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Stray
bone marrow cells can cause cancer-(Times of India-27/11/2004)
tomach cancer may arise from
stray bone marrow cells rather than stomach cells, researchers said in a
study that could overthrow theories about the origins of the disease. The
study challenges a long held assumption that stomach, lung and other
cancers start when a cell within that tissue racks up mutations and starts
to multiply uncontrollably. Timothy Wang of Columbia University wondered
whether bone marrow cells which are thought to home in on infected and
inflamed areas might be sparking cancers.
They studied mice infected with
heliobacter pylori which is an ulcer causing bacterium that triggers a
large proportion of human stomach cancers. They wiped out the animal's own
bone marrow with radiation and then infused them with fresh bone marrow
cells. These were labeled so that they could be tracked through the body.
20 weeks later some of the bone marrow cells had homed into the stomach
and divided and tumours had formed.
[Top]
Clues
to beating stomach cancer-(Yahoo News-12/08/2004)
Scientists believe they may
have found a new way to fight a potentially dangerous stomach infection.
Researchers in the United States have discovered that a chemical in the
body can protect against H.pylori. Over 50% of people carry this
bacterium, most without any ill effects. However, it can cause stomach
ulcers and cancer in others. Writing in Science, the researchers said
their discovery could lead to new treatments to fight the infection.
H.pylori - short for
Helicobacter pylori - is mostly found in the stomach. It usually resides
in the outer layer of mucous that lines and protects the stomach. It is
rarely found in the deeper layer of this mucous. This prompted researchers
at the Burnham Institute in California to carry out tests to see if there
were specific agents in the deeper layers that protected against H.pylori.
They looked specifically at a chemical called alpha
1,4-N-acetylgluseamine. This is found in the deeper layers of mucous but
not in the outer layers. The scientists
found that H.pylori lost its shape, became immobile and eventually died
when it came into contact with this chemical. They said the effect was
very similar to antibiotics, which attack and dissolve the bacterium's
cell wall.
The researchers also carried
out tests on the H.pylori bacterium. They found that a type of fat or type
of cholesterol called cholesteryl-alpha-D-gluco- pyranoside plays a key
role in helping it to grow. They said the discovery could lead to new
treatments to fight the infection. "This naturally-occurring
cholesterol offers a very specific target for the design of safer drugs
that could treat stomach ulcers and, long-term, prevent stomach cancer
linked with H.pylori," said Dr Minoru Fukuda, who led the study.
The findings were welcomed by
Cancer Research UK. "This is a fascinating and careful piece of
research which could lead to important new avenues in treating this
chronic gastric infection which is a major risk factor for stomach
cancer," said Dr Richard Sullivan, its head of clinical programmes.
[Top]
Apple
can protect against stomach cancer-(Yahoo News-23/06/2004)
Eating at least two
apples a day may reduce the risk of developing stomach cancer, Italian
media quoted a new study from the University of Naples. Italian researchers
said in the study, soon to be published in the prestigious international
gastroenterology journal GUT, substances in apples have a major protective
effect on stomach. They apparently achieve their beneficial effects by
warding off damage produced by free radicals, the culprits in a number
of processes including aging and the development of gastric tumors, the
study aid. The research team, led by Camillo Del Vecchio Blanco and Marco
Romano of Naples' Federico II University, found that the benefits of apple
extracts were due to their high content of anti-oxidants like catechin
and chlorogenic acid. The apple extract, along with the chlorogenic acid,
was shown to inhibit the growth of stomach cancer cells. "The next stage
is to move on to testing in humans and measuring the effect of the active
ingredients of apples as gastro- protective agents," Romano said. "It
is possible to conceive using these substances in other specific cases,
such as when patients have to take anti- inflammatory drugs." "In this
case the apple extracts reduce the negative effects that these medicines
have on gastric mucous, " he said.
[Top]
Use
of Asprin may Lower Risk of Stomach Cancer-(Times of India-12/03/2004)
A study by a Hong
Kong university research team found that long-term use of aspirin may
reduce the risk of stomach cancer. A team from the university of Hong
Kong's faculty of medicine reviewed data from 2,831 stomach cancer patients
and found that long-term use of aspirin or steroid-free, anti-inflammatory
drugs could reduce the risk of stomach cancer, or gastric cancer, by 22
per cent. The results were published in the journal of the National Cancer
Institute but researcher, Dr Benjamin Wang, said it was too early to forecast
whether aspirin could be used to treat cancer "The results we have at
this stage is for prevention only and we do not want to cause confusion
that this could also be used for treatment purposes," said Mr Wong. He
added this was merely a "first step" to prove the principle that aspirin
could reduce the risk of cancer and stressed more tests needed to be done,
including a clinical trial, to prove the results were accurate.
[Top]
Aspirin,
Ulcer Drug Tested for Cancer Prevention-(Reuters-29/12/2003)
British scientists
said they had launched a major clinical study to see whether a combination
of aspirin and an anti-ulcer drug could prevent thousands of cases of
cancer of the esophagus, or foodpipe. Millions of people already take
aspirin to relieve headaches and arthritis and to prevent heart attacks
and stroke. More recently, however, researchers have also suggested the
century-old drug could have a protective effect against cancer. The trial
will recruit 5,000 men at risk of cancer and last 10 years, making it
one of the largest cancer prevention trials in the world. Patients will
be given aspirin alongside AstraZeneca Plc's ulcer pill Nexium, with the
aim of preventing a pre-cancerous condition developing and subsequently
becoming cancerous.
Esophageal cancer
can start with a disorder called Barrett's esophagus, caused when stomach
acid regularly flows back from the stomach -- one of the symptoms of this
being heartburn. Acid damage can trigger changes within cells lining the
foodpipe and lead in a minority of cases to esophageal cancer, which kills
around 7,000 Britons a year. Cancer Research UK, which is funding the
study, believes successful treatment of Barrett's esophagus could prevent
up to a half of cases of cancer in the trial. Aspirin's mechanism of action
as a potential anti-cancer agent is unknown but researchers think it could
cut cancer risk because of its impact on an enzyme called cyclooxegenase-2,
which is involved in inflammation and is thought to be linked to the development
of cancer. If its anti-cancer properties are proven, aspirin -- which
began life as a simple painkiller developed by chemists at Germany's Bayer
AG -- will consolidate its position as one of the greatest finds in the
history of medicine. One of aspirin's side effects, however, is an increased
risk of stomach ulcers. Because of this, researchers decided to combine
it with a proven anti-ulcer medicine. Nexium works by limiting acid formation
in the stomach, so it may play a parallel role in minimizing damage to
the lining of the esophagus.
