Cancer research, progress, new drugs, etc.

[waltky]

Brain and pancreatic cancer discovery...

Gene domino effect behind brain, pancreatic tumors
Sep 4, `08 WASHINGTON (AP) - Scientists have mapped the cascade of genetic changes that turn normal cells in the brain and pancreas into two of the most lethal cancers. The result points to a new approach for fighting tumors and maybe even catching them sooner.

Genes blamed for one person's brain tumor were different from the culprits for the next patient, making the puzzle of cancer genetics even more complicated. But Friday's research also found that clusters of seemingly disparate genes all work along the same pathways. So instead of today's hunt for drugs that target a single gene, the idea is to target entire pathways that most patients share. Think of delivering the mail to a single box at the end of the cul-de-sac instead of at every doorstep. The three studies, published in the journals Science and Nature, mark a milestone in cancer genetics.

"This is the next wave," said Dr. Phillip Febbo of Duke University's Institute for Genome Sciences and Policy, who was not involved with the new research. "What's really important is that finding those common elements within the landscape suggests there are therapeutic interventions that can help the whole group." Despite 30 years of laborious work, scientists until now have found only a fraction of the genetic alterations required to cause any of the 200 diseases that collectively are called cancer. Different tumors require a different domino effect of genetic changes to arise, and to determine their severity and even which treatments will work.

The new maps do not include just mutated genes. They cite missing ones, extra ones, and overactive or underactive ones, too, in the most comprehensive look ever at human tumors. Teams led by Johns Hopkins University examined more than 20,000 genes in tumors taken from 24 pancreatic cancer patients and 22 patients with the most dangerous brain tumor, called glioblastoma multiforme. Separately, The Cancer Genome Atlas project - a government-funded network of 18 medical centers - analyzed 600 genes in glioblastomas from 206 patients.

More My Way News - Gene domino effect behind brain, pancreatic tumors

[waltky]

Adult cancer discoveries help kids...

Adult Cancer Therapies May Benefit Kids
Sept. 5, 2008 : New, Targeted Innovations Could Ease Smallest Victims' Pain

Of course there were celebrity appearances at Friday's Stand Up To Cancer prime-time special, but cutting-edge cancer research will also take center stage. And two of science's biggest breakthroughs might soon benefit cancer's littlest victims. When 11-year-old Pearce Quesenberry began treatment for a brain tumor, losing her long, brown hair wasn't the only thing she'd have to get used to, CBS News anchor Katie Couric reports. "Like when I was getting this in," Pearce said, pointing to a tube.

"This is called an NG tube. And it goes up my nose and down into my throat and down into my stomach," she explained. That feeding tube has been a Godsend, because the aggressive radiation and chemotherapy makes it almost impossible for her to eat. "So that's the nutrition you're getting?" Couric asked. "Yes, all nutrition," she said. In a way, it's like making a deal with the devil. Because the treatment, while it may save lives, can be really devastating to kids.

"Absolutely," said Dr. Peter Phillips of the Children's hospital of Philadelphia. "It's difficult enough going through the initial therapy. But the consequences, particularly of radiation therapy has profound effects in terms of their long-term quality of life," he said. But children may soon reap the benefits of newer, targeted therapies that have been successful in treating other types of cancer in adults. Dr. Tom Curran of the Children's Hospital of Philadelphia says science has yielded an exciting link between an adult form of skin cancer and medulloblastoma, the most common malignant brain tumor in children.

MORE

[waltky]

Time to rethink the war on cancer...

We Fought Cancer…And Cancer Won.
Sep 6, 2008 - After billions spent on research and decades of hit-or-miss treatments, it's time to rethink the war on cancer.

There is a blueprint for writing about cancer, one that calls for an uplifting account of, say, a woman whose breast tumor was detected early by one of the mammograms she faithfully had and who remains alive and cancer-free decades later, or the story of a man whose cancer was eradicated by one of the new rock-star therapies that precisely target a molecule that spurs the growth of malignant cells. It invokes Lance Armstrong, who was diagnosed with testicular cancer in 1996 and, after surgery and chemotherapy beat it back, went on to seven straight victories in the Tour de France. It describes how scientists wrestled childhood leukemia into near submission, turning it from a disease that killed 75 percent of the children it struck in the 1970s to one that 73 percent survive today.

