Today is the last day of May. At the end of the month, I like to step back and look at the "big picture." For those of us who follow breast cancer news and research daily, one study at a time, it can be easy to lose sight of it. At LATESTBreastCancer.com, we organize news and research by test or treatment option. The "big picture" in news and research for each option can be found on its page of our website.
This month, in our Complementary Therapies and Lifestyle sections, there were breast cancer research developments involving yoga, diet, Vitamin D and exercise.
Yoga
Two studies confirmed the benefits of yoga for breast cancer patients.
According to a May 3, 2011 story in Cure Today (Reuters), even starting classes years after diagnosis can be beneficial. Female cancer patients who attended weekly yoga and meditation classes for eight weeks had a better quality of life than those who did not. The patients in the study had been diagnosed an average of four years before. Although the study was small, it was randomised, which adds scientific value.
On May 19, 2011, Medical News Today covered an MD Anderson study which found that patients who took yoga while undergoing radiation therapy experienced improved physical functioning, better general health and lower stress hormone levels than those who participated in simple stretching. Those on yoga were also "better able to find meaning in their cancer experience."
The Mediterranean Diet
A UK study published in the European Journal of Clinical Nutrition found "no strong association" between breast cancer risk and the consumption of a Mediterranean-type diet. In premenopausal women, there was a "nonsignificant" reduction in risk associated with increasing adherence to the diet.
Vitamin D
A May 11 study in Breast Cancer Research found no association between serum Vitamin D levels and breast cancer risk in a predominantly premenopausal population.
However, a March 8 study in Breast Cancer Research and Treatment revealed that Vitamin D deficiencies were common in women with breast cancer and associated with reduced spinal bone mineral density.
Also for breast cancer patients, low serum Vitamin D levels have previously been associated with more aggressive cancers or worse prognoses. An April 29 news story from the University of Rochester Medical Center, a December 14, 2010 Annals of Surgical Oncology study and a January 1, 2011 PLoS One study all found low serum Vitamin D levels to have prognostic value for patients.
Exercise
According to a May 9 story in The Telegraph, about 20,000 British women could avoid breast cancer each year by exercising for a half hour a day, limiting alcohol to one drink a day and by losing weight.
Finally, it's not often that I find a research abstract amusing. A May 20 study in the Journal of Cancer Survivorship examined barriers to exercise among cancer survivors. Cancer survivors reported that they were "too busy" or had "no willpower" to exercise regularly. The researchers concluded that the "knowledge concerning these barriers" to exercise "may be helpful" in designing "physical activity interventions."
Doesn't it seem likely that anyone who doesn't exercise regularly may also report that they are "too busy" or have "no willpower?" Maybe someone will design a case-control study to confirm.
Please check back tomorrow for more daily breast cancer news updates.
Tuesday, May 31, 2011
Monday, May 30, 2011
The Breast Cancer News Update: May 29
Happy Memorial Day from LATESTBreastCancer.com. We hope everyone is able to enjoy a day with family and friends. We honor those we have lost in service to our country and those we have lost to other battles.
The research world continues to fight breast cancer. Here are today's top breast cancer research developments.
Mepilex Lite dressings for skin reactions to radiation
For women undergoing radiation therapy for breast cancer, a recent randomised trial found that Mepilex Lite dressings significantly reduced the severity of radiation-induced skin reactions when compared to standard aqueous creams. The dressings reduced pain and discomfort and permitted women to wear normal clothing, thereby increasing quality of life.
Three breast conserving surgery (lumpectomy) studies
This weekend, we added three studies on breast conserving surgery to our database. All three were from the International Journal of Radiation Oncology, Biology, Physics and may be found on the breast conserving surgery (lumpectomy) page of our website.
The first, from The Netherlands, found that for patients under 40 with early-stage breast cancer, 10-year overall survival rates were "not impaired" after breast conserving surgery as compared to after mastectomy. In addition, patients with 1 to 3 positive nodes had a better prognosis after breast conserving surgery than after mastectomy.
Researchers from the Harvard Radiation Oncology Program found that women with basal and HER2 molecular subtypes of breast cancer had higher true recurrence rates than others after breast conserving surgery. They concluded that for basal cancers, strategies such as increased boost doses, concomitant radiation and chemotherapy, and/or targeted agents should be explored.
Finally, French researchers concluded that women who had previously received radiation therapy for Hodgkin's Lymphoma, were still candidates for breast conserving surgery plus radiation, with accommodations to protect heart and lung tissue.
More on cancer cell behavior from the biology labs
Medical News Today covered two discoveries in from the breast cancer biology labs.
The first revealed that in healthy cells, the p53 tumor suppressor can resist signals from defective growth factors and prevent improper cell division for 8 continuous hours. After 8 hours of signals from a growth factor, p53 releases "its grip on the cell's DNA, allowing it to divide." Cancerous cells lack or have defective p53. This understanding of differences between healthy and cancerous cells may lead to "new effective approaches to chemotherapy."
The second study revealed that cancer cells accelerate aging of nearby connective tissue, resulting in inflammation, which provides "fuel" for the tumor to grow or metastasize. This discovery may lead to future treatments involving anti-inflammatory and antioxidant products.
We'll continue to add developments in breast cancer research to our database and website, and highlight new discoveries here. Please stay tuned.
The research world continues to fight breast cancer. Here are today's top breast cancer research developments.
Mepilex Lite dressings for skin reactions to radiation
For women undergoing radiation therapy for breast cancer, a recent randomised trial found that Mepilex Lite dressings significantly reduced the severity of radiation-induced skin reactions when compared to standard aqueous creams. The dressings reduced pain and discomfort and permitted women to wear normal clothing, thereby increasing quality of life.
Three breast conserving surgery (lumpectomy) studies
This weekend, we added three studies on breast conserving surgery to our database. All three were from the International Journal of Radiation Oncology, Biology, Physics and may be found on the breast conserving surgery (lumpectomy) page of our website.
The first, from The Netherlands, found that for patients under 40 with early-stage breast cancer, 10-year overall survival rates were "not impaired" after breast conserving surgery as compared to after mastectomy. In addition, patients with 1 to 3 positive nodes had a better prognosis after breast conserving surgery than after mastectomy.
Researchers from the Harvard Radiation Oncology Program found that women with basal and HER2 molecular subtypes of breast cancer had higher true recurrence rates than others after breast conserving surgery. They concluded that for basal cancers, strategies such as increased boost doses, concomitant radiation and chemotherapy, and/or targeted agents should be explored.
Finally, French researchers concluded that women who had previously received radiation therapy for Hodgkin's Lymphoma, were still candidates for breast conserving surgery plus radiation, with accommodations to protect heart and lung tissue.
More on cancer cell behavior from the biology labs
Medical News Today covered two discoveries in from the breast cancer biology labs.
The first revealed that in healthy cells, the p53 tumor suppressor can resist signals from defective growth factors and prevent improper cell division for 8 continuous hours. After 8 hours of signals from a growth factor, p53 releases "its grip on the cell's DNA, allowing it to divide." Cancerous cells lack or have defective p53. This understanding of differences between healthy and cancerous cells may lead to "new effective approaches to chemotherapy."
The second study revealed that cancer cells accelerate aging of nearby connective tissue, resulting in inflammation, which provides "fuel" for the tumor to grow or metastasize. This discovery may lead to future treatments involving anti-inflammatory and antioxidant products.
We'll continue to add developments in breast cancer research to our database and website, and highlight new discoveries here. Please stay tuned.
Friday, May 27, 2011
The Breast Cancer News Update: May 27
It's the Friday breast cancer research wrap-up. Today, we'll highlight some of the links to research publications we added to the LATESTBreastCancer.com database this week.
Breast cancer prevention: prophylactic mastectomies are safe and effective
A Swedish study published in the Annals of Surgery found that bilateral prophylactic mastectomies for asymptomatic women at high-risk of breast cancer were safe and "efficacious in reducing future breast cancer." However, "unanticipated reoperations are common."
Breast cancer prognosis: very small tumors may be highly aggressive
According to a Dana-Farber Cancer Institute study published in the Journal of Clinical Oncology, very small tumors with four or more positive lymph nodes conferred a worse prognosis than larger tumors with the same number of positive lymph nodes. Dr. Rinna Punglia told Reuters Health that women with very small tumors and significant lymph node involvement "should be treated very aggressively."
Neoadjuvant chemotherapy: Taxotere dose schedule affects quality of life
A study published in BMC Cancer found patients who received twelve cycles of weekly Taxotere (docetaxel) before surgery had a better quality of life than those who received four cycles of "three weekly" docetaxel. All patients also received Adriamycin/Cytoxan. Therapeutic response, breast conserving surgery rates and survival outcomes were similar for both groups.
Metastatic treatment: studies on Ixempra and Herceptin response
A study published in Cancer found a positive risk/benefit ratio of adding Ixempra (ixabepilone) to Xeloda (capecitabine) for advanced/metastatic patients who were refractory to anthracyclines and taxanes, despite added toxicities. Quality-adjusted survival was higher for those who took the Ixempra/Xeloda combination than for those who took Xeloda alone.
Also in Cancer this week, an Italian study found that high estrogen receptor expression predicted a reduced probability of tumor response to Herceptin (trastuzumab) plus chemotherapy. For hormone receptor positive patients, the addition of hormone therapy to Herceptin upon the completion of chemotherapy was associated with significant progression-free survival.
On Monday, we'll highlight the weekend breast cancer news. Please stay tuned.
Breast cancer prevention: prophylactic mastectomies are safe and effective
A Swedish study published in the Annals of Surgery found that bilateral prophylactic mastectomies for asymptomatic women at high-risk of breast cancer were safe and "efficacious in reducing future breast cancer." However, "unanticipated reoperations are common."
Breast cancer prognosis: very small tumors may be highly aggressive
According to a Dana-Farber Cancer Institute study published in the Journal of Clinical Oncology, very small tumors with four or more positive lymph nodes conferred a worse prognosis than larger tumors with the same number of positive lymph nodes. Dr. Rinna Punglia told Reuters Health that women with very small tumors and significant lymph node involvement "should be treated very aggressively."
Neoadjuvant chemotherapy: Taxotere dose schedule affects quality of life
A study published in BMC Cancer found patients who received twelve cycles of weekly Taxotere (docetaxel) before surgery had a better quality of life than those who received four cycles of "three weekly" docetaxel. All patients also received Adriamycin/Cytoxan. Therapeutic response, breast conserving surgery rates and survival outcomes were similar for both groups.
Metastatic treatment: studies on Ixempra and Herceptin response
A study published in Cancer found a positive risk/benefit ratio of adding Ixempra (ixabepilone) to Xeloda (capecitabine) for advanced/metastatic patients who were refractory to anthracyclines and taxanes, despite added toxicities. Quality-adjusted survival was higher for those who took the Ixempra/Xeloda combination than for those who took Xeloda alone.
Also in Cancer this week, an Italian study found that high estrogen receptor expression predicted a reduced probability of tumor response to Herceptin (trastuzumab) plus chemotherapy. For hormone receptor positive patients, the addition of hormone therapy to Herceptin upon the completion of chemotherapy was associated with significant progression-free survival.
On Monday, we'll highlight the weekend breast cancer news. Please stay tuned.
Thursday, May 26, 2011
HER2 Part 4: How doctors determine if you're HER2 positive
Note: This is the blog of LATESTBreastCancer.com, where you can get personalized information about the latest in breast cancer treatment.