[Top]
Will
Wiping Out Ulcer Bug Stop Stomach Cancer?-(HealthDayNews-13/01/2004)
A new Chinese study
finds that treating people at risk for stomach cancer because they have
the ulcer bacterium is not much more effective than treating them with
a dummy drug. The results on ridding the bacterium, Helicobacter pylori,
weren't all bad, however. Among patients who had H. pylori, but who did
not have precancerous lesions caused by the infection, eradication of
the bug did significantly reduce the development of gastric cancer. The
study "proves that H. pylori causes gastric cancer, and that treatment
of H. pylori reduces the risk of developing cancer," says study leader
Dr. Benjamin Wong, an associate professor of medicine at the University
of Hong Kong. However, "in subjects with existing precancerous lesions,
the benefit, according to our findings, were minimal, but we need more
research on this. In
high-risk areas or high-risk groups, treatment of H. pylori to prevent
cancer should be advocated. This should be done early in life, when the
precancerous lesion has not developed yet because once precancerous lesions
have developed, the effect of treatment of H. pylori may be lost," Wong
adds.
"The connection between
H. pylori and gastric cancer is well documented," says Dr. Julie Parsonnet,
an associate professor of medicine and health research and policy at Stanford
University. Parsonnet, who co-authored an accompanying editorial, adds,
"I don't doubt that H. pylori is a very important cause of stomach cancer.
The only question is, is there a reasonable strategy to address it." H.
pylori is the main cause of gastritis and is responsible for about 80
percent of gastric ulcers and about 95 percent of duodenal ulcers. It
has also been associated with causing gastric cancer. In 1994, H. pylori
was defined as a grade 1 carcinogen.
To prevent gastric
cancer, experts have recommended that patients with gastric or duodenal
ulcers who also have H. pylori have the ulcer bug eradicated with a regimen
of antibiotics. In the study, Wong and his colleagues randomly assigned
1,630 healthy patients who had H. pylori to a two-week regimen of antibiotics
or placebo. During more than seven years of follow-up, the researchers
found 18 cases of gastric cancer -- seven among those who received treatment
and 11 among those who received a placebo. This is not a significant difference,
Wong's team reports in the Jan. 14 issue of the Journal of the American
Medical Association. However, in a subgroup of patients who did not have
precancerous lesions, none of the patients who were treated for H. pylori
developed gastric cancer compared with six patients who received placebo.
"What we would like
to see is that if you treat everybody to eradicate H. pylori, you can
cost-effectively prevent stomach cancer. But what this data shows is that
this simple answer may not be possible," Parsonnet says. Parsonnet speculates
the follow-up of the patients was not long enough, and that seen over
a longer period of time H. pylori eradication would have proven more effective
in preventing gastric cancer. There are a lot of unanswered questions,
Parsonnet adds: "If you treat whole populations, are there going to be
side effects? Is there going to be increased drug resistance? Are you
going to increase the risk for other diseases? Are you going to prevent
other diseases? Are you going to decrease total mortality?" Parsonnet
believes a cheap, effective, noninvasive way of finding those with H.
pylori who do not have precancerous lesions needs to be developed. This
could identify those who would benefit most from treatment, she says.
More effort should be placed on eradicating H. pylori in developing countries,
where it is most prevalent, Parsonnet believes.Gastric
cancer is becoming rare in the United States, but it is common in these
countries. "The reason gastric cancer is getting rare in the U.S. is because
H. pylori is disappearing rapidly from the U.S." Parsonnet say.
"So maybe that should
be our focus -- how to get H. pylori to disappear around the world, and
focus less on treatment than on prevention." Dr. Steven Moss, an assistant
professor of medicine at Brown University, agrees with Parsonnet. "In
areas where gastric cancer and H. pylori are very common, it is a big
public health issue," he says. In the United States, Moss believes that
screening for H. pylori in high-risk immigrant communities might be an
effective way of preventing stomach cancer. Moss says other studies are
going on in Asia, and they may show a stronger connection between treating
the bacterium and preventing stomach cancer. Dr. David Y. Graham, a professor
of medicine and molecular virology at Baylor College of Medicine, comments
that "H. pylori causes gastric cancer, and if treated early enough can
prevent gastric cancer." "Eradication of H. pylori would eliminate the
second most common cancer in the world," he adds
[Top]
Western
Diet Link to Intestinal Cancer Studied-(HealthDayNews-20/11/2003)
A $10-million, five-year
grant from the National Institutes of Health will be used by researchers
at Montefiore Medical Center in New York City to investigate how a diet
high in fat and phosphorus and low in calcium and vitamin D may predispose
people with genetic mutations to develop cancer of the intestine This
is the first major national study to explore how a Western-style diet
that mimics the key risk factors for colon cancer interacts with genetic
factors and molecular pathways to increase the risk of intestinal cancer.
Researchers will use a genetic research tool called microarray analysis
and other technologies designed to image gene expression and analyze protein
structure. They plan to determine on a molecular level how each component
of the Western diet by itself, and in combination with genetic mutations
known to initiate tumor formation, influences 27,000 specific genes and
the mechanisms of intestinal cell growth that can lead to tumor formation.
The study will link data from both animal research and human clinical
trials.
[Top]
High
Vitamin E Levels Reduce Gut Cancer Risk-(Reuters Health-25/09/2003)
High blood levels
of alpha-tocopherol, a form of vitamin E, may reduce a person's chances
of getting stomach and esophagus cancer, new research suggests The findings,
which are reported in the Journal of the National Cancer Institute, are
based on a Chinese study in which participants took supplements containing
vitamin E or used no supplements. People who used the supplements were
less likely to die from cancer than those who did not, Dr. Philip R. Taylor,
of the National Cancer Institute, in Bethesda, Maryland, and colleagues
note.
Further analysis
revealed that the risk of esophagus cancer and a type of stomach cancer
decreased as blood levels of alpha-tocopherol rose. In contrast, levels
of gamma-tocopherol, another form of vitamin E, were not related to the
risk of either cancer. Surprisingly, high levels of alpha-tocopherol appeared
to raise the risk of another type of stomach cancer called gastric noncardia
cancer (GNCC). "We have no ready explanation for our finding that higher
blood levels of alpha-tocopherol were associated with an elevated...risk
of GNCC," the authors note. The results "provide support for a role of
alpha-tocopherol in the (cause) and prevention of" esophagus and stomach
cancers, the investigators conclude.
[Top]
A
Few Main Risk Factors Account for Stomach Cancer-(Reuters Health-19/09/2003)
A few main risk factors
account for most stomach and esophagus cancers that occur in the general
population, new research shows. Although numerous reports have identified
risk factors for these diseases, "no study has comprehensively examined
their contributions to the cancer burden in the general population," lead
author Dr. Lawrence S. Engel, from Memorial Sloan-Kettering Cancer Center
in New York, and colleagues note. The current study involved 1143 patients
with esophagus or stomach cancer and 695 healthy people. The patients
were diagnosed between 1993 and 1995 in Connecticut, New Jersey, or Washington.
