Tag Archives: carolina

Eating right, exercise may help prostate cancer patients reduce risk of aggressive tumors

Led by Lenore Arab, PhD, JCCC member and professor in the departments of medicine and biological chemistry, the researchers examined associations between adherence to WCRF recommendations and risk of highly aggressive prostate cancer among subjects enrolled in the North Carolina-Louisiana Prostate Cancer Project. …

Human and canine lymphomas share molecular similarities, first large-scale comparison shows

A team of scientists from the University of North Carolina School of Medicine, North Carolina State University’s College of Veterinary Medicine and Duke University have conducted one of the first studies to directly compare canine and human B-cell lymphoma by examining molecular similarities and differences between the two species. The study was published June 19, 2013 online in the journal Cancer Research. Kristy Richards, MD, PhD, corresponding author, said, "Comparing the molecular similarities of lymphomas across species has allowed us to see what parts of lymphoma development and growth are evolutionarily conserved. This teaches us more about what components of human lymphoma biology are most fundamental and critical. …

Surgeon shortage linked to burst appendices

Living in an area with few general surgeons may make people with appendicitis more likely to turn into ruptured appendix cases by the time they get to surgery, according to new research. “The study shows that access to surgical care, especially general surgical care, is important and low access can have real impacts that affect peoples' health,” coauthor Thomas Ricketts of the University of North Carolina at Chapel Hill told Reuters Health by email. The Affordable Care Act includes a provision for incentive payments to increase the supply of doctors in areas with shortages, but those bonuses only apply in places with too few primary care doctors. General surgeon and primary care shortage areas don't always line up, Ricketts said, and even when they do, general surgeons can't move to areas that don't already have primary care physicians to serve the community and refer patients back to them. Almost 30,000 patients with appendicitis - a quarter of whom suffered a burst appendix - were discharged from hospitals in North Carolina between 2007 and 2009, according to data from hospitals and surgery centers in the state analyzed by the researchers. There are 95,000 burst appendices per year in the U.S. according to the Agency for Healthcare Research and Quality. A 2008 study found that an appendectomy can cost between $10,000 and $18,000 more when the appendix has burst. With surgery before a rupture, typically about 20 hours or less after abdominal pain begins, patients usually recover quickly. If the appendix has burst (roughly 40 hours after symptoms begin), that could mean repeat operations and longer recovery time, according to the Merck Manual. To see whether a surgeon shortage was linked to more burst appendices in an area, the researchers compared the number of cases of appendicitis, and specifically burst appendices, with the number of general surgeons in “surgical service areas” of the state that roughly align with zip codes. Having less than 3 general surgeons per 100,000 people increased the likelihood of having a ruptured appendix by five percent, compared to areas with at least 5 surgeons, Ricketts and his colleague report in the Annals of Surgery. However, areas with the most severe shortage had a 25 percent rate of rupture, compared to 24 percent in areas with no shortage. According to Dr. Edward Livingston, who has written about using ruptured appendices as a measure of care but was not involved in the new study, that is much too small a difference to draw any conclusions. Logic dictates that ruptures would be more common in rural areas, since patients have to travel farther to get to care, but that's the opposite of what the study found if the results are reliable, said Livingston, the deputy editor for clinical content at the Journal of the American Medical Association in Chicago. There were fewer surgeons relative to the population in urban areas, but the study didn't account for the residents, physician's assistants and nurse practitioners who add to the surgical work force in large urban medical centers, Livingston said. The results of the same study with more patients from more diverse regions might not show any difference between groups at all, Livingston told Reuters Health in an email. It would make more sense to measure the delay between when symptoms begin and when the patient reaches surgery in several different areas, and see if areas with longer delays correspond to areas with fewer surgeons, in order to infer that fewer surgeons lead to delays which lead to ruptures, Livingston said. “They would have to measure the delay to prove their point,” Livingston said. “This highlights a problem in studies like this one, where conclusions are made based on assumptions about what happens without really knowing what is happening at a patient level,” he said.source : http://www.foxnews.com/health/2013/06/17/surgeon-shortage-linked-to-burst-appendices/

