Elderly may be more likely to die if they have subclinical hyperthyroidism

ScienceDaily (June 5, 2011) — A common hormone abnormality in older adults -- a mild form of overactive thyroid called subclinical hyperthyroidism -- is linked to a much higher risk of dying, a new study finds.

See Also:Health & MedicineThyroid DiseaseHormone DisordersElder CareHealthy AgingDiseases and ConditionsCancerReferenceHyperthyroidismHypothyroidismThyroid hormonePituitary gland

The results are being presented at The Endocrine Society's 93rd Annual Meeting in Boston.

Because this condition sometimes does not even cause symptoms, elderly people may be unaware they have altered thyroid function until serious complications occur, said the study's main author, Graziano Ceresini, MD, PhD, a clinical researcher at the University of Parma in Italy.

"Subclinical hyperthyroidism can be responsible for important medical problems, such as cardiac arrhythmias -- irregular heartbeat -- as well as altered bone structure and cognitive abnormalities, especially in elderly individuals," Ceresini said. "Now we know that it also may be accompanied by increased mortality in people ages 65 and older."

In the new study, the investigators used data from the Italian Aging in the Chianti Area study to evaluate the relationship between thyroid function and death from all causes in older people. Thyroid function test results were available for 950 subjects age 65 or older. At enrollment in the study, 819 subjects (86 percent) had normal thyroid function and 83 (nearly 9 percent) had subclinical hyperthyroidism.

Technically, subclinical hyperthyroidism is a below-normal or undetectable blood concentration of thyroid-stimulating hormone (TSH) with normal levels of the thyroid hormones called free T3 and T4.

In evaluating the death statistics, the researchers adjusted for age, sex and other factors that could bias the results, such as congestive heart failure, body mass index, cancer and stroke. They found that subjects who had subclinical hyperthyroidism at the beginning of the study had a 65 percent higher risk of dying during the six-year follow-up than did subjects with normal thyroid function.

"Although our results would suggest the need for thyroid function testing in elderly people, confirmation of our data by further studies is needed before a screening recommendation can be made. There are no current recommendations to test all elderly individuals for subclinical hyperthyroidism," Ceresini said.

He suggested, however, that elderly persons with signs of subclinical hyperthyroidism, especially arrhythmias or thyroid disease, should ask their doctor about getting a thyroid function test. Other symptoms may include weight loss, feeling too hot and nervousness.

Subclinical hypothyroidism, or a mildly underactive thyroid, also is common in elderly people but in this study was not linked to decreased survival. There were not enough subjects with overt underactive or overactive thyroid to analyze their death risk, the authors reported.

The National Institute on Aging participated in and helped fund this study. Both the Italian Ministry of Health and the Italian Ministry of University and Research also provided funding.

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Hormone test predicts ovarian function after chemotherapy for breast cancer

ScienceDaily (June 5, 2011) — A test that shows how many eggs a woman has in her ovaries may help young women with breast cancer know what their reproductive function will be after chemotherapy, a new study finds.

See Also:Health & MedicineWomen's HealthBreast CancerLung CancerMenopauseOvarian CancerColon CancerReferenceMenopauseHysterectomyOvarian cancerInfertility

The results are being presented at The Endocrine Society's 93rd Annual Meeting in Boston.

Called the anti-Mullerian hormone (AMH) test, this blood test measures levels of an ovarian hormone that reflects the size of the ovarian reserve, or remaining egg supply. Currently, doctors use it to quantify a woman's ovarian reserve before in vitro fertilization treatments. Now researchers from Scotland have found that measurement of AMH indicates how likely it will be for a woman to still have eggs in her ovaries after chemotherapy, which can often damage a woman's eggs and cause infertility.

"Future reproductive function is a concern for many young women with cancer," said lead investigator Richard Anderson, MD, PhD, professor of clinical reproductive science at the University of Edinburgh. "This test will be of benefit to women with newly diagnosed cancer to help decide whether they need to take steps to preserve their fertility."

In the U.S. alone, breast cancer is diagnosed in more than 25,000 women younger than 45 each year, according to the American Cancer Society.

For this study, Anderson and his colleagues recruited 50 premenopausal women, ages 29 to 51, who had just received a diagnosis of early breast cancer. All women had normal menstrual cycles and were asked to keep a daily record of their menstrual cycle, as an index of ovarian activity, during the two years of the study. Before the women started chemotherapy, they gave blood samples for AMH testing. They again had AMH tests one and two years after starting treatment.

Before chemotherapy the median AMH level was 0.4 nanograms per milliliter (ng/mL). After cancer treatment the AMH level fell rapidly, becoming undetectable (below 0.16 ng/mL) in 68 percent of the women after one cycle of chemotherapy, the authors reported. By one-year follow-up, 11 women withdrew from the study, mostly because of cancer recurrence, Anderson said. Menstrual records were available for 39 women at one year and for 29 women at two years.

A low AMH measurement before treatment correlated well with amenorrhea, or absence of menstruation, after treatment. Women whose AMH before treatment was low (below 0.4 ng/mL) were 16 times likelier to have stopped menstruating after chemotherapy than women with a high pretreatment AMH value, Anderson said. The odds of losing ovarian function remained higher even after statistical analysis controlled for increasing age, which tends to lower AMH levels. Women whose AMH before chemotherapy exceeded 0.92 ng/mL were reportedly almost five times more likely to continue menstruating after treatment.

"Our data suggest that the AMH test, taken before cancer treatment, can help individualize a woman's infertility risk after chemotherapy for breast cancer," Anderson said.

He added that results of this study, which was funded by the U.K. Medical Research Council, are likely to apply to other types of cancer as well.

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Targeted cancer therapy kills prostate tumor cells, study finds

ScienceDaily (June 6, 2011) — A new targeted therapy for prostate cancer halts tumor growth in animals with advanced prostate cancer that is resistant to hormone therapy, a new study finds.

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The results are being presented at The Endocrine Society's 93rd Annual Meeting in Boston.

"This targeted therapy may provide a treatment breakthrough that will extend the lives of men with advanced, hormone-refractory prostate cancer," said lead investigator Shuk-mei Ho, PhD, chairwoman of the Department of Environmental Health at the University of Cincinnati.

Men with prostate cancer that has recurred or has spread outside the prostate routinely receive androgen deprivation therapy, which blocks the action of the male hormones. This castration occurs through surgical removal of both testes or more often with medications. Although effective, this hormone-blocking treatment eventually stops working in some patients, Ho said.

"These patients are left with very few treatment options and usually succumb quickly to the disease," she said.

Ho's team previously found they can inhibit the growth of prostate cancer cell lines in culture by targeting and activating a protein called G protein-coupled receptor 30 (GPR30) using the experimental drug G-1, a GPR30 agonist, or stimulator.

In their new study, funded by the Veterans Affairs and the National Institutes of Health, Ho and her co-workers tested G-1 in an animal model of castration-resistant prostate cancer. They implanted human prostate cancer cells beneath the skin of male mice. The established tumor regressed upon castration and after the cancer relapsed, they injected the mice with a low dose of G-1. They also gave G-1 to noncastrated, or "intact," male mice that had prostate tumors. In these intact mice that still had male hormones, G-1 did not stop growth of the prostate tumors or cause substantial death of tumor cells (necrosis), they found.

"Surprisingly, G-1 was highly effective in halting the growth of the tumors that re-emerged after castration," Ho said.

The castration-resistant tumors showed a 65 percent necrosis. These mice had increased expression of GPR30 after castration, which Ho believes sensitized prostate tumors to the cell growth-inhibiting effects of G-1.

"These results mean G-1 won't work without androgen deprivation therapy," she said.

Therefore, Ho reported, the window of time when this targeted therapy might be effective for treating hormone-resistant prostate cancer is after androgen deprivation therapy. She said she believes G-1 can make androgen blockade more effective. G-1 caused no harm to the prostate or other vital organs in mice, she added.

Although GPR30 may have a role in cell growth in female tissues, Ho said it appears to have the opposite effect in men with hormone-resistant prostate cancer. "The beauty of this GPR30 is that it does not have any estrogen, and so it will not cause any side effects of estrogen," she said.

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Anticancer effect of mushrooms demonstrated

ScienceDaily (June 4, 2011) — City of Hope researchers have investigated compounds in natural foods for their potential anticancer benefits, with a focus on food items that are easily found in grocery stores to ensure greater access and availability. Shiuan Chen, Ph.D., associate chair and professor of City of Hope's Department of Cancer Biology, identified phytochemicals in mushrooms that block the ezyme aromatase from producing estrogen. Controlling aromatase activity can help decrease estrogen levels, which controls and kills hormone-dependent breast cancers. In addition, mushrooms also demonstrate the ability to inhibit cancer call activity and slow tumor growth.

See Also:Health & MedicineBreast CancerCancerLung CancerPlants & AnimalsMiceVeterinary MedicineFungusReferenceHormone replacement therapyMenopauseBreast cancerMetastasis

Promising data from two early stage studies using mushrooms in preventing breast cancer recurrence and treatment of lung cancer are being presented at the 2011 Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago, running from June 3 through 7.

Research highlights include:

"A dose-finding clinical trial of mushroom powder in postmenopausal breast cancer survivors for secondary breast cancer prevention."

An estimated one in five breast cancer survivors will experience a recurrence of his or her cancer within 10 years of treatment of the initial cancer diagnosis. With more than 80 percent of cancers diagnosed in women after menopause being hormone-dependent, there is a need for preventive treatments to lower that risk. The natural aromatase-inhibiting qualities of mushrooms noted in preclinical studies has the potential to offer a dietary intervention that may help prevent recurrence of hormone-dependent breast cancers.

