The truth about kids and smoking

Every day, more than 3,800 children ages 12 to 17 in the United States smoke their first cigarette, according to the 2012 US Surgeon General’s report, Preventing Tobacco Use Among Youth and Young Adults, putting themselves at risk for nicotine addiction and the many diseases associated with smoking, including lung cancer.

Among the report’s key statistics:
-About 3 million high school students and 624,000 middle school students smoke.
-One out of 4 high school seniors is a regular cigarette smoker.
-Among those who continue to smoke, about half will die earlier than their non-smoking peers, losing on average about 13 years of life.
-88% of adults who smoke daily started smoking by age 18; 99% started by age 26.

Read the American Cancer Society news release here.
Read the full report here.

Stereotactic radiosurgery shows promise for kidney cancer

A first-of-its-kind clinical trial conducted at University Hospitals (UH) Case Medical Center Seidman Cancer Center has shown encouraging results for the use of stereotactic radiosurgery to treat kidney cancer. This non-invasive treatment technique may represent a potential new non-surgical option for patients with this deadly disease who have limited treatment options. Rod Ellis, MD, and Lee Ponsky, MD, presented results of a Phase 1 clinical trial in 20 patients with localized primary renal cancer at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Boston. Read more here.

Laser-light testing of breast tumor fiber patterns helps show whose cancer is spreading

Using advanced microscopes equipped with tissue-penetrating laser light, cancer imaging experts at Johns Hopkins have developed a promising, new way to accurately analyze the distinctive patterns of ultra-thin collagen fibers in breast tumor tissue samples and to help tell if the cancer has spread. The Johns Hopkins researchers say their crisscrossing optical images, made by shining a laser back and forth across a biopsied tissue sample a few millionths of a meter thick, can potentially be used with other tests to more accurately determine the need for lymph node biopsy and removal in women at risk of metastatic breast cancer. Read more here.

Study mentioned: Kakkad SM, et al. Collagen I fiber density increases in lymph node positive breast cancers: pilot study. J Biomed Opt. 2012 Nov 1;17(11):116017. PMID: 23117811

Feedback loop maintains basal cell population

Notch—the protein that can help determine cell fate—maintains a stable population of basal cells in the prostate through a positive feedback loop system with another key protein TGF beta (transforming growth factor beta), said Baylor College of Medicine researchers in the journal Cell Stem Cell. Read more here.

Study mentioned: Valdez JM, et al. Notch and TGFβ Form a Reciprocal Positive Regulatory Loop that Suppresses Murine Prostate Basal Stem/Progenitor Cell Activity. Cell Stem Cell. 2012 Nov 2;11(5):676-88. PMID: 23122291

Male fertility can be restored after cancer treatment, says Pittsburgh team

An injection of banked sperm-producing stem cells can restore fertility to male primates who become sterile due to cancer drug side effects, according to researchers at the University of Pittsburgh School of Medicine and Magee-Womens Research Institute. In their animal study, published in Cell Stem Cell, previously frozen stem cells restored production of sperm that successfully fertilized eggs to produce early embryos. Read more here.

Study mentioned: Hermann BP, et al. Spermatogonial stem cell transplantation into rhesus testes regenerates spermatogenesis producing functional sperm. Cell Stem Cell. 2012 Nov 2;11(5):715-26. PMID: 23122294

Team uses antisense technology that exploits gene splicing mechanism to kill cancer cells

Cancer cells grow fast. That’s an essential characteristic of what makes them cancer cells. They’ve crashed through all the cell-cycle checkpoints and are continuously growing and dividing, far outstripping our normal cells. To do this they need to speed up their metabolism. CSHL (Cold Spring Harbor Laboratory, a private, not-for-profit institution on the north shore of Long Island) Professor Adrian Krainer and his team have found a way to target the cancer cell metabolic process and in the process specifically kill cancer cells. Read more here.

Study mentioned: Wang Z, et al. Manipulation of PK-M mutually exclusive alternative splicing by antisense oligonucleotides. Open Biology. Published online October 31, 2012.

A prescription for safer care: Medication reconciliation

November 1, 2012 – Ottawa
Accreditation Canada, the Canadian Institute for Health Information, the Canadian Patient Safety Institute, and the Institute for Safe Medication Practices Canada released a report today entitled Medication Reconciliation in Canada: Raising the Bar.