The researchers looked at the four main types of cancer that involve the
esophagus and stomach: adenocarcinoma of the esophagus, squamous cell
cancer of the esophagus, adenocarcinoma of "cardia" region of the stomach,
and adenocarcinoma of other stomach areas. The new findings are reported
in the Journal of the National Cancer Institute.
Being overweight
accounted for the greatest percentage of esophagus adenocarcinomas--41
percent, the authors state. The next biggest contributor--ever smoking--accounted
for 40 percent of cases. Together, being overweight, ever smoking, reflux
of stomach contents into the esophagus, and low fruit and vegetable consumption
accounted for 79 percent of cases. Alcohol consumption was responsible
for the greatest percentage of esophageal squamous cell cancers--72 percent.
Nearly 90 percent of cases could be accounted for by alcohol use, a history
of ever smoking, and low fruit and vegetable intake.
For stomach cardia
adenocarcinomas, smoking was the biggest contributor, responsible for
45 percent of cases. A history of ever smoking and being overweight together
accounted for 56 percent of cases. For other stomach adenocarcinomas,
increased nitrite intake, a compound found in smoked foods, accounted
for the greatest percentage of cases--41 percent, the researchers point
out. The rapid rise in the rate of new cases of stomach and esophagus
cancers that has occurred in Western populations appears to result from
increases in the prevalence of several risk factors that people are capable
of changing, the authors note. "Efforts to reduce the prevalence of being
overweight, having gastroesophageal reflux, and smoking and to improve
diet could reverse this troubling cancer trend," they add.
[Top]
Taxotere(R)
(docetaxel) Injection Concentrate Regimen Shown to Provide Survival Benefits
in Advanced Stomach Cancer-(MARKET WIRE-02/06/2003)
Results from an interim
analysis of a landmark study show that patients with advanced stomach
cancer, also known as gastric cancer, who received a Taxotere®-based chemotherapy
treatment had a marked improvement in median survival rates compared to
patients who received a standard treatment. One-year survival rates reached
44 percent for patients treated with the Taxotere®-based regimen. The
results of the largest Phase III international study of advanced stomach
cancer patients to date were highlighted at the 39th annual meeting of
the American Society of Clinical Oncology (ASCO). Results also showed
that patients had a 67 percent higher rate of tumor shrinkage as compared
to patients who did not receive Taxotere® (response rate was 39 percent
vs. 23 percent), a statistically significant improvement with the Taxotere®-containing
regimen.A statistically
significant improvement in time to tumor progression (time without the
cancer growing) was also observed with the Taxotere®-containing arm.
"The incorporation
of Taxotere® into a commonly used chemotherapy regimen may be the most
important advance in the treatment of stomach cancer in the last 20 years,"
said Jaffer A. Ajani, MD, Professor, GI Medical Oncology, The University
of Texas M. D. Anderson Cancer Center, Houston, Texas, who is one of the
two principal investigators of this study. "Doctors treating patients
with stomach cancer urgently need new therapeutic strategies. It makes
sense to investigate an agent such as Taxotere®, which has been shown
to have definite anti-tumor activity in other aggressive types of cancer.
We need better treatment options to help patients with this devastating
cancer."
Approximately 800,000
new cases of stomach cancer are diagnosed annually, and the disease is
the second most common cause of cancer death worldwide. At diagnosis,
most stomach cancer patients have advanced disease with an expected survival
of only six to nine months.
The planned interim
analysis evaluated study results of 223 patients who were randomized to
treatment with either Taxotere®, cisplatin and 5-fluorouracil (5-FU),
(111 patients), or cisplatin and 5-fluorouracil (5-FU), (112 patients).
The median survival of patients receiving the Taxotere®-containing regimen
was 10.2 months vs. 8.5 months for patients receiving cisplatin and 5-FU
alone, p=0.0064. In addition, the Taxotere® combination significantly
improved the time to progression (5.2 months vs. 3.7 months, p=0.0008)
when compared to cisplatin and 5-fluorouracil. The response rate was also
significantly higher among patients receiving the Taxotere® therapy (39
percent vs. 23 percent, p=0.012). The two treatments were associated with
comparable rates of side effects, with the Taxotere®-based regimen resulting
in higher rates of diarrhea and infection, while the standard treatment
resulted in higher levels of nausea, vomiting and stomatitis. The Taxotere®
combination also resulted in an increased incidence of low white blood
cell counts. Supportive medications are available to control this problem.
"Medical oncologists
should treat only those patients whose symptoms are fairly well controlled.
Careful monitoring and management after this treatment is essential to
reduce or prevent undesirable effects," emphasized Dr. Ajani. "A team
approach that involves the patient, patient's caregiver, nurses, and physician,
for the treatment of patients is much more effective than all previous
approaches." Nearly 100 percent of the patients enrolled in this randomized,
international, multi-center study, had cancer that spread beyond the stomach.
"These interim results showed that advanced stomach cancer patients receiving
the Taxotere®-based regimen lived longer than those receiving standard
treatment," said Prof. Eric Van Cutsem, MD, PhD, Department Internal Medicine,
University Hospital, Leuven, Belgium, who is one of the two principal
investigators of this study. "This is the first time we are seeing survival
rates of 44 percent at the one-year point in patients with advanced stomach
cancer."
[Top]
New
Ideas on How Gut Bacteria Cause Ulcers, Cancer-(Reuters Health-29/05/2003)
Research
released Thursday may offer a new explanation for how a bacterium known
to cause ulcers and stomach cancer does its damage in the gut. Reporting
in the journal Science, researchers in U.S. and Italy discovered that
a form of the bacterium, known as Helicobacter pylori, may cause problems
in the gut by disrupting the junctions between the cells that make up
the protective stomach lining. These junctions contain important substances
that help the body with numerous processes, such as repairing damaged
stomach cells, study author Dr. Manuel Amieva of Stanford University in
California told Reuters Health. Disrupting those junctions may prevent
the body from repairing damage in the stomach when it occurs, perhaps
allowing a relatively minor problem to eventually progress to something
more serious, such as an ulcer or stomach cancer, Amieva said.
The research focused
on the form of H. pylori that contains a gene known as CagA. Among different
types of H. pylori, the CagA-carrying form is presumed to be particularly
capable of causing illness, Amieva said. He estimated that slightly more
than half of H. pylori strains may carry CagA. During the study, Amieva
and his team discovered that removing CagA prevents H. pylori from disrupting
these junctions, suggesting that the CagA protein plays an important role
in this process, he noted. Based on these findings, it may one day be
possible to protect people from CagA-carrying bacteria by designing a
drug or vaccine that blocks CagA, the researcher said. However, he cautioned
that researchers need to learn more about how CagA causes damage in the
body before they can begin designing therapies that stop it. "I think
we're just starting to get at the biology of what's going on," Amieva
said. "I think we need to know more first about what (CagA) is doing."
