LOCAL HEALTH NEWS: Jefferson Offers Free Screenings For Prostate Cancer

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

09/17/2008

Philadelphia - Philadelphia area residents can get free prostate cancer screenings today at the Bodine Center for Cancer Treatment at 111 South 11th Street at Thomas Jefferson University Hospital. The service will be provided between 9 a.m. and 3 p.m. to all men who come and request it.

The free screenings are part of a research program and include a rectal exam as well as a blood test for levels of prostate specific antigen (PSA), testosterone and cholesterol.

"The blood test right now should be done once a year over the age of 50," recommended Dr. Leonard Gomella, chairman of the department of urology at Thomas Jefferson University's Kimmel Cancer Center.

Prostate cancer is the most common non-skin cancer in the United States, affecting one in six American men. It is the second-leading cancer killer, after lung tumors, among men.

Screening is generally recommended for men aged 40 to 75, and beginning at age 35 if there is family history of prostate cancer or you are of African American or Hispanic background.

The benefits of screening for older men above age 75 has been questioned in recent studies, but discussing your options and risks with your doctor is still best, said Dr. Gomella. "More men die with prostate cancer than of prostate cancer."

Although the government does not endorse PSA screenings and there is currently no cure for the disease, discovering the cancer earlier allows for possible treatment of symptoms and monitoring for continued progression.

The American Cancer Society notes that the year 2007 saw 218,890 men diagnosed in the U.S. and about 27,050 deaths. Worldwide, approximately 780,000 men are diagnosed with it each year, 250,000 of whom die.

The event is in its 19th year and is sponsored by Jefferson's Kimmel Cancer Center and the Foundation for Breast and Prostate Health. The month of September is the country's newly designated Prostate Cancer Awareness Month.


Heather J. Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

HEALTH NEWS: Study: Breast Cancer Survivors Still At Risk

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/14/2008

New research from a 16-year study indicates that early-stage breast cancer patients who have completed five to 10 years of drug and/or chemotherapy treatment have a one in five - around 20 percent - chance of relapse.

Between 1985 and 2001, oncologists/researchers at the University of Texas' M.D. Anderson Cancer Center examined 2,838 patients with stage I to III breast cancers who had been treated at the center. All were cancer-free five years after initial treatment with surgery or surgery and radiation.

All of the women underwent up to five years of additional treatments with chemotherapy, the anti-estrogen drug tamoxifen or both. After a 28-month follow-up, 215 women developed recurrent cancer.

This incidence rate put the risk at 7 percent for women with stage I breast cancer, 11 percent for stage II, and 13 percent for women with stage III cancer. This relapse rate increased to 20 percent 15 years after first being diagnosed.

"The risk of relapse was still small, but certainly not insignificant," Abenaa M. Brewster, M.D., an oncologist and researcher with M.D. Anderson Cancer Center told WebMD. "I think these numbers are somewhat reassuring, but they also highlight the need for new [therapeutic] options for women who have completed five years of treatment."

Factors associated with the risk of recurrence were tumor grade, hormone receptor status and endocrine therapy.

Forms of treatment available to newly diagnosed patients usually include surgery and radiation therapy (chemotherapy) or surgery and drug therapy.

Up until the year 2000, drug treatment consisted of tamoxifen for both premenopausal and postmenopausal women with estrogen-receptor positive tumors (they respond to hormone treatments). Today, a newer class of drugs called aromatase inhibitors are used.

In the study, 34 ER-negative women had a relapse and 149 ER-positive women did. The study and results were published Tuesday in the online edition of the Journal of the National Cancer Institute.

Estrogen-receptor (ER) negative tumors are considered more deadly than ER-positive ones. However, "women who had ER-positive cancer were more likely to have late recurrences than those with ER-negative," according to Len Lichtenfeld, M.D., the American Cancer Society deputy chief medical officer in healthday.com.

However, what to do about this continued risk is up in the air, Dr. Lichtenfeld said.

A possible treatment alternative is in the works by British and Finnish researchers, who are testing a combination of two inexpensive, commonly used and easily available drugs on killing cancer-cells in tumors.

The first drug is doxorubicin, a common chemotherapy-regimen drug, followed 24 hours later by the osteoporosis medication zoledronic acid. When tested on mice, the drug combo was 99.99 percent effective in killing such cells. Human trials are currently underway with results expected later this year.

This announcement was also made in the Journal of the National Cancer Institute.

Each year in the U.S., around 180,000 women are diagnosed with breast cancer. In the U.K., almost 46,000 new cases are diagnosed every year.


Heather J. Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

HEALTH: Report: Prostate Cancer Screenings Pose Greater Risk Than Benefit For Older Men

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/07/2008

Recommendations by a federal task force are challenging routine preventive care practices for prostate cancer for the country's population of older men.

The guidelines, issued Monday by the U.S. Preventative Services Task Force and updated from its inconclusive stance in 2002, advise that such cancer screenings should not be performed on men aged 75 years and older. Reasons cited include a lack of strong evidence of overall benefit compared to the potential risks of screening.

In younger men, the efficacy of prostate-specific antigen (PSA) screenings remains unclear. Here, the task force advises early counseling about the risks and few benefits so men may elect not to be tested.

The study's results were published in the Aug. 5 issue of Annals of Internal Medicine. This is the first time a specific recommendation has been made on the issue.

According to Dr. Ned Calonge, chair of the 16-member task force, "the benefit of screening at this time is uncertain ... You have a chance that screening will help you live longer or better, and ... the chance that screening detection and treatment will harm you. At age 75, the chances are great that you'll have negative impacts from the screening."