Postmenopausal breast cancer survivors who were cancer free after completion of cancer therapy were enrolled in the trial. Groups received a 12-week course of white button mushroom extract at 5, 8, 10 or 13 gram doses. Because aromatase inhibition leads to a decrease in estrogen levels, a specific estrogen called estradiol was monitored and response was defined as a greater than 50 percent decrease in free estradiol levels in the blood circulation. Mushroom extract was well tolerated at all doses. However, no dose could be identified that met response criteria. In spite of this, a measurement of aromatase activity developed by Dr. Chen suggested some modest transient aromatase inhibition that lasted longest at the highest dose level (6 hours), suggesting that weak aromatase inhibition by mushrooms is achievable in patients, but that likely much higher amounts would be needed to achieve a clinically significant result.

"City of Hope developed a test sensitive enough to track aromatase activity that is sensitive to short-term changes, and we were able to successfully utilize that in the trial," said Melanie Palomares, M.D., M.S., assistant professor of the High Risk Breast Program at City of Hope, and lead author of the study. "Over the course of 12 weeks, we were able to observe phytochemical activity, but not at high enough concentrations to significantly reduce estrogen levels in our patients. Future studies should focus on more highly concentrated preparations of mushroom extract. Tissue levels of estrogens may also be a better measure than circulating estrogens."

"A phase I study of MM-10-001 in advanced nonsmall cell lung cancer."

Marianna Koczywas, M.D., assistant professor in City of Hope's Department of Medical Oncology & Therapeutics Research, is the principal investigator of a lung cancer study on a novel therapy, MM-10-011, derived from Shiitake Mycelium in mushrooms. The trial is in progress and Koczywas is presenting preliminary data from an interim analysis. MM-10-001 has demonstrated the ability to provoke and immune response specific to tumor cells in laboratory tests. The phase I clinical trial is intended to determine the toxicity of treatment and the highest dose patients can tolerate. This is a first step in three phases of clinical trials in humans to establish the safety, dosing and efficacy of new therapies. To date, 20 patients with advanced nonsmall cell lung cancer have received treatment with escalating doses of MM-10-001, from 5 to 10 to 20 mg, over 28 days.

No severe adverse events were reported. Two patients reported grade 2 fatigue, and one patient each reported loss of appetite, high protein levels in the blood and joint pain. The maximum tolerated dose of MM-10-001 had not been reached at the time of interim analysis.

"The clinical trial is ongoing, but the interim data are promising, with indications that MM-10-001 may be stimulating an immune response against the tumor," said Koczywas. "In a majority of the patients, we observed a possible decrease in interleukin-12 levels corresponding to treatment cycles, suggesting that lower interleukin levels are associated with improved survival."

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Early transplants are no better than chemotherapy followed by transplant for non-Hodgkin lymphoma patients, study finds

ScienceDaily (June 3, 2011) — Patients with a very aggressive form of non-Hodgkin lymphoma who receive a stem cell transplant after standard chemotherapy during their first remission have comparable survival rates to those who receive the same standard therapy alone and, if needed, a transplant when they relapse.

See Also:Health & MedicineLymphomaWounds and HealingToday's HealthcareMultiple Sclerosis ResearchDiseases and ConditionsCancerReferenceBone marrow transplantTransplant rejectionLiver transplantationClinical trial

These findings from a U.S. and Canadian clinical trial of 370 patients conducted at 40 clinical institutions were presented by Patrick Stiff, MD, lead investigator and director, Loyola Cardinal Bernardin Cancer Center, at the annual meeting for the American Society of Clinical Oncology (ASCO).

"The trial was based on several preliminary studies that indicated a survival benefit to early stem cell transplants," Dr. Stiff said. "These findings may save some patients from undergoing a stem cell transplant unnecessarily."

However, a subset with all of the possible poor risk factors with this form of non-Hodgkin lymphoma did seem to have a higher chance of survival in a sub- analysis.

"Additional research is necessary to determine the best plan of care for the highest-risk patients," Dr. Stiff said. "In the meantime, these patients will have to consult with their physician to carefully determine their treatment plan."

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Novel experimental agent is highly active in CLL patients, interim study shows

ScienceDaily (June 3, 2011) — An interim analysis of a phase II clinical trial indicates that a novel experimental agent for chronic lymphocytic leukemia (CLL) is highly active and well tolerated both in patients who are undergoing treatment for the first time and those who have relapsed and are resistant to other therapy.

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The agent, called PCI-32765, is the first drug designed to target Bruton's tyrosine kinase, whose function is essential for CLL-cell survival and proliferation.

Study leader Dr. John C. Byrd, director of the division of hematology at Ohio State University Comprehensive Cancer Center -- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC -- James) presented the findings June 5 at the 2011 American Society of Clinical Oncology annual meeting in Chicago.

The analysis involved the first 21 cases in the untreated-patient group and the first 27 individuals in the relapsed/refractory-patient group. One patient in each group had a complete remission, and 13 patients (62 percent) in the previously untreated group and 12 patients (44 percent) in the relapsed group had partial remissions.

"We are excited about these early findings because they suggest that PCI-32765 is a highly active oral therapeutic that produces a high rate of durable remissions -- the remissions last months on end -- with acceptable toxicity in relapsed and refractory CLL," Byrd says.

Complete remission means there is no detectable CLL in anywhere in the body; partial remission means that the individual's disease volume has decreased 50 percent or more in a sustained manner.

"It is exciting to see a drug that was shown to be active in the laboratory translate to clinical benefit for CLL patients," says researcher Dr. Amy Johnson, assistant professor of medicine at the OSUCCC -- James. Johnson co-led the pre-clinical CLL work at Ohio State with Byrd and now coordinates several correlative studies for this clinical trial.

Byrd stresses that the patients show several benefits of the treatment, such as higher platelet counts and hemoglobin levels, and that many report that they feel dramatically better overall with less fatigue, factors that are difficult to measure and report as a number.

"These responses last for many months in part because patients are willing to remain on the drug since the side effects are very tolerable," he notes.

The ongoing phase II clinical trial involves 78 patients with previously untreated or relapsed and refractory CLL or small lymphocytic leukemia. The previously untreated patients were all age 65 or older; individuals in the relapsed group all had two or more earlier treatments followed by recurrent disease.

"These are early findings, so patients with partial remissions could improve to complete remissions with further observation," Byrd says. "Usually patients with highly resistant and refractory CLL would have progressed and possibly died by this time, but 85 percent remain on PCI-32765 and continue to improve."

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Many of those living with HIV face a new life-threatening challenge: Cancer

ScienceDaily (June 6, 2011) — As the world marks the 30-year anniversary of the first reporting of HIV/AIDS, now comes the realization of a new challenge for people with the incurable disease. For reasons not yet clear, people with HIV face a higher rate of cancers not usually associated with HIV. This increasing rate of "non-AIDS defining cancers" includes lung, head and neck, liver, kidney, and anal cancers, among others. The alarming uptick in cancer rates highlights the critical need to understand how to treat tumors in people taking highly active anti-retroviral therapy (HAART) for HIV. Given what is known about HAART drug interactions, can newer targeted cancer therapies be given safely to patients with HIV?

See Also:Health & MedicineHIV and AIDSInfectious DiseasesCancerDiseases and ConditionsColon CancerBreast CancerReferenceClinical trialAntiretroviral drugMetastasisList of medical topics

To explore potential interactions between HAART and the newer cancer drugs, the AIDS Malignancy Consortium (AMC), a National Cancer Institute (NCI)-supported clinical trials group founded in 1995 to support innovative trials for AIDS-related cancers, has conducted the first of a planned series of studies. John Deeken, M.D., a research physician at Georgetown Lombardi Comprehensive Cancer Center and national chairman of the study, presented the findings during a poster session at the 2011 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago.

He says these early results already have the potential to change the way that cancer is treated in HIV patients.

"Up to this point, oncologists have not had much information about treating cancer in people taking HAART," says Deeken. "We're basically at square one because people with HIV usually are not included in cancer clinical trials. They're excluded because physicians are worried about causing further immune suppression in HIV patients, and because HAART drugs are notorious for causing drug-drug interactions and serious side effects."

The first drug being studied is sunitinib. Sunitinib (Sutent®) may stop the growth of cancer cells by blocking blood flow to the tumor and by blocking some of the enzymes needed for cell growth. However, agents in the HAART cocktail are thought to affect the same enzymes involved in sunitinib metabolism.

The AMC chose to study sunitinib because this oral medication was approved by the Food and Drug Administration to treat kidney cancer, which is occurring at an increasing rate among HIV patients, and the drug is being studied in other cancer types that also affect HIV patients, such as lung and liver cancers.

Safety was examined separately for two groups within the phase I study. Group one included those whose HAART combination did not include ritonavir, while patients in group two were taking a ritonavir-based protease inhibitor HAART cocktail.

Between August 2009 and April 2011, a total of 19 patients were enrolled, treated, and completed at least one cycle of therapy. Sunitinib (50mg/day) was well tolerated in patients in group one -- those taking non-ritonavir based HAART regimens. Patients treated with sunitinib who were in group two, those taking the ritonavir-based therapy, experienced more side effects including higher rates of neutropenia (compared to those reported on phase III studies of sunitinib).

"Already, we have important information that can impact treatment," says Deeken. "When the trial is complete, we may have data to recommend that patients take different dosages of sunitinib based on what HAART cocktail they are taking. We also found that patients could keep taking their HIV medications safely, and that sunitinib did not affect the HIV disease status of patients in either group."

"Our HIV disease is now frequently being well controlled with HAART medications, but we are still having multiple medical problems including getting cancer earlier and more frequently," says James Weihe, a community representative for the AIDS Malignancy Consortium. "I am 60 years old and have been diagnosed with 3 minor cancers and 2 major cancers within the last 2 years. Frequently we are rejected from clinical trials just because we are HIV positive. Dr. Deeken and the work his colleagues are doing give us new hope. Their research shows that we can be included in cancer research trials if the dosages of the medications are adjusted to avoid drug-drug interactions and other side effects."