Remember what's happening in the cancer cells of patients with an overabundance of HER2: 1) there's amplification of the part of chromosome 17 containing the HER2 gene which creates more copies of the HER2 gene (DNA), 2) as a result there is an increase in the amount of HER2 mRNA produced, 3) the HER2 mRNAs make more HER2 proteins, 4) these HER2 proteins go to the cell membranes and there they have to pair up with each other with other HER family members to send a grow signal into the cell.
The two standard tests look at two different points in this process: the amount of HER2 protein on the cell surface or the amount of HER2 gene due to amplification.
These two tests are known by acronyms.
IHC (immunohistochemisty, and usually a commercial test called HercepTest) looks at the amount of HER2 protein.
FISH (fluorescence in situ hybridization, and usually either the PathVysion test or the HER2 FISH pharmDx test) looks at the amount of HER2 DNA (genes).
Normally IHC (HercepTest) is used as the primary test. A biopsy sample is sent to a pathology lab. Slices of the sample are stained with special antibody-based reagents that bind to HER2 molecules on cells. The stained slice is put under a microscope. A histopathologist looks at the level of staining and assigns a value based on the amount of staining seen from 0 to 3+. Zero and 1+ are considered HER2 negative. A value of 3+ is considered HER2 positive. A value of 2+ (weakly staining) is considered "equivocal," or in other words, unclear. (See image, the HER2 protein on the cells stains orange-brown).
In situations where the IHC result is equivocal, they then look at a different cell characteristic -- DNA amplification -- using FISH. Again they use a biopsy sample. In FISH, DNA is stained with fluorescently-labeled DNA (Note: there is a newer technique called CISH -- commercial test name SPoT-Light -- which uses something called chromogenic staining instead of fluorescent staining, but these are essentially equivalent).
Anyway, with FISH, HER2 genes stain red. A region of chromosome 17 that is never amplified is stained green. Using a microscope, the ratio of red to green fluorescence is determined. The higher the ratio, the higher the degree of HER2 gene amplification. Information about the amount of HER2 gene amplification is used to resolve an equivocal 2+ IHC test result.
The concerns about the accuracy of HER2 testing (and thus the appropriate use of Herceptin and other HER2 targeted drugs) have to do standardization, accuracy and reproducibility of these tests. Both are subjective and only semi-quantitative. It isn't always easy to grade IHC stained cells to begin with and, on top of that, artifacts due to lab technique can sometimes impact staining.
In 2007 the major medical associations in this field stated in their published guidelines that standardization of IHC and FISH was major problem. A study in a reputable journal in 2002 estimated that 20% of HER2 testing might be inaccurate. Other studies generally found that variations between different laboratories caused a 10-20% disagreement in results between IHC and FISH. And a study in 2006 found that agreement in test results between local and centralized laboratories for IHC was just 75-82%, and for FISH was 88%. (References supplied upon request.)
The issue of HER2 testing accuracy remains. This is a topic we'll be digging into deeper in future blogs.
Next: Newer tests for determining HER2 status.
HER2 Part 3: Drugs that Target HER2
Note: This is the blog of LATESTBreastCancer.com, where you can get personalized information about the latest in breast cancer treatment.
For patients with HER2 over-expressing breast cancer, it is critical to target the HER protein. Here we'll look at an array of HER2 targeted drugs: current, new and future. If you're a patient with metastatic disease whose disease is progressing following Herceptin treatment, accessing one of these newer drugs through a clinical trial might be a reasonable option.
Herceptin (trastuzumab). "The big standard." The first drug to target HER2. Approved in 1998. Currently used for patients with all stages of HER2+ breast cancer. Picture how it works: Herceptin is a very large monoclonal antibody protein. It attaches to HER2 on the portion of the molecule that sits outside the cell. By binding to it, Herceptin effectively "flags" the cancer cell for destruction by the body's own immune system. Herceptin also seems to inhibit HER2 growth signaling more conventionally. But attracting an immune system attack is the primary way the drug works (also called, by pharma nerds, "mechanism of action" or MOA).
Tykerb (lapatinib). "The little newcomer." The second HER2 drug. Unlike Herceptin, Tykerb is a very small molecule that inhibits not only HER2 but also EGFR (HER1). Also unlike Herceptin, Tykerb attaches to EGFR and HER2 inside the cell. HER2 and EGFR still pair up with other members of the HER family, but because of Tykerb binding, the grow signal is never sent to other molecules in the "relay chain." Tykerb is used in patients with metastatic disease if they progress after using Herceptin. The other key point about Tykerb is that because it is a very small molecule, it can travel from the bloodstream into the brain, and it seems to reduce brain metastases in HER2 positive patients.
T-DM1. "Targeted AND chemotherapy." A modified version of Herceptin (trastuzumab). In this case "T" (trastuzumab) is attached to another molecule called "DM1" which is a traditional chemotherapeutic. How about this for tricky: the trastuzumab portion of the drug attaches to HER2 outside the cell. When it does, it causes HER2 to get pulled inside the cell, where there (and only there) the chemotherapy portion of the drug is released and kills the cell. So the chemotherapy only kills HER2-laden cancer cells and isn't released where it could do damage to other cells. T-DM1 appears to be doing well in clinical trials and is generating excitement.
OmniTarg (pertuzumab). "Separate, you two!" Remember that to send the grow signal inside the cell, HER family molecules on the cell membrane have to pair up. Well, Genentech has created a drug that inhibits this pairing ("dimerization"). Pertuzumab is a large monoclonal antibody like Herceptin. Like Herceptin, it binds to HER2 outside the cell. But it binds to a different part of the molecule than Herceptin, effectively inhibiting HER2 from pairing up with EGFR (HER1), HER3 and probably HER2 as well. No pairing, no growth signal. Lone HER2s just float around the cell membrane doing nothing. Cancer cell growth and proliferation slows or halts (in theory).
afatinib and neratinib "Same but (maybe) better." These two drugs are in clinical trials. They both work much like Tykerb, but they might end up being more potent and thus more effective. Like Tykerb, both are small molecules, both are taken orally as tablets, and both attach to HER2 inside the cell to inhibit growth signaling. But unlike Tykerb, they are so-called "irreversible" inhibitors of HER2. They bind and then stay attached to HER2. Tykerb is a "reversible" inhibitor that binds but sometimes detaches.
To find clinical trials for these drugs, you can go to clinicaltrials.gov. Or, better yet, try out a newer, easier-to-use site called BCTrials.org. This site provides personalized info about available clinical trials. It's sponsored by UC San Francisco.
Next: How doctors determine if you're HER2 positive
The Breast Cancer News Update: May 26
Today's breast cancer news addressed the cost of breast cancer treatment.
Those with high co-pays more likely to discontinue aromatase inhibitor therapy
Last night, Reuters reported on a Journal of Clinical Oncology study which found that women with high insurance co-pays were more likely to discontinue taking aromatase inhibitors such as Arimidex (anastrazole). Dr. Alfred Neugut, from Columbia University Medical Center, noted that less than 50 percent of women complete the recommended 5 years of treatment. Those who don't complete the 5 years "lose most or all of the survival benefit from the therapy."
"The Costly War on Cancer"
Today, The Economist examined the high cost of new, targeted therapies for breast cancer treatments such as Avastin (bevacizumab) and Herceptin (trastuzumab). The story considered factors such as the shift towards personalized medicine, where new drugs treat fewer patients, patent protections, government programs and private insurance. The author noted that one "important benefit" of America's "propensity to pay," was that it encouraged "reinvestment in research."
The Avastin debate continues
With the FDA hearing on Avasin (bevacizumab) for metastatic patients approaching, the public debate continues. Yesterday, the New York Times published an op-ed, titled "Drugs and Profits" detailing why Avastin should not be approved. Today, a reply ran in OpenMarket.org. There are strong opinions on both sides of the fence.
At LATESTBreastCancer.com, we'll continue to keep you updated on the Avastin FDA appeal. In the meantime, you'll find all the news and research for every test and treatment option on our website.
Those with high co-pays more likely to discontinue aromatase inhibitor therapy
Last night, Reuters reported on a Journal of Clinical Oncology study which found that women with high insurance co-pays were more likely to discontinue taking aromatase inhibitors such as Arimidex (anastrazole). Dr. Alfred Neugut, from Columbia University Medical Center, noted that less than 50 percent of women complete the recommended 5 years of treatment. Those who don't complete the 5 years "lose most or all of the survival benefit from the therapy."
"The Costly War on Cancer"
Today, The Economist examined the high cost of new, targeted therapies for breast cancer treatments such as Avastin (bevacizumab) and Herceptin (trastuzumab). The story considered factors such as the shift towards personalized medicine, where new drugs treat fewer patients, patent protections, government programs and private insurance. The author noted that one "important benefit" of America's "propensity to pay," was that it encouraged "reinvestment in research."
The Avastin debate continues
With the FDA hearing on Avasin (bevacizumab) for metastatic patients approaching, the public debate continues. Yesterday, the New York Times published an op-ed, titled "Drugs and Profits" detailing why Avastin should not be approved. Today, a reply ran in OpenMarket.org. There are strong opinions on both sides of the fence.
At LATESTBreastCancer.com, we'll continue to keep you updated on the Avastin FDA appeal. In the meantime, you'll find all the news and research for every test and treatment option on our website.
Wednesday, May 25, 2011
The Breast Cancer News Update: May 25
Today's breast cancer news is all about surgery.
"Modest" delay before surgery is not associated with tumor growth
A new study suggests that a "modest" delay before breast cancer surgery is not associated with tumor size progression in clinically node-negative patients. The authors concluded that patients may "undergo preoperative work-up without significant disease progression." According to a quote from one of the MD Anderson researchers in Reuters, although "rapid treatment is desirable," taking "a few weeks to coordinate care is safe. It is unlikely there will be tumor progression."
Lipofilling during breast reconstruction appears to be safe
Today, MSN and HemOnc Today both covered a study which found that lipofilling, or transferring fat tissue from the abdomen to the breast during breast reconstruction, appears to be safe. Previous studies found that fatty tissue may spur cancer cells to multiply. The current study found no significant difference in five-year recurrence rates between women who had lipofilling and those who did not. Researchers cautioned that it was still too early in the follow-up to draw definitive conclusions. Further research is needed.
At LATESTBreastCancer.com, we'll continue share developments in breast cancer research. Please browse our Treatment pages for the latest news and research on all test and treatment options.
"Modest" delay before surgery is not associated with tumor growth
A new study suggests that a "modest" delay before breast cancer surgery is not associated with tumor size progression in clinically node-negative patients. The authors concluded that patients may "undergo preoperative work-up without significant disease progression." According to a quote from one of the MD Anderson researchers in Reuters, although "rapid treatment is desirable," taking "a few weeks to coordinate care is safe. It is unlikely there will be tumor progression."
Lipofilling during breast reconstruction appears to be safe
Today, MSN and HemOnc Today both covered a study which found that lipofilling, or transferring fat tissue from the abdomen to the breast during breast reconstruction, appears to be safe. Previous studies found that fatty tissue may spur cancer cells to multiply. The current study found no significant difference in five-year recurrence rates between women who had lipofilling and those who did not. Researchers cautioned that it was still too early in the follow-up to draw definitive conclusions. Further research is needed.
At LATESTBreastCancer.com, we'll continue share developments in breast cancer research. Please browse our Treatment pages for the latest news and research on all test and treatment options.
Tuesday, May 24, 2011
The Breast Cancer News Update: May 24
Today's breast cancer news is all about personalized medicine. The stories address patient access to medical records, a test to identify the best treatment options for DCIS patients and targeted, individual therapies in development.
