Judah Folkman discusses future of antiangiogenic drugs -- (Scientific American) November, 2002

In an interview with writer Sergio Pistoi, Judah Folkman discusses clinical trials of angiostatin and endostatin. He also explains how Phase I and II trials work and why the process of clinical trials moves slowly with a radically different drug like the the antiangiogenics.

Read the Interview in Scientific American.

No link found between consumption of fried foods high in acylamide and cancer in humans -- STOCKHOLM (AP) January 29, 2003 -- Early research has not found a linke between acrylamide and an increased risk of colon, bladder, or kidney cancer.

Carbohydrate foods prepared at high temperatures, such as french fries, bread, and potato chips, contain high levels of acrylamide which has been shown to cause cancer in animals.

Researchers at Karolinska Institute in Stockholm and the Harvard School of Public Health in Boston, Mass., compared the diets of 987 cancer patients and 538 healthy people, who listed their food habits for an unrelated study four years ago.

The researchers found no increased risk, but some scientists question the study since the questionnaires were originally designed for another research purpose. They call the results "preliminary."

Read it here on Yahoo Health.

American Cancer Society Screening Guidelines for the Early Detection of Cancer 2003 -- (CA- A Cancer Journal for Clinicians) January 2003 -- Each year the American Cancer Society publishes the latest guidelines for screening and surveillence for several types of cancer. These include breast, cervical, endometrial, prostate, lung, and colorectal cancers.

The new colorectal screening and surveillence guidelines include some changes in frequency of testing and add immunochemical fecal occult blood tests for the first time.

In 2002 the US Preventive Services Task Force, which includes most of the key experts in colorectal cancer prevention, updated the guidelines after balancing evidence for both risk and benefits for the four recommended procedures. These are fecal occult blood testing, flexible sigmoidoscopy, colonoscopy, and double-contrast barium enema.

Tables for screening and surveillence of both average risk and higher risk individuals are part of this comprehensive article.

Read the article in CA here.

Emerging Screening Technologies -- (CA-A Cancer Journal for Clinicians) January 2003

This is the full article discussion in CA of new technologies to screen for colorectal cancer. The authors discuss virtual colonoscopy, a different approach to FOBT, and stool screening using markers that showed altered DNA. They also studied the video capsule that is swallowed and transmits pictures of the intestinal tract.

Iimmunochemical fecal occult blood tests (FOBT) like HemeSelect, !nSure, and Flexsure work differently than the traditional guaiac FOBT tests. Because they detect a protein in human blood rather than heme itself, they don't require that patients avoid certain foods and drugs for several days prior to the test.

With the exception of the immunochemical FOBT's, the authors determined that there was not yet sufficient evidence to recommend the new technologies (virtual colonoscopy, capsule endoscopy, stool DNA testing) as part of the guidelines for routine colorectal cancer screening.

Read the article in CA here.

Swedish study finds no convincing connection between foods with acrylamide and increased risk for colon cancer -- (British Journal of Cancer) 2003

Earlier work describes a modest association between cholecystectomy and the risk of colorectal cancer. We conducted a prospective study of 85 184 women, 36-61 years old, who had no history of cancer to evaluate whether known risk factors for colorectal cancer, including dietary history, that have not been controlled for in previous analyses can help explain the observed association. During 16 years of follow-up, 877 cases of colorectal cancer were documented and 1452 women who underwent endoscopy during the follow-up time were diagnosed with distal adenomas. After adjustment for age and other known or suspected risk factors, we found a significant, positive association between cholecystectomy and the risk of colorectal cancer (multivariate relative risk RR 1.21, 95% CI 1.01-1.46). The risk was highest for cancers of the proximal colon (RR 1.34, 95% CI 0.97-1.88) and the rectum (RR 1.58, 95% CI 1.05-2.36). However, we did not observe a significant association between cholecystectomy and distal colorectal adenomas. In this large prospective cohort study, a history of cholecystectomy appears to increase modestly the risk of colorectal cancer, even after adjustment for other colorectal cancer risk factors.

British Journal of Cancer (2003) 88, 79-83. doi:10.1038/sj.bjc.6600661



Dietary acrylamide and cancer of the large bowel, kidney, and bladder: Absence of an association in a population-based study in Sweden

Study shows increased risk for colorectal cancer following gall bladder surgery --(British Journal of Cancer)

Earlier work describes a modest association between cholecystectomy and the risk of colorectal cancer. We conducted a prospective study of 85 184 women, 36-61 years old, who had no history of cancer to evaluate whether known risk factors for colorectal cancer, including dietary history, that have not been controlled for in previous analyses can help explain the observed association. During 16 years of follow-up, 877 cases of colorectal cancer were documented and 1452 women who underwent endoscopy during the follow-up time were diagnosed with distal adenomas. After adjustment for age and other known or suspected risk factors, we found a significant, positive association between cholecystectomy and the risk of colorectal cancer (multivariate relative risk RR 1.21, 95% CI 1.01-1.46). The risk was highest for cancers of the proximal colon (RR 1.34, 95% CI 0.97-1.88) and the rectum (RR 1.58, 95% CI 1.05-2.36). However, we did not observe a significant association between cholecystectomy and distal colorectal adenomas. In this large prospective cohort study, a history of cholecystectomy appears to increase modestly the risk of colorectal cancer, even after adjustment for other colorectal cancer risk factors.