"We don't know that CagA directly is causing the ulcers or causing the
cancers ... there's probably other things that contribute to this," he
added. "What we do know is that if you have CagA around, then you are
more likely to get these diseases."
Approximately half
of the population carries H. pylori, which usually causes no harm but,
in some instances, can increase the risk of ulcers, gastritis, and stomach
cancer. Amieva explained that researchers have known that around 10 percent
of all the bacteria found in the stomach attach to the cells that make
up the stomach lining. Working with samples of stomach cells in the laboratory,
Amieva and his colleagues discovered that once attached to those cells,
only forms of H. pylori that carry CagA concentrate around the edges between
two cells, near the junctions that hold stomach lining cells together.
"If we remove the CagA gene from the bacteria, they still attach to the
cells, but they don't concentrate over the junction," Amieva said. Once
near the junctions, the bacteria inject the CagA protein into the lining
cells. After that occurs, the researchers found that the proteins that
make up the junctions begin to migrate away from the junctions and toward
the H. pylori cells, thereby disrupting the integrity of the region. And
after removing the CagA gene from H. pylori, the researchers saw that
the proteins involved in the junctions no longer migrated toward the attached
bacteria, leaving the junctions intact. Amieva added that a recent study
suggests that H. pylori may also cause ulcers by secreting a protein that
binds to the surface of stomach-lining cells and causes the lining to
break apart, exposing the stomach to ulcer-causing substances such as
acid and bile. "It is possible that there are other insults that disrupt
the (stomach lining) and start the process of forming an ulcer," he said.
[Top]
Halitosis
Could Be Sign of Ulcer Bug Infection-(Reuters Health-31/01/03)
Persistent bad breath
could be a warning sign that a patient is infected with a bacterium linked
to ulcers and stomach cancer, according to new research from Turkey. Researchers
from Baskent University discovered that halitosis was one of the most
common symptoms in patients diagnosed with Helicobacter pylori infection.
They believe it could be used more widely to screen for the bug and prescribe
drugs to eradicate it. In a report in the European Journal of Internal
Medicine, research leader Dr. Ender Serin and colleagues write that bad
breath is a "frequent, but treatable, symptom" of H. pylori infection.
In people with the infection, halitosis "may be a valid indication" for
therapy to eliminate the bacterium, according to the researchers.
Many cases of H.
pylori infection emerge only when people develop symptoms, such as bloating,
pain or indigestion. The Turkish researchers wanted to assess the frequency
of halitosis before and after eradication therapy for the bacterium. They
studied 148 people who had a type of indigestion called dyspepsia and
bad breath and gave them all treatment to kill off the bug. Four weeks
later their symptoms were assessed again. The results showed that, before
treatment, bad breath was the third most common symptom, behind bloating
and pain. More than 60% of the patients involved had halitosis. After
eradication therapy however, many patients reported their bad breath had
disappeared.
"In patients with
confirmed H. pylori eradication, the most successfully resolved symptoms
were halitosis and hunger-like pain," the researchers report. Professor
John Summerfield, a specialist in gastroenterology at the Imperial College
of Science, Technology and Medicine in London, said he had never heard
of a link between bad breath and gut infection. "I've certainly never
heard of halitosis associated with H. pylori. The trouble is halitosis
is so subjective," Summerfield said. "It's a perception rather than a
real thing. Everybody's breath smells to a certain extent." Besides ulcers,
infection with H. pylori can cause chronic stomach inflammation called
gastritis and may increase the risk of stomach cancer. Antibiotics and
drugs called proton pump inhibitors can clear the infection.
[Top]
Vaccine
May Be Useful Against Ulcer Bug-(Reuters Health-30/12/2002)
Vaccination may be
a promising strategy for preventing re-infection with an ulcer-causing
bacterium, researchers in Sweden report. But vaccines against the ulcer
bug, H. pylori, or Helicobacter pylori, caused stomach inflammation in
mice, so they may need to be combined with antibiotics, according to the
study's first author, Sukanya Raghavan of Goteborg University. The results
of the research were published in the journal Infection and Immunity.
Besides ulcers, infection with H. pylori can cause chronic stomach inflammation
called gastritis and may increase the risk of stomach cancer. Antibiotics
and drugs called proton pump inhibitors can clear the infection, but there
is a need for another treatment, according to Raghavan and her colleagues.
They point out that treatment can be expensive, patients do not always
follow the treatment as prescribed and some strains of H. pylori have
become resistant to medications. This is where vaccines come in.
Most vaccines are
used to prevent infection, but "therapeutic" vaccines can be given to
someone already infected to boost the immune system. Working with mice,
Raghavan and her colleagues, under the leadership of senior author Dr.
Ann-Mari Svennerholm, tested several types of H. pylori vaccines. Some
of the vaccines contained whole versions of H. pylori that had been killed,
while other so-called lysed vaccines contained only bits of dead bacteria.
Some, but not all, of the vaccines that contained whole, killed H. pylori
were "highly effective" at reducing H. pylori levels, Raghavan said.
The effectiveness
of these vaccines varied depending on what strain of H. pylori they contained.
For vaccines containing whole H. pylori to be effective, the type of strain
would have to be matched to the most common types of the ulcer bug, according
to Raghavan. In contrast, the vaccines that contained only portions of
the ulcer bug were effective at reducing H. pylori levels, regardless
of what strain was used. But getting rid of H. pylori was not without
side effects.
Mice experienced
stomach inflammation after being vaccinated. Raghavan noted, however,
that this inflammation "was not harmful, and it could be treated by eradicating
the H. pylori bacteria still remaining in the stomach with antibiotics."
The researchers propose that a strategy that includes both vaccination
and eradication is the "optimal choice" for treating H. pylori infection.
"We hope that this strategy of combined vaccination and antibiotic treatment
should be evaluated in humans in the near future," Raghavan said.
[Top]
GERD:
A Growing Concern-(HealthScoutNews-24/11/2002)
Gastroesophageal
reflux disease, or GERD, is a chronic condition that is more common than
you might think but missed more often than you might guess. Yet, GERD's
symptoms are all too familiar to the 25 million American adults who experience
them on a daily basis: heartburn; an acid taste in your mouth; trouble
swallowing; and regurgitation of food. Most mild cases are easily treated
with changes in eating habits and medications, and more severe ones can
be treated with the latest in surgical procedures. But some doctors are
starting to make the troubling link between the increasing number of GERD
cases and a similar jump in the number of cases of esophageal cancer.
