Researchers at the Cleveland Clinic’s Lerner Research Institute (for those not “in the know”, the Cleveland Clinic is  a highly regarded institution)  are now conducting human trials of a breast cancer vaccine.  The vaccine specifically targets a protein common to breast cancer tumors (a-lactalbumin).

Studies upon mice (Sorry PETA, that’s what [...]]]> Source:  BBC Health; Journal Nature Medicine.

Researchers at the Cleveland Clinic’s Lerner Research Institute (for those not “in the know”, the Cleveland Clinic is  a highly regarded institution)  are now conducting human trials of a breast cancer vaccine.  The vaccine specifically targets a protein common to breast cancer tumors (a-lactalbumin).

Studies upon mice (Sorry PETA, that’s what they’re really good for) have demonstrated reason to be hopeful.  There are currently two cancer vaccines approved for use in the US, however neither of these actually prevent cancer.  One (Gardasil) prevents HPV while the other prevents Hepatitis B, both precursors to cancers.  If the breast cancer vaccine is effective in human trials it would be the first vaccine against cancer tumors.

Some background is in order.  Cancer actually describes a process of rapid and unrestrained cell growth.  The inability of the human body to switch off the growth of cells results in formation of clusters of cells forming tumors or spreading (metastasizing) throughout the body.  Where viruses are foreign to the immune system and defended against, cancerous cells are not.

The vaccine would target the proteins at the cellular level so that they can not continue to form tumors.  Unlike traditional chemotherapy (chemical agents) or radiation, which destroys not only cancer tissue but a good deal of healthy tissue and organs with it, a targeted vaccine would actually prevent one from ever developing breast cancer (in theory) in much the same way that the polio vaccine prevented generations of children from contracting polio.

Definitely one to watch.

~Posted by D.M. Schwadron, Esquire

Still think screening for breast cancer doesn’t matter?  In this country there is a lot of debate about that very topic.  Opponents of screening suggest that it results in over-treatment for “lumps” that may be benign cysts or nothing at all.  What is over-treatment?  Sometimes simple referral for ultrasound [...]]]> Source:  BBC Health; Journal of Medical Screening

Still think screening for breast cancer doesn’t matter?  In this country there is a lot of debate about that very topic.  Opponents of screening suggest that it results in over-treatment for “lumps” that may be benign cysts or nothing at all.  What is over-treatment?  Sometimes simple referral for ultrasound or MRI and sometimes referral to a breast surgeon for aspiration (withdrawing cells through a needle), biopsy (cutting out a portion of the lump) or excision (removal of the lump).

Well the latest study, out of England, focused upon 80,000 women aged 50 and over.  (Women in England between 50 and 70 receiving screening every 3 years under the National Health System).  The results?  Over a period of 20 years,  5.7 (yeah, I don’t know what a .7 person is either) breast cancer deaths were prevented for every 1,000 women screened.  2.3 of those 1,000 women were told they had a lump of unclear significance.  Okay, that’s raw numbers, what does it mean?  Well, for every 28 cases diagnosed, 2.5 women had their lives saved and 1 woman was over-diagnosed.

According to the authors of the study, “The benefits in terms of numbers of deaths prevented are around double the harm in terms of over-diagnosis.”  Projecting forward leads them to believe that, “A significant reduction in breast cancer deaths in association with mammographic screening.”

Because of research such as this the NHS plans to extend mammography to women 47 to 73 by 2012.  Meanwhile, here in the United States and with the possible implementation of a National Health Care Service we appear to be going in the opposite direction.  Here we debate the costs of screening women under 50.  Whether or not it’s prudent.  Economically effective.  And whether or not too much screening, rather than resulting in more diagnosis and lives saved, results in over-treatment (read more money).

And back across the pond, a spokesperson for Cancer Research UK, Sara Hiom, was quoted saying, “What we need to remember is that detecting cancers earlier generally means improved survival.  And we know through trials and through research that breast cancer screening can save lives.”

Deputy Directer of the NHS cancer screening programmes (thats Brit for programs) adds, “There is a risk of over-diagnosis and possible subsequent over-treatment associated with any screening programme” and that, “The latest independent study shows that the risk of over-diagnosis is very much lower than some other recent estimates have claimed and that the benefits [of mammography screening] far outweigh the risks.”  Well put.

