate Biopsy

According to the results of a study published in the Journal of the National Cancer Institute, prostate cancer is found in roughly 32% of prostate biopsies.

In 2007, roughly 219,000 men in the U.S. will be diagnosed with prostate cancer and over 27,000 will die of the disease.[1]

Since the late 1980s, the primary screening tool for early detection of prostate cancer has been the prostate specific antigen (PSA) test. While this test is widely used, it remains controversial, due to both false-positive and false-negative test results. Produced by cells in the prostate, PSA levels in the blood tend to be elevated in men who have prostate cancer. However, not all men with prostate cancer have elevated PSA, and not all men with elevated PSA have prostate cancer. PSA levels can also become elevated as a result of noncancerous conditions of the prostate such as benign prostatic hyperplasia (BPH) or prostatitis.

Men who have elevated levels of PSA are often referred for a prostate biopsy in order to determine whether prostate cancer is present. To describe prostate biopsy results and patterns of use, researchers linked Medicare data to a U.S. cancer registry.[2] The combined dataset included information about more than 10,000 prostate biopsies performed between 1993 and 2001. The study was restricted to men age 65 and older.

Overall, 32% of the biopsies showed evidence of prostate cancer.
The proportion of biopsies that showed evidence of prostate cancer increased with age, from 26% among men between the ages of 65 and 69 to 41% among men age 80 or older.
Among men with no evidence of cancer at their initial biopsy, 38% had a repeat biopsy within the next five years. Prostate cancer was detected in 21% to 25% of the repeat biopsies.
The researchers conclude that roughly one-third of prostate biopsies show evidence of prostate cancer. Men with a negative initial biopsy frequently undergo repeat biopsy, and some of these men are eventually diagnosed with prostate cancer.

References:

[1]American Cancer Society. Cancer Fact & Figures 2007. Available at: http://www.cancer.org/docroot/stt/stt_0.asp (Accessed September 18, 2007).

[2] Welch HG, Fisher ES, Gottlieb DJ, Barry MJ. Detection of prostate cancer via biopsy in the Medicare-SEER population during the PSA era. Journal of the National Cancer Institute. 2007;99:1395-400.

Pancreatic cancer symptoms

2007-09-23T17:17:00.000-07:00

Pancreatic Symptoms & Signs of Pancreatic cancer

People with pancreatic cancer may experience the following symptoms. Sometimes, people with pancreatic cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor.

Doctors often refer to pancreatic cancer as a silent disease because it usually does not cause any symptoms in the beginning. Also, there are currently no blood tests that can reliably detect the cancer while it is in its early stage. As the cancer grows, symptoms may include:

Yellow skin and eyes, darkening of the urine, itching, and clay-colored stool, which are signs of obstructive jaundice that may occur during the early stage of the disease

Pain in upper abdomen or upper back

Burning feeling in stomach or other gastrointestinal discomforts

Floating stools with a particularly bad odor, due to malabsorption of fats

Weakness

Loss of appetite

Nausea and vomiting

Weight loss with no known explanation

Presentation

Early diagnosis of pancreatic cancer is difficult because the symptoms are so non-specific and varied. Common symptoms include abdominal pain, loss of appetite, significant weight loss and painless jaundice. All of these symptoms can be blamed on other causes. Therefore, diagnosis of pancreatic cancer is often late-stage in its development.

Jaundice occurs when the tumor grows and pressure obstructs the common bile duct, which runs partially through the head of the pancreas. Tumours of the head of the pancreas (approximately 60% of cases) will more easily give rise to such symptoms.

Trousseau's sign (which is a a sign of malignancy: the blood may spontaneously form clots in the portal vessels, the deep veins of the extremities, or the superficial veins anywhere on the body) is found to be associated this cancer

Clinical depression has also been associated with pancreatic cancer, sometimes presenting before the cancer is diagnosed. However, the mechanism for this is not known..

PET Imaging May Help Guide Treatment of Esophageal and Gastric Cancers

2007-09-23T16:53:00.000-07:00

PET Imaging May Help Guide Treatment of Esophageal and Gastric Cancers

According to the results of a study published in Lancet Oncology, use of positron emission tomography (PET) imaging to evaluate response to neoadjuvant (before surgery) chemotherapy may help guide treatment of patients with cancer of the lower part of the esophagus or the upper part of the stomach (adenocarcinoma of the esophagogastric junction).

For patients with operable, locally advanced adenocarcinoma of the lower esophagus, stomach, or esophagogastric junction (the area where the esophagus joins the stomach), a Phase III clinical trial indicated that chemotherapy before and after surgery may improve outcomes.[1] Not all patients respond to chemotherapy, however. Being able to identify early in the course of treatment those patients who are not responding to chemotherapy would allow these patients to stop chemotherapy early and proceed more quickly to surgery.

Positron emission tomography is an imaging technique that is sometimes used to help stage cancer. Prior to a PET scan, a substance containing a type of sugar attached to a radioactive isotope (a molecule that spontaneously emits radiation) is injected into the patient’s vein. The cancer cells “take up” the sugar and attached isotope. The low energy radiation emitted by these cells helps physicians locate cancer.

To evaluate the use of PET for assessing early response to neoadjuvant (before surgery) chemotherapy, researchers conducted a Phase II clinical trial among 110 patients with locally advanced adenocarcinoma of the lower esophagus or the upper part of the stomach.[2] Patients were assessed by PET prior to the start of neoadjuvant chemotherapy and after the first two weeks of neoadjuvant chemotherapy. A comparison of the two scans allowed physicians to assess which cancers were responding to chemotherapy.