GERD occurs when
stomach acid makes its way into the esophagus, usually because the valve
that separates the two relaxes as people age. Alcohol, chocolate, caffeine
and heavy meals can aggravate the condition. "For most people, GERD is
a lifestyle issue," says Dr. Garth Ballantine, a New Jersey surgeon who
treats those with serious GERD. "If you're like me and have steak and
red wine for dinner and maybe a cigar and glass of port afterwards, well,
anyone who has that meal is going to have reflux. And I can choose not
to have reflux by avoiding those foods."
However, those whose
symptoms are more constant and more severe need to get treatment before
more serious conditions develop. That's part of the reason why the fourth
annual GERD Awareness Week starts today, supported by the International
Foundation for Functional Gastrointestinal Disorders (IFFGD). "GERD, of
which heartburn is the most common symptom, is pretty common among adults,"
says Dr. Timothy Wang, head of gastroenterology at the University of Massachusetts
School of Medicine. "And the major concern is that esophageal cancer is
the fastest-rising cancer in the United States -- up 8 percent a year
-- and a presumption is that the rise is related to GERD." "But while
there is a lot of research on GERD, there aren't a lot of answers," Wang
adds. "So we are treating GERD more aggressively, but don't want to over-alarm
people, as those at risk for cancer are a pretty small group, only about
1 percent."
That group includes
those with a condition called Barrett's esophagus, which occurs when chronic
GERD has changed the cellular makeup of the lining of the esophagus, Wang
says. When that happens, those people face a higher risk of esophageal
cancer. Esophageal cancer strikes men three times more often than women,
according to the American Cancer Society. It's not a common cancer --
roughly 13,100 new esophageal cancer cases will be diagnosed in 2002,
according to estimates. That compares to 131,600 new cases of colon cancer.
Although people with
Barrett's esophagus need to be monitored regularly, Wang says, the majority
of people with GERD can turn to simpler treatments to control their discomfort.
"The usual numbers are that 40 percent of the adult population get heartburn
once a month, 7 percent once a week and 3 percent once a day. And 98 percent
of these symptoms are controlled by lifestyle changes or over-the-counter
medicines," Ballantine says. To relieve symptoms, people can take antacids,
which eases heartburn by neutralizing the acid in the esophagus. For chronic
reflux, he says, doctors prescribe stronger medicines, including Pepcid
and Tagamet, and proton pump inhibitors such as Prilosec.
For approximately
2 percent of people, however, medication doesn't help. Doctors then have
to check for a hiatal hernia -- when part of the stomach moves up into
the chest. They can also assess the acid levels in the esophagus and look
at the lining of the esophagus through a small camera, a procedure called
an endoscopy, Wang says. The procedure can find inflammation, ulcers or
the cellular changes in the esophageal lining that signal Barrett's esophagus,
Wang says, "but most peoples' esophageal linings look normal." If doctors
do find that chronic GERD is too uncomfortable or dangerous to a person's
health, there are some surgical procedures that can tighten the valve
that controls the amount of acid that leaks into the esophagus.
The U.S. Food and
Drug Administration (FDA) recently approved two minimally invasive surgeries
for GERD that can be done on an outpatient basis. One procedure uses a
tube with a tiny device on the end that can stitch and tighten the valve,
and the other uses a catheter with needle electrodes that use radio waves
to tighten the valve. However, Ballantine and Wang say early results on
both of these procedures are mixed. As a last resort, Ballantine says,
patients can have laparoscopic surgery that can correct a hiatal hernia
or tighten the stomach around the bottom of the esophagus. Better yet,
he says, you can stop GERD before it leads to problems. "Most people can
choose among certain lifestyle changes that will or will not prompt reflux,"
he says.
[Top]
Many
Stomach Cancer Cases Caused by Tobacco Use (Reuters Health-08/10/2002)
Cigarette smoking
and use of other tobacco products significantly increases the risk of
death from stomach cancer in men and women, a large study of US adults
indicates. Stomach cancer is the second most common cancer worldwide and
is known to be linked to chronic infection with the ulcer-causing bacteria
Helicobacter pylori. In its Review of Tobacco conducted in June of this
year, the International Agency for Research on Cancer concluded that there
is "sufficient evidence in humans" to infer a causal relationship between
stomach cancer and tobacco use, Dr. Ann Chao of the American Cancer Society
in Atlanta, Georgia, told Reuters Health.
Findings of the current
study by Chao and her colleagues, published in the October 1st issue of
the International Journal of Cancer, back up this conclusion. Chao's group
examined stomach cancer mortality in relation to cigarette smoking in
women and cigarette, cigar, pipe and smokeless tobacco use in men enrolled
in the Cancer Prevention II Study. They identified 996 and 509 stomach
cancer deaths among 467,788 men and 588,053 women, respectively. The researchers
found that compared to non-smokers, male cigarette smokers had slightly
more than double the risk of dying from stomach cancer, while the risk
for female smokers was 49% higher than for non-smokers.
Among men, current
cigar smoking increased the risk of death from stomach cancer 2.3 times
compared to non-smokers. Men with chronic indigestion or stomach ulcers
who smoked cigarettes were more than 3 times more likely to die from stomach
cancer, and nearly 9 times more likely to die from the disease if they
smoked cigars, compared with non-smokers, the authors report. If causal,
the authors estimate that the proportion of stomach cancer deaths attributable
to tobacco use would be 28% in US men and 14% in women. "These results
were very consistent in our study population that has overall lower rates
of stomach cancer compared to other countries, and have major implications
for countries with much higher stomach cancer rates and increasing smoking
prevalence," Chao told Reuters Health.
[Top]
Gleevec
May Fight Broader Range of Cancers (Reuters Health-14/08/2002)
A cancer drug already
known to fight one form of leukemia may benefit a wider range of cancer
patients, according to research. Two studies separately found that the
drug imatinib mesylate shrunk tumors in a majority of patients with gastrointestinal
stromal tumors (GIST), and greatly improved the condition of four patients
with blood cancers known collectively as chronic myeloproliferative disease.
Imatinib is sold as Gleevec in the US and Glivec in Europe. Gleevec was
first approved by the US Food and Drug Administration (FDA) last year
for the treatment of chronic myeloid leukemia. The new findings on GIST
add to the data that earlier this year convinced the FDA to approve imatinib
for treating GIST, a relatively rare but tough-to-treat cancer that arises
in the stomach and intestines. And with the additional study on chronic
myeloproliferative disease, the drug now holds promise for some patients
with this group of disorders. The results of both studies are published
in The New England Journal of Medicine. Both received funding from the
Swiss pharmaceutical company Novartis, the maker of imatinib.
Imatinib has received
much attention since its debut because it is among the first in a new
wave of cancer therapies designed to specifically target molecular abnormalities
on cancer cells, leaving healthy cells unharmed. Imatinib inhibits three
forms of a cellular protein called tyrosine kinase: ABL, KIT and platelet-derived
growth factor receptor beta (PDGFRB). These proteins all help regulate
the proliferation and survival of cells, but when their normal signaling
patterns go wrong, abnormal cells may get a green light to multiply and
spread. An abnormality in ABL is at work in chronic myeloid leukemia,
while gene mutations that keep KIT activity perpetually "on" are usually
seen in GIST. And in a small number of people with chronic myeloproliferative
disease, a defective PDGFRB gene is to blame.