British Journal of Cancer (2003) 88, 79-83. doi:10.1038/sj.bjc.6600661



Cholecystectomy and the risk for developing colorectal cancer and distal colorectal adenomas

New Screening and Surveillance Guidelines from the American Gastroenterological Association (Gastroenterology) February, 2003 -- The colorectal cancer guidelines developed in 1997 by the joint GI Consortium have been reviewed and revised. Updated guidelines are published in the February 2003 issue of Gastroenterology.

A few of the key changes include:

Frequency of double-contrast barium enema downgraded to every 5 years from every 5 to 10 years because its sensitiveity is lower than colonoscopy.

Colonoscopy should be relied on exclusively for the diagnostic investigation of patients with findings on screening, for post-polypectomy surveillance and for patients with a family history of non-polyposis colorectal cancer.

Virtual colonoscopy remains an investigational tool.

Most patients with adenomas less than 1 cm should have repeat scopes in 5 rather than 3 years.

The U.S. Multisociety Task Force on Colorectal Cancer is comprised of representatives of the AGA, ACG, ACP-ASIM and ASGE

Read the press release here.

Combination chemotherapy produces tumour regression in oligodendroglioma/oligoastrocytoma
Jan. 23, 2003 - Researchers in the United States report that combination chemotherapy with procarbazine, lomustine and vincristine (PCV), administered before radiation, produces tumour regression in a meaningful proportion of patients with low-grade oligodendroglioma/oligoastrocytoma (LGO/LGOA).
Read a Doctor's Guide review of the Journal of Clinical Oncology article here.

Do doctors profit unfairly by charging patients for chemotherapy drugs? NEW YORK (NY Times) January 26, 2003 -- For a decade, oncologists have purchases chemotherapy drugs at a dscount and charged patients and insurers high prices for them.

The physicians say that the increased reimbursement for drugs helps cover the large cost of administering them, but both government Medicare programs and insurers are questioning this practice.

Pharmaceutical companies may supply drugs at a huge discount to physicians, but this discount is not passed on to patients. For instance, a dose of leucovorin may cost the doctor $3. The charge to patient and insurer is $17.50, with some patients paying $3.50 out of pocket.

Insurers in some areas are increasing payments for administration of chemotherapy if oncologists allow insurers to purchase and supply the drugs. Medicare is also considering changes to the system, including not paying for prescription drugs administered in physician offices.

Some insurers also question whether physicians can remain objective in deciding who should receive chemotherapy and for how long. A study in 2001 found that 1/3 of chemo patients were being treated in the last six months of their lives, even when their cancers were considered unresponsive to therapy.

Read the NY Times article here.

American Cancer Society releases new ACS Cancer Facts & Figures 2003 -- (ACS News Today) January 22, 2002

The American Cancer Society has released its annual January estimate to numbers of new cancer cases and deaths for 2003.

Lung cancer continues to be the leading cause of cancer death. ACS estimates that there will be 157,200 deaths from lung cancer in 2003.

Colorectal cancer is the second leading cause of death with an expected 57,100 deaths and 147,500 new cases.

While there are significantly more new cases of both breast cancer (212,600) and prostate cancer (220,900), deaths from these two causes are lower than for colorectal cancer. 40,200 are expected to die from breast cancer in the coming year and 28,900 from prostate cancer.

The entire report is available online along with Cancer Prevention & Early Detection Facts & Figures 2003 which include information on risk factors such as tobacco use, nutrition, physical activity, obesity, and cancer screening.

Read the ACS news release onYahoo! Health News.

FOBT after colon cancer surgery detects recurrent cancer and new polyps with very high degree of success -- (Colorectal Disease - January 2003)

Results Six hundred and eleven patients had both FOBT and colonoscopy. Fifty-nine (13.6%) were categorized as FOBT-positive.

FOBT provided sensitive detection of recurrent cancer in a group of 611 patients scheduled for follow-up colonoscopy. A sample for FOBT was obtained during rectal exam. Fifty-nine tests were positive for fecal occult blood. Of these, there were 9 cancers and 12 adenomatous polyps.

In the remaining 552 FOBT-negative patients, no cancers were found. Thirty-eight patients had polyps removed.

The authors of the study conclude that " The immunological faecal occult blood test provides sensitive detection of metachronous and recurrent cancer in postoperative surveillance. Routine application may be used to reduce the frequency of colonoscopic surveillance, as a negative FOBT may be taken as a sign that colonoscopy may be deferred safely."

Results of the study by P. Skaife, F. Seow-Choen, K. W. Eu and C. L. Tang at Singapore General Hospital appear in Colorectal Disease
Volume 5 Issue 1 Page 45 - January 2003.

Read the abstract here.

Five year rnadomized, doubled-blinded study of British individuals at high risk for coronary disease showed no effect of antioxidant vitamin therapy on heart attack, stroke or cancer. (APC Journal Club) January 2003 -- As reported in The Lancet, more than twenty thousand people who were at risk for a coronary or vascular event because of previous history, diabetes, hypertension, or blood clots were treated with vitamin therapy.

After five years there were no differences in deaths or in incidence of coronary events, stroke, or cancer.

Ten thousand patients received a combination of 600 mg Vitamin E, 250 mg vitamin C, and 20 mg beta-carotene. The other ten thousand received placebo.

Read a discussion of the Lancet article here on American College of Physicians Journal Club.