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Tuesday, July 19, 2016

Overweight or obese women who lost weight through diet or a combination of diet and exercise also significantly lowered levels of proteins in the blood that help certain tumors grow, according to a Fred Hutchinson Cancer Research Center study published July 14 in Cancer Research (doi: 10.1158/0008-5472.CAN-16-0399).

The study measured three proteins that are known to enhance tumor-related angiogenesis – the formation of blood vessels that feed tumors and enable them to grow. It was intended to see how cancer-promoting proteins changed when overweight, sedentary, postmenopausal women lost weight through diet or diet and exercise over the course of a year. The study enrolled 439 healthy women (they did not have cancer), placing each participant in one of four study arms: calorie- and fat-restricted diet; aerobic exercise five days a week; combined diet and exercise; and control (no intervention).

Study data found that women in the diet arm and the diet and exercise arm lost more weight and had significantly lower levels of angiogenesis-related proteins, compared with women in the exercise-only arm and the control arm.

The authors said that it is known that being overweight and having a sedentary lifestyle are associated with increased risk for developing certain cancers, but the reasons for this relationship are not clear.

This study shows that weight loss may be a safe and effective way to improve the "angiogenic profile" of healthy individuals, meaning they would have lower blood levels of cancer-promoting proteins. Although the researchers cannot say for certain that this would impact the growth of tumors, they believe there could be an association between reduced protein levels and a less favorable environment for tumor growth.​

Thursday, July 14, 2016

While active surveillance is often recommended for patients with nonaggressive prostate cancer to reduce unnecessary treatment, the challenge for clinicians is to monitor and distinguish early-stage tumors from advanced cancers. A team of scientists led by researchers from Roswell Park Cancer Institute, Buffalo, N.Y., have demonstrated photoacoustic imaging (PAI) may be an effective tool for more accurately viewing and monitoring prostate cancer. The new research has been published in the June 2016 issue of the Journal of Biomedical Optics (doi:10.1117/1.JBO.21.6.066019).

PAI is an emerging noninvasive imaging modality that has not yet been used in clinical settings. Using PAI, this team of scientists focused a laser light on prostate cells and then "listened" using ultrasound technology to see how a dye attached to a specific prostate cancer marker, PSMA, reacted to the light waves. They chose to study this technology's use in imaging prostate cancer, as the prostate can be imaged in situ. PAI of these prostate cells, the researchers found, enabled good discrimination between cells with and without the cancer marker.

"This proof-of-concept study demonstrates that this technology may allow for real-time monitoring of prostate cancer in patients during the course of active surveillance. For patients with more aggressive disease, the technology could offer more precise targeting of biopsies to confirm the need for definitive therapy," says senior author of the study Kent Nastiuk, PhD, Assistant Professor of Cancer Genetics and Genitourinary Cancers at Roswell Park. "This technology offers the potential to confirm the initial prostate cancer diagnosis, guide biopsies and monitor tumor volume—which is currently not measureable—for improved case management and treatment decision-making."


Friday, July 8, 2016

A single breath may be all it takes to identify the return of lung cancer after surgery, according to a study authored by University of Louisville Researchers and posted online by The Annals of Thoracic Surgery (doi: 10.1016/j.athoracsur.2016.04.068).​

Exhaled breath contains thousands of volatile organic compounds (VOCs) that vary in composition and pattern depending on a person's health status. A subset of four VOCs—called carbonyl compounds because of their carbon base—have been discovered in the exhaled breath of lung cancer patients. Being able to identify this lung cancer "signature" through a simple breath test has emerged as one of the most promising ways to diagnose the disease. Now the test is being used to monitor for disease recurrence.

Erin M. Schumer, MD, Victor van Berkel, MD, PhD, and colleagues from the University of Louisville analyzed breath samples collected before and after surgery from 31 lung cancer patients and compared their carbonyl VOCs levels with samples from 187 healthy patients.

The researchers found a significant decrease in overall carbonyl VOC levels following surgery; in fact, three of the four carbonyl VOCs normalized after surgery, matching levels in the control group.

"The rapid normalization of almost all of the four compounds after surgery provides strong evidence that they are directly produced by the tumor environment," Schumer said. "This study confirms that the technology is accurate."

Lung cancer is the leading cause of cancer death. The American Cancer Society estimates that more than 224,000 Americans will be diagnosed with lung cancer this year, and more than 158,000 lung cancer patients will die—that translates to 433 lung cancer deaths per day in the United States.

Schumer said those grim statistics underscore the need for early detection, "We hope that breath analysis will allow us to diagnose patients with primary or recurrent lung cancer long before they suffer from symptoms, when we have more options for treating them, giving them the best chance for cure."

