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Overall Decrease In Kidney Cancer Deaths In Europe (Yahoo News - 12/04/2008)
Overall deaths from kidney cancer have now fallen across Europe after peaking in the early 1990s, according to a detailed analysis of mortality rates for 32 countries published in the urology journal BJU International.
The review is based on official death records collated by the World Health Organization from 1984 to 2004.
Male deaths from kidney cancer showed an overall reduction of 13 per cent between 1992 and 2002 across the European Union and female deaths fell by 17 per cent during the same period.
Figures for the previous decade had shown a 17 per cent rise for men and an 11 per cent rise for women.
Women are significantly less likely to die of kidney cancer than men - between 2000 and 2004 the death rate was 1.8 per 100,000 people for women and 4.1 for men.
"It is clear from our study that death rates for kidney cancer peaked in the 1990s and are now showing an overall downward trend" say lead authors Professor Fabio Levi from the University of Lausanne, Switzerland, and Professor Carlo La Vecchia from the University of Milan, Italy.
"However we found wide variations between countries when it came to deaths from kidney cancer and incidence of the disease."
The largest reductions in kidney cancer deaths between 1992 and 2002 were in Austria (down 33 per cent for men and 32 per cent for women) and Germany (down 31 per cent for both men and women).
When it came to incidence rates, the largest reductions for men between 1992 and 2002 were in Sweden (down 18 per cent) and Finland (down 11 per cent) and for women in Sweden (down 19 per cent) and Denmark (down 12 per cent).
"Our study confirms that overall kidney cancer rates declined in the 1990s and that these decreases have been larger in men, people who are middle-aged and in western European countries" says Professor Levi.
"The fall in male deaths is consistent with the links between tobacco usage and kidney cancer risk as men, particularly those from western Europe, are the group who have shown the most favourable changes in smoking habits over the last few decades."
There are a number of factors that may play a role in reducing the incidence of kidney cancer and death rates from the disease.
"Dietary factors might also play some role" says Professor Levi. "Although their influence on kidney cancer remains unclear, some studies have shown that people who eat a diet rich in vegetables and fruit are less likely to develop the disease.
"Other factors could include reduced exposure to occupational carcinogens, although the risk of such carcinogens on kidney cancer remains unclear."
The authors say that there may also be a link with better control of high blood pressure, a known risk factor for the disease, and better control of urinary tract infections.
"The current study quantifies recent reductions in kidney cancer deaths and, to a lesser degree, the incidence of the disease" concludes Professor Levi.
"But apart from the role played by reduced tobacco smoking in men, interpretation of these trends remains open to discussion."
Kidney cancer treatment option (Health Team 8 - 10/04/2008)
There is a new option for people diagnosed with kidney cancer and the procedure stops the tumors cold.
Raking leaves takes little effort for Bill Magner. But when doctors discovered a tumor in his right kidney, he was a bit skittish.
"It was very small and it was on the outer edge," Bill said. Cancer had already claimed Bill's other kidney.
"I was probably nervous what else they might find. I really didn't want to be cut," said Bill.
Fortunately, Bill was able to avoid surgery because kidney cryoablation is now an option.
"Using the CT scanner, our ideal is to place this probe right through the middle of the tumor," explained Dr. John Straub from Jefferson Radiology.
Dr. Straub performed Bill's procedure at Hartford Hospital. "The probe has argonne gas running through it, it doesn't get into the patient. It stays in the probe and when it goes through a tiny appeture in the probe, that gas expands and when it does it causes extreme cooling which causes an ice ball," said Dr. Straub.
The procedure takes about 90 minutes under local anesthesia. "We freeze for 10 minutes, thaw for 8 minutes, then freeze again for 10 minutes and that cycle destroys all the cells.
"We were talking back and forth about different things and I said have you started yet and he said he was almost finished," Bill said.
Dr. Straub says the recurrence rate for patients like Bill is less than five percent. "If there is no tumor a year out, and the area that we've treated is shrinking down, the chance of a recurrence in that area is very small," he said.
Another tumor could still pop up elsewhere on the same kidney and that's why Bill will be monitored closely.
The procedure is ideal for patients with small tumors in the kidney. Surgery is still the standard treatment but doctors say that could change with this less invasive procedure.
Antigenics wins Russian approval of cancer vaccine( Reuters - 8/04/2008)
The tiny biotechnology company Antigenics Inc said on Tuesday it has won approval to market its kidney cancer vaccine, Oncophage, in Russia, making it the only cancer vaccine available in the world.
The product was approved despite failing to win approval in the United States. It is the first time the Russian government has approved a drug that was not first cleared in its country of origin, Antigenics said.
The company expects to launch Oncophage and potentially begin generating revenue in the second half of this year.
Antigenics is also planning to file for approval of the vaccine in Europe by the end of the year. Unlike the United States, European regulators are sometimes willing to approve a drug on a conditional basis, meaning companies can market their products while simultaneously conducting additional follow-up of patients or further clinical studies.
If at the end of the trial period the regulatory agency is not satisfied, it can pull the drug from the market.
"Filing in Europe won't be a slam dunk, and will probably be more difficult than in Russia," Garo Armen, the company's chief executive, said in an interview.
He added that the European review process would likely take 12 to 18 months.For
Antigenics, the Russian approval caps years of dogged determination to bring the vaccine to the market despite the failure of a major clinical trial and investor skepticism towards the cancer vaccine field in general.
Oncophage is designed to reprogram a patient's immune system to target cancer cells from a specific tumor.
The company takes tissue from a tumor following surgery, extracts certain proteins it says activate the immune system and then injects the enriched protein back into the body through the skin.
FAST-GROWING MARKET
A late-stage trial of Oncophage in 2006 failed to show that the vaccine delayed the recurrence of kidney cancer. However, in a subset of patients -- those whose cancer was least likely to recur following surgery -- Oncophage lengthened the period before which the disease recurred by 45 percent, or an average of 1.8 years, versus those in the control group.
The U.S. Food and Drug Administration does not consider subset analysis a valid measure of success or failure since all manner of sub-populations can be carved out retrospectively.
Even so, in this case, Russian regulators have accepted the validity of the subset, in part because roughly a third of the 604 patients enrolled in the late-stage trial were tested in Russia, and about 70 percent of those fell into the subset of patients whose prognosis following surgery was better than that of the total population.
There are about 16,000 new cases of kidney cancer a year in Russia, according to Armen, of which about a quarter fit the profile of patients most likely to benefit from Oncophage -- a market theoretically worth about $200 million to Antigenics.
The Russian pharmaceuticals market is one of the fastest growing in the world. It will grow by nearly 60 percent to $19.4 billion in 2009 from about $12.3 billion in 2006, the research group DSM estimates.
Armen said he expects the initial sales ramp-up for Oncophage to be "modest."
"We would have to price this probably at the low to mid range of other new-generation cancer drugs," Armen said.
Such drugs can cost as much as $60,000 per patient per year, he said. "How much of that market we achieve depends on how well we iron out reimbursement issues and how effectively we can reach every single patient," said Armen, who is learning Russian to help him in the task.
Antigenics, which also receives royalties on a vaccine component known as QS-21 that turbocharges the power of vaccines in general, said Oncophage would need to generate roughly $30 million in sales in order for the company as a whole to become profitable.
Shares of Antigenics have fallen roughly 54 percent to $2.50 over the last 12 months.
(Additional reporting by Ben Hirschler in London; Editing by Gary Hill)
Panel sees promise in Novartis' cancer drug (East Bay Business Times)
Novartis AG said Thursday that an independent data monitoring committee stopped a major trial of an investigational drug after interim results showed significantly better survival rates in kidney-cancer patients taking the therapy.
