Testing Guidelines for HNPCC Revised

National Cancer Institute -- February 17, 2004

An international panel of experts on hereditary colon cancer have revised the Bethesda Guidelines for which colorectal tumors should be tested for microsatellite instability (MSI), a factor in the diagnosis of hereditary non-polyposis colon cancer (HNPCC). The new guidelines are published in the February 18, 2004 issue of The Journal of the National Cancer Institute.

HNPCC usually occurs in patients under age 45 and is inherited directly. Under the new guidelines, patients with any of the following characteristics should have their tumors tested for MSI, with positive results followed up with genetic counseling and testing.

--The patient is younger than age 50.

--The patient has multiple HNPCC-associated tumors in the colon or in other areas known to be caused by the same mutations, either at the same time or occurring over a period of time.

--A patient younger than age 60 has colorectal cancer that has microscopic characteristics that are often indicative of MSI.

--A patient has one or more first-degree relatives who had an HNPCC-related tumor at age 50 or younger.

--A patient has two or more first- or second-degree relatives who had HNPCC-related tumors at any age.

HNPCC-related tumors include colon, rectum, endometrium, stomach, ovaries, brain, and skin.

Genetic testing can provide gudance for surveillance of other family members and follow-up care for patients who are identified with HNPCC.

Read the press release from the National Cancer Institute.

Cancer patients at high risk for blood clots

(Ivanhoe Newswire) February 3, 2004

As many as 15% of patients receiving chemotherapy for colorectal cancer with fluorouracil and leucovorin calcium (5-FU/Leucovorin) experienced blood clots, known as venous thromboembolism (VTE), according to a study in the Netherlands reported in The Archives of Internal Medicine. Clotting did not seem to be influenced by surgery, central venous catheters, or the amount of tumor.

Cancer patients overall had a 7.3% chance of having a blood clot within 3 months of chemotherapy. Over a year the risk increased to almost 11%.

The study authors believe that the risk for VTE is underestimated by physicians and that additional clinical trials should be done to evaluate the use of anti-coagulant drugs during chemotherapy, especially for patients with colorectal cancer.

The study results appear in The Archives of Internal Medicine Vol. 164 No. 2 - January 26, 2004.

Read the Ivanhoe.com article.

Read the abstract in The Archives of Internal Medicine.

Regular use of aspirin reduces colon polyp risk in women

(Ivanhoe newswire) -- February 3, 2004

A new analysis of data from The Nurse's Health Study reported in The Annals of Internal Medicine found that women who regularly took 2 or more standard aspirin tablets a week had 25% fewer colon adenomas (polyps) than women who reported no aspirin use.

More than 27,000 women were enrolled in the study and underwent lower endoscopy between 1980 and 1998. During that time 1,400 women were diagnosed with adenomas -- the colon polyps that can become cancerous.

More aspirins per week seemed to reduce risk the most, but the researchers found no connection to how long aspirin was used.

Currently, some doctors recommend a low-dose aspirin for colon polyp prevention. The study calls into question what the safest and most effective dose might be and recommends further studies to verify the results of information from the Nurse's Health Study and determine the best dose.

The study appears in The Annals of Internal Medicine - February 3, 2004 -- Volume 140 Issue 3 Pages 157-166.

Read the news story on Ivanhoe.com.

Read the abstract in The Annals of Internal Medicine.

Head of National Cancer Institute says that suffering and death from cancer can be eliminated by 2015.

American Association of Retired Persons -- December, 2003

Andrew C. von Eschenbach, M.D., director of the National Cancer Institute (NCI), in an interview for the AARP Bulletin says that 2015 is a reasonable goal for ending cancer death and its painful burdens. He does not believe that being diagnosed with cancer will never happen but that it will come to be a manageable chronic disease.

He told the interviewer, "Beyond that, I see a time coming when we'll be able to develop interventions that not only prevent and eliminate the disease in some people, but that also control cancer in others—much like we control high blood pressure and diabetes today. So thanks to research, there'll be people who will live with it and who will not die from cancer. There'll be others who won't get it in the first place."

Read the interview in AARP Bulletin Online.