GENERAL

Next Era of Cancer Therapy Aims to Separate Cancer From Blood Supply -(M.D. Anderson Cancer Center-16/05/2003)

With cancer, it's all about the body's bounty of blood. If all the blood vessels in the body were lined up end-to-end, they would form a line that could circle the earth twice. Yet the body produces still more blood vessels on demand, such as to heal wounds or grow embryos. This task of forming new blood vessels -a process called angiogenesis - is also critical to the development of cancer. In order for a rapidly growing tumor to maintain its growth, a tumor "signals" already existing blood vessels to sprout new branches to feed it - and new tiny vessels develop in short bursts. Given the thousands of miles of blood flow already in place in a human body, vessels usually don't have far to grow to hook up to a tiny tumor that cries for blood. But scientists know that unless a tumor connects to a supply of blood, it will grow to a mere 1,000 cells and then stop. Separating cancer from its blood supply - or keeping them from linking in the first place - is the goal of clinicians and researchers at The University of Texas M.D. Anderson Cancer Center and other leading research institutions.

Teams of multidisciplinary investigators are working to understand the factors that bind blood vessels to cancer and then to perfect "anti-angiogenic" therapies that prevent further blood vessel growth. They are examining the problem from all angles and situations. Tumor angiogenesis occurs when cancer cells begin sending signals to surrounding tissue, activating proteins that encourage the growth of new blood vessels - so researchers are investigating ways to shut down those signals to stop a tumor from becoming rooted. They also are studying what to do if the cancer already has an established blood vessel network and how to give blood vessels themselves the power to resist a cancer. M.D. Anderson's focus on the blood vessel-cancer paradigm has garnered scientific praise from around the world, as well as millions in funding for research - for example, $9.2 million was awarded to the institution in 2002 from the National Cancer Institute for anti-angiogenic research. That grant supports four different angiogenic research projects that provides a backbone to ongoing clinical research. Among other areas, researchers are examining markers of angiogenesis and the specific signaling pathways through which angiogenic proteins are controlled. They are developing methods, including non-invasive imaging, to detect tumor cell death and blood vessel damage from new anti-angiogenic therapies. "Founded on the hypothesis that interim measures will enable early and accurate clinical assessment of anti-angiogenic therapies, this program is an important example of the outstanding translational research being conducted," says Waun Ki Hong, M.D., head of M.D. Anderson's Division of Cancer Medicine. "We must move beyond conventional approaches, combining targeted therapeutic strategies with established regimens of chemotherapy, radiotherapy, and surgery to develop effective cancer treatment and cancer prevention strategies."

More than 60 different anti-angiogenesis compounds are in human testing around the world, and one estimate has it that at least 6,500 cancer patients worldwide have been treated with some form of experimental anti-angiogenic therapy. While the development of drugs that inhibit angiogenesis as a means of controlling cancer is moving forward, the progress is slow, Ellis says. "Researchers are just beginning to understand this complicated process," he explains. Many of these "baby steps" have to do with the nature of the treatment. Most traditional cancer treatments, like chemotherapy, exert a toxic punch on cancer cells, and therefore their effect can be readily measured; either tumors quickly shrink or they don't. Biologic drugs, like anti-angiogenesis agents, however, are designed to rather quietly interrupt a molecular process that leads to cancer development or growth. It can be hard to know if the drugs are working - they may not shrink a tumor immediately but slow its growth, or stop it from spreading. And that is difficult to measure, especially in comparison to the short-term timeframe used to evaluate chemotherapy effects. Such is the case with endostatin, the naturally occurring protein known to inhibit tumor growth in animals. It was discovered by Michael O'Reilly, M.D., an assistant professor in radiation oncology at M.D. Anderson, when he was a researcher at Harvard Medical School in the 1990's.

Endostatin was one of the first specific anti-angiogenic drugs to be tested and M.D. Anderson was one of three centers chosen in 1999 to conduct a clinical trial using the agent, which had received wide publicity even before it had ever been tested in humans. But results of that trial, published in September, 2002, show endostatin, although safe to use, is only minimally effective when given as a single agent in the treatment of advanced cancer. Still, extensive testing hinted that some biologic activity may be going on, although that is a subject of debate. "We saw several tumors shrink for a short time, so it appears endostatin may be having an effect," says the study's co-leader, Roy Herbst, M.D., Ph.D., associate professor of medicine in the Department of Thoracic/Head and Neck Medical Oncology. The fact that endostatin didn't show dramatic clinical activity is not unusual, says James Abbruzzese, M.D., professor and chairman of the Department of Gastrointestinal Medical Oncology at M.D. Anderson. It takes time to understand how a new agent, especially a biologic drug, may be working, and then to tweak it, he says. "For first-generation drugs, progress is often incremental, but research should go on," says Abbruzzese.

As an example of how difficult it is to test these new drugs, Ellis and other colleagues at M.D. Anderson have found that using an anti-angiogenesis inhibitor may initially increase blood flow to a tumor rather than decrease it. "Ironically, it may reduce leakiness in blood vessels, and allow small vessels to open up," he says. But as the agent works over time, a tumor may shrink or stop growing. "We are into testing the third generation of anti-angiogenesis therapies," says Ellis. "The agents are constantly being refined to be more effective."

One class of angiogenesis inhibitors being tested in cancer patients at M.D. Anderson are molecules designed to stop the growth of blood vessels cells. Included in this category is endostatin, but also thalidomide, a drug developed in Germany which was marketed in the 1950's as a sleep aid and reliever of morning sickness, until it was realized that thalidomide inhibited limb development during the first trimester of pregnancy. Although a widely feared drug, thalidomide is currently used as an anti-inflammatory agent, particularly to treat some symptoms of leprosy. It also has been reported to be beneficial as a treatment of skin lesions and some diseases associated with AIDS. In the mid-1990's, researchers wondered if the very qualities that damaged the growth of limbs in neonates - angiogenesis - might be helpful in preventing tumors from promoting blood vessel formation. Today, at M.D. Anderson, thalidomide is being tested in a number of different cancers, including prostate cancer, multiple myeloma, brain and ovarian cancer.

Another group of angiogenesis inhibitors being tested in human clinical trials at M.D. Anderson are molecules that interfere with steps in the angiogenesis "signaling cascade" - the biochemical pathway that leads to new vessel development. Included in this category are drugs that block the binding of the growth factor known as vascular endothelial growth factor (VEGF) to cells lining the blood vessels (also known as endothelial cells). VEGF is produced by tumor cells and initiates the process of angiogenesis, promoting the development of a new network of blood vessels that sprout and grow toward a tumor. By blocking the binding of VEGF, these drugs help deprive the tumor of necessary nutrients to grow.

Among such experimental drugs being tested at M.D. Anderson is AE-941 (Neovastat), a naturally occurring product extracted from shark cartilage. Charles Lu, M.D., an assistant professor in Thoracic/Head and Neck Medical Oncology is leading a nationwide, Phase III trial of Neovastat in advanced lung cancer. Another agent, bevacizumab (also known as Avastin, anti-VEGF, RhuMabVEGF), is undergoing extensive review at M.D. Anderson, in a variety of cancers - lung cancer, malignant mesothelioma, carcinoid tumors, myeloid leukemia and pancreatic cancer. Like other molecularly targeted drugs, bevacizumab is designed to specifically interfere with a biological process that promotes tumor growth or survival. This drug is an antibody that neutralizes the VEGF protein by "sticking" to it, preventing it from triggering blood vessel growth.

Researchers are also investigating the power of a common arthritis medication to impede angiogenesis. They have already found that celecoxib (Celebrex) can reduce the number of colon polyps that develop in a rare genetic form of colon cancer - a discovery which led to FDA approval of the medication for that cancer therapy. Now, other ongoing M.D. Anderson clinical trials with celecoxib include studies on its effectiveness in prevention of Barrett's esophagus (a precursor to esophageal cancer), and superficial bladder cancer. It is also being tested with locally advanced lung cancer and cervical cancer, in combination with other treatments.

Other M.D. Anderson researchers are going back to the lab to pick apart what works and what doesn't - and why. Using mouse models, O'Reilly is finding that the order in which new cancer therapies are delivered is crucial. For example, chemotherapy has to get into cancer cells to be effective, but anti-angiogenesis drugs are designed to block off access to cancer cells - and may render chemotherapy ineffective if used first, he says. On the other hand, chemotherapy treatment may leave behind cells that are hard to kill with anti-angiogenesis therapy, O'Reilly says. "Sequencing matters, and that has been a surprise," he says, "But it helps us understand a lot about tumor biology."

What researchers are discovering about anti-angiogenesis is helping them put together the pieces of a grand plan - a way to deliver anticancer drugs efficiently and effectively to a single tumor site in the body, and nowhere else. Just as the post office uses street addresses and zip codes to deliver a letter to one home out of millions, researchers at M.D. Anderson have discovered that blood vessels have a vascular address system of their own. That's how blood cells circulating in the blood stream know where to go, according to the researchers who made the discovery, Renata Pasqualini, Ph.D., and Wadih Arap, Ph.D., associate professors in the Department of Genitourinary Medical Oncology and Cancer Biology. "Scientists have long thought that blood vessels are uniform and generic, much like plumbing in a house," says Arap. "Recently, we recognized that blood vessels that feed various organs are actually strikingly different, and blood vessels in tumors stand out as being particularly unusual," adds Pasqualini.

This diversity, signified by different vascular zip codes, can be used to target the delivery of diagnostic and therapeutic agents to specific organs and to sites of disease such as tumors and metastasized cancer cells, says Pasqualini. Physicians in the future may be able to deliver a cornucopia of anti-angiogenesis drugs, each of which works in different vascular zip codes, says Abbruzzese. He adds it may even prevent cancer development in susceptible patients using these agents. "We still have much to learn," says Abbruzzese. "But with such promising research, we now have some real opportunities to make progress."

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Study: Radiation Starves Cancer While Killing It-(HealthScoutNews-15/05/2003)

Radiation kills cancer cells in more than one way, says a new study that lends support to a sometimes controversial theory. In addition to killing cells directly, radiation also stops angiogenesis, the growth of blood vessels that are essential for a tumor's growth, says a report in Science. This is the first genetic evidence that damage to the blood vessels that feed a cancer can cause that cancer to shrink, say researchers from the Memorial Sloan-Kettering Cancer Center in New York City. Dr. Judah Folkman of Harvard Medical School proposed the theory several years ago that stopping angiogenesis could be an effective way to treat cancer. However, that theory remains controversial because a number of trials aimed at stopping angiogenesis in cancer patients have produced mixed results.

Radiation kills cancer cells directly. But working with genetically engineered mice, the researchers showed that it damages cells other than those of the cancer -- the delicate endothelial cells that line blood vessels and are essential to their function. The mice were manufactured to be deficient in an enzyme called acid sphingomyelinase, which regulates apoptosis, the process of natural endothelial cell death. Cells of two kinds of cancer, melanoma and fibrosarcoma, were implanted in those mice. The tumors grew at twice the rate seen in normal mice. And the cancers did not shrink when the mice were exposed to radiation, as would normally happen.

The new study arose from previous work indicating that damage to small blood vessels played a role in the injury caused to the gastrointestinal tract caused by radiation, says a statement by Dr. Richard Kolesnick, head of Memorial Sloan-Kettering's signal transduction laboratory and a leader of the research team. "It was unclear that this would also happen in tumors," Kolesnick says. "Our new study shows that damaging the angiogenic blood vessels of the tumor does indeed contribute to tumor regression." There are several ways the finding could be used to improve cancer treatment, says Dr. Carlos Cordon-Cardo, director of the Memorial-Sloan Kettering division of molecular pathology and a member of the research team. "Knowing that these blood vessels respond to specific factors, we can aim therapy at those factors," he says. And it may be possible to combine anti-angiogenesis therapy with radiation therapy that is aimed not at the cancer cells themselves but at the factors that promote blood vessel growth, Cordon-Cardo says. But more research is needed to determine such important factors as the exact role radiation treatment would play in such combined therapy and the most effective radiation doses, the researchers say.

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Study Links Obesity To Certain Cancers-(ET-23/04/2003)

New research suggests carrying extra pounds could increase the risk of certain cancers. NewsCenter 5's Liz Brunner reported that a study published in New England Journal of Medicine shows that not only does being overweight increase the likelihood of diabetes and heart disease, it also increases the risk of cancer. "This is really important," said Dr. Graham Colditz, of the Harvard School of Public Health. "We can unequivocally say 14 percent of cancer in men and 20 percent in women is due to being overweight and obesity." That's 90,000 deaths each year that could be prevented if Americans maintained a normal weight.

Colditz said putting on an extra pound here and there can be dangerous over time. "Typically we've been looking at a 20- to 40-pound gain over the weight at the end of high school as indicating an increase in risk of cancer," Colditz said. The study also suggests that certain cancers not previously linked with obesity actually are, including cervical, ovarian, pancreatic, and liver cancer, as well as non-Hodgkin's lymphoma. "It's going to give us a much more powerful motivation to work at avoiding weight gain in adulthood because the payoff across many cancers is going to be substantial," Colditz said. Previously, researchers linked breast, colon and gallbladder cancer with obesity. Doctors said it's not clear what the connection is, although the theory is being overweight changes hormone levels, which somehow affects cancer cell growth.

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WHO: Cancer May Rise 50 Percent by 2020-(ET-04/04/2003)

The number of new cancer cases worldwide is expected to increase by 50 percent over the next 20 years, partly because poor nations are adopting unhealthy Western habits, the World Health Organization said. The World Cancer Report is the first comprehensive examination of cancer around the globe, covering the current understanding of its causes, prevention and treatment. "The overall message is that we can prevent a third of cancers," one of the report's editors, Australian cancer specialist Bernard Stewart said.

Worldwide, about 10 million people are diagnosed with cancer every year and 6 million people die from it. The report projects that the annual number of diagnoses will reach 15 million by 2020, based on current trends in smoking, diet and exercise. Although one-third of the cases theoretically were preventable, that does not mean the coming increase realistically could be slashed by that amount, said WHO's cancer chief, Dr. Paul Kleihues. "I think what we can do is slow down the increase. Anything more is not realistic," said Kleihues, director of WHO's International Agency for Research on Cancer.

Rich nations have more cancer than poor ones, mostly because of tumors tied to bad habits such as smoking and drinking, eating too much or the wrong kinds of foods, and lack of exercise. "If we want to go back to a lifestyle associated with a low incidence of cancer, small changes to our lifestyles would not be sufficient. We would really have to go down to a very restricted diet, no overfeeding, starting in childhood. I don't think that's realistic expectation," Kleihues said. From one angle, the task of stemming the impending rise in cancer is easier in poor countries, Kleihues said, because 23 percent of tumors there are due to infections that can be prevented now or soon. "We already have a first-class vaccination against hepatitis B virus and there is no question that soon the rates of hepatitis B-induced liver cancer will come down in many countries," he said.Eradication of the helicobacter pylori bug, which causes stomach cancer, also would help, as would the advent of a vaccine against the human papillomavirus, which causes cervical cancer.

However, officials are especially concerned about the trend toward unhealthy lifestyles in the developing world, where early detection and treatment of cancer is not as good as in rich nations. In developing countries, 80 percent of cancer patients die, compared with 50 percent in rich nations. "It's quite disturbing. Many of them are taking up smoking and striving to get the Western lifestyle. That's very hard to stop. They will unfortunately miss this unique chance of maintaining a low cancer burden," Kleihues said. WHO plans to update the 350-page cancer report every few years. The report attempts to condense the wealth of knowledge about cancer into one book, offering governments an important resource in their efforts to tackle the disease. "This book has the advantage of putting between two relatively slim covers all of the facts that otherwise amount to a stack of textbooks about 5 feet tall," said Stewart, director of cancer services for the Southeastern Sydney area health service.

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Making sure the chemo isn't worse than the cancer-(Seattle Post Intelligencer Reporter-31/03/03)

Getting cancer is hard enough. Getting treatment shouldn't make it worse. But for a small percentage of patients, chemotherapy is more terrible than the disease itself, causing organ failure and even death. It's not just a bad-luck lottery that determines which patients do poorly with chemo. There are biological differences between them that, once better understood, could help doctors tailor "custom chemo" regimens for patients and eliminate treatment-induced deaths. That's the goal of Dr. George McDonald, a Fred Hutchinson Cancer Research Center scientist who, along with a team of colleagues, recently published work that marks a significant first step in such a strategy.

Since the 1950s, chemo doses have been determined in a relatively crude manner. "You increased it until the toxicity was too high or there was no evidence of benefit," said McDonald. "You'd push and push until you cured much of the cancer, but not at the expense of the patient dying." But some patients still died, even though they got doses that were tolerated by many others. And some got significantly sicker than others.

Kathleen Summers didn't die, but nearly five years after receiving treatment for leukemia, she is still recovering from the effects and has to be careful of her liver. Summers, now 34, found out she had leukemia in the same phone call that confirmed she was pregnant. The Woodinville woman waited to undergo treatment until she delivered her son. Then, only days after recovering from a Caesarean section, she started an intensive regimen in preparation for a bone marrow transplant. "Over a four-day period I got completely lambasted with chemo and radiation," she said. "I felt like they had completely fried my brain and insides." At one particularly frightening point, her body started to quit. "Everything shut down," she said. "I wasn't breathing. I had seizures." Summers is grateful, though. Everyone else on her floor died, either from cancer or from treatment. She vowed to do something to improve the odds for others. Summers was one of 147 patients who participated in McDonald's research to determine how different people handle chemo."We've been doing this for 30 years," said McDonald. "And even with a finely worked out recipe, 10 to 15 percent of patients suffer organ damage."

As a hematologist, McDonald has spent his clinical career studying the aftermath of treatment by oncologists. A fortuitous test-tube observation, however, led McDonald and his colleagues to dream of a new approach. Dr. Laurie DeLeve at the University of Southern California, an old friend of McDonald's, was looking at how Cytoxan, one of the oldest and most widely used chemo drugs, affected liver cells in test tubes. For decades, doctors had believed that Cytoxan didn't harm the liver. The drug itself isn't toxic, but is broken down in the liver into various components, one of which has an anti-cancer effect. That active component destroys DNA in cancer cells, which is how chemo works. But in the process of breaking down the drug to produce the active component, the liver also creates another byproduct, and this one is toxic to a specialized cell that lines parts of the liver.

"A liver is like a sponge with holes and blood percolates through the holes," he said. The holes are lined with endothelial cells. When DeLeve put Cytoxan in a test tube with liver cells, nothing bad happened. But when she put it in with both liver cells and endothelial cells, something attacked and destroyed the endothelial cells. That was one of the first indicators that the breakdown of Cytoxan by the liver cells was creating some end product that could cause organ damage, said McDonald. More important, it was a clue that could change the way cancer drugs were given. "How you metabolize (the drug) is a clear predictor of whether you are in the 10 to 15 percent of people with organ damage," he said.

McDonald's research, published this month in Blood, the journal of the American Society of Hematology, showed there was a wide range in how people metabolized the same dose and that this difference was reflected in who died. "If you're a high-toxin generator, your risk of dying is roughly sixfold greater," he said. In the initial study, for example, 15 of the 147 patients died of treatment-related complications, but it was not known at the time they received the treatment who among them would be at risk. "How you metabolize the drug is critical," he said. Researchers are now using the data to try to deduce a formula for giving the high

est dose with the least possibility of damage. Chemo doses prior to bone marrow or stem cell transplants are normally divided into two equal parts. But McDonald plans to test whether adjusting the second dose, based on the body's response to the first one, will help patients better tolerate the treatment. The hope is that a customized approach could reduce deaths during treatment by as much as 20 percent, said McDonald. Indeed, customizing drug delivery is a very hot topic in medical circles today, said John Slattery, a professor of pharmaceutics at the University of Washington. "This issue of understanding the different disposition of drugs in the body is extremely important in terms of optimizing therapy," he said. Down the road, however, an even more tantalizing approach could exist. If scientists can figure out the genetics underlying the differences, they may be able to devise a genetic test that would tell in advance who would do poorly with chemotherapy. The National Cancer Institute has just funded a study to "ask the question, is this wide variation (in metabolism) due to a genetic difference," said McDonald. "We're going gene hunting."