"The NCI has called for clinical trials criteria to include people with HIV though the adoption of these criteria has been slow," says Deeken. "Here we are, years after many new and effective anti-cancer treatments have been identified and we know so little about using these drugs in people who are also on therapy for their HIV. While the need for caution is understandable, it may be scientifically unjustified as well as fundamentally unfair to exclude patients with HIV from clinical trials."

The AMC study is sponsored by the National Cancer Institute under a Clinical Trials Agreement with Pfizer, Inc who provided the sunitinib.

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New strategy to attack tumor-feeding blood vessels

ScienceDaily (June 6, 2011) — Scientists at the Walter and Eliza Hall Institute have discovered a key molecule needed to kill the blood vessels that supply tumours.

See Also:Health & MedicineLung CancerCancerBreast CancerBrain TumorOvarian CancerLeukemiaReferenceMetastasisInterventional radiologyTumorLymphoma

The research team from the institute's Molecular Genetics of Cancer and Cancer and Haematology divisions found that for anti-cancer therapies that target tumour blood vessels to work the death- inducing molecule Bim is required. The finding could lead to improved anti-cancer treatments that are based on a two- or three-pronged attack on both the tumour and its blood supply. The research will be published online in the Journal of Experimental Medicine.

The growth of solid tumours, such as lung cancer, breast cancer and melanoma, depends on nutrients and oxygen being provided by the tumour blood supply. Cancer cells encourage the growth of blood vessels to feed a tumour by producing the hormone-like protein, vascular endothelial growth factor (VEGF). The research by Drs Edwina Naik, Leigh Coultas and Lorraine O'Reilly, and Professors Jerry Adams and Andreas Strasser showed that VEGF produced by tumours blocks production of Bim in the cells that line the tumour blood vessels.

New 'anti-angiogenic' medications that attack the blood vessels within tumours are showing promise in starving many types of cancers by reducing their blood supply.

In this study, in experimental melanoma, lung cancer and breast cancer models, Bim levels increased in the cells lining the blood vessels when VEGF was depleted by anti-angiogenic drugs, ultimately killing the blood vessel cells. VEGF depletion reduced the number of blood vessels in tumours, making the tumours shrink. However, in mice in which the blood vessels do not express Bim, VEGF depletion did not affect the number of tumour-associated blood vessels, and tumours grown in Bim-deficient mice did not respond to anti-angiogenic treatments.

Dr Strasser said this finding suggests that strategies for treating tumours by attacking the tumour blood supply could be optimised by incorporating drugs called BH3-mimetics that cause cell death by acting like Bim at a molecular level. "Similarly, therapies that increase the amount of Bim in tumour blood vessels could enhance the effects of anti-angiogenic agents," Dr Strasser said.

"BH3 mimetics may have two beneficial effects in cancer therapy. Our previous research had showed they can directly trigger death in tumour cells, particularly when the tumour is also attacked by chemotherapeutic drugs. We now think BH3-mimetics could also impact tumour cells indirectly by killing endothelial cells within tumours.

"This suggests that a promising new approach to the therapy of solid tumours may be to use a three-medication combination of a drug that specifically targets the tumour cell, an anti- angiogenic agent to impair the tumour blood vessels, plus a BH3 mimetic that will help the anti- tumour drug to directly kill the tumour cells and also will help the anti-angiogenic agent to kill the intra-tumoral endothelial cells, which in turn will starve the tumour, causing even more tumour cell death."

The research was supported by the Cancer Council Victoria, the National Health and Medical Research Council, the Australian Research Council, the US National Institutes of Health, the Leukemia and Lymphoma Society and Genentech.

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Research creates nanoparticles perfectly formed to tackle cancer

ScienceDaily (June 8, 2011) — Researchers from the University of Hull have discovered a way to load up nanoparticles with large numbers of light-sensitive molecules to create a more effective form of photodynamic therapy (PDT) for treating cancer.

See Also:Health & MedicineLung CancerProstate CancerCancerMatter & EnergyOpticsNanotechnologyOrganic ChemistryReferenceNanomedicineMetastasisNanoparticleInflammation

Photodynamic therapy uses molecules which, when irradiated with light, cause irreparable damage to cells by creating toxic forms of oxygen, called reactive oxygen species. Most PDT works with individual light-sensitive molecules -- but the new nanoparticles could each carry hundreds of molecules to a cancer site.

A number of different light-sensitive molecules -- collectively known as photosensitisers -- are used in PDT and each absorbs a very specific part of the light spectrum. The research team -- from the University of Hull's Department of Chemistry -- placed one kind of photosensitiser inside each nanoparticle and another on the outside, which meant that far more reactive oxygen species could be created from the same amount of light. The findings are published in the current issue of Molecular Pharmaceutics.

The nanoparticles have also been designed to be the perfect size and shape to penetrate easily into the tumour, as lead researcher, Dr Ross Boyle, explains.

"Small cancer tumours get nutrients and oxygen by diffusion, but once tumours reach a certain size, they need to create blood vessels to continue growing, " he says. "These new blood vessels, or neovasculature, are 'leaky' because the vessel walls are not as tightly knit as normal blood vessels. Our nanoparticles have been designed so the pressure in the blood vessels will push them through the space between the cells to get into the tumour tissue."

The nanoparticles are made from a material that limits the leaching of its contents while in the bloodstream, but when activated with light, at the tumour, the toxic reactive oxygen species can diffuse freely out of the particles; meaning that damage is confined to the area of the cancer.

The researchers tested the nanoparticles on colon cancer cells, and while they were able to penetrate the cells, they also found that the nanoparticles could still be effective when near -- rather than inside -- the cancer cells.

"Some types of cancer cell are able to expel conventional drugs, so if we can make this kind of therapy work simply by getting the nanoparticles between the cancer cells, rather than inside them, it could be very beneficial," says Dr Boyle.

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Molecular movements could lead to new way to treat cancer

ScienceDaily (June 6, 2011) — Work by researchers at Queen Mary, University of London could point to a new way to treat aggressive types of cancer. The scientists have found that a molecule called Met is responsible for stimulating the growth and spread of cancer because it is relocating to the wrong part of the cell.

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Experiments in the lab suggest that moving Met molecules from the inside of the cell to the cell surface could halt the growth of cancer cells and even cause tumours to shrink.

Met molecules are involved in the growth of cells in the human body but they are usually only active in a growing embryo or in wound-healing.

However, Met has also been found in many different types of tumour, including breast and lung cancers, where cells are growing uncontrollably. And tumours with high levels of Met tend to be the most aggressive.

Previous research on Met and similar molecules has attempted to tackle the problem by completely blocking the molecule but this has only achieved limited results.

In this new study, published in the journal Nature Cell Biology, the researchers instead attempted to chemically relocate Met to a different part of the cancer cells. Using this approach they were able to halt the growth of cancer cells in the lab and shrink tumours in mice.

The researchers say the study is still in its very early stages but, in the future, it could point the way to a new treatment for cancers.

Dr Stéphanie Kermorgant, who led the study, is a Lecturer in Cellular Oncology at Barts Cancer Institute, part of Queen Mary, University of London. She said: "Previous research has indicated that Met has a role in the development of cancer. We've made a fascinating discovery that, in some cancer cells, this molecule is not only present but it's located in the wrong part of the cell -- it would normally be on the outside of the cell and we've found it on the inside.

"Our study shows that it's not only the presence of the molecule but also where it is in the cell that may promote cancer. We've also shown that we may be able to take advantage of this discovery to design new types of drugs.

"Scientists have been trying to create new cancer drugs by testing chemicals that block Met, or other similar molecules, but results have been mixed.

"Our findings led us to try a new approach -- using a chemical to prevent Met molecules going to the wrong part of the cell. Importantly, this method works even when blocking Met does not work.

"It's early days but this approach looks promising and could eventually lead to new drugs for treating these aggressive types of cancer."

The researchers were funded by the Medical Research Council and Barts and the London Charitable Foundation.

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Survival niche for cancer cells

ScienceDaily (June 6, 2011) — Cancer cells do not grow equally well everywhere in the body. Often, they first create the conditions in which they can grow. Many years ago researchers discovered that solid tumors attract blood vessels to ensure their supply of nutrients by secreting specific factors. Now the immunologist Dr. Uta Höpken (Tumor and Immunogenetics Research Group at the Max Delbrück Center for Molecular Medicine, MDC, Berlin-Buch in the Helmholtz Association) and the hematologist Dr. Armin Rehm (Charité -- Virchow-Klinikum, Department of Hematology, Oncology and Tumor Immunology, MDC) have shown for the first time that specific forms of lymphoma also create their own survival niche.

See Also:Health & MedicineLymphomaImmune SystemStem CellsBrain TumorCancerProstate CancerReferenceLymph nodeLymphatic systemMetastasisHodgkin's lymphoma

Lymphoma is the term used to describe a group of cancers of the lymphatic system. Lymphoma cells are abnormal immune cells (B cells or T cells), a specific group of white blood cells (lymphocytes). Using a mouse model, Dr. Rehm and Dr. Höpken demonstrated for the first time that the dissemination of lymphoma cells and their accumulation in the lymph nodes or spleen is dependent on specific signaling or growth substances, the chemokines CCL19 or CCL21.

Chemokines normally attract immune cells to a site of infection or inflammation. As former immune cells, lymphoma cells have special antennas (receptors) on their cell surface to which these signaling substances bind. If the lymphoma cells receive the signal via their CCR7 receptor, they migrate into the lymph nodes and into specific areas within the spleen.

Paradox

CCR7 not only mediates the migration of the lymphoma cells, it is also apparently crucial for their development and survival. As the two researchers showed in a next step, the lymphoma cells proliferate in the lymph nodes or in the spleen very slowly if this receptor is absent.