Novartis, a Swiss company with Emeryville operations, was in Phase III of clinical trials, generally the last trial stage before drug companies seeks regulatory approval, for a once-a-day oral therapy called
everolimus). The independent committee stopped the trial, involving some 400 patients in a dozen countries, because the study met its primary endpoint.
The company will present complete results of the study as a late-breaking abstract for presentation at the American Society of Clinical Oncology annual meeting in May.
The company also plans to start worldwide regulatory filings for the drug, beginning with the United States and the European Union in the second half of 2008.
The study showed that patients who took the tablet by mouth once a day had better chances of progression-free survival than those in the placebo group.
Researchers say the targeted therapy could have promise for people with late-stage renal-cell cancer. Researchers are also evaluating the drug's use in neuroendocrine tumors, lymphoma and other cancers.
Belly fat, weight cycling ups kidney cancer risk-
(Reuters- 05/10/2007)
Postmenopausal women who are overweight or obese appear to have a greater risk of developing, renal cell carcinoma, a common form of kidney cancer, and study findings suggest that a larger waist girth and a history of weight loss and regain further increase this risk.
"Our study suggests that the risk of renal cell carcinoma can be lowered if overweight individuals lose excess central body fat and then maintain stable weight at a more desirable level," Dr. Juhua Luo, of Karolinska Institutet, Stockholm, Sweden told Reuters Health.
Luo and colleagues analyzed data from more than 140,000 U.S. women, aged 50 to 79 years, enrolled in the Women's Health Initiative study.
They compared associations between the development of renal cell carcinoma, a cancer of the lining of the kidney, and the women's body weight and frequency of weight loss and regain (weight cycling) over an average of 7.7 years.
The findings are published in the American Journal of Epidemiology.
Overall, obese women with a body mass index (BMI) at or above 35, had a 60 percent excess risk of renal cell carcinoma compared with women of normal weight (BMI less than 25), the researchers note. This risk increased 3 percent for every unit increase in BMI.
When the investigators analyzed abdominal obesity as an independent risk factor they found that each 0.1-unit increase in waist-to-hip ratio increased the risk of developing renal cell carcinoma by 24 percent.
Moreover, women with a history of 10 or more weight cycles had more than double the risk of developing renal cell carcinoma, compared with women who held a steady weight over the study period, the investigators note.
The researchers say their findings provide further evidence that obesity, particularly central adiposity, is associated with increased risk of developing renal cell carcinoma, and that a history of weight cycling may further increase this risk among postmenopausal women.
Pfizer Expands Access To
Cancer Drug Sutent- (Yahoo News- 24/08/2006)
Pfizer (nyse: PFE - news - people ) announced an expansion of a program
that provides patients with access to its cancer drug Sutent, which was
recently submitted to the Food and Drug Administration and is still
considered experimental. The program will allow patients with advanced kidney cancer that has
spread to other parts of their bodies to try Sutent if they have failed
other therapies. A program in stomach lining tumors is also continuing.
Interested patients and physicians can call 1-877-416-6248 or visit
www.pfizeroncology.com.
"Kidney cancer has traditionally been a difficult cancer to treat, and to
date there have been few options to offer patients with this deadly
disease," said Bill Bro, president of the Kidney Cancer Association, in a
statement released by Pfizer. "We are pleased that continued research
efforts and new potential treatment options such as Sutent are bringing
hope to kidney cancer patients in need." Bayer and Onyx Pharmaceuticals, who are developing a competing drug that
was submitted to the FDA a month earlier than Sutent, already have their
own compassionate-use program in place for their kidney cancer pill,
sorafenib.
First U.S. Kidney Cancer Vaccine
Trial Underway At Columbia University Medical Center-(Yahoo News-27/01/2005)
The first U.S. kidney cancer
vaccine trial is now underway at Columbia University Medical Center and New
York-Presbyterian Hospital/Columbia. While the potential for vaccines to
treat solid tumors has been recognized for more than a decade, this trial is
pioneering the use of tumor immunotherapy – boosting the body’s natural
immune system – as a way to fight cancer.
“Vaccines are an exciting prospect in cancer treatment and this trial is
an example of our program’s dedication to bringing the latest advances in
tumor vaccines and immunotherapy to patients with cancer,” said Howard L.
Kaufman, M.D., associate professor of surgery and pathology at Columbia
University Medical Center and director, Tumor Immunotherapy Program at New
York-Presbyterian/Columbia. “We expect that combining IL-2 with Trovax
will double the treatment response rate for our kidney cancer patients,
offering new hope for these patients.”
Vaccines, usually associated with the prevention of infectious diseases,
e.g., measles, help the body’s immune system recognize and kill foreign
invading organisms. Recent research has provided evidence that vaccines may
also be useful for preventing or treating cancer. Tumor vaccines contain a
specific protein of the tumor cell that stimulates an immune response.
In the study, patients with stage IV renal cell carcinoma are given
regular doses of an investigational kidney cancer vaccine, called Trovax, in
conjunction with Interleukin-2 (IL-2). High-dose IL-2 is currently the only
approved treatment for kidney cancer, and Columbia University Medical Center
and New York-Presbyterian Hospital/Columbia are the only site in New York to
offer IL-2. Kidney cancer is one of the few cancers for which chemotherapies
are not effective treatments.
A small protein (cytokine) naturally produced by the cells of the immune
system, IL-2 stimulates T-cells, which are activated in an immune response
system and create tumor killing cells. The response rate (i.e., rate of
tumor shrinkage) of IL-2 given alone is typically 17-25 percent. While IL-2
stimulates all T-cells, the Trovax Vaccine helps IL-2 selectively target
only cancer cells, reducing side effects by not targeting and unnecessarily
killing normal cells. Trovax has shown promise in similar trials conducted
in Europe in colon cancer.
About Trovax
Trovax belongs to a class of medicines called a vaccine. Trovax consists
of a virus that has been changed so that it is no longer infectious and
carries a gene for a protein called 5T4. This protein is carried by many
kidney cancer calls. When the virus is injected, it makes the protein, and
the body’s immune system is then able to recognize this protein and kill the
cells that have it (i.e. the cancer cells).
About the Trial
The Trovax vaccine with IL-2 trial is being conducted by a team of
physicians, scientists, nurses, pharmacists, and social workers with
expertise in the use of immunotherapy in patients with cancer.
The trial aims to enroll 25 patients in total. To date, two patients have
enrolled. Patients need to meet certain medical requirements to join the
clinical trial. An interested patient or medical oncologist may contact us
to learn about eligibility requirements. Participation is voluntary and
patients may withdraw at any time.
The Tumor Immunotherapy Program at New York-Presbyterian/Columbia, unique
in the Metropolitan New York area, includes doctors and nurses with
specialized training in biologic therapy and vaccines who are actively
conducting clinical studies of tumor vaccines. The program also includes
scientists working in research laboratories within Columbia University to
translate clinical learnings into new vaccines and therapies.
Bananas, Root
Veggies May Cut Kidney Cancer Risk (Yahoo News - 21/01/2005)
People who like their bananas, carrots and
beets may have a lower risk of developing kidney cancer than those who
turn their noses up at the foods, a large Swedish study suggests.
Some past studies, though not all, have shown that diets rich in fruits
and vegetables may help stave off kidney cancer. The new findings, based
on dietary information from 61,000 Swedish women, zero in on certain foods
-- namely, bananas, root vegetables, salad greens and cabbage -- that
may confer such a benefit.
