Screening test finds signs of rapidly dividing cells -- COVENTRY, UK (Reuters) October 29, 2002 Prof. Ron Laskey and his colleagues at the University of Cambridge have found a group of molecules that appear only to be present only in cells that are making new DNA and are rapidly dividing and multiplying.

Lasky's team found the molecules in the stool of colon cancer patients, but not in healthy volunteers. Similar molecular changes can also be found in salvia, urine, needle breast biopsies, and cervical smears.

Further testing in a larger population is necessary to confirm the results found in colon cancer patients and to discover if the testing can find early cancers or pre-malignant conditions.

"We're really excited by our results so far, which suggests that our test is not only sensitive but also specific, in that it does not accidentally pick out healthy people as having bowel cancer," Lasky said.

Read it here on Yahoo! News .

Smoking increases incidence of colorectal polyps -- (HealthScout News) October 22, 2002 -- Smokers have an equal risk as those with a family history of colon cancer to have colorectal polyps according to a statistical analysis of 1,556 patients who had screening colonoscoy between Dember 1999 and April 2002.

Dr. Rajeev Attam, the study's lead author said, "Polyps were found in about 19 percent of ex-smokers and about 17 percent of nonsmokers, whereas 25 percent of smokers had polyps."

In addition, a larger proportion of smokers had two or more polyps, a larger polyp, or polyps with a greater risk of becoming malignant.

The researchers at the State University of New York at Stony Brook believe that the results indicate that smokers should be screened earlier than age 50 for colorectal cancer.

Read the Health Scout report.

EXACT Science stool test for colorectal cancer shown sensitive in finding invasive cancers. MAYNARD, Ma (Business Wire) October 23, 2002 -- Data were reported this morning at the American College of Gastroenterology's Annual Meeting in Seattle demonstrated a 65%sensitivity for invasive cancer and a 50% sensitivity for advanced adenomas (polyps).

The test appears to be equally sensitive for early and late cancers.

PreGen-Plus tests stool for DNA. Fecal occult blood testing, an older and more established stool test, is effective in finding colorectal cancer about 30% of the time and have been clinically shown to reduce deaths from colorectal cancer.

Participants in the study were at average risk for colorectal cancer.

Lead investigator for the study is Dr. Sapna Syngal, of Boston's Brigham and Women's Hospital, who collaborated with EXACT Sciences and physicians at the Dana Farber Cancer Institute, Massachusetts General Hospital, Lahey Clinic Medical Center and Boston Medical Center, all of Massachusetts.

Read the press release from EXACT Sciences on Yahoo

Stool DNA Screening Clinical Trial -- Exact Sciences is enrolling men and women over the age of 65 in a study of a stool test for colorectal polyps.

Participants must be over the age of 65 and not had a colonoscopy, barium enema, or flexible sigmoidoscopy in the last 10 years.

For more information call 888-355-6892

Read a description of the study on the EXACT Sciences website

Research confirms importance of starting colon cancer screening for women at age 50 --SEATTLE (October 21, 2002) - Women at average risk benefit from having colonoscopy in their fifties. An analysis of 1328 women who had screening colonoscopy for colorectal cancer revealed that 18% of women in their fifties and 21% of women in their sixties had adenomatous polyps -- a precursor of colon cancer.

Philip Schoenfiled, M.D., at the University of Michigan at Ann Arbor, presented the results of his analysis at the American College of Gastroenterology's Scientific Meeting.

Read the ACG Press Release here.

Elderly are able to tolerate and benefit from cancer drugs -- NICE, France (AP) October 21, 2002 -- Elderly patients without other health problems can tolerate cancer drugs better than doctors believe they can.

For cancer diagnoses, elderly patients are those over age 70. Usually these patients are not included in most clinical trials. Frequently these patients are not offered chemotherapy based solely on age.

Three studies of elderly patients with breast, ovarian, Hodgkins disease patients showed that patients who were fit, were not taking other medication, and did not have other illness, particularly heart or breathing conditions, did as well on therapy as younger patients.

The researchers urge a multidimensional geriatric evaluation that looks at other illness, medication, depression, and how well patients are able to care for themselves at home rather than basing decisions on age alone.


InteliHealth: Health News

No evidence that positive thinking can prolong the lives of cancer patients. NICE, FRANCE ( AP) October 20, 2002 --A review of eleven studies on the effect of positive thinking on the lives of cancer patients finds no evidence that such approaches prolong life. However, group support and other techniques do improve the quality of life.

Dr. Edzard Ernst, a professor of complementary medicine at the University of Exeter in England, led the study and reported it at the European Society for Medical Oncology.

"The data provided no evidence at all to show that these types of approaches prolong life in cancer patients," Ernst said.

He said, however, that he favors such efforts because they help cancer patients cope with their disease.

Read the AP story on Yahoo! News here.

Wireless endoscopy has strong potential for future (Medscape Medical News) October 11, 2002 -- Video capsule endoscopy was more sensitive than x-rays of the small bowel in diagnosing obscure gastrointestinal bleeding. The procedure was well-tolerated by the the 20 studied patients.