Most patients prefer full access to their medical records
For personalized medicine to work, patients need access to their medical records to be able to make informed decisions. There has been some concern that providing such access will lead to increased patient anxiety.
According to a French study, most cancer patients who were given full access to their medical records said they were better able to understand and discuss their disease, without an increase in anxiety. About 70 percent of them said if given the choice, they would want full access again. However, a few did complain that the medical records were "too heavy to carry around." The authors caution that the patients in the study had early-stage cancer with a good prognosis. The conclusions about anxiety levels may not apply to others.
OncotypeDX reveals which DCIS patients will benefit from radiation
Personalized medicine relies upon testing to determine the individual characteristics of a cancer and the risks and benefits of various treatment options.
Today, Genomic Health announced positive preliminary results of a study of its OncotypeDX test for predicting risk of local recurrence for DCIS patients. The preliminary results suggest that the test may be used to identify DCIS patients who may be treated with surgery alone and those who would benefit from radiation after surgery. Complete data will be presented at the 2011 San Antonio Breast Cancer Symposium in December. The OncotypeDX DCIS Score is expected to be available to patients and physicians by the end of the year.
The "next wave of cancer therapy" is to match treatments to patients
The American Society of Clinical Oncology (ASCO) released summaries of more than 4,000 clinical trials which will be presented at its annual meeting next month. According to a Reuters story, the "next wave of cancer therapy is focused on better ways of matching medicines to patients. . ." Dr. George Sledge, the president of the ASCO, said there is a shift towards "treating cancers based on their molecular and genetic characteristics."
At LATESTBreastCancer.com, we understand that personalized medicine is the wave of the future. Our site is designed to provide access to the very latest news and research on all breast cancer test and treatment options, so patients are able to make informed decisions. Subscribers may tailor their research to their individual pathology reports and diagnoses.
We'll continue to follow breast cancer research developments and keep you posted.
Most patients prefer full access to their medical records
For personalized medicine to work, patients need access to their medical records to be able to make informed decisions. There has been some concern that providing such access will lead to increased patient anxiety.
According to a French study, most cancer patients who were given full access to their medical records said they were better able to understand and discuss their disease, without an increase in anxiety. About 70 percent of them said if given the choice, they would want full access again. However, a few did complain that the medical records were "too heavy to carry around." The authors caution that the patients in the study had early-stage cancer with a good prognosis. The conclusions about anxiety levels may not apply to others.
OncotypeDX reveals which DCIS patients will benefit from radiation
Personalized medicine relies upon testing to determine the individual characteristics of a cancer and the risks and benefits of various treatment options.
Today, Genomic Health announced positive preliminary results of a study of its OncotypeDX test for predicting risk of local recurrence for DCIS patients. The preliminary results suggest that the test may be used to identify DCIS patients who may be treated with surgery alone and those who would benefit from radiation after surgery. Complete data will be presented at the 2011 San Antonio Breast Cancer Symposium in December. The OncotypeDX DCIS Score is expected to be available to patients and physicians by the end of the year.
The "next wave of cancer therapy" is to match treatments to patients
The American Society of Clinical Oncology (ASCO) released summaries of more than 4,000 clinical trials which will be presented at its annual meeting next month. According to a Reuters story, the "next wave of cancer therapy is focused on better ways of matching medicines to patients. . ." Dr. George Sledge, the president of the ASCO, said there is a shift towards "treating cancers based on their molecular and genetic characteristics."
At LATESTBreastCancer.com, we understand that personalized medicine is the wave of the future. Our site is designed to provide access to the very latest news and research on all breast cancer test and treatment options, so patients are able to make informed decisions. Subscribers may tailor their research to their individual pathology reports and diagnoses.
We'll continue to follow breast cancer research developments and keep you posted.
Monday, May 23, 2011
HER2 Part 2: What Goes Wrong in Breast Cancer?
If you have "HER2-positive" breast cancer, then there's a huge overabundance of HER2 molecules on surface your breast tumor cells.
To paint a clearer picture, there are normally about 10,000-20,000 HER2 molecules on a breast cell. On a HER2 positive breast cancer cell, there are 1-2 million... so a 100-fold increase.
Having this many extra HER2 cells on the cell surface ready and waiting to pair up with other HER molecules upon their binding with EGF very simply sends a much louder "grow" signal inside the cell and into the nucleus. The cell grows faster and divide more often. They have one of the key characteristics of cancer cells: rapid, uncontrolled growth.
Why are there so many HER2 molecules on the cell surface? We have to look into the nucleus at the world of DNA. DNA is a long filamentous molecule. It's packaged as chromosomes (23 pairs, one from mom and one from dad, so 46 total). And it contains messages called genes that provide the code for making specific proteins. On chromosome 17 sits one of the 20,000 human genes that code human life. It is the gene that makes the HER2 protein.
In an earlier blog we talked about the fact that everything that goes awry in cancer cells, including uncontrolled growth, blood vessel formation, cell mobility, etc.... everything is due to gene mutations and problems with DNA repair.
Well, one of the general kinds of mutations that occur when a cell is having problems keeping its DNA pristine is called gene amplification. In gene amplification, one section of a very long DNA molecule starts creating extra copies of itself. The extra copies remain attached to the main strand. Visualize this as a long rope where in one section, there is a big bulge of extra rope strands. Rampant gene amplification is a common characteristic in cancer cells.
In HER2 positive cancer cells, a specific gene amplification occurs at the part of chromosome 17 where the HER2 gene sits. This results in many extra copies of the HER2 gene that in turn produce an overabundance of HER2 proteins that lodge themselves in the cell membrane, poised to send too much grow signal inside the cell.
So the answer to the question in today's title is: "Gene amplification on chromosome 17 that results in up to a 100-fold overabundance of HER2 growth factor receptor."
Next: Drugs that Target HER2
To paint a clearer picture, there are normally about 10,000-20,000 HER2 molecules on a breast cell. On a HER2 positive breast cancer cell, there are 1-2 million... so a 100-fold increase.
Having this many extra HER2 cells on the cell surface ready and waiting to pair up with other HER molecules upon their binding with EGF very simply sends a much louder "grow" signal inside the cell and into the nucleus. The cell grows faster and divide more often. They have one of the key characteristics of cancer cells: rapid, uncontrolled growth.
Why are there so many HER2 molecules on the cell surface? We have to look into the nucleus at the world of DNA. DNA is a long filamentous molecule. It's packaged as chromosomes (23 pairs, one from mom and one from dad, so 46 total). And it contains messages called genes that provide the code for making specific proteins. On chromosome 17 sits one of the 20,000 human genes that code human life. It is the gene that makes the HER2 protein.
In an earlier blog we talked about the fact that everything that goes awry in cancer cells, including uncontrolled growth, blood vessel formation, cell mobility, etc.... everything is due to gene mutations and problems with DNA repair.
Well, one of the general kinds of mutations that occur when a cell is having problems keeping its DNA pristine is called gene amplification. In gene amplification, one section of a very long DNA molecule starts creating extra copies of itself. The extra copies remain attached to the main strand. Visualize this as a long rope where in one section, there is a big bulge of extra rope strands. Rampant gene amplification is a common characteristic in cancer cells.
In HER2 positive cancer cells, a specific gene amplification occurs at the part of chromosome 17 where the HER2 gene sits. This results in many extra copies of the HER2 gene that in turn produce an overabundance of HER2 proteins that lodge themselves in the cell membrane, poised to send too much grow signal inside the cell.
So the answer to the question in today's title is: "Gene amplification on chromosome 17 that results in up to a 100-fold overabundance of HER2 growth factor receptor."
Next: Drugs that Target HER2
HER2 Part 1: Know the Molecule
For about a fourth of breast cancers, a molecule called HER2 plays a key role in both the cause of the disease and its treatment. For the next few days, we'll cover what HER2 is, its involvement in breast cancer, how it's targeted by drugs, and how HER2-positive patients are identified.
The methods for identifying HER2-positive patients are under scrutiny. One often-cited study states that up to 20% of HER2 test results could be inaccurate. If these inaccuracies result in inappropriate use or non-use of Herceptin (trastuzumab) and other powerful HER2-targeted drugs, then the impact on patient survival and unwanted side effects could be significant. So we'll also look at some new tests that might be able to help better identify HER2-positive patients, including TargetPrint (Agendia), HERmark (Monogram Biosciences/LabCorp), and DNAarray HER2 Pro (CombiMatrix Diagnostics).
First, HER2... Let's step back to biology for a minute. You need to know just a couple things before we discuss treatments and tests.
We know that cancer is a disease in which cells grow out of control because molecules involved in normal growth control "go haywire." Normal growth control in healthy breast cells looks like this: small signalling molecules called growth factors attach to antenna-like molecules called growth factor receptors on the outside of breast cells. These antenna molecules span the cell membrane. When a signal molecule attaches to the part outside the cell, the molecule transmits the signal to the part that sits inside the cell. There, it passes the signal on to a series of signal transducer molecules that work like a relay team, carrying the signal deeper inside the cell and eventually into the nucleus, the home of the cell's genes. When the signal arrives inside the nucleus, it "tells" still more molecules to turn on genes that produce proteins involved in cell growth. With these proteins active, the cell grows and divides.
For breast cells, Epidermal Growth Factor, or EGF, is a key growth factor. EGF targets a family of four similar growth factor receptors (antennae) called HER1, HER2, HER3 and HER4. In the often confusing world of molecule naming, proteins often have more than one name. HER1 is more often called EGFR (Epidermal Growth Factor Receptor). HER, by the way, stands for Human Epidermal growth factor Receptor. And HER2 is also called HER2/neu as well as ErbB2. Sorry. Not much we can do about that...
Finally, let's paint a clearer picture of how HER2 and its family members work. In a word, they work in pairs. When EGF attached to a HER family member, it doesn't cause the growth signal to be transmitted into the cell instantly. Instead, EGF binding cause HER receptors of all four types to want to link up with one another. It could be two HER2s. Or it could be other pairings like a HER2 with a HER3 (see diagram). When pairing occurs, it changes the shape of both of the paired HER molecules, and this causes each HER molecule to activate it's companion inside the cell. It's these activated, paired HERs that transmit signal to the relay team of signal transducer molecules.
Next: What goes wrong with HER2 in breast cancer?
The Breast Cancer News Update: May 23
All of today's breast cancer news involves early research. Although these discoveries are not yet available in clinical practice, it's interesting to see what's coming down the pike.
Link between obesity gene and breast cancer risk
Chicago researchers discovered a connection between obesity and breast cancer risk. In the study, people who possessed a variant in the fat mass and obesity associated gene (FTO) had a 30% greater risk of developing breast cancer. Everyone carries the FTO gene, but only 18% have the variant. Testing is not currently available.
Biomarker predicts Taxane-induced neuropathy
Researchers in Indiana identified a biomarker which predicts who is at risk for neuropathy, or nerve pain, numbness or tingling, from taxane chemotherapy, such as Taxol (paclitaxel). Again, a test is not currently available and further research is planned.
Protein is involved in development of tamoxifen resistance
UK researchers identified a protein which is involved in the development of tamoxifen resistance. In animal and cell studies, blocking the production of the protein made tamoxifen resistant cancer cells more responsive to tamoxifen. Scientists are now looking for drugs to block the effects of the protein.
At LATESTBreastCancer.com, we'll continue to follow these and other early breast cancer research developments. When something becomes clinically relevant, or an option for a patient today, even if off-label or in clinical trial, we add it to our database. All clinically relevant test and treatment options can be found on our website.