In one of the new
studies, Dr. Jane F. Apperley and colleagues treated four such patients
with a PDGFRB mutation. All had high numbers of certain abnormal blood
cells, and one patient--first seen at age 6--had developed widespread
skin lesions. But within 4 weeks of starting imatinib, all patients had
normal blood cell counts, and the patient with skin lesions began to see
them heal shortly after starting therapy, according to Apperley's team.
"The cells expressing PDGFRB disappear," said Apperley, a researcher at
Imperial College in London. "Presumably, (imatinib) induces cell death
in some way." She told Reuters Health that the success of imatinib so
far signals the beginning of "intelligent chemotherapy." "(Imatinib) is
only the start of targeted therapies," Apperley said. "There will be many
other drugs designed to selectively inhibit certain cellular proteins."
In the GIST study,
a team led by Dr. George D. Demetri of the Dana-Farber Cancer Institute
in Boston, Massachusetts, found that 54% of their 147 patients had a partial
response to imatinib therapy--meaning their tumors shrunk by at least
50%. This adds longer-range--and more-positive--data to the initial results
presented to the FDA, Demetri pointed out. The shorter-term findings had
shown that 38% of patients saw their tumors shrink by one half. Given
that the patients had advanced GIST, for which there has been no effective
drug, these results are "really remarkable," Demetri told Reuters Health.
Before imatinib, he said, patients like those in his study would all have
died within 18 months. Among the study patients, 88% were still alive
one year after imatinib treatment.
The treatment is
not without limitations, however. Cancer patients treated with a single
drug commonly develop resistance to the medication, and this is "what
we expect over time" with imatinib, Demetri said. According to the researcher,
"what is really exciting" about the recent imatinib findings is the fact
that the growing understanding of the abnormal cell signaling involved
in these relatively rare cancers should shed light on the roots of more-common
cancers. Knowing which cell signals go wrong in cancer should allow scientists
to develop "rational" drugs that zero in on these processes--rather than,
Demetri said, going through "trial and error" with non-specific drugs.
[Top]
Pre-Surgery
Chemo Boosts Esophageal Cancer Survival-(Reuters-17/05/2002)
Treating patients
suffering from cancer of the esophagus with chemotherapy before surgery
helps them live longer, British scientists said. In a study published
in The Lancet medical journal, researchers from Britain's government-funded
Medical Research Council (MRC) said pre-surgery treatment improved the
patients' ability to swallow and the outcome of the surgery itself. "The
results of this trial have enabled the management of esophageal cancer
in routine practice to be improved," Dr. David Girling, who coordinated
the research, said in a statement. In the trial of more than 800 patients,
43% of the cancer patients given chemotherapy before their tumor was removed
were alive two years later, compared to 34% of patients who had chemotherapy
after surgery. Esophageal cancer develops in the cells that line the esophagus,
or food pipe, which connects the throat to the stomach.
[Top]
'Ulcer
Bug' Can Be Found in Store-Bought Food-(Reuters Health-23/05/2002)
A bacterium that
can cause gastric ulcers and increase the risk of gastric cancer was present
in as much as 40% of chicken purchased in a local grocery store, Chicago
researchers reported at Digestive Disease Week, an annual meeting of gastroenterologists
being held here. "If we don't cook food fully, there's a possibility we
could get contaminated," study co-author Christy Jack, a research assistant
at the Evanston Northwestern Healthcare Research Institute, told Reuters
Health. "It was an eye-opener." The bacterium Helicobacter
pylori is believed to be transmitted orally by ingesting food or water
infected with fecal matter. The bacteria probably contaminated the food
products during handling in the store or slaughterhouse, Jack said. H.
pylori infects the stomach lining, causing an inflammatory response that
can increase the risk for gastritis and gastric cancer, but may be treated
with a regimen of antibiotics, she noted. The researchers evaluated 13
different food types purchased from behind the counter at a local grocery
store. They were able to grow cultures of the H. pylori on about one third
of the samples of the chicken, shrimp, pork, crab, clam and fish. As a
more accurate follow-up, they then conducted genetic-based testing on
the chicken and determined that 40% of the chicken pieces tested positive
for the presence of the H. pylori bacteria.
[Top]
Broccoli:
The Latest Cancer Killer?-(Health Scout News-28/05/2002)
Instead of driving
to the pharmacist for a course of antibiotics, people infected with a
common bacterium that causes stomach ulcers and stomach cancers may head
one day to the supermarket for a dose of broccoli or broccoli sprouts.
Scientists from Johns Hopkins University in Baltimore and the French National
Scientific Research Center have completed a laboratory study that shows
that sulforaphane, a compound found in abundance in broccoli and broccoli
sprouts, also kills helicobacter pylori, the bacterium responsible for
a majority of stomach ulcers and stomach cancers worldwide. "The results
are quite interesting, but the dosage and human studies are still needed,"
says Shiuan Chen, professor of biological sciences at City of Hope Cancer
Center in Los Angeles. Clinical trials to see whether dietary intake of
vegetables containing sulforaphane yields the same results are slated
to begin shortly. The findings, reported
in the Proceedings of the National Academy of Sciences, could have significant
public health implications. About 40 percent of people in developed countries
and 70 percent in developing nations carry heliobacter. Infected individuals
have a three-to-six times higher risk for developing stomach cancer, the
second most common cancer in the world and the leading cancer killer in
the developing regions of Asia, Africa and South America. Stomach cancer
is much less common in areas of the world where there is a high consumption
of fruits and vegetables, indicating that the cancer is highly preventable.
In areas of the world where H. pylori is most common, antibiotics are
difficult to obtain and use and are not always effective. Some 15 percent
to 20 percent of infections are resistant to conventional antibiotics.
The new research
started in an most unscientific way, when Dr. Jed Fahey of Johns Hopkins,
the lead author of the study, heard a story about several individuals
who'd had stomach ulcers and who had unexpectedly seen their symptoms
disappear after eating three-day-old broccoli sprouts. Broccoli and broccoli
sprouts are known to contain abundant quantities of sulforaphane, a compound
that has been shown to inhibit the growth of a variety of microorganisms.
Sulforaphane also can protect cells against cancer by increasing production
of certain enzymes. Fahey and his colleagues took sulforaphane to the
laboratory and found that it killed many different strains of heliobacter,
including strains that were resistant to commonly used antibiotics. And
unlike antibiotics, sulforapahen killed the bacterium whether it was inside
or outside the cells. Bacteria that "hide" in cells lining the stomach
are difficult to eradicate and have posed a major problem in combating
the disease. "It [broccoli] hits resistant bacteria and it's also intracellular,"
says Dr. Paul Talalay, a co-author of the study and professor of pharmacology
at Johns Hopkins University School of Medicine. "It's better than conventional
antibiotics."