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Eating Less Meat Boosts Longevity, Report Says-(Reuters-10/03/2003)

People who eat little or no meat can expect to live significantly longer than the general population, a new report from the Center of Cancer Research in Germany (DKFZ) says. Between 1978 and 1999, the DKFZ monitored almost 2,000 people who ate either no meat or less than average. The group was comprised of vegans, who eat no meat, fish, eggs or dairy products, vegetarians, who eat eggs and dairy products, but no meat or fish, and occasional meat eaters, aged between 10 and 70. The monitored group had an average of 59 deaths for every 100 deaths in the general population during the period, results obtained from age-specific comparisons with the general population over five-year intervals showed.

But the study also revealed that completely avoiding meat does not make for the healthiest diet: within the group, for every 100 deaths among vegans, there were 66 among vegetarians and 60 among occasional meat eaters. "Essentially, the key issue here is having a properly balanced diet," said Jenny Chang-Claude from the DKFZ. Smokers in the group showed increased mortality rates of 70 percent compared with non-smokers. And those taking the most exercise reduced their mortality rates by more than 30 percent. No clear conclusions could be drawn on the influence of moderate alcohol consumption on longevity, the DKFZ said.

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Study suggests stress before cancer diagnosis can raise death risk-(USA TODAY-11/03/03)

Early-stage breast cancer could be most likely to kill women who had severe stress -- a family death, divorce, financial crisis -- in the year before diagnosis, a study says. The research tracked 80 patients over seven years, starting within a year of their diagnosis. There were 20 recurrences and 15 deaths. ''It's a very small study to be making any sweeping conclusion. But it does pose questions that need to be followed up on,'' says Frances Visco, president of the National Breast Cancer Coalition, an education and advocacy group in Washington, D.C. The women, all diagnosed with Stage 2 cancer that had not been detected beyond the lymph nodes, filled out questionnaires about stressors in their lives. Severe stress after their cancer diagnosis had no relation to recurrence or death, says psychiatrist Karen Weihs of George Washington University School of Medicine in Washington, D.C. But major troubles in the year before diagnosis nearly tripled the women's odds of having a recurrence or dying from the disease, Weihs says. She and co-author Diane Blyler reported at the American Psychosomatic Society meeting here.

Breast cancer is so stressful that it can swamp any other troubles, blurring the differences in life stress among the women after diagnosis, Weihs speculates. But terrible jolts in the year before diagnosis could affect the body's ability to fight off disease, Weihs says. For example, post-traumatic stress disorder impairs the immune system. Women in the study had sons who were fighting AIDS , had lost their jobs and faced other traumas. ''Their immune system may already be maxed out,'' says Weihs, so they could be vulnerable to more lethal forms of cancer.

Psychologist Steven Tovian has counseled breast cancer patients for 25 years. He says he sees no tie between life stress before diagnosis and dying, ''but it would be difficult to prove either way.'' ''We are learning more and more that stress does affect the immune system, though we're not at a point yet to say it causes cancer,'' says Tovian, director of the health psychology program at Evanston Northwestern Healthcare in Illinois. ''There are so many individual differences in immune function, and stress affects people differently,'' he says. Weihs says she intends to repeat the study with 500 patients to see whether the findings hold up.

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U.S. To Adopt Stricter Cancer Guidelines for Kids-(Environment News Service-04/03/2003)

The final draft of revised U.S. federal guidelines for cancer risk assessment assumes that children are more vulnerable to the effects of certain carcinogens than adults. It is the first time the U.S. government has officially accepted this position The move could change the way the federal government devises rules and policies to limit the American public's exposure to environmental pollutants. "This is a really big step and has far reaching implications for protecting children's health," said Jane Houlihan, vice president of research for Environmental Working Group, a non profit environmental research organization. "The government's message is simple. Children are at greater risk from exposure to carcinogens than adults."

The U.S. Environmental Protection Agency's (EPA) final draft of new guidelines for cancer risk assessment, released Monday, "explicitly recognizes that variation exists among people in their susceptibility to carcinogens." The final draft considers children aged two and younger to have 10 times the cancer risk of adults when exposed to mutagenic carcinogens, which cause cancer through direct damage to DNA. Children aged two through 15 would be considered to have three times the risk of adults.

Mutagenic carcinogens include arsenic, benzene, formaldehyde, mutagen X, brominated organics and polycyclic aromatic hydrocarbons. EPA's guidelines for carcinogen risk assessment are the framework for agency scientists to assess possible cancer risks from exposures to environmental pollutants. They are used throughout the federal government to evaluate risks from environmental pollutants. These guidelines have not been updated since they were first issued in 1986 and the current review is intended to make greater use of the increasing scientific understanding of risks from carcinogens. The proposed updates to these guidelines could prompt reevaluation of existing standards.

For its review, EPA analyzed 23 peer reviewed studies of cancer incidence from the past 50 years. Environmentalists and public health advocates said the new guidance is a good first step, but some are concerned it does not consider gender differences in cancer risks and worried that it could allow new guidelines for adult risks to carcinogens to be weakened. And EPA has evidence that supports increasing the risk standard for children even further, Houlihan said. The figure of 10 times used by EPA for children under two years of age is the average of its analysis, but some mutagenic carcinogens have been shown to be some 65 times more potent when exposure occurs during childhood. EPA data shows that half of lifetime cancer risk accumulates in the first two years of life, Houlihan said, and the agency should extend its guidance to cover carcinogens that act through other mechanisms than mutagenicity, such as phthalates and atrazine. "The guidelines need to extend to all carcinogens," said Houlihan.

EPA's review finds not enough available data to determine cancer risk assessment from non mutagenic carcinogens for specific segments of the population. It suggests that a variety of approaches still need to be developed and additional research is required. The increasing scientific evidence that children face higher risks from exposure to carcinogens prompted the agency to release for public review and comment draft supplemental guidance for assessing early life exposure to carcinogens. The supplemental guidance is part of the agency's response to a 1994 recommendation by the National Research Council that "EPA should assess risks to infants and children whenever it appears that their risks might be greater than those of adults." The final draft guidelines on risk assessment, according to EPA, reflect many of the comments and suggestions provided to EPA by public and independent scientific peer reviews. The public can submit comments on the proposed guidelines through May 1, 2003. They will take effect after a final review by an independent scientific advisory board.

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Possible cancer causer appears in nutritious food as well as in fast food-(AP-25/02/2003)

A possibly cancer-causing substance appears not only in popular fast foods, but in everyday, nutritious staples, too, U.S. government scientists say. Acrylamide, a substance that at very high doses causes cancer in animals, made headlines last spring when Swedish scientists discovered it lurking in popular foods like french fries and chips. High-carbohydrate foods cooked at very high temperatures seem to contain far more acrylamide than other foods. But products with lower levels that are eaten more frequently than junk-food snacks - from vitamin-packed breakfast cereal to toast and coffee - increase the U.S. population's overall exposure, the Food and Drug Administration said.

That means someone who dislikes fries but guzzles coffee or eats cereal every morning might eventually absorb as much as a fry-lover, suggests the FDA's new computer model. Don't change your diet, FDA scientists stressed. Cereals, for instance, are fortified with vitamins and minerals that make them a far better choice than many breakfast options - especially since no one knows yet if acrylamide really poses a cancer risk to people. But as manufacturers hunt for ways to remove the chemical from popular foods, "the point of this is ... no one food is contributing to the majority of the acrylamide" in the U.S. diet, said FDA scientist Donna Robie.

"There are going to be no quick fixes," added Robert Brown, a nutritionist at Frito-Lay Inc., which is experimenting with acrylamide-lowering techniques. "We have a very complex problem involving the entire food supply." Frito-Lay and Procter & Gamble outlined some simple steps that might eventually remove acrylamide from at least some foods, without risking safety or taste. Options include adding the amino acid cysteine or minerals such as calcium that may block acrylamide formation, or changing cooking techniques. "The research, through preliminary, looks very encouraging," said FDA food chief Joseph Levitt.

The FDA and safety regulators worldwide are studying how acrylamide gets into food and if enough is there to pose any risk to people. Scientists have discovered that it forms when a naturally occurring amino acid called asparagine is heated to very high temperatures - baking or frying, not boiling or microwaving - with certain sugars such as glucose. Potatoes are especially rich in both asparagine and glucose, leading to the high acrylamide levels in chips and fries. Cooking increases the level in some other foods. Soft bread, for instance, contains very little acrylamide, but toasting more than quadruples the chemical level. Other foods, such as milk, frozen vegetables and meat, contain little or no acrylamide.

The FDA, extrapolating from national diet studies, estimates that seven food types probably account for most exposure. Fries and chips had the highest levels, from 16 to 48 micrograms per serving. Other foods made the list with far lower levels because so many people eat so much of them: _Toast, at 9.8 micrograms per serving, and soft bread, at 2.2. _Breakfast cereal, 7.3 micrograms. _Cookies, 6.6 micrograms. _Coffee, 2 micrograms. Other popular foods, including pizza, have yet to be measured for acrylamide.

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Delaying Radiation Treatment Leads To Cancer Recurrence-(ET-25/02/2003)

Many cancer patients hope to wait to begin their radiation treatments until after they've fully recovered from their surgery. But it hasn't been clear until now whether waiting has any unfavorable effects on the progression of the disease. Researchers from Canada, reporting in the Journal of Clinical Oncology (Vol.21, Issue 3, 2003; 555-563) now say that delaying radiation leads to a higher chance the cancer will come back. Canadian doctors have a reason to be concerned about delays in radiation. Canada, along with several other countries, may have too few radiation oncology facilities. This means patients have to wait their turn in spite of having a life threatening disease.

Local Recurrence Seen In Breast Cancer Patients:To better understand the hazards of this delay, the researchers, led by William Mackillop at the Queen's Cancer Research Institute, reviewed studies in which the outcomes of early radiation therapy were compared with those of later treatment. The only cancers for which there was enough information were breast cancer that had been treated with lumpectomy, and head and neck cancer (cancers of the throat, voice box, mouth, nasal passages). In both types of diseases, radiation is commonly used to prevent the cancer from returning in the area in which it started. Lumpectomy - removing only the cancer - is the preferred surgery for most women with breast cancer. This allows the woman to keep her breast and maintain a normal appearance. But because the cancer will often recur in the breast, radiation therapy is used as a preventive. Most of the time it is successful.

The researchers found that if radiation is delayed, the treatment is less successful. They divided breast cancer patients who had been treated with lumpectomy into 2 groups: those receiving radiation within 8 weeks of surgery and those treated after 8 weeks. They found the cancer came back in the breast 60% more often if radiation was delayed by more than 8 weeks.

Chemotherapy May Add To The Delay: Often, after surgery for breast cancer, other treatment such as tamoxifen and/or chemotherapy is recommended. These are mainly aimed at stopping the cancer from traveling to distant sites such as the bones, lungs, or liver. Because chemotherapy can increase the side effects of radiation, the radiation is often delayed until chemotherapy is complete. So even though the patient is receiving chemotherapy, this delay still leads to a doubling of the local recurrence rate, according to the Canadian study. If the cancer does come back in the breast, it can almost always be treated with surgery. Although a mastectomy will usually be needed, the woman isn't in any greater danger of dying from the cancer. The researcher couldn't find any evidence that women whose radiation was delayed were more likely to die of their cancer.

Delay Also Troubling For Head And Neck Cancers: The same thing held true for head and neck cancer. Delaying radiation treatment after surgery - this time by more than 6 weeks - lead to a tripling of the recurrence rate. Once again, it wasn't clear that this delay led to a greater chance that the patient would die of their cancer. This study by Canadian physicians was likely initiated because of their difficulty in obtaining prompt treatment for their patients. On average, most patients in the US receive treatment about 10 days after being referred for radiation. In Canada it takes more than a month to begin treatment.

Still, the problem of delay poses a dilemma for doctors and their patients in the US as well. Often, chemotherapy is recommended immediately after surgery. There is a body of literature demonstrating that it can lead to a higher cure rate. Many times, radiation is put off to avoid the side effects of the combined treatment. Now it appears that there may be a trade-off between long-term cure and the problems that can arise if the cancer comes back in the local area. Often, in women with breast cancer, this means they will lose their breast. But in the absence of chemotherapy, there should be no dilemma, according to the study. "The longer radiotherapy is delayed, the poorer the outcome is likely to be," write the study authors. "We recommend that delays in initiating radiotherapy should be as short as reasonably achievable."

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New Molecule May Help Enhance Cancer Treatments-(Reuters-26/02/2003)

Scientists have identified a molecule they believe could improve cancer treatments and help protect people from the lethal effects of high levels of radiation in a nuclear attack. The molecule, MDC1, acts like an emergency service in cells to detect and repair DNA damage caused by radiation. Scientists believe its discovery will improve understanding of how cells respond to radiation and how defects in those responses lead to mutations that cause cancer. "Understanding what happens within our cells when they're pounded with radiation is important for a whole range of reasons, not least for predicting the effects of cancer radiotherapy," said Professor Steve Jackson. "In addition, it may suggest how the effects of radiation might be curtailed following a possible nuclear attack," the molecular biologist at the University of Cambridge in England added.

MDC1 is one of several molecules that work together to prevent cells from dividing unless all DNA damage has been repaired. Jackson and colleagues in Britain and Denmark believe the molecules act together like an engine to repair damage that can lead to cancer. Blocking the activity of MDC1 makes cells more susceptible to genetic damage caused by radiation. "It is becoming clear that drugs based around this kind of knowledge do have the potential in the clinic, particularly in the cancer area, to enhance existing cancer therapies," Jackson, whose research is funded by the charity Cancer Research UK, explained in an interview.

The scientists believe a drug that blocks MDC1 could make radiotherapy treatments, which cause lethal damage to DNA in cancerous cells, more effective. Radiotherapy may not kill all cancerous cells so increasing their vulnerability could prevent the cancer from recurring. By contrast, if scientists could find a method to enhance the activity of the molecule, which Jackson concedes would be much more difficult, it may theoretically be possible to spare people the effects of high doses of radiation in a nuclear accident or attack. Jackson and his team, who reported their findings in the science journal Nature, are now trying to determine how much MDC1 is found in cancerous tumors. "There is the potential of using this information in a diagnostic way, for example identifying which patients have MDC1 could help to predict response to treatment," he added.

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Gene Found for Cancer's Spread-(HealthScoutNews-28/02/2003)

An American research team has discovered a gene responsible for the spread of cancer through the body -- a process that ultimately kills the cancer patient. The researchers are hopeful that the discovery will lead to new, less-toxic drug therapies for the disease. Their strategy hinges on "knocking out" the cancer-spreading gene in order to halt the movement of cancer cells from the primary tumor site. "We've found a gene that is essential for the migration of cells. And potentially, by blocking the action of this gene product, we can control the cancer and manage the disease," says lead author Dr. Richard Pestell, who is now chairman of Georgetown's department of oncology. The work was done at the Albert Einstein College of Medicine, before Pestell went to Georgetown. It will appear in the May issue of Molecular Biology of the Cell.

Pestell's team was tipped off that the cyclin D1 gene might play a role in metastasis after learning that patients with spreading cancer also had an over-expression of the gene. The scientists tested this curious phenomenon in the laboratory by examining the progression of cancer in mice that were missing the cyclin D1 gene. Using a high-powered microscope, they observed that the cancer cells were missing an outer "ruffle" layer that would typically enable them to migrate. Without this structure, the cancerous cells were immobilized and the disease was held in check. Current therapies for cancer halt the disease's spread by hobbling the cell division process. As a result, patients suffer from hair loss and other side effects. If the researchers can determine exactly how cell migration differs from cell proliferation, new therapies could focus on just the cells that migrate, which would eliminate many of the debilitating symptoms that come with chemotherapy.

While suggestive, the findings are not conclusive, says Dr. Danny Welch, a professor of pathology at University of Alabama-Birmingham. "The data show that mice without the cyclin D1gene ... tend to develop tumors at a much lower rate. And if you couple those observations with the clinical observation that cyclin D1 is associated with more aggressive tumor spread, the implication is that it may control metastasis," he says. "But they haven't tested that theory directly in this paper. It's a great lead-in for a big number of future experiments," he adds. While such a treatment would not eliminate a cancerous tumor, it would control the disease and prevent the cancer from attacking other parts of the body, Pestell says. "Like diabetes, patients could live normally with the cancer in place," he adds.

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Some Cancer Patients Benefit from Online Support-(Reuters Health-19/02/2003)

Many breast cancer patients who go online for emotional help find Internet support groups helpful, according to new study findings. This may be particularly good news for women who live in rural areas, or those otherwise less able to access social services than their peers. The findings "proved the feasibility of providing high quality professional service to women with breast cancer (and) demonstrated that real and deep relationships, necessary for productive groups, can be established online," study author Dr. Morton A. Lieberman of the University of California at San Francisco told Reuters Health. "The women in the groups maintained close relationships long after the groups ended," he added.

The study involved 32 women--divided into four groups--who met online for one-and-a-half hours weekly for 16 weeks. Half of the women lived in rural areas or small towns and the others lived in medium-sized or large cities. Most (56%) of the women were in the early stages of the disease. Roughly two-thirds of the women said they benefited from the Internet support groups, Lieberman and his colleagues write in the journal Cancer. The women reported less depression, and while they said their pain was as intense as ever, they had fewer negative reactions to it. For example, they found the pain more tolerable and less agonizing than they did previously. These women also tended to express more "zest for life" and increased spirituality, according to the researchers. Yet, they seemed to be more likely to suppress their emotions after they participated in the support groups than they were beforehand. The reason for this latter finding is unknown, according to Lieberman. "This is an issue for further study," he said.

Six (20%) women withdrew from the study--a rate nearly comparable to that for group face-to-face psychotherapy, Lieberman and his team note. These women appeared to be less able to cope with their anxiety and more likely to report suppressing their cancer-related thoughts and feelings than those who continued in the study. They were less likely, however, to say that their pain interfered with their daily life, study findings indicate. "Those who began and did not finish may be a different kind of woman," the researchers write. For example, their reports of less pain "may be an indicator of less need for a support group." On the other hand, Lieberman and his team speculate, this may also "represent an aspect of suppression." Altogether, in light of the findings, "the rapid spread of internet use...suggests that internet delivered support groups can be made available to diverse populations," Lieberman said, such as those who live in areas that lack social resources for dealing with cancer and other illnesses.

Another benefit of the online intervention is that it was much less costly than traditional face-to-face support groups, he added. Lieberman is currently involved in a study comparing Internet and face-to-face support groups and another evaluating the benefit of Internet support groups for people with Parkinson's disease and other illnesses. A recent report by the Pew Charitable Trust found that 52 million adults in America obtain health or medical information online and nearly 5 million participate in online support groups. The California Breast Cancer Research Program funded the study.

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Breaking the Bad News When the Word Is 'Cancer'-(Reuters Health-18/02/2003)

Hearing the word "cancer" is never easy, but a new study suggests that patients are less likely to be depressed later on if their doctor doesn't tiptoe around the word when breaking the news. Patients are also less likely to be depressed later if doctors discuss their diagnosis in a forthright manner, talk about the severity of the situation and encourage patients to be involved in treatment decisions. "Without a doubt, people are far more well-informed about cancer," said Dr. Penny Schofield. "In general, people want to find out everything they can about their disease and treatment options." The findings are from a study of 131 Australian patients newly diagnosed with melanoma, the most rare but dangerous type of skin cancer. Most were male and the average age was 58, according to the report in the journal Annals of Oncology.

The patients filled out a questionnaire about four months after their diagnosis, and then two more in the 13 months following the first survey. Patients who said they had been told all the options or as many as they wanted to hear, reported the highest levels of satisfaction. Those who felt they had a "major say" in their course of treatment were less likely to be depressed 17 months later. Most patients in the study were satisfied with their doctors' communication strategies because they listened to their needs, said Schofield, who is at the Peter MacCallum Cancer Institute in Victoria, Australia. "Encouraging patients to express their feelings and actively listening to their responses are skills which are pivotal in the communication training programs that are now becoming widely available for health professionals working with cancer," she said.

Patients who felt their doctor was reassuring and prepared them for their diagnoses, and who received clear and complete information when they requested it, had the highest levels of satisfaction. Having family members present, or people who the patient asked to have in the office when their doctor broke the news, resulted in a higher level of patient satisfaction as well. Schofield said family members play a very important role to the cancer patient. "The type of support wanted varies from person to person, and can vary from day to day in the same person," she said. "The best advice I can give," said Schofield, "is for relatives and family to try to understand how their loved one wants to be supported."