The study found that a high overall intake of fruits and vegetables was
related to a lower risk of kidney cancer, though the effect was not significant
in statistical terms. There were, however, significant effects when it
came to certain foods. Women who ate bananas four to six times a week,
for example, had about half the risk of kidney cancer as those who did
not eat the fruit. Regular consumption of root vegetables, including carrots
and beets, was linked to a 50 percent to 65 percent decrease in risk.
There are about 190,000 cases of kidney cancer diagnosed worldwide each
year. Research has uncovered a number of risk factors -- including smoking,
obesity, high blood pressure and occupational exposure to certain chemicals,
such as asbestos and cadmium. But studies on diet have been inconsistent.
The new study is the largest to show an association between kidney cancer
and fruit and vegetable intake, according to lead author Dr. Bahram Rashidkhani
of the Karolinska Institute in Stockholm. It adds to the body of research,
by suggesting that it's the consumption of particular foods, rather than
total fruit and vegetable intake, that may matter.
The study, reported in the International Journal of Cancer, included
61,000 women ages 40 to 76 who were followed for an average of 13 years. At
the start of the study, the women completed dietary questionnaires,
reporting how often during the past 6 months they had eaten various foods.
During the follow-up period, 122 women developed renal cell carcinoma, by
far the most common form of kidney cancer.
Besides bananas and root vegetables, white cabbage -- widely consumed
in Sweden -- and "salad vegetables," including lettuce and cucumber,
were linked to a lower cancer risk. The associations held up when Rashidkhani's
team calculated the effects of other factors, such as age, weight and
smoking. Bananas, Rashidkhani noted, contain an especially high amount
of antioxidant compounds called phenolics. For its part, white cabbage
contains isothiocyanates, chemicals that lab research suggests may fight
tumor formation. There were a number of fruits the study did not consider
because of their lack of popularity in the study population; these included
peaches, plums, grapes and berries.
And when it came to fruit juice, the researchers found that high intake
was associated with a greater risk of kidney cancer. The reason for the
link, according to Rashidkhani, is unclear, and it could be just a "chance"
finding.
New treatment
for kidney cancer 'cooks' tumours (CTV.ca News Staff)
An Ontario man has become the first in the country to receive a new treatment
for cancer of the kidney -- one that involves "cooking" the
tumour without removing it. More than 2,000 Canadians are diagnosed with
kidney cancer each year. If the cancer spreads, there's usually little
chance of a cure. Sometimes the entire kidney is removed, but that's a
risky procedure. Sometimes just the tumour is removed, but that leaves
a risk of serious bleeding and a chance that some cancer cells will be
left behind. For tumours that appear deep in the kidney, the new technique
offers an easier, non-surgical solution with a promising recovery rate.
When doctors offered high school vice principal, Paul Clinton, this new
treatment for a menacing growth on his kidney, he chose the experimental
method rather than full removal of his kidney. Clinton is one of the first
Canadians to undergo "Radio Frequency Ablation," a new and minimally
invasive technique for treating tumors localized to certain organs such
as the liver, kidney and, adrenal glands. With this new procedure, doctors
take a probe and insert it directly into the kidney tumour through small
holes in the patient's abdomen. The metal probe is then heated to 105
degrees Celsius. The tumour and a small band of healthy tissue around
it are burned for seven minutes. The tumour shrinks slowly during the
procedure, and while the cancer cells are destroyed, most of the kidney
is preserved.
Early results of on Radio Frequency Ablation in the United States show
promising statistics. "After a two-year follow up we have 98 per
cent of patients free of cancer," says Dr. Ed Matsumoto, one of the
specialists introducing the technique in Canada, in his case at St. Joseph's
Health Care in Hamilton, Ont. Dr. Paul Whelan, director of the McMaster
Institute of Urology at St. Joseph's Healthcare, says the benefits of
the procedure are already apparent. Patient recovery time is speedier
using Radio Frequency Ablation, as it requires no surgery nor, for most
patients, any general anesthesia.
[Top]
Bayer
and Onyx' kidney cancer drug granted orphan drug status-(Yahoo News-28/10/2004)
Bayer Pharmaceuticals Corporation and Onyx
Pharmaceuticals co-developed kidney cancer drug has been granted orphan
drug status by the FDA. Bayer Pharmaceuticals Corporation and Onyx
Pharmaceuticals' co-developed kidney cancer drug has been granted orphan
drug status by the FDA. The compound, sorafenib, is being evaluated for
the treatment of metastatic renal cell carcinoma, an advanced form of
kidney cancer. A similar designation has been granted in the European
Union by the Committee for Orphan Medicinal Products (COMP) of the
European Medicines Agency (EMEA).
Currently in phase III clinical testing,
BAY 43-9006 is a novel RAF kinase and VEGFR inhibitor that is intended to
prevent tumor growth by combining two anticancer activities, inhibition of
tumor cell proliferation and tumor angiogenesis. BAY 43-9006 recently
received the FDA's fast track designation and both the fast track and
orphan drug designation provide mechanisms for more frequent
communications with the FDA, helping to streamline development as well as
the review and approval process.
BAY 43-9006, a novel investigational drug
candidate, has demonstrated both anti-proliferative and anti-angiogenic
properties - two important anticancer activities. In pre-clinical models,
the compound inhibited tumor cell proliferation by targeting the RAF/MEK/ERK
signaling pathway at the level of RAF kinase. It also exerted an antiangiogenic
effect by targeting the receptor tyrosine kinases VEGFR-2 and PDGFR and
their associated signaling cascades. Bayer
and Onyx also recently reported positive phase II trial results for the
experimental kidney cancer treatment, revealing its ability to shrink
tumors and stabilize disease in advanced progressive kidney cancer.
[Top]
Alcoa
workers' high kidney cancer rate-(Yahoo News-30/06/2004)
KIDNEY cancer rates
are higher among Alcoa's Victorian workers than in the general populace.
A study of 4396 male workers at Alcoa's Geelong and Portland smelters
has found that 14 suffered kidney cancer. Researchers expected half that
figure to correlate with the general population. The latest research from
Healthwise, a study to gauge links between employee health and working
at Alcoa going back to 1984, also shows that the incidence of stomach
cancer among Victorian Alcoa workers was higher than the general population.
And the mortality rate from prostate cancer among Victorian production
workers was higher than the general national figure. Alcoa's occupational
physician, Dr Michael Donoghue, said the findings would prompt further
in-depth investigation.
Despite the disturbing
cancer findings, the study by researchers from Monash University and the
University of Western Australia found a lower risk of early death among
Alcoa employees than the general population. It found that mortality rates
for all four major categories of death - circulatory disease, respiratory
disease, cancer and injury/trauma - were lower among Alcoa workers than
in the general population. It also found the total incidence of cancer
in past and present Alcoa employees was lower than the general population.
Dr Donoghue said the research showed that on the whole Alcoa employees
were healthier than the general population. ``But (it) also raises a number
of finds that we wish to see followed up with further investigation,''
he said.
While some studies
showed that occupations such as aluminium smelting, coke oven work and
oil refining attracted a greater risk of kidney cancer, Dr Donoghue said
other studies had reported no increase in these risks. ``Smoking has consistently
been found to increase the risk of kidney cancer and further analyses
of cancer incidence in relation to duration of employment, workplace exposure
and smoking may clarify whether there is an occupational or lifestyle
cause for this result and the researchers will be prioritising this finding
for further investigation.'' He was not surprised the study found high
mortality rates and incidence of asbestos-linked cancer. ``Mesothelioma
is almost always caused by asbestos exposure and like many companies in
the 1960s and 70s, Alcoa used asbestos in the early operation of the Point
Henry smelter and rolling mill and it is likely that these cases relate
to occupational exposure at Alcoa.''