But we are going to tell you instead about Robert Mayberry. In 2002 a routine physical found a lesion on his lung, which turned out to be cancer. Surgeons removed the malignancy, which had not spread, and told Mayberry he was cured. "That's how it works with lung cancer," says oncologist Edward Kim of the University of Texas M. D. Anderson Cancer Center in Houston, who treated Mayberry. "We take it out and say, 'You're all set, enjoy the rest of your life,' because really, what else can we do until it comes back?" Two years later it did. The cancerous cells in Mayberry's lung had metastasized to his brain—either after the surgery, since such operations rarely excise every single microscopic cancer cell, or long before, since in some cancers rogue cells break away from the primary tumor as soon as it forms and make their insidious way to distant organs. It's impossible to know. Radiation therapy shrank but did not eliminate the brain tumors. "With that level of metastasis," says Kim, "it's not about cure. It's about just controlling the disease." When new tumors showed up in Mayberry's bones, Kim prescribed Tarceva, one of the new targeted therapies that block a molecule called epidermal growth factor receptor (EGFR) that acts like the antenna from hell: it grabs growth-promoting signals out of the goop surrounding a cancer cell and uses them to stimulate proliferation. Within six months—it was now the autumn of 2005—the tumors receded, and Mayberry, who had been unable to walk when the cancer infiltrated his brainstem and bones, was playing golf again. "I have no idea why Tarceva worked on him," says Kim. "We've given the same drug to patients in the same boat, and had no luck." But the luck ran out. The cancer came back, spreading to Mayberry's bones and liver. He lost his battle last summer.

We tell you about Mayberry because his case sheds light on why cancer is on track to kill 565,650 people in the United States this year—more than 1,500 a day, equivalent to three jumbo jets crashing and killing everyone aboard 365 days a year. First, it shows the disconnect between the bench and the bedside, between what science has discovered about cancer and how doctors treat it. Biologists have known for at least two decades that it is the rare cancer that can be completely cured through surgery. Nevertheless, countless proud surgeons keep assuring countless anxious patients that they "got it all." In Mayberry's case, says Kim, "my gut feeling is that [cells from the original lung tumor] were smoldering in other places the whole time, at levels so low not even a whole-body scan would have revealed them." Yet after surgery and, for some cancers, radiation or chemotherapy, patients are still sent back into the world with no regimen to keep those smoldering cells from igniting into a full-blown metastatic cancer or recurrence of the original cancer. Mayberry's story also shows the limits of "targeted" cancer drugs such as Tarceva, products of the golden age of cancer genetics and molecular biology. As scientists have learned in just the few years since the drugs' introduction, cancer cells are like brilliant military tacticians: when their original route to proliferation and invasion is blocked, they switch to an alternate, marching cruelly through the body without resistance.

More Rethinking the War on Cancer | Newsweek War on Cancer | Newsweek.com

[waltky]

Protect against dangers of 3 quiet cancers...

Protecting against dangers of quiet cancers
Fri., Sept. 5, 2008 - These common diseases are often overlooked by doctors

Your doctor has given you the lowdown on how to protect yourself against breast, colon, and lung cancer: Get yearly mammograms (check) and regular colonoscopies (check), and don't smoke (double check). But when was the last time she asked if you had any persistent mouth sores, unexplained fevers or joint pain, or discomfort during sex?

These can be symptoms of three cancers — oral, leukemia, and endometrial — that don't get the attention they deserve. Even though they are among the most common cancers affecting women over age 55, these diseases can fall through the cracks as doctors focus on the biggest killers hogging the health headlines, says Elmer Huerta, MD, MPH, president of the American Cancer Society.

Read more for the facts behind these quiet dangers — and the simple ways you can protect yourself.

Oral cancer

Your risk: 1 in 98, with diagnoses peaking between the ages of 55 and 65. Oral cancer is lethal more often than it needs to be because people tend to ignore symptoms (it's typically caught in late stages).