Some of the insights found in the report include:

•  In 2009 – 2010, the estimated economic burden of preventable patient safety incidents in acute care in Canada was $397 million. Medication reconciliation was identified as key to reducing this burden. 
• One quarter of seniors have three or more chronic conditions that often need to be treated with multiple medications. These seniors are at higher risk of adverse events related to medication use, and unplanned visits to emergency departments and hospitals. 
• Of the 288 health care organizations surveyed by Accreditation Canada in 2011, only 60% had a process for medication reconciliation at admission, and 50% had a process for medication reconciliation at transfer or discharge. 
• Medication reconciliation practices showed the highest improvement from 2010 to 2011, yet continue to be one of the greatest patient safety challenges. 
• The National Medication Reconciliation Strategy, co-led by CPSI and ISMP Canada, is actively developing curriculum for health care practitioners, as well as tools, resources, and technology supports - including medication checklists, a mobile app to help patients better manage their own medications, and an interactive web-based map of innovative medication reconciliation resources by region. 

More is here. 

Genetic test results for Lynch syndrome improved with new computer program

Many patients who have genetic testing for Lynch syndrome receive the inconclusive result "variants of uncertain clinical significance." This can be a problem, as people with Lynch syndrome have a much higher probability to develop colon cancer, and often develop colon cancer at an earlier age than is common among the general population; consequently, they need to begin screening at a much younger age. Now, between two-thirds and three-fourths of these genetic variants can be classified into categories that indicate the most appropriate screening and treatment guidelines, according to two complementary papers published in Human Mutation. Read more here.

Study mentioned: Thompson BA, et al. Calibration of Multiple In Silico Tools for Predicting Pathogenicity of Mismatch Repair Gene Missense Substitutions. Hum Mutat. 2012 Sep 4. [Epub ahead of print] PMID: 22949387

Study mentioned: Thompson BA, et al. A Multifactorial Likelihood Model for MMR Gene Variant Classification Incorporating Probabilities Based on Sequence Bioinformatics and Tumor Characteristics: A Report from the Colon Cancer Family Registry. Hum Mutat. 2012 Sep 4. [Epub ahead of print] PMID: 22949379

Health Canada urges radon testing in homes

You can’t see it and you can’t smell it. But radon in your home, seeping up through the foundation, could be a serious risk to your health. Since it’s a risk that can be mitigated, Health Canada wants homeowners to measure the radon in their dwellings and take steps to lower levels if they are high. Radon is the second leading cause of lung cancer after smoking, responsible for about 16 per cent of lung cancer cases among Canadians. Lung cancer is the No. 1 cancer killer in Canada for both men and women. Read more here.

Mixing drugs and herbal remedies may pose a major health risk, researchers warn

Canadians wary of antidepressants may rely on St. John’s wort, an age-old herbal remedy, to keep mood disorders at bay. But while the yellow-flowering plant is potent enough to relieve mild to moderate depression, it is also the herbal medicine most likely to interfere with pharmaceutical drugs, researchers have found. Read more here.

Study mentioned: Tsai HH, et al. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-1078. PMID: 23067030

New video for skin cancer self-exam

The American Academy of Dermatology has released a new video explaining how to conduct a skin cancer self-exam.  The most common cancer in the United States, it is estimated that one in five Americans will be diagnosed with skin cancer at some point in their lives. 

The video identifies 5 key identifying skin factors to be aware of, particularly when checking moles for melanoma, the most deadly type of skin cancer: asymmmetry of a spot; irregular, poorly defined border; spots of varying colors, diameter, and whether or not the mole or spot is evolving.  According to dermatologist Dr. Thomas Rohrer, "examining your skin only takes a few minutes, but it could save your life." 

Click here to view the video and learn more.

Memantine protects cognitive function after whole brain irradiation

Memantine, a drug normally prescribed for slowing cognitive decline in Alzheimer’s disease, can help to preserve cognitive function in cancer patients who have undergone whole brain irradiation, a study showed. In a phase III trial, patients with brain metastases were randomly assigned to take 20 mg memantine (Namenda) or placebo daily for 24 weeks after whole brain radiation therapy (WBRT). The memantine cohort had a 17% relative reduction in cognitive decline compared with patients who got a placebo, Dr. Nadia N. Laack reported at the annual meeting of the American Society for Radiation Oncology. Read more here.

Cardiac toxicity not seen 25 years after breast radiation

Here’s heartening news that physicians can convey to breast cancer survivors: Modern breast irradiation did not appear to cause late-term cardiac toxicity in a study that examined women a quarter of a century after they were treated. Investigators found no significant differences in Framingham Heart Study risk scores, hemodynamic parameters, pericardial thickening, or heart failure among 50 women who had been randomized in the 1970s and 1980s to either mastectomy or breast-conserving surgery (BCS) and radiation, Dr. Charles B. Simone II reported at the annual meeting of the American Society for Radiation Oncology. Read more here.

