Breast milk content may affect child's obesity risk
Mothers nurse their babies in Malaga, southern Spain June 30, 2007. June 30, 2007. Mothers who breast feed and have high levels of a protein secreted by lipids in their milk may be increasing the risk that their child will be overweight, German researchers report. (Jon Nazca/Reuters)NEW YORK (Reuters Health) - Mothers who breast feed andhave high levels of a protein secreted by lipids in their milkmay be increasing the risk that their child will be overweight,German researchers report.
Dr. Maria Weyermann of The German Cancer Research Center inHeidelberg and her colleagues found that a child's likelihoodof being overweight by age 2 rose with the amount ofadiponectin in his or her mother's milk.
The significance of these findings remain unclear, Dr.Matthew W. Gillman and Dr. Christos S. Mantzoros, HarvardMedical School, Boston, point out in an editorial accompanyingthe study, because infants may not be able to absorb theadiponectin contained in breast milk.
Also, they add, high levels of adiponectin in adultsactually reduce heart disease and diabetes risk, making it"counterintuitive" that high levels would contribute to excessweight in children.
The jury is still out on whether nursing does protectchildren from becoming overweight, Weyermann and her team add.
The researchers investigated how breast-feeding mightinfluence obesity risk by looking at adiponectin and anotherprotein secreted by fat cells, leptin, which regulates appetiteas well as the body's use of energy from food.
Adiponectin is involved in metabolism of fats and sugars.The fetus and placenta produce both proteins at high levels,the researchers point out, raising the possibility that theyplay a role in fetal development.
The levels of both proteins were measured in the breastmilk of the mothers of 674 children when the infants were sixweeks old. Among the children who were breast-fed for at leastsix months, obesity risk rose in tandem with breast milkadiponectin levels. However, leptin levels showed noassociation with whether or not a child would be overweight.
"Our data provide evidence that the possible protectiveeffect of breast-feeding against childhood obesity mightdepend, at least in part, on low levels of breast milkadiponectin," Weyermann and her team write.
More research is needed before it's possible to determinethe health implications of the research, if any, Gillman andMantzoros add. "The best advice remains that all women shouldstrive to breast-feed their children for at least 12 months,with the first 4- to 6- months consisting of exclusivebreast-feeding."
SOURCE: Epidemiology, November 2007.
Showing posts with label Breast. Show all posts
Showing posts with label Breast. Show all posts
Tuesday, January 1, 2008
Side effects vary by breast cancer maintenance therapy
Side effects vary by breast cancer maintenance therapy
NEW YORK (Reuters Health) - Among postmenopausal womenreceiving adjuvant therapy for early breast cancer, exemestaneis associated with fewer hot flashes than is tamoxifen, but italso causes more sleep problems, according to a study publishedthe Journal of Clinical Oncology.
"Hormonal breast cancer treatment increases menopausalsymptoms in women," note Dr. Stephen E. Jones and colleaguesfrom US Oncology Research Inc., Houston.
The investigators used questionnaires, completed by morethan 1,500 women to assess 10 common symptoms in the first yearof a clinical trial of tamoxifen or exemestane. Tamoxifen issold under the trade name Nolvadex, and exemestane is soldunder the trade name Aromasin.
The patients had completed surgery and chemotherapy forearly breast cancer. All of the women had hormonereceptor-positive cancers, which respond to these two agents.
The prevalence of the initial symptoms ranged from 2percent (for vaginal bleeding) to 75 percent (for fatigue).
Patients who received tamoxifen experienced significantlymore vaginal discharge than those who received exemestane.Those who received exemestane had more bone and muscle aches,vaginal dryness, difficulty sleeping and decreased libido.
In both treatment groups, hot flash scores peaked at about3 months and decreased thereafter. As mentioned, patients inthe tamoxifen group had a significantly higher mean hot flashscore at 12 months than those in the exemestane group.
"These are common complaints and the treatments used makesome worse," Jones commented to Reuters Health. "Oncologistsand other oncology health professionals need to be aware of thecommonplace nature (of these side effects) and attempt to helpwherever possible," he said. For example, he suggested it maybe necessary to treat the hot flashes if they are affecting thepatient's of life.
SOURCE: Journal of Clinical Oncology, October 20, 2007.
NEW YORK (Reuters Health) - Among postmenopausal womenreceiving adjuvant therapy for early breast cancer, exemestaneis associated with fewer hot flashes than is tamoxifen, but italso causes more sleep problems, according to a study publishedthe Journal of Clinical Oncology.
"Hormonal breast cancer treatment increases menopausalsymptoms in women," note Dr. Stephen E. Jones and colleaguesfrom US Oncology Research Inc., Houston.
The investigators used questionnaires, completed by morethan 1,500 women to assess 10 common symptoms in the first yearof a clinical trial of tamoxifen or exemestane. Tamoxifen issold under the trade name Nolvadex, and exemestane is soldunder the trade name Aromasin.
The patients had completed surgery and chemotherapy forearly breast cancer. All of the women had hormonereceptor-positive cancers, which respond to these two agents.
The prevalence of the initial symptoms ranged from 2percent (for vaginal bleeding) to 75 percent (for fatigue).
Patients who received tamoxifen experienced significantlymore vaginal discharge than those who received exemestane.Those who received exemestane had more bone and muscle aches,vaginal dryness, difficulty sleeping and decreased libido.
In both treatment groups, hot flash scores peaked at about3 months and decreased thereafter. As mentioned, patients inthe tamoxifen group had a significantly higher mean hot flashscore at 12 months than those in the exemestane group.
"These are common complaints and the treatments used makesome worse," Jones commented to Reuters Health. "Oncologistsand other oncology health professionals need to be aware of thecommonplace nature (of these side effects) and attempt to helpwherever possible," he said. For example, he suggested it maybe necessary to treat the hot flashes if they are affecting thepatient's of life.
SOURCE: Journal of Clinical Oncology, October 20, 2007.
Breast-Feeding Cuts Food Allergy Risk
Breast-Feeding Cuts Food Allergy Risk
Mothers breastfeed their newborn babies at a government hospital in Manila June 21, 2007. (Joseph Agcaoili/Reuters)WEDNESDAY, Nov. 14 (HealthDay News) -- Breast-feeding in the firstthree months of life appears to help shield children from developing foodallergies.
That's just one of a number of findings on food allergies scheduled tobe presented this week at the annual meeting of the American College ofAllergy, Asthma and Immunology in Dallas.
Research has determined a possible role for food allergy preventionstrategies in high-risk children, including maternal food avoidance inpregnancy, breast-feeding, maternal food avoidance while breast-feeding,use of hypoallergenic formulas, delayed introduction of allergenic foodsand probiotics, noted one expert.
"A review of 18 studies demonstrates a significant protective effect ofexclusive breast-feeding for at least three months for children with highrisk for atopy (genetic tendency to develop allergic diseases) against thedevelopment of atopic dermatitis and early childhood asthma-likesymptoms," Dr. Robert Wood, international health director for pediatricallergy and immunology at Johns Hopkins School of Medicine, said in aprepared statement.
He offered a number of recommendations for children at high risk ofallergic diseases:
Women should avoid peanuts and tree nuts during pregnancy and whilebreast-feeding.Mothers should supplement breast-feeding with a hypoallergenic formula(extensively or partially hydrolyzed).Delay feeding these children solid foods until they're six monthsold.Delay introduction of milk and egg until age 1 and peanut and treenuts until age 3.Start early intervention when signs of food allergy appear (secondaryprevention).
In a planned presentation about allergies and dietary restrictions,another expert noted that a person may have an allergy to one member of afood family, but may be able to eat other members of the same foodfamily.
For example, one study on nine common fish found cross-reactivity andallergenicity were highest among cod, salmon and pollack and lowest amonghalibut, flounder, tuna and mackerel. Another study on edible nuts foundcross-reactivity was strong among walnut, pecan and hazelnut; moderateamong cashew, pistachio, Brazil nut and almond; and extremely low betweenpeanut and tree nuts.
"You may be allergic to a particular part of a food, but not to anotherpart," Dr. Sami Bahna, chief of allergy and immunology at Louisiana StateUniversity in Shreveport, said in a prepared statement.
Another expert said doctors need to consider food allergy as apotential cause of gastrointestinal or dermatological symptoms inpatients.
"The eosinophilic gastrointestinal disorders (EGID) which may affectthe esophagus, stomach, colon and rectum are mostly chronic and recurrentdisorders that adversely impact quality of life for patients andfamilies," Dr. Amal Assa'ad, director of the Food Allergy &Eosinophilic Disorders Clinic at Cincinnati Children's Medical Center,said in a prepared statement.
"Patients with EGID have a high rate of sensitization to food andenvironmental allergens, and many of them have a high rate of clinicalsymptoms with various food ingestions. A subset of patients respond toremoval of major food allergens from their diet," Assa'ad said.
"EGID management often requires multiple specialists, including theprimary physician, allergy and immunology, gastroenterology, nutrition andpsychology," she noted.
More information
The U.S. National Institute of Allergy and Infectious Diseases has moreabout food allergy.
Mothers breastfeed their newborn babies at a government hospital in Manila June 21, 2007. (Joseph Agcaoili/Reuters)WEDNESDAY, Nov. 14 (HealthDay News) -- Breast-feeding in the firstthree months of life appears to help shield children from developing foodallergies.
That's just one of a number of findings on food allergies scheduled tobe presented this week at the annual meeting of the American College ofAllergy, Asthma and Immunology in Dallas.
Research has determined a possible role for food allergy preventionstrategies in high-risk children, including maternal food avoidance inpregnancy, breast-feeding, maternal food avoidance while breast-feeding,use of hypoallergenic formulas, delayed introduction of allergenic foodsand probiotics, noted one expert.
"A review of 18 studies demonstrates a significant protective effect ofexclusive breast-feeding for at least three months for children with highrisk for atopy (genetic tendency to develop allergic diseases) against thedevelopment of atopic dermatitis and early childhood asthma-likesymptoms," Dr. Robert Wood, international health director for pediatricallergy and immunology at Johns Hopkins School of Medicine, said in aprepared statement.
He offered a number of recommendations for children at high risk ofallergic diseases:
Women should avoid peanuts and tree nuts during pregnancy and whilebreast-feeding.Mothers should supplement breast-feeding with a hypoallergenic formula(extensively or partially hydrolyzed).Delay feeding these children solid foods until they're six monthsold.Delay introduction of milk and egg until age 1 and peanut and treenuts until age 3.Start early intervention when signs of food allergy appear (secondaryprevention).
In a planned presentation about allergies and dietary restrictions,another expert noted that a person may have an allergy to one member of afood family, but may be able to eat other members of the same foodfamily.
For example, one study on nine common fish found cross-reactivity andallergenicity were highest among cod, salmon and pollack and lowest amonghalibut, flounder, tuna and mackerel. Another study on edible nuts foundcross-reactivity was strong among walnut, pecan and hazelnut; moderateamong cashew, pistachio, Brazil nut and almond; and extremely low betweenpeanut and tree nuts.
"You may be allergic to a particular part of a food, but not to anotherpart," Dr. Sami Bahna, chief of allergy and immunology at Louisiana StateUniversity in Shreveport, said in a prepared statement.
Another expert said doctors need to consider food allergy as apotential cause of gastrointestinal or dermatological symptoms inpatients.