The researchers also
showed that sulforaphane can protect against stomach cancer in mice. Though
these preliminary results are hopeful, it remains to be seen whether dietary
sources of sulforaphane will have the same or similar effects in humans.
There's also the question of whether this "treatment" could be exported
to developing regions of the world. "The implementation of any type of
therapy on large populations that are developing is an incredibly complex
problem, but it would be much easier to implement by a dietary strategy
than by having take pills every day," Talalay says.
[Top]
Bugs
may cause stomach cancer: Report -(Times of India Online-17/01/2002)
Chronic heartburn
may keep millions reaching for antacids but taking them may actually make
the stomach more hospitable to the bacteria the body is trying to kill
and an antibiotic may be a better choice. Two reports published this week
suggest that a variety of bacteria may be responsible for the inflammation
that causes ulcers and stomach cancer. The studies done so far only in
mice, build on the recent and startling discovery that the bacteria Helicobacter
pylori is behind most cases of stomach cancer.
It turns out that
H pylori may be just one of many bacterial culprits, said Dr Juanita Merchant
of the University of Michigan, who led both studies. And drugs used to
lower stomach acidity may actually promote the growth of these other bacteria."One important take-home
point from our papers is that you don't want to block acid secretion over
the long term just to treat either the bacterial overgrowth or the Helicobacter
infection, because that's going to potentially create other problems,"
Merchant said. "Antibiotics should be used to treat such bacterial overgrowth,
which will restore the normal acid-control mechanism."
The strongest acid
blockers are the most dangerous to use long-term, Merchant said. Her team
tested omeprazole, sold by AstraZeneca under the brand names Prilosec
and Losec. Another drug in the same class, known as proton pump inhibitors,
is lansoprazole, sold under the name Prevacid by TAP pharmaceuticals,
a joint venture of Abbott Laboratories Inc. and Japan's Takeda Chemical
Industries Ltd."In treating patients
with gastrointestinal disorders, physicians usually aim to increase the
pH of the stomach (lower its acidity) to try to protect their stomach
linings from ulceration which physicians initially believed was due only
to stomach acid," Merchant said. "There is also the dogma that most ulcers
are due to infections by Helicobacter." Merchant's team tested mice for
their studies, published in the January issues of Gastroenterology and
the American Journal of Physiology.
When they treated
normal mice with omeprazole for two months, the mice developed stomach
inflammation that was due to bacterial overgrowth. The inflammation went
away when the mice were given antibiotics. In another study they genetically
engineered mice that do not make gastrin, a hormone associated with acid
production. The mice developed
stomach inflammation, called gastritis, but they could not be infected
with Helicobacter. It turned out that the mice had so many other bacteria
in their stomachs that there was no room for the Helicobacter to grow.
Merchant said it is probably the body's response to the bacteria that
is causing the damage that leads to ulcers and stomach cancer. Her findings
build on previous research by other scientists, who believe some people
may be genetically programmed to respond more strongly to bacteria --
which is why only some people get ulcers from bacterial infections.
"It's the inflammation
that is probably doing the damage," Merchant said in a telephone interview.
"It doesn't matter whether it is Helicobacter or bacterial overgrowth.
The stomach reacts the same."The bacteria that
could be involved include lactobacillus, enterobacter, staphylococcus
and probionibacterium. What concerns Merchant is the possibility that
strong acid blockers may become available over the counter, without a
doctor's prescription. "People may stay on them long term and create problems
for themselves," she said. Popping the occasional calcium tablet or even
taking a weaker prescription antacid is probably not risky, she said.
"I don't think there is a problem over the short term," Merchant said.
"It is months and years of chronic acid suppression (that causes the problem)." In the long term,
Merchant said, it may be best to treat gastritis with anti-inflammatory
drugs perhaps something safer than the current available medications such
as aspirin and ibuprofen, which can worsen stomach pain. But she stressed
that many studies will have to be done in people before that could be
determined.
[Top]
Folic
acid potential for stomach cancer-(Cancer Info-20/12/2001)
A daily dose of folic
acid could help prevent stomach cancer, new research suggests. Pregnant
women are advised to take the supplement to protect their unborn child
and prevent birth defects. Now, scientists have found folic acid had a
beneficial effect on digestive tract cancers in beagles. It is hoped the
results may be applicable to human gastric cancers and that folate could
be used to prevent the development of digestive tract cancers.Lack of the nutrient
can activate substances called proto-oncogenes that promote the development
of tumours, say scientists. In the first reported study of its kind, published
in the medical journal Gut, scientists gave a cancer-inducing chemical
to 16 dogs for eight months. For 15 months, half the dogs were treated
with 20mg of folic acid. Tissue samples were taken from the gut wall every
two to three months. All eight dogs given the cancer-inducing chemical
alone, developed stomach cancer, while only three of the dogs treated
with folic acid did so.Fifteen months after the experiment, circulating
and gastric tissue levels of folate were still very high in the dogs given
the supplement. Dr Sh-Dong Xiao, of
the Shanghai Institute of Digestive Disease, which carried out the research,
said a folate intake of 400g a day, largely obtained from dietary sources,
usually prevents folate deficiency. He suggested higher doses might need
to be obtained from supplements."It is possible that
high dose folic acid might postpone the development of gastric cancer.
"It is hard to draw the conclusion that high dose folic acid only postpones
but does not prevent the development of gastric cancer. "Our study has
shown it has a marked interventional effect on gastric carcinogenesis."
[Top]
Blood
test could detect stomach cancer risk-(Times of India Online-25/10/2001)
A blood test to detect
a common stomach bug could help to identify people with a high risk of
developing stomach cancer, a British scientist said. Helicobacter pylori,
a bacterium that lives in the lining of the stomach, is the leading cause
of stomach cancer which is a particularly deadly disease that kills nearly
a million people worldwide each year. Professor David Forman, of the University
of Leeds in England, told a European cancer conference that a blood test
could easily detect who was infected with the bacterium which can be treated
with antibiotics.
"Apart from smoking, very few established causes of cancer have been associated
with an attributable risk of this magnitude. The critical question concerns
the extent to which H.pylori pre-cancerous changes will regress or be
prevented from progressing after the eradication of H.pylori from the
stomach," Forman said large scale studies were needed to determine if
eliminating the bacterium from the stomach would be useful in preventing
the disease. "It would be cheaper than other screening interventions,
such as breast screening and cervical cytology (smear tests), requiring
expensive technology and frequent repeat examinations."Along with the bacterium, genes also play a role in the development of
the illness and could be the key to why some people with the infection
develop stomach cancer and others don't. Some researchers believe stomach
cancer is an overreaction of the immune system against H.pylori. The infection
is also linked with ulcers and gastritis, or inflammation of the stomach.