There has been little research done on communicating with children who have cancer. Schofield says that they should be treated the same as adults, and that every person has a right to know the truth about their illness. She says children should be given opportunities to ask questions about cancer and be given "truthful responses in words they can understand."

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Developing World Has Most Cases of Child Cancer-(Reuters-14/02/03)

British cancer experts called for an international campaign to improve the treatment of childhood cancers in the developing world where 72,000 youngsters die of the illness each year. Seventy percent of children with cancer in Britain and the United States are alive five years after diagnosis, but because of poverty, malnutrition and a lack of medical facilities and drugs it's often a death sentence in poor countries. "What is required is an international campaign...to improve the supply and reduce the cost of drugs used to treat cancer in these countries, and a commitment from those more privileged to help those in the developing world to help themselves," said Vaskar Saha, the head of the charity Cancer Research UK's children's cancer group.

Childhood cancer is comparatively rare but 84% of the 166,000 children under the age of 15 who are diagnosed with the disease worldwide live in poor countries. Saha told a news conference to mark International Childhood Cancer Day on Saturday that partnerships forged between hospitals in the developed and developing world have made strides in improving treatments for children with cancer in poor countries but more needs to be done. "We have the technology to cure seven out of 10 children with cancer," he said.

Advances in chemotherapy drugs, which are now more effective and less toxic, and a better understanding of how to treat cancer in children have resulted in improved survival rates, but most children in the developing world do not have access to the best treatments. "We should try to get the cost of these drugs reduced," said Saha, adding that a campaign to reduce the costs of drugs, similar to what is being done to improve access to AIDS treatments in poor countries, would be a good step. World trade negotiators have been trying to hammer out a formula that will improve access in developing countries to cheaper or generic drugs. Earlier this week they agreed to allow more time to reach a decision.

Leukemia is the most common childhood cancer and accounts for nearly one third of all cases of the disease. It is followed by brain and spinal tumors. Fifty-four percent of childhood cancers are in Asia, where 55% of deaths occur, followed by Africa with 20% of cases and 25% of deaths, according to the charity.

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Group to Focus on Cancer, Genes' Function-(Reuters04/02/03)

British and Dutch scientists launched an international initiative to uncover the function of genes and to determine how new drugs can be designed to fight cancer. The ambitious project will use data from the human genome project, which mapped the estimated 35,000 genes in humans, to try to pinpoint which ones are involved in cancer and could be potential targets for new therapies. "This is the first time such an undertaking has been made," Dr Julian Downward, of the British charity Cancer Research UK which is funding the project, told a news conference.

Together with Dr Rene Bernards and scientists at the Netherlands Cancer Institute, Downward and his colleagues will use a technique called RNA interference to systematically find out which genes are linked to cancer. RNA is a messenger system that carries instructions to other parts of the cells. RNA interference (RNAi), which has been dubbed the biggest scientific breakthrough in a decade, silences a targeted gene. The natural mechanism was discovered in the nematode worm which uses tiny pieces of RNA to switch off rogues genes that could harm it. Scientists have already used RNAi to switch off genes one by one in the worm in an effort to pinpoint those linked to fat storage and obesity.

The Anglo-Dutch consortium plans to use RNA interference to initially de-activate and look at the function of 300 genes that have been linked to cancer. If the technique is successful, they will continue the process with another 8,000 genes and hope to eventually extend the initiative to cover the 35,000 genes in humans. The scientists will also use RNA interference on 30,000 cancer cells to find common genetic components. "Using RNA interference, we should be able to find out precisely what we need to take away from a cancerous cell in order to make it normal again -- essentially we will be dismantling cancer at the level of its genes," Downward said. The function of most of our genes is still unknown, so the big challenge for scientists is to discover what they all do. "Such an endeavor has never before been possible, because dissecting out the function of a single gene from around 35,000 is extremely difficult," said Paul Nurse, chief executive of Cancer Research UK. "But thanks to the incredible discovery of RNA interference, we think we should now be able to crack the problem," he s

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Older Cancer Patients Fare Well with Chemotherapy-(Reuters Health-07/02/03)

People over age 70 who have cancer appear to be able to handle chemotherapy treatment, a small study suggests. While the bulk of cancer patients are over the age of 65, previous research has found that older patients are less likely to be given chemotherapy compared to younger cancer patients. Doctors may avoid chemotherapy treatment in older patients because they underestimate a patient's life expectancy or they fear the toxic side effects may be too much for older people, according to the report. However, despite experiencing the general toxicity associated with chemotherapy drugs, older patients with cancer who are otherwise healthy appear to tolerate the treatment, report lead study author Dr. Hongbin Chen and colleagues from the University of South Florida in Tampa.

The study included 37 patients, 70 years or older, with a variety of cancers including breast, lung, colon, ovary, prostate and uterine, among others. All of the cancer patients were followed for about 130 days and were assessed for various aspects of their physical and mental health and quality of life, according to the report in the journal Cancer. The patients all received various chemotherapy regimens. Thirteen (35%) had a beneficial response, either partially or completely, nine remained stable, and in seven patients the cancer became worse. Seven patients required additional chemotherapy. While many of those in the study experienced decreases in physical and emotional functioning, "changes in most (test) scores were small in magnitude clinically," the authors report. "Older cancer patients undergoing chemotherapy may experience toxicity but generally can tolerate it with limited impact on independence, comorbidity (other illnesses) and quality of life levels, write Chen and colleagues. "It is important to recognize and monitor these changes during geriatric oncology treatment," they conclude.

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Study Doubts Acrylamide in Food Causes Cancer-Reuters-28/01/03)

Fried foods such as potato chips and French fries may contain a substance that can cause cancer in animals, but the levels do not appear high enough to increase the risk of the disease in humans, researchers said. Swedish scientists sparked a worldwide food scare last year when they found high levels of acrylamide, a suspected human carcinogen, in high-carbohydrate foods including crackers, certain cereals and cooked potatoes. But new research by scientists at the Harvard School of Public Health in Boston, Massachusetts, and the Karolinska Institute in Sweden--the first to look at acrylamide in terms of human diet and cancer risk--suggests it may not be as dangerous as people have been led to believe.

"There was a lot of concern in the public that was raised from the initial findings of acrylamide in food," said Dr. Lorelei Mucci of Harvard. "This study provides some evidence that the amount of acrylamide people are taking in is probably not sufficient to increase the risk of cancer," she told Reuters.Although conclusions about the health risks of acrylamide cannot be drawn from one study, Mucci said the research is a starting point that could help to address some of the concerns raised by Sweden's National Food Administration, a government food safety agency.

Acrylamide, a colorless compound used in manufacturing processes, in laboratories and in water purification, is labelled as a probable carcinogen based on data from animal research. But Mucci said doses given in animal studies were several times higher than what humans would be exposed to through diet or other sources. "These data suggest the doses of acrylamide people are taking in can be effectively detoxified," she said, referring to her research, which is published in the British Journal of Cancer.

The American and Swedish researchers studied the diets of 987 patients with either cancer of the colon, bladder, rectum or kidney, as well as more than 500 healthy people, to determine whether levels of acrylamide could be a factor in the development of the disease. They calculated participants' dietary acrylamide intake by asking them how often they ate a range of different foods, including items--such as fried potatoes, bread and biscuits--that have been found to have medium or high levels of acrylamide. The researchers found no link between the compound in food and the risk of bladder or kidney cancer, and high amounts of acrylamide were associated with a reduced risk of bowel cancer.

However, the scientists said the lower bowel-cancer risk could be due to other factors, such as the high fibre content in the foods. "This study provides preliminary evidence that there's less to worry about than was thought," Mucci said. Scientists believe acrylamide is formed during the cooking process, when starchy foods like potatoes, rice and cereals are fried or baked at high temperatures. "We know that acrylamide can be carcinogenic to animals, but this study suggests that either the levels in food are too low to affect cancer risk, or that the body is able to deactivate the chemical in some way," Sir Paul Nurse, chief executive of the charity Cancer Research UK, said in a statement.

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Genetic Switch Discovery Offers New Cancer Hope-(Reuters-31/01/03)

Scientists have discovered how a genetic switch that allows cancerous cells to divide and spread works, in a finding that could open up a new avenue to treat many of the most common cancers. The switch controls an enzyme called telomerase. In normal cells, the gene that regulates it is tightly packaged and coiled and the switch is off, so the enzyme is not produced and the cells can only divide a finite number of times. But British and Swiss researchers found that cancer cells manage to unravel the gene and flip the telomerase switch back on, and that blocking the process cuts off the enzyme and cancerous cells stop multiplying. "The discovery of how the switch works is what we have done and of course that has implications for therapies because there is a great interest in new drugs that will modify the way genes express (or work)," Professor Robert Newbold, of Brunel University north of London, told Reuters.

Cancer develops when the control signals in a cell go wrong and it mutates. Instead of destroying itself, the cell multiplies uncontrollably and forms a tumour. Although there are more than 200 types of cancer, they all start in the same way. Newbold and scientists from the Swiss Cancer Research Institute in Lausanne flipped off the telomerase switch in cancerous cells in the laboratory by adding genes from normal cells that made the telomerase gene recoil into its compact form. "We have shown that when we add back these repressor genes from normal cells the switch flips and the gene rapidly flips back to its compact, silent form," said Newbold. "We know that if we stop telomerase working in cancer cells they stop dividing. The question is how we go about stopping it," he added.

The scientists, whose findings are reported in the journal Cancer Research, believe that a drug that targets the gene and the way it is packaged could switch off telomerase in cancerous cells. Because telomerase is active in about 85-90 percent of cancers, a drug that blocks its production could potentially be effective against many different types of cancer. Newbold is setting up a European-wide collaboration between research institutes and pharmaceutical companies to design drugs to block the production of telomerase. In normal cells it switches off when a fetus is about 20 weeks old and still in the womb. Newbold believes the shutting down is a protective process to prevent the development of cancer because without the enzyme cells have a finite lifespan -- they can only divide a certain number of times. Newbold thinks the mechanism evolved to protect humans against cancer. "If evolution has used this route to protect us from cancer. The logic goes that it should be the route to use to treat it," he added.

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Targeting Cancer Cells-(HealthScoutNews-27/12/2002)

A new method that uses ultrasound to deliver chemotherapy drugs to specific body areas affected by cancer could help reduce side effects and enhance the potency of anti-cancer drugs, says a study in the Cancer Research. Brigham Young University researchers tested the new technique in laboratory animals.

In this approach, a drug is packaged in tiny molecules of water-soluble plastic. That prevents the drug from interacting while passing through the bloodstream. Ultrasound is then used to release the drug from the package once the package reaches the specific area of the body affected by cancer. The tests using this method on laboratory animals produced significant reductions in tumor size, but it will be several years before this technique might be used on humans. People with cancer who are being treated with chemotherapy often suffer painful side effects as the powerful chemotherapy drugs course though their bodies, damaging healthy tissue as well as tumors.

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EU Experts Confirm Safety of Aspartame-(Reuters Health-24/12/2002)

The much-studied artificial sweetener aspartame is indeed safe, according to scientific advisors to the European Union. The EU's Scientific Committee on Food (SCF) conducted a review of scientific research published about aspartame since 1988, when it last reviewed the sweetener's safety. Issues raised in the past include possible toxicity from methanol, which is formed when aspartame is broken down in the body, and a possible link with epilepsy and brain tumors, which has been disputed. All these areas have been addressed in scientific studies and reviews of evidence, the committee notes.

The sweetener has also been investigated by bodies such as the US Food and Drug Administration, Britain's Committee on Toxicity and the French health regulator, AFSSA, the EU scientists note. In their report, the committee quotes the French agency on the cancer-causing potential of aspartame: "Taking into account all the studies that have been conducted...it was concluded that aspartame had no carcinogenic potential on the brain in experimental animals." On the subject of behavioral or neurological changes, the report states that a number of well-designed studies in healthy individuals "failed to highlight any treatment-related adverse effects on behavior."

Other studies show that aspartame is no more likely than a dummy-pill to trigger headaches. The review highlights a range of studies showing no link between aspartame and epilepsy. In particular, it notes that the Epilepsy Institute in the US concluded in 1986 that aspartame is not the cause of epileptic seizures. As for brain cancer, the committee looked at the one study purporting a link. "The SCF considered this report and concluded that the data did not support the proposed...increase in the incidence of brain tumors," they write. "The Committee concluded that on the basis of its review of all the data in animals and humans available to date, there is no evidence to suggest that there is a need to revise the outcome of the earlier risk assessment or the acceptable daily intake previously established for aspartame," the report concludes.

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Dignity Crucial During Last Months of Life: Report-(Reuters Health-20/12/2002)

Interviews with dying patients suggest that most feel they have not lost a great deal of dignity during their final days. However, those who do experience a loss of dignity say that loss is accompanied by hopelessness, psychological stress and feeling dependent on others, new research reports.

In a sample of 213 cancer patients with a life expectancy of less than 6 months, only 16 said they felt they had a moderate to strong sense of a loss of dignity. However, that minority was also more likely than others to report feeling anxiety, depression, and that they had lost their will to live. Those with a so-called "fractured" sense of dignity also reported more feelings of hopelessness, of being a burden to others, and a low quality of life. Those who felt a loss of dignity were also more likely to say they needed help with a variety of activities, such as bathing and dressing, and felt more dependent on others. While most terminally ill patients do not appear to experience a loss of dignity, these findings demonstrate that when they do, it can have seriously detrimental effects, study author Dr. Harvey Max Chochinov of the University of Manitoba in Winnipeg told Reuters Health.

As such, preserving terminal patients' dignity may prevent other unwanted feelings and experiences, Chochinov noted, and should therefore become an integral aspect of caring for dying patients. "Making dignity at the end of life needs to be accepted as the only gold standard in providing end-of-life care," Chochinov said. He and his colleagues report their findings in The Lancet.

In an accompanying editorial, experts write that the current study gives some cause to celebrate. The "finding that 93% of patients in the study reported no loss of dignity is remarkable," according to Drs. Manish Agrawal and Ezekiel J. Emanuel of the National Institutes of Health in Bethesda, Maryland. However, the editorialists note that the high levels of dignity among terminal patients could also stem from flaws in the study design, such as in evaluating dignity. Chochinov and his colleagues also excluded patients with especially painful symptoms, Agrawal and Emanuel write, and those with more pain may be more likely to experience a loss of dignity. Alternatively, the authors suggest that end-of-life care could simply have improved. "These data suggest that death and dying in the modern world are not inherently undignified," Agrawal and Emanuel conclude.

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Chemotherapy for Pediatric Cancer Does Not Affect Subsequent Pregnancy- (Reuters Health-06/11/2002)

Female survivors of childhood cancer who were treated with chemotherapeutic agents do not have an increased risk of adverse pregnancy outcomes, according to a report in the American Journal of Obstetrics and Gynecology. However, pelvic irradiation does seem to increase the likelihood of having a low birth weight infant.

Dr. Daniel M. Green, of Roswell Park Cancer Institute, Buffalo, New York, and colleagues examined the effect of prior radiation therapy or chemotherapy for childhood cancer on pregnancy loss, live births, and birth weight. They reviewed medical records and pregnancy outcomes of females in the Childhood Cancer Survivor Study (CCSS) who completed questionnaires. The researchers note that 4029 pregnancies were reported by 1915 women. Sixty-three percent resulted in live births, 1% in stillbirths, 15% miscarriages, 17% abortions, and 3% unknown or in gestation. "The rate of live birth was not lower and the rate of stillbirth was not higher for the patients treated with any particular chemotherapeutic agent in comparison to those who had not been treated with the agent," Dr. Green and colleagues report.

The offspring of women who received pelvic irradiation were more likely to weigh less than 2500 g at birth (RR 1.85). There was an increased risk of miscarriage among women whose ovaries were in the radiation therapy field (relative risk [RR] 1.86) or near the field (RR 1.64). However, none of these differences were statistically significant. The risk was not increased in women whose ovaries were shielded (RR 0.90) compared with patients who did not receive radiation therapy. The investigators believe that the findings "are reassuring and generally support the conclusion that prior treatment with chemotherapeutic agents does not adversely affect pregnancy outcome." However, they add that patients and their physicians should be aware of potential complications related to prior pelvic irradiation.

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Wisconsin Research Sheds New Light on Cancer Metastasis-(cancerpage.com-07/11/2002)

University of Wisconsin researchers believe they may have discovered a key ingredient cancer cells need to metastasize or spread throughout the body. Once cancer has spread beyond its primary tumor site, it is much more difficult to control and a cure is less likely. "The real, life-threatening problem with most cancers is that they migrate away from the initial site," Richard Anderson, a UW-Madison pharmacology professor and senior author of the paper tells cancerpage.com. Anderson and colleagues have identified an enzyme, PIPKIã661, that all cells use to build "focal adhesions," structures cells use to hitch rides on other cells for transport elsewhere in the body. "Researchers have been looking for this enzyme for years," Anderson says. "There is not another enzyme like this that plays this role, that's why we think this is so key."

The discovery could lead to determining a method of turning off the production of the enzyme in cancer cells and thus depriving them the ability to metastasize. But the research, Anderson says, also demonstrates the enzyme's role in other crucial activities during a cancer cell's life cycle. "This enzyme is the first step in a process that leads not only to a cell's ability to move but to enhance proliferation as well and enhance its own survival," Anderson says. Anderson likens the enzyme's functions to the supporting function of a tree trunk. If you eliminate the trunk, all the branches - growth, reproduction and movement - aren't possible. The question Anderson and his colleagues are trying to answer now is how to selectively turn off cancer's ability to produce and utilize this enzyme.

They are also examining the DNA structure of metastatic cells to see if cancer cells that have spread from the primary tumor have somehow altered the enzyme in a way that allows them to utilize it more efficiently than normal cells. Earlier this year, scientists at the Beatson Institute in Glasgow, Scotland identified a molecule that breaks down the natural adhesion in solid tumors allowing cancer cells to move away from the primary tumor. The Anderson team research examined the next step; how those loosened cells use PIPKIã661 to construct the vehicles (the focal adhesions) needed to migrate. "Improving our understanding of how cancer spreads should help in the development of drugs to block the process," Professor Margaret Frame of the Beatson Institute said in August. "If we could confine cancer cells to the original tumor it would give surgery a much greater chance of success and reduce the risk of the disease reappearing in other parts of the body." The Anderson team's research is published in the journal Nature.

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Austrian Scientists Working on Cancer 'Vaccine'-(Reuters Health-25/11/2002)

Austrian researchers are developing a new cancer treatment that involves "vaccinating" patients against their own tumor by stimulating the immune system. In a 3-year pilot study carried out at St. Anna's Children's Hospital in Vienna, 20 children in the final stages of cancer underwent treatment with the new approach. Results were promising enough to prompt a larger study.

In the study, doctors first removed the patients' tumors by surgery. They then took a sample of white blood cells, out of which dendritic cells were cultured. Dendritic cells alert the immune system to the presence of cancer or other unwanted materials by displaying small parts of the foreign substance on their surface. Researchers think that activating dendritic cells might prevent secondary tumors from developing by stopping cancer cells from slipping past the immune system.

The Austrian group took the children's own dendritic cells and exposed them to tumor cells, prompting them to display tumor antigens. After a final quality check, the vaccine was administered to the children in the form of an injection over a 4.5-month period. The new treatment, the first to use this specific type of in-vitro manipulated dendritic cell in childhood cancer, was found to have very mild side effects, with only slight itching on injection and a mild fever. Although the preliminary study was not designed to look at the effectiveness of the treatment, researchers found that, in some cases, the disease stabilized and tumor growth slowed, Dr. Heinrich Kovar, scientific director at Vienna's Children's Cancer Research Institute, told Reuters Health. "This is the first time this type of anti-tumor vaccine has been used in pediatric malignancies. The goal of the pilot study was to determine whether vaccination using antigen pulsed dendritic cells was feasible in children and whether there would be any toxicity," Kovar said.