Some cancer survivors reported poor health-related quality of life years after diagnosis

Survivors of many common cancers enjoy a mental and physical health-related quality of life equal to that of adults who have not had cancer, but survivors of other cancers are in poorer health, according to results published in Cancer Epidemiology, Biomarkers & Prevention. Patient-reported, health-related quality of life was assessed using the 10-item Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10). This tool allows researchers to measure, from the patient perspective, health outcomes like physical functioning, depression, pain and fatigue. Read more here.

Study mentioned: Weaver KE, et al. Mental and Physical Health-Related Quality of Life among U.S. Cancer Survivors: Population Estimates from the 2010 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev. 2012 Oct 30. [Epub ahead of print] PMID: 23112268

Fox Chase researchers connect multifocal/multicentric breast cancer to a patient's increased risk of local recurrence

Not all women diagnosed with operable breast cancer present with a single tumor, some have multifocal disease appear in the breast—which means multiple tumors all arising from the same primary tumor. Others face a diagnosis of multicentric disease, where multiple tumors have formed independently in the breast. Standard radiation treatment is not tailored to the number of tumors found in the breast, so patients with multifocal or multicentric disease do not receive radiation after mastectomy and if they undergo lumpectomy, they receive the same dose and extent as patients presenting with a single mass. Read more here.

Age tied to spread of rectal cancer to lymph nodes

Rectal cancer is more likely to spread to the lymph nodes in younger patients, according to new findings that Fox Chase Cancer Center researchers will be presenting on October 29 at the American Society for Radiation Oncology’s 54th Annual Meeting. The results—which are the first of their kind—suggest that doctors should search for spreading more aggressively in these patients. Read more here.

Proton therapy treatment preserves quality of life for men with prostate cancer

Two studies led by The University of Texas MD Anderson Cancer Center have found that proton therapy preserves the quality of life, specifically urinary and bowel function, in men treated with this targeted radiation modality for prostate cancer. Both studies, led by Andrew K. Lee, M.D., M.P.H., associate professor in MD Anderson's Department of Radiation Oncology, will be presented in a poster session at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO). Read more here.

Mayo Clinic: Antidepressant eases radiation-related mouth pain in head, neck cancer

An oral rinse of the antidepressant doxepin significantly eased pain associated with oral mucositis in patients receiving radiation therapy for cancers of the head and neck, a study led by Mayo Clinic found. The findings were presented at the American Society for Radiation Oncology annual meeting in Boston. Read more here.

Unexpected factor contributes to melanoma risk in red-haired, fair-skinned individuals

The elevated risk of melanoma among people with red hair and fair skin may be caused by more than just a lack of natural protection against ultraviolet radiation. Researchers at the MGH Cutaneous Biology Research Center and Cancer Center have found that the type of skin pigment predominantly found in red-haired, fair-skinned individuals may itself contribute to the development of melanoma. Read more here.

Study mentioned: Mitra D, et al. An ultraviolet-radiation-independent pathway to melanoma carcinogenesis in the red hair/fair skin background. Nature. Published online 31 October 2012.

Routine blood test predicts prognosis in aggressive skin cancer

A routine blood test may help predict survival in patients with an aggressive form of skin cancer known as Merkel cell carcinoma, according to new findings by Fox Chase Cancer Center researchers. The results will be presented on Wednesday, October 31 at the American Society for Radiation Oncology’s 54th Annual Meeting. Read more here.

Scientific team sequences 1,092 human genomes to determine standard range of human genetic variation

Completing the second phase of the 1000 Genomes Project, a multinational team of scientists reports that they have sampled a total of 1092 individuals from 14 different populations and sequenced their full genomes. The researchers described the feat as a collegial effort to equip biologists and physicians with information that can be used to understand the normal range of human genetic variants so that a patient's disease genome can be interpreted in a broader context. Read more here.

Study mentioned: The 1000 Genomes Project Consortium. An integrated map of genetic variation from 1,092 human genomes. Nature. 2012; 491:56-65.

NIH study uncovers new mechanism of action for class of chemotherapy drugs

National Institutes of Health (NIH) researchers have discovered a significant new mechanism of action for a class of chemotherapy drugs known as poly (ADP-ribose) polymerase inhibitors, or PARP inhibitors. They have also identified differences in the toxic capabilities of three drugs in this class which are currently being tested in clinical trials. Read more here.