"The eosinophilic gastrointestinal disorders (EGID) which may affectthe esophagus, stomach, colon and rectum are mostly chronic and recurrentdisorders that adversely impact quality of life for patients andfamilies," Dr. Amal Assa'ad, director of the Food Allergy &Eosinophilic Disorders Clinic at Cincinnati Children's Medical Center,said in a prepared statement.
"Patients with EGID have a high rate of sensitization to food andenvironmental allergens, and many of them have a high rate of clinicalsymptoms with various food ingestions. A subset of patients respond toremoval of major food allergens from their diet," Assa'ad said.
"EGID management often requires multiple specialists, including theprimary physician, allergy and immunology, gastroenterology, nutrition andpsychology," she noted.
More information
The U.S. National Institute of Allergy and Infectious Diseases has moreabout food allergy.
Cell Insights May Predict Breast Cancer's Spread
Cell Insights May Predict Breast Cancer's Spread
FRIDAY, Nov. 16 (HealthDay News) -- U.S. researchers believethey're on the way to solving a major question about breast cancer: Whichwomen have a type of lesion in their breast duct that will progress toinvasive disease?
"It's an exciting step forward -- people have been trying to gettraction on this big clinical problem for about 40 years, and this is abig crack in the door," said lead researcher Thea Tlsty, a professor ofpathology at the University of California, San Francisco.
Ductal carcinoma in situ (DCIS), as this type of lesion is officiallyknown, is diagnosed in about 47,000 American women every year, accordingto the U.S. National Cancer Institute. To prevent its recurrence asinvasive breast cancer, DCIS generally is treated by lumpectomy alone(approximately 25 percent of cases) or lumpectomy with adjunctivetreatments such as radiation, chemotherapy, and/or hormones (approximately40 percent).
In about 25 percent of cases, complete mastectomies are performed. Lessthan an estimated 5 percent of women choose "watchful waiting" in lieu ofa surgical intervention, Tlsty said.
But doctors are still confronted with a guessing game when it comes topredicting those patients at highest risk for recurrence, Tlsty said."Only about 12 to 15 percent of women diagnosed with DCIS are going tohave a future invasive cancer, and all the others won't. Up until now, theproblem was that we couldn't distinguish the 12 to 15 percent from thosewho were not [at risk]," explained Tlsty.
Consequently, some women unknowingly are overtreated by having amastectomy, and others are undertreated if they chose a course of watchfulwaiting rather than surgical intervention, Tlsty added.
In their pilot study, published in the November issue of CancerCell, the UCSF team looked at how a collection of biomarkers,including molecules called p16 and ki67, interact to predict invasivetumors, she explained.
Because this initial study was done on tissue samples from 70 women, alarger retrospective study is under way at UCSF to validate the initialresults, Tlsty said.
Further research, including a large prospective trial, is also neededbefore the findings can be ready for clinical use, she added. If that workupholds the results of the pilot study, the biomarkers could be ready forclinical use within four to five years, Tlsty said.
Dr. Joseph Geradts, a professor of pathology at Duke University inDurham, N.C., said that finding biomarkers that predict the conversion ofDCIS into invasive cancer is "the holy grail of breast cancer research."He said there have been a number of previous studies that have beenpublished, but, so far, they've been "mostly a fruitless effort."
According to Geradts, the UCSF study "is valuable," because "theauthors propose two new biomarkers that in the past have not been lookedat." The UCSF team's findings "are intriguing preliminary data" that"merit confirmation and subsequent studies," he added.
Geradts said his own lab currently is researching whether changes inDNA may identify a tumor's capacity to metastasize or become invasive.Other researchers are looking at other DCIS biomarkers, he said.
"DCIS itself is a non-life threatening condition" with rare exceptions,noted Dr. Eric Winer, director of breast oncology at the Dana-FarberCancer Institute in Boston, and women are usually treated to help preventinvasive cancer. If the findings of the initial UCSF study are confirmed,then with "careful investigation, we may get to the point where we don'thave to treat all women with DCIS, and we may be able to tailor it so somewomen get less, and some women get more" depending upon their risk forinvasive breast cancer, Winer said.
"It's a very complex and interesting study" added Dr. Richard Bleicher,a surgical oncologist at Fox Chase Cancer Center in Philadelphia. "We needto be cautiously optimistic."
Bleicher added that while the findings have "significant potential,"women at this point shouldn't "pin all your hopes on it," because the p16assay is not something they can ask their doctors for at this point intime.
FRIDAY, Nov. 16 (HealthDay News) -- U.S. researchers believethey're on the way to solving a major question about breast cancer: Whichwomen have a type of lesion in their breast duct that will progress toinvasive disease?
"It's an exciting step forward -- people have been trying to gettraction on this big clinical problem for about 40 years, and this is abig crack in the door," said lead researcher Thea Tlsty, a professor ofpathology at the University of California, San Francisco.
Ductal carcinoma in situ (DCIS), as this type of lesion is officiallyknown, is diagnosed in about 47,000 American women every year, accordingto the U.S. National Cancer Institute. To prevent its recurrence asinvasive breast cancer, DCIS generally is treated by lumpectomy alone(approximately 25 percent of cases) or lumpectomy with adjunctivetreatments such as radiation, chemotherapy, and/or hormones (approximately40 percent).
In about 25 percent of cases, complete mastectomies are performed. Lessthan an estimated 5 percent of women choose "watchful waiting" in lieu ofa surgical intervention, Tlsty said.
But doctors are still confronted with a guessing game when it comes topredicting those patients at highest risk for recurrence, Tlsty said."Only about 12 to 15 percent of women diagnosed with DCIS are going tohave a future invasive cancer, and all the others won't. Up until now, theproblem was that we couldn't distinguish the 12 to 15 percent from thosewho were not [at risk]," explained Tlsty.
Consequently, some women unknowingly are overtreated by having amastectomy, and others are undertreated if they chose a course of watchfulwaiting rather than surgical intervention, Tlsty added.
In their pilot study, published in the November issue of CancerCell, the UCSF team looked at how a collection of biomarkers,including molecules called p16 and ki67, interact to predict invasivetumors, she explained.
Because this initial study was done on tissue samples from 70 women, alarger retrospective study is under way at UCSF to validate the initialresults, Tlsty said.
Further research, including a large prospective trial, is also neededbefore the findings can be ready for clinical use, she added. If that workupholds the results of the pilot study, the biomarkers could be ready forclinical use within four to five years, Tlsty said.
Dr. Joseph Geradts, a professor of pathology at Duke University inDurham, N.C., said that finding biomarkers that predict the conversion ofDCIS into invasive cancer is "the holy grail of breast cancer research."He said there have been a number of previous studies that have beenpublished, but, so far, they've been "mostly a fruitless effort."
According to Geradts, the UCSF study "is valuable," because "theauthors propose two new biomarkers that in the past have not been lookedat." The UCSF team's findings "are intriguing preliminary data" that"merit confirmation and subsequent studies," he added.
Geradts said his own lab currently is researching whether changes inDNA may identify a tumor's capacity to metastasize or become invasive.Other researchers are looking at other DCIS biomarkers, he said.
"DCIS itself is a non-life threatening condition" with rare exceptions,noted Dr. Eric Winer, director of breast oncology at the Dana-FarberCancer Institute in Boston, and women are usually treated to help preventinvasive cancer. If the findings of the initial UCSF study are confirmed,then with "careful investigation, we may get to the point where we don'thave to treat all women with DCIS, and we may be able to tailor it so somewomen get less, and some women get more" depending upon their risk forinvasive breast cancer, Winer said.
"It's a very complex and interesting study" added Dr. Richard Bleicher,a surgical oncologist at Fox Chase Cancer Center in Philadelphia. "We needto be cautiously optimistic."
Bleicher added that while the findings have "significant potential,"women at this point shouldn't "pin all your hopes on it," because the p16assay is not something they can ask their doctors for at this point intime.
Sunday, December 30, 2007
Cannabis Compound May Stop Metastatic Breast Cancer
Cannabis Compound May Stop Metastatic Breast Cancer
MONDAY, Nov. 19 (HealthDay News) -- A non-toxic, non-psychoactivecompound in marijuana may block the progress of metastatic breast cancer,according to a new study by researchers in California.
"This is a new way to treat a patient that is not toxic likechemotherapy or radiotherapy. It is a new approach for metastatic cancer,"said lead researcher Sean D. McAllister, an associate scientist at theCalifornia Pacific Medical Center Research Institute in San Francisco.
The compound found in cannabis, called cannabidiol (CBD), inhibits agene, Id-1, that researchers believe is responsible for the metastaticprocess that spreads cells from the original tumor throughout thebody.
Opting for a musical metaphor, senior researcher Pierre-Yves Desprezlikened Id-1 to "an [orchestra] conductor. In this case, you shoot theconductor, and the whole orchestra is going to stop. If you shoot theviolinist, the orchestra just continues to play."
In humans, the Id-1 gene is found only in metastatic cancer cells, saidDesprez, a staff scientist at the institute. Before birth, they arepresent and involved in the development of human embryos, but after birth,they go silent -- and should stay that way, he said.
But in metastatic cancer "when [the genes] wake up, they are very bad,"he said. "They push the cells to behave like embryonic cells and grow.They go crazy, they proliferate, they migrate." Desprez said, "We need tobe able to turn them off."
According to the study, CBD does exactly that.
"We are focusing on the latest stages of cancer," Desprez added. Thecancer cell itself is not the problem, because a tumor can be "removedeasily by surgery," he said. The problem is the development of metastaticcells which is "conducted" by Id-1.
McAllister and Desprez said they are not suggesting thatpatients with hormone-independent metastatic breast cancer smokemarijuana. For one thing, a sufficient amount of CBD could never beobtained in that way, they said.
The research that has been done on marijuana and its compounds,however, is helpful, McAllister, said. CBD has been around for a longtime, and researchers have found it is not psychoactive, and its "toxicityis very low," he added.
The new findings are published in the November issue of MolecularCancer Therapeutics.
If McAllister's and Desprez's work results in the development of acancer treatment, someone with metastatic cancer might be placed on CBDfor several years. That means low toxicity is important, McAllisterexplained.
McAllister also suggested that Id-1 is "so important in providing the[metastatic] mechanism in these cells in so many types of cancers" thatthey "provide us an opportunity potentially to target other types ofcancers."
The study's findings were "were a serendipitous discovery, in a way,"McAllister said. Desprez noted that he had been working on the Id-1 genefor 12 years. His lab had demonstrated that it was a key gene for invasivebreast cancer and tumor progression, and Desprez had found a way toinhibit it in mice, but not in humans.
Then, two years ago, McAllister -- an expert on cannabinoids -- andDesprez, a cancer researcher, started to work together. Through theircombined forces "what we found is actually what I was looking for for thelast 12 years," Desprez said.
Further study is needed before CBD can be conclusively identified as atreatment option, McAllister and Desprez said. "We need to involve a teamof physicians, because we are bench [basic] scientists," McAllistersaid.
One expert called the findings intriguing but preliminary.
"This is the first evidence that a cannabinoid can target theexpression of an important breast cancer metastasis gene," noted ManuelGuzman, a Spanish expert on cannabinoids and cancer. He described theCalifornia study as giving "preliminary insight into the question ofwhether CBD could be used clinically to treat metastatic breastcancer."
However, "all the experiments in the paper have been conducted incultured cells and none of them in any animal model of breast cancer,which would be one of the steps for further research," added Guzman, whois a professor of biochemistry and molecular biology at ComplutenseUniversity in Madrid.