The team at the Children's Cancer Research Institute, which is led by Dr. Thomas Felzmann, is now planning a second phase of trials. These will include adult patients who have responded to chemotherapy but still have tumor cells in their bodies. The trials will involve hospitals in Austria, Germany and the Czech Republic. "The long-term aim is to use the anti-tumor immune therapy to help patients with minimum residual disease," Kovar said. He added that the treatment could be in use within 5 to 10 years. The research is unpublished, although Felzmann told Reuters Health the group expects to submit patient data for publication early next year

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Possible Cancer Chemical Varies in Foods-(AP-04/12/2002)

The longer french fries and certain other starchy foods are fried or baked, the higher their level of a possible cancer-causing substance, new federal research suggests. The substance, called acrylamide, made headlines last spring when Swedish scientists discovered that it forms in fries, potato chips and other high-carbohydrate foods cooked at high temperatures. Several other European countries confirmed Sweden's discovery - and now the latest batch of tests, revealed Wednesday by the U.S. Food and Drug Administration, shows that acrylamide levels vary widely even within the same brand of food. For example, FDA scientists bought french fries at four different Popeye's restaurants and found a three-fold difference between the batches with the highest and lowest acrylamide levels. In tests of 25 seemingly identical bags of Lay's Classic Potato Chips, only two bags contained the exact same acrylamide level.

Acrylamide forms during traditional cooking methods - whether you buy a ready-made food or fry or bake from raw ingredients in your own kitchen - and it seems that the longer certain foods are cooked at especially high temperatures, the more acrylamide appears. What does all this mean for consumers? Acrylamide causes cancer in test animals, but has never been proved to do so in people - meaning no one knows if higher levels in one food than another is a problem. FDA scientists stressed that there's no reason yet for Americans to start avoiding certain foods for fear of acrylamide - a message echoed by the food and restaurant industries. Instead, concentrate on eating "a variety of foods that are rich in high-fiber grains and fruits and vegetables," said FDA food safety chief Janice Oliver.

Because acrylamide forms during traditional cooking methods, dietary exposure "is something that's been going on a long time," noted FDA senior scientist Bernard Schwetz. But the big variability suggests acrylamide levels can be lowered in foods, FDA scientists told a meeting of the agency's food advisory board. Scientists in FDA chemist Steven Musser's laboratory bought frozen french fries that, before baking, contained almost no acrylamide. Baking them for 10 to 15 minutes as the package directs caused a very slight acrylamide increase - but none of the six scientists considered the fries done enough to be appetizing, so they stuck them back in the oven. After 30 minutes of baking, the fries were golden brown - and contained 120 times as much acrylamide. After 45 minutes, the now extra-crispy fries contained 400 times as much acrylamide as a mere 15-minute baking produced.

It's not just an issue for french fries. Even toasting bread increased acrylamide levels six- to 10-fold, the FDA testing showed. In contrast, microwaving frozen french fries produced no acrylamide, Musser said. Likewise, other scientists say the chemical doesn't appear to form when foods are boiled. Nobody knows why, but perhaps those cooking methods aren't hot enough to produce the chemical reaction thought necessary to form acrylamide. Acrylamide is used to produce plastics and dyes and to purify drinking water. Although traces have been found in water, no one expected high levels to be in basic foods. Now scientists know it apparently forms when a naturally occurring amino acid called asparagine is heated with certain sugars such as glucose. Potatoes are especially rich in both asparagine and glucose, although foods from grains to even asparagus also contain it. Indeed, roasting asparagus produced very high acrylamide levels.

In contrast, the FDA tested hundreds of food samples and found products from infant formulas and baby food to frozen vegetables and meats acrylamide-free - foods that either contain little asparagine or aren't cooked at super-high temperatures. Food manufacturers insist their products aren't risky, but they're working with the FDA to understand acrylamide formation and to lower levels if possible, said Henry Chin of the National Food Processors Association. It may not be easy, he cautioned. For example, if frying temperatures are lowered too much potato chips turn out soggy. Also, levels of asparagine and glucose vary in different potato batches according to growing conditions and how long the tubers are stored raw, Chin said.

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Detecting Cancer's Spread (HealthScoutNews-05/12/2002)

A combination of positron emission tomography (PET) and computed tomography (CT) detects the spread of cancer better than PET alone. That's the finding of a new study by researchers at Johns Hopkins Medical Institutions. The research, presented today at the Radiological Society of North America's annual meeting in Chicago, found PET-CT was better able to distinguish cancerous from normal tissue and better able to locate where metastases have spread in the body.

The researchers used a scanner that fuses CT and PET technology. CT provides anatomical detail, while PET detects the metabolic activity of tumors. They performed 10 PET and 33 PET-CT scans on 28 people with ovarian cancer that was suspected to have spread to the abdominal cavity. PET alone produced three true positive and two true negative results, while PET-CT produced 14 true positives and 10 true negatives. The PET produced two false positives, while PET-CT produced no false positives. PET-CT produced five false negatives, and PET alone produced no false negatives. PET-CT was able to distinguish cancer from non-cancer 100 percent of the time), compared to 50 percent for PET. The researchers caution this was a limited study, and more research is needed to properly compare PET-CT to PET or CT alone.

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Painkillers May Be Source of New Anti-Cancer Drugs-(Reuters Health-05/12/2002)

By tinkering with the structure of a class of popular anti-inflammatory drugs designed to be easier on the stomach than aspirin and other arthritis drugs, it may be possible to develop new anti-cancer medications, new research suggests. The drugs, known as COX-2 inhibitors, "can be used as a molecular starting point to generate a new class of antitumor agents," Dr. Ching-Shih Chen of Ohio State University in Columbus, the study's lead author, told Reuters Health. Chen said that he and his colleagues have started trying to develop such drugs.

COX-2 inhibitors, like older drugs such as ibuprofen and naproxen, are nonsteroidal anti-inflammatory drugs, or NSAIDs. Older NSAIDs reduce inflammation by blocking an enzyme called COX-2, but they also block an enzyme called COX-1. This enzyme helps protect the lining of the stomach, so blocking COX-1 can cause stomach irritation. COX-2 inhibitors only block COX-2, leaving the stomach-protecting COX-1 alone. Although COX-2 inhibitors were designed to relieve pain, there have been several reports that the medications, along with other NSAIDs, may offer some protection against cancer, especially colon cancer, since the drugs' approval in the late 1990s.

According to Chen, researchers first suspected that blocking COX-2 enzymes encouraged cancer cells to kill themselves, a process called apoptosis. But in a previous study, Chen and his colleagues demonstrated that the effect of celecoxib and other COX-2 inhibitors on apoptosis was independent of their effect on COX-2. In fact, even though the drugs celecoxib (Celebrex) and rofecoxib (Vioxx) both block COX-2, celecoxib has a much more powerful effect on cancer cells. The new research, Chen said, "extends this concept" that COX-2 inhibitors affect cancer in some other way than by blocking COX-2. According the Ohio State scientist, the experiments were aimed at identifying the structures on celecoxib and rofecoxib that trigger cell death in prostate cancer cells.

In the research, which was not funded by drug companies and is reported in the Journal of the National Cancer Institute, Chen's team first scrutinized the make-up of celecoxib and rofecoxib. Then the researchers, using COX-2 inhibitors as the base, developed a new class of compounds that target prostate cancer. The research confirmed that COX-2 inhibitors affect cancer cells independently of their effect on COX-2. "Our data indicate that celecoxib also inhibits other cellular targets that are crucial to the survival of cancer cells," Chen told Reuters Health. "Disruption of the functions of these cellular targets," he said," leads to cancer cell death." Likewise, the investigators found that the compounds derived from these drugs also did not influence cancer cells by blocking COX-2. Instead, these derivatives targeted signaling pathways within prostate cancer cells. The research "is a tour-de-force in chemical synthesis," according to Dr. Raymond N. DuBois at Vanderbilt University Medical Center in Nashville, Tennessee. He cautions in an accompanying editorial, however, that these compounds need to be studied much more extensively. The development of new drugs "is extremely important for the success of the entire field of cancer prevention," according to DuBois, but he notes that "these new agents must be studied and tested in a systematic way to ensure their safety and efficacy."

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Red Wine Component to Be Studied Against Cancer-(Reuters Health-05/11/2002)

Scientists in Britain and the US announced plans to begin studying a possible new cancer prevention drug based on resveratrol, a natural compound found in red wine. Researchers at the University of Leicester in England and the University of Michigan will begin testing tablets of pure resveratrol in healthy volunteers early next year, the British university said in a statement. The US National Cancer Institute (NCI) is funding the research. Leicester's Professor Will Steward said resveratrol is found in peanuts and several berries, as well as grape skins and wine--particularly red wine. "Consumption of resveratrol has been proposed as one possible explanation for the low incidence of cardiovascular disease in Southern European countries with high red wine consumption, and resveratrol has been shown to possess anti-inflammatory and anti-cancer activity in experimental models. Since resveratrol may be of value in preventing cancer, the NCI are funding early clinical studies of pure resveratrol capsules in healthy volunteers and patients with early cancer," Steward added.

The 20 or so healthy volunteers in the study will initially be given one tablet containing 0.5 grams of resveratrol--equivalent to the amount in dozens and dozens of bottles of wine, Leicester researcher Professor Andreas Gescher told Reuters Health. Later trials will look at repeated doses. The point of these preliminary studies is to analyze how long the compound stays in the body and how much circulates in the blood. The researchers will also look for evidence of biochemical changes that might suggest a protective effect. "You obviously have to know that you're taking enough to get to the places that you want to prevent cancer," Gescher said. Several studies have found that wine drinkers seem to be less likely to develop cancer. Resveratrol has been suggested as one possible reason, but the benefits of wine may be due to a combination of reasons. "It is quite possible that after all this work we find resveratrol isn't active alone," Gescher said. "But first you have to look at what these single agents do and then you look at the next step."

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Thalidomide-Like Drugs Have Anti-Cancer Properties-(Reuters-29/10/2002)

Drugs similar to thalidomide, which was taken off the market four decades ago after causing severe birth defects, have cancer-fighting properties, scientists said. In a study reported in The British Journal of Cancer, researchers at St. George's Hospital in London said thalidomide-like drugs can reduce inflammation, prime the immune system to attack cancer and reduce blood flow to the tumor. "This group of thalidomide-like drugs seem to have very complex and yet exciting properties," said Dr Keith Dredge, the author of the study.

Thalidomide was used in the 1950s and early 1960s as an anti-nausea drug for pregnant women until doctors realized it was causing limb deformities in unborn children by limiting blood supply. Cancer experts believe the same property that caused the deformities could be harnessed to starve a tumor of its blood supply. Dredge and his team looked at different versions of compounds called IMiDs and SelCIDs in laboratory studies. They found that both were 10 times as potent as thalidomide in preventing the growth of blood vessels. New Jersey-based biotechnology company Celgene Corp, which funded the research study, has developed the thalidomide-like drugs. Dredge said the new compounds have the potential to stimulate the immune system which could help to prevent cancer. "Conversely, inflammation, which also occurs naturally in the body, may contribute to the development of cancer and our research shows that thalidomide-like drugs can reduce inflammation," he added in a statement. Scientists are also looking into the effectiveness of using thalidomide in treating lung, skin, kidney and breast cancer.

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Chinese Herbs for Cancer Care Put to 'Western' Test (Reuters Health-21/10/2002)

Researchers in Hong Kong are putting Chinese herbal medicines to the test using Western scientific methods, in the hope that they can offer solid advice to the many cancer patients who consider using the traditional remedies. Many people take Chinese medicines, particularly to reduce chemotherapy symptoms, said Dr. Tony Mok from the Chinese University of Hong Kong. "We just don't know whether it is effective or safe to use at the same time as conventional medicine," he said. "We tend, therefore, to advise against it--but we should know for sure."

Chinese herbal medicine uses combinations of around 250 possible herbs to restore an individual's internal harmony and fight illness. Because the approach is so different from Western medicine, comparing them is difficult, Mok said. "It is a different concept to conventional medicine, which is based on 'one drug for one disease,"' he explained.

At the European Society for Medical Oncology conference here, the doctor described a study that looked at whether the capacity of Chinese herbs to reduce the side effects of chemotherapy could be studied in so-called double-blind, placebo-controlled trials. Such studies are considered the best way to determine whether or not a treatment is effective. These trials compare a treatment with an inactive substance, or placebo. Only at the end of the study is it revealed--to doctors and patients alike--which patients received the treatment and which the placebo. The researchers studied 40 breast cancer patients and 13 colon cancer patients who had not previously been treated with chemotherapy. The participants were treated either with a powdered form of Chinese herbs prescribed by a traditional herbalist, or a placebo powder. Half of the treatments lasted at least 84 days and the Chinese remedies included an average of 17 different herbs. The trial has not finished, but early results suggest a small reduction in nausea, vomiting and loss of appetite, Mok said. "We have already demonstrated the feasibility of capturing the information from clinical research on Chinese herbal medicine with this methodology," he said. "And we could find something really useful that could point where we should look for better treatment."

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Studies show elderly can tolerate strong cancer drugs (AP Medical Writer-20/10/2002)

Many elderly patients can tolerate powerful cancer drugs better than doctors think, according to new research. Half of all cancers are diagnosed after the age of 65 and experts predict that 30 years from now, elderly people will comprise 70 percent of cancer diagnoses. However, there is no clear treatment strategy for cancer in the elderly. Most cancer drug trials exclude patients over 70 and doctors are subsequently reluctant to give the medications to older patients because they fear the side effects may be too harsh for them. Studies presented at a meeting of the European Society of Medical Oncology indicate that, at least in some cancers, elderly patients can be treated more aggressively. "Elderly patients must be offered the same treatment options as younger patients, even if treatment of the elderly is less cost-effective," said Dr. Silvio Monfardini, president of the International Society of Geriatric Oncology who was not connected with any of the studies. "It is wrong and unethical to discriminate against a patient because of their age.The whole problem of cancer in the elderly cannot be (avoided) because of the progressively aging population."

Experts agreed that researchers must start including elderly patients in clinical trials, given that as the population in many countries continues to age, people over 70 will make up an increasing proportion of cancer patients. People are considered elderly, in a medical context, once they are older than 65, but for cancer, patients are not considered elderly until they are 70.

One study presented at the meeting showed that elderly women with breast cancer can tolerate powerful medication. Treatment for elderly breast cancer patients is usually influenced by the patient's age, instead of standard factors such as the size of the tumor, whether the cancer has spread to lymph nodes and how fast the tumor is growing. Dr. Anne Chantal Braud examined the effects of surgery, radiotherapy, chemotherapy and hormone therapy in 179 women over 70 at the Institute Paoli Calmettes in Marseilles, France and found that many elderly women who were fit did well with the aggressive treatments.

In another study, Dr. Gilles Freyer of the South Lyon Central Hospital in Lyon, France, applied a geriatric evaluation test to 83 women over 70 suffering from advanced ovarian cancer. Elderly patients may be more vulnerable to the toxic side effects of treatments. They experience more psychological problems, such as depression, and it can be difficult for doctors to communicate properly with elderly people whose mental faculties are deteriorating. Transport to and from the hospital is a practical difficulty. He found that women who were depressed before treatment began, those who couldn't take care of themselves at home and those living in nursing homes were particularly vulnerable to the toxic side effects and that the chemotherapy was less effective in those women. He also found that the women fared worse on cancer treatment if they were taking lots of medication for other illnesses. "Chronological age has no influence on survival in our population," Freyer told doctors. He concluded that a multidimensional geriatric evaluation test may help doctors predict how well individual elderly patients will tolerate side effects and benefit from chemotherapy for advanced ovarian cancer. "Oncologists should weigh up the cumulative effects of these factors when making decisions about treatment," Freyer said. "Standard therapy however, should be made available to patients as far as possible."

Another study, involving 521 English Hodgkin's disease patients of all ages, found that age did not influence survival, but that the presence of other illnesses, particularly heart or breathing problems, were the main obstacles to elderly patients beating the cancer.

A fourth study, involving 91 Italian patients, found that low dose chemotherapy was not effective in elderly patients with small cell lung cancer, but that the full dose was successful and well tolerated by the patients. "These data could perfectly be generalizable to the United States. It's a universal issue," said Dr. Martine Extermann, a professor of medicine at the University of South Florida and a geriatric cancer specialist at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida. "One of the important messages that needs to go to the community oncologists is that it is not an issue of age alone and that they need to learn to individualize treatment," said Extermann, who was not connected with any of the studies

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Study finds positive thinking does not improve cancer survival, but feels better (AP Medical Writer-19/10/2002)

New research has dealt a blow to the idea that a positive outlook might improve a patient's chances of surviving cancer, scientists said. However, experts said that it is still worthwhile for patients to try to improve their mindsets, perhaps by joining a cancer support group, because it does make them feel better. The findings were presented at a meeting of the European Society of Medical Oncology in Nice, France. The study evaluated whether psychologist-run support groups kept patients alive. The researchers conducted a systematic review of the evidence on the topic. "There were some studies out there showing that positive thinking type of support will not only improve your quality of life - which undoubtedly it does, I'm not questioning that - but also will prolong the lives of cancer patients," said Dr. Edzard Ernst, a professor of complementary medicine at the University of Exeter in England who led the study. "One study from 1989 gets cited over and over and over again, and we knew there were one or two negative studies on this too, so we decided to see if it was true," he said.The researchers analyzed 11 studies that included a total of 1,500 patients. "The data provided no evidence at all to show that these types of approaches prolong life in cancer patients," Ernst said. He said, however, that he favors such efforts because they help cancer patients cope with their disease.

"Clearly the Holy Grail is to help people live longer, but the flip side is you can't make data out of nothing," said Dr. Nathan Cherney, a palliative care specialist at the Shaare Zedek Medical Center in Jerusalem, who was not connected with the research. "We like to believe we have a ready handle on cancer, we like to believe we have control, but the truth of the matter is the studies seem to indicate that we don't," Cherney said. Perhaps the disappointing findings might help some patients to have more realistic expectations, he said. When patients relapse, they sometimes feel guilty, Cherney explained. "The people who have been drawn in by this power of positive thinking thing - We've had situations of husbands berating their wives that they haven't been doing enough meditation, that they haven't been thinking positively enough," Cherney said. "This whole school of thought created an illusion of control, and when people do poorly, it's as if to say they haven't managed to control their tumor well enough, and that's not fair." However, Cherney said the ability of psychological support to improve the lives of cancer patients should not be underestimated.

Experts say doctors are increasingly recognizing the value of palliative care, treatments that do not prolong life or fight cancer, but make life better for patients with incurable diseases. "Some of them need palliation for their symptoms from the earliest stages of their disease, regardless of surgery, chemotherapy, radiation therapy," said Dr. Paris Kosmidis, head of medical oncology at Hygeia Hospital in Athens, Greece, the incoming president of the European Society of Medical Oncology.

As part of that recognition, the organization has established a committee to spread the latest knowledge on palliation throughout Europe. The organization has started a palliation fellowship program where young oncologists will spend time at specialist centers. The European organization has also drafted guidelines for such care, such as minimum standards for palliative care, curriculum for the training of oncologists and criteria for designation of a center for excellence in the integration of supportive cancer care. "The big issues are management of physical symptoms and management of psychological symptoms such as depression, anxiety, suicidal thoughts," said Cherney, who sits on the European society's committee. "We're prepared to look at our own dirty laundry to see where there are problem so we can start to make practical improvements."

Cherney presented results of a survey of attitudes to supportive cancer care among European and American oncologists. It is the first study of its kind. He found that, overwhelmingly, oncologists have the right attitudes but think it's a job for someone else. "We found that about 20 percent of oncologists have pervasively negative views about treating people with advanced cancer, particularly dying patients. They don't want to be involved in it. It depresses them. It burns them out," he said. Those oncologists tended to work at comprehensive cancer centers, he said. "These are the people who are likely to say to their patients: 'Well, the chemotherapy isn't working. Why don't you go home and have your relatives take care of you.' They really dump the ball," Cherney said. The job of an oncologist, Cherney said, is not to sell chemotherapy, but to sell the best care possible for someone living with cancer. "Chemotherapy is just one tool, but we've got a lot of other tools as well," he said.

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Cancer Survival Rates Better Than Thought (HealthScoutNews-10/10/2002)

Life expectancies for people diagnosed with cancer may be longer than we think. A study appearing in The Lancet computes 20-year survival estimates that are 1 percent to 11 percent higher for a range of cancers when calculated with a new method that uses up-to-date computer programs. "This is really good news and optimistic. It shows that in recent years more cancer patients are living longer," says Dr. Ruth Oratz, an associate professor of medicine at New York University School of Medicine in New York City. "We are making progress in the war against cancer."