Outlawing drugs like marijuana censors science, researchers say

The outlawing of drugs such as cannabis, magic mushrooms and other psychoactive substances amounts to scientific censorship and is hampering research into potentially important medicinal uses, leading scientists argued on Wednesday. Laws and international conventions dating back to the 1960s have set back research in key areas such as consciousness by decades, they argued in the journal Nature Reviews Neuroscience. “The decision to outlaw these drugs was based on their perceived dangers, but in many cases the harms have been overstated,” said David Nutt, a professor of neuropsychopharmacology at Imperial College London. In a statement accompanying the Nature Reviews paper, he said the laws amounted “to the worst case of scientific censorship since the Catholic Church banned the works of Copernicus and Galileo”. “The laws have never been updated despite scientific advances and growing evidence that many of these drugs are relatively safe. And there appears to be no way for the international community to make such changes,” he said. “This hindering of research and therapy is motivated by politics, not science.” Nutt and Leslie King, both former British government drugs advisers, and co-author David Nichols of the University of North Carolina, called for the use of psychoactive drugs in research to be exempted from severe restrictions. “If we adopted a more rational approach to drug regulation, it would empower researchers to make advances in the study of consciousness and brain mechanisms of psychosis, and could lead to major treatment innovations in areas such as depression and PTSD,” Nutt said. Nutt was sacked as a government adviser in 2009 after publicly criticizing the government for ignoring scientific advice on cannabis and ecstasy. He has conducted a small human trial using psilocybin, the psychedelic ingredient in magic mushrooms. His study, using volunteers, suggested the drug had the potential to alleviate severe forms of depression in people who did not respond to other treatments. But in April, Nutt said his plans to conduct the first full clinical trial to explore psilocybin as a treatment had stalled because of stringent rules on the use of illegal drugs in research. The scientists said their call for reform had been endorsed by the British Neuroscience Association and the British Association for Psychopharmacology.source : http://www.foxnews.com/health/2013/06/12/outlawing-drugs-like-marijuana-censors-science-researchers-say/