Guzman also noted that "Id-1 is just one of many genes involved inbreast cancer metastasis" and that future research also needs to examinethe impact of CBD on these other metastasis genes.
More information
There's more on breast cancer at the U.S.National Cancer Institute.
MONDAY, Nov. 19 (HealthDay News) -- A non-toxic, non-psychoactivecompound in marijuana may block the progress of metastatic breast cancer,according to a new study by researchers in California.
"This is a new way to treat a patient that is not toxic likechemotherapy or radiotherapy. It is a new approach for metastatic cancer,"said lead researcher Sean D. McAllister, an associate scientist at theCalifornia Pacific Medical Center Research Institute in San Francisco.
The compound found in cannabis, called cannabidiol (CBD), inhibits agene, Id-1, that researchers believe is responsible for the metastaticprocess that spreads cells from the original tumor throughout thebody.
Opting for a musical metaphor, senior researcher Pierre-Yves Desprezlikened Id-1 to "an [orchestra] conductor. In this case, you shoot theconductor, and the whole orchestra is going to stop. If you shoot theviolinist, the orchestra just continues to play."
In humans, the Id-1 gene is found only in metastatic cancer cells, saidDesprez, a staff scientist at the institute. Before birth, they arepresent and involved in the development of human embryos, but after birth,they go silent -- and should stay that way, he said.
But in metastatic cancer "when [the genes] wake up, they are very bad,"he said. "They push the cells to behave like embryonic cells and grow.They go crazy, they proliferate, they migrate." Desprez said, "We need tobe able to turn them off."
According to the study, CBD does exactly that.
"We are focusing on the latest stages of cancer," Desprez added. Thecancer cell itself is not the problem, because a tumor can be "removedeasily by surgery," he said. The problem is the development of metastaticcells which is "conducted" by Id-1.
McAllister and Desprez said they are not suggesting thatpatients with hormone-independent metastatic breast cancer smokemarijuana. For one thing, a sufficient amount of CBD could never beobtained in that way, they said.
The research that has been done on marijuana and its compounds,however, is helpful, McAllister, said. CBD has been around for a longtime, and researchers have found it is not psychoactive, and its "toxicityis very low," he added.
The new findings are published in the November issue of MolecularCancer Therapeutics.
If McAllister's and Desprez's work results in the development of acancer treatment, someone with metastatic cancer might be placed on CBDfor several years. That means low toxicity is important, McAllisterexplained.
McAllister also suggested that Id-1 is "so important in providing the[metastatic] mechanism in these cells in so many types of cancers" thatthey "provide us an opportunity potentially to target other types ofcancers."
The study's findings were "were a serendipitous discovery, in a way,"McAllister said. Desprez noted that he had been working on the Id-1 genefor 12 years. His lab had demonstrated that it was a key gene for invasivebreast cancer and tumor progression, and Desprez had found a way toinhibit it in mice, but not in humans.
Then, two years ago, McAllister -- an expert on cannabinoids -- andDesprez, a cancer researcher, started to work together. Through theircombined forces "what we found is actually what I was looking for for thelast 12 years," Desprez said.
Further study is needed before CBD can be conclusively identified as atreatment option, McAllister and Desprez said. "We need to involve a teamof physicians, because we are bench [basic] scientists," McAllistersaid.
One expert called the findings intriguing but preliminary.
"This is the first evidence that a cannabinoid can target theexpression of an important breast cancer metastasis gene," noted ManuelGuzman, a Spanish expert on cannabinoids and cancer. He described theCalifornia study as giving "preliminary insight into the question ofwhether CBD could be used clinically to treat metastatic breastcancer."
However, "all the experiments in the paper have been conducted incultured cells and none of them in any animal model of breast cancer,which would be one of the steps for further research," added Guzman, whois a professor of biochemistry and molecular biology at ComplutenseUniversity in Madrid.
Guzman also noted that "Id-1 is just one of many genes involved inbreast cancer metastasis" and that future research also needs to examinethe impact of CBD on these other metastasis genes.
More information
There's more on breast cancer at the U.S.National Cancer Institute.
Thursday, December 27, 2007
BRCA genes raise breast cancer risk for men too
BRCA genes raise breast cancer risk for men too
NEW YORK (Reuters Health) - Mutations in the BRCA1 andBRCA2 genes that increase the risk of breast cancer for womenalso do the same in men.
Men can develop breast cancer, although they account foronly about 1 percent of breast cancer cases. Previous studieshave shown that men who carry mutations in the BRCA2 gene areat greater risk of developing breast cancer than men in thegeneral population. Now, new research suggests that the same istrue for men with BRCA1 mutations.
Dr. Sining Chen from Johns Hopkins School of Medicine inBaltimore, Maryland, and colleagues studied data on 1,939families that included 97 male patients with breast cancer.
"At all ages, the cumulative risks of male breast cancerwere higher in both BRCA1 and BRCA2 mutation carriers than innoncarriers," the researchers report in the Journal of theNational Cancer Institute.
The likelihood of developing breast cancer was highest formen in their 30s and 40s and decreased with increasing age. Forexample, for BRCA2 mutation carriers, 30-year-old men were 22times more likely to develop breast cancer than carriers at 70years of age.
The risk was higher for BRCA2 than BRCA1 mutation carriers.The investigators calculate that, by age 70, the chances ofdeveloping breast cancer are 1.2 percent for male BRCA1mutation carriers and 6.8 percent for men with the BRCA2mutation.
They point out that these estimates of risk are "importantfor determining appropriate risk management strategies" formale members of families with mutations in BRCA1 or BRCA2.
SOURCE: Journal of the National Cancer Institute, December5, 2007.
NEW YORK (Reuters Health) - Mutations in the BRCA1 andBRCA2 genes that increase the risk of breast cancer for womenalso do the same in men.
Men can develop breast cancer, although they account foronly about 1 percent of breast cancer cases. Previous studieshave shown that men who carry mutations in the BRCA2 gene areat greater risk of developing breast cancer than men in thegeneral population. Now, new research suggests that the same istrue for men with BRCA1 mutations.
Dr. Sining Chen from Johns Hopkins School of Medicine inBaltimore, Maryland, and colleagues studied data on 1,939families that included 97 male patients with breast cancer.
"At all ages, the cumulative risks of male breast cancerwere higher in both BRCA1 and BRCA2 mutation carriers than innoncarriers," the researchers report in the Journal of theNational Cancer Institute.
The likelihood of developing breast cancer was highest formen in their 30s and 40s and decreased with increasing age. Forexample, for BRCA2 mutation carriers, 30-year-old men were 22times more likely to develop breast cancer than carriers at 70years of age.
The risk was higher for BRCA2 than BRCA1 mutation carriers.The investigators calculate that, by age 70, the chances ofdeveloping breast cancer are 1.2 percent for male BRCA1mutation carriers and 6.8 percent for men with the BRCA2mutation.
They point out that these estimates of risk are "importantfor determining appropriate risk management strategies" formale members of families with mutations in BRCA1 or BRCA2.
SOURCE: Journal of the National Cancer Institute, December5, 2007.
Combo PET/CT Scan Helps Spot Breast Cancer's Spread
Combo PET/CT Scan Helps Spot Breast Cancer's Spread
TUESDAY, Nov. 27 (HealthDay News) -- A technique that combines aPET scan with a CT scan can help spot the spread of inflammatory breastcancer, a rare but very aggressive form of the disease, researchersreport.
"It is a quicker way of assessing everything," said lead researcher Dr.Selin Carkaci, assistant professor of radiology at The University of TexasM.D. Anderson Cancer Center in Houston. "Our results show it is veryuseful," she said.
Carkaci was expected to present her findings Monday at the annualmeeting of the Radiological Society of North America, in Chicago.
According to the American Cancer Society, IBC accounts for 1 percent to5 percent of all breast cancer cases in the United States. Often by thetime it is discovered, it has spread. The five-year survival rate forthose with IBC is 25 percent to 50 percent, according to the cancersociety.
The new combo technology has been used in recent years for assessingother cancers as well, Carkaci noted. While the separate technologies ofPET (positron emission tomography) and CT (computed tomography) have beenin use since the early 1970s, their combined use came into practice onlyabout eight years ago. Patients being treated at cancer centers across theUnited States should have access to this test, which is becoming morecommon, Carkaci said.
The technique she used is called FDG-PET/CT -- for "F-18fluorodeoxyglucose positron emission tomography and computed tomography".
In a PET scan, a small amount of the radioactive drug F-18-labeledglucose is injected into the body. Fast-growing cancer cells feed onsugars and absorb it more quickly than do normal cells, Carkaci explained,so they "light up" on the images created by the PET scanner.
On the other hand, "the CT scanner takes a series of X-ray pictures,which are combined by a computer to create an extremely detailed image ofthe internal organs or other parts of the body," she said.
The scan gives great anatomical detail including the size, shape andlocation of the tumor. Together, the tests provide the most complete dataon the tumor and its spread, Carkaci said.
In the study, doctors scanned 41 women newly diagnosed withinflammatory breast cancer. They found metastases in 20 patients, or 49percent. They used biopsy or additional imaging to confirm the resultswhen possible. Biopsy confirmation of metastases were available in four of13 patients and additional imaging confirmation in nine.
"We found that FDG-PET/CT is 95 percent accurate in identifying distantmetastases and 98 percent accurate in identifying regional lymph nodemetastases," Carkaci said.
"This [scanning] is done immediately after diagnosis, and thenfollowing the chemotherapy, to evaluate the response to treatment," shesaid.
The hope is to stop the cancer in its tracks.
One co-author, Dr. Homer Macapinlac, chair and professor of nuclearmedicine at M.D. Anderson, reported being a consultant for GeneralElectric Company and Siemens AG. Both companies produce scanners.
The study findings are "significant for the high rate of metastaticdisease, with almost one half of the women with PET/CT able to identifythe tumors at an early stage," said Dr. David Bluemke, professor ofradiology and medicine and clinical director, MRI, Johns Hopkins MedicalInstitution, Baltimore.
"The data is very compelling for routine and early use of PET/CT forpatients with inflammatory breast cancer," he said. "Although the studywas small, the high accuracy rate appears promising for patients with thiscondition."
More information
To learn more about inflammatory breast cancer, visit the U.S. National Cancer Institute.
TUESDAY, Nov. 27 (HealthDay News) -- A technique that combines aPET scan with a CT scan can help spot the spread of inflammatory breastcancer, a rare but very aggressive form of the disease, researchersreport.
"It is a quicker way of assessing everything," said lead researcher Dr.Selin Carkaci, assistant professor of radiology at The University of TexasM.D. Anderson Cancer Center in Houston. "Our results show it is veryuseful," she said.
Carkaci was expected to present her findings Monday at the annualmeeting of the Radiological Society of North America, in Chicago.
According to the American Cancer Society, IBC accounts for 1 percent to5 percent of all breast cancer cases in the United States. Often by thetime it is discovered, it has spread. The five-year survival rate forthose with IBC is 25 percent to 50 percent, according to the cancersociety.
The new combo technology has been used in recent years for assessingother cancers as well, Carkaci noted. While the separate technologies ofPET (positron emission tomography) and CT (computed tomography) have beenin use since the early 1970s, their combined use came into practice onlyabout eight years ago. Patients being treated at cancer centers across theUnited States should have access to this test, which is becoming morecommon, Carkaci said.