[Top]
Kidney
Cancer Surgery Appears Safer at High-Volume Hospitals-(Yahoo News-17/05/2004)
Research has shown
with certain types of surgery that the more often a hospital performs
that surgery, the better patients fare. Now a new study by University
of Michigan Health System researchers finds that patients undergoing surgery
for kidney cancer are less likely to die at hospitals that perform the
operations frequently. The study appears in the May issue of Urology.
In the first study to look nationwide at the relationship between surgical
volume and mortality for nephrectomy for cancer, the researchers found
patients faced a 32 percent lower risk of dying at high-volume hospitals
compared to hospitals that performed fewer nephrectomies. "Following nephrectomy
performed for cancer diagnoses, there were fewer in hospital deaths at
hospitals that performed more of these surgeries. Our study confirms what
others have found in different conditions, that surgical experience has
a significant impact on outcomes," says senior study author John Wei,
M.D., assistant professor of Urology at U-M Medical School.
The researchers looked
at 20,765 patients who underwent kidney surgery because of cancer at 962
hospitals from 1993-1997, based on data from the Nationwide Inpatient
Sample, a random sample of 20 percent of all hospital discharges in the
United States maintained by the Agency for Health Care Research and Quality.
Patients underwent radical nephrectomy (complete removal of the kidney),
nephroureterectomy (removal of the kidney and ureter) or partial nephrectomy.
The participating hospitals were classified according to the number of
nephrectomies performed each year as low-volume, medium-volume or high-volume.
Overall, 1.39 percent of patients died in the hospital following nephrectomy.
Patients at high-volume hospitals had nearly one-third lower risk of dying
compared to patients at medium-volume hospitals, and one-quarter lower
risk of dying compared to patients at low-volume hospitals. Older patients,
patients who underwent emergency surgery and patients with chronic pulmonary
disease or whose cancer had spread faced a higher risk of dying in the
hospital after surgery. High-volume hospitals were more likely to perform
partial nephrectomies, a newer procedure that's equally effective as radical
nephrectomy at controlling cancer. Patients who had this procedure at
a high-volume hospital saw better outcomes. The researchers did not find
any difference in the length of hospital stay based on surgery volumes,
suggesting that other factors such as age, gender and urgent hospital
admission have a stronger effect on length of stay. Based on this and
other studies showing a link between surgical volumes and lower mortality
rates, some organizations have made efforts to reduce the variation between
hospitals. "Patients should keep in mind that with nephrectomy for cancer,
other factors besides surgical volumes can affect the outcome, such as
age or the size of the tumor; therefore, we cannot specify an absolute
cutoff for the number of surgeries that hospitals need to perform to be
considered 'adequate' experience," says lead study author David Taub,
M.D., a Urology resident at U-M Medical School. In addition to Wei and
Taub, study authors were David Miller, M.D., and James Montie, M.D., of
the U-M Department of Urology, John Cowan, M.D., from Neurosurgery, and
Justin Dimick, M.D., from Surgery.
[Top]
Urine
test 'spots kidney cancer'-(Yahoo News-09/05/2004)
A simple urine test
could one day be used to diagnose kidney cancer. Scientists from Fox Chase
Cancer Center in the United States say DNA from the disease can be found
in urine. They carried out tests on 50 people with the disease. They found
cancer DNA in the urine of 44. The DNA disappeared when they patients
were cured. Speaking at the American Urological Association's annual meeting
in San Francisco, they said the test may be a simple way to diagnose the
disease.
The number of people
being diagnosed with kidney cancer has increased sharply over the past
20 years. Almost 6,000 people in the UK are told they have the disease
each year. However, rates vary considerably between different countries.
They are much higher in affluent western countries than they are in developing
countries. Scientists suspect lifestyle choices, such as smoking and obesity,
play an important role. Like all cancers, a person's chances of beating
it are highest if it is diagnosed and treated early. However, those chances
fall sharply if it is spotted late and if it has spread to other parts
of the body. The most common symptom of the disease is blood in the urine.
This latest study suggests urine also carries DNA from the cancer. According
to the scientists, the urine test was highly accurate. It was tested on
people with the disease and people without.
It did not give any
"false-positives", which means the test did not suggest that any of the
healthy volunteers had the disease. The scientist said the test was also
able to distinguish between different stages of the disease. "The test
appears to be remarkably accurate," said Dr Robert Uzzo, a surgeon at
the hospital and one of those involved in the study. He said the findings
suggested a urine test could be used to identify patients with prostate
cancer and also to track their progress during treatment. "This step in
our research further supports the accuracy of this potential screening
test but also demonstrates the possibility of using urine to monitor the
patient after treatment." Dr Nick James from Cancer Research UK welcomed
the study. "The research is very interesting and a simple urine test for
kidney cancer would certainly be welcome. "This type of work is technically
feasible because huge advances have been made in protein analysis techniques.
"There is a lot of similar research being carried out in this area."
[Top]
Activists
argue for more attention and more research-(Yahoo News-20/04/2004)
Jay Bitkower of Manhattan
was 61 when he was diagnosed with kidney cancer. His left kidney was removed,
and now, three years later, Bitkower is free of cancer. But the experience
altered how he looks at the disease and started him on a mission to generate
more awareness for it. Last year, Bitkower, a computer consultant, and
a group of survivors started Action to Cure Kidney Cancer (ACKC), a nonprofit
organization whose mission is to raise awareness and increase government
and private funding for research. The survivors met at a support group
in Washington, D.C., organized by the Kidney Cancer Association. Although
that organization includes advocacy as part of its mission to educate
patients and work with medical professionals, Bitkower and the others
left the meeting with the impression that little was being done to lobby
Congress to spend more to screen for and treat the disease. The members
of the newly created group started doing their own research and soon learned
that while the Department of Defense spends $150 million per year on breast
cancer research, $85 million per year on prostate cancer and $10million
a year on ovarian cancer, nothing close to those figures was being spent
on kidney cancer. They discovered that National Cancer Institute funding
is also disproportionate, Bitkower says.
Of the 56 research
programs conducted by the institute, 11 are dedicated to prostate cancer
and 10 to breast cancer. There is only one funded for kidney cancer. "There
is no major investment by the federal government who, through the National
Cancer Institute, does research," he says. "There is hardly any private
investment compared to other cancers. There is no private fund- raising
for kidney cancer research. We realized if we didn't form a grassroots
organization, it would continue the same way, and more people would die
and wouldn't get treated." "What we're looking for is fairness," says
Fred Atkin, a kidney cancer survivor from Commack who was diagnosed in
2001 and now serves as ACKC's vice president. "We want a fair share of
the research dollars."
Kidney cancer specialists
seem to agree. "It is a significant cause of death," says Dr. Berton Zbar,
chief of the Laboratory of Immunobiology at the National Cancer Institute.
"It needs attention. There are about 35,000 cases of kidney cancer in
the U.S. each year. The number of cases seems to be rising. It's not entirely
clear why. "It seems to be rising faster in the African-American community
than the [white] community, but it is rising in both."
