Does sex matter in colon cancer screening? - Yahoo! News:
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New Anti-Cancer Agents Show Promise for Treating Aggressive Breast Cancers
ScienceDaily (July 19, 2011) — Some of the most aggressive forms of breast cancer are more vulnerable to chemotherapy when it is combined with a new class of anti-cancer agent, researchers from the Walter and Eliza Hall Institute have shown.
ABT-737 is one of a new class of anti-cancer agents called BH3 mimetics that target and neutralise the so-called Bcl-2 proteins in cancer cells. Bcl-2 proteins act to 'protect' the cells after they have been damaged by chemotherapy drugs, and prevent the cancer cells from dying.
Professors Geoff Lindeman and Jane Visvader, who led the research with colleagues Dr Samantha Oakes and Dr François Vaillant from the institute's Stem Cells and Cancer division, said that the BH3 mimetics showed promise for treating breast cancers, including 'triple negative' cancers. Their research is published in the Proceedings of the National Academy of Sciences.
Triple negative breast cancers are so-called because they test negative for oestrogen, progesterone and HER2 receptors, and cannot be treated with hormone therapy or trastuzumab. They account for up to 20 per cent of all breast cancers and are typically aggressive with a poor prognosis.
Dr Lindeman said that early results suggest navitoclax (an orally-available BH3 mimetic) could provide new hope for treating some breast cancers that are not candidates for other currently available treatments.
"ABT-737 targets proteins from the Bcl-2 family, which are found at high levels in up to 70 per cent of breast cancers," Dr Lindeman said. "We have shown that breast tumours that have high levels of Bcl-2 respond well to treatment with ABT-737 when used in combination with a conventional chemotherapy drug."
ABT-737 and navitoclax were discovered by Abbott scientists and are based on the discovery made at the Walter and Eliza Hall Institute in the 1980s that Bcl-2 is a 'pro-survival' protein responsible for preventing cell death in healthy and diseased cells. ABT-737 and navitoclax are not yet available for patient treatment, but navitoclax is currently in phase II clinical trials to establish its efficacy in treating some types of leukemia and lymphoma. Navitoclax is being jointly developed by Abbott and Genentech, Inc.
Dr Visvader said combined treatment with ABT-737 and docetaxel (a commonly used chemotherapy drug for treating breast cancer) in mice transplanted with human breast cancer cells improved tumour response and survival rates, when compared to docetaxel as a single agent. ABT-737 alone was not effective in treating cancers with high levels of Bcl-2, nor was it effective in treating cancers that did not express Bcl-2.
"The research suggests that these agents make the cancer cells more vulnerable to chemotherapy," Dr Visvader said. "We are particularly excited that the research shows a good response in Bcl-2-expressing breast cancer, including basal-like breast cancer, which is often the most aggressive and hardest to treat."
Dr Lindeman said the research could lead to the development of new treatment regimens that make resistant and difficult-to-treat breast cancers more vulnerable to conventional chemotherapy treatments. "We have had a good result in pre-clinical models of disease, but we are still a way off this being used in humans," Dr Lindeman, who is also an oncologist at The Royal Melbourne Hospital, said. "We hope that these results could see a clinical trial of navitoclax for treating breast cancer with high Bcl-2 levels within the next few years."
The project was supported by the Victorian Breast Cancer Research Consortium through the Victorian Cancer Agency, the National Health and Medical Research Council, Australian Cancer Research Foundation and the National Breast Cancer Foundation. Breast cancer samples were provided with the support of the Victorian Cancer Biobank.
Source : ScienceDaily
ABT-737 is one of a new class of anti-cancer agents called BH3 mimetics that target and neutralise the so-called Bcl-2 proteins in cancer cells. Bcl-2 proteins act to 'protect' the cells after they have been damaged by chemotherapy drugs, and prevent the cancer cells from dying.
Professors Geoff Lindeman and Jane Visvader, who led the research with colleagues Dr Samantha Oakes and Dr François Vaillant from the institute's Stem Cells and Cancer division, said that the BH3 mimetics showed promise for treating breast cancers, including 'triple negative' cancers. Their research is published in the Proceedings of the National Academy of Sciences.
Triple negative breast cancers are so-called because they test negative for oestrogen, progesterone and HER2 receptors, and cannot be treated with hormone therapy or trastuzumab. They account for up to 20 per cent of all breast cancers and are typically aggressive with a poor prognosis.
Dr Lindeman said that early results suggest navitoclax (an orally-available BH3 mimetic) could provide new hope for treating some breast cancers that are not candidates for other currently available treatments.