However, with the aid of CCR7 the cancer cells find their survival niche in the T-cell zones of the lymph nodes and the spleen. In these zones T cells are usually made fit for defense. "It is paradoxical that lymphoma cells as former B cells find an absolutely optimal microenvironment for their growth in these T-cell zones," Dr. Höpken said.

There the lymphoma cells crosstalk with stromal cells (connective tissue cells), which subsequently secrete increased quantities of the chemokines CCL19/CCL21. The CCR7 receptor not only mediates the homing of additional lymphoma cells to the lymph nodes or spleen, but also stimulates their proliferation.

On the other hand, the lymphoma cells themselves secrete a signaling substance (lymphotoxin) which induces the stromal cells to secrete more and more chemokines. In this way the lymphoma cells ensure their survival. This may also explain why some lymphomas are so aggressive.

In mice the researchers succeeded in breaking this vicious cycle. Using an active substance that blocks the binding of the lymphotoxins to the stromal cells, they were able to stop tumor growth. "In the future," Dr. Rehm said, "it may be that therapeutic strategies will not target the lymphoma cells directly, but rather the connective tissue so vital for their survival."

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Blood clotting and bowel cancer risk

ScienceDaily (June 6, 2011) — Back in the mid 19th century, a French doctor, Armand Trousseau, discovered a connection between cancer and thrombosis -- the formation of often dangerous blood clots that can lead to venous occlusion. Today it is known that cancer and its treatment change blood flow properties and thus promote the formation of clots. However, clots do not only occur as a side effect and consequence of cancer, but, vice versa, an increased blood clotting tendency may also be associated with an elevated cancer risk.

See Also:Health & MedicineBlood ClotsColon CancerBreast CancerLeukemiaCancerLung CancerReferenceHaemophiliaHormone replacement therapyHealth benefits of teaLeukemia

About twelve different blood proteins called clotting factors interact in a coordinated manner in the blood clotting (coagulation) process. In the same way as hemophilia (decreased blood clotting) is inherited, genes also play a role in an increased clotting tendency (thrombophilia): There are well studied gene variants (polymorphisms) of a number of clotting factors which are associated with an increased or decreased clotting tendency. Between two and five percent of the population carry such genetic variants.

At the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) in Heidelberg, scientists headed by Professor Dr. Hermann Brenner have been studying six gene variants of different clotting factors for a possible connection with colorectal cancer risk. In a large study, they analyzed the occurrence of these six variants in approximately 1.800 colorectal cancer patients and in the same number of healthy control persons.

The team found the most obvious connection for a variant that substantially increases the risk of thrombosis and which is known as factor V Leiden (FVL). Study participants who carry this genetic variant on both copies of their chromosome 1 were found to have a six fold increase in colorectal cancer risk compared to participants who carry two copies of the "standard variant" of factor V. If only one copy of chromosome 1 had the FVL variant, bowel cancer risk was not elevated.

Another connection with bowel cancer prevalence was found by the research team for a particular gene variant of clotting factor XIII: People with this mutation are slightly more rarely affected by venous thrombosis than those who carry the factor XIII standard version. Now the DKFZ team has shown that their colorectal cancer risk is also 15 percent lower. For the other four gene variants studied the team found no connection with bowel cancer risk.

It is known today that coagulation and carcinogenesis are associated. Thus, the interplay of all coagulation (clotting) factors leads to the formation of active thrombin, which, in turn, activates hemostatic fibrin. However, thrombin also contributes to the formation of new blood vessels and is able to dissolve the extracellular matrix, which is the adhesive that keeps cells together. Thrombin may thus make it easier for cancer cells to invade surrounding tissue.

"It is interesting that not every gene variant that increases the tendency to clot automatically also increases the risk of developing colorectal cancer. It also makes a difference whether the gene variant is present on both chromosomes or just on one of them. We therefore have to analyze in detail which clotting factors affect cancer risk and in what manner," explained study head Hermann Brenner. The knowledge of these connections is the first prerequisite for finding out whether and for whom drugs that affect blood clotting may prevent bowel cancer.

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Immune cells link pregnancy and tumor spread

ScienceDaily (June 6, 2011) — Individuals with cancer often do not die as a result of their initial tumor but as a result of tumors at distant sites that are derived from the initial tumor. Pregnancy is a condition that seems to be permissive for tumor dissemination, as breast tumors arising during pregnancy display a tendency for early spread to distant sites (metastasis). Research in mice, led by Ivan Stamenkovic, at the University of Lausanne, Switzerland, has now uncovered a possible reason for this.

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Stamenkovic and colleagues found that the increased metastasis from tumors of several different types that they observed in pregnant mice was a result of decreased activity of immune cells known as NK cells. Furthermore, at least part of the inhibitory effect on NK cells was mediated by another group of immune cells, myeloid-derived suppressor cells. Consistent with this, the gene expression profile of the lungs of pregnant mice (a site to which many of the tumors metastasized) was reflective of myeloid-derived suppressor cell accumulation.

Of clinical interest, the majority of genes downregulated in the lungs of pregnant mice were also expressed at lower levels in samples from lung cancer patients with poor prognosis than in samples from patients with better prognosis. The authors therefore suggest that myeloid-derived suppressor cells may represent a shared mechanism of immune suppression during pregnancy and tumor growth.

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Supplement found to improve quality of life for female cancer survivors

ScienceDaily (June 6, 2011) — A natural nutritional supplement, marketed for the last decade as a sexual aid, has been shown to significantly improve overall quality of life for female cancer survivors, according to researchers at Wake Forest Baptist Medical Center.

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The findings will be presented June 6 at the 2011 American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

Interested in quality of life issues for female cancer survivors, Kathryn M. Greven, M.D., a radiation oncologist at Wake Forest Baptist, first learned of the supplement, called ArginMax for WomenTM, from a small study conducted at Stanford University that found that it improved sexual function. Sexual dysfunction is prevalent in female cancer survivors, so Greven set out to see if the supplement could produce the same benefit in this population. She found that, while taking the supplement did not result in any improvement in sexual function for female cancer survivors, the supplement did improve their overall quality of life.

With funding from the National Cancer Institute, researchers at the Comprehensive Cancer Center at Wake Forest Baptist, the Derrick L. Davis Forsyth Regional Cancer Center, and multiple other cancer centers across the country recruited 186 female cancer survivors to participate in the study.

To be considered, adult female volunteers had to be at least six months beyond their last active treatment for any kind of cancer, with no current evidence of cancer. Adhering to standard double-blind, placebo-controlled protocol, neither the participants nor the investigators knew who was receiving the supplement and who was receiving a placebo.

The Daily Wellness Company, based in Honolulu, Hawaii, provided materials for the study, including ArginMaxTM and placebo pills. Participants received three capsules of either ArginMaxTM or placebo twice a day for 12 weeks and were asked to complete two standardized questionnaires that accurately measure sexual function and quality of life. The questionnaires were completed at the start of the study, at four weeks, eight weeks and 12 weeks.

The Female Sexual Function Index is a questionnaire that measures different aspects of sexual function, such as desire, arousal, lubrication, orgasm, satisfaction and pain.

The FACT-G questionnaire measures overall quality of life and has been used in research of all cancer types. It evaluates physical, emotional, social and functional well-being.

ArginMaxTM was originally designed as a sexual enhancement aid, so researchers were primarily looking for improvements in sexual function in this new population. They found no benefit in this area.

However, the study findings did reveal an across-the-board boost in measures of overall quality of life for the patients who were randomized to take ArginMaxTM. The FACT-G questionnaires showed improvements in both physical and functional well being among the participants taking the supplement.

"The group taking the supplements experienced significant improvement in overall quality of life, particularly physical well-being," said Greven, the lead investigator on the study. "Bothersome symptoms such as lack of energy, pain, nausea, and sleeplessness were all improved, as were measures of functional well-being, for example the ability to perform normal activities at home or work. Simply, they reported a greater enjoyment of life, without any additional side effects from the supplement."

Edward G. Shaw, M.D., M.A., an oncologist as well as counselor, is principal investigator for Wake Forest Baptist's Community Clinical Oncology Program Research Base and a co-researcher on the study. He explained that cancer survivors can suffer from persistent inflammation, also known as chronic oxidative stress, that can continue for years following treatment of cancer causing fatigue that affects quality of life. He hypothesized that the ingredients in ArginMax for WomenTM may be helping to counteract this process.

ArginMaxTM is made from a patented formula containing a proprietary blend of L-arginine, ginseng, ginkgo, and 14 vitamins and minerals noted for boosting energy and circulation and optimizing hormonal balance. A separate Men's formula also is available.

"Beyond managing individual symptoms as they appear, the medical community has not been able to offer cancer patients more global symptom relief," he said. "This research is empowering for the community of cancer survivors. There's been some thought that dietary supplements could offer a potential benefit, but previous studies on other drugs and supplements have had disappointing outcomes. We'd like to see the results replicated in other studies, as they give us renewed hope in this area."

Greven said the findings have sparked interest among researchers about whether the supplement could improve quality of life and energy levels for other populations, as well. Future studies are being planned.

"It is very exciting that we've found something that has the potential to affect and improve quality of life for female cancer survivors," Greven said. "We still need to do further work to find an approach that will improve female sexual dysfunction."

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Greater cancer detection is possible with 4-D PET image reconstruction

ScienceDaily (June 8, 2011) — A study introduced at SNM's 58th Annual Meeting is advancing a positron emission tomography (PET) imaging method that uses new 4D image reconstruction to achieve the highest diagnostic capability for the detection of cancer. Mounting evidence shows that PET imaging, which provides visual representations of bodily functions, is significantly more sensitive when used with cutting-edge 4D image reconstruction technology that accounts for patient respiration and produces clearer, more easily interpreted images.