Patients who responded to chemotherapy (as assessed by PET) continued on chemotherapy for a total of 12 weeks. Patients who did not respond to chemotherapy stopped chemotherapy after the first two weeks and proceeded directly to surgery.

49% of patients were classified as chemotherapy responders on the basis of their PET results.
Median survival without cancer relapse was 29.7 months in the chemotherapy responders and 14.1 months in the chemotherapy nonresponders. The survival among the chemotherapy nonresponders was similar to the survival noted in a previous study in which nonresponders continued on chemotherapy; this suggests that stopping chemotherapy early in the nonresponders did not have an adverse effect on treatment outcomes.
The researchers conclude that use of PET to monitor chemotherapy response is feasible in patients with adenocarcinoma of the lower esophagus or upper stomach, and may allow for more individualized treatment. Early identification of patients who are not responding to chemotherapy may allow these patients to avoid unnecessary side effects and to consider other treatment options. The researchers note, however, that Phase III clinical trials will be necessary to further evaluate these issues.

References:

[1] Cunningham D, Allum W, Stenning S, et al. Perioperative Chemotherapy Versus Surgery Alone for Resectable Gastroesohpageal Cancer. New England Journal of Medicine. 2006 ; 355:11-20.

[2] Lordick F, Ott K, Krause B-J et al. PET to assess early metabolic response and to guide treatment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase II trial. Lancet Oncology. 2007;8:797-805.

Chemotherapy Delays Need for Radiation in Children with Ependymoma

2007-09-23T16:49:00.001-07:00

Chemotherapy Delays Need for Radiation in Children with Ependymoma

According to the results of a study published in the journal Lancet Oncology, post-surgery treatment with chemotherapy can delay or eliminate the need for radiation therapy in many young children with a type of brain tumor known as an ependymoma.

Other than leukemia and lymphoma, brain tumors are the most common type of cancer in children. An ependymoma is a specific type of brain tumor that accounts for roughly 9% of childhood brain tumors.[1]

Treatment of ependymoma often includes surgery to remove as much of the tumor as possible, and may also include radiation therapy or chemotherapy. Although radiation therapy is effective, a concern with the use of radiation therapy to the brain is that it can cause cognitive impairment and other problems, particularly when given to very young children (children under the age of three years).

To evaluate whether post-surgery treatment with chemotherapy can avoid or delay the need for radiation therapy in young children with ependymoma, researchers conducted a study among 89 children age three or younger.[2]

After surgery all study participants were treated with chemotherapy. The intended duration of the chemotherapy was one year. Radiation therapy was not given until there was evidence of cancer progression.

Among children with non-metastatic cancer at the time of initial diagnosis, 42% avoided radiation therapy for at least five years.
Overall three-year survival was 79%, and overall five-year survival was 63%.
For the children who received radiation therapy as a result of cancer progression, the median delay in radiation therapy (the time from initial cancer surgery to initiation of radiation therapy) was 20 months.
The researchers concluded that post-surgery treatment with chemotherapy “avoided or delayed radiotherapy in a substantial proportion of children younger than 3 years without compromising survival.”

References:
[1] National Cancer Institute. General Information About Childhood Ependymoma. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/childependymoma/Patient (Accessed July 31, 2007).

[2] Grundy RG, Wilne SA, Weston CI et al. Primary postoperative chemotherapy without radiotherapy for intracranial ependymoma: the UKCCSG/SIOP prospective study. Lancet Oncology [early online publication]. July 20, 2007.

HPV Vaccine Does Not Treat Existing Infections

2007-09-23T16:45:00.000-07:00

HPV Vaccine Does Not Treat Existing Infections

According to the results of a study published in the Journal of the American Medical Association, Cervarix™—a vaccine designed to prevent infection with two high-risk types of human papillomavirus (HPV)—does not treat HPV infections in women who are already infected at the time of vaccination.

Human papillomaviruses (HPV) consist of more than 100 different viruses. Some types of HPV cause warts on the hands or feet; others cause genital warts; and some have been linked with cancer, most notably cervical cancer. The types of HPV most commonly linked with cervical cancer are HPV 16 and HPV 18, but several other high-risk types contribute to cancer as well.

The types of HPV that cause cervical cancer or genital warts are transmitted sexually. HPV infection is extremely common and generally occurs soon after an individual becomes sexually active. Although most infections resolve on their own, some persist and can lead to precancerous or cancerous changes to the cervix, vulva, vagina, penis, and anus.

Vaccines that prevent infection with high-risk types of HPV have the potential to greatly reduce the occurrence of cervical cancer. The HPV vaccine that is currently on the market is Gardasil®, which targets HPV types 6 and 11 (which are linked with genital warts) as well as the cancer-associated types 16 and 18. Another HPV vaccine that may be approved is Cervarix™, which targets HPV types 16 and 18 only. Because HPV types 16 and 18 are thought to account for roughly 70% of all cases of cervical cancer, widespread use of these vaccines would have the potential to eliminate most (but not all) cases of cervical cancer.

Although Cervarix and Gardasil were both developed to prevent infection with high-risk types of HPV—and not to treat existing infections—researchers in Costa Rica evaluated the effect of Cervarix on existing HPV infections.