"ABT-737 targets proteins from the Bcl-2 family, which are found at high levels in up to 70 per cent of breast cancers," Dr Lindeman said. "We have shown that breast tumours that have high levels of Bcl-2 respond well to treatment with ABT-737 when used in combination with a conventional chemotherapy drug."
ABT-737 and navitoclax were discovered by Abbott scientists and are based on the discovery made at the Walter and Eliza Hall Institute in the 1980s that Bcl-2 is a 'pro-survival' protein responsible for preventing cell death in healthy and diseased cells. ABT-737 and navitoclax are not yet available for patient treatment, but navitoclax is currently in phase II clinical trials to establish its efficacy in treating some types of leukemia and lymphoma. Navitoclax is being jointly developed by Abbott and Genentech, Inc.
Dr Visvader said combined treatment with ABT-737 and docetaxel (a commonly used chemotherapy drug for treating breast cancer) in mice transplanted with human breast cancer cells improved tumour response and survival rates, when compared to docetaxel as a single agent. ABT-737 alone was not effective in treating cancers with high levels of Bcl-2, nor was it effective in treating cancers that did not express Bcl-2.
"The research suggests that these agents make the cancer cells more vulnerable to chemotherapy," Dr Visvader said. "We are particularly excited that the research shows a good response in Bcl-2-expressing breast cancer, including basal-like breast cancer, which is often the most aggressive and hardest to treat."
Dr Lindeman said the research could lead to the development of new treatment regimens that make resistant and difficult-to-treat breast cancers more vulnerable to conventional chemotherapy treatments. "We have had a good result in pre-clinical models of disease, but we are still a way off this being used in humans," Dr Lindeman, who is also an oncologist at The Royal Melbourne Hospital, said. "We hope that these results could see a clinical trial of navitoclax for treating breast cancer with high Bcl-2 levels within the next few years."
The project was supported by the Victorian Breast Cancer Research Consortium through the Victorian Cancer Agency, the National Health and Medical Research Council, Australian Cancer Research Foundation and the National Breast Cancer Foundation. Breast cancer samples were provided with the support of the Victorian Cancer Biobank.
Source : ScienceDaily
New Anti-tumor compounds from Curcumin
From the results of research conducted by Chieko Kudo, Hiroyuki Yamakoshi, Atsuko Sato, Hiroshi Nanjo, Hisatsugu Ohori, Chikashi Ishioka, Yoshiharu Iwabuchi and Hiroyuki Shibata titled "Synthesis of 86 species of 1,5-diaryl-3-oxo-1, 4 -pentadienes analogs of curcumin can yield a good lead in vivo "published by BioMed. Stating that they successfully synthesize new anti-tumor compounds.
Curcumin is known to have many anti-tumor such as tumor growth inhibition and induction apotosis. However, the limited bioavailability of curcumin prevented clinical application. A synthesized curcumin analogues, 1,5-diaryl-3-oxo-1 ,4-pentadiene as GO-Y030, has the potential for increased anti-tumor in vitro and in mouse models of colorectal carcinogenesis.
From the results of tests on mice, they found a survival rate of mice given the compounds synthesized. The conclusions of their research are:
The 1,5-diaryl-3-oxo-1 ,4-pentadiene analogs can yield good lead compounds for cancer chemotherapy, to Overcome the low bioavailability of curcumin.
For the full article on this research. You can read it at the following link;
http://www.biomedcentral.com/1471-2210/11/4
Curcumin is known to have many anti-tumor such as tumor growth inhibition and induction apotosis. However, the limited bioavailability of curcumin prevented clinical application. A synthesized curcumin analogues, 1,5-diaryl-3-oxo-1 ,4-pentadiene as GO-Y030, has the potential for increased anti-tumor in vitro and in mouse models of colorectal carcinogenesis.
From the results of tests on mice, they found a survival rate of mice given the compounds synthesized. The conclusions of their research are:
The 1,5-diaryl-3-oxo-1 ,4-pentadiene analogs can yield good lead compounds for cancer chemotherapy, to Overcome the low bioavailability of curcumin.
For the full article on this research. You can read it at the following link;
http://www.biomedcentral.com/1471-2210/11/4
“Get to Know what is cancer”
All over the world, cancer is known to be as one of the most deadly disease ever to have affected the human race. Most of the medical researchers all over the world, consider cancer to be a “metabolic disease”. Metabolic diseases are those diseases, which are known to affect the metabolism rate of the human body. As already said, we know that cancer has been concluded as to be a “metabolic disease” and that conclusion has been drawn from the fact that, cancer as a disease affects the human cells in the body.