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"PET imaging with 4D image reconstruction could potentially help with early cancer detection, which is an imperative in the field of nuclear oncology," says Si Chen, lead author of the study, Johns Hopkins School of Medicine, Baltimore, Md. "The results of this study and our other studies indicate that the sensitivity of small cancer lesion detection for patients will likely benefit from this novel image reconstruction method, which incorporates an accurate and patient-specific respiratory motion estimation algorithm we previously developed. The improved diagnostic accuracy would allow physicians a more informed understanding of a patient's situation in order to provide better treatment planning for the best possible outcome."

The objective of the study was to quantify the improvement of PET image quality using the 4D PET image reconstruction method with respiratory motion compensation compared to a more conventional 3D PET image reconstruction method. The researchers evaluated the image reconstruction methods using the receiver operating characteristic (ROC) methodology, which is based on signal detection theory widely adopted in diagnostic radiology. A ROC curve is a graphical plot of the sensitivity versus specificity for lesion detection based on the reconstructed PET images. Realistically simulated PET images were employed in this evaluation study using the 4D XCAT phantom -- a digital anthropomorphic phantom that realistically models a typical patient's anatomy, respiratory and cardiac motions. A total of twelve spherical tumors of 10mm diameter were planted inside the lungs and liver of the phantom, which was input to realistic simulation of PET data acquisition using another methodology called Monte-Carlo simulation. The simulated PET data were then reconstructed using both imaging reconstruction methods. The researchers used a mathematical observer, i.e., channelized hotelling observer (CHO), to mimic the interpretation of these PET images by human observers.

Using these methodologies, researchers were able to compare the sensitivity and specificity of the two image reconstruction methods and found that the 4D PET image reconstruction method with respiratory compensation improved the detection sensitivity for the cancer lesions in the liver and lungs. This indicates that evaluation of cancer for lesions smaller than 10 millimeters could be enhanced by compensating for respiratory motion with the 4D image reconstruction method.

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Hybrid PET and MRI imaging on the horizon: Shows promise for the detection of cancerous tumors

ScienceDaily (June 6, 2011) — Preliminary research presented at SNM's 58th Annual Meeting is breaking new ground for the development of a brand new hybrid molecular imaging system. Simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) is providing important diagnostic information about soft tissues and physiological functions throughout the body. Scans focused on screening suspicious lesions for cancer are already comparable to more conventional molecular imaging methods. Further research could lead to the clinical use of PET/MRI as an additional tool for detecting cancer and other diseases.

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"Combining MRI technology with PET in a single integrated system adds the advantages of the extremely broad spectrum of diagnostic MRI procedures to the arsenal of available PET procedures," said Alexander Drzezga, MD, TU Muenchen, Munich, Germany, lead author of the study. "This could potentially result in the development of new imaging agents that bring together specific diagnostic strengths of PET and MRI. It offers exciting scientific options to image physiologic and pathophysiologic processes at the same time and to improve our understanding of both. This and further studies could potentially open a whole new hybrid imaging discipline within the field of nuclear medicine."

The most commonly used hybrid molecular imaging technology is the PET/CT system. MRI shows some advantages for combination with PET when compared to computed tomography (CT), which uses X-ray technology to capture structural information but it is not as sensitive as MRI data in terms of soft tissue contrast. CT images of certain areas of the body -- including the brain, head and neck, and pelvis -- provide restricted resolution of anatomical structures. MRI technology is excellent for imaging these complex areas of soft tissue and may provide answers to unresolved musculoskeletal questions. In combination with PET, MRI may also have value for imaging liver and breast tissues and would provide a useful tool for imaging children due to its reduced radiation dose.

Simultaneous PET and MRI imaging has been a tricky business, as the magnetic field of MRI technology has limited PET imaging in the past, specifically the photomultipliers needed for data acquisition. Previous prototypes have been simply side-by-side designs or were solely for imaging the brain. The advent of "avalanche photodiodes" and their introduction to the new, fully integrated and whole-body PET/MRI prototype used in the current study is a leap forward for this technology. A number of these integrated scanners are available for research purposes worldwide. It is speculated that these systems will grow rapidly in number if clear clinical benefit continues to be demonstrated.

For this study, eleven patients with cancer diagnoses underwent dual-imaging single-injection PET/CT imaging followed by PET/MRI imaging. Simultaneous PET/MRI acquisition was feasible and offered good-quality PET and MRI diagnostic data. Tracer-uptake was similar in relation to lung, liver, spleen and bone scanning, all acquired within a short examination timeframe. Results already indicate that combined PET/MRI shows comparable performance in the detection, diagnosis and allocation of suspected tumors in patients with oncological diagnoses as compared to conventional PET/CT.

The next step for PET/MRI is studying the added benefit of introducing sophisticated MRI sequences to the diagnostic imaging protocol. This and other related studies may lead to the establishment of hybrid PET/MRI imaging as a new diagnostic imaging system similar to PET/CT for its effectiveness and ability to provide a wealth of both functional and anatomical information about the body.

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Irregular breathing can affect accuracy of 4-D PET/CT, study finds

ScienceDaily (June 6, 2011) — A study presented at SNM's 58th Annual Meeting focuses on the effect that breathing irregularities have on the accuracy of 4D positron emission tomography (PET) scans and outlines a PET imaging method that reduces "motion artifacts" or image blurring arising from respiratory motion. Non-gated PET imaging with 4D computed tomography may be useful for imaging patients who do not benefit from the use of respiratory gating, most notably patients with erratic breathing.

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"Breathing irregularities can lead to significantly underestimated lesion activity in respiratory-gated PET imaging," says Boon-Keng Teo, PhD, assistant professor of radiation oncology at the University of Pennsylvania in Philadelphia, Pa. "Non-gated PET imaging corrected with 4D computed tomography (CT) may be more effective for imaging patients with irregular breathing. This could potentially lead to a more robust and quantitatively accurate reading of active tumors."

Respiratory gating technologies have dramatically improved the diagnostic quality of PET imaging, which provides functional images of physiological processes occurring in the body. Sensors in respiratory gating systems placed on or around the patient monitor the phase of the breathing cycle. They then transmit information about the patient's breathing to the scanning technology for image processing. Instead of creating one fluid image that shows so-called motion artifacts, respiratory-gated PET imaging is much like a series of photos taken during different phases of the respiratory cycle that are grouped together to create a series of images corresponding to each phase. The problem is that patients with respiratory disease, heart conditions or other serious disease are likely to be breathing unevenly. Respiratory gating systems are designed to work with normal breathing patterns, but not with irregular respiratory cycles.

Researchers conducted phantom studies to compare respiratory-gated PET imaging with non-gated PET imaging corrected with 4D computed tomography. CT uses X-ray technology and complex data processing to produce very high-resolution images of structural anatomy. Phantom studies were performed with inanimate objects and specialized motion devices that move in a controlled manner in order to simulate tumors in respiratory motion. The 4D PET and CT studies were conducted in succession with a hybrid PET/CT system. Various degrees of motion irregularities were simulated to study their impact on the accuracy of 4D PET for suppressing motion artifacts.

Results of the study show that non-gated PET with 4D CT imaging can be an alternative to respiratory-gated PET imaging for determining tumor activity in patients with highly irregular breathing. These findings could change imaging protocols for patients with uneven breathing and potentially improve overall accuracy of tumor detection, thereby informing clinicians about appropriate treatments and perhaps even surgical planning for better cancer management.

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Novel imaging agent targets breast tumor development

ScienceDaily (June 6, 2011) — Scientists presented new research at SNM's 58th Annual Meeting that has the potential to help physicians detect breast cancer by imaging the proliferation of blood vessels carrying oxygen and nutrients to breast tumors. Their study is evaluating a new imaging agent that is naturally drawn to angiogenesis -- the development of new blood vessels in tissues both normal and cancerous. This process turns malignant during the growth stage of many cancerous tumors including those in breast tissue.

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"The positive outcomes of this study are encouraging and may provide clinicians with additional information for breast cancer management," says Andrei Iagaru, MD, lead author of the study and assistant professor of radiology and nuclear medicine at Stanford University Medical Center, Stanford, Calif. "PET imaging with this agent could potentially lead to better clinical decisions; patients with progressive cancer who are ideal candidates for aggressive therapies could be identified earlier to improve their prognosis."

The new imaging agent central to this study is called 18F FPPRGD2, which combines the medical isotope fluorine-18 (18F) with a protein biomarker ideal for imaging the expression of an integrin known as αvβ3. Integrins are essentially protein-based receptors that regulate the adhesion between cells and connecting tissues. They are also involved in cell signaling, which mediates a cell's shape, movement and lifecycle, but their most useful trait is their key involvement in angiogenesis. Upon injection the agent seeks out tissues in a state of angiogenesis and is then captured using a molecular imaging technique known as positron emission tomography (PET), which produces functional imaging of the body.

Six female participants with breast cancer were recruited for the study and were imaged twice using 18F FPPRGD2 and 18F FDG PET/CT within two weeks. PET imaging with 18F FPPRGD2 showed superior functionality for identifying angiogenesis in breast tissue, with strong uptake and distribution in both primary cancers and metastatic lesions.

Further studies evaluating the effectiveness of 18F FPPRGD2 for targeting breast tumor angiogenesis could lead to its availability for clinical use for patients known to have breast cancer. This agent could be an effective tool for cancer staging and may improve patient treatment planning as a result of the information it provides. Preliminary findings show that it could become a useful weapon in the fight against breast cancer.

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New molecular imaging agent targets cornerstone of cancerous tumors

ScienceDaily (June 13, 2011) — A study introduced at SNM's 58th Annual Meeting may lead to the next wave of cancer imaging by helping to develop a molecular imaging agent that detects many malignant cancers' incessant development of blood vessels -- a process called angiogenesis. A protein biomarker known as CD105 has been shown to indicate tumor angiogenesis in cancer patients.