Cancer patients also should be buoyed by the findings. Dr. Allan Novetsky, director of medical oncology at Maimonides Medical Center in Brooklyn, N.Y., says, "As a practicing oncologist, I am often faced with trying to convey to patients what the current prognosis is for their disease. And the more accurately I can tell a patient what the probability of them living five, 10, 15 or 20 years is, the more I am able to help them accept treatment, understand what the impact is and make plans for their short-term and long-term needs."

In the new study, Dr. Hermann Brenner, scientific director of the German Centre for Research on Aging in Heidelberg, Germany, compared survival estimates using the relatively new "period analysis" method and the traditional "cohort method." The cohort method involves looking at longevity in patients who were diagnosed with cancer many years ago. Period analysis uses more recent data, thereby, theoretically, reflecting advances in detection and treatment. Brenner compared survival estimates obtained with period analysis for the year 1998, and cohort analysis for patients diagnosed between 1978 and 1993. He used data from the U.S. National Cancer Institute's Surveillance, Epidemiology and End Results program. With period analysis, estimates of five-year, 10-year, 15-year and 20-year survival rates for all types of cancer were 63 percent, 57 percent, 53 percent and 51 percent, respectively. This represented increases of 1 percent, 7 percent, 11 percent and 11 percent, respectively, over the cohort-based analysis. Period analysis also showed 20-year survival rates that were nearly 90 percent for thyroid and testicular cancer, greater than 80 percent for melanomas and prostate cancer, about 80 percent for endometrial cancer and almost 70 percent for bladder cancer and Hodgkin's disease. The 20-year survival rate for breast cancer was estimated to be 65 percent, for cervical cancer 60 percent and for colorectal, ovarian and kidney cancer, 50 percent.

Is this just an exercise in statistical sophistry? It depends on whom you ask. Some experts versed in the art and science of numbers are skeptical of the study's value. "I think it's similar to people in Congress wanting to change the way they define poverty," says Andre Rogatko, chairman of biostatistics at Fox Chase Cancer Center in Philadelphia. "You're not solving the problem. You're just changing your perception." Oncologists have a different perception. Novetsky points out the study could not only influence the ability to obtain funding for research, it also helps people focus on where progress has occurred (for example, prostate cancer) and where more progress still needs to take place (lung cancer, for instance). Then there are the patients. "Being able to encourage a patient is a tremendous blessing," Novetsky says. "One of the most common questions we get asked is, 'What are my chances?' 'What are my chances of being alive to see my son's wedding or my daughter's graduation?' " "The more hope you can offer a patient, the better they deal with their disease, the more likely they are to accept the side effects of treatment because they know that there is a much stronger probability of being successful," he says.

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Chemotherapy-Cell Death Link Studied (HealthScoutNews-08/10/2002)

Healthy cells have a chemical switch that protects them from being killed by DNA-damaging cancer chemotherapy drugs, new research finds. Researchers at Washington University School of Medicine in St. Louis uncovered this biochemical switch in a protein called Bcl-xL, according to a study in current issue of Cell. DNA-damaged chemotherapy drugs are carried in the blood and work by gumming up DNA in rapidly-dividing tumor cells. That damage to the DNA causes the tumor cells to self-destruct through a process called apoptosis. The drugs can also trigger apoptosis in healthy cells that are rapidly dividing, such as hair follicle cells. But the drugs don't trigger apoptosis in normal healthy cells that aren't dividing. The researchers wanted to find out the reasons for that. "Our findings show that normal cells somehow suppress the signal that throws the switch and avoid self-destructing," says researcher Dr. Steve J. Weintraub, an assistant professor of surgery, medicine and cell biology and physiology.

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Green Group Says Diesel Soot Is Big Cancer Risk-(Reuters-03/10/2002)

Tiny soot particles emitted by diesel-fueled cars, trucks and construction equipment are a major contributor to the cancer risk from air pollution, the U.S. Public Interest Research Group said. The environmental group said its findings showed that the Environmental Protection Agency should enforce tough anti-pollution standards for diesel trucks, buses, farm tractors, bulldozers and forklifts. "Americans in every state and county in the continental United States and the District of Columbia were exposed to diesel soot at levels that exceeded the California EPA's cancer benchmark concentration in 1996," PIRG said.

PIRG said its review of scientific studies in recent years found that Americans on average face a 1 in 2,100 risk of developing cancer in their lifetimes from breathing pollutants in the outdoor air. That is nearly 500 times greater than the 1 in 1 million health protection standard established in the federal Clean Air Act, it said. The vast majority of the airborne pollution cancer risk is linked to diesel engines, according to the group.

Diesel engines emit a mixture of gases and fine particles that contain some 40 chemicals, including benzene, butadiene, dioxin and mercury compounds. Last month, the EPA released a report that concluded for the first time that diesel exhaust is a likely human carcinogen. Diesel fumes can also cause eye irritation, nausea and respiratory problems. The EPA report, based on exposure to exhaust from diesel engines built before the mid-1990s, did not attempt to quantify the cancer risk. Last year, the EPA issued standards to clean up dirty diesel trucks and buses, which it said would prevent more than 360,000 asthma attacks and 8,300 premature deaths annually. But the Bush administration said this summer it would consider allowing diesel engine makers to trade emissions credits in a more market-oriented approach to pollution curbs, rather than produce cleaner trucks and buses.

"The administration should reject this flawed approach and honor its commitment to fully implement clean air standards for diesel trucks and buses," PIRG said. Diesel engine manufacturers such as Caterpillar Inc have tried to delay the rules, contending they need more time to buy and install new technology. Currently, off-road vehicles such as construction equipment and farm tractors do not have any diesel emission standards, but the EPA has said it will consider adopting regulations. In 1996, diesel-fueled cars, trucks, bulldozers and other vehicles emitted more than 519,000 tons of diesel soot into the air, PIRG said.

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Scientists find clue to cause of possible carcinogen in french fries, other foods-(Associated Press-29/09/2002)

Scientists have found a clue to the chemical reaction that may cause potato chips, french fries and other fried or baked starchy foods to build up high levels of a possible cancer-causing substance. The suspect is asparagine, a naturally occurring amino acid that, when heated with certain sugars such as glucose, leads to the formation of the worrisome substance acrylamide. The U.S. Food and Drug Administration has made studying acrylamide's risk and determining how to lower its levels in food one of its highest research priorities, according to a plan that agency officials were to discuss with consumer groups and food manufacturers.

Canada's government made the discovery about the suspect chemical reaction and has ordered food manufacturers to look for ways to alter it and thus lower levels of acrylamide in food. Cincinnati-based manufacturer Procter & Gamble Co. says its scientists, too, have found the asparagine connection. It is the first clue to emerge in the mystery of acrylamide since Swedish scientists made the surprise announcement in the spring that high levels of the possible carcinogen are in numerous everyday foods: french fries, potato chips, some types of breakfast cereals and breads - plenty of high-carbohydrate foods that are fried or baked at high temperatures. The chemical was not found in boiled foods, which are cooked at lower temperatures.Sweden's findings were confirmed by governments in Norway, Britain and Switzerland, and preliminary testing of several hundred foods by the FDA suggests U.S. foods contain similar acrylamide levels, said Richard Canady, who is directing the agency's assessment of acrylamide's risk.

Acrylamide is used to produce plastics and dyes and to purify drinking water. Although traces have been found in water, no one expected high levels to be in basic foods. It causes cancer in test animals, but it has not been proved to do so in people. Still, Swedish scientists have said the levels are high enough that foodborne acrylamide might be responsible for several hundred cases of cancer in that country each year. In the United States, the FDA has been careful to caution that acrylamide so far is only a suspected carcinogen. The FDA has not yet advised consumers to alter their diets to avoid it. Still uncertain is whether the FDA, once it finishes testing different foods next year, will publicly identify which brands contain the most acrylamide - information wanted by consumer advocates.

For now, Canady said, "We want to reinforce ... eating a balanced diet with plenty of fruits and vegetables. That's the best way to ensure that you're getting adequate nutrition." The food industry stresses that while fried potato products are getting most of the bad publicity - most testing so far shows the highest levels in them - acrylamide is in a wide variety of foods. Procter & Gamble said that its testing found acrylamide in such previously unimplicated foods as roasted asparagus and banana chips.

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Cancer Survival Might Be Matter of Race (HealthScoutNews-23/09/2002)

Racial and ethnic differences play a part in cancer survival rates. So says a study in today's issue of Archives of Internal Medicine. National Cancer Institute researchers found that male and female American Indians and Alaskan natives had the highest relative risk of cancer death for all cancers combined -- 70 percent higher for men and 80 percent higher for women. They also had the highest risk of death for most of the four most common cancers -- breast, colorectal, lung and prostate. The exceptions to that trend were a 20 percent higher relative risk of cancer death for black men with colorectal cancer and a 60 percent higher relative risk for black women with breast cancer.

The researchers studied 917,021 men and 862,437 women diagnosed with their first cancer between Jan. 1, 1975, and Dec. 31, 1997, in nine geographic areas of the United States. Non-Hispanic whites accounted for 84 percent of all the cancer patients, while 9 percent were black, 3 percent were Hispanic whites, and less than 1 percent were Hawaiian natives, American Indians and Alaskan natives. Overall, relative risks for cancer death for all minority groups except Asian Americans were significantly higher for each of the four most common cancers and for all cancers combined. Asian men and women had the lowest relative risk (between 7 percent and 27 percent lower) for cancer death from the four common cancers. Asian American women had the lowest relative risk for all cancers combined.

The researchers say there may be a number of reasons for the different cancer death rates in ethnic groups. That includes differences in health-care access. "Some studies have reported that as many as 30 percent to 50 percent of minority women with abnormal mammography findings did not receive a timely follow-up," the authors say. "In summary, this study provides the first known population-based data on cancer-specific survival rates and relative risks of cancer death for the six major racial or ethnic groups in the United States. Additional research is needed to clarify the role of socioeconomic, medical, biological, cultural and other determinants of racial or ethnic differences in survival rates for patients with cancer described in this article," the authors say.

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Being Overweight Shown to Raise Cancer Risk (Reuters-18/09/2002)

Young overweight adults have a higher risk of dying from cancer later in life than their slimmer counterparts. New research by scientists at the University of Bristol in western England shows that every additional 11 lb. of weight increases the chances of dying of cancer. "The results of this study provide evidence for a positive association between BMI in young adulthood and mortality in later life," Dr. Mona Okasha said in a report in the Journal of Epidemiology and Community Health.

The scientists compared the adolescent body mass index (BMI), a method of measuring obesity, of 10,500 students at the University of Glasgow in Scotland from 1948 to 1968 with deaths from cancer later in life. BMI is calculated by dividing weight in kilograms (2.2 lb.) by height in meters (3.3 feet) squared. A BMI of more than 25 is overweight, higher than 30 is considered obese. During a 41-year follow-up period, 200 men and 61 women died of cancers not related to smoking. Even after taking into account other contributing factors that could increase the risk, weight still had a significant impact. "BMI in young adulthood is related to cancer mortality in later life," Okasha said, adding that it was particularly evident for breast cancer and prostate cancer deaths. The scientists called for more research into the role of weight patterns throughout life and its relation to cancer risk.

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Herbal Remedy May Be Effective Against Cancer (Reuters Health-18/09/2002)

The roots and leaves of the Petiveria alliacea L. plant--long used as an herbal remedy for various medical conditions--may also have some anticancer properties, recent study findings suggest. "Nature often creates molecules unlike any that most scientists would ever imagine, and these, particularly when they are shown to be efficacious, can provide important clues regarding how to combat a particular disease," Dr. Rabi Ann Musah of the State University of New York at Albany told Reuters Health. "The discovery of novel molecules in plants that have the ability to destroy or inactivate disease-causing microbes can often serve as templates for the creation of more potent and perhaps less toxic drugs," she added.

Native to the Amazon Rainforest, the Petiveria alliacea L. plant--commonly known as anamu--has been used extensively in South America both alone and in combination with other herbs to treat gastrointestinal inflammation, bacterial infections and some gastrointestinal and oral cancers, according to Musah. She and her colleagues conducted the current study to determine if there was any scientific evidence to back up the plant's purported healing effects. They found that of the 20 compounds present in the plant--several of which had never been identified in nature before--three were similar to compounds identified in garlic, a plant known to have certain medicinal properties. In fact, the anamu plant itself has an odor that is "very similar but different" to garlic, Musah said.

Further, laboratory experiments show that certain compounds in the anamu plant were able to differentiate between normal stomach cells and cancer cells, killing only cancerous stomach cells. The next phase of Musah's research will be to investigate the plant's cardiovascular effects, she said. Since some of the molecules identified in garlic are known to lower cholesterol and blood pressure, it is suspected that their counterparts in the Petiveria alliacea L. plant may have the same effect. The study findings were presented in Boston during the recent annual meeting of the American Chemical Society.

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Patents to Expire on Cancer Drugs (Reuters Health-16/09/2002)

Cancer drugs worth more than $15 billion will lose patent protection over the next decade, triggering a dramatic influx of cheaper generic equivalents that will enable more patients in developing countries to be treated, analysts said on Monday. "This translates into enormous cost savings for consumers, as generic drugs are typically priced at around 30% to 60% of the price of the original," they said in a report from Datamonitor. "This will allow effective treatment of more patients for the same cost in developed markets, and greater availability of cancer therapies in developing markets, which face restrictive healthcare budgets."

The loss of patent protection on so many important cancer drugs offered a "dramatic new opportunity" for generic manufacturers. But it posed a "considerable threat" to revenues of research-based pharmaceutical companies. The report says blockbuster drugs facing imminent patent expiry include AstraZeneca's breast cancer drug tamoxifen, marketed under the brand name Nolvadex, which loses market exclusivity in the US in February 2003. "Tamoxifen is considered to be the gold-standard hormonal treatment for breast cancer, used as both first-line treatment for postmenopausal early-stage patients, and as a preventative treatment. Global sales of tamoxifen in 2001 were $1,024 million."

Bristol-Myers Squibb's platinum-based drug Paraplatin (carboplatin), which had sales in excess of $700 million in 2001, faced US patent loss in 2004. The drug is indicated for ovarian cancer but is also used in several other cancer types including lung cancer.

Combined sales of sustained-release leuprolide products made by Abbott, Takeda and TAP Pharmaceuticals for prostate cancer exceeded $1 billion in 2001, with US patent expiry starting in 2004.

"The launch of a generic equivalent to the widely used cancer drug paclitaxel in the US by Ivax Pharmaceuticals in 2000 illustrates the potential value of high sales cancer products to the generics industry," the report notes. "Bristol-Myers Squibb's original branded paclitaxel product, Taxol, achieved global sales of almost $1.6 billion in 2000, of which $988 million was from the US market. (But) BMS saw US sales of Taxol drop by 45% to $545 million in 2001, with sales in 2002 not expected to exceed $200 million following a price drop and further generic competition."

Paul Tunnah, cancer analyst at Datamonitor, said traditional strategies, such as the extensive patent litigation pursued by BMS and AstraZeneca to defend their products, could be rendered obsolete by proposed regulatory reform in the US. The US McCain-Schumer Act, recently approved by the Senate, would plug loopholes that allow pharmaceutical manufacturers to delay generic drug launches if signed into law by the president.

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Cutting Copper to Combat Cancer (HealthScoutNews-13/09/2002)

Researchers at the University of Michigan have unraveled some of the cellular mechanisms that explain why a particular drug is able to slow the growth of some cancerous tumors. The drug, tetrathiomolybdate or TM, was originally developed to reduce excess copper levels in patients with Wilson's disease, a rare and potentially lethal genetic disorder. Scientists had noticed in other research that blood vessels didn't grow well when copper levels were depleted. Dr. Sofia D. Merajver, senior author of the study appearing in the current issue of Cancer Research, and her colleagues wondered if using the drug to lower copper levels in cancer patients would reduce the uncontrolled growth of blood vessels that fuel tumors. "We surmised that perhaps the copper requirement for angiogenesis was higher than for very fundamental single cell processes that depend on copper," says Merajver, an associate professor of internal medicine and director of the University of Michigan Breast and Ovarian Cancer Risk Evaluation Program.

Angiogenesis refers to the growth of blood vessels, a normal and essential process. Uncontrolled angiogenesis, however, is an important factor contributing to the growth of cancerous tumors. When the researchers gave TM to mice that had been programmed to develop cancer, no cancer growths appeared. In fact, lab mice given TM on a regular and long-term basis thrived, though their mammary glands harbored tiny cancers that were not acquiring blood vessels. The next -- giant -- step was to see what would happen in humans. "Nobody had intentionally made humans copper deficient. This wasn't a joke," Merajver says. "Here we were taking people walking and talking. It was not completely obvious that this was an OK thing to do." But it soon became obvious.

In 1997, Merajver opened clinical trials involving humans with end-stage cancer, people who had exhausted all other options. Among 42 patients, almost half (45 percent) experienced stabilization or some regression of their disease, an effect that lasted for six months or more. This was among a group of patients with a typical life expectancy of about three months. One patient from that trial is still alive and has been on TM for four years.

Throughout the last six years of research, Merajver and her colleagues have been searching for the magic "why." Why do low copper levels have this effect on tumors? As it turns out, the explanation is deceptively simple. A master switch that controls many different molecules that promote angiogenesis and inflammation is inhibited by a copper deficient environment. "It's a very efficient way to turn things off," Merajver explains. "It's a brand new concept that copper plays any role at all in the master switch. This was completely unknown." The drug is unlikely to play a role in advanced cancer but could be promising for early stage cancer, she says. "We are very excited about the practical applications and we are also very excited about perhaps opening the door to new avenues of basic science investigation," says Merajver. While the findings may be cause for quiet celebration, experts caution that the results are extremely preliminary.

"It's obviously very interesting. But I think one of the problems is that [people develop] great expectations and, unfortunately, in the world of angiogenesis, there has been a lot of tremendous enthusiasm with very little proof that any of the agents have an effect in terms of the clinical care of patients," says Dr. Jay Brooks, chief of hematology/oncology at the Ochsner Clinic Foundation in Baton Rouge, La. "That does not mean that this research should not go on but to actually translate this into clinical practice will take time," he says.

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Swedish review of cell phone studies finds no 'consistent evidence' of cancer link (Associated Press-18/09/2002)

A review of cell phone studies commissioned by the Swedish Radiation Protection Authority has found no "consistent evidence" of an increased risk of cancer from usage, the agency said. Studies have differed on whether the use of mobile phones increases the risk of cancer as the handsets have become increasingly popular and efficient. The governmental agency asked Dr. John D. Boice, Jr. and Dr. Joseph K. McLaughlin of the International Epidemiology Institute in Rockville, Maryland, to evaluate all published epidemiological research on the subject. The review included factors such as type of phone, duration and frequency of use and brain tumor location and found that more research was needed.

"No consistent evidence was observed for increased risk of brain cancer (or other forms)," the agency said in a news release. The agency acknowledged public concern in the issue and said many studies were still being performed and continued follow-up was needed on any possible carcinogenic effect linked to mobile phone usage. "You can never say that something is without risk, but at least we can say that there is no scientific evidence for a causal association between the use of cellular phones and cancer," said Lars-Erik Paulsson, a radiation expert with the agency.

The review singled out research by Swedish oncologist Lennart Hardell, which said that long-term users of old-fashioned analog cell phones were at least 30 percent more likely than nonusers to develop brain tumors. Newer digital phones emit less radiation than older analog models of the sort studied. Hardell has testified in connection with a 800 million dollars lawsuit against Motorola Corp. and other major mobile-phone carriers that was brought by Christopher Newman, a Maryland doctor stricken with brain cancer. Hardell, whose study was published recently in the European Journal of Cancer Prevention, studied 1,617 patients with brain tumors and compared them with a similar-sized group of people without tumors. He could not immediately be reached for further comment. The review said that Hardell's study and some U.S. research with similar findings was "non-informative, either because the follow-up was too short and numbers of cancers too small, or because of serious methodological limitations."