Cells are microscopic living units in the body, which together form all living organs in the body. At any given time or state, the human body is made up of a billion cells, which together constitute the human organs. Cancer as a disease is considered to be a very deadly disease, just because of the fact that the disease affects the human cells. In cancer, abnormal and unusual cells crop up in the human body and they grow and spread in the human body at an alarming and fast rate. The abnormal cells grow and star spreading at a very fast rate. Usually, the normal cells divide and grow up to a certain level and then they die after a little time, unlike the unusual cells which do not follow the normal rate of growth and division. The cancer cells keep on dividing and continue growing on unlike the usual cells. The cancer cells unlike the usual cells do not die and start getting clumped together, which in turn forms a tumor.
It is said that cancer actually is a stage in the body when the cells turn, “trophoblastic”. Trophoblastic is a situation in the human body, when the cells in the human body tend to multiply at a faster rate than the normal. This stage can be explained for example, when a human body gets an external or internal injury, then the cells of the human body start the healing process, by starting to multiply. In case, the cells are in a trophoblastic stage, then although the cells start healing, but they don’t stop multiplying, thereby causing a lump. This in medical term is also called as a tumor. This lump goes numb even if the body controls the growth of the trophoblastic cells and proves to be highly injurious if the cells keep spreading. The removal of such tumor would rather lead to the uncontrolled growth of those trophoblastic cells, because of more effected sited due to the operation, and thus result in increasing the cancer.
The known medical treatments for cancer are radiation therapy and chemotherapy. But neither radiation therapy is effective due to the reason it creates more wounded parts and thus increases the cancer cells, nor chemotherapy is effective because it adversely effects the immune system of the body and the body holds no-more ability of natural healing.
The king of berries: super fruit Cancer Prevention
www.dailymail.co.uk (on 28th June 2011) reported that there is a fruit that grows in England that British black raspberries have the ability to prevent cancer.
This fruit will go on sale on 28th June 2011 yesterday. This variety is named Mac Black
has a stronger flavor. Maybe this is a substance that researchers say could prevent cancer.
The Mac
Blacks are rich in ellagic acid, anthocyanins and antioxidants, and have been Called the "king of berries' for Their superior health benefits.
Mac Black raspberries originally came from North America and were the resource persons Brought over to the UK five years ago by the UK's Biggest berry growers Hunter Hall, near Twyford, Berkshire.
More news can be read here http://www.dailymail.co.uk/health/article-2008907/The-king-berries-British-black-raspberry-superfood-help-prevent-cancer.html
This fruit will go on sale on 28th June 2011 yesterday. This variety is named Mac Black
has a stronger flavor. Maybe this is a substance that researchers say could prevent cancer.The Mac
Blacks are rich in ellagic acid, anthocyanins and antioxidants, and have been Called the "king of berries' for Their superior health benefits.Mac Black raspberries originally came from North America and were the resource persons Brought over to the UK five years ago by the UK's Biggest berry growers Hunter Hall, near Twyford, Berkshire.
More news can be read here http://www.dailymail.co.uk/health/article-2008907/The-king-berries-British-black-raspberry-superfood-help-prevent-cancer.html
What is Male Breast Cancer ?
Male breast cancer such as breast cancer in women, abnormal growth of breast tissue or cells are caused by mutations. Channels women, behind breast nonfunctioning oil each have a small amount of breast tissue and connective tissue. According to the Mayo Clinic, about 100 times more than men, women are more likely to develop breast cancer. seen, male breast cancer is often due to assumptions about the development of breast cancer and their prognosis is worse for women why not take a diagnosis. In fact, although more common in women's breast cancer awareness, prediction is the same.
The History of Breast Cancer
Fighting the Most Common Cancer in Women
In the 1970's the movement to increase breast cancer awareness began to grow rapidly. More and more non-profit organizations, governmental organizations and other organizations have been formed in order to increase knowledge and awareness of this disease, but also to sponsor research to aid in its eradication. While breast cancer survival rates have gone up somewhat in the last twenty years, the fact remains that this disease is still far too prevalent and killing far too many women.
The history of breast cancer is a long and far too often tragic one. The earliest recorded cases of the disease date back to ancient Egypt. The three earliest documented cases arise from the famous Edwin Smith Papyrus, one of whom was a man. Breast cancer treatment began in the 18th century and is still being researched and developed to this day.
The earliest known medical document known to man is what is known as the Edwin Smith Papyrus. Edwin Smith was an Egyptologist who bought fragments of the document in London in 1862. Although he understood its importance he never published on it and the papyrus became all but forgotten. In the 20th century this vastly important work was rediscovered. Dating back to 1600 BC it is our first known medical writing. Important to the history of breast cancer it also describes in writing the earliest known cases of the disease, one of which was a man.