Link between obesity gene and breast cancer risk
Chicago researchers discovered a connection between obesity and breast cancer risk. In the study, people who possessed a variant in the fat mass and obesity associated gene (FTO) had a 30% greater risk of developing breast cancer. Everyone carries the FTO gene, but only 18% have the variant. Testing is not currently available.
Biomarker predicts Taxane-induced neuropathy
Researchers in Indiana identified a biomarker which predicts who is at risk for neuropathy, or nerve pain, numbness or tingling, from taxane chemotherapy, such as Taxol (paclitaxel). Again, a test is not currently available and further research is planned.
Protein is involved in development of tamoxifen resistance
UK researchers identified a protein which is involved in the development of tamoxifen resistance. In animal and cell studies, blocking the production of the protein made tamoxifen resistant cancer cells more responsive to tamoxifen. Scientists are now looking for drugs to block the effects of the protein.
At LATESTBreastCancer.com, we'll continue to follow these and other early breast cancer research developments. When something becomes clinically relevant, or an option for a patient today, even if off-label or in clinical trial, we add it to our database. All clinically relevant test and treatment options can be found on our website.
Friday, May 20, 2011
The Breast Cancer News Update: May 20
It's the Friday breast cancer news weekly research wrap-up. Today we'll highlight some of the links to medical journal abstracts we added to the LATESTBreastCancer.com database this week.
Hormone therapy research: Fareston and Arimidex
A review from China, published in Breast Cancer Research and Treatment, concluded that toremifene (Fareston) is "an effective and safe alternative to tamoxifen" for adjuvant endocrine therapy. The authors analyzed four randomized trials with over 3,700 patients.
There were two Journal of Clinical Oncology studies involving aromatase inhibitors this week. The first found that patients respond differently to anastrozole (Arimidex) therapy depending upon body mass index (BMI). The second found that aromatase inhibitor use before surgery can reduce mastectomy rates. Both stories attracted media attention. Links to the research abstracts and news stories can be found on the anastrozole (Arimidex) page of our website.
Chemotherapy research: Taxol
An MD Anderson study published in Breast Cancer Research and Treatment found that the addition of paclitaxel (Taxol) to the doxorubicin (Adriamycin)/cyclophosphamide (Cytoxen) chemotherapy combination (AC) had no impact on locoregional control (LRC) in patients with node-positive breast cancer. Researchers concluded that the historically inferior LRC without paclitaxel may have been due to "an inadequate duration of systemic therapy and not due to the absence of paclitaxel."
Complementary Therapies: Vitamin D
A study published in Breast Cancer Research found that blood plasma levels of 25-hydroxyvitamin D "were not significantly associated with breast cancer risk" in a premenopausal population. Last month, the media reported that plasma levels of Vitamin D were associated with more aggressive tumors. This week's study and last month's news can be found on the Vitamin D page of our website.
Check back on Monday for a summary of the weekend breast cancer news. In the meantime, I'll send any important updates out on Twitter (@ann_latestbc).
Hormone therapy research: Fareston and Arimidex
A review from China, published in Breast Cancer Research and Treatment, concluded that toremifene (Fareston) is "an effective and safe alternative to tamoxifen" for adjuvant endocrine therapy. The authors analyzed four randomized trials with over 3,700 patients.
There were two Journal of Clinical Oncology studies involving aromatase inhibitors this week. The first found that patients respond differently to anastrozole (Arimidex) therapy depending upon body mass index (BMI). The second found that aromatase inhibitor use before surgery can reduce mastectomy rates. Both stories attracted media attention. Links to the research abstracts and news stories can be found on the anastrozole (Arimidex) page of our website.
Chemotherapy research: Taxol
An MD Anderson study published in Breast Cancer Research and Treatment found that the addition of paclitaxel (Taxol) to the doxorubicin (Adriamycin)/cyclophosphamide (Cytoxen) chemotherapy combination (AC) had no impact on locoregional control (LRC) in patients with node-positive breast cancer. Researchers concluded that the historically inferior LRC without paclitaxel may have been due to "an inadequate duration of systemic therapy and not due to the absence of paclitaxel."
Complementary Therapies: Vitamin D
A study published in Breast Cancer Research found that blood plasma levels of 25-hydroxyvitamin D "were not significantly associated with breast cancer risk" in a premenopausal population. Last month, the media reported that plasma levels of Vitamin D were associated with more aggressive tumors. This week's study and last month's news can be found on the Vitamin D page of our website.
Check back on Monday for a summary of the weekend breast cancer news. In the meantime, I'll send any important updates out on Twitter (@ann_latestbc).
Thursday, May 19, 2011
The Breast Cancer News Update: May 19
The beauty of the LATESTBreastCancer.com website is that subscribers are able to filter information to see only the treatment options, news and research relevant to them. Our news blog is different. Here, we summarize the day's news all in one place. Not everything is relevant to everyone. So, we're going to start adding headings to help our readers scan for the information that interests them most.
Yoga benefits those receiving radiation
For patients undergoing radiation therapy, a new study from MD Anderson confirmed the benefits of yoga. According to a story in Medical News Today, patients who were exposed to yoga rather than simple stretching experienced better physical functioning, better general health, lower stress hormone levels and were "better able to find meaning in their cancer experience."
Some HER2 positive patients may be able to avoid chemotherapy
According to a study from Baylor College of Medicine, some patients with HER2 positive breast cancer may be able to avoid neoadjuvant chemotherapy if treated with a combination of Tykerb (lapatinib) and Herceptin (trastuzumab). Women in the study were given the Tykerb/Herceptin combination once a week. After 12 weeks, 38% of the estrogen-receptor (ER) negative tumors and 21% of the ER positive tumors were completely eradicated. Another 34% of the ER positive tumors were reduced to "only small amounts of tumor left after treatment." A future study will compare 12 to 24 weeks of treatment to determine the optimal duration.
News for metastatic patients: Nexavar and Circulating Tumor Cell testing
For metastatic patients and locally advanced breast cancer patients who have been previously treated with Avastin, results from a mid-stage trial show that Nexavar (sorafenib) delayed tumor progression longer than chemotherapy alone.
Also for metastatic patients, a Georgetown study found that circulating tumor cell (CTC) counts were a "powerful predictor" of patient response to treatment. Favorable CTC blood test results may reduce the number of more expensive and more invasive imaging procedures. Last week a French study found CTC levels to have strong prognostic value. Today, the French study can be found under the news tab of our circulating tumor cell analysis page. Tomorrow, after our website is synchronized tonight, both studies will be there.
Smoking increases breast cancer risk; Alcohol not associated with risk
US News & World Report and Internal Medicine News covered a new study which found that smoking increases breast cancer risk for women already at high-risk for breast cancer. The more years one smoked, the greater the risk. In the same study, alcohol use was not associated with a higher risk.
We hope that the new headings have enhanced our daily update. We welcome any and all feedback.
Yoga benefits those receiving radiation
For patients undergoing radiation therapy, a new study from MD Anderson confirmed the benefits of yoga. According to a story in Medical News Today, patients who were exposed to yoga rather than simple stretching experienced better physical functioning, better general health, lower stress hormone levels and were "better able to find meaning in their cancer experience."
Some HER2 positive patients may be able to avoid chemotherapy
According to a study from Baylor College of Medicine, some patients with HER2 positive breast cancer may be able to avoid neoadjuvant chemotherapy if treated with a combination of Tykerb (lapatinib) and Herceptin (trastuzumab). Women in the study were given the Tykerb/Herceptin combination once a week. After 12 weeks, 38% of the estrogen-receptor (ER) negative tumors and 21% of the ER positive tumors were completely eradicated. Another 34% of the ER positive tumors were reduced to "only small amounts of tumor left after treatment." A future study will compare 12 to 24 weeks of treatment to determine the optimal duration.
News for metastatic patients: Nexavar and Circulating Tumor Cell testing
For metastatic patients and locally advanced breast cancer patients who have been previously treated with Avastin, results from a mid-stage trial show that Nexavar (sorafenib) delayed tumor progression longer than chemotherapy alone.
Also for metastatic patients, a Georgetown study found that circulating tumor cell (CTC) counts were a "powerful predictor" of patient response to treatment. Favorable CTC blood test results may reduce the number of more expensive and more invasive imaging procedures. Last week a French study found CTC levels to have strong prognostic value. Today, the French study can be found under the news tab of our circulating tumor cell analysis page. Tomorrow, after our website is synchronized tonight, both studies will be there.
Smoking increases breast cancer risk; Alcohol not associated with risk
US News & World Report and Internal Medicine News covered a new study which found that smoking increases breast cancer risk for women already at high-risk for breast cancer. The more years one smoked, the greater the risk. In the same study, alcohol use was not associated with a higher risk.
We hope that the new headings have enhanced our daily update. We welcome any and all feedback.
Wednesday, May 18, 2011
The Breast Cancer News Update: May 18
Here are today's top news stories.
First, there's breast cancer research news about a potential new biomarker to evaluate whether a patient will benefit from tamoxifen. According to a study in the Journal of Clinical Oncology this week, women whose tumors expressed active Stat5 were more likely to benefit from tamoxifen. Larger trials are planned to confirm the findings.
In insurance news, the Oregon Senate approved a bill to expand insurance coverage for breast reconstruction after breast cancer surgery. Although insurers are currently required to cover reconstruction after mastectomy, a loophole permitted them to deny coverage for breast conserving surgeries or lumpectomies. The bill heads next to the governor's desk.
Finally, we just added an Exercise Guide for Breast Cancer Survivors to the site. Thanks to our Twitter friends for sharing resources!
As always, at LATESTBreastCancer.com, we welcome all comments, feedback and news tips!
First, there's breast cancer research news about a potential new biomarker to evaluate whether a patient will benefit from tamoxifen. According to a study in the Journal of Clinical Oncology this week, women whose tumors expressed active Stat5 were more likely to benefit from tamoxifen. Larger trials are planned to confirm the findings.
In insurance news, the Oregon Senate approved a bill to expand insurance coverage for breast reconstruction after breast cancer surgery. Although insurers are currently required to cover reconstruction after mastectomy, a loophole permitted them to deny coverage for breast conserving surgeries or lumpectomies. The bill heads next to the governor's desk.
Finally, we just added an Exercise Guide for Breast Cancer Survivors to the site. Thanks to our Twitter friends for sharing resources!
As always, at LATESTBreastCancer.com, we welcome all comments, feedback and news tips!
Tuesday, May 17, 2011
The Breast Cancer News Update: May 17
Today's breast cancer news addressed risk, a potential new device for detecting margins during breast cancer surgery and the Avastin FDA appeal.
First, the National Cancer Institute updated its Breast Cancer Risk Assessment Tool for Asian and Pacific Islander American women. The risk factors remain the same, but the weighting and calculations have been adjusted. Tests of the new model revealed that the previous model overestimated risk for Chinese and Filipino women, and most other Asian and Pacific Islander groups. Hawaiian women, however, have higher breast cancer rates than Caucasian women.
Researchers in Virginia have discovered a new biomarker for determining risk of recurrence. Unlike OncotypeDX and MammaPrint, which evaluate tumor cells, the new five-gene signature evaluates immune system cells at the tumor site. Future studies will be conducted to validate the findings.
In surgery news, the Boston Business Jounral reports that the FDA has granted an expedited review of the MarginProbe System, which detects cancerous cells at the margins during breast cancer surgery.
Finally, Genentech recently released an advance summary of the evidence and arguments it will present at the FDA Avastin hearing. For more on the history of the FDA dispute, visit the news section of our Avastin page.