About 12,000 deaths
result from kidney cancer each year. Kidney cancer accounted for 3 percent
of estimated new cancer cases among U.S. men in 2003, compared with an
estimated 33 percent of new cases attributed to prostate cancer in the
same year, according to the American Cancer Society. Bill Bro, chief executive
of the Kidney Cancer Association, noted kidney cancer's status as "not
quite a rare disease," with more than 200,000 people in the United States
living with it. "When it comes to cancers that affect adults later in
life, the sad reality is that they will always be underfunded," Bro says.
Unlike other cancers, there is no screening test to diagnose kidney cancer,
and chemotherapy is not reliable. According to Dr. Walter Stadler, a nationally
recognized kidney cancer researcher based at the University of Chicago
Medical Center, most kidney cancer diagnoses are made by CT scan. When
the cancer is confined to the kidney, symptoms include blood in the urine.
Most patients exhibiting symptoms have advanced disease. Surgery is the
treatment of choice for cancer that hasn't spread. For metastatic disease,
the standard of care is either interferon alpha or interleukin-2, or both.
These are both considered immunotherapy, Stadler says. Interferon-alpha
has been demonstrated to improve survival, while interleukin-2 has been
successful in 3 percent to 8 percent of patients with metastatic disease.
Those patients have a 60 percent to 80 percent chance of long-term survival.
"We have modest success
with traditional chemotherapy ... with 10 to 15 percent of patients experiencing
tumor shrinkage, but we don't know whether this actually improves survival,"
Stadler says. "People who have metastatic disease that has spread beyond
the kidney don't have a lot of options," Zbar says. "The options they
do have are primarily what might be called experimental. More options
are needed." Now Bitkower spends his days researching what treatments
are on the horizon. He investigates where money would be best spent if
he and the others succeed in obtaining their goals. As a group, they contact
physicians and members of Congress to raise more awareness of kidney cancer
patients' plight. "It's become a full-time job," says Bitkower, who, like
the others, is not paid for his efforts. The first step, they believe,
is to get Congress to take notice. Recently, Bitkower and Atkin joined
other kidney cancer survivors and physicians on a trip to Washington,
D.C., where they gave messages to the House of Representatives Cancer
Caucus. "We hope that in this session of Congress there will be an appropriations
bill that will start the process," says Pat Thaler of Amagansett, a kidney
cancer survivor who is active in the group and whose brother, former New
York City mayor Ed Koch, has helped open some doors. "It's a tough fight.
There is a huge national deficit. There is a sense that Congress doesn't
want to increase appropriations. But this is our fight, and we will do
whatever we can," she says.
Bro, of the Kidney
Cancer Association in Evanston, Ill., has been fighting the same battle
for several years now and says ACKC has a point. "Clearly, there is disparate
funding between kidney cancer and other genitourinary cancers," he says.
His group recently started a governmental affairs committee at Bitkower's
urging to help set the organization's agenda for advocacy at the state
and local levels. Although he says he's not sure why a separate organization
needs to exist, he says he can appreciate why the survivors who are working
for it are trying to fulfill their goals. "Understanding the urgency that
seriously ill people without a definite cure for a disease feel, there
is nothing I would do to discourage an independent effort." Still, he
adds, "the path to a cure for the disease is seldom a straight line."
Stadler agrees, stating that progress often comes from unexpected sources.
"If you focus funding very narrowly on a disease, it does not necessarily
mean you are going to make better progress than if you focus funding more
broadly. I'm always a little bit leery when organizations say we want
funding for disease X, because you can not always predict where success
in a field is going to come from. I think a broader vision is important.
"I think we're far better off having a broader vision of funding that
can be applied to various diseases and problems."
[Top]
Kidney
Cancer Vaccine Shows Promise-(HealthDayNews-20/02/2004)
An experimental vaccine
for kidney cancer appears to reduce the risk of recurrence and increase
survival odds for people with the disease. The findings, appearing in
the Feb. 21 issue of The Lancet, have led the study authors to conclude
the vaccine can be considered for patients who have tumors larger than
2.5 centimeters, the group that benefited the most from the vaccine in
the study. Outside experts, however, state that while researchers may
be closer to a vaccine for kidney cancer, they still are not there. "The
findings are suggestive, but not conclusive," says Dr. Len Lichtenfeld,
deputy chief medical officer of the American Cancer Society in Atlanta.
While surgery to
remove all or part of the kidney is standard practice for this type of
cancer, additional treatments such as chemotherapy or radiation have not
met with much success. As a result, half of patients will have a recurrence
within five years. On the other hand, there has been a great interest
in developing a vaccine for this particular type of cancer because some
people have had unexplained response in their tumors even without treatment.
"Kidney cancer has been recognized as a possible target for a vaccine
therapy because of the way the cancer itself behaves," Lichtenfeld says.
"Some people have had unexplained changes in their tumor, suggesting that
the body may in fact be able to recognize kidney cancer."
This unexplained
behavior has long represented a hopeful window of opportunity for researchers
in this field. Although many studies are ongoing, no cancer vaccines have
yet been approved for use. The idea is to take cancer cells (often from
the actual patients) and process them in such a way that they can be given
back to the patients to help foster an immune response. The current trial,
which used cells from the patients' own tumors, is one of the largest
and furthest along of its kind. "As far as I can tell, this is the largest
vaccine phase III [final stage] trial for kidney cancer that's been finished
and come out," says Dr. Mayer Fishman, an assistant professor of interdisciplinary
oncology at the Moffitt Cancer Center of the University of South Florida
in Tampa and author of an accompanying commentary.
The study authors
analyzed information on 379 patients from 55 medical centers in Germany
who had had surgery for cancer of the kidney. Before surgery was performed,
all of the participants were randomized to receive a vaccine (six injections
in all) or no additional treatment. More than three-quarters (77 percent)
of the vaccine group and 68 percent of the control group survived without
a recurrence for five years. Patients who were at a high risk for recurrence
(that is, they had a large tumor size and high tumor grade) had an even
greater therapy, although this data was not outlined in the report.
The trial was sponsored
by a company, LipoNova of Hannover, Germany, a factor Fishman says may
have affected how the data was presented. The paper did not include overall
survival comparisons between the two groups, Fishman points out. "The
primary endpoint of the study was not about survival, and the purpose
of the paper was not to be the final word about data," he says. "This
is an industry-sponsored trial, and every page of that they consider to
be proprietary information." At this point, the findings are specific
and limited, experts say. "We're dealing with a study that has been published
that suggests tumor vaccines may work in this situation, but we still
have a long way to go in knowing how really effective these vaccines may
be in this type of cancer," Lichtenfeld says. "It's similar to other studies
that suggest a possible effect, but more research is needed before we
can incorporate it into therapy for all kidney cancer."
According to Fishman,
the company has already started approval proceedings in Germany, but it's
unclear if that will succeed and, even if it does, how the U.S. Food and
Drug Administration will respond. "I don't think they have enough from
this study to get this product approved for this indication," Fishman
adds. On the other hand, the company may be using the study to find out
what additional specific information the regulatory authorities need before
approving the product. "In that sense, that's a reasonable commercial
endeavor."
[Top]
Urine
Test May Find Early Kidney Cancer-(HealthDayNews-15/12/2003)
Researchers are reporting
what could be the first test for early detection of kidney cancer, a potential
lifesaver for tens of thousands of patients. Nearly 32,000 Americans will
be diagnosed with kidney cancer this year, making it the eighth most common
malignancy, and an estimated 11,900 will die of it. Detected early, kidney
cancer is potentially curable -- usually by surgery to remove the affected
kidney -- but the prognosis for advanced stages of the disease is poor.