In ancient Egypt the history of breast cancer treatment begins with cauterization of tumors found in the breast with an instrument known as "the fire drill." Although medical practitioners are able to remove these tumors in some cases they are for the most part unable to stop the disease from taking its course. Writes the ancient Egyptian doctor of breast cancer: "There is no treatment."
Such was the prevailing wisdom throughout the history of breast cancer. Although cases of breast cancer are documented throughout history, it is not until the 17th century in Europe that medical understanding of the human body is able to begin to comprehend the nature of breast cancer. European doctors linked the tumors in the breast to the lymph glands in the armpit. In the early 18th century two extremely important figures in the history of breast cancer arise: Jean Louis Petit and Benjamin Bell who performed the first surgeries removing the lymph nodes, breast tissue and breast muscle in order to remove the cancer from the body and fight its spread.
This pioneering work was continued by the surgeon William Stewart Halsted who began performing complete mastectomies in 1882. His procedure is known as the Halsted radical mastectomy and was popular throughout the 20th century up until the 1970's and is still common today.
Although doctors have been fighting breast cancer for centuries, it was not until the 20th century that movements to increase breast cancer awareness as well as cancer awareness in general began. In 1952 the American Cancer Society created the Reach to Recovery program, one of the landmark programs in the history of breast cancer treatment and advocacy. The Reach to Recovery program was a group of women helping women, where women would go visit patients in hospitals who had just had mastectomies for support. This group continues its operations today.
In the 1970's the movement to increase breast cancer awareness began to grow rapidly. More and more non-profit organizations, governmental organizations and other organizations have been formed in order to increase knowledge and awareness of this disease, but also to sponsor research to aid in its eradication. While breast cancer survival rates have gone up somewhat in the last twenty years, the fact remains that this disease is still far too prevalent and killing far too many women.
Many great strides have been made in the history of breast cancer treatment but there is still a great amount of work to be done. One in 12 or 13 women will suffer from breast cancer at some time during their lives in the western world. In the United States these numbers can be even higher. One of the most important aspects of the fight against breast cancer is breast cancer awareness. The more knowledge known about the disease and the more done to check for early warning signs the better chance for survival. Research and development continues to be done so that one day we can say the history of breast cancer is over.
Rare, evolutionarily unlikely missense substitutions in CHEK2 contribute to breast cancer susceptibility: results from a breast cancer family registry (CFR) case-control mutation screening study
Florence Le Calvez-Kelm 
, Fabienne Lesueur , Francesca Damiola , Maxime Vallee , Catherine Voegele , Davit Babikyan , Geoffroy Durand , Nathalie Forey , Sandrine McKay-Chopin , Nivonirina Robinot , Tu Nguyen-Dumont , Alun Thomas , Graham B Byrnes , The Breast Cancer Family Registry , John L Hopper , Melissa C Southey , Irene L Andrulis , Esther M John and Sean V Tavtigian
Breast Cancer Research 2011, 13:R6doi:10.1186/bcr2810, Fabienne Lesueur , Francesca Damiola , Maxime Vallee , Catherine Voegele , Davit Babikyan , Geoffroy Durand , Nathalie Forey , Sandrine McKay-Chopin , Nivonirina Robinot , Tu Nguyen-Dumont , Alun Thomas , Graham B Byrnes , The Breast Cancer Family Registry , John L Hopper , Melissa C Southey , Irene L Andrulis , Esther M John and Sean V Tavtigian | Published: | 18 January 2011 |
Abstract (provisional)
Introduction
Both protein truncating variants and some missense substitutions in CHEK2 confer increased risk of breast cancer. However, no large-scale study has used full open reading frame mutation screening to assess the contribution of rare missense substitutions in CHEK2 to breast cancer risk. This absence has been due in part to a lack of validated statistical methods for summarizing risk attributable to large numbers of individually rare missense substitutions.Methods
Previously, we adapted an in silico assessment of missense substitutions used for analysis of unclassified missense substitutions in BRCA1 and BRCA2 to the problem of assessing candidate genes using rare missense substitution data observed in case-control mutation screening studies. The method involves stratifying rare missense substitutions observed in cases and/ or controls into a series of grades a priori ordered from least to most likely to be evolutionarily deleterious, followed by a logistic regression test for trend to compare the frequency distributions of the graded missense substitutions in cases versus controls. Here we used this approach to analyze CHEK2 mutation screening data from a population based series of 1303 female breast cancer cases and 1109 unaffected female controls.Results