Check back tomorrow for more news updates from LATESTBreastCancer.com.
First, the National Cancer Institute updated its Breast Cancer Risk Assessment Tool for Asian and Pacific Islander American women. The risk factors remain the same, but the weighting and calculations have been adjusted. Tests of the new model revealed that the previous model overestimated risk for Chinese and Filipino women, and most other Asian and Pacific Islander groups. Hawaiian women, however, have higher breast cancer rates than Caucasian women.
Researchers in Virginia have discovered a new biomarker for determining risk of recurrence. Unlike OncotypeDX and MammaPrint, which evaluate tumor cells, the new five-gene signature evaluates immune system cells at the tumor site. Future studies will be conducted to validate the findings.
In surgery news, the Boston Business Jounral reports that the FDA has granted an expedited review of the MarginProbe System, which detects cancerous cells at the margins during breast cancer surgery.
Finally, Genentech recently released an advance summary of the evidence and arguments it will present at the FDA Avastin hearing. For more on the history of the FDA dispute, visit the news section of our Avastin page.
Check back tomorrow for more news updates from LATESTBreastCancer.com.
Sunday, May 15, 2011
The Breast Cancer News Update: May 16
I discovered a great new source for breast cancer news this weekend - TheDoctorsChannel.com. When an important study makes news, the site publishes the story and a short video with a real person. Easy to understand slides explain the highlights. The stories are meant for doctors and cover every health topic. I'll keep my eye out for breast cancer news. I'll add links on the appropriate pages on our site, and highlight new developments here.
Today, we added two great videos to the LATESTBreastCancer.com website.
The first was about how a patient's weight affects the benefits of anastrozole (brand name Arimidex). The second was a nice summary of the factors affecting the decision to have genetic testing for breast cancer risk.
In other news, we all know family medical history is part of clinical evaluation. According to US News and World Report, only about 61% of patient reports about family history of breast cancer were accurate. Only 27% of reports of family history of colorectal cancer and 32% of family history of prostate cancer were accurate. Researchers concluded that developing "systemic ways to enhance family history ascertainment should be a research priority."
In imaging news, a recent study found that lowering radiation doses during molecular breast imaging did not have a substantial impact on image quality. Although the test was early, results suggest that it may be possible to lower radiation exposure by 60%.
In treatment news, Breastcancer.org published an analysis of a recent study which compared recurrence rates for DCIS patients treated with surgery alone to those treated with surgery plus radiation.
Finally, from the biology labs, researchers report that cancer cells act like "cheaters on a diet." When deprived of sugar and oxygen, instead of dying, they turn to fatty acids for energy. This discovery could lead to future new treatments.
Don't worry about keeping track of all this news. All of these stories will appear on the relevant treatment pages of the LATESTBreastCancer.com website. Our goal is to make the latest news and reseach available in a clear, organized way. Stay tuned!
Today, we added two great videos to the LATESTBreastCancer.com website.
The first was about how a patient's weight affects the benefits of anastrozole (brand name Arimidex). The second was a nice summary of the factors affecting the decision to have genetic testing for breast cancer risk.
In other news, we all know family medical history is part of clinical evaluation. According to US News and World Report, only about 61% of patient reports about family history of breast cancer were accurate. Only 27% of reports of family history of colorectal cancer and 32% of family history of prostate cancer were accurate. Researchers concluded that developing "systemic ways to enhance family history ascertainment should be a research priority."
In imaging news, a recent study found that lowering radiation doses during molecular breast imaging did not have a substantial impact on image quality. Although the test was early, results suggest that it may be possible to lower radiation exposure by 60%.
In treatment news, Breastcancer.org published an analysis of a recent study which compared recurrence rates for DCIS patients treated with surgery alone to those treated with surgery plus radiation.
Finally, from the biology labs, researchers report that cancer cells act like "cheaters on a diet." When deprived of sugar and oxygen, instead of dying, they turn to fatty acids for energy. This discovery could lead to future new treatments.
Don't worry about keeping track of all this news. All of these stories will appear on the relevant treatment pages of the LATESTBreastCancer.com website. Our goal is to make the latest news and reseach available in a clear, organized way. Stay tuned!
Friday, May 13, 2011
The Breast Cancer News Daily: May 13
It's Friday. Today, we'll highlight some of the medical journal research we added to the LATESTBreastCancer.com database this week. Topics include prevention, radiation, metastatic treatment and music therapy.
For those concerned with breast cancer prevention, a study in the Journal of Clinical Oncology weighed the risks and benefits of tamoxifen and raloxifene (brand name Evista) for women over 50. The American researchers created an index to "complement clinical evaluation" of whether to start chemoprevention and the risks and benefits of tamoxifen and raloxifene.
There's been some concern about axillary failure (recurrence) after MammoSite accelerated partial breast irradiation, which does not treat the axillary region. A study published in the Annals of Surgical Oncology concluded that the rate of axillary failure after "MammoSite APBI is low and appears to be similar to that achieved with whole-breast irradiation."
For HER2 positive metastatic patients, a study in the Annals of Oncology found that prior exposure to trastuzumab-DMI "does not exhaust the potential benefit of ongoing anti-HER2 therapy with trastuzumab and/or lapatinib-based regimens."
Finally, a study in Breast Cancer Research and Treatment examined the effects of music therapy on post-matectomy pain. The Chinese researchers found "some evidence" that music therapy had both short and long-term positive effects on alleviating pain.
On Sunday, we'll highlight the weekend breast cancer news. Please stay tuned.
For those concerned with breast cancer prevention, a study in the Journal of Clinical Oncology weighed the risks and benefits of tamoxifen and raloxifene (brand name Evista) for women over 50. The American researchers created an index to "complement clinical evaluation" of whether to start chemoprevention and the risks and benefits of tamoxifen and raloxifene.
There's been some concern about axillary failure (recurrence) after MammoSite accelerated partial breast irradiation, which does not treat the axillary region. A study published in the Annals of Surgical Oncology concluded that the rate of axillary failure after "MammoSite APBI is low and appears to be similar to that achieved with whole-breast irradiation."
For HER2 positive metastatic patients, a study in the Annals of Oncology found that prior exposure to trastuzumab-DMI "does not exhaust the potential benefit of ongoing anti-HER2 therapy with trastuzumab and/or lapatinib-based regimens."
Finally, a study in Breast Cancer Research and Treatment examined the effects of music therapy on post-matectomy pain. The Chinese researchers found "some evidence" that music therapy had both short and long-term positive effects on alleviating pain.
On Sunday, we'll highlight the weekend breast cancer news. Please stay tuned.
Thursday, May 12, 2011
The Breast Cancer News Daily: May 12
Today's breast cancer news covered breast cancer screening, genetic testing and aesthetics after breast cancer treatment.
First, Scientific American featured a story addressing current screening methods, (mammography, MRI and ultrasound), and products of the future, such as elastography, screening blood tests, a light energy scan and a breath test in development.
In Europe, a study funded by Cancer Research UK, found that a genetic blood test could reduce the number of screening mammograms without reducing the number of cancers detected. In theory, a simple blood test taken before a woman turns 35 would reveal her risk of breast cancer and when she should start screening mammography. For some, that would be at 35, for others, not until their 50s, 60s or later. The study was based upon a theoretical model, and more research is needed. Maybe this will someday put the "when to start screening" debate to rest!
On the subject of genetic testing, PhsyOrg.com reported that UK researchers are working on a genetic test to identify breast cancer patients at risk for bone metastasis.
In the only story not relating to testing, oncologists and surgeons are meeting in Portugal to discuss standards for evaluating aesthetic results of breast cancer surgery and radiation. According to a quote from the story in Medical News Today, "Medical professionals are now more concerned with the importance of the aesthetic results for patients who have undergone breast cancer treatment and conserving the breast in an 'aesthetically pleasing' way is seen as being essential to ensure a good quality of life."
Tomorrow, we'll highlight developments from the research world with our weekly look at the medical journals. As always, at LATESTBreastCancer.com, we welcome all comments and feedback.
First, Scientific American featured a story addressing current screening methods, (mammography, MRI and ultrasound), and products of the future, such as elastography, screening blood tests, a light energy scan and a breath test in development.
In Europe, a study funded by Cancer Research UK, found that a genetic blood test could reduce the number of screening mammograms without reducing the number of cancers detected. In theory, a simple blood test taken before a woman turns 35 would reveal her risk of breast cancer and when she should start screening mammography. For some, that would be at 35, for others, not until their 50s, 60s or later. The study was based upon a theoretical model, and more research is needed. Maybe this will someday put the "when to start screening" debate to rest!
On the subject of genetic testing, PhsyOrg.com reported that UK researchers are working on a genetic test to identify breast cancer patients at risk for bone metastasis.
In the only story not relating to testing, oncologists and surgeons are meeting in Portugal to discuss standards for evaluating aesthetic results of breast cancer surgery and radiation. According to a quote from the story in Medical News Today, "Medical professionals are now more concerned with the importance of the aesthetic results for patients who have undergone breast cancer treatment and conserving the breast in an 'aesthetically pleasing' way is seen as being essential to ensure a good quality of life."
Tomorrow, we'll highlight developments from the research world with our weekly look at the medical journals. As always, at LATESTBreastCancer.com, we welcome all comments and feedback.
The biology of cancer treatment (part 3 of 3)
And finally, but very importantly, DNA repair...
DNA Repair
All four of the cell functions are broken in cancer cells because DNA mutations either inactivate or hyperactivate proteins that are central to those processes. The fifth and last process that gets broken in cancer cells is DNA repair itself.
Normal healthy cells regularly repair DNA damage (mutations) that occurs frequently in the cell. But when a mutation actually damages a gene required for repairing other mutations, then the total number of "unfixed" mutations in a cell can skyrocket. And so does the chance that a mutation will occur in a gene that produces a protein critical in one of the key four cell functions.
An analogy might be crime increasing when policemen themselves "go bad."
Relating all this to treatments
This mini biology lesson is highly relevant to treatment options -- current options as well as new ones in clinical development. Here is a quick, partial list of some common breast cancer treatment options and how they relate to the five cell processes we've discussed.
Herceptin (Cell growth control): HER2 is a cell surface receptor that sends a "grow" signal into the cell. In some breast cancers, there is an overabundance of HER2 molecules on the cell surface. This increases the signal. Herceptin binds to HER2, inhibiting it from sending the "grow" command and thus slowing tumor cell growth.
Tamoxifen and aromatase inhibitors (Cell growth control): Many breast cancers are fueled by estrogen, which binds to the estrogen receptor inside the cell to send a "grow" command (cells get multiple different grow commands, not just one). Tamoxifen works very differently than aromatase inhibitors (Arimidex, Femara and Aromasin) but the effect is the same: to damp down the estrogen-related grow signal.
Oncotype DX (Cell growth control, cell suicide, cell mobility). Measure the expression of 16 genes that are"turned on" at different levels in in in less aggressive vs. more aggressive tumors. Not surprisingly, the genes the test looks at relate to cell growth control (6 relate specifically to estrogen and HER2 signaling), mobility (also called "invasion", 2 genes), and proliferation (5 genes). Proliferation likely involves a combination of uncontrolled growth and the absence of normal cell suicide.
Avastin (Blood vessel formation). Avastin attaches to and inhibits a key protein involved in blood vessel formation called vascular endothelial growth factor (VEGF). Avastin are a treatment for breast cancer is controversial right now, but enormous research effort ihas and is being expended to target blood vessel formation using Avastin and other drugs.