The technique she used is called FDG-PET/CT -- for "F-18fluorodeoxyglucose positron emission tomography and computed tomography".
In a PET scan, a small amount of the radioactive drug F-18-labeledglucose is injected into the body. Fast-growing cancer cells feed onsugars and absorb it more quickly than do normal cells, Carkaci explained,so they "light up" on the images created by the PET scanner.
On the other hand, "the CT scanner takes a series of X-ray pictures,which are combined by a computer to create an extremely detailed image ofthe internal organs or other parts of the body," she said.
The scan gives great anatomical detail including the size, shape andlocation of the tumor. Together, the tests provide the most complete dataon the tumor and its spread, Carkaci said.
In the study, doctors scanned 41 women newly diagnosed withinflammatory breast cancer. They found metastases in 20 patients, or 49percent. They used biopsy or additional imaging to confirm the resultswhen possible. Biopsy confirmation of metastases were available in four of13 patients and additional imaging confirmation in nine.
"We found that FDG-PET/CT is 95 percent accurate in identifying distantmetastases and 98 percent accurate in identifying regional lymph nodemetastases," Carkaci said.
"This [scanning] is done immediately after diagnosis, and thenfollowing the chemotherapy, to evaluate the response to treatment," shesaid.
The hope is to stop the cancer in its tracks.
One co-author, Dr. Homer Macapinlac, chair and professor of nuclearmedicine at M.D. Anderson, reported being a consultant for GeneralElectric Company and Siemens AG. Both companies produce scanners.
The study findings are "significant for the high rate of metastaticdisease, with almost one half of the women with PET/CT able to identifythe tumors at an early stage," said Dr. David Bluemke, professor ofradiology and medicine and clinical director, MRI, Johns Hopkins MedicalInstitution, Baltimore.
"The data is very compelling for routine and early use of PET/CT forpatients with inflammatory breast cancer," he said. "Although the studywas small, the high accuracy rate appears promising for patients with thiscondition."
More information
To learn more about inflammatory breast cancer, visit the U.S. National Cancer Institute.
New breast cancer risk prediction model for black women in US
New breast cancer risk prediction model for black women in US
Silhouettes representing breast cancer victims. Scientists have developed a new, more accurate risk assessment model for breast cancer in African American women, a risk they said had been underestimated, in a new study out Wednesday.(AFP/File/Greg Wood)WASHINGTON (AFP) - Scientists have developed a new, more accurate risk assessment model for breast cancer in African American women, a risk they said had been underestimated, in a new study out Wednesday.
The Breast Cancer Risk Assessment Tool, also widely known as the Gail model, has been used for years to determine breast cancer risk in all racial groups, and in the United States to determine eligibility for participation in clinical testing of cancer treatments and preventive care.
But much of the model is based on breast cancer data only from white women.
The new study, called the Women's Contraceptive and Reproductive Experiences (CARE) study, was run to gather data on African American women with and without breast cancer.
Mitchell Gail of the National Cancer Institute in Bethesda, Maryland, who developed the old model, and colleagues, "used data from the CARE study and the Surveillance, Epidemiology, and End Results (SEER) program to build a new model for estimating breast cancer risk in African American women," they said in a statement.
They used data from two trials, the Women's Health Initiative and the Study of Tamoxifen and Raloxifene (STAR), to test the model, they said.
The new model found that 30 percent of African American women over 45 had an at least 1.66 percent chance of developing breast cancer over a five-year period, twice as high as in the Gail model (14.5 percent).
Still "the CARE model is not recommended for women with a previous history of breast cancer, and it may underestimate breast cancer risks in certain other women," the doctors warned in their statement.
Silhouettes representing breast cancer victims. Scientists have developed a new, more accurate risk assessment model for breast cancer in African American women, a risk they said had been underestimated, in a new study out Wednesday.(AFP/File/Greg Wood)WASHINGTON (AFP) - Scientists have developed a new, more accurate risk assessment model for breast cancer in African American women, a risk they said had been underestimated, in a new study out Wednesday.
The Breast Cancer Risk Assessment Tool, also widely known as the Gail model, has been used for years to determine breast cancer risk in all racial groups, and in the United States to determine eligibility for participation in clinical testing of cancer treatments and preventive care.
But much of the model is based on breast cancer data only from white women.
The new study, called the Women's Contraceptive and Reproductive Experiences (CARE) study, was run to gather data on African American women with and without breast cancer.
Mitchell Gail of the National Cancer Institute in Bethesda, Maryland, who developed the old model, and colleagues, "used data from the CARE study and the Surveillance, Epidemiology, and End Results (SEER) program to build a new model for estimating breast cancer risk in African American women," they said in a statement.
They used data from two trials, the Women's Health Initiative and the Study of Tamoxifen and Raloxifene (STAR), to test the model, they said.
The new model found that 30 percent of African American women over 45 had an at least 1.66 percent chance of developing breast cancer over a five-year period, twice as high as in the Gail model (14.5 percent).
Still "the CARE model is not recommended for women with a previous history of breast cancer, and it may underestimate breast cancer risks in certain other women," the doctors warned in their statement.
Wednesday, December 26, 2007
Interim data show Aranesp no help in breast cancer
Interim data show Aranesp no help in breast cancer
LOS ANGELES (Reuters) - Amgen Inc said on Friday interimresults from an independent study involving breast cancerpatients found its anemia drug Aranesp did not enhance theeffect of chemotherapy prior to surgery.
Amgen shares fell 4 percent to $53 in extended trade as thecompany also reported preliminary follow-up data showing thatthe participants who received Aranesp had numerically moredeaths and reports of tumor growth than the control group.
The company cautioned that the results -- which land amidconcerns about the overuse and safety of the anemia drug class-- were preliminary and said no conclusions should be drawnuntil the final study report is completed.
The study, involving 733 patients, was designed to evaluatewhether Aranesp prevented anemia and augmented the therapeuticeffects of the chemotherapy regimens, Amgen said.
"This interim analysis shows that the use of Aranesp tosupport neo-adjuvant chemotherapy has no significant impact ontumor response to chemotherapy at the time of surgery," saidDr. Michael Untch, lead investigator of the study conducted bythe German Gynecological Oncology Study Group and the GermanBreast Group.
There were no deaths during the treatment period,researchers said.
Preliminary long-term follow-up data as of October 30 alsoshowed numerically more deaths in the group receiving Aranesp,50 of 356 patients, compared with 37 deaths among the 377 inthe control group.
There also were more tumor progression events in theAranesp group, 88 of 356, versus the control group's 70 of 377.
"No definitive conclusions should be drawn from the interimresults of the long-term follow up until the final study reportis completed," Untch said.
A formal statistical analysis of survival is anticipated inearly 2009.
Aranesp and its predecessor Epogen were Amgen's top-sellingdrugs in 2006, reaping combined revenue of $6.6 billion.
Sales of those Amgen drugs totaled $4.5 billion at the endof the third quarter, down 11 percent from the year earlier.
Anemia drugs, which also include products from Johnson &Johnson and Roche Holding AG, accounted for global sales ofabout $12 billion last year. They are used to treat anemia incancer and kidney dialysis patients.
The entire class has been under a microscope as debatesrage over whether anemia drugs increase the risk of heartattack and stroke, and whether they may play a role in fuelingthe growth of cancer.
Shares in Amgen, the largest U.S. biotechnology company byrevenue, are down 19 percent so far this year.
(Additional reporting by Bill Berkrot in New York)
(Editing by Braden Reddall and Andre Grenon)
LOS ANGELES (Reuters) - Amgen Inc said on Friday interimresults from an independent study involving breast cancerpatients found its anemia drug Aranesp did not enhance theeffect of chemotherapy prior to surgery.
Amgen shares fell 4 percent to $53 in extended trade as thecompany also reported preliminary follow-up data showing thatthe participants who received Aranesp had numerically moredeaths and reports of tumor growth than the control group.
The company cautioned that the results -- which land amidconcerns about the overuse and safety of the anemia drug class-- were preliminary and said no conclusions should be drawnuntil the final study report is completed.
The study, involving 733 patients, was designed to evaluatewhether Aranesp prevented anemia and augmented the therapeuticeffects of the chemotherapy regimens, Amgen said.
"This interim analysis shows that the use of Aranesp tosupport neo-adjuvant chemotherapy has no significant impact ontumor response to chemotherapy at the time of surgery," saidDr. Michael Untch, lead investigator of the study conducted bythe German Gynecological Oncology Study Group and the GermanBreast Group.
There were no deaths during the treatment period,researchers said.
Preliminary long-term follow-up data as of October 30 alsoshowed numerically more deaths in the group receiving Aranesp,50 of 356 patients, compared with 37 deaths among the 377 inthe control group.
There also were more tumor progression events in theAranesp group, 88 of 356, versus the control group's 70 of 377.
"No definitive conclusions should be drawn from the interimresults of the long-term follow up until the final study reportis completed," Untch said.
A formal statistical analysis of survival is anticipated inearly 2009.
Aranesp and its predecessor Epogen were Amgen's top-sellingdrugs in 2006, reaping combined revenue of $6.6 billion.
Sales of those Amgen drugs totaled $4.5 billion at the endof the third quarter, down 11 percent from the year earlier.
Anemia drugs, which also include products from Johnson &Johnson and Roche Holding AG, accounted for global sales ofabout $12 billion last year. They are used to treat anemia incancer and kidney dialysis patients.
The entire class has been under a microscope as debatesrage over whether anemia drugs increase the risk of heartattack and stroke, and whether they may play a role in fuelingthe growth of cancer.
Shares in Amgen, the largest U.S. biotechnology company byrevenue, are down 19 percent so far this year.
(Additional reporting by Bill Berkrot in New York)
(Editing by Braden Reddall and Andre Grenon)
Monday, December 24, 2007
Panel Recommends Against Avastin for Breast Cancer (American Cancer Society)
Panel Recommends Against Avastin for Breast Cancer (American Cancer Society)
An advisory panel for the US Food and Drug Administration(FDA) says the drug Avastin (bevacizumab) should not be approved for breastcancer treatment.
The Oncology Drug Advisory Committee recommended against FDA approval bya 5-4 vote Wednesday, noting that Avastin does not help breast cancerpatients live longer and can cause severe side effects. The FDA oftenfollows the recommendations of its advisory panels, but does not have to. Afinal decision by the agency is expected by late February 2008.
Avastin is approved to treat colon cancer and lung cancer.Studies have shown that Avastin helps patients with these cancers livelonger. Even if the FDA does not approve it for treatment of breast cancer,some doctors may still prescribe it "off label" for this use, althoughinsurance reimbursement might be an issue.
Survival Not Significantly Improved
In making its recommendation, the advisory panel reviewed the results ofa clinical trial involving 722 women with breast cancer that had returnedafter initial treatment or that had spread to other parts of their body.The women were randomly assigned to receive either Avastin plus thechemotherapy drug paclitaxel, or paclitaxel alone.
Adding Avastin to paclitaxel kept the cancer from growing for an averageof 11.3 months, compared to 5.8 months for the women getting paclitaxelalone. But overall survival was not significantly better, and women whoreceived Avastin had more serious side effects compared to those who gotpaclitaxel alone. Those included high blood pressure, blood clots, heartproblems, holes forming in the colon (bowel perforation) and high levels ofprotein in the urine, which is a sign of kidney damage. These are all knownside effects of Avastin.