The study involved 2,189 women between the ages of 18 and 25 years. All women tested positive for HPV prior to vaccination. Half the study participants were vaccinated with Cervarix and half were given a hepatitis A vaccine. The women given the hepatitis A vaccine served as the comparison group.

By six months, the percent of women who had cleared their HPV infection was 33.4% among women who received Cervarix and 31.6% among women who received the hepatitis A vaccine.
By 12 months, the percent of women who had cleared their HPV infection was 48.8% among women who received Cervarix and 49.8% among women who received the hepatitis A vaccine.
The researchers conclude that Cervarix does not speed the clearance of existing HPV infections, and should not be used to treat existing HPV infections.

Reference: Hildesheim A, Herrero R, Wacholder S et al. Effect of human papillomavirus 16/18 L1 viruslike particle vaccine among young women with preexisting infection. JAMA. 2007;298:743-753.

Shortened Interval Between Chemotherapy Cycles Does Not Improve Survival with Osteosarcoma

2007-09-22T06:18:00.000-07:00

Shortened Interval Between Chemotherapy Cycles Does Not Improve Survival with Osteosarcoma

According to the results of a study published in the Journal of the National Cancer Institute, osteosarcoma patients treated with the chemotherapy drugs cisplatin and doxorubicin every two weeks did not have better survival than patients who received the same drugs every three weeks.

Osteosarcoma is a type of cancer that originates in the bone. Patients with osteosarcoma are often young; the disease most commonly affects individuals between 10 and 25 years of age.

Dose-dense chemotherapy generally refers to chemotherapy administered with a shortened interval between cycles; for example, chemotherapy that is usually given every three weeks may be given every two weeks. These dose-dense regimens may kill more cancer cells, but they also allow less time for bone marrow recovery and are associated with anemia (low red blood cell level) and neutropenia (low white blood cell level).

To compare dose-dense chemotherapy to conventional chemotherapy in patients with nonmetastatic, high-grade osteosarcoma of an extremity, researchers in Europe conducted a
Phase III clinical trial among 497 patients.

All study participants received six cycles of cisplatin and doxorubicin. Half the patients received chemotherapy every three weeks (conventional chemotherapy group), and half the patients received chemotherapy every two weeks (dose-dense group). To reduce the risk of neutropenia (below normal levels of neutrophils, a type of white blood cell), patients in the dose-dense group also received treatment with a white blood cell booster. Patients in both study groups had surgery during the sixth week of treatment.

• 78% of patients in the conventional chemotherapy group and 80% of patients in the dose-dense chemotherapy group completed six cycles of chemotherapy.
• Patients in the dose-dense group were less likely to experience very low white blood cell levels and more likely to experience thrombocytopenia (low platelet levels) and mucositis (inflammation of the lining of the mouth or gastrointestinal tract).
• There was no significant difference between study groups in overall or progression-free survival.

This study suggests that among patients with high-grade osteosarcoma treated with cisplatin and doxorubicin, shortening the interval between chemotherapy cycles from three weeks to two weeks does not improve survival.

Reference: Lewis IJ, Nooij MA, Whelan J et al. Improvement in histologic response but not survival in osteosarcoma patients treated with intensified chemotherapy: a randomized Phase III trial of the European Osteosarcoma Intergroup. Journal of the National Cancer Institute. 2007;99:112-28.

Ovarian cancer symptoms

2007-09-22T05:50:00.000-07:00

Ovarian cancer Symptoms & Signs of Ovarian cancer

Women with ovarian cancer may experience the following symptoms. Sometimes, women with ovarian cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

Abdominal or pelvic discomfort or pain

Persistent indigestion, gas, nausea, diarrhea, or constipation

Frequent or urgent need to urinate

Abdominal or pelvic pressure, swelling, or bloating

Loss of appetite

Feeling of fullness, even after a light meal

Unexplained weight loss or gain, especially in the abdominal area

Abnormal bleeding from the vagina

Pain during intercourse

Constant tiredness

Lower back pain

Mouth (Oral) cancer symptoms

2007-09-22T05:48:00.000-07:00

Oral cancer symptoms and Signs of oral cancer

Often, a dentist is the first person to find an oral cavity cancer on a routine examination. People with oral and oropharyngeal cancer may experience the following symptoms. Sometimes, people with oral and oropharyngeal cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor.

Sore in the mouth or on the lip that does not heal (the most common symptom)

Red or white patch on the gums, tongue, tonsil, or lining of the mouth

Lump on the lip, mouth, neck, or throat or a feeling of thickening in the cheek

Persistent sore throat, or a feeling that something is caught in the throat

Hoarseness or change in voice

Numbness of the mouth or tongue

Pain or bleeding in the mouth

Difficulty chewing, swallowing, or moving the jaws or tongue

Ear and/or jaw pain

Chronic bad breath

Changes in speech

Loosening of teeth or toothache

Dentures that no longer fit

Unexplained weight loss

Fatigue

Loss of appetite, especially when prolonged (anorexia); this may happen later in the course of the illness

People who notice any of these warning signs should consult a doctor and/or dentist right away. When detected early, cancers of the oral cavity and oropharynx have a much better chance of cure.

Because many of these symptoms can be caused by other noncancerous health conditions as well, it is important for people to receive regular health and dental screenings, especially those who routinely drink alcohol or currently use tobacco products or have used them in the past.

Because many of these symptoms can be caused by other noncancerous health conditions as well, it is important for people to receive regular health and dental screenings, especially those who routinely drink alcohol or currently use tobacco products or have used them in the past.