BRCA testing (DNA repair): BRCA1 and 2 have multiple functions, but they are above all key players in repairing DNA damage. Inheriting one "broken" copy (one of the two you have on both of your parental chromosomes) of a gene that repairs DNA damage puts your cells at a disadvantage with regard to repairing cancer causing mutations. Thus the chance of getting cancer is increased.
We've just touched on these treatment options here, but in the coming weeks we'll be looking at these and other treatment options in more detail. Understanding a bit about the biology explains how newer treatment options work and why they are so exciting.
DNA Repair
All four of the cell functions are broken in cancer cells because DNA mutations either inactivate or hyperactivate proteins that are central to those processes. The fifth and last process that gets broken in cancer cells is DNA repair itself.
Normal healthy cells regularly repair DNA damage (mutations) that occurs frequently in the cell. But when a mutation actually damages a gene required for repairing other mutations, then the total number of "unfixed" mutations in a cell can skyrocket. And so does the chance that a mutation will occur in a gene that produces a protein critical in one of the key four cell functions.
An analogy might be crime increasing when policemen themselves "go bad."
Relating all this to treatments
This mini biology lesson is highly relevant to treatment options -- current options as well as new ones in clinical development. Here is a quick, partial list of some common breast cancer treatment options and how they relate to the five cell processes we've discussed.
Herceptin (Cell growth control): HER2 is a cell surface receptor that sends a "grow" signal into the cell. In some breast cancers, there is an overabundance of HER2 molecules on the cell surface. This increases the signal. Herceptin binds to HER2, inhibiting it from sending the "grow" command and thus slowing tumor cell growth.
Tamoxifen and aromatase inhibitors (Cell growth control): Many breast cancers are fueled by estrogen, which binds to the estrogen receptor inside the cell to send a "grow" command (cells get multiple different grow commands, not just one). Tamoxifen works very differently than aromatase inhibitors (Arimidex, Femara and Aromasin) but the effect is the same: to damp down the estrogen-related grow signal.
Oncotype DX (Cell growth control, cell suicide, cell mobility). Measure the expression of 16 genes that are"turned on" at different levels in in in less aggressive vs. more aggressive tumors. Not surprisingly, the genes the test looks at relate to cell growth control (6 relate specifically to estrogen and HER2 signaling), mobility (also called "invasion", 2 genes), and proliferation (5 genes). Proliferation likely involves a combination of uncontrolled growth and the absence of normal cell suicide.
Avastin (Blood vessel formation). Avastin attaches to and inhibits a key protein involved in blood vessel formation called vascular endothelial growth factor (VEGF). Avastin are a treatment for breast cancer is controversial right now, but enormous research effort ihas and is being expended to target blood vessel formation using Avastin and other drugs.
BRCA testing (DNA repair): BRCA1 and 2 have multiple functions, but they are above all key players in repairing DNA damage. Inheriting one "broken" copy (one of the two you have on both of your parental chromosomes) of a gene that repairs DNA damage puts your cells at a disadvantage with regard to repairing cancer causing mutations. Thus the chance of getting cancer is increased.
We've just touched on these treatment options here, but in the coming weeks we'll be looking at these and other treatment options in more detail. Understanding a bit about the biology explains how newer treatment options work and why they are so exciting.
Wednesday, May 11, 2011
The Breast Cancer News Daily: May 11
Lately, breast cancer news has been making headlines. Several media sources pick up interesting stories and create attention-grabbing headlines to attract readers and Tweeters. News articles cover stories from different perspectives. At LATESTBreastCancer.com, we read it all. We strive to share the most scientific coverage of a story and include perspectives from reputable sources so that our readers can come to their own conclusions.
For example, yesterday, several sources reported on the benefits of parsley with titles such as "Parsley, Celery May Fight Breast Cancer." We tried to be objective in our blog coverage with a link to the press release which provided the details of the study. (Many of the news stories were based on this same press release.)
Today, coffee made headlines such as "Study: Five Cups of Coffee a Day Could Prevent Breast Cancer." In the study, Swedish researchers found an association between "high daily intake of coffee" and a "statistically significant decrease" in estrogen receptor negative breast cancer among postmenopausal women. BBC News, US News & World Report and WebMD covered the study from different perspectives.
Late yesterday, there was media coverage of positive results from a study of a genetic test to predict response to chemotherapy. We've been following this test for years. You can read yesterday's press release, Bloomberg News and US News &World Report coverage on the Response to taxanes (Nuvera) page of our website, as well as a story from 2008.
At LATESTBreastCancer.com, you will find links to breast cancer news in two places. On this blog page, we highlight daily breast cancer news developments on all topics. On the treatment pages of our website, you will find links to all news about a treatment option under the news tab. (For example, see our Arimidex (anastrazole) page.)
For subscribers, news items on treatment pages are filtered so that only the ones most relevant to them show. Of course, subscribers can see all the news anytime on this blog, or by clicking the "show all options" box on a treatment page. On our site, just about every option, including drugs, tests, imaging, radiation, surgeries and complementary therapies has news tab with links to years of relevant news.
Our goal is to keep you posted.
For example, yesterday, several sources reported on the benefits of parsley with titles such as "Parsley, Celery May Fight Breast Cancer." We tried to be objective in our blog coverage with a link to the press release which provided the details of the study. (Many of the news stories were based on this same press release.)
Today, coffee made headlines such as "Study: Five Cups of Coffee a Day Could Prevent Breast Cancer." In the study, Swedish researchers found an association between "high daily intake of coffee" and a "statistically significant decrease" in estrogen receptor negative breast cancer among postmenopausal women. BBC News, US News & World Report and WebMD covered the study from different perspectives.
Late yesterday, there was media coverage of positive results from a study of a genetic test to predict response to chemotherapy. We've been following this test for years. You can read yesterday's press release, Bloomberg News and US News &World Report coverage on the Response to taxanes (Nuvera) page of our website, as well as a story from 2008.
At LATESTBreastCancer.com, you will find links to breast cancer news in two places. On this blog page, we highlight daily breast cancer news developments on all topics. On the treatment pages of our website, you will find links to all news about a treatment option under the news tab. (For example, see our Arimidex (anastrazole) page.)
For subscribers, news items on treatment pages are filtered so that only the ones most relevant to them show. Of course, subscribers can see all the news anytime on this blog, or by clicking the "show all options" box on a treatment page. On our site, just about every option, including drugs, tests, imaging, radiation, surgeries and complementary therapies has news tab with links to years of relevant news.
Our goal is to keep you posted.
The biology of cancer treatment (Part 2 of 3)
Continuing from yesterday, remember that we defined four cell functions, plus DNA repair, that "break" as tumor cells progress toward dangerous metastatic behavior.
1) Cell growth control
2) Programmed cell suicide
3) Blood vessel formation
4) Cell mobility
We'll pick up today where we left off: with programmed cell suicide.
Programmed cell suicide
Cells are "smart." They sense when their internal (molecular) processes have gone awry. And when they sense that they have become abnormal, for whatever reason, they initiate a process that results in their own orderly death. When it's working properly, programmed cell suicide ("apoptosis"... pronounced ay'-pop-toh-sis) kills cells that are becoming cancerous.
But when mutations occur in genes critical for programmed cell death, then the cell becomes more dangerous. It isn't able to kill itself when it senses it is growing too fast or cell processes are "out of whack." It's likely that when both cell growth control (step 1) and programmed cell suicide (step 2) are broken, a small tumor can form.
Blood vessel formation
A cell with broken growth signaling and broken programmed cell suicide can form a small tumor, but it can't get very large and it can't move to other parts of the breast or body. The reason is that the tumor needs blood to grow larger. Normal cells can't create blood vessels/capillaries to both feed themselves and provide a means of transport.
That brings up the next cell process that goes awry in cancer cells: blood vessel formation ("angiogenesis"... pronounced an-gee-oh-gen'-a-sis). Cancer cells receive DNA mutations that actually turn on cell processes that result in the attraction or formation of blood vessels. Once this third type of mutation occurs, the tumor can grow larger. But it's still likely that the cells stay confined to the main tumor.
Cell mobility
Normal healthy cells stay where they are in the body. They are immobile. Cancer cells gain the ability to physically move in the body tissues, including into blood vessels that transport them to other locations in the body. The fourth cell function that goes haywire in cancer cells is cell mobility.
Cell mobility can be caused by genes breaking or by genes becoming abnormally activated. But with this final cell process broken, we now have a cancer cell that: 1) is growing and dividing rapidly, 2) can't kill itself, 3) has attracted blood vessels (nutrient supply lines) and grow into a larger tumor, and 4) that can move around the body. This is a dangerous cell.
Tomorrow: How DNA repair fits in, and relating all this to breast cancer treatment
Tuesday, May 10, 2011
The Breast Cancer News Daily: May 10
Today's breast cancer news is short and sweet.
Celery and parsley drew a lot of media attention today. Several sources covered a study which found that apigenin, which is found in celery and parsley, and to a lesser extent in apples, oranges and nuts, hindered the development of tumor blood vessels in animal studies. Researchers noted that while apigenin delayed tumor growth, it did not stop the initial development of breast cancer cells. Also, ideal amounts for humans are still unknown.
Aromatase inhibitors, anastrazole (Arimidex), letrozole (Femara) and exemestane (Aromasin), were also in the news. According to a study from Washington University in St. Louis, aromatase inhibitor therapy before breast cancer surgery reduces mastectomy rates. Of 159 women who were told they needed mastectomies, 81 were able to instead have breast-conserving surgery after 16 weeks on aromatase inhibitors. Of 4 women who were originally not candidates for surgery at all, after aromatase inhibitor treatment, three were able to have breast-conserving surgery, and one underwent a mastectomy.
Please check back tomorrow for more breast cancer news. Until then, you can follow me on Twitter (@ann_latestbc) for more updates throughout the day.
Celery and parsley drew a lot of media attention today. Several sources covered a study which found that apigenin, which is found in celery and parsley, and to a lesser extent in apples, oranges and nuts, hindered the development of tumor blood vessels in animal studies. Researchers noted that while apigenin delayed tumor growth, it did not stop the initial development of breast cancer cells. Also, ideal amounts for humans are still unknown.
Aromatase inhibitors, anastrazole (Arimidex), letrozole (Femara) and exemestane (Aromasin), were also in the news. According to a study from Washington University in St. Louis, aromatase inhibitor therapy before breast cancer surgery reduces mastectomy rates. Of 159 women who were told they needed mastectomies, 81 were able to instead have breast-conserving surgery after 16 weeks on aromatase inhibitors. Of 4 women who were originally not candidates for surgery at all, after aromatase inhibitor treatment, three were able to have breast-conserving surgery, and one underwent a mastectomy.
Please check back tomorrow for more breast cancer news. Until then, you can follow me on Twitter (@ann_latestbc) for more updates throughout the day.
The biology of cancer treatment (Part 1 of 3)
One of our main goals at LATESTBreastCancer is to help patients understand the biology of cancer so that they can better understand current and potential treatments (for example, new kinds of gene-based tests, drugs in clinical trials, etc.). This week kicks that off.
To begin, we need a basic and common understanding of what cancer is and a language to describe it. With that framework (note 1), we'll be able to mentally place later blog entries about specific treatments into a larger perspective. In general, I don't want to focus on basic biology as a topic unto itself. Rather, I want to explain biology only to the extent it's needed to understand treatment.
We'll start by telling the whole story of cancer in one paragraph and then go into individual chapters over the next couple days.
The Whole Story (quick version)
Cancer is caused when mutations in the DNA (genes) inside breast cells cause proteins--proteins that normally perform important cell functions--to work improperly.
