Friday, August 19, 2011

Cancer video: Genetic basis of cancer hallmark; Thyroid cancer treatment variation; Vitamin D's confirmed roll in colon cancer

Interesting video.

Cancer video: Genetic basis of cancer hallmark; Thyroid cancer treatment variation; Vitamin D's confirmed roll in colon cancer
Cancer video: Genetic basis of cancer hallmark; Thyroid cancer treatment variation; Vitamin D(Aug 18, 2011 - Insidermedicine) From Washington, research published in today’s issue of Science reveals the genetic basis of aneuploidy, or an abnormal number of chromosomes in cells. Aneuploidy is known to be a hallmark of cancer. Today’s research identifies the specific gene mutation that gives way to aneuploidy, thereby identifying a possible new direction for cancer therapy. From Ann Arbor, research published in the Journal of the American Medical Association highlights the variations in thyroid cancer treatment. Thyroid cancer is one of the 10 most common cancers in the United States. The findings show that beyond size and severity of tumour, additional unexplained hospital factors seemed to play a significant role in determining whether a patient was subjected to radioactive iodine treatment, leading the researchers to call for better standardized treatment guidelines. From Barcelona, research published in PLoS One has confirmed the key role of vitamin D in hindering colon cancer progression. The findings affirm that chronic vitamin D deficiency represents a risk factor for aggressive colon tumours.

Thursday, August 18, 2011

FDA Approves Skin Cancer Drug Zelboraf - ABC News

The BRAF mutation mentioned below occurs in some forms of Papillary Thyroid Cancer.

FDA Approves Skin Cancer Drug Zelboraf

PHOTO: The FDA approved the late-stage melanoma drug Zelboraf.

The U.S. Food and Drug Administration today approved the second late-stage melanoma drug this year, adding the drug to the treatment arsenal for patients with one of the deadliest forms of skin cancer.
The drug, known as Zelboraf, could offer hope for patients with metastatic melanoma that cannot be removed with surgery, experts said.
Zelboraf, which was reviewed under the FDA's priority review program, received advanced approval after a single international study published in June 2011 showed that patients who took drug lived longer.
"Approval of this drug is extremely significant because the treatments we have had up until this year were well known to have no effect on overall survival," said Dr. Kelly McMasters, chairwoman of the department of surgery at the University of Louisville Hospital. "It is gratifying to see a well-tolerated new targeted therapy that is effective."
The study, funded by the drug's pharmaceutical developer, Hoffman-La Roche, followed 675 patients randomized to receive either Zelboraf or a standard chemotherapy drug. Seventy-seven percent of those who received Zelboraf were still living after eight months, compared to only 64 percent of those who received the standard chemotherapy drug.
The drug specifically targets tumors with the genetic mutation known as BRAF V600E. The agency also approved a diagnostic test that will determine whether someone has the mutation.
Skin Cancer Drug Approved Watch Video
Melanoma Treatment Huge Success in Early Study Watch Video
New Melanoma Treatment Targets Gene Mutation Watch Video
"Today's approval of Zelboraf and the cobas test is a great example of how companion diagnostics can be developed and used to ensure patients are exposed to highly effective, more personalized therapies in a safe manner," Alberto Gutierrez, director of the FDA's Office of In Vitro Diagnostic Device Evaluation and Safety, said in a statement.
BRAF protein mutation is found in nearly half of all patients with late-stage melanoma.
"We now have the capability to analyze a patient's melanoma tumor for the genetic mutation BRAF and use the targeted treatment Zelboraf to attack the tumor, shrink it and stop the progression of this deadly disease," said Dr. Anna Pavlick, director of the NYU Melanoma Program at the NYU Cancer Institute, who has been involved in clinical trials for Zelboraf.
Unlike chemotherapy, which only stops mutated cells from dividing, Zelboraf shuts down the abnormal signals of the tumor cells that are caused by the genetic mutation and stops the cells from dividing, without affecting healthy cells.
While the study focused on patients who had not undergone any treatment for their melanoma prior to Zelboraf, earlier trials showed the drug was still effective even for patients who previously received chemotherapy for their condition.
"Patients who failed previous therapy whose tumor harbors BRAF V600E mutation should be considered for this treatment," said Dr. Sekwon Jang, a medical oncologist at Washington Hospital Center in Washington, D.C., who specializes in melanoma.
Although Zelboraf is only approved for late-stage melanoma, some experts believe it is worth researching whether the drug could also help patients with non-metastatic melanoma.
"I anticipate a clinical trial testing this drug in those patients who have high risk of recurrence after surgery to answer whether this drug can reduce melanoma recurrence," said Jang.
Skin cancer is the most common form of cancer, affecting more than 1 million new people each year, according to the National Cancer Institute. Melanoma, one of the most deadly of these cancers, accounts for approximately 70,000 of these new cases. It also kills an estimated 9,000 people.
Since the same genetic mutation is found in tumors that develop into other forms of cancer, some experts say the drug could be a possibility for other types of cancers beyond skin cancer.
The drug is now being tested in patients with thyroid cancer with the BRAF V600E mutation, Jang said.
In March 2011, the FDA approved Yervoy, another drug that trials showed extended life for many patients with late-stage melanoma.

Music Eases Cancer Patients' Anxiety: Study

As a singer, I know this is true - music is a Godsend!

FRIDAY, Aug. 12 (HealthDay News) -- Listening to music or having sessions with trained music therapists can help ease cancer patients' anxiety, researchers say.