It contrasted those with three hospital-based case-control studies in the United States, a registry-based case-control study in Finland and a registry-based cohort study of over 400,000 cellular phone users in Denmark. Those studies found "a consistent picture... that appears to rule out, with a reasonable degree of certainty, a causal association between cellular telephones and cancer to date," the agency said.

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Preserving Fertility After Radiation Treatment (Cancer Page-02/09/2002)

Results of laboratory tests on mice may in the future offer hope of protecting fertility of young women undergoing radiation treatment for cancer. Researchers at the Memorial Sloan-Kettering Cancer Center and Harvard Medical Center have discovered that a naturally occurring compound protects the fertility of mice after radiation. Not only are the female mouse eggs protected from radiation induced cell death, but they appear to be no more genetically compromised than eggs of mice not subjected to radiation.

Ovarian failure and infertility are common side effects of many cancer treatments including radiotherapy and chemotherapy. While advances in cancer treatments have significantly improved survival, especially for children with cancer, many times these miracle treatments have left the survivors sterile and unable to have children of their own. If this early research on laboratory animals proves true for humans, female cancer survivors may be able to lead more normal reproductive lives.

Richard Kolesnick, MD, and Zvi Fuks, MD, of Memorial Sloan-Kettering Cancer Center and Jonathan Tilly, PhD, of Harvard Medical School set out to test the benefits of adding the naturally occurring compound sphingosine 1-phosphate (S1P) to the ovaries of irradiated mice. The body produces S1P in response to stresses that can lead to cell death (apoptosis.) In the case of radiation damage, the cell protection offered by S1P is overwhelmed, leading to widespread cell death. Could S1P be augmented to offer extra protection for immature eggs (or oocytes) against radiation-induced cell death in the ovaries? And, assuming they could be protected, would they be worth saving or would the added S1P simply keep genetically damaged oocytes alive? Researchers found that if they injected S1P into the ovaries of mice right before radiation treatment, the oocytes did not die as normally happens. Without S1P treatment, oocyte numbers were significantly reduced in irradiated animals compared to non-irradiated animals. S1P treated animals had oocyte numbers in the normal range of the non-irradiated group. The researchers found that the S1P-protected oocytes had DNA damage at a level similar to the residual population of non-protected irradiated oocytes.

As there was no apparent increase in damage, they wanted to see if any damage would be passed on to subsequent generations. Mice were mated starting two months after irradiation. In the offspring, researchers found that "S1P-based protection of the female germ line from radiation is not associated with discernible propagation of genomic damage." The offspring had genetic abnormalities similar to the number found in age-matched non-irradiated controls. Before this research ever gets to the human testing stage, researchers will want to make sure that S1P does not allow genetically compromised human eggs to survive and possibly pass mutations on to future generations. "If we eventually get to test this question in humans we will have to go back and again make sure that we’re not preserving damaged oocytes," Kolesnick tells cancerpage.com The research by Kolesnick, Fuks, and colleagues did not investigate using S1P to protect fertility against chemotherapy agents but because it has shown promise in the test tube, chemotherapy testing will likely be the next course of animal study

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EPA: Diesel Exhaust Can Cause Cancer (Associated Press Writer-01/09/2002)

Inhaling diesel exhausts from large trucks and other sources over time can cause cancer in humans, an Environmental Protection Agency report concludes after a decade of study. The EPA finding is expected to buttress the government's push to reduce truck tailpipe emissions by requiring cleaner-burning engines and diesel fuel with ultra-low sulfur content. While acknowledging uncertainties about the long-term health effects of exposure to diesel exhausts, the EPA report said studies involving both animal tests and occupational exposure suggest strong evidence of a cancer risk to humans. "It is reasonable to presume that the hazard extends to environmental exposure levels" as well, the report said. "The potential human health effects of diesel exhausts is persuasive, even though assumptions and uncertainties are involved."

The report mirrors conclusions made previously in documents from various world health agencies and studies in California and is particularly significant because the EPA is the federal agency that regulates diesel emissions under the Clean Air Act. Some environmentalists have raised concerns recently that the Bush administration might try to back away from a Clinton-era regulation that would establish tougher requirements on emissions from large trucks and a separate rule that virtually would eliminate sulfur from diesel fuel. EPA Administrator Christie Whitman repeatedly has promised to go ahead with the tougher truck and diesel rules. Last month, with White House approval, the EPA rebuffed attempts by some diesel engine manufacturers to postpone the requirements, approving new penalties against manufacturers who fail to meet an October deadline for making cleaner-burning truck engines. The engine rule does not affect emissions from trucks already on the road, although the separate regulation cutting the amount of sulfur in diesel fuel is expected to produce pollution reductions.

The EPA's 651-page diesel health assessment did not attempt to estimate the probability of an individual getting cancer, given certain exposure to diesel exhaust. Such a risk assessment is commonly made by the EPA when gauging pollution health concerns. But in this case, the report said, "the exposure-response data are considered too uncertain" to produce a confident quantitative estimate of cancer risk to an individual. Nevertheless, said the report, the "totality of evidence from human, animal and other supporting studies" suggests that diesel exhaust "is likely to be carcinogenic to humans by inhalation, and that this hazard applies to environmental exposure." The report reiterated that environmental exposure to diesel exhausts poses short-term health problems and in the long term has been shown to be a "chronic respiratory hazard to humans" contributing to increased asthma and other respiratory problems. In some urban areas diesel exhausts account for as much as a quarter of the airborne microscopic soot, the report said.

Environmentalists welcomed the study as clear evidence that pollution needs to be curtailed not only from large trucks but also from off-road diesel-powered vehicles. EPA spokeswoman Steffanie Bell said the agency expects to publish a rule early next year dealing with those diesel exhaust sources, which include farm tractors and construction equipment. Emily Figdor of the U.S. Public Interest Research Group, a private environmental organization, said: "To reduce the public's exposure to harmful diesel emissions, the Bush administration should ... fully implement clean air standards for diesel trucks and buses and should pass equivalent standards for diesel construction and farm equipment." Allen Schaeffer, executive director of the industry group Diesel Technology Forum, said the EPA's report "focused on the past," whereas "the future is clean diesel. Diesel trucks and buses built today are more than eight times cleaner than just a dozen years ago." The report acknowledged that its findings were based on emissions levels in the mid-1990s, but said the results continued to be valid because the slow turnover of truck engines has kept many of these vehicles on the road.

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Third Parties Helpful During Doctor-Patient Visits (Reuters Health-19/08/2002)

Many individuals find it helpful to take a family member or friend along when they visit the doctor. And in the long run, both patient and doctor appear to benefit from the presence of a third party, researchers report. "Companions that patients choose to bring to their medical visits are generally very helpful and improve the communication and understanding that occurs between the patient and the physician," lead study author Dr. Lisa M. Schilling of the University of Colorado Health Sciences Center in Denver told Reuters Health.

Schilling and her team analyzed nearly 1,300 patient visits to determine the frequency, role and influence of companions during outpatient visits. Overall, patients were accompanied by a companion in nearly 3 out of every 10 visits, and in 16% of the cases, the companion also followed the patient into the examination room, the researchers report in The Journal of Family Practice. In most cases (93%), the companion was a family member. Reasons given for the accompaniment included helping patients with transportation, giving them emotional support and keeping them company, the report indicates.

In the examination room, companions helped facilitate better doctor-patient communication, helped the patient to remember the physician's advice and instructions, helped the patient make decisions and expressed their own concerns to the physician. In fact, according to patients, their companions favorably influenced three out of four of their medical visits, particularly by helping them better communicate with their doctor, the authors note.

Doctors also agreed that their patients' companions were an asset during the medical visits, the researchers report. Six out of every 10 physicians said that the patients' companions helped them better understand their patients, and 46% said the companions helped increase the patient's own understanding. Altogether, waiting room companions were "very helpful" for nearly three out of four visits to the doctor, according to patient reports. And examination room companions were even more helpful, study findings indicate.

In light of the findings, "people might want to consider bringing a companion to their doctor's visit," Schilling said. "A lot of information is exchanged during one's visit with a doctor and having a trusted friend or family member present may help you and your physician," the researcher added.

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Report Cites 'Dangerous' Cancer Advice on Web (Reuters Health-20/08/2002)

Some Internet sites that promote alternative remedies for cancer are potentially dangerous to patients, according to the results of a new survey. The study of 13 alternative medicine sites revealed that some discourage patients from using conventional treatments, such as chemotherapy, and instead promote alternative remedies for which there is little or no evidence of effectiveness. The findings, by researchers from the department of complementary medicine at the University of Exeter, are highlighted in an editorial in the latest edition of the British Journal of Cancer. Research leader Professor Edzard Ernst said many of the sites recommended a multitude of treatments, with little consensus among them. "Cancer patients get confused in the maze of claims and counter claims and often turn to the Internet for information which can give advice that has led to real harm and even death in some cases," he said in a statement.

Ernst and fellow researcher Katja Schmidt found 5 of the 13 Web sites offered potentially harmful advice to patients and said that two more, in their opinion, were "dangerous." One of the sites lists what it describes as botanical cancer cures like goldenseal, pokeroot, wild indigo, thuja, figwort and red clover. But Schmidt stressed: "There is no evidence that any of these herbal medicines cure cancer." However, the researchers praised the award-winning site run by the charity Cancer Research UK as "a very useful source of information" that discusses complementary as well as conventional cancer therapies.

Schmidt told Reuters Health that most questionable Web sites appeared to be based in the US. But she said that rather than being forced to close, the sites should be encouraged to subscribe to Health on the Net--a code of conduct that seeks to raise the quality of health information on the Web. Sally Penrose, chief executive of the British Homoeopathy Association, said the organization does not condone any claims that homoeopathic medicine can treat or cure cancer on its own. But she added that at least two National Health Service homoeopathic hospitals in the UK do have experts who specialize in cancer care. "Homoeopathy is never, as far as I'm aware, used as a solo treatment for cancer," Penrose said. "But it is used in a complementary and palliative way."

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Scientists Find Potential New Cancer Therapy (Reuters-07/08/2002)

Australian scientists have found that a master gene appears to play a key role in switching on and off genes that kill cells, a discovery that could offer a new way to fight cancer. Researchers at Monash Institute in Melbourne found that after deleting the molecule ETS1 from mouse embryonic stem cells, the cells were less susceptible to programmed cell death or apoptosis. Apoptosis is the body's way of killing cells, including pre-cancerous or damaged cells, that it does not want or need. "It means that one day, cancers may be able to be treated with therapies that focus on ETS1 in addition to the pathways through which it works," Monash Institute of Reproduction and Development researcher Dakang Xu said.

The findings, published in the European Molecular Biology Organization Journal, identified the mechanism by which ETS1 contributes to cell death. As a potential target for fighting cancer, drug companies could look to enhance the function of ETS1 to kill pre-cancerous cells, said Xu's colleague Trevor Wilson. "We've identified this in a mouse model system. The next step is to go ahead and determine exactly what cancers and what proportion of cancers this is really occurring in," Wilson told Reuters. To get the research from this stage to clinical trials would take roughly another five to 10 years, he said. The cells in the experiments were not cancer cells, but Wilson said embryonic stem cells in culture, as used in the research, mutate in ways similar to pre-cancerous cells. Work on ETS1 could also have a role in future embryonic stem cell research, which hinges on finding how cells grow, differentiate and die as they transform themselves into the different tissues of the body. Stem cell research is a hot topic as scientists believe the master cells could provide repair kits for a range of problems from diabetes to spinal injuries.

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Green Tea Cancer Benefits Detailed (HealthScoutNews-09/07/2002)

A researcher at the Medical College of Georgia has uncovered specific information about how green tea helps fight cancer. A study by cell biologist Dr. Stephen Hsu says that compounds, called polyphenols, in green tea activate separate cell pathways -- one in which healthy cells are moved to safety and another in which cancer cells are sent to their death. This is Hsu's latest finding on green tea's cancer-fighting abilities.

His earlier research included the discovery that polyphenols in green tea help eliminate free radicals. These free radicals can alter DNA, leading to mutations and cancer. He then identified the role of a protein called P-57, which regulates cell growth and differentiation. Hsu found this P-57 protein changes the behavior of healthy cells as the polyphenols target cancer cells. In this latest study, Hsu discovered the polyphenols actually separate healthy cells containing the P-57 protein from cancer cells, which lack the protein. While the healthy cells are sent to safety, the polyphenols attack the cancer cells. The polyphenols go after the cancer cells' mitochondria, the main energy source in cells. The destruction of the mitochondria weakens the cancer cells, and eventually leads to their death. The study was published in a recent issue of General Dentistry.

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Britain Has World's Largest Drop in Cancer Deaths-(Reuters-03/07/2002)

Britain has recorded the world's biggest decreases in early deaths from lung and breast cancer in recent decades thanks to better diagnosis and treatment and more smokers quitting, scientists said. Twenty-five years ago, tobacco caused more than half the cancer deaths in men under 70 years old and a growing proportion of women, but the latest statistics show tobacco-related deaths have fallen by half in men. In women they are half what they would have been if females who smoked in the 1970s continued the habit.

"We've got the best decrease in the world in lung cancer deaths and we've got the best decrease in breast cancer deaths," Sir Richard Peto, of the charity Cancer Research UK, told a news conference. Britain had one of the worst cancer death rates in the 1950s but during the 1990s premature deaths from cancer fell by one fifth--the greatest decrease of any time during the previous century. "This was partly, as is the case with breast cancer, because of better diagnosis and treatment. But a large part of the decrease was as a result of smoking cessation. Half of those who keep on smoking will eventually be killed by their habit," Peto added.

Sir Richard Doll, the epidemiologist who first identified the link between smoking and lung cancer, said Britain has been enormously successful in persuading people to quit smoking. "As a result, the death rate from lung cancer is tumbling more quickly than anywhere else in the world," he said. In addition to causing 90% of lung cancer cases, smoking also contributes to stomach, liver, kidney and cervix cancers and a type of leukemia. Deaths from breast cancer had risen during the past century because more women are living longer and having fewer children.

Women with more children have a lower risk of developing the disease. But in the 1990s, screening to detect the disease at its earliest and most curable stage and improvements in treatments, including chemotherapy drugs and tamoxifen, pushed death rates in women under 70 years of age down by 30%--the sharpest drop in the world. Tamoxifen stops cancer by blocking hormone receptors on the cancer cells and chemotherapy drugs kill cancerous cells in the body. Peto had previously calculated that 20,000 breast cancer deaths in Britain and 40,000 in the United States had been avoided in the 1990s because of improvements in treatment. The statistics presented by Doll and Peto were up to 1999. Peto believes death rates for both lung and breast cancers will continue to drop in the coming decades. He emphasized the importance of quitting smoking in bringing down cancer rates. Half of all people who smoke will be killed by a tobacco-related disease and a quarter will die in middle age. Peto added that better understanding of the causes of other types of cancer, including colon and stomach, are leading to further drops in cancer deaths.

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Couch Potatoes Court Cancer-(HealthScoutNews-02/07/2002)

Americans are so fat and lazy they may not even be able to help themselves any longer. That's the conclusion of the American Cancer Society, which estimates that as many as 180,000 Americans each year will die of cancers related to obesity and lack of activity. Overweight people are particularly at risk for colon and breast cancer, researchers say. Facing an epidemic of obesity, the cancer society is calling on governments, schools and businesses to help promote exercise and healthy living in communities. "The environment in which we live -- where we work, where we play, where we hang out -- has really become a barrier in terms of making choices," says Colleen Doyle, director of nutrition and physical activity for the cancer society.

Subdivisions without sidewalks. Shopping centers located miles from any homes. Fast-food restaurants on every corner. Cutbacks in school physical education programs. Reduced leisure time in two-income households. These have all contributed to a couch potato society, Doyle says. "The way we build, it's harder for people to walk places or to find safe places to be active," she says. "The environment really has an impact on the kind of individual choices we make. We need walking paths, bike lanes, buses that have racks for bikes." The cancer society revises its guidelines on diet and exercise every five years. The latest version, released earlier this spring, calls for society to wage war against obesity.

"Obesity and inactivity are like our version of the infectious diseases of 100 years ago," says Dr. Anne McTiernan, director of the Prevention Studies Clinic at the Fred Hutchinson Cancer Research Center in Seattle and a member of the committee that wrote the cancer society guidelines. "At least 35 percent of all cancer deaths may be related to overweight and lack of activity," she says. "In order to help people, we are really recommending that communities get involved." Of course, individuals can still make choices that lead to healthier living. As it always has, the cancer society is urging Americans to eat better and exercise more. That means eating at least five servings a day of fruit and vegetables and getting moderate exercise for 30 minutes a day, five days a week. Studies have shown people who maintain a healthy weight are less prone to developing colon and breast cancer, in particular. All the details aren't known, but McTiernan says exercise is believed to speed the passage of food through the colon, thereby reducing the amount of time that any toxins are in contact with the body. Overweight people also tend to have more insulin, which promotes the growth of tumors. For women, exercise reduces the level of estrogen, a hormone linked to breast cancer. Even after menopause, exercise reduces the estrogen level and the risk of breast cancer, says McTiernan

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Personality Not a Cancer Risk Factor-(HealthScoutNews 11/06/2002)

Don't blame your cancer on your personality. Danish researchers have concluded that, on its own, personality is not a risk factor for cancer, although it may be linked to behaviors -- like smoking, for example -- that are linked with an increased risk. Previously, investigators have found links between psychic vulnerability and other physical symptoms and diseases such as pain, irritable bowel syndrome and peptic ulcer disease. Studies have also suggested that such specific personality traits as depression and repression are associated with an increased risk of developing cancer. The study, which appears in the June 15 issue of Cancer, is the first to look at the link between "psychic vulnerability" and cancer. And experts say the findings should reduce people's stress over whether stress causes cancer.

"I think it's a fairly widespread belief that stress causes illness of all sorts, and, in particular, cancer. But there's really not a shred of evidence, and this study helps to put this issue in a more proper scientific framework," Dr. Jeffrey Weitzel, director of clinical cancer genetics at the City of Hope Cancer Center in Los Angeles, says. Two competing theories seek to explain the apparent connections between cancer and personality traits. One posits that personality leads to behaviors (like smoking) that influence the risk of cancer. Another theory says there's a common underlying biological factor, which impacts both personality and the risk for cancer. In this study, the researchers used the "Test of Psychic Vulnerability," originally developed to identify men who were not psychologically fit for military service, to test for a cancer association. The exact meaning of the term is somewhat elusive.

"You cannot say it's clearly neurotic, but a little bit insecure," says the lead author of the study, Dr. Christoffer Johansen, head of the psychosocial cancer research department at the Danish Institute of Cancer Epidemiology. People who have psychic vulnerability, he adds, are "not so good in social relations and have problems obtaining friendship. It's a kind of a social-psychological mismatch with the average population." "The researchers looked at various psychological conditions that are probably fairly widespread, and the good news is that they did not find an association," Weitzel says. "It's a reasonable scientific study, especially from a psycho-epidemiologic perspective."

The study looked at data, including demographic and health questionnaires as well as the Test of Psychic Vulnerability, from 5,136 people living in Copenhagen County in Denmark. This information was then cross-referenced with the Danish Cancer Registry to find associations between cancer and personality, age, alcohol consumption, smoking, social class, marital status or body mass index. Even after adjusting for various known cancer risk factors, the investigators did not see an increased risk for cancer in relation to psychic vulnerability. Not surprisingly, however, older people had an increased risk, as did those who smoked and those who drank more than 14 units of alcohol a week.

Very often, cancer patients point to a stressful event in their life and feel it has a causative effect on their illness, says Ruth Oratz, an associate professor of clinical medicine at New York University School of Medicine, who also emphasizes that there is no evidence for this point of view. "It's not that there's no link between our emotional state and physical health, it's just that that link is probably not a strong direct link," she says. But there may be an indirect link, and these findings buttress the hypothesis that personality traits lead to behaviors (smoking and drinking alcohol included), that, in turn, translate into an increased risk for cancer. "We didn't find an increased risk of cancer, but what is interesting is that there was an increased number of smoking- and alcohol-associated cancers in psychically vulnerable individuals," says Johansen. The conclusions also suggest where to aim future prevention efforts. "It shows a new theme for prevention of smoking," Johansen says. Another paper by the same authors, this one appearing in this week's American Journal of Epidemiology, linked 90,000 depressed individuals with an elevated cancer risk and an increased risk of smoking. "This points to the fact that more of the smoking prevention activities should be aimed at people who are depressed and who demonstrate psychic vulnerability," Johansen says. And for cancer prevention in general, it comes back to the same old story: Eat a balanced diet with lots of green leafy vegetables, cut out tobacco and drink alcohol only in moderation, advises Weitzel.