More The dangers of three quiet cancers - Cancer - MSNBC.com

[waltky]

Childhood blood cancer survival rates improve...

More kids surviving childhood blood cancers
9 Sept.`08 WASHINGTON - Researchers credit improved treatment for types of leukemia, lymphoma

Survival rates have improved in the United States for children with three common types of blood cancer since the 1990s, thanks to improved treatment, researchers in Germany said on Tuesday. The study tracked rising survival rates in the five and 10 years after children were diagnosed with acute lymphoblastic leukemia, or ALL, the most common childhood cancer, as well as acute non-lymphoblastic leukemia and non-Hodgkin lymphoma. Survival rates for a fourth similar type of cancer, Hodgkin lymphoma, did not change, they found.

Leukemia and lymphoma make up 40 percent to 60 percent of all childhood cancer cases. For ALL, under 10 percent of children in the early 1970s lived for 10 years after diagnosis. Their survival rates now top 80 percent, according to the study published in the Journal of the National Cancer Institute. Researchers led by Dr. Hermann Brenner of the German Cancer Research Center in Heidelberg used U.S. government cancer data for their study. They said better treatments drove the survival gains and expressed hoped the findings would help families feel less fear when a child is diagnosed with leukemia or lymphoma.

Dr. Barton Kamen, chief medical officer for the Leukemia & Lymphoma Society, said the improved treatment included new combinations of existing drugs. For example, with acute lymphoblastic leukemia, “we haven’t really added a new drug in 30 to 40 years,” Kamen said. “We’ve got new combinations and we’ve learned who needs a (bone marrow) transplant and we’ve learned who needs intensification,” Kamen said in a telephone interview.

More More kids surviving childhood blood cancers - Kids and parenting - MSNBC.com

See also:

New cervical cancer test beats pap smear
Tues., Sept. 9, 2008 - Study: Screening for protein detects more lesions with fewer false positives

A new way to test for cervical cancer is more accurate than a pap smear and identified more dangerous lesions, an Italian study showed on Tuesday. Researchers used the traditional test for the human papilloma virus that causes cervical cancer and combined it with another that indicated specific cancer-causing activity in cells, said Guglielmo Ronco, a cancer epidemiologist at the Centre for Cancer Prevention in Turin, who led the study.

A simple test for a protein called P16INK4A provided a biomarker showing cell changes that indicated a woman likely has pre-cancerous lesions, Ronco and colleagues reported in the journal Lancet Oncology. "The marker shows there was some sort of disruption by the HPV virus," Ronco said. "Only a small minority of women who have an HPV infection actually develop cancer. The challenge is to find out who are at higher risk of developing cancer."

Cervical cancer is the second most common type of cancer in women. Each year an estimated 500,000 women are diagnosed with the disease and about 300,000 die from it, mostly in the developing world. Merck & Co's Gardasil and GlaxoSmithKline's Cervarix are vaccines that protect against some strains of the virus. More countries are also adopting screening tests, but the problem is pap smears produce too many false positives — meaning women get a test that suggests they have potentially cancerous or pre-cancerous changes when in fact they do not.

More New cervical cancer test beats pap smear - Cancer - MSNBC.com

[waltky]

HPV shot helps protect against two other cancers...

HPV shot also protects against 2 other cancers
Fri., Sept. 12, 2008 WASHINGTON - FDA updates label to say Gardasil guards against cancers of vagina, vulva

The Food and Drug Administration has updated the label of Merck's cervical cancer vaccine Gardasil, adding new information about its protective effects against two other gynecological cancers. The new labeling indicates the vaccine also protects against cancers of the vagina and vulva, which affect more than 5,000 women in the U.S. each year, according to Merck.

The vaccine works by defending against four strains of the human papillomavirus, which cause the majority of cervical cancers. A Merck scientists said the virus accounts for a smaller portion of vaginal and vulvar cancers, though he added it plays a role in more than half of them. "Anytime we have evidence of additional cancer protection, that's a really important piece of information," said Merck's Rick Haupt, executive director for HPV vaccines. It was not immediately clear what the additional indication would mean for sales of the vaccine, which have fallen short of the company expectations.