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"Non-invasive molecular imaging is a critical component of 21st century personalized medicine, and one of the hallmarks of cancer is angiogenesis," says Weibo Cai, PhD, assistant professor of radiology, medical physics and biomedical engineering at the University of Wisconsin-Madison's School of Medicine and Public Health. "CD105 is considered by many to be the best biomarker for evaluating tumor angiogenesis. Non-invasive imaging of this protein's expression could potentially play a variety of roles in the future of cancer patient management. CD105-targeted imaging agents also represent a new paradigm for the assessment of cancer therapies that target tumor angiogenesis. Applications for this agent could reach far beyond cancer and open many new avenues for future research."

Malignant cancers are defined by their ability to grow like weeds, forming fast and strong networks of blood vessels that carry oxygen and nutrients to the cancer's insatiable cellular structure. Endoglin, or CD105, is a naturally occurring protein that resides on the cell's surface. Above-normal expression of this protein is associated with poor cancer prognosis in more than 10 solid tumor types. The clinical standard for evaluating tumor angiogenesis is microvessel density (MVD) analysis, which is conducted by staining CD105 in tumor tissues that have been obtained by either surgical removal or biopsy. This study represents the first of its kind to report preliminary data on the non-invasive imaging of CD105 expression with positron emission tomography (PET), which provides a reliable measure of angiogenesis in the tumor.

Researchers used the medical isotope Copper-64 (64Cu) to label an antibody called TRC105, which binds to CD105. The full name of the agent is (64)Cu-DOTA-TRC105. The TRC105 antibody is currently being studied in a U.S. multicenter phase 1 human trial and multiple phase 2 therapy trials are planned or already underway for a range of cancer types. The current study specifically marks the effectiveness of using 64Cu-DOTA-TRC105 to gauge tumor angiogenesis. Results of the study showed this PET imaging agent to be highly effective, with rapid and persistent CD105-targeted uptake by tumors in mice.

Not only could this potentially be a turning point for cancer imaging and therapy, but some other major causes of death like heart attack, stroke and atherosclerosis also actively demonstrate the over-expression of CD105. Molecular imaging of this protein could one day lead to expanded tools for the detection and treatment of any number of diseases characterized by enhanced angiogenesis.

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High-impact radiopeptide therapy halts neuroendocrine cancer

ScienceDaily (June 6, 2011) — Research introduced at SNM's 58th Annual Meeting could be a sign of hope for patients with neuroendocrine cancer not responding well to standard therapies. Most radiotherapies use medical isotopes that emit beta radiation. The therapy in this study employs alpha particles, which have potential for higher potency. In fact, one single atom could be enough to kill an entire cancer cell.

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"Until now, the usage of alpha radionuclides was limited to direct injection into the tumor or the use of only very small doses," says Clemens Kratochwil, MD, lead author of the study from the University of Heidelberg, Heidelberg, Germany, and the Institute for Transuranium Elements, European Commission, Joint Research Centre, Karlsruhe, Germany. "This is the first patient study of dose escalation involving the injection of a specific tumor-targeted peptide tagged with an alpha-emitter. This provides additional options for patients with therapy-resistant cancers; further studies could expand the development and safe use of alpha-emitter therapies for patients with other forms of cancer."

Neuroendocrine cancer affects cells that translate neuronal information into hormonal information. Hormones and neuroendocrine nerve cells control a range of physiological processes, including efficiency of digestion, cellular metabolism, blood flow and the reproductive cycle. This type of cancer can therefore affect organs including the pancreas, the bowel, the thyroid gland and the lungs, among many others. Neuroendocrine cancer can go undetected for years and spread (metastasize) to other organs, especially the liver, bones and lymph nodes.

Standard therapy for neuroendocrine cancer is surgery and chemotherapy, as well as radiotherapy. Radiotherapy uses ionizing radiation to kill cancer cells by damaging their DNA. More targeted therapies come in the form of radioimmunotherapy and radiopeptide therapy, comprising a radionuclide bound or used in conjunction with an antibody or peptide that specifically targets the cancer tissue. A range of radionuclides, also known as medical isotopes, are used depending on the type of cancer, the kind of tumor and stage of disease. Most radiotherapies use beta-emitting particles, but more recently researchers have been conducting studies regarding the use of alpha-emitting particles, which have a very near-range and high-energy effect where administered. The benefit of alpha-therapy is its high cytotoxicity, or ability to kill cells -- both cancerous and healthy cells. For this reason, scientists must test the safety of alpha-therapy and identify the most appropriate dose to avoid toxicity in normal tissues.

This study is focused on a cancer therapy called 213Bi-DOTATOC peptide receptor alpha-therapy. DOTATOC, as a tumor-targeting probe labeled with different radionuclides, has been under investigation in the University Hospital of Heidelberg for more than a decade. This peptide analog mimics the endocrine-system regulating hormone somatostatin. The latest advance for the treatment is the use of alpha-emitter 213 Bismuth, a radionuclide that is bound to DOTATOC and injected. Researchers administered the therapy to 14 patients with neuroendocrine liver metastases resistant to previous treatment with beta-particle peptide therapy. The therapy was found to be highly effective for targeting neuroendocrine tumors and inducing remission of metastases without dangerous toxicity to healthy tissues. Further studies are scheduled to escalate dosage further for even greater cancer-killing power for metastatic neuro-endocrine cancer patients. Additional alpha-emitter therapy studies are also continuing to determine their efficacy for treating other therapy-resistant cancers.

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New pretargeted radioimmunotherapy for colorectal cancer

ScienceDaily (June 6, 2011) — Investigators at SNM's 58th Annual Meeting are presenting results from a phase 1 clinical trial for a cancer therapy that has the potential to kill colorectal tumors with less destruction of healthy tissue. Further research could lead to the use of this radioimmunotherapy to eliminate residual cancer after surgery or as a standard treatment to keep tumors from returning or spreading to other organs.

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"Compared to the conventional way of guiding radiation to tumors with radiolabeled antibody, pretargeted radioimmunotherapy offers an attractive potential alternative because the delivery of therapeutic isotope is rapid and is separated from the long antibody delivery process, thereby reducing the harmful effects of radiation to the body, especially the bone marrow," says Rafke Schoffelen, MD, scientist of the study at Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. "This results in an optimal scheme with maximum therapeutic effect and minimal side effects."

According to the American Cancer Society it is estimated that more than 141,200 Americans in 2011 will be diagnosed with colorectal cancer, and 48,000 will die of the disease. Colorectal cancer is currently the third most commonly diagnosed cancer and the third leading cause of cancer death for both men and women across the country. This form of cancer develops in the colon and rectum, usually as a result of polyps, or abnormal growths, that extend from mucous membranes in the lower gastrointestinal tract. Once cancer is detected, the most common treatments are surgery and chemotherapy, but chemotherapy is associated with many side effects, some of them serious and lifelong. This pretargeted radioimmunotherapy is engineered to be an effective alternative with far fewer adverse effects.

In recent years the development of radioimmunotherapy has led to increasingly targeted cancer therapies that combine antibodies pinpointing specific physiological processes of the cancer and medical isotopes that deliver a dose of radiation to the cancer tissue. Pretargeted radioimmunotherapy takes this a step further by breaking the therapy into two phases. In the first phase, an antibody is infused that recognizes both an antigen from the tumor and the building blocks of proteins that serve as a vehicle for the radioisotope. When the antibody has cleared the rest of the patient's system, leaving only the tumor-bound antibody, a second phase is administered in the form of an injected small protein labeled with the medical isotope. The drug binds with the already tumor-bound antibody and delivers the radiation dose. The fraction of the drug that is not bound is quickly cleared from the rest of the body by the kidneys and out through the urine.

The objective of this study -- the first of its kind to treat patients with metastatic, or spreading, colorectal cancer with pretargeted radioimmunotherapy -- was to improve patients' prognosis without compromising their quality of life. It is conducted in collaboration with Garden State Cancer Center, Belleville, Immunomedics Inc. (NASDAQ: IMMU) and IBC Pharmaceuticals Inc. of Morris Plains, N.J., developers of the pretargeting mechanism and reagents.

First, patients were administered a test-cycle to map the path and predict the radiation dose of the subsequent therapy injection. The antibody, TF2, was infused followed by the small protein, IMP288, carrying a non-therapeutic isotope, 111In, which was measured by whole-body planar and single photon emission computed tomography imaging. Patients were then administered TF2 again, and the therapeutic isotope and agent 177Lu-IMP288. Research showed effective targeting of tumors and minimal healthy tissue damage, which could lead the way for further studies with higher or multiple dosing strategies and greater targeting of cancer tissue.

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Combined imaging agents advance PET imaging of cancer

ScienceDaily (June 6, 2011) — Research presented at SNM's 58th Annual Meeting is taking targeted molecular imaging to a new level by combining two commonly used imaging agents into one molecular imaging procedure. The combination of these agents creates a comprehensive examination of the extent of cancer spread within a variety of organ systems in the body.

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"During a time when health care costs are under intense scrutiny, consolidated procedures such as this one that provide comprehensive imaging data are a benefit to everyone -- to clinicians, healthcare administrators and especially patients who would need only one scan instead of two," says Andrei Iagaru, MD, lead author of the study and assistant professor of radiology and nuclear medicine at Stanford University Medical Center, Stanford, Calif. "What we stand to gain from combining these two agents is the diversification of tumor targeting. The beauty of it is that each agent has its own strength, and those are unified in the imaging. In combination they represent a powerful new tool for acquiring as much information as possible about the extent of a patient's cancer."

The objective of the study was to gauge the value of combining two molecular imaging agents for cancer imaging with a hybrid molecular imaging system. Researchers used a positron emission tomography and computed tomography (PET/CT) system, which combines both nuclear medicine and X-ray technology to produce images that provide information about both physiological processes and structural anatomy.