Negative effects listed by the panel include psychological harm, impotency and incontinence, "additional medical visits, adverse effects of prostate biopsies, anxiety and overdiagnosis" - detection when treatment won't affect life expectancy. Some studies suggest that overdiagnosis alone can occur between 29 to 44 percent of the time.

Prostate cancer is the most common non-skin cancer in the United States and affects one out of every six men. Risk factors include family history of cancer or an African-American background.

According to the American Cancer Society, last year saw 218,890 men diagnosed with prostate cancer and about 27,050 deaths. It is the second-leading cancer killer, after lung tumors, among men. The overall mortality rate from the disease has dropped since it peaked in 1991.

Currently, one third of American men receive either PSA screenings, which test for protein blood levels, or a digital rectal exam, which identifies abnormal growth of the prostate gland. Detection enables doctors to monitor a patient whose condition is slow-growing, or to provide treatment. Some men die before their cancer even becomes an issue.

Still, the panel says their findings do not support definitive advice, and the new guidelines will not prevent a man from seeking screening and treatment for prostate cancer symptoms, such as frequent or painful urination or blood in the urine or semen.

"Larger, longer-term [clinical] studies are urgently needed," Dr. Calonge, who is also the chief medical officer for the Colorado Department of Public Health and Environment said. "We recommend that men concerned about prostate cancer talk with their health care providers to make a decision based on their individual risk factors and personal preference."

While the age limitation may be welcome for some, many doctors find the lack of strong new evidence against screening as not enough to discourage preventative care.

"The spirit of the recommendations is good, but the problem is they really do send the wrong message to older men who could have prostate cancer," said Dr. Leonard Gomella, chairman of the department of urology at Thomas Jefferson University's Kimmel Cancer Center. "This study falls short of the fact that there are older men over 75 who do need treatment."

Falling mortality rates and longer life spans around the world where PSA testing have been made available may support continued preventative care, as well.

"Men are living a lot longer these days. I play golf with 84-year-old guys who beat me all the time," Dr. E. David Crawford, a professor of surgery and radiation at the University of Colorado at Denver said to the Washington Post. "You have to individualize treatment."

"If it turns out that PSA screening and aggressive treatment saves lives, maybe all the harm that it has caused is worth it," Dr. Otis W. Brawley, chief medical officer at the American Cancer Society added. "We just don't know yet."

The PSA test was approved by the Food and Drug Administration in 1986 and has been utilized increasingly since the mid-1990s as stigmas faded, awareness grew, and screenings for other cancers such as breast and ovarian became more popular.

Heather J. Chin can be reached at hchin@thebulletin.us.

©The Evening Bulletin 2008

MEDICINE: Tobacco Plants Used As Basis For Cancer Vaccine

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin
07/24/2008

In spite of years of its name being associated with cancer, the tobacco plant has recently shown potential in the development of personalized vaccine cells to fight a specific type of non-Hodgkin's lymphoma.

Potential medicinal applications for tobacco are still in preliminary stages, but scientists at the Stanford University School of Medicine in California have published their current findings in the Proceedings of the National Academy of Science.

In their report, the researchers focused on creating antibodies for follicular B-cell lymphoma, which attacks the immune system and is currently considered incurable. A "B-cell" is a type of white blood cell responsible for defending the body against bacteria and other pathogens that cause illnesses.

After isolating the patient's cancer cells, the antibody-producing gene is extracted and transplanted to the "tobacco mosaic virus," which is then used to infect the tobacco plants. The infection then spreads through the cells and the gene produces large quantities of antibodies. After only a few days, the researchers ground up some of the leaves and extract the antibodies necessary.

Only a few plants are needed to produce enough vaccine for one patient.

In the first test of a plant-based vaccine on humans, 16 patients recently diagnosed with follicular B-cell lymphoma were injected with their individualized vaccines. More than 70 percent of the patients had an immune response and 47 percent had the specific response the researchers hoped for.

While the idea of producing and using individualized antibodies for patients is not new, as previous cancer vaccine trials have been done using animal and human cells, but those had mixed results. This early study using plant tissue has both speed and limited side effects on its side.

"This would be a way to treat cancer without side effects. The idea is to marshal the body's immune system to fight cancer," said Dr. Ronald Levy, senior author of the study. "We know that if you get the immune system revved up, it can attack and kill cancer."

Part of the appeal and benefit is in the speed and inexpensive production process. Each year, about 16,000 people are diagnosed with follicular B-cell lymphoma. Treatment is often limited to constant monitoring by doctors to see if a patient's condition worsens, with chemotherapy being avoided. With so few options, a vaccine would have a significant positive impact.

Since the study was only designed to test whether the plants were practical, safe and effective in stimulating a boosted immune system response, larger and more in-depth studies would need to be conducted to test how well such vaccines might perform in reducing the size of tumors.

The irony of using plants that produce tobacco - the main component in cigarettes, a known cancer-causing agent - as the base from which to develop a cancer-related vaccine was not lost on the researchers and everyone involved.

"It's pretty cool technology, and it's really ironic that you would make a treatment for cancer out of tobacco," said Dr. Levy. "That appealed to me."

The tobacco plants and research technology were provided by Large Scale Biology Corp., a company located in Vacaville, Calif., and the study was funded by the U.S. National Institutes of Health. Further studies into plant vaccines will be taken to major pharmaceutical company, Bayer, which has similar technology and greater financial resources to support the research.


Heather J. Chin can be reached at hchin@thebulletin.us


©The Evening Bulletin 2008