SurvivorLink: Online tool helps child cancer survivors maintain healthy lives

Ansley Riedel was just 10 months old when she was diagnosed with acute myeloid leukemia (AML) – a cancer of the blood and bone marrow. She immediately began radiation and chemotherapy, undergoing treatment up until she was a little older than 3-and-a-half years old.  Then, after receiving a second bone marrow transplant from her 4-month-old baby brother in July of 1991, Riedel reached the goal that every cancer patient hopes to achieve: Remission. “We celebrate what we call my second birthday,” Riedel told FoxNews.com, regarding the special occasion. Nearly 21 years later, Riedel is doing better than ever – but she hasn’t forgotten her time spent in the hospital so many years ago.  Though she was only a toddler at the time, her bout with cancer ultimately inspired her to become a nurse in order to help others like herself. “I remember a lot of the clinic visits – the routine of going to the clinic, getting labs, some of my hospital stays,” Riedel said. “I remember my nurses a lot, which is why I chose to become a nurse.  They were really like my first group of friends that I got to know really well.” While Riedel was ultimately able to turn her cancer into a source of inspiration, post-cancer life has still had its fair share of difficulties. The radiation treatment Riedel underwent at such a young age has had a lasting impact on her health. Between the ages of 10 and 14, Riedel had to receive daily shots of growth hormone because her development had been stunted by treatment.  She also takes a daily medication for low thyroid function – something her doctors speculate may have been affected by radiation. “There’s a lot of unknown because I was so young,” Riedel said. “I have to be pretty careful with my teeth.  The radiation kind of damaged my permanent teeth, so I’m more susceptible to cavities.  I see more of a specialist for my regular cleanings. My roots were damaged and I couldn’t have braces because of that.” The health setbacks Riedel has had to face are not uncommon for cancer survivors.  While radiation and chemotherapy are meant to kill fast-growing cancer cells, they can also damage healthy cells in the heart, kidneys, lungs and more in the process. “Obvious problems cancer survivors have are endocrine (issues), growth hormone deficiency, low thyroid, problems beginning puberty and fertility,” Dr. Lillian Meacham, a pediatric endocrinologist and director of the Cancer Survivor Program at the Aflac Cancer Center in Atlanta, told FoxNews.com.  “They can have…problems related to scarring of the lungs or damage to the heart muscle.  We have to be vigilant about almost every organ to be sure that we are looking out for these problems, mainly because we want to preserve quality of life and decrease health care costs.” For children diagnosed in the 1960s with acute lymphoblastic leukemia, which is the most common form of childhood cancer, the chance of survival was only 10 percent. Fortunately, chances of survival have increased to 80 percent today. Therefore, finding ways to help cancer survivors maintain a healthy lifestyle post-cancer is an ever increasing necessity. To address this need, Meachem and others at the Aflac Cancer Center have created SurvivorLink, an online tool that aims to improve cancer survivors’ quality of life.  According to its website, SurvivorLink hopes to increase awareness about the long-term health needs of child cancer survivors, as well as create a patient portal, which will provide patients with easy access to all their relevant health information. “When kids come to the survivor clinic, we give them a Survivor Health Care Plan – which details what they need throughout their lives to stay healthy,” Meachem said. “They can upload that into this website, so let’s say they move to North Carolina or Montana, they can share their documents to new health care providers.  It’s like having an electronic chart they carry with them at all times.” Riedel is currently in the process of filling out her patient profile on SurvivorLink, and she said she likes how it is specifically tailored to her own personal needs. “One of the good things about SurvivorLink is it’s based on your diagnosis and based on your protocol.  Depending on how much chemo you had, it will tell you specifically that for this one chemo, these are the big side effects and long term things that can result.” As someone who is still actively involved in health care, Riedel is very passionate about increasing knowledge and communication among cancer survivors and their health care providers.  For her, easy access to information is essential for a long and healthy life. “The main message is just to get informed and get help if you need to – but really be an advocate for yourself,” Riedel said. “If you take care of yourself, then other people are going to be more willing to work with you.” Click for more on SurvivorLink.source : http://www.foxnews.com/health/2013/06/05/survivorlink-online-tool-helps-child-cancer-survivors-maintain-healthy-life/