Mesothelioma symptoms

2007-09-22T05:35:00.000-07:00

Mesothelioma Symptoms & Signs of Mesothelioma Cancer

Mesothelioma

Symptoms

People with mesothelioma may experience the following symptoms. Sometimes, people with mesothelioma do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. Often, symptoms of mesothelioma may not appear until years or decades after asbestos exposure. If you are concerned about a symptom on this list, please talk to your doctor.

General mesothelioma symptoms may include:

Weight loss

Fatigue

Problems with blood clotting

Anemia (low blood count)

Fever

Night sweats

If mesothelioma is present in the lung area, symptoms may include:

Shortness of breath, caused by fluid from the cancer or the increasing size of the tumor limiting the amount of chest space for the lungs to expand

Pain in the chest area

If mesothelioma is present in the abdominal area, symptoms may include

Abdominal pain

Abdominal swelling

Bowel obstruction

Lung cancer symptoms

2007-09-22T05:34:00.003-07:00

Lung cancer Symptoms & Signs of Lung cancer

People with lung cancer may experience the following symptoms. Sometimes people with lung cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

For people with lung cancer who have no symptoms, their lung cancer can be discovered on a chest x-ray or CT scan performed for some other reason, such as checking for heart disease. Most people with lung cancer are diagnosed when the tumor grows, takes up space, or begins to interfere with nearby structures. Lung tumors may also make fluid that can collect in the lung or the space around the lung. A tumor can push the air out of the lungs and cause the lung to collapse. In this way, lung tumors can prevent the exchange of oxygen and carbon dioxide by blocking the flow of air into the lungs, or by using up the space normally required for oxygen to come in and carbon dioxide to go out of the lung.

Symptoms of a lung cancer may include:

Fatigue (tiredness)

Cough

Shortness of breath

Chest pain, if a tumor invades a structure within the chest or involves the lining of the lung

Loss of appetite

Coughing up phlegm or mucus

Hemoptysis (coughing up blood)

Although lung cancer can metastasize (spread) anywhere in the body, the most common sites of spread are the lymph nodes, lungs, bones, brain, liver, and structures near the kidneys called the adrenal glands. Metastases (spread to more than one area) from lung cancer can cause further breathing difficulties, bone pain, abdominal or back pain, headache, weakness, seizures, and/or speech difficulties. Rarely, lung tumors can release hormones that result in chemical imbalances, such as low blood sodium levels or high blood calcium.

Symptoms such as fatigue, malaise (feeling out-of-sorts or unwell), and loss of appetite are not necessarily due to metastases. The presence of cancer anywhere in the body can cause a person to feel unwell in a general way. Loss of appetite can result in weight loss. Fatigue and weakness can further worsen breathing difficulties.

Liver cancer symptoms

2007-09-22T05:34:00.001-07:00

Liver cancer symptoms and Signs of liver cancer

People with adult primary liver cancer may experience the following symptoms. Sometimes, people with adult primary liver cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. Symptoms of adult primary liver cancer often do not appear in the early stages of the disease. If you are concerned about a symptom on this list, please talk with your doctor.

Pain, especially at the top right of the abdominal area, which may also be felt close to the right shoulder, near the right shoulder blade, or in the back

Weight loss

A hard lump under the ribs on the right side of the body, indicating that the liver has increased in size

Weakness or fatigue

Increasingly, liver cancer is being detected before any symptoms develop by screening people who are at high risk for developing liver cancer, such as those who have cirrhosis, or those who are carriers of the hepatitis B or C virus.

At the time of diagnosis of liver cancer, some people will already know that they have cirrhosis and will already be under the care of a doctor. People who already have cirrhosis may experience different liver cancer symptoms than someone without cirrhosis, including abdominal swelling due to ascites (fluid accumulation), or the individual may find that he or she needs increasing amounts of diuretics (water tablets) to control the abdominal fluid accumulation. Hepatic encephalopathy (mental confusion) and bleeding from the esophagus or stomach, or any worsening of the condition, may also indicate cancer.

Kidney cancer symptoms

2007-09-22T05:33:00.002-07:00

Kidney cancer symptoms and Signs of kidney cancer

Many kidney cancers are found incidentally, when a person has an x-ray or ultrasound test for other reasons.

People with kidney cancer may experience the following symptoms. Sometimes, people with kidney cancer do not show any of these symptoms. Often, many symptoms of cancer, such as blood in the urine, can also signal other conditions. In its earliest stages, kidney cancer causes no pain. Therefore, symptoms of the disease usually appear when the tumor is quite large and begins to affect nearby organs. If you are concerned about a symptom on this list, please talk with your doctor.

Remember that the symptoms below may occur with other conditions and don’t necessarily indicate the presence of kidney cancer.

Symptoms of kidney cancer may include:

Hematuria (blood in the urine)

Pain or pressure in the side or back

A mass or lump in the side or back

Swelling of the ankles and legs

High blood pressure, or anemia (low red blood cell count)

Fatigue

Loss of appetite

Unexplained weight loss

Recurrent fevers (not from cold, flu, or other infections)

In a man, a rapid development of a varicocele (a cluster of enlarged veins) around the testicle

Routine screening tests to detect early kidney cancer are not available. Doctors may suggest that people at high risk for the disease undergo imaging tests to look inside the body. In patients with a family history of kidney cancer, CT scans will sometimes be used to search for early-stage kidney cancer. However, CT scans have never been shown to be a useful screening tool for kidney cancer in the general community.