Study mentioned: Murai J, et al. Trapping of PARP1 and PARP2 by clinical PARP inhibitors. Cancer Res. 2012; 72:5588-5599.

Deviating from radiation protocols increases risk of treatment failure and death

Implementing measures to ensure radiation therapy protocols are followed not only decreases deviations, but it can also improve overall survival in cancer patients, Thomas Jefferson University Hospital researchers suggest in a study presented during a plenary session at the American Society for Radiation Oncology (ASTRO) 54th Annual Meeting in Boston (28-31 October, 2012). The findings revealed that deviating from protocols was associated with up to a 75% increased risk of treatment failure and overall mortality. This suggests that implementing QA measures to ensure protocols are followed could improve outcomes for cancer patients, according to the authors. Read more here.

Proneurotensin hormone level linked to increased risk of diabetes, cardiovascular disease, breast cancer, death

Dr. Olle Melander and his colleagues at Lund University, Sweden have conducted a study to determine the association of proneurotensin, an amino acid peptide, on future risk of diabetes mellitus, cardiovascular disease, breast cancer, and death.  Primarily expressed in the nervous system and gastrointestinal tract, little is known about neurotensin's role in development of breast cancer or cardiometabolic disease.  Dr. Melander's study indicates that, "exclusively in women, proneurotensin was related to incident diabetes, cardiovascular disease, breast cancer, total mortality, and cardiovascular mortality." 

Click here to read more about this study and other feature articles in the November 2012 issue of Artemis, the John Hopkins Breast Center monthly newsletter.

Single-DNA images give clues to breast cancer

For the first time, researchers at the University of California, Davis, have watched single strands of DNA being prepped for repair. The research, published this week in the journal Nature, has implications for understanding the origins of breast cancer. Read more here.

Study mentioned: Bell JC, et al. Direct imaging of RecA nucleation and growth on single molecules of SSB-coated ssDNA. Nature. 2012 Oct 24. [Epub ahead of print] PMID: 23103864

Key discovered to how chemotherapy drug causes heart failure

Doxorubicin, a 50-year-old chemotherapy drug still in widespread use against a variety of cancers, has long been known to destroy heart tissue, as well as tumors, in some patients. Scientists have identified an unexpected mechanism via the enzyme Top2b that drives the drug's attack on heart muscle, providing a new approach for identifying patients who can safely tolerate doxorubicin and for developing new drugs. Read more here.

Study mentioned: Zhang S, et al. Identification of the molecular basis of doxorubicin-induced cardiotoxicity. Nat Med. 2012 Oct 28. [Epub ahead of print] PMID: 23104132

Radiation treatment following surgery improves survival for elderly women with early-stage breast cancer

Elderly women with early-stage breast cancer live longer with radiation therapy and surgery compared with surgery alone, researchers at the University of Maryland School of Medicine have found. The researchers, who collected data on almost 30,000 women, ages 70 to 84, with early, highly treatable breast cancer enrolled in a nationwide cancer registry, are reporting their findings at the 54th annual meeting of the American Society for Radiation Oncology (ASTRO). Read more here.

Drop in testosterone tied to prostate cancer recurrence

Men whose testosterone drops following radiation therapy for prostate cancer are more likely to experience a change in PSA levels that signals their cancer has returned, according to new research from Fox Chase Cancer Center. The findings will be presented on October 29 at the American Society for Radiation Oncology’s 54th Annual Meeting. Read more here.

Prostate cancer linked to working nights: research

Men who work nights are almost three times as likely to develop prostate cancer as those who do day shifts, new research shows. In the latest study, published in the American Journal of Epidemiology, researchers studied 3,137 men who had been diagnosed with cancer and compared them to 500 men without the disease. Read more here.

Study mentioned: Parent MÉ, et al. Night work and the risk of cancer among men. Am J Epidemiol. 2012 Nov 1;176(9):751-9. Epub 2012 Oct 3. PMID: 23035019

Carboplatin injection (600mg/60mL) - visible particles in one lot - Notice to hospitals

Hospira Healthcare Corporation, in consultation with Health Canada, would like to inform you that a recall has been initiated of one lot of Carboplatin injection distributed in Canada due to visible crystal like particulate matter observed during an inspection of retained samples. The lot was distributed in Canada between March 2012 and June 2012. Carboplatin is a platinum coordination compound that is used as a cancer chemotherapeutic agent. Carboplatin Injection is indicated in the treatment of ovarian cancer of epithelial origin in first line therapy, and in second line therapy after other treatments have failed. Read more here.