We found evidence of risk associated with rare, evolutionarily unlikely CHEK2 missense substitutions. Additional findings were: (1) the risk estimate for the most severe grade of CHEK2 missense substitutions (denoted C65) is approximately equivalent to that of CHEK2 protein truncating variants; (2) the population attributable fraction and familial relative risk explained by the pool of rare missense substitutions were similar to those explained by the pool of protein truncating variants; and (3) post-hoc power calculations implied that scaling case-control mutation screening up to examine entire biochemical pathways would require roughly 2,000 cases and controls to achieve acceptable statistical power.Conclusions
This study shows that CHEK2 harbors many rare sequence variants that confer increased risk of breast cancer, and a substantial proportion of these are missense substitutions. The study validates our analytic approach to rare missense substitutions and provides a method to combine data from protein truncating variants and rare missense substitutions into a one degree of freedom per gene test.Source : http://breast-cancer-research.com/content/13/1/R6
Annual Breast Cancer Screening Beginning at Age 40 Reduces Mastectomy Risk, Study Finds
ScienceDaily Report
(Dec. 1, 2010) — Having a yearly mammogram greatly reduces the risk of mastectomy following breast cancer in women between the ages of 40 and 50, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
"The results of this study support the importance of regular screening in the 40 to 50 age group," said lead author Nicholas M. Perry, M.B.B.S., F.R.C.S., F.R.C.R., director of The London Breast Institute at The Princess Grace Hospital in London. "Women in this age group who had undergone mammography the previous year had a mastectomy rate of less than half that of the others."
An estimated 207,090 new cases of invasive breast cancer will be diagnosed in American women in 2010. Currently, the American Cancer Society recommends annual mammography screening for women beginning at age 40 in the U.S., but last year, the U.S. Preventive Services Task Force recommended changing the guidelines to begin screening biennially (every other year) at age 50. There are no routine screening guidelines for women under 50 in the U.K.
The researchers studied the benefits of screening women between the ages of 40 and 50, the frequency of mammography and the type of treatment after breast cancer diagnosis.
Dr. Perry and colleagues reviewed the clinical data available on women from 40 to 50 that had been diagnosed with breast cancer and treated at The London Breast Institute. Between 2003 and 2009, 971 women had been diagnosed with breast cancer. At the time of diagnosis, 393 (40 percent) of the women were under 50, with 156 of these women completing treatment at the center. Of the treated women, 114 (73 percent) had no prior mammograms. Forty-two women had been previously screened with mammography, of whom 29 had at least one mammogram within the previous two years. Of those, 16 women had a mammogram one year prior.
"We reviewed the records of the women needing mastectomy to determine whether or not they had undergone mammography the previous year," Dr. Perry said. "We were surprised at the degree of benefit obtained from yearly screening in this age group."
Data showed that mastectomy was the required treatment for 3 (19 percent) of the 16 women who had been screened the prior year, compared to 64 (46 percent) of the 140 women who had not been screened in the past year.
"Regular screening is already proven to lower the chance of women dying from breast cancer," Dr. Perry said. "The results of our study support the importance of regular screening in the under-50 age group and confirm that annual mammography improves the chances of breast conservation should breast cancer develop."
Dr. Perry's coauthors are Sue Milner, B.Sc., D.C.R., Kefah Mokbel, M.B.B.S., M.S., F.R.C.S., Stephen W. Duffy, B.Sc., M.Sc., and Katja Pinker, M.D.
(Dec. 1, 2010) — Having a yearly mammogram greatly reduces the risk of mastectomy following breast cancer in women between the ages of 40 and 50, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
"The results of this study support the importance of regular screening in the 40 to 50 age group," said lead author Nicholas M. Perry, M.B.B.S., F.R.C.S., F.R.C.R., director of The London Breast Institute at The Princess Grace Hospital in London. "Women in this age group who had undergone mammography the previous year had a mastectomy rate of less than half that of the others."
An estimated 207,090 new cases of invasive breast cancer will be diagnosed in American women in 2010. Currently, the American Cancer Society recommends annual mammography screening for women beginning at age 40 in the U.S., but last year, the U.S. Preventive Services Task Force recommended changing the guidelines to begin screening biennially (every other year) at age 50. There are no routine screening guidelines for women under 50 in the U.K.
The researchers studied the benefits of screening women between the ages of 40 and 50, the frequency of mammography and the type of treatment after breast cancer diagnosis.