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Energy Drink Gives Cancer Patients a Boost (Reuters-11/06/2002)

A drink that raises levels of a compound that helps metabolize food into energy can give cancer patients a much needed boost, Italian doctors said. Patients taking chemotherapy drugs can suffer from extreme tiredness because the treatments can deplete levels of carnitine, a natural substance in the body. Scientists at the Urbino Hospital in central Italy found that a pineapple-flavored drink containing a compound called levocarnitine, which the body converts into carnitine, helped most patients recover from their fatigue within a week. "After one week their fatigue diminished and their levels of carnitine improved," Dr. Francesco Graziano said in an interview. Patients with advanced lung, pancreatic and gastric cancers who are given the drugs cisplatin and ifosfamide can suffer from depleted levels of carnitine. "Our study was the first to take this new approach to treating fatigue and the results, although preliminary, are very encouraging," Graziano added.

In research reported in The British Journal of Cancer, the scientists measured carnitine levels in the blood of 50 cancer patients suffering from fatigue and gave the energy drink to each one twice a day. A week later they found patients' average blood carnitine levels had risen by 50%, while 45 of the 50 patients said they had more energy. "The quality of life of our patients improved markedly over the course of the week, and it seems likely that the improvements were a result of the supplement they were taking," Graziano said in a statement. The scientists are planning a larger, randomized study comparing the energy drink to a placebo. Only patients taking cisplatin and ifosfamide were given the drink, but Graziano said in the future it may help patients taking other cancer drugs that have a similar effect. "We now need larger scale trials, to test the extent to which the supplement can restore patients' energy levels. It could become an important way of maintaining quality of life for patients undergoing intensive treatment for cancer," Graziano added.

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Rich Nations Have Higher Cancer Prevalence (Reuters-06/06/2002)

Rich nations such as Sweden, Switzerland and Germany have the highest prevalence of cancer in Europe while Poland, Estonia and Slovakia have the lowest, according to a survey. Countries with low infant mortality and high gross domestic income tended to have higher cancer prevalence--the number of patients with the disease at a given time--than their poorer neighbors. The high prevalence in wealthier nations is linked, at least in part, to better detection and improved survival rates. Low prevalence is due to a low incidence of the disease but also a high mortality rate. "The study documents for the first time what the prevalence of cancer is across countries," Professor Michel Coleman of the London School of Hygiene said in an interview. It shows that about two percent of the population are cancer survivors, he added.

Dr. Diane Stockton, of the Scottish Cancer Intelligence Unit in Edinburgh, said the research shows that almost half of people living with cancer have survived more than five years since being diagnosed with the disease. Breast cancer accounted for 34% of female cancers and women made up 61% of the total cancer prevalence, mainly because so many are being successfully treated for the disease and surviving. The most prevalent cancer among men was colorectal cancer, which made up 15% of all male cancers. "A poorer country's cancer mix will tend toward cancers of poor prognosis and those of a more advanced stage, and this caseload, coupled with a lower expenditure on health, will inevitably deliver a lower overall cancer survival rate and a comparatively low cancer prevalence," Professor Graham Giles, of CCRI, Cancer Epidemiology Centre in Carlton, Australia, said in an editorial in the journal. Information on three million patients from 38 cancer registries in 17 countries was used in the study.

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More Fiber, Later Periods (HealthScoutNews-10/06/2002)

The higher the fiber intake of young girls, the more likely their periods will occur later than average. That's the finding of a new study by researchers at the University of Toronto. And later periods, in turn, reduce the risk of getting breast cancer later in life, previous research suggests. "This is the first study to actually focus on fiber and components of fiber [and its effect on the onset of menstruation]," says Malcolm Koo, assistant professor of public health sciences at the University of Toronto, who led the study, published in the journal Public Health Nutrition. Other studies have evaluated fiber and other dietary components, body weight, a mother's age of first menstruation and additional factors to predict when a girl's periods will start.

Koo's team evaluated 589 girls, ages 6 to 14, taking into account their weight, physical activity and mother's first menstruation. The researchers also asked the girls about their dietary fiber intake. The age of menstruation onset varied from 8.5 to 15.6 years, with a median of 13.6. In the United States, the average age of menstruation onset is 12 or 13 years. Least likely to menstruate at younger ages were those girls who ate the most fiber. Those who ate about 25.5 grams a day were half as likely to have early menstruation as those in the lower intake group, who averaged 18.2 grams daily. The fiber lowers the body's estrogen levels, Koo says, and that delays the onset of menstruation. "Dietary fiber can bind with free estrogens in the intestinal tract, increasing the elimination of estrogen from the body," he says. "The more estrogen circulating in the bloodstream, the earlier menstruation starts. By keeping the concentration of estrogen in the body low, you delay the onset of menstruation."

In his study, Koo also found that girls who eat high amounts of monounsaturated fats, such as olive and canola oils, also have later onset of menstruation. "Some previous studies have shown that a high-fat diet leads to early onset of periods because of higher body fat [from eating a lot of fat]," Koo says. But he found that did not apply to the monounsaturated fats. Although there is no formal recommendation for dietary fiber intake in the United States, most experts recommend adults take in between 20 grams and 35 grams a day.

According to Koo, the general guideline for children is the child's age plus 5 to 10 grams. A girl aged 10, for instance, could take in about 20 grams of fiber a day. A one-cup serving of raisin bran cereal has four grams, for instance, and a raw unpeeled apple has about three grams. Another expert has praise for the study, but says it still doesn't completely answer the question of timing of onset of menstruation. "I think that the conclusions are pretty good," says Dr. Donna Shoupe, a professor of obstetrics and gynecology at the Keck School of Medicine at the University of Southern California, Los Angeles. But she wonders if the fiber deserves all the credit. "It has long been known that a critical body weight seems to trigger pubertal events; the problem is that no one really knows why. I think that those who eat lots of fiber tend to be those who also eat less fat and carbs (carbohydrates) and are more slender."

But Koo is convinced it's the fiber. "I adjusted for body weight, so that consideration is taken care of," he says. "It's important to know your daughter's dietary fiber intake," Koo tells parents of young girls. Increasing the fiber just slightly, he says, could delay onset of menstruation and reduce the risk of breast and other cancers later in life. Even if the fiber doesn't succeed in delaying menstruation onset, he says, there are other benefits to hefty amounts of fiber. "It helps prevent chronic diseases, such as high blood cholesterol, [and] reduces the risk of colon cancer," he says. And, of course, it's good for promoting regularity.

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Post-Cancer Childbirth Findings 'Reassuring': Report-(HealthScout News Service-28/05/2002)

Not long ago, simply surviving cancer was a feat for women of reproductive age, but the possibility of becoming pregnant or having a healthy child was generally ruled out. But preliminary reports on research coming out this summer suggest that a surprising number of former cancer patients go on to have healthy children with few numbers of congenital abnormalities and very low cancer rates, reports the New York Times today.

The findings, due to soon be published in the American Journal of Obstetrics and Gynecology, come from an ongoing study of 20,000 cancer survivors from 25 cancer centers around the nation. While higher rates of miscarriage and lower birth weights were indeed observed among the survivors, the results are nevertheless encouraging, say experts. Without providing details, lead researcher Leslie Robison, an epidemiologist at the University of Minnesota Medical School, told the Times "The data are extremely reassuring. It's a very good-news type of report."

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Scientists begin urgent meeting on cancer fears from acrylamide in food-(AP Writer-25/06/2002)

European, North American and Japanese scientists specializing in cancer-causing agents in food began an urgent meeting to pull together information on the newly suspected substance acrylamide. Meanwhile, the U.S. consumer group Center for Science in the Public Interest released findings in Washington from a study confirming inital tests reported in Sweden that found high levels of acrylamide in some fried foods. Acrylamide, used to produce plastics and dyes and to purify drinking water, has been shown to be carcinogenic in animal experiments and is suspected of causing cancer among people exposed to high levels for long periods. Although traces of it have been found in water, its possible presence at high levels in basic foods came as a shock. The initial alarm was raised by the publication in April of a Swedish study that some starch-based foods cooked at high temperatures contained acrylamide. Subsequent studies in Norway, Britain and Switzerland basically backed up the findings of Sweden's National Food Administration, officials at the World Health Organization said.

However, a number of scientists have voiced misgivings about the validity of the Swedish results, which were based on 100 foods, and were released at a government news conference rather than passing through normal peer review procedures in a scientific journal. The U.S. federal Food and Drug Administration, meanwhile, said it has developed its own method to test precise levels of acrylamide in foods and has begun testing dozens of different products. "We're also trying to see ... why the acrylamide is developing under these various cooking processes," FDA food safety chief Janice Oliver told The Associated Press. That's a critical question, because understanding what makes acrylamide form could in turn lead to ways to limit, perhaps even eliminate, the substance. Until scientists have completed enough research to tell what the different levels in food may mean for health, consumers shouldn't panic, Oliver said. "Consumers should eat a balanced diet consisting of a wide variety of foods from a wide variety of sources," the FDA food safety chief said.

In Geneva, about 25 scientist from universities and national food authorities, including the U.S. Food and Drug Administration, were meeting behind closed doors in the three-day U.N.-sponsored session. In Washington, the consumer group said that the tests it commissioned on a dozen popular brands found high levels of acrylamide in some brands of french fries and potato chips. The U.S. findings agreed with European findings that french fries had the highest levels of acrylamide. A large serving of McDonald's fries had the most, 72 micrograms, of the four fast-food competitors tested. The U.S. consumer group compared that to the U.S. Environmental Protection Agency's limit of 0.12 micrograms in a glass of drinking water. But the U.S. group found puzzling variation in levels.

One brand of corn chips had a tiny amount of acrylamide while another had a moderate amount and a brand of similarly made corn taco shells had lots. No one knows why there would be such variation because so little is known about how acrylamide forms, said Michael Jacobson, executive director of the U.S. consumer group. "The big challenge is to figure out what are the chemical reactions and the conditions that lead to acrylamide," because there may be a way to avoid its buildup in food, he said. In their study, Swedish government scientists estimated it could be responsible for several hundred of the 45,000 cancer cases in the country each year, based on experiments in which rats were fed fried food. Jorgen Schlundt, coordinator of WHO's food safety division, said the type of cancers provoked by acrylamide in animals were not just limited to the digestive tract, but also included the mammary and testicular glands, and skin. But he stressed there was no evidence to suggest this could apply to humans.

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Study: Farmworkers More Diseased-( Associated Press Writer-17/03/2002)

A state agency's study found that Hispanic farmworkers have higher rates of brain, leukemia, skin and stomach cancers than other Hispanics in California, a phenomenon their union blames on pesticide exposure. Female Hispanic farmworkers also had more cases of uterine cancer than the rest of the state's Hispanic women, according to the Cancer Registry of California study, "Cancer Incidence in the United Farm Workers of America, 1987-1997." The study, published in the the American Journal of Industrial Medicine, doesn't directly link pesticide use to the higher rates of cancer. Another study will examine what pesticides were used and how long farmworkers were exposed to them, said Paul Mills, the study's author and cancer epidemiologist at the Cancer Registry.

But the UFW believes there is a direct relationship between the chemicals and cancer, said Doug Blaylock, the union's medical plan administrator.

Bob Krauter, California Farm Bureau Federation spokesman, said that without discounting for family histories and lifestyles, there's no way to prove a direct link. "Just because workers work in an agricultural setting where pesticides were used, they say, 'We're attributing this to pesticides.' I just don't see the connection there," he said.

Joseph Wiemels, a cancer epidemiologist at the University of California at San Francisco, cautioned that with general population studies like the registry study, "there are so many opportunities for bias because you're roughly putting data together."

The registry used data from 146,581 farmworkers who had been members of the union from 1973 to 1997 and compared it with the state's general Hispanic population. It found that out of more than 140,000 farmworkers, 1,001 had been diagnosed with cancer from 1973 into 1997, and that there were 59 percent more reports of leukemia and 69 percent more reports of stomach cancers than there were in California's general Hispanic population. The study found fewer incidents of breast and colon cancer among the farmworkers than there were in the state's general Hispanic population, but did not offer an explanation for the finding. Mills said the study's results show the lack of health care and education available to the farmworkers. The farmworkers were diagnosed at a later stage than most of the state's Latinos, according to the study. Many cancers, such as uterine cancer, are more treatable with early detection, Mills said.

Armando Sanchez, 66, who spent 40 years spraying chemicals on vineyards and citrus orchards in the Imperial Valley, blames the pesticides for his leukemia. Employers provided workers with gloves and masks, but Sanchez said it was often too hot to wear them. Temperatures often rise above 100 degrees where he worked near Palm Springs. Krauter noted that rates of pesticide injuries and illness have declined in the past 20 years. In 2000, the state Department of Pesticide Regulation recorded 893 incidents, down 1,201 from 1999, according to a recent report.

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Prozac Scientist Plays Down Cancer Fears-(Reuters-26/03/2002)

Prozac and related antidepressants could in theory pose a cancer threat by blocking the body's innate ability to kill tumor cells, British scientists said. But Professor John Gordon of the University of Birmingham, who led the research, said patients should keep taking their drugs since there was no evidence of any link in practice.

In test-tube research, Gordon and others found the brain's mood-regulating chemical serotonin caused some cancer cells to self-destruct. Eli Lilly and Co's Prozac, Glaxo SmithKline Plc's Paxil and Lundbeck's Celexa all "substantially blocked" this process.

The finding reopens controversy about the widespread use of the class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) that first went on sale in the 1980s. Millions of people with depression and anxiety have been prescribed the drugs, which have emerged as one of the biggest sellers for the international pharmaceutical industry. They work by stopping serotonin getting into cells. Gordon's discovery that serotonin plays a role in killing a type of cancer called Burkitt's lymphoma was published in the online edition of the medical journal Blood.

"We've shown that, in the test-tube, the SSRIs stop the action of the serotonin on the cancer cells. But it's nigh on impossible to extrapolate to what's happening in the body," Gordon. "We must stress the effects shown for SSRIs on cancer cells is indirect and should cause no concern whatsoever to the many millions of people throughout the world who are prescribed this class of antidepressants."

A spokesman for Britain's Department of Health said the research was at a very early stage and no increased risk of cancer had been detected.

Rather than being alarmed, Gordon is excited a new class of anti-cancer drugs may one day be developed that exploits serotonin's ability to kill cancer cells. "Because we know the mechanism, we are now in a position to develop drug analogs of serotonin that will do the same job but have better pharmacological properties," Gordon said.

His work also provides an intriguing insight into the way that "positive thinking" associated with serotonin levels may play a key part in effective cancer care.

The mechanism by which serotonin can get inside cancer cells and tell them to commit suicide -- a process known as apoptosis -- suggests there is a clear "dialogue" between the brain and the immune system, he said.

Prozac was the first SSRI to reach the market in 1987 but it has since been overtaken by Paxil, also known as Seroxat, which racked up sales last year of 1.86 billion pounds ($2.7 billion). Drug company officials said they did not believe their pills caused any rise in cancer and questioned whether the high doses used in Gordon's experiments may have affected the results. "These data are from an in vitro (test tube) study and as such they cannot be extrapolated to a clinical setting with any degree of certainty," said Martin Sutton, a spokesman for GSK.

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Research gives hope to cancer patients-(The Age-05/03/2002)

Cancer patients could reduce their symptoms and live longer by taking part in group therapy, thinking positively and meditating, Australian researchers claim. The University of Newcastle scientists found "a dramatic decrease in physical symptoms" among patients who talked openly about their illness and learnt relaxation techniques.

John Shea, the senior lecturer in psychology who conducted the pilot study, plans to embark on a more comprehensive, three-year study to prove his controversial thesis. The benefits of psychological techniques such as relaxation and group therapy have been hotly debated since 1989, when Stanford University scientists in the United States found breast cancer patients who took part in group therapy lived up to 18 months longer. Over a six-month period, Dr Shea compared the symptoms of 21 cancer patients who took part in special "support groups" with 50 who did not. "The differences were profound," he said. "We found a dramatic reduction in physical symptoms in people who attended our groups."

Patients reported improvements in a wide range of physical symptoms including pain, stomach upsets, hair loss and sleeping. One man from the support group, who had two brain tumours, had gone into complete remission, which doctors had attributed to chemotherapy. He plans to use up to 400 cancer patients for the next study. The support group discussed their illnesses to rid themselves of "negative emotion". Patients were also introduced to past research that suggested relaxation improved immune responses.

David Vaux, a principal research fellow at the Walter and Eliza Hall Institute, said there was no scientific evidence to prove cancer patients who meditated and went to support groups lived longer. "If you can make people happier when they're suffering from a major disease, that's a good thing, but there's no evidence that it increases life expectancy," he said.

Cancer experts - even those sceptical about alternative treatments - agree that positive thinking improves cancer patients' quality of life. Afaf Girgis, director of the Cancer Education Research Program of the NSW Cancer Council, said psychological techniques could be beneficial as long as they did not replace traditional methods of treatment. "It would be irresponsible to promote them as an alternative," she said. "(But) a lot of people report them to be helpful to see them through the experience of treatment like chemotherapy."

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Cancer patients have to wait too long in UK: Report-(Times of India Online-04/03/2002)

The number of cancer patients waiting a dangerously long time for radiological treatment in Britain has doubled in two years, according to findings reported in the Observer. The newspaper said a survey by the Royal College of Radiologists found that the number of patients starting treatment within the government's target time of four weeks fell from 68 percent in 1998 to 32 percent in 2000. It said the average waiting time for radiotherapy climbed from 5.1 weeks in 1999 to six weeks in 2001, but that there were huge variations from area to area.

At one unidentified hospital, one in 10 patients have to wait more than eight months for radiology, the report said. "In particular, we're concerned that cancers may be spreading to areas outside the areas in which they started, while patients are waiting for treatment. And we know that in general, once the cancer has spread, your chances of cure have dropped dramatically," the report's author, Dr Nick James of Birmingham University's Institute of Cancer Studies said.

Cancer survival rates are lower in the United Kingdom than many other European countries. Government targets say all cancer patients should start radiotherapy within four weeks after their specialist recommends the treatment.

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Nuclear testing caused 11,000 cancer deaths-(Times of India Online-03/03/2002)

Radioactive fallout from Cold War nuclear testing exposed virtually everyone in the United States, and contributed to about 11,000 cancer deaths, an unpublished study by the national Centers for Disease Control and Prevention concludes. The radioactive exposure also contributed to a minimum of 22,000 U.S. cancer cases overall, according to a progress report the CDC provided Congress last year. The report first came to light in USA Today.

The study is the first to consider the health effects of nuclear detonations - including those performed by foreign countries - between 1951 and 1962, when above-ground testing was banned. It is also the first to consider forms of radioactive fallout other than iodine-131, the most serious public health threat posed by atmospheric nuclear tests.

A 1997 assessment by the National Cancer Institute found that 11,300 to 212,000 thyroid cancers could have been caused by iodine-131 produced in nuclear explosions at the Nevada Test Site. The new CDC research does not challenge that result, and suggests iodine-131 fallout is responsible for almost all ill health effects from nuclear testing.

The CDC report does conclude, however, that nuclear testing has been responsible for about 550 leukemia deaths since 1951. The number of cancer cases attributable to nuclear testing is small, relative to other causes. For example, among the 3.8 million Americans born in 1951, who would have been exposed to the highest fallout levels in their most vulnerable early years, testing is expected to account for an estimated 1,000 additional cancer deaths. Smoking, in comparison, is expected to account for about 250,000 cancer deaths in the same group.

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Pranayam has scientific basis, says US expert-(Times of India Online-03/03/2002)

Yogic breathing techniques may be doing much more than relieving stress. A senior psychiatrist at Columbia University, New York, Dr Richard P Brown, says certain techniques may actually help people connect better with each other and regulate their dietary intake and thereby help lose weight. In New Delhi to participate in a two-day international symposium on Sudarshan Kriya, Pranayam and consciousness organised by the Institute Rotary Cancer Hospital at the All India Institute of Medical Sciences in association with the Times Foundation, Brown has been experimenting with meditation techniques to cure his patients of depression.