Merck has already scaled back full-year sales estimates for Gardasil from between $1.9 billion and $2.1 billion to between $1.4 billion and $1.6 billion, following regulatory setbacks and challenges making inroads with young adult patients. First approved in 2006, Gardasil is the only cervical cancer vaccine approved for the lucrative U.S. market, though Merck has had limited success expanding use.

More HPV shot also guards against 2 other cancers - Cancer - MSNBC.com

[waltky]

Better breast cancer vaccine...

New breast cancer vaccine helps body fight tumors
Mon Sep 15, 2008 WASHINGTON (Reuters) - Researchers who designed one experimental breast cancer vaccine say they have fine-tuned the process and come up with another that they hope will be more effective.

Their new vaccine delivers a cancer-fighting gene into cells, which then produce immune system proteins as well as tumor-destroying cells. "In our own mind it is a very significant advance because we have put the gene into the cells in the body. The vaccine is produced by your own cells," Wei-Zen Wei of Wayne State University in Detroit, who led the study, said in a telephone interview. "It is made right in your body."

The vaccine eliminated tumors in mice from a type of cancer called HER2 positive cancer, they reported in the journal Cancer Research. HER2-positive cancers account for between 20 percent and 30 percent of breast cancers.

It even worked to eliminate HER2 tumors that had developed resistance to drugs designed to fight them, the said. The HER2/neu protein is over-expressed, meaning it is over-active, in several tumors including breast, colorectal and ovarian cancer.

More New breast cancer vaccine helps body fight tumors | Markets | Markets News | Reuters

[waltky]

New colonoscopy less invasive...

Virtual Colonoscopy Effective for Average Risk People
September 17, 2008 - Regular colonoscopy's long-term value is also confirmed, studies report

For people with an average risk of colon cancer, two new studies offer good news on the colon cancer screening front. First, one study found that virtual colonoscopy -- or CT colonography -- was effective in detecting 90 percent of precancerous lesions larger than 10 millimeters. And, the second study found that five years after having an initial standard colonoscopy, no cancers were found in people who repeated the test. "CT colonography is a reasonable option for colon cancer screening," said Dr. Durado Brooks, director of prostate and colorectal cancer for the American Cancer Society. "It will miss some abnormalities, but even colonoscopy is not a perfect tool. Studies of back-to-back colonoscopy show miss rates of between 2 and 11 percent."

The second study, Brooks said, "reinforces the fact that colonoscopy screening does not need to be taking place at an every five-year interval." He said that, although the current cancer society recommendations for people with an average colon cancer risk are to have a colonoscopy every 10 years, some doctors feel that interval is too long and advise their patients to have a colonoscopy every three to five years. Since this new study found no cancers at all after five years, Brooks said this should "provide an additional level of comfort" to those who were concerned that the screening interval was too long. Results of both studies are published in the Sept. 18 issue of the New England Journal of Medicine.

The first study included 2,531 people from 15 centers across the United States. All were over age 50 and had no known significant risk factors for colon cancer. The study participants underwent CT colonography (virtual colonoscopy) and then a follow-up colonoscopy on the same day to verify the CT colonography findings. The preparation for CT colonography is the same as it is for colonoscopy and includes a limited diet the day before the test and the use of purging laxatives. (Brooks said there is ongoing research trying to devise a prep-less CT colonography, since the preparation for the test is what people often find most objectionable.) CT colonography found nine out of 10 lesions that were 10 millimeters or larger. And, for smaller lesions -- those over 6 millimeters but less than 10 millimeters -- virtual colonoscopy found nearly eight out of 10.

MORE

[waltky]

Something else to worry about besides h. pylori...

How gut bugs could trigger cancer
Sunday, 21 September 2008 - Scientists believe a type of bacterium living in our intestines could be linked to the development of colon cancer.