Problems with these proteins can be grouped into four categories based on the functions of the cell that they "break." All four of the following cell functions go awry as tumor cells progress toward dangerous metastatic behavior.
1) Cell growth control (this breaks)
2) Programmed cell suicide (this breaks)
3) Blood vessel formation (becomes abnormally active)
4) Cell mobility (becomes abnormally active)
There is one additional underlying cell function that breaks and makes the tumor cell more susceptible to the other four problems. It's DNA repair. When the cell's ability to repair DNA damage is itself damaged, then mutations that cause problems with the other four processes are more likely to occur.
Let's look at each of these four (really 5, including DNA repair) cell functions that break. At the end, we'll look at specific breast cancer treatments like Herceptin, Avastin and OncotypeDX and see how they fit into this story.
Cell growth control
The first cell function that breaks is the cell's ability to control its growth (note 2). Normal cells grow (proliferate) and divide only when signaling molecules from outside the cell attach to receptors on the cell's surface and send a growth signal through a series of proteins into the cell nucleus. In the nucleus, specific genes required for cell growth and division are turned on.
Cancer cells have broken signaling genes that send the "grow" signal into the cell's nucleus even though no signal was received from outside the cell. Think of this as "the foot being on the gas pedal all the time." Broken cell signaling is the first step (or at least a very early step) in a normal cell becoming a cancer cell.
Tomorrow: Steps 2, 3 and 4.
Note 1: To give credit where it's due, the framework I'll use is a slightly simplified version of one proposed by Hanahan and Weinberg (2000) that's commonly used in the field.
Note 2: Scientists don't know to what extent cell functions have to break in the order that I'll present. But many assume that they break roughly in this order.
Monday, May 9, 2011
The Breast Cancer News Daily: May 9
At LATESTBreastCancer.com, our breast cancer news updates come from many sources. We follow several reputable newspapers, health publications, medical journals and websites daily. In addition, our readers send us links to news items of interest. Reader input makes this blog better. It helps us to focus on what interests you most. It allows readers to share news with others in the community. It is something we encourage and welcome.
Today's breast cancer news features two stories. The first, about breast cancer risk and prevention, we found on our own. The second, about a potential new treatment for mouth sores, was sent to us by a reader.
Today, The Telegraph (UK) reported that the World Cancer Research Fund estimated that 42% of new UK breast cancer cases, about 20,000 a year, could be prevented with healthy lifestyle choices. Recommended prevention measures included drinking less alcohol, exercising more, maintaining a healthy weight and eating less sugar and red meat. The story included a cautionary comment that these measures will not prevent breast cancer in everyone because "genetic and environmental factors can also play a part."
This morning, a reader shared a cnet News story about a new treatment, the WARP 75, being studied by NASA to treat chemotherapy or radiation-related mouth sores known as oral mucositis. The WARP 75 uses light energy to soothe pain and discomfort. The treatment is undergoing the FDA pre-market approval process.
We'll continue to provide daily updates in breast cancer news. If you have a story to share, you may comment on this post or send me an email at abegun@latestmedical.com. You may also follow me on twitter (@ann_latestbc) for breast cancer news updates throughout the day.
Today's breast cancer news features two stories. The first, about breast cancer risk and prevention, we found on our own. The second, about a potential new treatment for mouth sores, was sent to us by a reader.
Today, The Telegraph (UK) reported that the World Cancer Research Fund estimated that 42% of new UK breast cancer cases, about 20,000 a year, could be prevented with healthy lifestyle choices. Recommended prevention measures included drinking less alcohol, exercising more, maintaining a healthy weight and eating less sugar and red meat. The story included a cautionary comment that these measures will not prevent breast cancer in everyone because "genetic and environmental factors can also play a part."
This morning, a reader shared a cnet News story about a new treatment, the WARP 75, being studied by NASA to treat chemotherapy or radiation-related mouth sores known as oral mucositis. The WARP 75 uses light energy to soothe pain and discomfort. The treatment is undergoing the FDA pre-market approval process.
We'll continue to provide daily updates in breast cancer news. If you have a story to share, you may comment on this post or send me an email at abegun@latestmedical.com. You may also follow me on twitter (@ann_latestbc) for breast cancer news updates throughout the day.
Sunday, May 8, 2011
Breast Cancer News Weekend Update: May 7 and 8
As usual, breast cancer news was a little light this weekend.
Cure Today covered the one research development, a German study which found that goserelin (brand name Zoladex) does not prevent ovarian failure from breast cancer chemotherapy.
Although the scientific breast research news was a little light this weekend, there were a couple of less scientific stories relevant to the breast cancer community.
First, The Los Angeles Times reported that the National Association of Insurance Commissioners is working on draft disclosure labels for health insurance policies. When complete, the labels will disclose the expected patient out-of-pocket costs for standard maternity, diabetes and breast cancer treatment, based on average national prices. In a California study, patient cost for breast cancer treatment was $4,000 under one plan and $38,000 under another with similar deductible and out-of-pocket maximum. The goal of the new labels is to help consumers make informed choices about health insurance.
An Arizona ABC News affiliate published a interview with a breast cancer specialist about how to talk to children about cancer.
Finally, on Mother's Day, The Boston Herald ran a story of a mother who dealt with breast cancer while pregnant.
This week, LATESTBreastCancer.com will continue to update breast cancer news daily. Please stay tuned.
Cure Today covered the one research development, a German study which found that goserelin (brand name Zoladex) does not prevent ovarian failure from breast cancer chemotherapy.
Although the scientific breast research news was a little light this weekend, there were a couple of less scientific stories relevant to the breast cancer community.
First, The Los Angeles Times reported that the National Association of Insurance Commissioners is working on draft disclosure labels for health insurance policies. When complete, the labels will disclose the expected patient out-of-pocket costs for standard maternity, diabetes and breast cancer treatment, based on average national prices. In a California study, patient cost for breast cancer treatment was $4,000 under one plan and $38,000 under another with similar deductible and out-of-pocket maximum. The goal of the new labels is to help consumers make informed choices about health insurance.
An Arizona ABC News affiliate published a interview with a breast cancer specialist about how to talk to children about cancer.
Finally, on Mother's Day, The Boston Herald ran a story of a mother who dealt with breast cancer while pregnant.
This week, LATESTBreastCancer.com will continue to update breast cancer news daily. Please stay tuned.
Thursday, May 5, 2011
The Breast Cancer News Daily Update: May 6
It's Friday. Today we'll cover the morning breast cancer news and highlight the noteworthy abstracts from medical research publications we added to our database this week.
First the news.
This morning, The Telegraph (UK) reported that tamoxifen only reduces risk of breast cancer in about half of the women who take it for breast cancer prevention.
The screening mammography discussion continued today with a Reuters story about the impact of the US Preventative Services Task force recommendation against mammograms for women in their 40s on minority women. According to the report, "minority women are more likely to develop breast cancer in their forties than white women."
In prognostic testing, Irish and American researchers compared the OncotypeDX test to the PAM50 test. According to the story in Medical News Today, the tests predicted similar risk for those with high and low risk. For those with intermediate risk, the PAM50 identified more patients who would not benefit from chemotherapy.
Also in prognostic testing, French researchers reported that baseline circulating tumor cell (CTC) counts are prognostic at baseline for metastatic patients, and that CTC changes during treatment, "may be an early indicator of chemotherapy efficiency."
This week, we added a few interesting abstracts from breast cancer research medical publications to our database.
Researchers in Chicago reviewed hospital and emergency room admission records to see which 5-HT(3) RA class drugs for chemotherapy-related nausea and vomiting were most effective. They concluded that breast cancer patients on cyclophosphamide-based chemotherapy had "a significantly lower risk" of hospital-related nausea and vomiting if they started and continued taking palonosetron (brand name Aloxi).
The Annals of Plastic Surgery published a study that found "nearly 1 in 5" healthy breasts removed during a contralateral prophylactic mastectomy contained a malignant or pre-malignant lesion. Risk factors for finding a malignancy in a healthy breast included "a lobular histology in the original specimen" and patient age over 54.
In the UK, a study in The British Journal of Cancer found clinical benefit in continuing trastuzumab (brand name Herceptin) beyond disease progression in patients with locally advanced or metastatic HER2 positive disease.
Please check back Sunday evening for a recap of the weekend breast cancer news. As always, at LATESTBreastCancer.com we welcome any and all feedback. We want to know what interests you most.
First the news.
This morning, The Telegraph (UK) reported that tamoxifen only reduces risk of breast cancer in about half of the women who take it for breast cancer prevention.
The screening mammography discussion continued today with a Reuters story about the impact of the US Preventative Services Task force recommendation against mammograms for women in their 40s on minority women. According to the report, "minority women are more likely to develop breast cancer in their forties than white women."
In prognostic testing, Irish and American researchers compared the OncotypeDX test to the PAM50 test. According to the story in Medical News Today, the tests predicted similar risk for those with high and low risk. For those with intermediate risk, the PAM50 identified more patients who would not benefit from chemotherapy.
Also in prognostic testing, French researchers reported that baseline circulating tumor cell (CTC) counts are prognostic at baseline for metastatic patients, and that CTC changes during treatment, "may be an early indicator of chemotherapy efficiency."
This week, we added a few interesting abstracts from breast cancer research medical publications to our database.
Researchers in Chicago reviewed hospital and emergency room admission records to see which 5-HT(3) RA class drugs for chemotherapy-related nausea and vomiting were most effective. They concluded that breast cancer patients on cyclophosphamide-based chemotherapy had "a significantly lower risk" of hospital-related nausea and vomiting if they started and continued taking palonosetron (brand name Aloxi).
The Annals of Plastic Surgery published a study that found "nearly 1 in 5" healthy breasts removed during a contralateral prophylactic mastectomy contained a malignant or pre-malignant lesion. Risk factors for finding a malignancy in a healthy breast included "a lobular histology in the original specimen" and patient age over 54.
In the UK, a study in The British Journal of Cancer found clinical benefit in continuing trastuzumab (brand name Herceptin) beyond disease progression in patients with locally advanced or metastatic HER2 positive disease.
Please check back Sunday evening for a recap of the weekend breast cancer news. As always, at LATESTBreastCancer.com we welcome any and all feedback. We want to know what interests you most.
The Breast Cancer News Daily Update: May 5
Today's breast cancer news addressed the long term cognitive effects of breast cancer treatment and long term benefits of meditation and yoga.
First, The New York Times covered a study which found that the foggy thinking known as "chemo brain" may last five or more years after treatment. Although the patients in the study were treated for blood cancers, the researchers said their findings were "likely to apply to breast cancer patients" and others undergoing chemotherapy.
Cure Today shared results from a study which showed that meditation and yoga had a positive impact on quality of life and stress levels years after cancer diagnosis. More about meditation, yoga and other complementary therapies, such as aromatherapy, art therapy and hypnosis, can be found on the LATESTBreastCancer Mind-Body Connection menu.
Celecoxib, brand name Celebrex, was in the news today as a potential new breast cancer treatment. Dutch researchers recently reported their findings that the anti-inflammatory induced a molecular anti-tumor response in patients scheduled for breast cancer surgery. This was a short, preliminary study. For now researchers "can only speculate" that longer treatment would result in "measurable tumor shrinkage as well."
From the biology labs, researchers in Spain published a paper describing how BRCA1 gene mutations influence progesterone receptors and progesterone gene expression. The connection may explain how BRCA1 mutations lead to the development of breast cancer. According to the story published in Medical News Today, understanding how BRCA1 genes act may lead to improvements in breast cancer treatment and prevention.