In a report prepared for the panel, the FDA also said Avastin treatmentmay have caused as many as 6 deaths. However, Avastin's manufacturer,Genentech, disagreed with that assessment. The company's analysisattributed all those deaths to breast cancer or other causes, not totreatment with Avastin.
The advisory panel also reviewed the results of another clinical trialof Avastin in women who had previously been treated for metastatic breastcancer. In that study, the 462 patients received either Avastin incombination with the chemotherapy drug capecitabine, or capecitabine alone.Avastin did not significantly improve survival, or the time it took for thecancer to start growing again.
Genentech executives said they were "disappointed" by the committee'svote and will continue working with the FDA to get Avastin approved forbreast cancer.
An advisory panel for the US Food and Drug Administration(FDA) says the drug Avastin (bevacizumab) should not be approved for breastcancer treatment.
The Oncology Drug Advisory Committee recommended against FDA approval bya 5-4 vote Wednesday, noting that Avastin does not help breast cancerpatients live longer and can cause severe side effects. The FDA oftenfollows the recommendations of its advisory panels, but does not have to. Afinal decision by the agency is expected by late February 2008.
Avastin is approved to treat colon cancer and lung cancer.Studies have shown that Avastin helps patients with these cancers livelonger. Even if the FDA does not approve it for treatment of breast cancer,some doctors may still prescribe it "off label" for this use, althoughinsurance reimbursement might be an issue.
Survival Not Significantly Improved
In making its recommendation, the advisory panel reviewed the results ofa clinical trial involving 722 women with breast cancer that had returnedafter initial treatment or that had spread to other parts of their body.The women were randomly assigned to receive either Avastin plus thechemotherapy drug paclitaxel, or paclitaxel alone.
Adding Avastin to paclitaxel kept the cancer from growing for an averageof 11.3 months, compared to 5.8 months for the women getting paclitaxelalone. But overall survival was not significantly better, and women whoreceived Avastin had more serious side effects compared to those who gotpaclitaxel alone. Those included high blood pressure, blood clots, heartproblems, holes forming in the colon (bowel perforation) and high levels ofprotein in the urine, which is a sign of kidney damage. These are all knownside effects of Avastin.
In a report prepared for the panel, the FDA also said Avastin treatmentmay have caused as many as 6 deaths. However, Avastin's manufacturer,Genentech, disagreed with that assessment. The company's analysisattributed all those deaths to breast cancer or other causes, not totreatment with Avastin.
The advisory panel also reviewed the results of another clinical trialof Avastin in women who had previously been treated for metastatic breastcancer. In that study, the 462 patients received either Avastin incombination with the chemotherapy drug capecitabine, or capecitabine alone.Avastin did not significantly improve survival, or the time it took for thecancer to start growing again.
Genentech executives said they were "disappointed" by the committee'svote and will continue working with the FDA to get Avastin approved forbreast cancer.
Common Household Chemical Could Raise Breast Cancer Risk
Common Household Chemical Could Raise Breast Cancer Risk
THURSDAY, Dec. 6 (HealthDay News) -- A chemical found in manyplastic products used in households caused accelerated breast developmentand genetic changes in newborn female lab rats, a condition that mightpredispose the animals to breast cancer later in life, a new studysays.
Butyl benzyl phthalate (BBP) is commonly used to soften polymers andplastics. It's found in everything from plastic pipes, vinyl floor tilesand carpet backing to lipstick. BBP has also been found to be an endocrinedisruptor, which mimics the effect of hormones. Endocrine disruptors areknown to damage wildlife and have also been implicated in reduced spermcounts and neurological problems in humans, the researchers said.
"Our study is the first one demonstrating that exposure to thiscompound (BBP) soon after birth results in alterations in the expressionof genes present in the mammary gland," said lead researcher Dr. JoseRusso, a breast cancer expert at the Fox Chase Cancer Center, inPhiladelphia.
The findings are important, Russo said, because the researchers arestudying the lifetime effect of BBP on the mammary gland, long before itstarts developing under the influence of the hormones of puberty, and thepotential implications on humans.
Because of lasting genetic changes in the breast, exposure to BBP couldincrease the risk for developing breast cancer later in life, Russosaid.
"To prevent breast cancer in adulthood, it is necessary to protect boththe newborn child and the mother from exposure to this compound that hasan estrogenic effect and could act as an endocrine disruptor," headded.
For the study, Russo's team fed lactating rats BBP, which theiroffspring absorbed through breast milk. The rat pups received levels ofthe chemical equivalent to the U.S. Environmental Protection Agency's safedose limit for humans, according to the report in the Dec. 5 online issueof BMC Genomics.
The researchers found that BBP affected characteristics of the femaleoffspring of the rats, such as more rapid breast development and changesin the genetic profile of the mammary glands. While these effects wore offafter exposure to BBP was stopped, the changes caused by the chemicalmight have an effect later in life, the researchers said.
"Our original observations are that the genomic changes induced by BBPoccur very early in life, and they could result in significantmodifications in the risk of the mammary gland to develop cancer later onin life," Russo said.
Russo said he and his colleagues are currently evaluating how changesin gene expression caused by BBP respond to cancer-causing chemicals givento adult rats.
"We are also studying the effects of exposure to BBP before birth. Inaddition, we are following a cohort of girls entering puberty fordetermining the tempo of breast development and their first menstrualperiod and associating these events with exposure to environmental agentssuch as BBP," Russo said.
One expert said scientists are only beginning to learn how many genesare affected by exposure to chemicals early in life.
"The early exposure to BBP altered breast development and may thereforealter the susceptibility to breast cancer," said Dr. Ted Schettler,science director at the Science and Environmental Health Network, in Ames,Iowa.
Schettler thinks people need to be aware of the possible effects ofchemicals on genes during early life, and how these changes can influencesusceptibility to disease in adulthood.
"People are finally getting the idea that early life events can matterlater in life," Schettler said. "When people see that commonly encounteredenvironmental agents like BBP can cause genetic changes, it's of publichealth interest."
However, Dr. Jonathan Borak, a clinical professor of environmentalmedicine at Yale University School of Public Health, said there's noevidence that exposure to BBP increases the risk of breast cancer.
"To date, studies have failed to find an association between BBP andbreast cancer," Borak said. "This study doesn't add specific informationon breast cancer and environmental interactions."
Efforts to reach the American Chemistry Council, a chemical industrygroup, for comment on the study were unsuccessful.
In October, California adopted a law that will ban trace amounts of BBPin toys and baby products such as teething rings, according to publishedreports.
And in March, a study published in the journal Environmental HealthPerspectives suggested that exposure to phthalates could be fuelingthe obesity epidemic by contributing to abdominal obesity and insulinresistance in men.
THURSDAY, Dec. 6 (HealthDay News) -- A chemical found in manyplastic products used in households caused accelerated breast developmentand genetic changes in newborn female lab rats, a condition that mightpredispose the animals to breast cancer later in life, a new studysays.
Butyl benzyl phthalate (BBP) is commonly used to soften polymers andplastics. It's found in everything from plastic pipes, vinyl floor tilesand carpet backing to lipstick. BBP has also been found to be an endocrinedisruptor, which mimics the effect of hormones. Endocrine disruptors areknown to damage wildlife and have also been implicated in reduced spermcounts and neurological problems in humans, the researchers said.
"Our study is the first one demonstrating that exposure to thiscompound (BBP) soon after birth results in alterations in the expressionof genes present in the mammary gland," said lead researcher Dr. JoseRusso, a breast cancer expert at the Fox Chase Cancer Center, inPhiladelphia.
The findings are important, Russo said, because the researchers arestudying the lifetime effect of BBP on the mammary gland, long before itstarts developing under the influence of the hormones of puberty, and thepotential implications on humans.
Because of lasting genetic changes in the breast, exposure to BBP couldincrease the risk for developing breast cancer later in life, Russosaid.
"To prevent breast cancer in adulthood, it is necessary to protect boththe newborn child and the mother from exposure to this compound that hasan estrogenic effect and could act as an endocrine disruptor," headded.
For the study, Russo's team fed lactating rats BBP, which theiroffspring absorbed through breast milk. The rat pups received levels ofthe chemical equivalent to the U.S. Environmental Protection Agency's safedose limit for humans, according to the report in the Dec. 5 online issueof BMC Genomics.
The researchers found that BBP affected characteristics of the femaleoffspring of the rats, such as more rapid breast development and changesin the genetic profile of the mammary glands. While these effects wore offafter exposure to BBP was stopped, the changes caused by the chemicalmight have an effect later in life, the researchers said.
"Our original observations are that the genomic changes induced by BBPoccur very early in life, and they could result in significantmodifications in the risk of the mammary gland to develop cancer later onin life," Russo said.
Russo said he and his colleagues are currently evaluating how changesin gene expression caused by BBP respond to cancer-causing chemicals givento adult rats.
"We are also studying the effects of exposure to BBP before birth. Inaddition, we are following a cohort of girls entering puberty fordetermining the tempo of breast development and their first menstrualperiod and associating these events with exposure to environmental agentssuch as BBP," Russo said.
One expert said scientists are only beginning to learn how many genesare affected by exposure to chemicals early in life.
"The early exposure to BBP altered breast development and may thereforealter the susceptibility to breast cancer," said Dr. Ted Schettler,science director at the Science and Environmental Health Network, in Ames,Iowa.
Schettler thinks people need to be aware of the possible effects ofchemicals on genes during early life, and how these changes can influencesusceptibility to disease in adulthood.
"People are finally getting the idea that early life events can matterlater in life," Schettler said. "When people see that commonly encounteredenvironmental agents like BBP can cause genetic changes, it's of publichealth interest."
However, Dr. Jonathan Borak, a clinical professor of environmentalmedicine at Yale University School of Public Health, said there's noevidence that exposure to BBP increases the risk of breast cancer.
"To date, studies have failed to find an association between BBP andbreast cancer," Borak said. "This study doesn't add specific informationon breast cancer and environmental interactions."
Efforts to reach the American Chemistry Council, a chemical industrygroup, for comment on the study were unsuccessful.
In October, California adopted a law that will ban trace amounts of BBPin toys and baby products such as teething rings, according to publishedreports.
And in March, a study published in the journal Environmental HealthPerspectives suggested that exposure to phthalates could be fuelingthe obesity epidemic by contributing to abdominal obesity and insulinresistance in men.
Black Women Wait Longer for Breast Cancer Surgery
Black Women Wait Longer for Breast Cancer Surgery
THURSDAY, Dec. 6 (HealthDay News) -- A woman's age and race caninfluence how quickly she receives surgery after a breast cancerdiagnosis, U.S. researchers report.
A team at the Johns Hopkins Medical Institutions in Baltimore alsofound that a lengthy delay in surgery for breast cancer affects overallsurvival.
Factors such as socioeconomic status and the cumulative effects of apatient's other illnesses likely contribute to breast cancer surgerydelays, according to preliminary findings of the study, which looked at1,477 breast cancer patients who had either a lumpectomy or a mastectomyat Johns Hopkins between 2000 and 2005.
The team found that the average interval from breast cancer diagnosisto surgery was six days longer for black American women than for whitewomen (34 days vs. 28 days). Women older than age 70 had to wait anaverage of 12 more days for surgery than women younger than 40. Thoseyounger women were treated within 21 days, compared with: 28 days forpatients ages 40 to 50; 31 days for women in their 50s; 29.5 days forpatients ages 60 to 70; and more than 33 days for women older than 70.