~Posted by D.M. Schwadron, Esquire

As it sometimes happens in medicine, a drug that has been proven to work in less than stellar ways for a given condition may have a completely unintended but surprisingly beneficial medical outcome.  What the heck am I talking about?  Some examples may be in order here.  You [...]]]> Source:  BBC Health; European Breast Cancer Conference, Barcelona

As it sometimes happens in medicine, a drug that has been proven to work in less than stellar ways for a given condition may have a completely unintended but surprisingly beneficial medical outcome.  What the heck am I talking about?  Some examples may be in order here.  You may have heard of a drug called Imitrex, used for the treatment of migraines.  Well it was originally formulated as an anti-seizure drug with mixed results.  A few accidental results and a new generation of migraine treatments was born.

Not familiar with that one?  Okay, you may have heard of a drug called Viagra which is fairly well-knonw (to the internet spam community in particular).  Well, Viagra, was an anti-hypertensive drug which despite years of development and testing did less for hypertension than it did for…well, you get the idea.

Enter beta blockers, a classification of blood pressure medications estimated to be currently prescribed to over two million people in the UK alone.  A team of UK and German researchers has found that in a study of women with breast cancer tumors, those taking beta blockers had a 71% lower chance of dying from metastatic (spreading) disease.

Granted the study was small, focusing upon some 466 European women with breast cancer.  However, the results could be significant.  Breast cancer remains the single largest killer of women, with some 30,000 diagnosed in the UK each year.  It is thought that beta blockers may also block hormones which trigger the spread of cancer cells beyond the breast.  The chances of curing breast cancer differ remarkably where cancer can be confined to the breast or to a small area of the breast.  Once cancer metastasizes (spreads) throughout the body, chances of a cure diminish.

Beta blockers attach to the same cancer cell receptors as metastatic associated hormones, thereby reducing the ability of the cancer cells to spread beyond the confines of a tumor.  So it may just be that the hope for a “new” drug to treat breast cancer exists in an old drug, beta blockers, which have been used for years now with relative safety.  It is hoped that a combination of existing chemotherapy drugs and beta blockers may offer breast cancer patients greater chance of cure and certainly greater chance of confining, and thereby surviving, breast cancer.

The even better news?  Unlike the introduction of a completely new drug, the re-purposing (If I may) of a drug isn’t as rigorous a process and it appears that the studies are well into the clinical trial stages.  Granted this is taking place in Europe and our FDA may not be as enlightened.  However, this also means that it might not take another 7 years for beta blockers to emerge as accepted treatment for breast cancer.

~Posted by D.M. Schwadron, Esquire

It may be still in the early lab stages -how early? Well they are still testing the technique upon mice with tumors, however, researchers have found that freezing breast cancer tumors (cryoablation) helps to stop the spread of breast cancer.

Not only did the rapid freezing, through application of a cold [...]]]> Source: Annals of Surgical Oncology; Medline

It may be still in the early lab stages -how early? Well they are still testing the technique upon mice with tumors, however, researchers have found that freezing breast cancer tumors (cryoablation) helps to stop the spread of breast cancer.

Not only did the rapid freezing, through application of a cold probe to the tumor site, kill breast cancer tumors, there was a better outcome in terms of tumor spread (metastasis) to the lungs.

All is not lab mice though.  Cryoablation is being actively used to treat actual human patients with prostate cancer, kidney cancers and cancers that have spread to the bone marrow with encouraging results.  Hopefully this will be another tool to fight breast cancer in the near future.

~Posted by D.M. Schwadron, Esquire.

It is a fact of chemotherapy (chemical treatment for cancer) that some patients simply don’t respond to medications. Or that they stop responding over time.  With more than 45,400 women diagnosed with breast cancer every year, scientists have been furiously trying to decode our genetic patterns for reasons such as [...]]]> Source: BBC Health; The Lancet Oncology

It is a fact of chemotherapy (chemical treatment for cancer) that some patients simply don’t respond to medications. Or that they stop responding over time.  With more than 45,400 women diagnosed with breast cancer every year, scientists have been furiously trying to decode our genetic patterns for reasons such as this.

Starting with 829 genes present in breast cancer cells, the focus has been drawn to just 6 genes which appear to impact the efficacy (medical effectiveness) of chemotherapy.  If they are correct then it may be possible to develop a simple test to determine whether or not certain drugs, in this case paclitaxel, will be beneficial to patients.  Another one to watch.