Most cases of kidney cancer now are diagnosed by imaging techniques such
as ultrasound or CT scans, which look for an abnormal growth, followed
by a biopsy to detect cancer cells in a tissue sample. Generally, this
means the diagnosis is made only after surgery. But researchers at Fox
Chase Cancer Center in Philadelphia say a urine test has found genetic
patterns that signal the disease in patients with early stages of the
disease.
The test looks for
signs of methylation, a process that inactivates genes that work to suppress
cancer, explains Paul Cairns, director of the Molecular Detection of Cancer
Laboratory at Fox Chase and lead author of a report on the study in the
Dec. 15 issue of Cancer Research. Methylated genes were found in all of
50 urine samples from patients with early-stage kidney tumors, most of
them cancerous, the report says. No such altered genes were found in urine
samples from healthy individuals or patients with other kidney diseases.
Cairns says his group is planning "to extend the study to larger numbers,
to see if we can detect methylation in precancerous lesions. It would
be nice to get hold of what we call candidate precancerous lesions," cells
that are on the verge of becoming cancerous. Such a study will include
people who are at high risk because of a family history of kidney cancer,
Cairns says. "Before you propose a test on the general population, you
go to people with a known heritable mutation," he explains. While the
sort of test used in the study is relatively new, "the technology is now
a lot more widespread in laboratories around the world," Cairns says.
If all goes well
in the inevitable long series of studies that lie ahead, he says, the
test could become part of routine screening. "You can use the same technology
to detect bladder and prostate cancer," Cairns says. "If you could screen
for several cancers at once, that would make its use practical." The technology
used in the test is formally called methylation-specific polymerase chain
reaction. It searches for changes in six specific tumor-suppressor genes
that prevent normal kidney cells from the uncontrolled growth that is
cancer. The test could be used to screen for several cancers in a single
urine sample because similar changes are found in tumor-suppressor genes
for those cancers, Cairns says.
The study is "a good
start, but very preliminary," says Dr. Ronald M. Bukowski, director of
the Cleveland Clinic Taussig Cancer Center and director of the Kidney
Cancer Foundation medical advisory board. "One thing that should be noted
is that three of the patients they studied had benign kidney tumors, not
cancers," Bukowski says. The test might thus detect growths that do not
require the drastic measures needed for cancer, he adds. "They need to
study more patients with other cancers and they also have to expand the
number of people they study," he says. "The development of a urinary or
blood test for early detection is obviously very desirable."
[Top]
Immune
Therapy Promising for Advanced Renal Cell Cancer-(ET-30/10/2003)
According to a recent
article published in the Journal of Clinical Oncology, therapy utilizing
a donor's immune cells appears to provide anti-cancer activity in some
patients with recurrent or refractory renal cell cancer. The kidneys are
a pair of bean shaped organs located on each side of the spine. The kidneys
filter the blood and eliminate waste in the urine through a complex system
of filtration tubules. All of the blood in the body passes through the
kidneys approximately 20 times an hour. Renal cell cancer is an uncommon
form of cancer that is most often characterized by the presence of cancer
cells in the lining of the filtration tubules of the kidney. Recurrent
renal cell cancer (RCC) refers to cancer that has returned following previous
therapies, and refractory RCC refers to cancer that has stopped responding
to standard therapies.
Currently available
treatment options for recurrent or refractory RCC are limited and long-term
survival for this group of patients remains suboptimal. Approximately
32,000 people in the United States are estimated to be diagnosed with
RCC in 2003. Renal cell carcinoma tends to be responsive to treatment
with immunotherapy, or therapy used to stimulate the immune system to
attack the cancer. Thus, researchers have been evaluating novel ways in
which to utilize immune activity as treatment for RCC in order to improve
long-term survival in patients with this disease. One type of therapy
being evaluated is the utilization of a donor's immune cells. The donor's
immune cells are collected from a donor and infused into the patient in
the hopes that the donor immune cells will recognize the cancer cells
in the patient's body as foreign and attack them. Unfortunately, the donor's
immune cells also often mount an attack against healthy cells in the patient's
body, which can cause life-threatening complications. This occurrence
is referred to as graft-versus-host disease (GVHD). GVHD tends to occur
more often when antigens (protein and/or carbohydrate sequences on cells),
specifically human leukocyte antigens (HLA), do not match between donor
and patient.
Much research is
ongoing in an attempt to reduce the risk of GVHD while maintaining anti-cancer
effects derived from donor immune cells. Researchers from New Jersey recently
conducted a clinical trial evaluating the infusion of donor immune cells
to patients with advanced cancers. The donor's cells were only partially
HLA matched and were irradiated prior to infusion into the patient in
order to reduce the risk of GVHD. This trial involved 15 patients with
advanced, recurrent or relapsed (stopped responding to standard therapies)
cancers; 11 with RCC, 2 with melanoma and 2 with acute myeloid leukemia
(AML). For the patients with RCC, 3 experienced cancer regression and
2 experienced cancer stabilization following donor immune cell infusions.
Both patients with AML experienced cancer stabilization for approximately
4 months; however, both patients with melanoma experienced cancer progression
during therapy. There was no apparent GVHD caused by treatment in any
patient. The researchers concluded that infusions of donor irradiated
immune cells appear to produce anti-cancer effects in patients with recurrent
or refractory RCC. Although HLA antigens were only partially matched between
donor and patient, no evidence of GVHD occurred, as cells were irradiated
prior to infusion. Patients with recurrent or refractory RCC may wish
to speak with their physician about the risks and benefits of participating
in a clinical trial further evaluating donor cell infusions or other promising
therapeutic approaches.
[Top]
Avastin(TM)
Delays Progression of Metastatic Kidney Cancer-(ET-12/08/2003)
According to results
recently published in The New England Journal of Medicine, Avastin(TM)
(bevacizumab) delays time to cancer progression in metastatic clear-cell
renal carcinoma. The kidneys are a pair of bean shaped organs located
on each side of the spine. The kidneys filter the blood and eliminate
waste in the urine through a complex system of filtration tubules. All
of the blood in the body passes through the kidneys approximately 20 times
an hour. Renal cell cancer is an uncommon form of cancer that is most
often characterized by the presence of cancer cells in the lining of the
filtration tubules of the kidney. Metastatic renal cell cancer (RCC) refers
to cancer that has spread from the kidney to distant and/or several sites
in the body. Standard treatment for metastatic RCC often includes immunotherapy
agents such as Proleukin® or alfa-interferon which stimulate the immune
system to help fight the cancer.When
patients stop responding to standard therapies, they are left with few
effective treatment options.
Clear-cell renal
cancer is a type of kidney cancer that is usually caused by a mutation
in a gene called the von Hippel-Lindau tumor suppressor gene. A mutation
in this gene is associated with the overproduction of vascular endothelial
growth factor, an important component of angiogenesis. The inhibition
of angiogenesis has become a major focus and well-studied topic in recent
cancer research. Cancer cells require food, oxygen and growth proteins
in order to grow and spread. These essential nutrients are transported
to the cancer cells by blood vessels. Angiogenesis is the process of creating
new blood vessels necessary to transport food to the cancer cells. Two
key proteins that are necessary for the process of angiogenesis are called
matrix metalloproteinases (MMPs) and vascular endothelial growth factor
(VEGF). VEGF causes endothelial cells (cells comprising the innermost
layer of blood vessels) to replicate and migrate from existing blood vessels
to the cancer. Endothelial cells secrete MMPs, which create an opening
in existing tissues surrounding the cancer, allowing the endothelial cells
to move near the cancer and form new blood vessels to feed the cancer.