New cancer tools allow patients to reconsider chemo

After decades of using one-size-fits-all therapies to combat cancer, doctors are using new tools to help decide when their patients can skip chemotherapy or other harsh treatments. An approach to oncology that has been in place for decades is beginning to yield to an arsenal of long-term clinical studies, genetic tests and novel drugs that target cancer cells and their infrastructure. “What is happening is a combination of new technology and more-targeted cancer drugs,” said Dr Sandra Swain, medical director of the Cancer Institute at Washington Hospital Center and president of the American Society of Clinical Oncology (ASCO). “We've tried the approach of big, nonspecific treatments ... We have found that throwing chemo at patients has not (necessarily) cured them.” Traditional chemotherapy drugs work by interfering with the entire body's system of cell replication, causing harsh side effects like fatigue and hair loss. Since the completion of the human genome project in 2003, scientists have made progress in unlocking the genetic basis of a range of diseases, including cancer. That has paved the way for genetic testing as well as drugs that block specific pathways that cancer cells use to grow and reproduce. Such targeted cancer drugs, which sometimes preclude the need for chemotherapy, are being sold by companies ranging from Pfizer Inc, the world's largest drugmaker, to Ariad Pharmaceuticals Inc, which early this year launched its first drug, to treat leukemia. At the same time, large-scale studies that look at whether some types of patients are better off with less treatment are giving doctors more confidence to hold off on using traditional cancer drugs. Laurie Levin, now 64, was successfully treated in her 20s for non-Hodgkin's lymphoma, but faced a dilemma after being diagnosed with breast cancer in 2005 since the earlier radiation and chemotherapy had already raised her risk of developing heart problems or leukemia. A $4,000 genetic test showed that her breast cancer was unlikely to return, providing the confidence to undergo a lumpectomy and avoid chemotherapy. “It was like someone handed me my life back when I got those results,” she said. Use of the Oncotype DX test, which analyzes genes involved in tumor recurrence, has cut the use of chemotherapy in U.S. breast cancer patients by 20 percent over the past eight years, according to its maker, Genomic Health Inc. The company recently launched a similar test designed to measure whether men with prostate cancer need to undergo surgery or radiation. Tests and studies can clarify treatment, but costs remain on the upswing because the newest drugs are very expensive, with monthly price tags often in the thousands of dollars. By 2016 annual global sales of cancer drugs will nearly triple, to $88 billion from a decade earlier, according to IMS Health. 'RIGHT-SIZING TREATMENT' The “less is more” approach to cancer will be one highlight of ASCO's annual meeting in Chicago that begins at the end of this month. On Wednesday, ASCO released thousands of abstracts on new clinical trials of cancer treatments. One large, long-term study found that most men diagnosed with early-stage seminoma, a common type of testicular cancer, did fine with no treatment following surgery to remove the tumors. Cure rates for the disease have always been quite high. Several European countries, including Denmark where the study was conducted, monitor seminoma patients for any relapse before further treatment. In the United States, about half of early-stage patients are still given radiation or chemotherapy, according to ASCO. “Opting for surveillance spares patients, most of whom are young men, from the harmful side effects of chemotherapy and radiation without diminishing their chances for a long and healthy life,” said ASCO's incoming president, Dr Clifford Hudis, in a statement. Physicians say it is difficult to quantify in statistics, but there is growing recognition that less is more in terms of potentially toxic cancer treatments. The approach is especially important for young patients who will have many years ahead of them after beating an initial bout of cancer. “We are right-sizing treatment,” said Dr. James Mohler, chair of the department of urology at Roswell Park Cancer Institute in Buffalo, New York. He pointed to recent national guidelines calling for “active surveillance” of older men diagnosed with slower-growing prostate cancer. A study presented earlier this year at an ASCO meeting in Florida found similar survival rates for men with high-risk prostate cancer who received radiation and either 18 or 36 months of hormone therapy. The findings suggest the therapy, which causes significant side effects, could be given for less than the current standard of 24 to 36 months. Another recent study out of the Duke Cancer Institute in Durham, North Carolina, found that survival odds for women with early-stage breast cancer who underwent breast-preserving surgery such as lumpectomy were as good as, or even better than, the odds for women who had mastectomies. “We are going to see reevaluations of very successful therapies to determine whether or not we can achieve the same results using less treatment,” said Dr Armand Keating, director of the hematology division at the University of Toronto and president of the American Society of Hematology. The first-ever study showing that a type of leukemia could be cured without using chemotherapy was released in December. The Italian-German study found that a combination of a derivative of vitamin A, known as ATRA, and arsenic trioxide, a newer drug, worked as well as ATRA and chemotherapy in patients newly diagnosed with acute promyelocytic leukemia (APL). “APL used to be one of the most dreaded strains of cancer, but with ATRA and chemo the results are very gratifying,” Keating said. “Now we have two agents that are not chemo agents ... That to me is a milestone. I can't see any reason why this wouldn't become the standard of care.” A recent trial conducted in France found that omitting standard chemotherapy, which has been linked to heart damage, from the initial treatment of a type of childhood leukemia did not reduce survival outcomes. “The nice thing is you have omitted a potentially toxic agent that contributes to morbidity and maybe mortality down the road,” Keating said. The priciest therapies are designed to take advantage of genetic mutations associated with cancer cells, some of them found only in a small percentage of patients. A new drug for melanoma, BRAF inhibitor Zelboraf from Roche Holding AG, is designed to work by targeting a specific genetic mutation found in about half of all melanomas. Patients are first tested to see if they have it. Pfizer's lung-cancer drug Xalkori, which targets a mutation in the ALK gene, works in about 4 percent of lung cancer patients. It also has been effective as a treatment for a rare but aggressive type of childhood lymphoma. “We've been really trying for years to be more precise about who needs treatment ... Now we are more able to achieve it,” said Swain.source : http://www.foxnews.com/health/2013/05/16/new-cancer-tools-allow-patients-to-reconsider-chemo/