Dr. Perry and colleagues reviewed the clinical data available on women from 40 to 50 that had been diagnosed with breast cancer and treated at The London Breast Institute. Between 2003 and 2009, 971 women had been diagnosed with breast cancer. At the time of diagnosis, 393 (40 percent) of the women were under 50, with 156 of these women completing treatment at the center. Of the treated women, 114 (73 percent) had no prior mammograms. Forty-two women had been previously screened with mammography, of whom 29 had at least one mammogram within the previous two years. Of those, 16 women had a mammogram one year prior.
"We reviewed the records of the women needing mastectomy to determine whether or not they had undergone mammography the previous year," Dr. Perry said. "We were surprised at the degree of benefit obtained from yearly screening in this age group."
Data showed that mastectomy was the required treatment for 3 (19 percent) of the 16 women who had been screened the prior year, compared to 64 (46 percent) of the 140 women who had not been screened in the past year.
"Regular screening is already proven to lower the chance of women dying from breast cancer," Dr. Perry said. "The results of our study support the importance of regular screening in the under-50 age group and confirm that annual mammography improves the chances of breast conservation should breast cancer develop."
Dr. Perry's coauthors are Sue Milner, B.Sc., D.C.R., Kefah Mokbel, M.B.B.S., M.S., F.R.C.S., Stephen W. Duffy, B.Sc., M.Sc., and Katja Pinker, M.D.
Women With False-positive Mammograms Report High Anxiety And Reduced Quality Of Life
Doctors are calling for women to receive more information about the pitfalls of breast cancer screening, as well as the benefits, after some women who received false-positive results faced serious anxiety and reduced quality of life for at least a year.
A study published online by BJS, the British Journal of Surgery, shows that patients with false-positive results - where the mammogram is abnormal but no cancer is present - had to undergo more diagnostic procedures than women with breast cancer before they were given the all clear. Researchers from The Netherlands spoke to 385 women with abnormal mammogram results - 152 were subsequently diagnosed with breast cancer, but the other 233 had false-positive results and did not have cancer.
"Common sense tells us that early detection of breast cancer is good and most screening programmes have been successful in reducing breast cancer deaths" says lead author Dr Lideke van der Steeg from the Department of Surgery, St Elisabeth Hospital, Tilburg, and the Centre of Research and Psychology in Somatic Diseases, Tilburg University.
"However, while some women truly benefit from early detection, others experience harm and unnecessary anxiety. The women who received false-positives in our study experienced a significant reduction in their quality of life, especially if they were prone to anxiety, and the effects of this lasted at least a year.
"In fact, women who had a tendency to be anxious fared much worse if they received a false-positive - which is estimated to happen in 60 per cent of abnormal mammograms - than if they were actually diagnosed with breast cancer."
Women with abnormal mammograms attending three hospitals over a five-year period were invited to participate. Their quality of life (QoL) was assessed using the World Health Organization's Quality of Life instrument 100, which assesses QoL in six domains physical health, psychological health, level of independence, social relationships, environment and spirituality.
Clinical data were obtained from the women's medical records and they were also asked to complete questionnaires providing demographic information such as age, marital status, education and socioeconomic status.
Women in the breast cancer (BC) group were significantly older than the women in the false-positive (FP) group 60.2 years versus 57.3 years. They also had larger tumours than the FP group 17.4mm versus 9.9mm.
The key factors influencing QoL scores differed between the two groups:
-- Trait anxiety (a tendency to experience anxiety) accounted for up to 55 per cent of the variance in the QoL score in the FP group. It reached this peak at three months, but was similar at months one and 12 (43 per cent and 40 per cent respectively).
-- State anxiety (temporary anxiety due to a specific situation) accounted for up to 46 per cent of the variance in the BC group. It peaked at six months, but was similar in months one and 12 (32 per cent and 34 per cent).
-- State anxiety levels did not significantly influence QoL in the FP group and trait anxiety levels did not influence QoL in the BC group.
Significantly more diagnostic procedures, including biopsies, were needed in the FP group to reach a final diagnosis. Only 14 per cent of the BC group required four procedures - the other 86 per cent required three - while 32 per cent of the FP group required more than three. Fifty-five per cent of the FP group returned to the outpatient clinic in the first year, some as many as eight times.
The authors believe that the anxiety and lower QoL experienced by women in the FP group were soley due to the recall after screening and the subsequent diagnostic procedures.
"The decision to participate in a screening programme requires balanced information about the potential benefits and dangers" says Dr van der Steeg.
"Women often overestimate their risk of breast cancer and the material provided by healthcare professionals and government agencies often focus on the positive aspects of screening and are not always objective.