All PET imaging agents are not alike. Medical isotopes are often labeled with an antibody, peptide or any number of other useful molecules that guide the medical isotope directly to its target. One of the most prevalently used imaging agents is 18F-Fluorodeoxyglucose (18F FDG), a glucose analog that is metabolized by cells as fuel. This is useful because cancer cells are metabolically hyperactive compared to healthy cells. PET imaging with 18F FDG will show these areas of increased metabolism as "hot spots" on scans. But while it is an excellent agent, it can still miss some cancer lesions, such as those in the skeleton. For this study, researchers compare the results of 18F FDG and sodium fluoride-18 (18F NaF), another PET imaging agent that has been shown to provide superior functional imaging of skeletal tissue, both separately and together.

For this prospective study investigators recruited 78 patients with proven cancers and scanned them separately using 18F NaF PET/CT and 18F FDG PET/CT imaging methods. Participants then received a third PET/CT scan using 18F NaF and 18F FDG simultaneously. Results of all three imaging studies were then analyzed for their usefulness in evaluating tumor malignancy. Researchers found that combined 18F NaF and 18F FDG PET/CT imaging provided good-quality imaging of both skeletal and extra-skeletal malignant lesions from breast, lung, colorectal and other cancers.

Combined 18F NaF and 18F FDG PET/CT is a comprehensive new imaging procedure for cancer staging without any additional risk of toxicity. In fact, this technique reduces overall radiation dose due to the consolidation of imaging. With further demonstration of its clinical value, this imaging technique could become widely available for evaluating a host of different cancers in order to improve treatment planning and patient prognosis.

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Gamma imaging provides superior tumor detection for dense breasts

ScienceDaily (June 6, 2011) — A study revealed at SNM's 58th Annual Meeting is comparing the breast-tumor detection capabilities of two very different imaging technologies -- breast-specific gamma imaging (BSGI), which provides functional images of breast physiology, and ultrasound -- for women with complex breast imaging cases that require further evaluation. Many women who have dense breast tissue (radiodense breasts) are difficult to image using mammography, currently the gold standard of breast imaging. For women whose mammograms are not clear enough to determine whether cancer is present, support methods such as BSGI and ultrasound are used to answer any remaining diagnostic questions.

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"A lot of white shows up on the mammograms of women with radiodense breasts, and it becomes a lot like trying to find one cloud in a cloudy sky," says Douglas Kieper, BSNMT, professor and nuclear medicine research supervisor at Hampton University, Hampton, Va. "This study tells us that BSGI improves our ability to detect breast cancer when combined with other breast imaging techniques. What we are really looking at is the impact that BSGI and ultrasound have on breast cancer patient management. Comprehensive breast imaging including BSGI could improve breast cancer detection and provide a better prognosis for breast cancer patients."

According to the American Cancer Society, breast cancer is the foremost form of cancer developed by women, except for skin cancer. An estimated 207,090 women were diagnosed with breast cancer and approximately 39,840 died of the disease in 2010. Current statistics estimate that a woman's chance of developing the disease is slightly less than one in eight women. Mammography catches about 85 percent of breast cancers in women with normal breast tissue but only 60 percent in women with dense breast tissue. Instead of relaying information about the structure or anatomy as mammography and ultrasound imaging do, BSGI informs clinicians about functions of the breast tissues, specifically changes in tumor tissues that could be essential to appropriate treatment planning, whether for biopsy, lumpectomy or cancer therapy.

BSGI, also known as molecular breast imaging, is most valuable for women who have an unresolved diagnostic concerns after mammography. These are often labeled as BIRADS 0 mammograms according to the Breast Imaging Reporting and Data System. Breast cancer patients receive a score that assesses cancer in the range of one to six, the latter being confirmed malignancy. BIRADS 0 means that there is insufficient information and further evaluation is necessary, whether the patient has dense breasts, had negative results during a mammogram but nipple discharge, or has a family history of breast cancer.

For this study, 119 patients from four medical centers scheduled for BSGI evaluation were added to a registry, and results of their routine exams were collected for analysis. Results of both routine BSGI and ultrasound imaging were collected and compared for their ability to provide additional information about the case and change breast cancer patient management. Of the 119 subjects, 102 lesions were benign, 25 were malignant and 2 were labeled as high-risk for cancer. BSGI changed the diagnosis for 109 participants compared to ultrasound, which changed patient management in 71 cases. BSGI offered greater sensitivity for detecting breast cancer (100 percent versus 77 percent with ultrasound) and greater specificity, being negative in benign cases (82 percent versus 52 percent of cases with ultrasound).

Molecular breast imaging is continually expanding. If future studies also prove that BSGI imaging is clinically useful for patient management and the cost of technology and radiation dose are reduced with technological advancements, BSGI could potentially become an accepted imaging technique for initial cancer screening. Until then, BSGI is an effective tool for providing clinicians with additional information about complex breast cancer cases and could potentially improve cancer outcomes for women.

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PET imaging determines malignancy in potential ovarian cancer cases

ScienceDaily (June 6, 2011) — A study presented at SNM's 58th Annual Meeting may provide a new tool for detection of malignant-stage ovarian cancer. Researchers found that positron emission tomography and computed tomography (PET/CT), which images both functional and anatomical changes in the body, was useful for preoperative cancer imaging of ovarian masses when used with a radiotracer that is actively metabolized by cells as fuel. Physicians imaging patients suspected of having malignant tumors can see where cancerous cells are hyper-metabolizing the tracer and accurately predict whether a mass is malignant, cancerous but stable, or benign.

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"We found that PET/CT imaging with the radiotracer 18F-FDG gave us beneficial information about the ovarian cancer stage that helped gynecologists in their treatment planning," says Majbritt Frost, research technologist and lead author of the study at Aalborg Hospital Danmark in Aalborg, Denmark. "This research is important because it gives gynecologists and oncologists the opportunity to provide these women the best possible course of treatment. We were also able to find additional tumors, resulting in patient referral to the appropriate medical specialist."

The American Cancer Society estimates that more than 21,800 American women were diagnosed with ovarian cancer and approximately 13,850 women died from the disease in 2010.

This study was conducted to explore PET imaging with a radiotracer that combines a fluorine-based medical isotope with fluorodeoxyglucose (18F-FDG), which mimics glucose as a source of energy, to determine the malignancy of adnexal masses. These are lumps in the tissue of the adnexa, or connected structures of the uterus. Most commonly these masses affect the ovaries and fallopian tubes, but they can also develop within supporting tissues. PET imaging with 18F-FDG was able to ascertain whether lumps were malignant, because cancerous tissues are far more metabolically active than normal cells and this hyperactivity shows up as "hot spots" on PET scans.

For the purposes of this research, 104 patients with a mean age of 62 years presenting adnexal masses with the potential for ovarian cancer were imaged using PET/CT with the radiotracer 18F-FDG prior to surgery. Results of the scans were classified as either benign or malignant and were then compared to surgical findings. Preliminary research shows that 18F-FDG PET/CT was able to successfully detect 84 percent of benign and malignant tumors for these patients.

The ability to detect ovarian cancer expands hybrid molecular imaging in the field of gynecology. Already molecular imaging is useful for the staging of cervical cancer, and continuing research may one day open the door for the staging of endometrial and other cancers for women.

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Removal of a tiny RNA molecule can inhibit cancer growth, researchers discover

ScienceDaily (June 7, 2011) — Research from the University of Louisville report in the Proceedings of the National Academy of Sciences indicates the removal of a tiny RNA molecule in mice suppresses carcinogenic tumor formation.

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Yong Li, Ph.D., associate professor of biochemistry and molecular biology, and his research team led by postdoctoral fellows Xiaodong Ma and Munish Kumar found that the removal of a non-coding RNA molecule known as MicroRNA 21 suppressed the formation of skin tumors in mice. This molecule -- abbreviated as miR-21 -- was targeted for study because of its presence in human cancer formation, Li said.

"In virtually all types of cancer, miR-21 is found to be present at elevated levels," Li said. "We believe it is essential to the growth of cancers."

Two groups of mice -- 18 with miR-21 removed and a control group of 23 with miR-21 intact -- were studied after skin tumors known as papillomas were induced with a heavy dose of a carcinogen. The group without miR-21 had just 1.5 tumors per mouse after 30 weeks as compared to 2.5 tumors per mouse in the control group. Moreover, one of the mice without miR-21 was tumor-free at the end of the study.

"Our work leads us to believe that miR-21 ablation (removal) increases the body's own tumor suppressing ability to hold back tumors," Li said. "The cancer research community is increasingly aware the importance of the surroundings around tumor cells. Our ongoing study of miR-21 involves looking at how this molecule contributes to tumor environment."

The study's funding indicates the serendipitous aspect of bench science, Li said, because it was not funded by a cancer research agency or organization but in part by the American Heart Association and the UofL Diabetes and Obesity Center.

"We began our work in 2008 with the hypothesis that miR-21 plays a role in cardiovascular disease and diabetes," he said. "However, our research and reports from other groups suggest it does not, although we are continuing our work in these areas.

"Funding basic research is important because you never know where science will take you. It is clear from our research that miR-21 is taking us a bit closer to understanding tumor formation."

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Tai chi could help overcome cognitive effects of chemotherapy, evidence suggests

ScienceDaily (June 7, 2011) — According to the American Cancer Society, more than 11.4 million Americans are currently living with cancer. While cancer treatments are plentiful, many have negative side effects. Previous studies have indicated that a significant number of patients who receive chemotherapy also experience cognitive declines, including decreases in verbal fluency and memory. Now, one University of Missouri health psychologist has found evidence that indicates Tai Chi, a Chinese martial art, might help overcome some of those problems.