~Posted by D.M. Schwadron, Esquire

Tamoxifen (an estrogen blocker) is currently the most prescribed drug to fight breast cancer recurrence.  However up to 1/3 of women do not respond to Tamoxifen.  The reasons for this are not completely known as of this post but are believed to lie in a gene -FGFR1.

Researchers are now working [...]]]> Source:  BBC Health; Journal Cancer Research

Tamoxifen (an estrogen blocker) is currently the most prescribed drug to fight breast cancer recurrence.  However up to 1/3 of women do not respond to Tamoxifen.  The reasons for this are not completely known as of this post but are believed to lie in a gene -FGFR1.

Researchers are now working on methods to “switch off” the FGFR1 gene so that the therapeutic effects of Tamoxifen may be realized in greater numbers.  1 out of every 10 breast cancer survivors have the FGFR1 gene.  There are currently a number of drugs which are known to inhibit FGFR1.

The stage is now set for clinical trials.  If the laboratory evidence is repeatable in the real world this could mean less recurrence of breast cancer for more women.  Breast cancer is the most common disease causing death for women in the US and in the UK.

~Posted by D.M. Schwadron, Esquire

What do these three things have in common?  Well, men who are non-smokers and who eat more soy MAY have a lower risk of getting lung cancer than other men.  Okay, the non-smoking part may be an obvious one, but the soy?

Soybeans contain natural compounds called isoflavanones.  Isoflavanones mimic estrogen, [...]]]> Source: American Journal of Clinical Nutrition

What do these three things have in common?  Well, men who are non-smokers and who eat more soy MAY have a lower risk of getting lung cancer than other men.  Okay, the non-smoking part may be an obvious one, but the soy?

Soybeans contain natural compounds called isoflavanones.  Isoflavanones mimic estrogen, a hormone which women have in spades.  In contrast, men have high levels of testosterone.  Estrogen is associated with lower levels of breast cancer and prostate cancer, which makes intuitive sense. (Yes, men do get breast cancer. Women, however, do NOT get prostate cancer).

Enter researchers in Japan at the National Cancer Center in Tokyo who studied over 36,000 Japanese men between 45 to 75 years of age who were cancer free at the outset.  The group was compared with some 40,000 Japanese women.  Over the course of 11 years.

The results? 1 in 75 men (and 1 in 225 women) were diagnosed with lung cancer within 11 years.  (Men tend to get lung cancer at higher rates than women).  Of 13,000 men who never smoked, only 22 of them who ate very little soy were diagnosed with lung cancer.  Only 13 of them who ate a lot of soy (up to 162 grams per day) contracted lung cancer.

I was sold up until this point too, however, the authors of the study were very equivocal as to whether the intake of soy itself was the cause of the lower risk or whether non-smoking males adopted other healthier behaviors, such as exercise, which could explain the lower risk.

So what should one take away from such a study?  Well, there is a suggestion that eating more isoflavanones may be good for men.  In fact increased soy intake has already been demonstrated to lower risk of prostate cancer.  It follows that increased soy intake may also be beneficial for non-smoking males who wish to avoid lung cancer as well.  Again, just a suggestion.

~Posted by D.M. Schwadron, Esquire

Breast cancer is the second leading cause of death among women. An estimated 192,000 women will be diagnosed with breast cancer this year.

Not all breast cancers are the same, however.  Some breast cancers are hormone positive meaning that the presence of certain hormones (estrogen for example) contributes to cancer and [...]]]> Source: U.S. Food & Drug Administration

Breast cancer is the second leading cause of death among women. An estimated 192,000 women will be diagnosed with breast cancer this year.

Not all breast cancers are the same, however.  Some breast cancers are hormone positive meaning that the presence of certain hormones (estrogen for example) contributes to cancer and its rate of growth.  Breast cancer may also be protein based with HER2 being a common protein positive breast cancer.

Two chemotherapy drugs which have been effective in treating cancer, Tykerb (lapantinib) and Femara (letrozole) have now been approved for use in combination with one another. When a drug receives FDA approval it is typically for a “labeled use” only, meaning that it was developed to treat one specific disease or condition in a specific manner.  While medications are used “off label” at times at the discretion of physicians, the explicit approval of the FDA results in wider adoption and use.