Overall, the average time from diagnosis to surgery was 29 days.
Women who had to wait more than 60 days between breast cancer diagnosisand treatment were 1.8 times more likely to die from any cause compared towomen who had surgery within 60 days of diagnosis, the study found.
"We think that timely treatment could make a difference in patientcare," Dr. Hae Seong Park, a research coordinator in the oncologydepartment at the Sidney Kimmel Comprehensive Cancer Center at JohnsHopkins, said in a prepared statement.
The study also found the average length of time between diagnosis andsurgery varied year to year. It was 24 days in 2000-01, 34 days in2002-03, and about 30 days in 2004-05.
The stage of cancer at time of diagnosis did not seem to influence thelength of time a woman had to wait until surgery.
"Although this is one factor that one might expect a time differential,we did not observe much difference," Park said.
The researchers were especially concerned by a finding that almost 24percent of patients didn't receive adjuvant therapy, such as chemotherapyor hormone therapy, after they had their breast cancer surgery. Patientswho had surgery more than 60 days after their diagnosis seemed to be lesslikely to receive adjuvant therapy, which is known to improvesurvival.
"Most patients should have received such treatment, but it may be thatthe cancer registry data did not reflect all of this information," Parksaid.
The researchers also lacked information about patients' insurancestatus and other data that may help explain some of the time lags betweendiagnosis and surgery.
"We plan to review individual patient records and collect moreinformation to confirm what we observed and perhaps to think aboutinterventions to provide more timely and complete care," Park said.
The findings were expected to be presented Thursday at an AmericanAssociation for Cancer Research meeting in Philadelphia.
More information
Breastcancer.org has more about surgery for breast cancer.
THURSDAY, Dec. 6 (HealthDay News) -- A woman's age and race caninfluence how quickly she receives surgery after a breast cancerdiagnosis, U.S. researchers report.
A team at the Johns Hopkins Medical Institutions in Baltimore alsofound that a lengthy delay in surgery for breast cancer affects overallsurvival.
Factors such as socioeconomic status and the cumulative effects of apatient's other illnesses likely contribute to breast cancer surgerydelays, according to preliminary findings of the study, which looked at1,477 breast cancer patients who had either a lumpectomy or a mastectomyat Johns Hopkins between 2000 and 2005.
The team found that the average interval from breast cancer diagnosisto surgery was six days longer for black American women than for whitewomen (34 days vs. 28 days). Women older than age 70 had to wait anaverage of 12 more days for surgery than women younger than 40. Thoseyounger women were treated within 21 days, compared with: 28 days forpatients ages 40 to 50; 31 days for women in their 50s; 29.5 days forpatients ages 60 to 70; and more than 33 days for women older than 70.
Overall, the average time from diagnosis to surgery was 29 days.
Women who had to wait more than 60 days between breast cancer diagnosisand treatment were 1.8 times more likely to die from any cause compared towomen who had surgery within 60 days of diagnosis, the study found.
"We think that timely treatment could make a difference in patientcare," Dr. Hae Seong Park, a research coordinator in the oncologydepartment at the Sidney Kimmel Comprehensive Cancer Center at JohnsHopkins, said in a prepared statement.
The study also found the average length of time between diagnosis andsurgery varied year to year. It was 24 days in 2000-01, 34 days in2002-03, and about 30 days in 2004-05.
The stage of cancer at time of diagnosis did not seem to influence thelength of time a woman had to wait until surgery.
"Although this is one factor that one might expect a time differential,we did not observe much difference," Park said.
The researchers were especially concerned by a finding that almost 24percent of patients didn't receive adjuvant therapy, such as chemotherapyor hormone therapy, after they had their breast cancer surgery. Patientswho had surgery more than 60 days after their diagnosis seemed to be lesslikely to receive adjuvant therapy, which is known to improvesurvival.
"Most patients should have received such treatment, but it may be thatthe cancer registry data did not reflect all of this information," Parksaid.
The researchers also lacked information about patients' insurancestatus and other data that may help explain some of the time lags betweendiagnosis and surgery.
"We plan to review individual patient records and collect moreinformation to confirm what we observed and perhaps to think aboutinterventions to provide more timely and complete care," Park said.
The findings were expected to be presented Thursday at an AmericanAssociation for Cancer Research meeting in Philadelphia.
More information
Breastcancer.org has more about surgery for breast cancer.
Sunday, December 23, 2007
Mutated Suppressor Gene Leads to a Type of Breast Cancer
Mutated Suppressor Gene Leads to a Type of Breast Cancer
MONDAY, Dec. 10 (HealthDay News) -- Scientists believe they'vediscovered how mutations in the cancer-susceptibility gene called BRCA1can cause some breast cancers.
Basal-like breast cancers (BBCs) represent 10 percent to 20 percent ofall breast cancers. BBCs generally have a poor prognosis, are difficult totreat, and are almost always associated with hereditary mutations in theBRCA1 gene, the researchers said.
The researchers found that inherited mutations in the BRCA1 genedeactivate another gene known as PTEN, which helps to suppress tumors.This suppressor gene is deactivated by the mutated BRCA1 gene's failure torepair a break in the PTEN gene's DNA, the scientists said.
The loss of the PTEN gene's tumor-suppressing ability allows increasedcell activity that increases tumor growth. That action "can convert thecell from being a well-behaving entity to a bad citizen," said studyco-author Dr. Ramon Parsons, a professor of medicine and pathology atColumbia University's College of Physicians and Surgeons.
"This is a very important finding, because this type of breast cancerdoesn't have a type of therapy targeted at this point," Parsons said.Basal-like or triple negative tumors don't have receptors for the hormonesestrogen and progesterone or the protein HER2, which most breast cancertherapies target, he said. Drugs that can target the pathway related tomutated PTEN genes "may be a way we can improve the survival for womenwith these basal-like tumors," he added.
Parsons said several pharmaceutical companies already are developingdrugs to do just that.
"My guess is there's going to be a huge bolus of clinical trials withthese drugs in the next couple of years," he said. "Since there's going tobe such a large variety of compounds, my hunch is one or more will beeffective." By effective, Parson said he doesn't mean one of them willoffer a cure, but the drugs in the right combination could lead to acure.
The development of these drugs also may be important for other types ofcancers that can involve deactivating the PTEN gene, Parsons said.
The study results were published online Dec. 9 in the journal NatureGenetics.
Parsons said the discovery of the PTEN deactivation "was kind of a reallong-term detective story." For 10 years, researchers have been trying tounderstand how the mutation in the BRCA1 gene can cause breast cancer.Instead of using traditional gene-sequencing techniques, Parsons and hiscolleagues looked for physical breaks in the PTEN gene. "PTEN is actuallyphysically broken in half, we estimate, in 30 to more than 50 percent ofthe BRCA1 tumors," he said.
Dr. Jeffrey Weitzel, an associate professor of medical oncology at theCity of Hope Comprehensive Cancer Center in Duarte, Calif., said the studyby Parsons' team "helps us understand what's under-appreciated in thecomplex nature of tumor changes."
Andrew Godwin, director of the clinical molecular genetics laboratoryat the Fox Chase Cancer Center in Philadelphia, added: "As we move towardspersonalized health care [and] medicine, identifying the cadre of geneticdefects in a given breast tumor will likely influence how that patient isultimately treated."
MONDAY, Dec. 10 (HealthDay News) -- Scientists believe they'vediscovered how mutations in the cancer-susceptibility gene called BRCA1can cause some breast cancers.
Basal-like breast cancers (BBCs) represent 10 percent to 20 percent ofall breast cancers. BBCs generally have a poor prognosis, are difficult totreat, and are almost always associated with hereditary mutations in theBRCA1 gene, the researchers said.
The researchers found that inherited mutations in the BRCA1 genedeactivate another gene known as PTEN, which helps to suppress tumors.This suppressor gene is deactivated by the mutated BRCA1 gene's failure torepair a break in the PTEN gene's DNA, the scientists said.
The loss of the PTEN gene's tumor-suppressing ability allows increasedcell activity that increases tumor growth. That action "can convert thecell from being a well-behaving entity to a bad citizen," said studyco-author Dr. Ramon Parsons, a professor of medicine and pathology atColumbia University's College of Physicians and Surgeons.
"This is a very important finding, because this type of breast cancerdoesn't have a type of therapy targeted at this point," Parsons said.Basal-like or triple negative tumors don't have receptors for the hormonesestrogen and progesterone or the protein HER2, which most breast cancertherapies target, he said. Drugs that can target the pathway related tomutated PTEN genes "may be a way we can improve the survival for womenwith these basal-like tumors," he added.
Parsons said several pharmaceutical companies already are developingdrugs to do just that.
"My guess is there's going to be a huge bolus of clinical trials withthese drugs in the next couple of years," he said. "Since there's going tobe such a large variety of compounds, my hunch is one or more will beeffective." By effective, Parson said he doesn't mean one of them willoffer a cure, but the drugs in the right combination could lead to acure.
The development of these drugs also may be important for other types ofcancers that can involve deactivating the PTEN gene, Parsons said.
The study results were published online Dec. 9 in the journal NatureGenetics.
Parsons said the discovery of the PTEN deactivation "was kind of a reallong-term detective story." For 10 years, researchers have been trying tounderstand how the mutation in the BRCA1 gene can cause breast cancer.Instead of using traditional gene-sequencing techniques, Parsons and hiscolleagues looked for physical breaks in the PTEN gene. "PTEN is actuallyphysically broken in half, we estimate, in 30 to more than 50 percent ofthe BRCA1 tumors," he said.
Dr. Jeffrey Weitzel, an associate professor of medical oncology at theCity of Hope Comprehensive Cancer Center in Duarte, Calif., said the studyby Parsons' team "helps us understand what's under-appreciated in thecomplex nature of tumor changes."
Andrew Godwin, director of the clinical molecular genetics laboratoryat the Fox Chase Cancer Center in Philadelphia, added: "As we move towardspersonalized health care [and] medicine, identifying the cadre of geneticdefects in a given breast tumor will likely influence how that patient isultimately treated."
Fewer breast patients may need chemo
Fewer breast patients may need chemo
Big hair winner Tricia Nathan of Grafton, Mass., salutes to the judges during the Imperia Vodka Hair Competition in Manchester, N.H., in this June 2, 2007, file photo. Nathan competed against more than 40 contestants for the biggest hair and won the first place prize of $7,500 as they raise money for breast cancer. (AP Photo/Jim Cole/FILE)SAN ANTONIO - Thousands of breast cancer patients each year could be spared chemotherapy or get gentler versions of it without harming their odds of beating the disease, new research suggests.
One study found that certain women did better — were less likely to die or have a relapse — if given a less harsh drug than Adriamycin, a mainstay of treatment for decades.
Another study found that a gene test can help predict whether some women need chemo at all — even among those whose cancer has spread to their lymph nodes, which typically brings full treatment now.
The findings are sure to speed the growing trend away from chemo for many breast cancer patients and targeting it to a smaller group of women who truly need it, doctors said Thursday at the San Antonio Breast Cancer Symposium, where the studies were reported.
"We are backing off on chemotherapy and using chemotherapy more selectively" in certain women, said Dr. Eric Winer of the Dana-Farber Cancer Institute in Boston.