Eye cancer symptoms

2007-09-22T05:33:00.001-07:00

Eye cancer symptoms and Signs of eye cancer

People affected by intraocular melanoma often have no symptoms. Many times, an ophthalmologist finds the melanoma during a routine eye examination. The most common symptom is painless loss of vision. Unlike choroidal and ciliary body melanoma, iris melanoma can sometimes be seen because it looks like dark spots on the eye.

People with eye cancer may experience the symptoms described below. Sometimes people with eye cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your ophthalmologist.

Having trouble seeing

Losing part of the field of vision

Seeing flashes of light

Seeing spots, squiggly lines, or floating objects (floaters)

Having a dark spot on the iris

Esophageal cancer symptoms

2007-09-22T05:32:00.000-07:00

Esophageal cancer symptoms and Signs of esophageal cancer

Dysphagia (difficulty swallowing) is the first symptom in most patients. Odynophagia (painful swallowing) may be present. Fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty. Substantial weight loss is characteristic as a result of poor nutrition and the active cancer. Pain, often of a burning nature, may be severe and worsened by swallowing, and can be spasmodic in character. An early sign may be an unusually husky or raspy voice.

The presence of the tumor may disrupt normal peristalsis (the organised swallowing reflex), leading to nausea and vomiting, regurgitation of food, coughing and an increased risk of aspiration pneumonia. The tumor surface may be fragile and bleed, causing hematemesis (vomiting up blood). Compression of local structures occurs in advanced disease, leading to such problems as superior vena cava syndrome. Fistulas may develop between the esophagus and the trachea, increasing the pneumonia risk; this symptom is usually heralded by cough, fever or aspiration.

If the disease has spread to elsewhere, this may lead to symptoms related to this: liver metastasis could cause jaundice and ascites, lung metastasis could cause shortness of breath, pleural effusions, etc.

Cancer of the esophagus is most curable when it is diagnosed early. Because early esophageal cancer causes few symptoms, it is often more advanced when the diagnosis is made.

People with esophageal cancer may experience the following symptoms. Sometimes, people with esophageal cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor.

Difficulty swallowing, particularly when eating meat, bread, or raw vegetables (As the tumor grows, it can block the pathway to the stomach. Even liquid may be painful to swallow.)

Pressure or burning in the chest

Indigestion or heartburn

Vomiting

Frequent choking on food

Weight loss

Coughing or hoarseness

Pain behind the breastbone or in the throat

Endometrial cancer symptoms

2007-09-22T05:31:00.000-07:00

Endometrial cancer symptoms and Signs of endometrial cancer

abnormal uterine bleeding, abnormal menstrual periods

bleeding between normal periods in premenopausal women

vaginal bleeding and/or spotting in postmenopausal women

in women older than 40: extremely long, heavy, or frequent episodes of bleeding (may indicate premalignant changes)

lower abdominal pain or pelvic cramping

thin white or clear vaginal discharge in postmenopausal women

Colon cancer symptoms

2007-09-22T05:30:00.000-07:00

Colon cancer symptoms and Signs of colon cancer

By being alert to the symptoms of colorectal cancer, it may be possible to detect the disease early, when it is most likely to be treated successfully. Many people with colorectal cancer do not have any symptoms, so people need to be screened regularly.

People with colorectal cancer may experience the following symptoms. Sometimes, people with colorectal cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor and ask that a colonoscopy be scheduled.

A change in bowel habits

Diarrhea, constipation, or feeling that the bowel does not empty completely

Bright red or very dark blood in the stool

Stools that look narrower or thinner than normal

Discomfort in the abdomen, including frequent gas pains, bloating, fullness, and cramps

Weight loss with no known explanation

Constant tiredness or fatigue

Unexplained iron-deficiency anemia (low number of red blood cells)

Brain cancer symptoms

2007-09-22T05:28:00.000-07:00

Brain cancer symptoms and Sign of brain cancer (brain tumor)

People with a brain tumor often experience the following symptoms. Sometimes, people with a brain tumor do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor.

Symptoms of a brain tumor can be general (due to the pressure of the tumor on the brain or spinal cord) or specific (due to the interruption of the normal functioning of a specific part of the brain). Generally, a brain tumor is not diagnosed until symptoms begin.

General symptoms include:

Headaches, which may be severe and may worsen with activity or in the early morning

Seizures

Personality or memory changes

Nausea or vomiting

Vision changes, such as blurred vision

Symptoms that may be specific to the location of the tumor include:

Pressure or headache near the tumor

Loss of balance and difficulty with fine motor skills (cerebellum)

Changes in judgment, including loss of initiative, sluggishness, and muscle weakness or paralysis (frontal lobe of the cerebrum)

Partial or complete loss of vision (occipital lobe of the cerebrum)

Changes in speech, hearing, memory, or emotional state, such as aggressiveness and problems understanding or retrieving words (temporal lobe of cerebrum)

Altered perception of touch or pressure, arm or leg weakness on one side of the body, or confusion with left and right sides of the body (parietal lobe of the cerebrum)

Inability to look upward (pineal tumor)

Lactation, altered menstrual periods, and growth in hands and feet in adults (pituitary tumor)

Bone cancer symptoms

2007-09-22T03:50:00.001-07:00

Bone cancer symptoms and Signs of bone cancer

People with bone cancer may experience the following symptoms. Sometimes, people with bone cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

When a bone tumor grows, it compresses normal tissue and destroys bone tissue, which can cause symptoms. The earliest symptoms of bone cancer are pain and swelling in the area of the tumor. The pain may come and go at first, then become more severe and steady later. The pain may worsen with movement, and there may be swelling in the soft tissues nearby. A tumor that occurs near or in joints may cause the joint to swell and become tender or stiff, which means a person may experience a limited and painful range of movement.