Accordingly when the FDA permits the extension of approvals for the use of breast cancer drugs it is a big deal.  It is hoped that the combination of the two medications will be twice as effective in slowing the progression of  this killer of women.

~Posted by D.M. Schwadron, Esquire

Rates of new diagnoses and rates of death from all cancers combined declined significantly in the most recent time period for men and women overall and for most racial and ethnic populations in the United States.

The drops are driven largely by declines in rates of new cases and [...]]]> Source: U.S. Centers for Disease Control & Prevention

Rates of new diagnoses and rates of death from all cancers combined declined significantly in the most recent time period for men and women overall and for most racial and ethnic populations in the United States.

The drops are driven largely by declines in rates of new cases and rates of death for the three most common cancers in men (lung, prostate, and colorectal cancers) and for two of the three leading cancers in women (breast and colorectal cancer). New diagnoses for all types of cancer combined in the United States decreased, on average, almost 1 percent per year from 1999 to 2006. Cancer deaths decreased 1.6 percent per year from 2001 to 2006.

These findings are from a report authored by researchers from the National Cancer Institute (NCI), part of the National Institutes of Health, the Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), and the North American Association of Central Cancer Registries (NAACCR). The report was published early online Dec. 7, 2009, in the journal Cancer.

Overall cancer rates continue to be higher for men than for women, but men experienced the greatest declines in incidence (new cases) and mortality (death) rates. For colorectal cancer, the third most frequently diagnosed cancer in both men and women, and the second leading cause of cancer deaths in the United States, overall rates are declining, but increasing incidence in men and women under 50 years of age is of concern.

With accelerated cancer control efforts to get more Americans to adopt more favorable health behaviors (such as quitting smoking) and higher use of screening (colonoscopy), as well as optimal treatment outcomes for colorectal cancer (read more effective chemotherapy), there could be an overall colorectal cancer mortality reduction of 50 percent by 2020.

“The continued decline in overall cancer rates documents the success we have had with our aggressive efforts to reduce risk in large populations, to provide for early detection, and to develop new therapies that have been successfully applied in this past decade,” said NCI Director John E. Niederhuber, M.D. “Yet we cannot be content with this steady reduction in incidence and mortality. We must, in fact, accelerate our efforts to get individualized diagnoses and treatments to all Americans and our belief is that our research efforts and our vision are moving us rapidly in that direction.”

“The continued decline in incidence and death rates for all cancers combined is extremely encouraging, but progress has been more limited for certain types of cancer, including many cancers that are currently less amenable to screening, such as cancer of esophagus, liver and pancreas,” said Betsy Kohler, executive director of NAACCR.

Long-term incidence trends for colorectal cancer have been fairly consistent for men and women, with major declines from 1985 to1995, minor increases from 1995 to1998, and significant declines from 1998 to 2006.

“This report shows that we have begun to make progress reducing colorectal cancer. Yet, colorectal cancer still kills more people than any other cancer except lung cancer,” said CDC Director Thomas Frieden, M.D.

Let’s hope this trend continues downward on incidence and upward on survival.

~Posted by D.M. Schwadron, Esquire

A brief preface:  testing of drugs to see if they are effective in treating cancers is first done by researchers in laboratories on “cell-lines” grown in the laboratory.  However while scientists can duplicate cells they still need original cells from human patients to start with.

Following a review [...]]]> Sources:  Journal of the National Cancer Institute; BBC Health

A brief preface:  testing of drugs to see if they are effective in treating cancers is first done by researchers in laboratories on “cell-lines” grown in the laboratory.  However while scientists can duplicate cells they still need original cells from human patients to start with.

Following a review of such cell lines it was determined that cells thought to be representative for esophageal adenocarcinoma (a cancer of the esophagus) also contained tumor cells from the lung, bowel and stomach.  Cancer cells in different parts of the body act differently and also respond to drugs and treatment differently.

If enough of these cell lines are contaminated it could mean that the data from a number of studies upon potential new cancer drugs could be invalidated. How widespread is this problem?  more than 100 scientific publications, at least 3 U.S. research grants and 11 U.S. patents along with numerous clinical trials upon patients.

The result? More time to develop new (and needed) cancer drugs that may have shown promise in the laboratory.

~Posted by D.M. Schwadron, Esquire