"Women deserve more balanced information to help them to chose whether or not to accept a breast screening invitation. This should not only cover the supposed benefits, but explain the potential side-effects of a false-positive, such as the increased feelings of anxiety and reduced QoL found by our study."
Sources: Wiley - Blackwell, AlphaGalileo Foundation.
A study published online by BJS, the British Journal of Surgery, shows that patients with false-positive results - where the mammogram is abnormal but no cancer is present - had to undergo more diagnostic procedures than women with breast cancer before they were given the all clear. Researchers from The Netherlands spoke to 385 women with abnormal mammogram results - 152 were subsequently diagnosed with breast cancer, but the other 233 had false-positive results and did not have cancer.
"Common sense tells us that early detection of breast cancer is good and most screening programmes have been successful in reducing breast cancer deaths" says lead author Dr Lideke van der Steeg from the Department of Surgery, St Elisabeth Hospital, Tilburg, and the Centre of Research and Psychology in Somatic Diseases, Tilburg University.
"However, while some women truly benefit from early detection, others experience harm and unnecessary anxiety. The women who received false-positives in our study experienced a significant reduction in their quality of life, especially if they were prone to anxiety, and the effects of this lasted at least a year.
"In fact, women who had a tendency to be anxious fared much worse if they received a false-positive - which is estimated to happen in 60 per cent of abnormal mammograms - than if they were actually diagnosed with breast cancer."
Women with abnormal mammograms attending three hospitals over a five-year period were invited to participate. Their quality of life (QoL) was assessed using the World Health Organization's Quality of Life instrument 100, which assesses QoL in six domains physical health, psychological health, level of independence, social relationships, environment and spirituality.
Clinical data were obtained from the women's medical records and they were also asked to complete questionnaires providing demographic information such as age, marital status, education and socioeconomic status.
Women in the breast cancer (BC) group were significantly older than the women in the false-positive (FP) group 60.2 years versus 57.3 years. They also had larger tumours than the FP group 17.4mm versus 9.9mm.
The key factors influencing QoL scores differed between the two groups:
-- Trait anxiety (a tendency to experience anxiety) accounted for up to 55 per cent of the variance in the QoL score in the FP group. It reached this peak at three months, but was similar at months one and 12 (43 per cent and 40 per cent respectively).
-- State anxiety (temporary anxiety due to a specific situation) accounted for up to 46 per cent of the variance in the BC group. It peaked at six months, but was similar in months one and 12 (32 per cent and 34 per cent).
-- State anxiety levels did not significantly influence QoL in the FP group and trait anxiety levels did not influence QoL in the BC group.
Significantly more diagnostic procedures, including biopsies, were needed in the FP group to reach a final diagnosis. Only 14 per cent of the BC group required four procedures - the other 86 per cent required three - while 32 per cent of the FP group required more than three. Fifty-five per cent of the FP group returned to the outpatient clinic in the first year, some as many as eight times.
The authors believe that the anxiety and lower QoL experienced by women in the FP group were soley due to the recall after screening and the subsequent diagnostic procedures.
"The decision to participate in a screening programme requires balanced information about the potential benefits and dangers" says Dr van der Steeg.
"Women often overestimate their risk of breast cancer and the material provided by healthcare professionals and government agencies often focus on the positive aspects of screening and are not always objective.
"Women deserve more balanced information to help them to chose whether or not to accept a breast screening invitation. This should not only cover the supposed benefits, but explain the potential side-effects of a false-positive, such as the increased feelings of anxiety and reduced QoL found by our study."
Sources: Wiley - Blackwell, AlphaGalileo Foundation.
Genetic Predisposition Discovered For Breast, Kidney Cancers
Researchers at Cleveland Clinic's Genomic Medicine
Institute have revealed multiple genetic discoveries that may permit easier diagnosis and disease management for Cowden syndrome patients who are predisposed to breast and kidney cancer.
The research, which could allow for earlier discovery of cancerous tumors, is published in the Dec. 22 issue of the Journal of the American Medical Association (JAMA).
Charis Eng, M.D., Ph.D, Chair of the Genomic Medicine Institute at Cleveland Clinic, led the research. It revealed KILLIN as a novel predisposition gene for Cowden syndrome (CS) and Cowden-like syndrome (CLS) features in individuals without germline PTEN mutations, which also plays a role in cancer risk.
According to Dr. Eng, "CLS is at least 10 times more common than CS, but the genetic alteration responsible for CLS and its cancers has eluded the scientific community for more than a decade. From our research, we now know that KILLIN accounts for almost half of CLS, making diagnosis much more accurate."