An estimated 8,000 doctors, scientists and nurses are attending the five-day
meeting that ends on Thursday.
[Top]
Researcher
focuses on ulcer germ-(Times of India Online-14/09/2001)
Eradicating an ulcer-causing
germ as a way to prevent stomach cancer is a good idea at least in Japan,
a researcher says. Because the germ is common and stomach cancer relatively
rare, experts have disagreed about whether doctors should use antibiotics
to kill the bacteria, called Helicobacter pylori.
Of 1,526 patients with ulcers and other gastric problems in a study, 1,246
were infected with the bacteria, Dr Naomi Uemura wrote in the New England
Journal of Medicine. Of that group, 36 patients developed stomach cancer,
wrote Uemura, of Kure Kyosai Hospital in Kure City, Japan. Also in that
group, 253 patients were given treatment that eradicated their infections,
and none developed cancer, he wrote.
That is ``one of the most tantalizing and provocative findings in the
study,'' Dr Timothy G Wang of the University of Massachusetts Medical
Center and James G Fox, a veterinarian, at Massachusetts Institute of
Technology, wrote in an editorial in the journal. ``Most of those doubts
about the link between H. pylori and gastric cancer can now be put to
rest,'' Wang and Fox wrote.
Uemura wrote by e-mail that his recommendation to eradicate H. pylori
in patients who also have specific gastric problems is more applicable
in Japan than in the United States. Japan has the world's highest incidence
of gastric cancer partly because annual checkups include an endoscopic
examination, allowing very early detection, he noted. The incidence of
gastric cancer in the United States is much lower, although cancers unrelated
to H. pylori infections are on the rise. ``I do not recommend eradication
therapy for all symptomatic patients found to have H. pylori in the US,''
although those who want the treatment should be able to get it, Uemura
wrote.
[Top]
New
cancer drug is 'glimpse into the future'-(Cancer Info-06/07/2001)
A pioneering cancer
drug, which rapidly shrinks tumours, has been developed at a leading London
hospital. Initial trials of the ST1571 drug, known as Glivec, show that
tumours shrank or stopped growing in the majority of patients it was used
on at the Royal Mars-den Hospital. The drug, previously used to treat
chronic leukemia, has been harnessed in the fight against a rare form
of intestinal cancer called Gastro Intestinal Stromal Tumour (GIST). Even
patients with the advanced form of the disease benefited in trials of
the drug carried out in conjunction with the Institute of Cancer Research. Dr Ian Judson, who
led the research, said: "The benefits of Glivec are overwhelming. Most
striking is the speed of clinical improvement. These results could prove
a glimpse into the future of drug development and we are now seeking to
develop new drugs that will, like Glivec, precisely target the molecular
abnormalities in tumours." The drug offers an alternative to patients
with GIST, who previously could only be treated by surgery or pain control.
About 1,000 patients a year suffer from GIST tumours.
[Top]
Stomachs
removed after genetic tests –(Times of India Online-22/06/2001)
With her twin sister
dying of a rare hereditary stomach cancer, Natasha Benn made an extraordinary
decision that put her family at the forefront of the new genetic medicine:
She had surgeons remove her own, seemingly healthy stomach. As an identical
twin, she knew she was virtually certain to carry the same defective cancer
gene as her sister. The cancer had taken Benn's mother at age 29, along
with her grandmother, great-grandfather and great-aunt. ''It wasn't really
a decision. It was something I had to do,'' said Benn, of Victoria, Canada,
now 32 and cancer-free eight years later. ''It was something I had to
do for myself and my family, so they didn't have to worry about me.''
Without stomachs,
people lose weight and must eat smaller amounts more often. But the small
intestine can still digest food fairly well. Since her surgery, her older
sister and three members of another family underwent the same pre-emptive
operation and also spared themselves from the usually lethal disease.
In fact, the pre-emptive surgery approach was dramatically vindicated
when the removed stomachs of all five patients were examined and found
to have early traces of cancer that had escaped detection by other means. Most of the patients
were able to rely on a new genetic test that identified them as carriers
of the broken gene. All five cases reported on Thursday in The New
England Journal of Medicine underscore progress in the new and expanding
field of genetic screening for cancer. Genetic tests have
already prompted some people to undergo pre-emptive surgery to remove
breasts, ovaries, uteri, colons and thyroid glands. In their study, an
international team of investigators reported on Benn's family and another
family from Detroit. The four others besides Benn, who were ages 22 to
40, saved themselves thanks to discovery of the cancer gene in 1998. The gene, known as
E-cadherin, makes a protein needed by cells to detect their surroundings
properly. When the gene mutates and cannot make the protein, cells can
break free and invade other body tissues as cancer.
Stomach cancer is
the 13th most common cancer. But hereditary diffuse gastric cancer, the
form in these families, accounts for no more than 1 percent to 2 percent
of stomach cancers. The broken gene gives
a person an 80 percent chance of developing this stomach cancer. An examination of
the removed stomachs in all five cases found cancer. It is not clear how
long these patients might have lived without the surgery. The researchers
said people should consider such surgery when their families show a history
of this particular cancer and gene testing reveals the mutations. The
operation, though, is major surgery. Around 1 percent to 2 percent of
patients might die. Also, the patients had to change their eating habits. Benn is satisfied
with her decision. The new genetic test confirmed after the fact that
she, too, carries the bad gene. A sixth patient another woman in the Detroit
family had the surgery, like Benn, before the genetic test was developed.
The test later showed she did not carry the broken gene, meaning the surgery
was unnecessary for her. Her doctors said she is glad to know, at least,
that her children will not carry the genetic risk.
[Top]
Ulcers
can affect healthy women-(Times of India-10/07/2000)
Stomach ulcers are
traditionally associated with overweight, middle-aged men with a penchant
for cigarettes and booze. But almost as many women (1 in 15) as men (1
in 10) will get an ulcer at some point and 80% of ulcers are caused by
bacteria in the gut called heliobacter pyolori, referred to as H Pylori.
This particular bug is usually caught in childhood and lives in the sticky
fluid that coats the lining of the stomach and duodenum. Unless you develop
an ulcer you may never know you have the infection, but untreated, it
has a higher chance of developing into stomach cancer. Alcohol and stress
are not directly responsible although it can make symptoms worse. H Pylori can be detected
by a blood or breath test and treated with strong antibiotics as well
as drugs to control acid secretion. A diet of raw or lightly
steamed vegetables and fruits will help. Coffee, salt, spices, condiments,
alcohol and animal proteins should be avoided. Milk and yoghurt only irritate
the stomach linings. However, once obliterated, the ulcers will rarely
return.
[Top]
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