Here is how, he explains, yogic breathing techniques such as Pranayam and Sudarshan Kriya can activate certain positive bodily processes: Rapid breathing activates a nerve, Vagus, that connects with the diaphragm and some of the organs, including the heart and the brain. As a result of this stimulation, messages are sent along three different pathways that tell the body to shut off areas of worry while awakening areas that control feelings of happiness in the brain.

So, one pathway is created that leads up to the frontal cortex of the brain and starts shutting down areas controlling excess worries and depressions. Another pathway shuts off anxiety producing parts of the brain stem and a third wakes up the limbic system, which controls positive emotions, explains Brown. At the same time hormones are released that encourage connectedness in mammals. One such hormone, called the Cuddle hormone, released during sexual activity and also after child birth, is said to be released after the Sudarshan Kriya. The hormone encourages bonding.

He said that quite early on in his practice of psychiatry he began getting dissatisfied with the effects of drugs. ''I began looking for natural treatments. People responded to it very well. '' He then tried meditative techniques, but some of them were found to be strenous. ''The best results so far have been with Sudarshan Kriya,'' he said. ''Other techniques are either so difficult to do that people just stop practising them or take 30 years or more to show results,'' adds Brown, with a long standing interest in complementary medicine. ''The impact with the Art of Living course on Pranayam and Sudarshan Kriya, was so significant that I started sending people with horrible depressions and they became better,'' he added. ''People sent me 'thank you' notes even months later.'' Doctors need to understand that there is a scientific basis to it and it is not just a suggestion. It helps control eating disorders as well.

''People often soothe themselves by eating.'' But after this course, as the tension drains off, people can actually begin to lose weight. The hormone that promotes connectedness also has a relationship with a peptide hormone. Controlling the release of this hormone can in turn influence hunger and the body's ability to take only the required amount of food. ''People question me on whether I am following a cult and my answer has been 'If it's a cult, it's a cult of love. And it only encourages people to help others.''

For more information, contact, C-9 Green Park Extension, Phone:6562606 or Dr Vinod Kochupillai, Head, Institute Rotary Cancer Hospital, AIIMS. Phone:6516821.

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Scientists mull on ways plants protect against cancer -(Times of India Online-27/02/2002)

Scientists said they had gained fresh insight into how a natural anti-fungal agent found in grapes and other crops may help prevent cancer. Researchers from the School of Pharmacy at De Montfort University in Leicester, central England, reported in the British Journal of Cancer that resveratrol is converted in the body to a known anti-cancer agent which can selectively target and destroy cancer cells. Although previous studies have suggested plant-oestrogen might prevent cancer, they said it was the "first time that scientists had gained an insight into the underlying mechanism of the chemical's anti-cancer properties".

Professor Gerry Potter, the research group leader, said in a statement: "Resveratrol is a defensive molecule against fungus in grapes and other crops, and is found at higher levels in those which have not been treated with man-made fungicides. "Learning from nature in this way will help in our work to design drugs which are selectively activated in a tumour and can form the basis of anti-cancer treatments."

The researchers found that resveratrol is processed by the enzyme CYP1B1, which is found in a variety of different tumours. This converts resveratol into piceatannol, a closely related plant-oestrogen with known anti-cancer activity. Previous research by the team has shown that this process is restricted to the tumour itself, limiting the toxicity to the cancer cells and serving to selectively destroy them.

Scientists previously believed that CYP1B1 was a cause of cancer, because it is only found in tumours and not in healthy tissue. They now think the enzyme is there to fight it and the team is continuing research into ways to help it in its work. Potter said: "The belief that CYP1B1 is a cause of cancer is like blaming police for a crime just because they are on the scene.

"We suspected this natural product might be beneficial for health and have cancer preventative properties. This research shows just how it could prevent tumours developing by producing these anti-cancer molecules within the cancer cells themselves." The team is also looking into the beneficial effects of vegetables such as broccoli and cabbage that contain a molecule that activates the CYP1B1 enzyme.

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Chemotherapy may prove fatal-(Times Of India Online-26/02/2002)

A study of chromosomes in cancer cells has concluded that normal cells develop fragile regions when they are exposed to drugs used in chemotherapy and thus plant the seeds of a future cancerous growth while they are killing the current one. The research was conducted at the Hebrew University of Jerusalem lead Associate Professor of Genetics Batsheva Kerem also renowned for her work on the genetics of cystic fibrosis. She said that her research can lead to the development of more effective and less damaging chemotherapy drugs.

Prof. Kerem explains that in studying the differences between cancerous and healthy cells they found that the chromosomes of cancerous cells break recurrently at specific regions known as "fragile sites." In a previous study, researchers showed that fragile sites are sites where the mechanism responsible for DNA replication is disturbed. This could lead to breakage resulting in multiple rearrangements of the chromosomes, a striking characteristic of cancer cells.

Prof. Kerem explained that there are some 100 fragile sites in the human genome and five of these sites are now being studied. "Our work creates a better understanding of how drugs used against cancer work, which will lead to the creation of the next generation of drugs, which can halt the growth of cancerous cells without inducing fragile sites", a researcher said.

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Pregnant Cancer Patients Can Be Treated Without Harming Fetus-(Cancer Page-23/01/2002)

Pregnant patients with cancer need to be diagnosed and treated promptly, without either terminating the pregnancy or waiting for delivery, according to Dr. Elyce Cardonick, speaking at the 22nd annual meeting of the Society for Maternal-Fetal Medicine in New Orleans. In a prospective study that tracked maternal and neonatal outcomes after the mothers received chemotherapy during pregnancy, Dr. Cardonick and her colleagues found no increase in preterm delivery or growth restriction.

In a second prospective study, they found that infants exposed to chemotherapy after the first trimester were not at risk of preterm delivery, low birth weight, neutropenia, alopecia, myocarditis, or rashes.

"The majority of cancers are not worsened by pregnancy, although the treatment is more complicated," Dr. Cardonick told Reuters Health. "Also, the majority of cancers are not improved by termination of pregnancy." Dr. Cardonick is an assistant professor of maternal-fetal medicine at Thomas Jefferson Medical College in Philadelphia. "The problem with cancer in pregnancy is that the patient is afraid, and the physician is afraid, too," she said. "Therefore, diagnosis is delayed and the condition worsens. It's not the pregnancy that makes the cancer worse. It's the delay in diagnosis and treatment." Another dilemma is that some of the common occurrences of pregnancy, such as constipation, fatigue, and anemia, would cause suspicion of cancer if the patient were not pregnant.

The first study included 42 pregnant cancer patients: 18 with breast cancer and 4 each with melanoma, and tumours of the thyroid and central nervous system, respectively. Other cancers included Hodgkin's lymphoma, leukemia, and cancers originating in the ovaries, lung, vulva, cervix, and bladder.

At diagnosis the mean gestational age was 17.2 weeks. Of the six women advised to terminate pregnancies, four did so. Among the remaining patients, four had preterm deliveries. Two women were induced at 31 and 32 weeks, respectively, to avoid fetal exposure to cancer treatment, one was induced at 35 weeks because of pre-eclampsia, and one spontaneously delivered twins at 29 weeks. The infants' mean birth weight was 2798 g, with two below the 10th percentile for gestational age.

The second study included 18 pregnant patients undergoing chemotherapy. The mean gestational age at cancer diagnosis was 15.8 weeks. All patients were treated after the first trimester; no patients underwent radiation therapy.

The only fetal malformation occurred in an infant who was born with syndactyly of the right hand. The child had been exposed to multi-agent chemotherapy regimen at 14.6 weeks gestation while the mother was being treated for Hodgkin's lymphoma.

The only pregnancy complication was uterine contractions due to dehydration; this complication did not result in delivery. The infants' mean gestation age at time of delivery was 36.9 weeks; the mean birth weight was 2742 g. One infant's birth weight was below the 10th percentile for gestational age.

"If the fetus is 12 weeks or older, you can give chemotherapy without an increased risk of birth defects, mental retardation, or compromise in immune function," Dr. Cardonick told Reuters Health. "There are several diagnostic procedures that are safe to perform at that point in pregnancy, such as mammography and biopsies of several types of tissue."

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Ovary experiment gives hope on cancer, transplants-(Times of India Online-21/01/2002)

A successful experiment freezing the ovaries of rats could offer new hope to cancer patients, who fear treatment could make them infertile and to those waiting for transplants of hard-to-store organs. Researchers from Canada's McGill University and the University of Washington in the United States said they had restored fertility to laboratory rats after transplanting stored ovaries. A majority of the seven rats in the test regained their fertility and one became pregnant. It is thought to be the first time previously frozen organs have been successfully transplanted in animals or humans.

Dr Roger Gosden, who conducted the research in Montreal, said the technique could be used to preserve the fertility of women undergoing chemotherapy, which can damage the ovaries and cause premature menopause. If the technique is perfected and proven safe in humans, ovaries could be removed before cancer patients had treatment, frozen, and then replaced at a later date. The research may also shed new light on how to store other organs for later use to overcome the growing shortage of fresh kidneys, hearts and lungs needed for transplants.

"The ultimate goal was to try to store whole organs," Gosden said in a telephone interview. He described the results as encouraging and said that if studies on larger animals such as sheep and primates were successful human trials could follow.

It could offer women an alternative to freezing their eggs and give cancer patients who are too young to produce eggs the option of having children later in their lives. But Gosden said transplanting donated ovaries into women would not be an option because of rejection problems. "Frozen banking of reproductive organs could eventually be useful in breeding from endangered species and as a fertility option for women and children who have undergone sterilising chemotherapy," Gosden and his colleagues said in a report in the science journal Nature.

The scientists removed the ovaries and stored them in liquid nitrogen for several hours before transplanting them into genetically identical animals so the organs were not rejected. Gosden said the technique would be the same if the organs were frozen for an hour or 100 years.

The ovary may be more suitable for storing than other organs because it is a small, dynamic and can repair itself if there is some damage, Gosden explained. Freezing whole organs has been problematic because of tissue damage that can be caused by the freezing and thawing process. "The length of time in liquid nitrogen is not an issue," he added. Gosden performed a successful ovarian graft on a young American woman in 1999 to relieve menopausal symptoms after both her ovaries had been removed for medical reasons.

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Modern medicare transcends space-time barriers : Expert-(Times of India Online-17/01/2002)

"Patients from even remote areas could access highly specialised medical expertise," said Richard Kitney, professor of biomedical systems engineering at Imperial College in London, in a presentation on 'Key trends in health care and tele-medicine' organised by British Council and Gujarat Cancer Research Institute, as a part of the India-UK Science Festival.

Kitney talked about the convergence of biotechnology, digital communications and bio-medical research and its revolutionising impact on the health care delivery system. The new trend is to give integrated care by optimising the use of healthcare resources and bring cost control, quality and uniformity in global healthcare delivery system with the use of information technology. "And this is like reinventing healthcare as a knowledge industry providing border-less medicine and personalised health plans," he said.

Using powerful personal computers, available cellular network and web browsing technologies, a hospital can get connected with major healthcare centres world-wide. "With up-coming sound broad bandwidth and cellular network, hospitals in remote.

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Mouse to help detect tumour, heart trouble-(Times of India Online-10/01/2002)

Imagine a diagnostic tool that can give a complete three-dimensional view of your arteries, or a mammogram that alerts the doctor even before he can react to the signs of a tumour. Or a system that allows you to access all your medical records in any part of the world, with just the click of a mouse. All this and much more promises to rapidly change the way diseases are diagnosed and treated.

Rapid advances in medical technology are being combined with fast acting drugs to revolutionise medical care. So, not surprisingly, a high-profile British delegation to the ongoing India-UK Science Festival includes a professor of biomedical systems engineering at Imperial College of Science, Technology and Medicine, London, Professor Richard Kitney.

Kitney has not only designed an electronic patient record system that allows direct access to data such as elctro-cardiograms, X-rays and ultrasounds, but has also come up with systems to detect infants at risk of sudden infant death syndrome, early detection of breast cancer and for early detection of heart diseases. The electronic patient record system has already been put into place in some major hospitals like the University of California hospital, Los Angeles.

Another system developed for use with a mammogram helps flag areas of concern in the images for the clinician, who may be too tired after looking at hundreds of such images during the day, to react. However, this software does not replace the clinician but only helps in better diagnosis.

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Cancer panacea long way off -(Times of India Online-09/01/2002)

A single drug therapy for all forms of cancer may be a long way off, but as scientists put together the pieces of cancer cell proliferation jigsaw, treatment for conditions once considered a death sentence is gradually coming into sight. Already drug companies are trying to work towards treatment methods based on Nobel Laureate Paul Nurse's discovery, pinpointing the exact mechanisms of cell growth that eventually leads to cancer. While Nurse is not sure to what extent these drugs would prove beneficial, he believes moving towards finding a cure is a gradual process.

Sir Paul Nurse has identified the exact mechanism that controls the division of cells, an invaluable advance for the current knowledge on cancer. Nurse, who is visiting Delhi for an India-UK Science Festival, received last year's Nobel Prize for medicine for discovering the mechanism.

Cancer, says Nurse, is caused when certain genes get damaged and the body, as a result, is unable to check a proliferation of its own cells. The element that leads to this damage in the gene can be anything- tobacco, betel-nut chewing, asbestos and even the hepatitis B virus are some of the identified ones.

Working on yeast cells, which, though simple, resemble the structure of human cells, Nurse found that a specific enzyme, Cyclin Dependent Kinase (CDK) located on specific genes signals the cells to reproduce. The human cell, he found later, also worked in a similar manner. Such cell division, which goes on all the time, stops when the body senses a damaged gene. The CDK is signalled to stop this process. Cancerous cells, however, overcome this mechanism and go on proliferating, leading to a mass of cells, known as tumours, which then break off and travel to all parts of the body.

The body's check-point controls, to know whether all genes are copied correctly and whether any of them are damaged, are also defeated by the cancer-causing cells. ''We still do not understand the basic mechanism of the check-point control. Once we do, we will have better drugs,'' adds Nurse.

His current work involves studying cell shapes and processes that control them. Cancerous cells need to change their shapes so they can filter through tissues and reach all parts of the body. There are no answers available immediately as to how this happens. ''As of now, we have some cures that work against some cancers,'' he says. At this stage, he adds, the important thing is to know that cancer, if detected in time, is not a death sentence. ''We should be quietly optimistic, otherwise it is not realistic,'' says the scientist, who is now working as director-general of the Imperial Cancer Research Fund.

''Cancer treatment will gradually improve,'' he says, even he cautions against expecting any miraculous results. ''And perhaps in another 30 years we may have something that works for several cancers.''

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Tea helps prevent cancer, arthritis: Study-(Times of India Online-07/01/2002)

Tea, an antidote for environmentally induced diseases, decreases the harmful effect of tobacco and could help prevent tooth decay and diseases like cancer, arthritis, tumours, diabetes and certain skin infections, a panel discussion at the Indian Science Congress here felt. Recent researches have proved that tea which contained vitamins, flavonoids, proteins, poly-saccharides and poly-phenols, helps in absorbing fats, provides self-resistance and promotes blood circulation in a controlled way, the discussion on `Environment and Health' said.

According to a research paper ` Drinking of the Millennium Tea' presented by a group of researchers led by Dr Hasan Mukhtar, tea has the potential of giving quality to human health. The session, chaired by eminent scientist and former director of Central Drug Research Institute (CDRI), Prof B N Dhawan, said the non-alcoholic beverage makes the defence system of the body strong.

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Viruses to tackle cancer-(Cancer Info-06/01/2002)

Scientists are harnessing the ability of viruses to infect cells to treat a range of deadly cancers. A team from Hammersmith Hospital in London is launching a series of pioneering clinical trials to discover whether the technique can produce tangible results. They believe the use of genetically engineered viruses could prove to be more effective than conventional drug and radiation therapy. And they hope that the approach could help to increase survival rates for patients with solid tumours.

Despite advances in many forms of cancer care, the survival rate for solid tumours has changed little over the last ten years. Viruses have been successfully used to infect and destroy cancers in the laboratory. But until now it has proved difficult to replicate the results in humans. The problem has been how to engineer the virus so that it is effective at attacking cancer tissue, but does not cause significant damage to healthy cells.

Dr David Kirn, head of Hammersmith's viral and genetic therapy programme, has produced a mutant virus which can do this. Trials of this agent, and a number of other potential candidates, are due to start on humans in the next few months. Drug and radiation therapy rely on a single mode of attack designed to prompt cancer cells to commit suicide. However, in most cases solid tumours quickly develop resistance to these treatments.

Dr Kirn said the new approaches were not only potentially more potent, but did not rely exclusively on triggering cell death. He said: "Viruses have evolved over millions of years to express many of the qualities required for the ideal anti-cancer weapon. "Viruses will target and infect very specific types of cell (in this case cancers), multiply, cause cell death and release more viral particles to go on and infect other target cells. "Furthermore, the ability of viruses to replicate once inside the tumour tissue allows for an enormous amplification of the delivered dose precisely within the target site." Dr Kirn said the virus approach was also likely to lead to less side effects than current therapies. A review of work in this field is published in the journal Lancet Oncology.

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Human trial for the first DNA vaccine soon -(Times of India Online-06/01/2002)

The world's first DNA vaccine which would use the human immunodeficiency virus (HIV) that causes AIDS as the carrier is all set for human trials, according to a leading biologist. "A successful trial would open new vistas in the much acclaimed gene therapy," Dr Inder Verma said at the 89th Indian Science Congress here.

The virus will be used after removing the harmful genes from it, he said, adding, "The virus has a total of nine genes out of which six are harmful, while the remaining three are harmless. The scientists have already succeeded in isolating and removing the harmful genes and the stage is now set for the testing of the new therapy on human beings."

The US Food and Drug Administration (FDA) has approved the human trial of the DNA vaccine using a "defanged AIDS-causing virus" as the carrier. The animal trials have been successful and the new therapy would be first tried out on HIV patients, he said.

Addressing the Congress, Verma said that gene therapy would be mainly used to treat two types of diseases genetic diseases and acquired diseases. Cancer, whose usual treatment is chemotherapy, surgery and radiation, could also be treated with this emerging field of medicine. Verma said over 600 gene therapy trials have been conducted world over, but only few have become successful due to lack of expertise in the execution process.

"We are still not clear on how to introduce the gene, how long the gene will be there, how the genes will express the proteins and what is the long term impact of these proteins on the body, he added.

Though needles can be used to insert genes, the method is an ineffective one, he said adding the better way to insert genes is to use viruses that have an inbuilt capability of infecting the cells at an extraordinary fast pace. The virus can be genetically engineered to knock off the deleterious genes and replace them with genes that could produce therapeutic proteins.

"The main rationale for using the HIV virus is that it has one of the best capabilities in terms of delivery of therapeutic genes since it has one of the highest rates of multiplication to deliver the genes into brain, liver, brain and blood cells," he said.

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Anti-cancer protein may play role in ageing-(Times of India Online-01/01/2002)

A natural protein that suppresses cancers may also help regulate ageing, says a study that suggests mice age faster if the protein is overactive. The results "raise the shocking possiblity that aging may be a side effect of the natural safeguards that protect us from cancer," noted Gerardo Ferbeyre of the University of Montreal and Scott Lowe of Cold Spring Harbor Laboratory in Cold Spring Harbor, New York. They wrote a commentary accompanying the mouse study in the journal Nature. The study was done by scientists at the Baylor College of Medicine in Houston and elsewhere.

The protein is called p53. Cells produce it at the direction of the p53 gene, which is the best-known example of a "tumor-suppressor" gene. Mice that lack p53 rapidly succumb to cancer. The new work found that mice that appeared to have an overactive p53 protein because of a genetic mutation showed signs of premature aging, such as osteoporosis, organ shrinkage and shortened lifespan. Despite their rapid aging, the mice resisted tumor development, which fits with p53's anti-cancer effect.

The results may simply mean the genetic mutation produces a highly abnormal disease, but they might also reveal a role for p53 in normal aging, Ferbeyre and Lowe wrote. One disturbing possibility is that drugs used to treat cancer in young people might spur p53 activity and so speed up age-related disorders later on, they wrote.

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