Some people experience a pronounced limp (if the leg is affected) or even a fracture in the affected bone. These symptoms indicate that the disease may be more advanced. Symptoms such as fever, malaise (feeling unwell), weight loss, and anemia occur rarely with bone cancer.

Blood cancer symptoms

2007-09-22T03:47:00.001-07:00

Blood cancer symptoms and Signs of blood cancer

Damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds (petechiae).

White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the patient's immune system (white blood cells etc.) to start attacking other body cells.

Finally, the red blood cell deficiency leads to anemia, which may cause dyspnea. All symptoms may also be attributable to other diseases; for diagnosis, blood tests and a bone marrow examination are required.

Some other related symptoms

Fever, chills, night sweats and other flu-like symptoms

Weakness and fatigue

Loss of appetite and/or weight

Swollen or bleeding gums

Neurological symptoms (headache)

Enlarged liver and spleen

Easy Bruising

Frequent Infection

Bone Pain

Joint Pain

Swollen Tonsils

The word leukemia, which means 'white blood,' is derived from the disease's namesake high white blood cell counts that most leukemia patients have before treatment. The high number of white blood cells are apparent when a blood sample is viewed under a microscope. Many times, these extra white blood cells are immature or dysfunctional. The excessive number of cells can also interfere with the normal function of other cells.

Some leukemia patients do not have high white blood cell counts visible during a regular blood count. This less-common condition is called aleukemia. The bone marrow still contains cancerous white blood cells, and they are disrupting the normal production of blood cells. However, they are staying in the marrow instead of entering the bloodstream, where they would be visible in a blood test. For an aleukemic patient, the white blood cell counts in the bloodstream can be normal or low. Aleukemia can occur in any of the four major types of leukemia, and is particularly common in hairy cell leukemia.

Cervical cancer symptoms

2007-09-22T03:37:00.000-07:00

Cervical cancer symptoms and Signs of cervical cancer

Women with cervical cancer often experience the following symptoms. Sometimes, women with cervical cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.Most women do not have any signs or symptoms of a precancer or early stage cervical cancer. Symptoms usually do not appear until the cancer has spread to other tissues and organs.Any of the following could be signs or symptoms of cervical dysplasia or cancer:
• Blood spots or light bleeding between or following periods
• Menstrual bleeding that is longer and heavier than usual
• Bleeding after intercourse, douching, or a pelvic examination
• Pain during sexual intercourse
• Vaginal bleeding after menopause
• Increased vaginal discharge

Any of these six symptoms should be reported to the doctor. When these symptoms do appear, it is important to talk with your doctor about them even if they appear to be symptoms of other, less serious conditions. The earlier cancer or precancerous cells are found and treated, the better the chance that the cancer can be cured.

Evista® Approved for Prevention of Breast Cancer

2007-09-22T03:29:00.000-07:00

Evista® Approved for Prevention of Breast Cancer

The United States Food and Drug Administration (FDA) has approved Evista® (raloxifene) to prevent invasive breast cancer among postmenopausal women with osteoporosis and postmenopausal women who are at a high risk of developing breast cancer.

Breast cancer is diagnosed in over 200,000 women annually in the United States and is responsible for approximately 40,000 deaths. The majority of women with breast cancer have cancer that is estrogen-receptor positive (ER-positive). This type of breast cancer is stimulated to grow by the female hormones estrogen and/or progesterone.

Women with ER-positive breast cancer are commonly treated with hormone therapy. This approach suppresses the formation of estrogen or blocks estrogen from stimulating cancer cells to grow.

Some postmenopausal women at a high risk of developing breast cancer can be treated with the anti-estrogen agent tamoxifen. Results from studies have indicated that tamoxifen can reduce the risk of developing breast cancer in these high-risk women by approximately 50%.

However, serious side effects associated with tamoxifen may prevent physicians from recommending its use as a preventive agent or may stop patients from taking tamoxifen for breast cancer prevention. These side effects include an increased risk of endometrial (uterine) cancer and the development of blood clots.

Tamoxifen is widely used in the treatment of ER-positive breast cancer; the drug’s benefits outweigh its risks in this setting. However, a newer class of drugs that inhibit estrogen’s effects on stimulating cancer growth, referred to as aromatase agents, are being widely used for the treatment of ER-positive breast cancer, as outcomes are improved with aromatase agents over tamoxifen in this disease.

Evista is an agent that also reduces the stimulatory effects of estrogen on cancer growth. It was previously approved for the prevention and treatment of osteoporosis. However, due to the fact that it reduces estrogen’s effects on cells, researchers speculated that it may also be used as a preventive or therapeutic agent for ER-positive breast cancer.

The trial that prompted FDA approval for Evista in the prevention of breast cancer was referred to as the STAR trial. The STAR trial directly compared Evista to tamoxifen in the prevention of breast cancer in women who were considered at a high risk of developing the disease. This trial included over 19,000 women who were considered high risk due to the following factors: a family history of breast cancer, personal medical history, age, age at first menstrual period, and age at first live birth. Women were followed for nearly four years.