Guido Costamagna and colleagues from Catholic University in Rome, Italy reported their findings in the October issue of Gastroenterology.

In an accompanying editorial Douglas O. Faigel and M. Brian Fennerty, from Oregon Health and Science University in Portland wrote,
"Soon to come will be real-time imaging, devices to image the proximal gastrointestinal tract and colon, and devices that can take biopsies or provide therapy," they write. "The day may be fast approaching when we cut the umbilical cord and fully embrace wireless endoscopy as the new standard for imaging the gastrointestinal tract."

Read it here on Medscape.

Clinical trials show that glutathione reduces neurotoxicity during oxaliplatin treatment (Medscape) August 23, 2002 -- A randomized, double-blinding trial in Italy gave 52 patients either 1500 mg of glutathione or a 15 minute infusion of sterile water during bimonthly oxaliplatin treatments.

After the fourth treatment cycle, 7 glutathione patients and 11 placebo patients had clinically evident neuropathy. After eight cycles, 9 of 21 glutathione patients and 15 of 19 patients receiving placebo had neurotoxicity. Only two of the glutathione patients had the more serious grade 2 - 4 toxicity.

After 12 cycles, 3 treated patients and 8 untreated patients showed grade 2-4 neurotoxicity

The response rate to the oxaliplatin treatment was the same for both groups, showing no reductions in effectiveness with glutathione.

The authors, Stefano Cascinu, MD, and colleagues from the Universitaria di Parma in Italy, write, "These findings may have important clinical implications. In several cases, despite good clinical activity, treatment with oxaliplatin must be discontinued because of the onset of neurotoxicity," the authors write, noting expanding use of oxaliplatin in several other cancers as well as in the adjuvant setting. "The concomitant use of glutathione may allow the administration of an effective treatment for a more prolonged time. In fact, in the placebo arm, none of the patients could receive further oxaliplatin treatment because of the development of neurotoxicity; in the glutathione arm, seven patients did not develop any sign of clinical neurotoxicity and could continue on treatment."

Results were reported in the Journal of Clinical Oncology.2002;20(16):3478-3483.

Read article by Laurie Barclay, MD on Medscape here.

Iressa linked to deaths in Japan where it is approved as a treatment for lung cancer (ABC News-Reuters) October 15, 2002 -- Iressa, a drug that targets the epidermal growth factor receptors on cancer cells, has been implicated in the deaths of 13 lung cancer patients in Japan.

Japan was the first country to approve the drug, given in pill form, for non-small-cell lung cancer. It is in trials in the United States for lung cancer. There are also Phase I and II trials of the drug for metastatic colorectal cancer, where EGFR is positive in about 20% of patients.

The Japanese will change the drug's labeling to reflect the danger of pneumonia as a side effect of the drug.

Read the article here on ABCNEWS.com.

Reuters story on improved cancer survival --LONDON (Reuters) October 10, 2002 -- Using a newer rate of calculations, cancer survival rates are better than previously reported.

An estimated 57 percent of patients with all types of cancer are expected to be alive 10 years after being diagnosed, 53 percent will survive 15 years and 51 percent for 20 years.

The 20 year relative survival rate for colorectal cancer is 50%.

Read the article by Patricia Reaney on Yahoo! News.

Adjuvant chemotherapy in Stage III elderly patients is as effective as in younger patients (Journal of Clinical Oncology) October 1, 2002 -- A study of outcomes for older patients treated in the community with 5-FU shows a survival advantage over those who did not receive chemotherapy.

This advantage does not diminish as the patients get older.

The study was based on SEER and Medicare data of 3,357 elderly Medicare beneficiaries who had resection of Stage III colon cancer.

Read the abstract of the article by Theodore J. Iwashyna and Elizabeth B. Lamont in the Journal of Clinical Oncology.

Survival rates may be more optimistic than the usual quoted numbers
NEW YORK (The New York Times) October 11, 2002

Because survival rates are calculated based upon a "cohort" method which measures individuals whose disease was diagnosed 20 years ago and how many are alive today. That would base the 1998 statistical rate of survival on patients treated in 1978, with its screening and treatment possibilities.

The "period" method is a more sophisticated technique that multiplies the possibility of survival each year. It is currently used to compute life expectancy in populations of people.

Using the period method, a person diagnosed with cancer today would have a 51% chance of living 20 years, where under the ordinarily quoted cohort method, 20 year survival is only 40%.

Earlier detection and improved treatment have improved overall survival outlook for some cancers -- including colon and rectum -- significantly.

Dr. Hermann Brenner of the German Center for Research on Aging in Heidelberg used the National Cancer Institute's database to calculate new survival statistics.

Dr. Donald Berry, head of biostatistics at the M. D. Anderson Cancer Center in Houston, warned that overall survival numbers are too general for use with individual patients.