Enterococcus faecalis is harmless in the vast majority of people, but US scientists have found that it can produce harmful chemicals. The Journal of Medical Microbiology study found these can damage DNA, and prompt gene activity linked to cancer. A UK expert said it was plausible that bacteria could cause colon cancer. However, he stressed that E.faecalis was very unlikely to be the only bacterium which had such an effect. "This research puts into perspective the complexity of the effects normal gut bacteria can have on the health of the individual" - Professor Mark Huycke, Researcher

Our guts provide a home to dozens of different types of bacteria, many of which actually provide a useful service, helping break down indigestible sugars in food by fermentation, or even "training" the body's immune system. However, in recent years, scientists have suggested that in certain, susceptible individuals, these bacteria can actually do harm. E.faecalis, sometimes also known as Group D Streptococcus, is one of those under suspicion, and the research by the Department of Veterans Affairs Medical Center in Oklahoma City strengthens the link. The researchers investigated how colon cells in the laboratory reacted to the presence of the bacterium, when it is in a "fermentation" state. In this state, it produces a kind of oxygen molecule called "superoxide", and it is this which can damage DNA in surrounding cells.

Gene activity

Professor Mark Huycke, who led the research, found that the apparent effects were not limited to this. "We found that superoxide led to strong signalling in immune cells called macrophages - it also altered the way some cells in the gut grew and divided and even increased the productivity of genes which are associated with cancer." In total, the expression of 42 genes linked to vital processes in human cells was altered by the presence of E. faecalis in this state. "This research puts into perspective the complexity of the effects normal gut bacteria can have on the health of the individual."

Dr Barry Campbell, a gut microbiology researcher from the University of Liverpool, agreed that E.faecalis was a candidate for cancerous changes. However, he said that other bowel bacteria could also be behind the cell changes which eventually lead to tumours. He said: "There is not going to be only one culprit. Our own team is interested in a particular type of E.coli with this in mind. "There are also many other factors which are involved, such as genetics and environment."

BBC NEWS | Health | How gut bugs could trigger cancer

[waltky]

Shorter radiation for breast cancer...

Shorter Radiation for Cancer of the Breast
September 22, 2008 - Three weeks of radiation treatment work just as well as the usual course of five weeks or more for women with early-stage breast cancers, Canadian researchers have reported, after monitoring a large group of patients for 12 years.

The results, presented Monday at a conference in Boston, provide some of the strongest evidence yet that radiation schedules can safely be shortened to make life easier for patients and to let clinics reduce their waiting lists and treat more women without buying more machines. Experts say the new findings, from a respected study, could change the standard of care in the United States. The typical schedule now involves five to seven weeks of daily treatments, and most women would welcome a chance to get it over with faster — especially those who work, have small children or live far from the clinic.

About 180,000 women a year develop breast cancer in the United States, and most need radiation. From 30 percent to 40 percent may be candidates for the type of treatment given in the study. Some centers in this country already offer shorter courses of treatment, but they are more widely available in Canada and parts of Europe. “We’ve really got to give it serious consideration in the United States,” said Dr. Anthony L. Zietman, a radiation oncologist at Harvard Medical School and the Massachusetts General Hospital Cancer Center, and president-elect of the American Society for Therapeutic Radiology and Oncology. He was not involved in the Canadian study.

But Dr. Zietman cautioned that the results applied only to women with early cancers like those in the study, which were removed by lumpectomy and had not spread to the lymph nodes. Often, women with such early cancers do not need chemotherapy. Other major changes in radiation are also in the works. Doctors are experimenting with ways to treat just part of the breast rather than all of it, and to make the treatment safer, they are trying to avoid exposing the heart and lungs to radiation. The purpose of radiation is to keep cancer from coming back in the same breast where it first occurred, by killing any tumor cells that may have evaded surgery and chemotherapy. Cancer cells are more vulnerable to radiation than are normal ones, and the treatment has always been a balancing act between giving enough radiation to destroy the tumor cells but not enough to cause serious damage to healthy tissue and organs.

The changes now being made result in part from the overall success in treating early breast cancers, Dr. Zietman said. Survival rates have climbed so high — 98 percent of women with early-stage cancers survive at least five years — that it is now considered reasonable to step back, look at women’s quality of life and try modifying the regimens to make treatment less onerous. “It’s a bit of a change in our thinking,” Dr. Zietman said.

MORE