Avastin is a novel angiogenesis inhibitor that has completed the last
phase of clinical trials prior to FDA approval. Avastin produces its anti-angiogenic
effects by inhibiting the action of VEGF which halts the growth of new
blood vessels necessary to promote and maintain cancer cell growth. It
has demonstrated anti-cancer activity in the treatment of various cancers
and is presently being evaluated in several clinical trials.
Researchers affiliated
with the National Cancer Institute recently conducted a clinical trial
to evaluate Avastin in the treatment of metastatic clear-cell renal carcinoma.
This trial involved 116 patients, the majority of whom had cancer that
was progressing. The patients were treated with either high-dose Avastin,
low-dose Avastin or a placebo (inactive substitute) every 2 weeks and
were directly compared. Overall, patients treated with high-dose Avastin
had the longest progression-free survival, compared with the other two
groups. The average duration of progression-free survival at 4 months
following initiation of therapy was approximately 64%, 39% and 20% for
those treated with high-dose Avastin, low-dose Avastin and placebo, respectively.
Eight months following initiation of therapy, progression-free survival
was approximately 30%, 14% and 5% for those treated with high-dose Avastin
, low-dose Avastin and placebo, respectively.
There were no differences
in overall survival; however, longer follow-up may be necessary to reveal
differences in overall survival between these 3 groups of patients. Avastin
was well tolerated, with mild to moderate high blood pressure and protein
in the urine being the most common side effects. The researchers concluded
that Avastin delays time to cancer progression in patients with metastatic
clear-cell renal carcinoma and is easily tolerated. Longer follow-up is
necessary to determine if Avastin improves long-term survival in this
group of patients. Patients with advanced clear-cell renal carcinoma may
wish to speak with their physician about the risks and benefits of participating
in a clinical trial further evaluating Avastin or other promising therapeutic
approaches.
[Top]
Kidney
Cancer Growing Fastest in British Women-(Reuters-21/09/2002)
Cancer of the kidney
has surpassed breast and lung cancer to become the fasting-growing form
of the disease among British women. Figures released on Sunday by the
charity Cancer Research UK showed the incidence of the disease in British
women increased 22 percent in the past decade. During the same decade,
breast cancer rose 18 percent, skin cancer 15 percent and lung cancer
by four percent. "Certainly one plausible explanation is that it is related
to obesity, because there has been a stark rise in that as well," Dr.
Nick James, a kidney cancer expert at the Queen Elizabeth Hospital in
Birmingham, told Reuters. "It appears to be a Western world phenomenon,"
he added. "The same link has been noted in the States."
Health experts consider
obesity the fasting-growing health epidemic of the past two decades. An
estimated 28 percent of people in the United States and 20 percent in
Europe are obese. Scientists are not sure how obesity increases the risk
of kidney cancer, but they suspect it results from an imbalance in hormones,
particularly in women. "Being overweight alters the way you process hormones,"
James added.
Fat cells produce
more of the female hormone estrogen, which accelerates cell division.
Cancer develops when a mutated cell divides uncontrollably instead of
destroying itself. "We don't know whether the degree of obesity or the
age that weight gain occurs makes a difference to the risk," James said.
Kidney cancer is
usually treated with surgery and also chemotherapy and radiation, depending
on its severity. Smoking and obesity are the leading risk factors for
the disease. Some people have an inherited risk. The five-year survival
rate for kidney cancer is about 40 percent. The earlier the cancer is
detected, the better the prognosis. In Britain about 5,000 new cases of
kidney cancer are diagnosed each year and 3,000 people die of it.Blood
in the urine, which is often intermittent, can be an early sign of the
illness. James advised anyone who notices blood in urine to see a doctor
as soon as possible. "They need to have it investigated, always, even
if it goes away," he said. A lump in the abdomen and low back pain not
caused by an injury are other symptoms.
Obesity is measured
by body mass index (BMI), which is calculated by dividing weight in kilograms
by height in meters squared. A BMI of more than 30 is obese.
[Top]
Thalidomide
May Treat Metastatic Kidney Cancer-(HealthScoutNews-20/05/2002)
People with kidney
cancer that has spread to other parts of their body generally don't have
many choices when it comes to treatment, and the options they do have
are often not very effective at battling the disease. However, researchers
from Baylor College of Medicine in Houston are hoping to change that with
the help of thalidomide, a drug that became infamous for causing birth
defects. "Kidney cancer patients with metastatic cancer at the time of
diagnosis have an average survival of about 11 months," says Dr. Robert
Amato, lead researcher and an associate professor of urology at Baylor.
"We are looking at the merits of combining thalidomide with interleukin
2. There is some promising data unfolding with this combination."
Every year, 30,000
Americans are diagnosed with kidney cancer. It is twice as common in males
as it is in females, according to the Kidney Cancer Association. Symptoms
of the disease include blood in the urine and back pain. Since back pain
is a common symptom, people often ignore it until the cancer has spread.
The association estimates the cancer has metastasized to other parts of
the body in 15 percent to 25 percent of kidney cancer patients by the
time they are diagnosed with the disease. Amato and his colleagues recruited
15 people with metastatic kidney cancer to test whether combining the
commonly used interleukin 2 with thalidomide would work. Interleukin 2
helps the immune system recognize the presence of cancer cells.Studies
of interleukin 2 treatment alone show a partial positive response in 30
percent to 40 percent of the cases, says Dr. Samir Taneja, a urologist
at New York University Medical Center. Taneja says there's no real cure
for metastatic kidney cancer, although about 5 percent of patients respond
to current treatments.
Thalidomide, first
marketed as a sleeping pill, is now used as a treatment for leprosy, some
autoimmune diseases and some cancers because of its anti-inflammatory
properties. The drug was taken off the shelves in the 1960s because it
caused severe birth defects in the children of women who took the drug
early in pregnancy. In recent years, doctors discovered it was an effective
treatment for leprosy. Even with its newfound uses, people taking the
drug must take many precautions -- most importantly, making sure they
either don't get pregnant or don't impregnate anyone. Thalidomide may
work against cancer by limiting the development of new blood vessels,
Taneja says. Without a constant blood supply, the cancer is starved and
cannot thrive. "Eight of the 15 patients in this Phase I study have had
a benefit [from this drug combination]," says Amato. "That's a very small
patient number, but quite interesting data." Amato says the treatment
was fairly well tolerated, and the most common side effects were sedation,
fluid retention, skin rash and constipation. The researchers are currently
conducting the next phase of research on the combination with 33 patients.
Results of the study were presented at the American Society of Clinical
Oncologists meeting in Orlando, Fla. "This is a promising study," Taneja
says, but he cautions it was a very small study, designed to test for
toxicity and side effects, so the results need to be replicated in larger
studies.
[Top]
Kidney
cancer on the rise-(Times of India Online-21/02/2002)
There has been an
unprecedented rise in the number of patients with kidney cancer in Britain
in the last few decades. Figures from a cancer research centre show that
number of cases of kidney cancer has risen by a startling 68 percent over
the last 20 years.
Experts estimate
that up to 40 percent cases of kidney cancer are caused by smoking. However,
the disease is also linked to other risk factors, such as obesity and
high blood pressure, says a report in BBC. Dr Nick James, kidney cancer
expert and a consultant at the Queen Elizabeth Hospital in Birmingham,
said: "We can help to avoid kidney cancer by not smoking and maintaining
a healthy weight, but it's also essential that we keep watch for the signs
of kidney cancer.
"The most common
symptom of the disease is blood in the urine, but unfortunately the bleeding
is often intermittent and can be disregarded by patients and doctors."