Also in biology, Canadian researchers discovered a protein that inhibits the spread of cancer cells. The discovery could lead to therapies for preventing or limiting breast cancer metastasis.
Please check back tomorrow for more breast cancer news and for highlights from this week's research publications. At LATESTBreastCancer.com, our goal is to keep you posted.
First, The New York Times covered a study which found that the foggy thinking known as "chemo brain" may last five or more years after treatment. Although the patients in the study were treated for blood cancers, the researchers said their findings were "likely to apply to breast cancer patients" and others undergoing chemotherapy.
Cure Today shared results from a study which showed that meditation and yoga had a positive impact on quality of life and stress levels years after cancer diagnosis. More about meditation, yoga and other complementary therapies, such as aromatherapy, art therapy and hypnosis, can be found on the LATESTBreastCancer Mind-Body Connection menu.
Celecoxib, brand name Celebrex, was in the news today as a potential new breast cancer treatment. Dutch researchers recently reported their findings that the anti-inflammatory induced a molecular anti-tumor response in patients scheduled for breast cancer surgery. This was a short, preliminary study. For now researchers "can only speculate" that longer treatment would result in "measurable tumor shrinkage as well."
From the biology labs, researchers in Spain published a paper describing how BRCA1 gene mutations influence progesterone receptors and progesterone gene expression. The connection may explain how BRCA1 mutations lead to the development of breast cancer. According to the story published in Medical News Today, understanding how BRCA1 genes act may lead to improvements in breast cancer treatment and prevention.
Also in biology, Canadian researchers discovered a protein that inhibits the spread of cancer cells. The discovery could lead to therapies for preventing or limiting breast cancer metastasis.
Please check back tomorrow for more breast cancer news and for highlights from this week's research publications. At LATESTBreastCancer.com, our goal is to keep you posted.
Wednesday, May 4, 2011
The Breast Cancer News Daily Update: May 4
Today's news had to do with everything but breast cancer treatment. Topics included screening, risk and a test for recurrence.
First, there was a bit of breast cancer screening news. CBC News and Medical News Today covered a Canadian study about the need for new screening methods to detect an aggressive breast cancer that develops between mammograms. US News and World Report revealed the results of a mammogram poll. Apparently, women in their 40s want and continue to have mammograms despite the controversial 2009 US Preventative Services Task Force recommendation that screenings start at age 50 for most women. Two-thirds of the women polled were unaware of the USPSTF recommendations. The story noted that the American Cancer Society continues to recommend annual mammograms for women in their 40s.
On the topic of breast cancer risk and prevention, researchers at the Penn State Hershey Medical Center found that the use of breast shields during CT scans decreases radiation to breast tissue by 38%. Interestingly, they noted that the delivery of 1 rad to a 35 year old woman increases her lifetime breast cancer risk by 13.6%. A single CT scan delivers at least twice that dose.
For breast cancer survivors, an ABC News affiliate published a story and video about a potential new test for recurrence after breast cancer treatment. In a recent study, the VeraMarker-BCR Breast Cancer test detected recurrence 13 months earlier than standard techniques in 55% of women with recurrence. An October 2010 news article with more details can be found on the VeraMarker-BCR page of our website. Researchers hope the test will be commercially available late this year. We'll post any new developments on our website.
At LATESTBreastCancer.com, we'll continue to publish daily breast cancer news highlights. Please stay tuned!
First, there was a bit of breast cancer screening news. CBC News and Medical News Today covered a Canadian study about the need for new screening methods to detect an aggressive breast cancer that develops between mammograms. US News and World Report revealed the results of a mammogram poll. Apparently, women in their 40s want and continue to have mammograms despite the controversial 2009 US Preventative Services Task Force recommendation that screenings start at age 50 for most women. Two-thirds of the women polled were unaware of the USPSTF recommendations. The story noted that the American Cancer Society continues to recommend annual mammograms for women in their 40s.
On the topic of breast cancer risk and prevention, researchers at the Penn State Hershey Medical Center found that the use of breast shields during CT scans decreases radiation to breast tissue by 38%. Interestingly, they noted that the delivery of 1 rad to a 35 year old woman increases her lifetime breast cancer risk by 13.6%. A single CT scan delivers at least twice that dose.
For breast cancer survivors, an ABC News affiliate published a story and video about a potential new test for recurrence after breast cancer treatment. In a recent study, the VeraMarker-BCR Breast Cancer test detected recurrence 13 months earlier than standard techniques in 55% of women with recurrence. An October 2010 news article with more details can be found on the VeraMarker-BCR page of our website. Researchers hope the test will be commercially available late this year. We'll post any new developments on our website.
At LATESTBreastCancer.com, we'll continue to publish daily breast cancer news highlights. Please stay tuned!
Tuesday, May 3, 2011
The Breast Cancer Daily Update: May 3
Today, there were three news items of note and some announcements from the research world.
First, the news.
There's been a lot of confusion about the safety of hormone replacement therapy lately. Today, the Los Angeles Times published an interview with an expert in the field. He talks about breast cancer risk factors and age considerations.
On its website, Cure Today ran two Reuters stories about breast cancer. The first revealed that breast implants affect breast cancer screening, but not prognosis. The second covered a recent study about the association between serum Vitamin D levels and tumor aggression. The study had been covered by several other sources last week, with a focus on the importance of monitoring Vitamin D levels in current patients. Today's story went further to address implications for Vitamin D levels in healthy women. (All stories can be found on the news tab of the LATESTBreastcancer.com Vitamin D page.)
In the research world, Medical News Today published initial findings from a trial of the SAVI Accelerated Partial Breast Irradiation device, and news about early enrollment in a Phase II trial of eniluricil for metastatic patients.
There was some excitement across the pond, where according to the UK Daily Mail, researchers compared the discovery of three new breast cancer genes to "finding gold in Trafalgar Square." New drugs from the discovery may still be five years away.
We'll continue to post links to the latest breast cancer news every day. On Friday, we'll also highlight the new breast cancer research developments we discovered in medical publications this week. Stay tuned!
First, the news.
There's been a lot of confusion about the safety of hormone replacement therapy lately. Today, the Los Angeles Times published an interview with an expert in the field. He talks about breast cancer risk factors and age considerations.
On its website, Cure Today ran two Reuters stories about breast cancer. The first revealed that breast implants affect breast cancer screening, but not prognosis. The second covered a recent study about the association between serum Vitamin D levels and tumor aggression. The study had been covered by several other sources last week, with a focus on the importance of monitoring Vitamin D levels in current patients. Today's story went further to address implications for Vitamin D levels in healthy women. (All stories can be found on the news tab of the LATESTBreastcancer.com Vitamin D page.)
In the research world, Medical News Today published initial findings from a trial of the SAVI Accelerated Partial Breast Irradiation device, and news about early enrollment in a Phase II trial of eniluricil for metastatic patients.
There was some excitement across the pond, where according to the UK Daily Mail, researchers compared the discovery of three new breast cancer genes to "finding gold in Trafalgar Square." New drugs from the discovery may still be five years away.
We'll continue to post links to the latest breast cancer news every day. On Friday, we'll also highlight the new breast cancer research developments we discovered in medical publications this week. Stay tuned!
How to Research Side Effects
We get a lot of questions about how (or "whether") you can research side effects on the LATESTBreastCancer.com site. Not only can you research them, you can do so very thoroughly. No, it isn't as simple as typing "bone pain" into Google, but by using a more thoughtful approach, you'll end up with a more complete answer and you'll likely finish your research faster.
LATESTBreastCancer.com is organized by treatment options, so the key is to think of a side effect as being: 1) caused by a treatment option, and 2) addressed by a treatment option.
The side effects of a treatment option.
If you want to learn about the side effects associated with a treatment option (for example, "Herceptin") simply go to that treatment option page. You can find Herceptin under Drugs > Targeted Drugs, or you can enter Herceptin (or trastuzumab) in the search box. On the Herceptin page every high quality article that we have found over the past 2 years -- including every article about side effects -- is organized by type:
Descriptions: Get overviews of the side effects caused by Herceptin.
FDA Info: Check out Herceptin's FDA approved product label. It provides more detail about the types and frequencies of specific side effects.
News articles: Scan the articles to see if there is any new information about a side effect.
Medical journal abstracts: Scan the list for very recent, detailed information about side effects seen in specific patient populations or in specific treatment settings.
Within the Herceptin links, we include articles related to side effects caused by Herceptin as well as articles related to the treatment of side effects specifically caused by Herceptin.
Understanding your options for treating a side effect.
If you want to research how to address a side effect, every option is listed on the site. Go to Treatments and scan the lists of drugs and complementary therapies.
Drugs for side effects: Found in the Drugs section. Each drug summary states the side effect that the drug addresses. For example, EMEND: NAUSEA, and XGEVA: BONE-RELATED. This enables you to quickly scan the list.
Nutritional supplements: In addition to pharmaceuticals, some complementary therapies may address side effects for some women. We use the same convention of identifying the side effect at the beginning of each summary in capital letters: "Black cohosh: HOT FLASHES", "Ginger: NAUSEA."
Other complementary approaches: Other forms of complementary options might also be relevant to you. For example, under Mind Body Connection you'll find "Hypnosis: HOT FLASHES, PAIN", "Meditation: STRESS, ANXIETY." Under Manipulation and Touch you'll find "Acupuncture: NAUSEA."
In summary, with LATESTBreastCancer you can research side effects thoroughly, find the latest information quickly, and (unlike Google searching) easily identify options that you might not have known about.
LATESTBreastCancer.com is organized by treatment options, so the key is to think of a side effect as being: 1) caused by a treatment option, and 2) addressed by a treatment option.
The side effects of a treatment option.
If you want to learn about the side effects associated with a treatment option (for example, "Herceptin") simply go to that treatment option page. You can find Herceptin under Drugs > Targeted Drugs, or you can enter Herceptin (or trastuzumab) in the search box. On the Herceptin page every high quality article that we have found over the past 2 years -- including every article about side effects -- is organized by type:
Descriptions: Get overviews of the side effects caused by Herceptin.
FDA Info: Check out Herceptin's FDA approved product label. It provides more detail about the types and frequencies of specific side effects.
News articles: Scan the articles to see if there is any new information about a side effect.
Medical journal abstracts: Scan the list for very recent, detailed information about side effects seen in specific patient populations or in specific treatment settings.
Within the Herceptin links, we include articles related to side effects caused by Herceptin as well as articles related to the treatment of side effects specifically caused by Herceptin.
Understanding your options for treating a side effect.
If you want to research how to address a side effect, every option is listed on the site. Go to Treatments and scan the lists of drugs and complementary therapies.
Drugs for side effects: Found in the Drugs section. Each drug summary states the side effect that the drug addresses. For example, EMEND: NAUSEA, and XGEVA: BONE-RELATED. This enables you to quickly scan the list.
Nutritional supplements: In addition to pharmaceuticals, some complementary therapies may address side effects for some women. We use the same convention of identifying the side effect at the beginning of each summary in capital letters: "Black cohosh: HOT FLASHES", "Ginger: NAUSEA."
Other complementary approaches: Other forms of complementary options might also be relevant to you. For example, under Mind Body Connection you'll find "Hypnosis: HOT FLASHES, PAIN", "Meditation: STRESS, ANXIETY." Under Manipulation and Touch you'll find "Acupuncture: NAUSEA."
In summary, with LATESTBreastCancer you can research side effects thoroughly, find the latest information quickly, and (unlike Google searching) easily identify options that you might not have known about.
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