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"Scientists have known for years that Tai Chi positively impacts physical and emotional health, but this small study also uncovered evidence that it might help cognitive functioning as well," said Stephanie Reid-Arndt, assistant professor and chair of the Department of Health Psychology in the School of Health Professions. "We know this activity can help people with their quality of life in general, and with this new study, we are encouraged about how Tai Chi could also help those who have received chemotherapy. I also hope this encourages more people to think about Tai Chi positively on a broader scale in their lives."

Tai Chi involves practicing slow motion routines and is based on several principles, including mindfulness, breathing awareness, active relaxation and slow movements. The emphasis on slow movement makes Tai Chi particularly suited to a wide range of fitness levels, which makes it very relevant for those who have had chemotherapy and might be experiencing physical limitations as a result, Reid-Arndt said.

The MU pilot study followed a group of women with a history of chemotherapy. The women participated in a 60-minute Tai Chi class two times a week for 10 weeks. The women were tested on memory, language, attention, stress, mood and fatigue before and after the 10-week sessions. According to Reid-Arndt, the results of the tests indicated that the women had made significant improvements in their psychological health and cognitive abilities.

"Tai Chi really helps individuals focus their attention, and this study also demonstrates how good Tai Chi could be for anyone, whether or not they have undergone treatment for cancer," Reid-Arndt said. "Due to the small size of this study, we really need to test a larger group of individuals to gain a better understanding of the specific benefits of this activity for patients who have been treated with chemotherapy and how significant these improvements might be."

The study was published recently in Complementary Therapies in Clinical Practice.

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U.S. Veterans Health Administration similar or better than private sector for cancer patients ages 65 plus, study finds

ScienceDaily (June 6, 2011) — A new study finds that the cancer care provided by the Veterans Health Administration (VHA) for men 65 years and older is at least as good as, and by some measures better than, Medicare-funded fee-for-service care obtained through the private sector. The study, reported in the June 7 issue of Annals of Internal Medicine, was led by Nancy Keating, an associate professor of health care policy at Harvard Medical School.

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Several factors could account for the high quality of VHA care. "Care in the VHA is much better coordinated than most other settings," said Keating, who is also an associate physician at Brigham and Women's Hospital. "The VHA has a good, integrated medical record. Their doctors all work together and communicate more effectively. There are no incentives for the overuse of cancer treatments because VHA physicians are not rewarded financially for prescribing more drugs or procedures. The VHA also measures quality across a wide range of conditions, so there is a culture of quality improvement."

The VHA is the largest integrated healthcare system in the United States, and veterans who are part of the VHA get almost all of their care from this system. In contrast to the fee-for-service model of care common in the private health sector, the VHA operates on a set budget to provide coordinated and comprehensive healthcare services, and its doctors are salaried. Congress has mandated periodic assessments of the VHA's performance in various domains of health care. In contracting out the VHA's cancer care evaluation, the Office of Policy and Planning of the U.S. Department of Veteran Affairs turned to Keating and her colleagues.

Keating's team pooled registry and administrative data from 2001-2004 for men 65 years and older diagnosed with the three most common cancers in men -- colorectal, lung and prostate cancers -- or hematologic cancers, such as lymphoma and multiple myeloma. The researchers used sophisticated analyses to ensure unbiased comparisons between the VHA and fee-for-service Medicare patients, and compared how well various guideline-recommended criteria for care were met in these two settings.

When compared with fee-for-service Medicare patients, Keating and colleagues found that veterans in the VHA were diagnosed with colorectal cancers at earlier-stages and had higher adjusted rates of certain recommended treatments, including surgery for colon cancer, chemotherapy for lymphoma, and bisphosphonates for myeloma. With regard to other treatments studied, care was fairly equal in quality between the VHA and fee-for-service Medicare.

Keating conducted additional analyses to further account for differences that may exist between veterans and the Medicare population that they could not measure. For example, veterans are often in worse health than the general population. When they updated their results to account for these likely differences in health status, care in the VHA was better than that in fee-for-service Medicare for most indicators. One exception was a likely delay in the adoption of certain new and expensive radiation therapy technologies for prostate cancer.

Overall, rates of recommended care were relatively low in both settings for some of the treatments studied. This may result from lack of data on the benefits versus risks of these drugs in older patients. Keating recommended that cancer clinical trials include older individuals as well as those with comorbid illnesses.

"While the ongoing national health care debate centers on expanding insurance coverage, ensuring a coordinated health care delivery system that provides high-quality care at good value is equally important to improve outcomes and keep rising health care costs in check," said Keating.

This research was funded by the Department of Veterans Affairs Office of Policy and Planning.

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Scientists unlock potential of frog skin to treat cancer

ScienceDaily (June 7, 2011) — Scientists at Queen's University Belfast have discovered proteins in frog skins which could be used to treat cancer, diabetes, stroke and transplant patients by regulating the growth of blood vessels.

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The award-winning research, led by Professor Chris Shaw at Queen's School of Pharmacy, has identified two proteins, or 'peptides', which can be used in a controlled and targeted way to regulate 'angiogenesis' -- the process by which blood vessels grow in the body. The discovery holds the potential to develop new treatments for more than seventy major diseases and conditions that affect more than one billion people worldwide.

The proteins are found in secretions on the skins of the Waxy Monkey Frog and the Giant Firebellied Toad. Scientists capture the frogs and gently extract the secretions, before releasing them back in to the wild. The frogs are not harmed in any way during this process.

Professor Shaw said: "The proteins that we have discovered have the ability to either stimulate or inhibit the growth of blood vessels. By 'switching off' angiogenesis and inhibiting blood vessel growth, a protein from the Waxy Monkey Frog has the potential to kill cancer tumours. Most cancer tumours can only grow to a certain size before they need blood vessels to grow into the tumour to supply it with vital oxygen and nutrients. Stopping the blood vessels from growing will make the tumour less likely to spread and may eventually kill it. This has the potential to transform cancer from a terminal illness into a chronic condition.

"On the other hand, a protein from the Giant Firebellied Toad has been found to 'switch on' angiogenesis and stimulate blood vessel growth. This has the potential to treat an array of diseases and conditions that require blood vessels to repair quickly, such as wound healing, organ transplants, diabetic ulcers, and damage caused by strokes or heart conditions."

Explaining how his research team looks to the natural world to solve problems where other methods of drug discovery have failed, Professor Shaw said: "Because of its huge potential, angiogenesis has been a prime target for drugs development research over the past forty years. But despite an investment of around $4-5 billion by scientists and drugs companies around the world, they have yet to develop a drug that can effectively target, control and regulate the growth of blood vessels.

"The aim of our work at Queen's is to unlock the potential of the natural world -- in this case the secretions found on frog and toad skins -- to alleviate human suffering. We are absolutely convinced that the natural world holds the solutions to many of our problems, we just need to pose the right questions to find them.

"It would be a great shame to have something in nature that is potentially the wonder drug to treat cancer and not aim to do everything in our power to make it work."

The Queen's researchers will receive the Commendation in the Cardiovasular Innovation Award at the Medical Futures Innovation Awards in London June 6, 2011. The Awards are one of Europe's most prestigious healthcare and business awards, rewarding innovative ideas from front line clinicians, scientists and entrepreneurs. Professor Shaw's team are the only entry from Northern Ireland to be successful at this year's awards.

Congratulating Professor Shaw and his colleagues, Professor Brian Walker and Dr Tianbao Chen, on their commendation award, Queen's Vice-Chancellor Professor Peter Gregson said: "This award is not only an honour for Professor Shaw and his team, it is recognition of the world-class research taking place at Queen's School of Pharmacy, and the life-changing potential of the University's work in drug discovery."

For more information on the Medical Futures Innovation Awards 2011 visit: www.medicalfutures.co.uk

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Bankruptcy rates among cancer patients increase along with survival time, study finds

ScienceDaily (June 6, 2011) — An analysis linking federal bankruptcy court records to cancer registry data from nearly 232,000 adult cancer cases in western Washington during a 14-year period has found a hidden cost to survival: Insolvency rates increase along with the length of survival.

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"Patients diagnosed with cancer may face significant financial stress due to income loss and out-of-pocket costs associated with their treatment," said Scott Ramsey, M.D., Ph.D., a health care economist and internist at Fred Hutchinson Cancer Research Center who led the study. "On average, bankruptcy rates increased fourfold within five years of diagnosis." Ramsey presented the findings June 6 at the 2011 annual meeting of the American Society of Clinical Oncology in Chicago.

The study found that compared to the general population, bankruptcy rates were nearly twice as high among cancer patients one year after diagnosis, and that the median time to bankruptcy was two and a half years after diagnosis.

"The risk of bankruptcy for cancer patients is not well known, and previous studies have relied on individual self-reports about medically related reasons for bankruptcy filing," said Ramsey, a member of the Hutchinson Center's Public Health Sciences Division. "By linking two irrefutable government records of cancer and bankruptcy, we are able to determine how financial insolvency risk varies by cancer type, treatment and other factors," he said.

For the study, Ramsey and colleagues linked Washington state cancer registry data with federal bankruptcy court records in 13 western Washington counties. They measured the rate of bankruptcy after a first cancer diagnosis and identified factors that increased bankruptcy risk among people with common cancers.

They found that bankruptcy risk varies widely across cancer types. The risk is highest for lung, thyroid and leukemia/lymphoma cancer patients. In contrast, patients over 65, who are typically on Medicare, have a much lower risk of bankruptcy than younger patients. The researchers also found that bankruptcy rates among cancer patients have increased significantly since the U.S. financial crisis.

Ramsey and colleagues in the Hutchinson Center's Public Health Sciences Division, along with researchers at the University of Washington, conducted the study in collaboration with the U.S. Bankruptcy Court, Western District of Washington, Seattle.

The National Cancer Institute funded the research.

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