He said it was vital that people who noticed traces of blood in their
urine visited their GP as soon as possible.
Figures from Cancer
Research UK show that over 5,700 people are now affected by the disease
in Britain each year and survival rates are among the lowest in Europe.
Early disease can often be treated with surgery and survival rates are
as high as 94 percent.
However, once the
cancer has spread the chance of successful treatment drops dramatically.
The incidence of kidney cancer varies substantially between different
countries. It is far higher in affluent western countries than in the
developing world - a further indication that lifestyle factors play an
important role .
[Top]
British
scientists report kidney cell breakthrough-(Times of India Online-31/07/2001)
British scientists
have reported making kidney tissue out of bone marrow cells, a major development
in transplant surgery, according to the Independent. The breakthrough
could revolutionise treatment for patients waiting for transplants by
repairing damaged kidneys rather than relying on a donated organ, the
paper said. If the results are confirmed, the study will mark a major
development in the field of stem cell research, where the body's own cells
are reprogrammed to repair defective organs.
A team led by professor Nicholas Wright, head of the imperial cancer research
fund's histopathology unit in London, has shown for the first time that
adult bone marrow stem cells are capable of turning into mature kidney
cells, according to the Independent. The results of the study, to be published
in the Journal of Pathology, showed that it was possible to develop new
ways of treating kidney damage caused by cancer or other diseases.
[Top]
Study
Shows New Technique For Removing Cancerous Kidneys Makes Surgery And Recovery
Time Shorter-(Cancer Info-25/06/2001)
A new technique that
lets surgeons remove cancerous kidneys through a small incision with the
help of their hands and special cameras and instruments gets patients
out of the operating room faster than - and on the road to recovery just
as fast as - a more conventional laparoscopic technique, a new study finds.
The research may help steer more physicians to choose the less-invasive
and more precise technique for their patients. The study shows that hand-assisted
laparoscopic nephrectomy can be done in significantly less time than the
standard laparoscopic procedure, but that hand-assisted patients suffer
no more complications and spend no more time in the hospital than the
others.
The study covered
38 patients who had a kidney removed because of suspected renal cell carcinoma.
Compared with conventional open surgery, the procedures greatly reduce
the size of the incision, the complexity of the operation, and patients'
pain and recovery time.
Laparoscopic techniques,
which are performed with tiny cameras and instruments in tubes inserted
through small incisions, have nearly replaced the old-style nephrectomy
at many centers. But there has been a debate over whether the standard
laparoscopic approach, in which the surgeon uses the instruments alone
to place the kidney in a sack, cut it out, pulverize it, and remove the
pieces, is equivalent to the hand-assisted technique. In hand-assisted
operations, the patient's abdomen is inflated by gas so that the surgeon
can insert a hand through the small incision via a special pressurized
sleeve. With both a hand and laparoscopic instruments doing the work,
the surgeon has more control over the operation and more of a sense of
depth and sensation than can be gained through the lens of a camera. The
kidney can be removed intact, making it possible to evaluate the cancer.
The hand-assisted approach is also considered better for surgeons who
are still learning laparoscopic techniques.
The American Cancer
Society estimates that there will be about 30,800 new cases of all kidney
cancers this year in the United States, and that about 12,100 adults and
children will die from some form of the disease. Renal cell carcinoma
(RCC) is the most common type of kidney cancer in adults, and surgery
to remove the kidney and surrounding tissue, lymph nodes and the nearby
adrenal gland is the main treatment.
Even as more doctors
turn to hand-assisted laparoscopic nephrectomy as a front-line treatment
for cancer patients, they are also using it more and more to allow living
people to donate a kidney to someone whose own kidneys are failing. Dozens
of living-donor kidney removals for transplant are performed every year.
Results of the first-ever randomized clinical trial comparing open surgery
to laparoscopic surgery for kidney donors were presented. It was found
that patients who had the less-invasive operation used 47 percent less
painkillers, that their hospital stays were 35 percent shorter, and that
they have 73 percent less pain at six weeks past the operation. They also
returned to strenuous activity and work much sooner. But, the operation
for laparoscopic patients donating a kidney was longer and hospital costs
were higher.
These findings echo
the findings of previous studies that have compared either kind of laparoscopic
nephrectomy for cancer with traditional open surgery. For both those who
donate a kidney and those who have to have it removed, open surgery means
a foot-long incision, nearly a week in the hospital and more than a month
of painful recuperation. But laparoscopic surgery means a three-inch incision,
half the hospital stay and recovery, and much less pain. For the new cancer
study records of all 211 patients who had a kidney removed laparoscopically
between 1996 and 2000, for any reason were studied.
The 38 who had their
kidney out because a scan showed a suspicious mass or enlargement were
then surveyed about their experience during the recuperation period. Twenty-two
had had a hand-assisted operation; the other 16 had had the standard procedure.
The new study's results confirm that hospital stay and pain were the same
whether a cancer patient had the hand-assisted or standard laparoscopic
operation. The length of the operation was shorter for hand-assisted procedures,
though the length of the standard operation decreased as the physicians
gained experience with it after performing their first one in 1996. The
length of the hand-assisted procedures didn't change much as the team
gained experience starting with their first one in 1997. This learning
curve difference may signal another important advantage for the hand-assisted
technique. Surgeons who are used to doing open surgery can still use their
most familiar and flexible tool - their hand - to feel their way through
the area shown by the camera. And, they can handle major complications
that occur during the operation much better.
[Top]
Less
radical surgery for kidney cancer is equally effective to radical alternative
and less likely to cause failure to other kidney-(Cancer Info-10/12/2000)
A Mayo Clinic study
has found that a less radical surgical procedure that removes only the
tumor for treatment of kidney cancer results in equivalent long-term survival
when compared to its more radical alternative, removal of the entire kidney,
and is less likely to result in renal failure in the second kidney.
The study compared
the outcomes of 164 patients whose entire kidney was removed during a
procedure called radical nephrectomy to 164 patients who underwent nephron-sparing
surgery for kidney cancer between 1966 and 1999 at Mayo Clinic. At the
time of their first diagnosis, all of these patients with normal kidney
function had cancer in one kidney and their second kidney was cancer-free.
It was found that
patients who underwent radical nephrectomy had a significantly higher
risk of developing kidney failure in their remaining kidney and that long-term
survival of patients between the two types of procedures was entirely
identical.
At last follow-up,
126 patients (or 77 percent) who underwent radical nephrectomy and 130
patients (79 percent) who underwent the nephron-sparing surgery were alive
with no evidence of the disease. At 10 years, the cumulative incidence
of chronic renal failure was 22 percent for patients who had undergone
radical nephrectomy which was twice as high when compared to the 11 percent
of patients who underwent the less radical nephron-sparing procedure and
experienced renal failure. Patients whose kidneys fail experience a significant
decrease in quality of life, placing a financial burden on these patients
and society.
During a nephron-sparing
procedure, surgeons remove the tumor and spare the surrounding kidney
and preserve kidney function. The more radical procedure was first performed
in the 1960's and has been the standard for care for patients with cancer
in one kidney and a second cancer-free kidney. In recent years, the nephron-sparing
procedure has gained acceptance and become more widely used. About 31,000
cases of kidney cancer are diagnosed each year in the United States.
Mayo Clinic physicians
also found that when the kidney tumor was less than 4 cm. in diameter,
the tumor actually turned out to be benign in 22 percent of all cases.
Better diagnostic imaging techniques have improved the ability to identify
these tumors. In some cases, tumors can be benign and removal of the entire
kidney is unnecessary.
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