• Evista produced results equal to tamoxifen in reducing the risk of developing breast cancer among these women. Evista, however, had fewer side effects than tamoxifen.
• Rates of breast cancer were reduced by approximately 50% in both groups of patients.
• Among women who had not had a hysterectomy (approximately half of the women), those treated with Evista had a 38% lower rate of uterine cancer than those treated with tamoxifen.
• Women treated with Evista had a 29% reduced risk of developing blood clots compared with those treated with tamoxifen.
• Women treated with Evista had an approximately 20% reduced risk of developing cataracts compared with those treated with tamoxifen.
• Women treated with tamoxifen had fewer cases of lobular carcinoma in situ (LCIS) and ductal carcinoma in situ (DCIS)—conditions considered to be “pre-cancerous”—than those treated with Evista.

Post menopausal women who are either at a high risk of developing breast cancer or who have osteoporosis may wish to speak with their physician regarding their individual risks and benefits of receiving tamoxifen for the prevention of breast cancer. However, because all medications carry their own side effects and risks, it is important that each woman considering taking Evista understand side effects associated with this agent.

Reference: Eli Lilly. FDA Approves Lilly's Osteoporosis Drug EVISTA® (raloxifene HCl) to Reduce The Risk of Invasive Breast Cancer in Two Populations of Postmenopausal Women. Available at: http://newsroom.lilly.com/ReleaseDetail.cfm?ReleaseID=264036. Accessed September 2007.

Breast cancer symptoms

2007-09-22T03:27:00.000-07:00

Breast cancer symptoms and Signs of breast cancer

Women with breast cancer may experience the following symptoms. Sometimes, women with breast cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor.
However, many breast cancers develop with no symptoms at all. Some tumors may be visible on a mammogram before symptoms develop. It is important for all women to be familiar with the appearance, feel, shape, and texture of their breasts in order to detect changes as soon as they occur.

•New lumps (many women normally have lumpy breasts) or a thickening in the breast or under the arm
•Nipple tenderness, discharge, or physical changes (such as a nipple turned inward or a persistent sore)
• Skin irritation or changes, such as puckers, dimples, scaliness, or new creases
• Warm, red, swollen breasts with a rash resembling the skin of an orange (peau d'orange)
• Pain in the breast (usually not a symptom of breast cancer, but should be reported to a doctor)

Improved Outcomes with Higher Volumes for Radical Cystectomy

2007-09-22T03:19:00.000-07:00

Improved Outcomes with Higher Volumes for Radical Cystectomy

According to an early online publication in the Journal of Urology, patients with bladder cancer who undergo surgery to remove their bladder have improved outcomes if they receive treatment at a medical center where large volumes of these procedures are performed.

The bladder is a hollow organ located in the pelvis. Its primary function is to store urine (the waste produced when the kidneys filter the blood). Urine enters the bladder through two tubes called ureters and leaves the bladder through a single tube called the urethra. The bladder has a muscular wall that allows it to get larger and smaller as urine is stored or emptied.

Bladder cancer is diagnosed in roughly 50,000 men and 17,000 women annually in the U.S. Bladder cancer is most common in older individuals, with more than 70% of cases diagnosed after the age of 65.

The relationship between patient outcomes and the number of patients seen at a particular hospital or by a particular doctor has received a great deal of attention over the past 25 years. In general, studies report that “high-volume” hospitals and doctors (hospitals and doctors who treat more patients with a particular condition) have better patient outcomes for specific conditions.

Researchers from Vanderbilt have recently conducted a clinical study to evaluate data regarding a potential relationship between outcomes of patients undergoing a radical cystectomy (removal of the bladder) and the number of these procedures performed at the medical facility where they are treated. The data was obtained from the University HealthSystem Consortium Clinical Database. All institutions were categorized as “academic.” Data included 6,728 patients with bladder cancer who had undergone a radical cystectomy between 2002 and 2007.

• The mortality rate for patients undergoing a radical cystectomy was .54% for those treated in a facility performing more than 50 radical cystectomies per year, compared with 2.7% for those treated in a facility performing 10 or less procedures per year.
•Total hospital discharges or geographic region had no effect on patient outcomes.

The researchers concluded that these results provide further evidence that outcomes are improved among patients with various types of cancers undergoing procedures or treatment in medical facilities that perform a high volume of the same procedures. Patients who are to undergo a radical cystectomy may wish to speak with their surgeon regarding the number of procedures their medical institution performs annually.

Reference: Barbieri CE, Lee B, Cookson MS, et al. Association of procedure volume with radical cystectomy outcomes in a nationwide data base. The Journal of Urology [early online publication]. July 27, 2007.

Farrah Fawcett Is Fighting Cancer

2007-09-22T03:04:00.000-07:00

Farrah Fawcett Is Fighting Cancer
Actress Is Reportedly Getting Treatment for Anal Cancer
WebMD Medical News

Reviewed by Louise Chang, MD

Oct. 13, 2006 -- Former Charlie's Angel Farrah Fawcett faced many foes in her years playing private detective Jill Munroe, but she may now be facing her toughest enemy yet -- cancer.

While her publicist, Mike Pingell, did not confirm the type of cancer, actor Ryan O'Neal told People magazine that Fawcett had been diagnosed with anal cancer, a relatively rare cancer that occurs in the anus. The anal canal is a small section, about an inch and a half long, that connects the rectum to the outside of the body.