Mutations in the PTEN gene are the foundation of Cowden syndrome. PTEN is a tumor suppressor gene, helping to direct the growth and division of cells. Inherited mutations in the PTEN gene have been found in approximately 80 percent of Cowden syndrome patients. These mutations prevent the PTEN protein from effectively regulating cell survival and division, which can lead to the formation of tumors.
However, not all CS and CLS patients carry mutated PTEN. In fact, in CLS, less than 10 percent have PTEN mutations, yet they develop cancers just like CS. In those patients without the PTEN mutation, 42 percent of Cowden syndrome patients and 33 percent of Cowden-like syndrome patients have low levels of KILLIN tumor
suppressor gene.
"We know that 80 percent of Cowden patients carry the PTEN mutation and half of the remaining 20 percent carry the inactive KILLIN gene," Dr. Eng said. "What that means is that altogether PTEN and KILLIN should account for 90 percent of all cases of classic Cowden syndrome, a huge step forward in diagnosing an often overlooked disease. More importantly, KILLIN and PTEN should account for almost half of CLS individuals."
This study shows that CS/CLS individuals with KILLIN promoter methylation, which switches the KILLIN gene off, have a threefold greater risk of breast cancer, and a twofold greater risk of kidney cancer, compared to those with mutant PTEN. Having the ability to identify these individuals will allow for more proactive management of their health, such as more careful screening and shared best practices among physicians who treat them.
Findings from this study indicate that individuals with classic Cowden syndrome should be offered PTEN testing first; those found not to have PTEN mutations should then be screened for the inactivated KILLIN gene and offered genetic counseling. Those patients who carry neither the PTEN mutation nor the inactive KILLIN gene should be offered additional/alternative genetic testing and importantly, encouraged to participate in research.
Source:
Dan Doron
Cleveland Clinic Foundation
Breast
, Kidney Cancers
Institute have revealed multiple genetic discoveries that may permit easier diagnosis and disease management for Cowden syndrome patients who are predisposed to breast and kidney cancer.The research, which could allow for earlier discovery of cancerous tumors, is published in the Dec. 22 issue of the Journal of the American Medical Association (JAMA).
Charis Eng, M.D., Ph.D, Chair of the Genomic Medicine Institute at Cleveland Clinic, led the research. It revealed KILLIN as a novel predisposition gene for Cowden syndrome (CS) and Cowden-like syndrome (CLS) features in individuals without germline PTEN mutations, which also plays a role in cancer risk.
According to Dr. Eng, "CLS is at least 10 times more common than CS, but the genetic alteration responsible for CLS and its cancers has eluded the scientific community for more than a decade. From our research, we now know that KILLIN accounts for almost half of CLS, making diagnosis much more accurate."
Mutations in the PTEN gene are the foundation of Cowden syndrome. PTEN is a tumor suppressor gene, helping to direct the growth and division of cells. Inherited mutations in the PTEN gene have been found in approximately 80 percent of Cowden syndrome patients. These mutations prevent the PTEN protein from effectively regulating cell survival and division, which can lead to the formation of tumors.
However, not all CS and CLS patients carry mutated PTEN. In fact, in CLS, less than 10 percent have PTEN mutations, yet they develop cancers just like CS. In those patients without the PTEN mutation, 42 percent of Cowden syndrome patients and 33 percent of Cowden-like syndrome patients have low levels of KILLIN tumor
suppressor gene."We know that 80 percent of Cowden patients carry the PTEN mutation and half of the remaining 20 percent carry the inactive KILLIN gene," Dr. Eng said. "What that means is that altogether PTEN and KILLIN should account for 90 percent of all cases of classic Cowden syndrome, a huge step forward in diagnosing an often overlooked disease. More importantly, KILLIN and PTEN should account for almost half of CLS individuals."
This study shows that CS/CLS individuals with KILLIN promoter methylation, which switches the KILLIN gene off, have a threefold greater risk of breast cancer, and a twofold greater risk of kidney cancer, compared to those with mutant PTEN. Having the ability to identify these individuals will allow for more proactive management of their health, such as more careful screening and shared best practices among physicians who treat them.
Findings from this study indicate that individuals with classic Cowden syndrome should be offered PTEN testing first; those found not to have PTEN mutations should then be screened for the inactivated KILLIN gene and offered genetic counseling. Those patients who carry neither the PTEN mutation nor the inactive KILLIN gene should be offered additional/alternative genetic testing and importantly, encouraged to participate in research.
Source:
Dan Doron
Cleveland Clinic Foundation
Breast
, Kidney Cancers
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