The gene test in particular "will start changing practice nearly immediately," said Dr. Peter Ravdin of the University of Texas M.D. Anderson Cancer Center in Houston. "The results are compelling that this test ... helps select patients who will most benefit from chemotherapy."
Breast cancer is the most common major cancer in American women. More than 178,000 new cases are expected this year. Most are helped to grow by estrogen, and hormone-blocking medicines like tamoxifen are used to treat those.
Chemo usually is added if the disease has spread to lymph nodes — a situation faced by about 45,000 U.S. women each year. Doctors know that chemo won't help most of these women, but they have had no good way to tell who can safely skip its cost and misery.
Here's where Oncotype DX, a test that measures the activity of 21 genes and gives a score to predict a woman's risk of recurrence, comes in. Doctors have used it for several years to guide treatment for certain women with early breast cancers, especially those that not spread.
The new study, led by Dr. Kathy Albain of Loyola University in Chicago, looked at whether it accurately predicted chemo's benefit in 367 women whose hormone-driven cancer had spread to lymph nodes.
A decade after these women were treated, those who had low scores on the gene test were found to have had no benefit from chemo. Conversely, chemo did a lot of good for those with high scores.
Because 40 percent of the women scored low, it means that as many as 18,000 women each year might safely skip chemo.
The National Cancer Institute and the test's maker, Genomic Health of Redwood City, Calif., sponsored the study. Albain, Winer and Ravdin have consulted or been paid speakers for the company in the past.
Dr. Kelly Marcom, a Duke University cancer expert with no ties to the company, said the test would give valuable information to guide treatment for more patients in the future. He has used it on about 50 women in the last year.
"I've had it cut both ways" — ruling chemo in and out, Marcom said.
The test is expensive — $3,400 — though many insurers are paying for it because it can avoid even more costly chemo.
Albain plans to discuss using it with Andrea DeRosier, a 49-year-old health care administrator from suburban Chicago whose cancer has spread to a single lymph node.
When a surgeon said she likely would need chemo, "I remember thinking, 'Oh, that's terrible,'" DeRosier said. "I want whatever protocol is going to keep me alive," but not futile treatment, she said.Chemo's side effects are getting greater attention. One drug commonly used for early breast cancer — doxorubicin, sold as Adriamycin and generic brands — is known to cut the risk of having a recurrence or dying, but raises the risk of heart problems and even leukemia.Dr. Stephen Jones of Baylor-Sammons Cancer Center tested using Taxotere, a drug not linked to heart problems, in its place in more than 1,000 women with early breast cancer. After seven years, 87 percent of those given Taxotere survived, compared with 82 percent of those given Adriamycin. In addition, those given Taxotere were less likely to have had a recurrence.The study was sponsored by Taxotere's maker, Sanofi-Aventis SA, a French company with U.S. offices in Bridgewater, N.J. Jones consults for the company.A study in the New England Journal of Medicine in October showed that another drug, Taxol, does not work for the most common form of breast cancer.These new studies should lead to less use of chemo, but there has been "intense" pushback from doctors, who fear giving up on a treatment that might help some patients, said Barbara Brenner, head of the advocacy group Breast Cancer Action."It's very hard to turn a ship like this," she said. "Adding things never takes much, but removing things takes a mountain of data from the medical community."___On the Net:Breast cancer meeting: http://www.sabcs.orgNational Cancer Institute: http://www.cancer.gov
Big hair winner Tricia Nathan of Grafton, Mass., salutes to the judges during the Imperia Vodka Hair Competition in Manchester, N.H., in this June 2, 2007, file photo. Nathan competed against more than 40 contestants for the biggest hair and won the first place prize of $7,500 as they raise money for breast cancer. (AP Photo/Jim Cole/FILE)SAN ANTONIO - Thousands of breast cancer patients each year could be spared chemotherapy or get gentler versions of it without harming their odds of beating the disease, new research suggests.
One study found that certain women did better — were less likely to die or have a relapse — if given a less harsh drug than Adriamycin, a mainstay of treatment for decades.
Another study found that a gene test can help predict whether some women need chemo at all — even among those whose cancer has spread to their lymph nodes, which typically brings full treatment now.
The findings are sure to speed the growing trend away from chemo for many breast cancer patients and targeting it to a smaller group of women who truly need it, doctors said Thursday at the San Antonio Breast Cancer Symposium, where the studies were reported.
"We are backing off on chemotherapy and using chemotherapy more selectively" in certain women, said Dr. Eric Winer of the Dana-Farber Cancer Institute in Boston.
The gene test in particular "will start changing practice nearly immediately," said Dr. Peter Ravdin of the University of Texas M.D. Anderson Cancer Center in Houston. "The results are compelling that this test ... helps select patients who will most benefit from chemotherapy."
Breast cancer is the most common major cancer in American women. More than 178,000 new cases are expected this year. Most are helped to grow by estrogen, and hormone-blocking medicines like tamoxifen are used to treat those.
Chemo usually is added if the disease has spread to lymph nodes — a situation faced by about 45,000 U.S. women each year. Doctors know that chemo won't help most of these women, but they have had no good way to tell who can safely skip its cost and misery.
Here's where Oncotype DX, a test that measures the activity of 21 genes and gives a score to predict a woman's risk of recurrence, comes in. Doctors have used it for several years to guide treatment for certain women with early breast cancers, especially those that not spread.
The new study, led by Dr. Kathy Albain of Loyola University in Chicago, looked at whether it accurately predicted chemo's benefit in 367 women whose hormone-driven cancer had spread to lymph nodes.
A decade after these women were treated, those who had low scores on the gene test were found to have had no benefit from chemo. Conversely, chemo did a lot of good for those with high scores.
Because 40 percent of the women scored low, it means that as many as 18,000 women each year might safely skip chemo.
The National Cancer Institute and the test's maker, Genomic Health of Redwood City, Calif., sponsored the study. Albain, Winer and Ravdin have consulted or been paid speakers for the company in the past.
Dr. Kelly Marcom, a Duke University cancer expert with no ties to the company, said the test would give valuable information to guide treatment for more patients in the future. He has used it on about 50 women in the last year.
"I've had it cut both ways" — ruling chemo in and out, Marcom said.
The test is expensive — $3,400 — though many insurers are paying for it because it can avoid even more costly chemo.
Albain plans to discuss using it with Andrea DeRosier, a 49-year-old health care administrator from suburban Chicago whose cancer has spread to a single lymph node.
When a surgeon said she likely would need chemo, "I remember thinking, 'Oh, that's terrible,'" DeRosier said. "I want whatever protocol is going to keep me alive," but not futile treatment, she said.Chemo's side effects are getting greater attention. One drug commonly used for early breast cancer — doxorubicin, sold as Adriamycin and generic brands — is known to cut the risk of having a recurrence or dying, but raises the risk of heart problems and even leukemia.Dr. Stephen Jones of Baylor-Sammons Cancer Center tested using Taxotere, a drug not linked to heart problems, in its place in more than 1,000 women with early breast cancer. After seven years, 87 percent of those given Taxotere survived, compared with 82 percent of those given Adriamycin. In addition, those given Taxotere were less likely to have had a recurrence.The study was sponsored by Taxotere's maker, Sanofi-Aventis SA, a French company with U.S. offices in Bridgewater, N.J. Jones consults for the company.A study in the New England Journal of Medicine in October showed that another drug, Taxol, does not work for the most common form of breast cancer.These new studies should lead to less use of chemo, but there has been "intense" pushback from doctors, who fear giving up on a treatment that might help some patients, said Barbara Brenner, head of the advocacy group Breast Cancer Action."It's very hard to turn a ship like this," she said. "Adding things never takes much, but removing things takes a mountain of data from the medical community."___On the Net:Breast cancer meeting: http://www.sabcs.orgNational Cancer Institute: http://www.cancer.gov
Men carry breast cancer genes, too
Men carry breast cancer genes, too
SAN ANTONIO - Doctors are encouraging a new group of people to consider getting tested for genes that raise the risk of breast cancer: men. Male relatives of women with such genes often do not realize that they, too, may carry them, and face greater odds of developing male breast cancer, as well as prostate, pancreatic and skin cancer, new research suggests.
"Everyone thinks of breast and ovarian cancer and just assumes it's all women. They don't even realize these genes can be inherited from the father's side of the family," said Dr. Mary Daly of Fox Chase Cancer Center in Philadelphia.
After seeing breast cancer in several male patients who did not know they were at risk, Daly conducted a small study, which was presented Friday at a conference in Texas. She now is trying to convince more fathers, sons and brothers of women with the genes to get tested.
"Very few of them want to," she said.
Breast cancer is the most common major cancer in American women. More than 178,000 new cases, and more than 40,000 deaths from it, are expected in the U.S. this year.
But men get it, too — about 2,030 cases are estimated to occur this year, accounting for about 1 percent of all breast cancer cases, according to the American Cancer Society. About 450 of these male cases will prove fatal.
The BRCA-1 or BRCA-2 genes markedly raise the risk of breast cancer and are most prevalent among those of Eastern European Jewish descent. In men, they double the normal risk of prostate cancer, triple the risk of pancreatic cancer and make breast cancer seven times more likely to develop.
As part of a larger study on perceptions of genetic risk, Daly surveyed 24 close blood relatives of women who had tested positive for one of these genes and had told their male kin the results.
Six men said they hadn't been told, or had forgotten. Of the other 18, two mistakenly said the test had been negative. Seven did not think the results revealed anything about their own cancer risk. Only five understood they, too, might carry the genes.
Of the six who expressed any interest in being tested themselves, three said they were doing so mostly for their children's sake.
"We try to reach out to the men in these families, particularly men who have little children," Daly said. "If they were to die without being tested, their children would grow up without that information" that they, too, were at risk, she said.
Dr. Steven Vogl, a cancer doctor in private practice in New York, said he recognized that potential when his neighbor was dying of lung cancer and told him how many female relatives had suffered or died of breast and other cancers.
"Being a good doctor, I took a history," and realized the man, an Eastern European Jew, probably had the gene.
"At least it will help his granddaughter" to know of the risk, Vogl said.
Women, too, need to realize they are doing male relatives and their descendants a favor when they reveal their own genetic risk from BRCA genes.
"They don't realize they are at risk," or that their grandchildren may be, Daly said.
___
On the Net:Breast cancer meeting: http://www.sabcs.orgNational Cancer Institute: http://www.cancer.govAmerican Cancer Society: http://www.cancer.org
SAN ANTONIO - Doctors are encouraging a new group of people to consider getting tested for genes that raise the risk of breast cancer: men. Male relatives of women with such genes often do not realize that they, too, may carry them, and face greater odds of developing male breast cancer, as well as prostate, pancreatic and skin cancer, new research suggests.
"Everyone thinks of breast and ovarian cancer and just assumes it's all women. They don't even realize these genes can be inherited from the father's side of the family," said Dr. Mary Daly of Fox Chase Cancer Center in Philadelphia.
After seeing breast cancer in several male patients who did not know they were at risk, Daly conducted a small study, which was presented Friday at a conference in Texas. She now is trying to convince more fathers, sons and brothers of women with the genes to get tested.
"Very few of them want to," she said.
Breast cancer is the most common major cancer in American women. More than 178,000 new cases, and more than 40,000 deaths from it, are expected in the U.S. this year.
But men get it, too — about 2,030 cases are estimated to occur this year, accounting for about 1 percent of all breast cancer cases, according to the American Cancer Society. About 450 of these male cases will prove fatal.