"The reason people don't hear so much about anal cancer is not because it's taboo or a body part that we don't often talk about, it is because it is such an uncommon type of cancer," says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society (ACS) in Atlanta.

In 2006, there will be 4,660 new cases of anal cancer in the U.S. and about 660 deaths, according to ACS statistics.

When celebrities like Fawcett come forward with a cancer diagnosis, it can raise awareness and often change health behaviors, Saslow tells WebMD.

"When [CBS anchorwoman] Katie Couric talked about colon cancer, she really increased awareness about screening, but with anal cancer, we don't have screening, so we won't see the same behavior change," she says.

Couric became an advocate for colon cancer following the death of her husband, Jay Monahan, from the cancer at age 42. She underwent a colonoscopy live on the Today show in March 2000 and as a result, test rates jumped more than 20% nationwide.

The HPV Connection

"There is nothing recommended that we can do to screen for or prevent anal cancer," Saslow says. But "some people are looking at what causes anal cancer and focusing on human papillomavirus (HPV) infections," she says. A sexually transmitted infection, HPV has also been linked to cervical cancer. This summer, the FDA approved a vaccine against the virus.

"There aren't any studies to show that a vaccine will prevent anal cancer, but we have every reason to believe that it will," says Saslow. Fawcett's diagnosis may increase awareness about the recommendation to get vaccinated against HPV, she speculates.

"The HPV virus associated with cervical cancer is also associated with anal cancer, so it's a very reasonable expectation that incidence of anal cancer should decrease further if the population gets vaccinated," says Leonard Saltz, MD, an attending physician at Memorial Sloan-Kettering Cancer Center in New York City.

This is probably one more good reason for people to get the HPV vaccine, he tells WebMD.
In addition to HPV infection, smoking, multiple sex partners, and having a weakened immune system may increase risk for anal cancer.
However, some patients who develop anal cancer don't have any risk factors.
Symptoms may include bleeding or itching around the anus, pain in the anal area, a change in bowel habits, a lump in the anal area, swollen lymph nodes in the anal or groin area, and abnormal discharge from the anus.

"Anal cancer is rare, but colorectal cancercolorectal cancer is common and people tend to associate them together, so an awareness of nonspecific symptoms like rectal bleeding may encourage people to see a doctor," Saltz says.

Bright Prognosis

The good news is that most people with anal cancer will be cured. Treatment typically entails surgery, radiation, or chemotherapy. Media reports suggest that Fawcett is being treated with a combination of chemotherapy and radiation.

"There is a misconception in our society that cancers can't be beaten and cancer can't be treated, but many times, we can successfully treat and cure cancer, and anal cancer, when it's caught early, is quite treatable," says Saltz.

Doctors may find anal cancer early with a rectal exam. During this test the doctor inserts a gloved finger into the anus to feel for lumps or growths.

People at high risk for anal cancer should talk to their doctor about their risk. Those considered at high risk include transplant recipients, HIV-positive people, women who have had cervical cancer or vulvar cancer, and all men who have sex with men.

Fawcett remains optimistic. "I am resolutely strong and I am determined to bite the bullet and fight the fight while going through the next six weeks of cutting edge, state of the art treatment. I should be able to return to my life as it was before at the end of my treatment," she said in a prepared statement.

Bladder cancer symptoms

2007-09-22T02:55:00.000-07:00

Bladder cancer symptoms and Signs of bladder cancer

People with bladder cancer may experience the following symptoms. Sometimes, people with bladder cancer do not show any of these symptoms. Or, these symptoms may be similar to symptoms of other medical conditions. If you are concerned about a symptom on this list, please talk with your doctor.Bladder cancer usually does not cause symptoms that specifically indicate cancer. Most bladder cancers are diagnosed when a person complains of hematuria (blood in the urine). Doctors cannot use urine tests to make a specific diagnosis of bladder cancer because hematuria can signal other conditions besides bladder cancer, such as an infection or kidney stones.If you are concerned about a symptom on this list, please talk with your doctor.

• Hematuria
• Pain during urination
• Frequent urination
• Feeling the need to urinate throughout the night
• Feeling the need to urinate, but not being able to pass urine

Symptoms of advanced bladder cancer may include pain, a change in bowel habits, unexplained loss of appetite, and weight loss.
Sometimes when the first symptoms of bladder cancer appear, the cancer has already metastasized. In this situation, the symptoms depend on the site of metastasis. For example, lung metastases may cause cough or shortness of breath, liver metastases may cause abdominal pain or jaundice (yellowing of the skin and whites of the eyes), and bone metastases may cause bone pain or fractures.

Anal cancer symptoms

2007-09-22T02:20:00.000-07:00

Anal cancer symptoms

Many men have no visible symptoms of anal cancer. However, because the cancer is strongly associated with HPV infection, a history of anogenital warts is likely. Although most lesions are benign, any visible anal sore or bump should be examined. They may be a sign that others have developed in the anal canal. Other signs include the following:
• Abnormal discharge from the anus
• Bleeding from the rectum and anus
• Itching of the anus
• Pain or pressure around the anus
• Sore around the anus that does not heal

All of these signs warrant an examination by a physician. Signs of anal cancerPossible signs of anal cancer include bleeding from the anus or rectum or a lump near the anus. These and other symptoms may be caused by anal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
• Bleeding from the anus or rectum.
• Pain or pressure in the area around the anus.
• Itching or discharge from the anus.
• A lump near the anus.
• A change in bowel habits.