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Stomach Cancer
Chemo Drug
Improves Stomach Cancer Survival for Japanese Patients -(HealthDay-
31/10/2007)
Treatment of stomach cancer with
an experimental chemotherapy drug after surgery improved survival rates
for Japanese patients, a new study found.
The results of the trial won't mean much for Americans with stomach
cancer, because the drug, designated S-1, is classified as
"investigational" in the United States. But the study results could add
impetus to the use of drug and/or radiation therapy against stomach
cancer, U.S. experts said.
"This is the third large study that demonstrates a significant benefit
of adjuvant (combination) therapy either before or after surgery for
gastric cancer," said Dr. Manish Shah, an assistant attending oncologist
at Memorial Sloan-Kettering Cancer Center in New York City.
Until relatively recently, it had generally been thought that drug or
radiation therapy for stomach cancer wouldn't accomplish much, Shah
said. "With less than one-year survival with metastatic disease, there
may have been a sense that it didn't do any good," he said.
Metastatic means that the gastric cancer has spread outside the stomach,
establishing microscopic colonies beyond the reach of surgery. But the
almost 1,060 participants in the Japanese trial were potentially curable
with surgery, because the disease had not spread. Half were assigned S-1
treatment plus surgery, while the other half had surgery followed by
observation alone.
The trial, scheduled to last three years, was stopped after 12 months,
because the survival rate for the S-1 group was 80.1 percent, compared
to 70.1 percent for the surgery-only group.
The findings are published in the Nov. 1 issue of the New England
Journal of Medicine.
S-1 had been used in some U.S. trials but was abandoned because of the
high rate of side effects, Shah said. Japanese people apparently
metabolize the drug differently than Caucasians, minimizing its side
effects, he said.
Other drugs are being used successfully against stomach cancer, as is
radiation, said Dr. Jaffer Ajani, professor of medicine at the
University of Texas M.D. Anderson Cancer Center in Houston. But surgery
is the essential first step in treatment of stomach cancer, he said.
"Chemotherapy alone has never been shown to be beneficial," Ajani said.
The U.S. National Cancer Institute estimates that there are 21,260 new
cases of stomach cancer among Americans each year, with 11,210 deaths.
"Treatment for my patients includes radiation and chemotherapy
together," Ajani said. "Not for every patient, but for most patients."
Use of such adjuvant therapy for stomach cancer began slowly, with
studies showing that "chemotherapy was better than not for patients with
metastatic disease," Shah said. Later trials showed benefits for people
whose cancers had not spread.
"For gastric cancer, since 2001, some kind of adjuvant therapy has been
given here in the United States, along with radiation," Shah said.
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Sanofi Cancer
Drug Gets Priority Review -(Yahoo News- 2/12/2006)
Sanofi Aventis Says FDA Agrees to Speed Up Review for Company's
Application to Sell Cancer Drug. French drug giant Sanofi Aventis said Friday
that federal regulators have agreed to speed up the review process for
the company's application to sell a new chemotherapy treatment for
advanced stomach cancer.
Sanofi, maker of the Allegra allergy drug and Ambien insomnia treatment,
said the Food and Drug Administration granted a priority review for the
drug Taxotere in combination with chemotherapy treatment cisplatin. The
decision means the agency could act within six months of the
application's submission.
Sanofi said an international study of 457 patients with advanced stomach
cancer found that those treated with a Taxotere-based chemotherapy
showed significant improvements in overall survival compared with
patients who received a standard chemotherapy treatment.
Taxotere is currently approved in the United States to treat certain
types of breast cancer and, in combination with cisplatin, some lung
cancers. It is also approved to treat some prostate cancer in
combination with prednisone, a steriod.
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Digestive
cancers and the Chinese male factor -(Yahoo News)
Digestive cancer can strike anyone, but
possibly due to diet Chinese men seem to be more susceptible. Globally, three million new cases of digestive cancers are reported each
year, resulting in two million related deaths annually. In Malaysia,
stomach, colon and rectal cancers are the most common cancers and have
been on the list of the top 10 cancers for the past five years. As our
life expectancy increases, our chances of developing cancers in general
will also increase. However, current data indicates that Chinese males may
be more prone to develop digestive cancers such as stomach, colon, rectal
and liver cancer.
Consultant gastroenterologist Datuk Dr Goh Khean Lee observed that stomach
(gastric) cancer seems to affect mostly Malaysian Chinese men in numbers
similar to those of men in China or other overseas Chinese communities.
Current data indicates that gastric cancer is two times more common in
males than females and usually affects those between the ages of 50 and
70.