The BRCA-1 or BRCA-2 genes markedly raise the risk of breast cancer and are most prevalent among those of Eastern European Jewish descent. In men, they double the normal risk of prostate cancer, triple the risk of pancreatic cancer and make breast cancer seven times more likely to develop.
As part of a larger study on perceptions of genetic risk, Daly surveyed 24 close blood relatives of women who had tested positive for one of these genes and had told their male kin the results.
Six men said they hadn't been told, or had forgotten. Of the other 18, two mistakenly said the test had been negative. Seven did not think the results revealed anything about their own cancer risk. Only five understood they, too, might carry the genes.
Of the six who expressed any interest in being tested themselves, three said they were doing so mostly for their children's sake.
"We try to reach out to the men in these families, particularly men who have little children," Daly said. "If they were to die without being tested, their children would grow up without that information" that they, too, were at risk, she said.
Dr. Steven Vogl, a cancer doctor in private practice in New York, said he recognized that potential when his neighbor was dying of lung cancer and told him how many female relatives had suffered or died of breast and other cancers.
"Being a good doctor, I took a history," and realized the man, an Eastern European Jew, probably had the gene.
"At least it will help his granddaughter" to know of the risk, Vogl said.
Women, too, need to realize they are doing male relatives and their descendants a favor when they reveal their own genetic risk from BRCA genes.
"They don't realize they are at risk," or that their grandchildren may be, Daly said.
___
On the Net:Breast cancer meeting: http://www.sabcs.orgNational Cancer Institute: http://www.cancer.govAmerican Cancer Society: http://www.cancer.org
Arimidex Beats Tamoxifen in Keeping Breast Cancer at Bay
FRIDAY, Dec. 14 (HealthDay News) -- The aromatase inhibitor drugArimidex continues to outpace the old standard tamoxifen when it comes topreventing recurrences of hormone-receptor-positive breast cancers inpostmenopausal women.
Even three years after treatment was stopped, women taking Arimidexstill saw a benefit, researchers said.
"It has been very good news," said Dr. Aman Buzdar, U.S. principalinvestigator of the ATAC (Arimidex or Tamoxifen Alone or in Combination)trial, the results of which were expected to be presented Friday at the2007 San Antonio Breast Cancer Symposium.
"A lot more women receiving Arimidex are free of cancer compared totamoxifen, and the 100-month data show that these differences, ifanything, with time actually continued to increase -- meaning there werefewer and fewer recurrences on Arimidex compared with tamoxifen," Buzdarsaid.
"Arimidex is the standard of care for postmenopausal women withreceptor-positive breast cancer," confirmed Dr. Jay Brooks, chairman ofhematology/oncology at Ochsner Health System in Baton Rouge, La. "Onehundred months [over eight years] of follow-up is very profound. It's atrue credit to the investigators to be able to do the study and have thatmuch follow-up, and it shows that we have reached a new level of care forpostmenopausal women. That's what I use and continue to use."
Hormone-receptor-positive cancers respond to circulating estrogen orprogesterone. Experts estimate that from 50 percent to 70 percent ofbreast cancers are hormone receptor positive.
The new findings were also expected to be published in the journalThe Lancet Oncology to coincide with the presentation.
Arimidex (anastrozole) is an aromatase inhibitor, a relatively newclass of compounds that blocks estrogen production in the body. Accordingto Buzdar, who is professor of medicine and deputy chair of the departmentof breast medical oncology at the University of Texas M.D. Anderson CancerCenter, Arimidex is now indicated for postmenopausal women who have ahormone-dependent cancer.
Tamoxifen, which has been the gold standard of care in breast cancertreatment for more than 20 years, hinders the tumor's ability to useestrogen. Because Arimidex does not interfere with ovarian function,tamoxifen should still be used by premenopausal women with activeovaries, Buzdar said.
The first major results from ATAC, reported in 2001, found thatArimidex was more effective than tamoxifen in preventing a breast cancerrecurrence and was better tolerated.
Subsequent data continued to show positive results.
The current data represent five years of active treatment plus threeadditional years of follow-up. In all, more than 9,000 women in 21countries were involved in the study.
All the women had early-stage disease and had undergone surgery with orwithout chemotherapy and/or radiation. Eighty-four percent of participantshad hormone-receptor-positive tumors.
The women were randomized to receive Arimidex alone or tamoxifen alone(a third arm involving a combination therapy had been halted earlier).
At the time of this 100-month follow-up, the mean age of participantswas 72 years.
Arimidex improved disease-free survival by 15 percent compared withtamoxifen in women with hormone-receptor-positive breast cancer. The drugreduced the risk of all recurrences by 24 percent.
The improvement persisted even after treatment was stopped.
"The other question which was in all of our minds was what happensafter you stop the pill," Buzdar said. "The pill was stopped three yearsago, and the effect continues to be there. Even after stopping therapy,there are fewer recurrences in people who took Arimidex in the past."
The most common side effects were joint pain and estrogen deprivationleading to osteoporosis. Once the pill was stopped, however, a woman'srisk of developing osteoporosis returned to normal. No new side effectswere seen.
"Not only are you keeping more patients alive free of disease, but thesafety profile is much more predictable and much more favorable thantamoxifen," Buzdar said.
More information
There's more on aromatase inhibitors at the U.S. National Cancer Institute.
Even three years after treatment was stopped, women taking Arimidexstill saw a benefit, researchers said.
"It has been very good news," said Dr. Aman Buzdar, U.S. principalinvestigator of the ATAC (Arimidex or Tamoxifen Alone or in Combination)trial, the results of which were expected to be presented Friday at the2007 San Antonio Breast Cancer Symposium.
"A lot more women receiving Arimidex are free of cancer compared totamoxifen, and the 100-month data show that these differences, ifanything, with time actually continued to increase -- meaning there werefewer and fewer recurrences on Arimidex compared with tamoxifen," Buzdarsaid.
"Arimidex is the standard of care for postmenopausal women withreceptor-positive breast cancer," confirmed Dr. Jay Brooks, chairman ofhematology/oncology at Ochsner Health System in Baton Rouge, La. "Onehundred months [over eight years] of follow-up is very profound. It's atrue credit to the investigators to be able to do the study and have thatmuch follow-up, and it shows that we have reached a new level of care forpostmenopausal women. That's what I use and continue to use."
Hormone-receptor-positive cancers respond to circulating estrogen orprogesterone. Experts estimate that from 50 percent to 70 percent ofbreast cancers are hormone receptor positive.
The new findings were also expected to be published in the journalThe Lancet Oncology to coincide with the presentation.
Arimidex (anastrozole) is an aromatase inhibitor, a relatively newclass of compounds that blocks estrogen production in the body. Accordingto Buzdar, who is professor of medicine and deputy chair of the departmentof breast medical oncology at the University of Texas M.D. Anderson CancerCenter, Arimidex is now indicated for postmenopausal women who have ahormone-dependent cancer.
Tamoxifen, which has been the gold standard of care in breast cancertreatment for more than 20 years, hinders the tumor's ability to useestrogen. Because Arimidex does not interfere with ovarian function,tamoxifen should still be used by premenopausal women with activeovaries, Buzdar said.
The first major results from ATAC, reported in 2001, found thatArimidex was more effective than tamoxifen in preventing a breast cancerrecurrence and was better tolerated.
Subsequent data continued to show positive results.
The current data represent five years of active treatment plus threeadditional years of follow-up. In all, more than 9,000 women in 21countries were involved in the study.
All the women had early-stage disease and had undergone surgery with orwithout chemotherapy and/or radiation. Eighty-four percent of participantshad hormone-receptor-positive tumors.
The women were randomized to receive Arimidex alone or tamoxifen alone(a third arm involving a combination therapy had been halted earlier).
At the time of this 100-month follow-up, the mean age of participantswas 72 years.
Arimidex improved disease-free survival by 15 percent compared withtamoxifen in women with hormone-receptor-positive breast cancer. The drugreduced the risk of all recurrences by 24 percent.
The improvement persisted even after treatment was stopped.
"The other question which was in all of our minds was what happensafter you stop the pill," Buzdar said. "The pill was stopped three yearsago, and the effect continues to be there. Even after stopping therapy,there are fewer recurrences in people who took Arimidex in the past."
The most common side effects were joint pain and estrogen deprivationleading to osteoporosis. Once the pill was stopped, however, a woman'srisk of developing osteoporosis returned to normal. No new side effectswere seen.
"Not only are you keeping more patients alive free of disease, but thesafety profile is much more predictable and much more favorable thantamoxifen," Buzdar said.
More information
There's more on aromatase inhibitors at the U.S. National Cancer Institute.
Breast Cancer Genes Also Raise Men's Risk for Malignancy
FRIDAY, Dec. 14 (HealthDay News) -- Men whose mothers, sisters ordaughters test positive for a breast cancer-causing mutation in the BRCA1or BRCA2 genes may also have the mutation and be at increased risk forcancer, a new study finds.
Most of those men are unaware of the danger, noted researchers at FoxChase Cancer Center in Philadelphia, who examined how families discussgenetic test results.
Men with a mutation in the BRCA1 or BRCA2 genes have a 14 percentlifetime risk of developing prostate cancer and a 6 percent lifetime riskof developing breast cancer, the study authors said.
"Despite these health implications, we have found a lack ofunderstanding of genetic test results among men in these families," studylead author Dr Mary B. Daly, senior vice president for population scienceat Fox Chase, said in a prepared statement.
The researchers interviewed 24 men with a first-degree female relativewho tested positive for a BRCA1 or BRAC2 mutation. All the women said theytold their male relative about the test results, but only 18 of the menremembered that they were told.
About half the men (7) who did remember being told the test resultsdidn't believe that they also had an increased risk of cancer. Only 5 ofthe men correctly assessed their chance of having a BRCA1 or BRCA 2mutation.
"We devote a significant amount of time learning how best tocommunicate genetic test results to women, but this study shows we alsoneed to help them communicate the information to their male family memberswho may be impacted by the test results," Daly concluded.
The study was expected to be presented Friday at the San AntonioBreast Cancer Symposium.
More information
The U.S. National Cancer Institute has more about cancer genetics.
Most of those men are unaware of the danger, noted researchers at FoxChase Cancer Center in Philadelphia, who examined how families discussgenetic test results.
Men with a mutation in the BRCA1 or BRCA2 genes have a 14 percentlifetime risk of developing prostate cancer and a 6 percent lifetime riskof developing breast cancer, the study authors said.
"Despite these health implications, we have found a lack ofunderstanding of genetic test results among men in these families," studylead author Dr Mary B. Daly, senior vice president for population scienceat Fox Chase, said in a prepared statement.
The researchers interviewed 24 men with a first-degree female relativewho tested positive for a BRCA1 or BRAC2 mutation. All the women said theytold their male relative about the test results, but only 18 of the menremembered that they were told.
About half the men (7) who did remember being told the test resultsdidn't believe that they also had an increased risk of cancer. Only 5 ofthe men correctly assessed their chance of having a BRCA1 or BRCA 2mutation.
"We devote a significant amount of time learning how best tocommunicate genetic test results to women, but this study shows we alsoneed to help them communicate the information to their male family memberswho may be impacted by the test results," Daly concluded.
The study was expected to be presented Friday at the San AntonioBreast Cancer Symposium.
More information
The U.S. National Cancer Institute has more about cancer genetics.
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