"No clinician — well, almost no clinician," Dr. Berry said, would simply quote to a patient the overall survival numbers for a type of cancer. Any good doctor making a prognosis, he said, takes into account the size of a tumor, how far it has spread, the patient's age, success rates of new treatments and other factors.

Dr. Brenner agrees, but points out that the current statistics are available to patients in many forms. including the internet.

He also says that for colorectal cancer early detection and better treatment produce genuinely longer lives.

Read The New York Times article by Donald G. Mc Neil, Jr.

Read The Lancet article by Hermann Brenner MD.

Clinical trial of an inplantable pump to deliver pain medication shows improved pain control and increased survival -- (Medscape Medical News) October 4, 2002 -- A randomized, multicenter trial compared an implanted pump to medical management of refractory cancer pain. Thomas J. Smith MD, from Virginia Commonwealth University in Richmond, reports that patients on the pump had better pain relief, had significantly fewer side effects, and survived longer, overall.

The implantable intrathecal drug delivery system (IDDS) is a small, battery-powered pump placed under the skin with a catheter leading to an opening in the spinal column.

Patients on IDDS required much smaller doses of pain medication. Fatigue and reduced levels of consciousness were significantly reduced. Six month survival was 54% in the IDDS group and 37.2% in the medical management group.

The study authors write, "A possible connection between pain control with reduced side effects and improved survival makes intuitive sense. Patients who feel better may be more active, have less chance of thromboembolism, achieve better nutrition, pursue and tolerate active treatment, and have more 'will to live.' "

The original article appears in the Journal of Clinical Oncology: J Clin Oncol. 2002;20(19):4040-4049.

Read the review by Laurie Barclay MD in Medscape Medical News.

Read the abstract of the original article in the Journal of Clinical Oncology.

Diet and reduced risk of cancer -- (American Cancer Society News Today) October 9, 2002

ACS reports on a review of studies relating cancer and diet written by Timothy J. Key, PhD from the UK Cancer Research Epidemiology Unit at Oxford in England, published in The Lancet (Vol 360:861-868).

Adequate intake of fruits and vegetables probably lowers the risk for some cancers, including those of the gastrointestinal tract.

Meat is related to colon cancer, but it is not clear how. Vegetarians do not have a lowered risk. The authors speculate that it may the preparation of meat -- high temperatures, smoking, curing -- that is related and not the meat itself.

Calcium and folic acid supplements show some promise in preventing pre-cancerous colon polyps, but there is no connection with other diet supplements.

Obesity (or perhaps lack of exercise) is related to colon cancer risk.

The authors say it is usually difficult to make clear correlations between specific diet practices and cancers because people do not always remember and report eating patterns accurately. In addition, other factors may be more important: for instance people who don't eat large amounts of fruits and vegetables may be smokers or not exercise.

Fiber has been discounted as related to colon cancer risk, according to the review.

Read it here onYahoo! Health News.

Read the original article in The Lancet. Free, registration required.

An additional study confirms equal effectiveness of oral UFT (Uracil/Tegafur) and 5-FU in treating metastatic colorectal cancer: (Journal of Clinical Oncology, September 2002) --

A randomized, Phase III study of 380 patients with metastatic colorectal cancer showed no difference in the time to progression of the disease whether treated with oral UFT with leucovorin or IV fluorouracil and leucovorin.

However, the oral regime had a significant safety advantage with less stomatitis/mucositis and myelosuppression, resulting in fewer episodes of febile neutropenia. There was also additional diarrhea with the 5-FU treatment.

Read the abstract in the Journal of Clinical Oncology

Oral Uracil/Tegafur is equivalent in effectiveness and superior in safety to IV 5-FU in Phase III study of patients with metastatic colorectal cancer: (Journal of Clinical Oncology, September 2002) -- A randomized Phase III study of 1800 previously untreated patients with metastatic colorectal cancer compared treatment with oral Uracil/Tegafur (UFT) and oral leucovorin (LV) with IV bolus 5-FU and leucovorin (FU/LV). There was no significant difference in survival and a 9 day difference in median time to progression that favored 5-FU.

However, diarrhea, nausea and vomiting, and mouth sores and irritation were significantly less frequent with UFT/LV. Patients in the UFT/LV arm of the study had fewer episodes of fevers due to low white cell counts and fewer documented infections.

Read the Abstract in the Journal of Clinical Oncology

A flawed gene increases risk of colon cancer in Ashkenazi Jews by a factor of two to three --WASHINGTON (AP) September 20, 2002 -- Ashkenazki Jews who have a mutation in the BLM gene are two to three times more likely to have colon cancer, according to a study by Kenneth Offit, a researcher at Memorial Sloan Kettering Cancer Center.

About 1% of Ashkenazi Jews have the mutation. There are 10 million Ashkenazi Jews worldwide, 2.5 million in Israel, and about 1 million in New York City.

Offit believes that studying the biological mechanism that links the BLM mutation to colon cancer may lead to a basic understanding of biological underlying the cause of all colon cancers.

Read it here on InteliHealth