Over 99 per cent of gastric cancer starts from the lining of the stomach.
The cells lining the stomach grow uncontrollably and form tumours, causing
adenocarcinoma (cancer of the stomach glands). The cancer develops and
invades normal tissues to spread to other parts of the body.
A stomach bug that is on the World Health Organisation list of
cancer-causing agents is now known to increase its human host’s risk of
getting gastric cancer. Although not all people found with the
Helicobacter Pylori (H. Pylori) bacteria develop gastric cancers, it is
implicated in 70 per cent of gastric cancer cases.Dr Goh explained that other factors including a diet of mainly food that
is preserved, pickled or with a high salt content; lifestyle habits such
as smoking and excessive alcohol intake; and genetics play a part in
determining if an H. pylori infected person will develop cancer.
WHO data on gastric cancer prevalence shows that people who love salty
food, such as salted cod, or bacalao, in Portugal and Brazil; salted
pickles and salad in Japan and Korea, are populations with equally high
stomach cancer rates.
It can be prevented, according to Professor Dr Drs H.C. Meinhard Classen, co-chairman of
the International Digestive Cancer Alliance, an organisation that promotes
screening, early detection and primary prevention of digestive cancers
worldwide.
Dr Classen was in Malaysia to attend GUT 2005, the annual scientific
meeting of the Malaysian Society of Gastroenterology and Hepatology, in
Langkawi recently.
He said that cancer prevention starts with a healthy diet and regular
exercise. The European Prospective Investigation into Cancer and Nutrition
(EPIC), suggests that daily consumption of 500g of fruit and vegetables
can decrease the incidence of cancers of the digestive tract by up to 25
per cent.
Dr Classen also recommended 20 minutes of brisk exercise daily.
Unfortunately not many people exercise regularly, observed Dr Classen, who
went on to explain the link between inactivity, obesity and cancer.
“We always say that obesity is a risk factor for heart disease but an
interesting study between obesity and cancer has shown us that insulin is
not only responsible for obesity as it stimulates the appetite. It also
stimulates the growth of malignant cells and causes cancers.”
Early detection and elimination of the H. pylori bacterium will
substantially reduce your risk of gastric cancer, especially if you have a
family history of digestive cancer.
Dr Classen explained that H. pylori infection can occur as early as
childhood.
He said: “It takes many years for this bacterial infection to develop into
gastric cancer and we now know that in mother to child transmission, the
infected child is 10 times more likely to develop gastric cancer than if
the bacteria infection was picked up much later.”
If untreated, the bacteria may cause inflammation of the lining, an ulcer
or pre-cancerous lesion. In such cases getting rid of the bug may not
reduce this person’s risk of developing cancer. However, if there is no
lesion, treating the infection can prevent stomach cancer.
As part of its cancer prevention initiative, the IDCA is conducting a
campaign in Shandong province, China, where 60 per cent of the population
is H. Pylori infected with a goal to treat as many adults between 25 and
40 years old as possible.
Dr Classen said: “We hope to cover 100,000 young adults but it would
depend on the funds available for the project. We know that eradication of
the bacterial infection early would really reduce the incidence of gastric
cancer in that area.
“By treating the young women and mothers we can stop the mother and child
transmission that may develop into gastric cancer in later years.”
Colon cancer is also on the increase, and again Chinese men appear to be
at greater risk.
According to Dr Goh, the gene factor in colon cancer is very strong and
close family members of a person diagnosed with colon cancer should be
screened as well.
Colon cancer starts off as a benign adenomatous polyp. At this stage,
patients have no symptoms. It may take up to 20 years before this polyp
turns into a malignant cancer.
It is suggested that high-risk patients with a family history of gastric
cancer in one or more first-degree relatives should have annual digital
rectal examination and faecal occult blood testing from as early as age
35.
A screening colonoscopy, whereby the doctor examines the inside of the
colon with a special tube, should be performed at age 40.
If the immediate family have had cancer at under 40 years old, these tests
should be performed even earlier. If the examination is normal a repeat
scope can be carried out five years later.
If polyps (usually benign at this early stage) are seen during the
examination, removing them can prevent the development of colon cancer.
Colon cancer may be inherited but it appears other factors may be in play
to promote the disease.
Dr Goh said: “In areas where the Chinese embrace the ‘western-style diet’,
high in saturated fats, refined carbohydrates and animal proteins, he is
more likely to develop cancers than someone on the traditional Chinese
diet.”
Epidemiological studies suggest that the risk of developing colon cancer
can be reduced by eating less meat (particularly processed meat) and
increasing the intake of vegetables and fruit.
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