Music may also have positive effects on their mood, pain and quality of life, according to Joke Bradt of the department of creative arts therapies at Drexel University in Philadelphia.
Bradt and colleagues examined evidence from 1,891 cancer patients who took part in 13 trials that used music therapists and 17 trials that used pre-recorded music.
Compared to standard treatments, music was associated with a considerable reduction in anxiety, along with benefits in mood, pain, heart and respiratory rates, and blood pressure, according to a systematic review by the Cochrane Collaboration, which evaluates primary research and evidence-based medicine.
"The evidence suggests that music interventions may be useful as a complementary treatment to people with cancer," Bradt said in a news release.
"Music interventions provided by trained music therapists as well as listening to pre-recorded music both have shown positive outcomes in this review, but at this time there is not enough evidence to determine if one intervention is more effective than the other," she added.
More information
The U.S. National Cancer Institute has more about anxiety and stress among cancer patients and their families.
SOURCE: Wiley-Blackwell, news release, Aug. 9, 2011
Copyright © 2011 HealthDay. All rights reserved.

Wednesday, August 17, 2011

Overtreatment of thyroid cancer rampant: study | Reuters

(Reuters Health) - Researchers have found troubling signs that some doctors may be too quick to treat thyroid cancer patients with radioactive iodine, while others may be too slow.
The drug helps people with advanced tumors, but it is unclear if it benefits others, their report says.
By contrast, the downsides are clear: the therapy saps patients' energy and ups their risk of developing new cancers down the road, and it costs several thousand dollars.
"There are a lot of patients who are receiving iodine for what is considered low-risk tumors," said Dr. David J Sher, a cancer expert at Rush University Medical Center in Chicago, who was not involved in the new work.
"These patients generally have a superb prognosis without radioactive iodine," he told Reuters Health.
According to the report, published in the Journal of the American Medical Association, there are more than 40,000 new cases of thyroid cancer every year in the U.S. -- a number that's been climbing steadily.
"What they are diagnosing now is very small thyroid cancers, the ones that are being overtreated," Sher said.
The new study is based on data from the U.S. National Cancer Database, including nearly 190,000 patients who had their thyroid removed due to cancer.
Between 1990 and 2008, the percentage of patients treated with radioactive iodine climbed from 40 percent to 56 percent, and hospitals varied widely in their use of iodine.
More than a third of patients with low-risk tumors received radioactive iodine, on average, whereas three-quarters of high-risk patients got the treatment.
During the study period, guidelines recommended treating high-risk disease with iodine. But they said the benefits were unknown for patients at low risk, leaving treatment decisions up to the doctors and patients in those cases. That was recently changed, however, and experts now advise not treating low-risk tumors.
Dr. Megan Haymart from the University of Michigan in Ann Arbor, who worked on the study, said it's unclear why doctors would use radiation therapy in the absence of good evidence.
One possibility, she told Reuters Health, is that the uptick in early-stage tumors, which are less likely to cause harm, might have tricked them into believing the treatment actually worked, while that might not have been the case.
"At this point, there need to be better studies of which patients truly benefit from radioactive iodine," Haymart said, adding that even the current guidelines leave many patients in the gray zone.
Despite the grim picture, an editorial in the journal warns that relying on databases can sometimes be misleading.
Doctors and patients may have had good reasons to choose iodine treatment even with low-risk tumors, and those wouldn't necessarily be clear from the database.
Still, Sher said, "We know patients are getting overtreated, we know patients are getting undertreated, now we have to find out why."
SOURCE: Journal of the American Medical Association, August 17, 2011.

Monday, August 15, 2011

Sunitinib (Sutent) Summary

Here's a good summary of the effects and side effects of Sutent.

When it is to be taken : For gastrointestinal stromal tumor renal cell carcinoma- Adult- PO- The recommended dose is one 50 mg once daily, on a schedule of 4 weeks on treatment followed by 2 weeks off.
For pancreatic neuroendocrine tumors -The recommended dose is 37.5 mg taken orally once daily continuously without a scheduled off-treatment period.

How it should be taken : It comes as a capsule to take by mouth, with or withoutfood.

Special Instruction : 
* Caution should be exercised in patients with history of bleeding problem, chest pain, slow, fast, or irregular heartbeat,heartattack, heart failure, high blood pressure, pulmonary embolism (PE; blood clot in the lungs), transient ischemic attack (TIA) (mini-stroke), seizures, stroke,kidney, liver, or thyroid disease, any allergy, who are taking other medications, during pregnancy and breastfeeding.
* It may cause dizziness, do not drive a car or operate machinery while taking this medication.
* It may reduce platelet counts; avoid bruising or injury.
* Avoid contact with people who have infections in order to prevent the spread of infection.
* Monitor complete blood cell counts, blood electrolytes, blood pressure checks, thyroid function, liver function, and electrocardiograms (ECG) and other heart function regularly while taking this medication.

Side Effects : 
Most Common- Fatigue, weakness, fever, diarrhea, nausea, mouth ulcer, vomiting, indigestion, abdominal pain,constipation, high blood pressure, swelling in the extremities, rash, hand-foot syndrome, skin discoloration, dry skin,haircolorchanges, altered taste, headache, back pain, joint pain, cough, difficulty in breathing, loss of appetite, and bleeding.
Gastrointestinal-Drymouth, reflux, flatulence, mouth pain, burning tongue, and piles.
Heart- High blood pressure, fluid retention, andchestpain.
Skin- Hair loss, redness, and itching.
Central Nervous System- Dizziness, depression, andsleeplessness.
Musculoskeletal- Limb discomfort.
Endocrine- Thyroid deficiency.
Respiratory- Throat pain and upper respiratory tract infection.

Read more:Sunitinib