Currently, lung cancer patients are followed after surgery with chest computed tomography (CT) scans, which can be inconvenient, expensive, and expose the patient to radiation. "We hope that the breath analysis can serve as the primary screening tool for cancer recurrence and a CT scan ordered only if the breath test suggests that there has been a change," van Berkel said.

The process of breath analysis is relatively simple. The patient blows a single breath into a specialized balloon. The balloon is then connected to a pump that pulls the breath over a small microchip that is smaller in size than a quarter, trapping the chemicals. The microchip is sent to the lab, where the chemicals are analyzed within hours. Breath collection can be performed in the doctor's office.

The pump is reusable; the balloon, microchip, and lab test together cost around $20, all supporting the increasing acceptance of breath tests as a cost-effective, easy-to-perform, non-invasive and rapid option for the diagnosis of lung cancer.

"The great potential with breath analysis is detecting lung cancer at any point, both as a primary screening tool and to follow patients after disease has been treated," van Berkel said. "The technology is pretty robust. Our next step is getting approval from the FDA."

Wednesday, July 6, 2016

The first-ever record of a tumorous facial swelling found in a fossil has been discovered in the jaw of the dwarf dinosaur Telmatosaurus transsylvanicus, a type of primitive duck-billed dinosaur known as a hadrosaur.

An international group of researchers, including Kate Acheson, a PhD student at the University of Southampton, have documented a type of non-cancerous facial tumor, which is found in humans, mammals, and some modern reptiles, but never before encountered in fossil animals.

"This discovery is the first ever described in the fossil record and the first to be thoroughly documented in a dwarf dinosaur," said Acheson. "Telmatosaurus is known to be close to the root of the duck-billed dinosaur family tree, and the presence of such a deformity early in their evolution provides us with further evidence that the duck-billed dinosaurs were more prone to tumors than other dinosaurs."

The hadrosaur fossil, estimated to be approximately 69-67 million years old, was discovered in the 'Valley of the Dinosaurs' in the UNESCO World Heritage Site, the Haţeg County Dinosaurs Geopark in Transylvania, western Romania.

"It was obvious that the fossil was deformed when it was found more than a decade ago but what caused the outgrowth remained unclear until now," said Dr. Zoltán Csiki-Sava of the University of Bucharest, Romania, who led the field trip which uncovered the fossil. "In order to investigate the outgrowth, our team was invited by SCANCO Medical AG in Switzerland to use their Micro-CT scanning facilities and to 'peek' un-intrusively inside the peculiar Telmatosaurus jawbone."

The scans suggested that the dinosaur suffered from a condition known as an 'ameloblastoma', a tumorous, benign, non-cancerous growth known to afflict the jaws of humans and other mammals, and indeed some modern reptiles, too.

Dr. Bruce Rothschild, from the Northeast Ohio Medical University and a worldwide expert in palaeopathology (the study of ancient diseases and injuries) who studied the Micro-CT scans, said: "The discovery of an ameloblastoma in a duck-billed dinosaur documents that we have more in common with dinosaurs than previously realized. We get the same neoplasias."

"It was expected, due to the impoverished nature of the fauna, that our project to investigate diseases of the bone in the dwarf dinosaurs of the Haţeg County Dinosaurs Geopark would reveal some interesting results, but the discovery of a rare modern tumoral condition, and one that is so far unique in the fossil record, was a wonderful surprise," explained Mihai Dumbravă, PhD student at Babeş-Bolyai University in Cluj-Napoca, Romania and lead author of the study, published in the journal Scientific Reports.

It is unlikely that the tumor caused the dinosaur any serious pain during its early stages of development, just as in humans with the same condition, but researchers can tell from its size that this particular dinosaur died before it reached adulthood. Since its preserved remains consist of only the two lower jaws, no one can ascertain its cause of death. The researchers were left wondering, nonetheless, whether the presence of the ameloblastoma could have contributed to its death.

"We know from modern examples that predators often attack a member of the herd that looks a little different or is even slightly disabled by a disease. The tumor in this dinosaur had not developed to its full extent at the moment it died, but it could have indirectly contributed to its early demise," said Csiki-Sava.

"The particular make-up of the rocks allowed us to identify that this fossil was preserved near the channel of an ancient river. In a setting like this, it is extremely rare to find the complete specimen, and so it is almost impossible to determine the specific cause of death. One can only make an informed guess based upon the evidence we have," added Acheson.​

Friday, July 1, 2016

Improved cancer detection and treatment efforts, combined with demographic trends, are creating larger numbers of older cancer survivors who are likely to have other health conditions that impact care and well-being.

Researchers have been anticipating a growing number of older Americans, sometimes referred to as a "silver tsunami." Meanwhile, advances in cancer detection and treatment mean that more people are surviving cancer. "Understanding the impact of a graying nation on cancer prevalence is critical in informing efforts to design and implement quality cancer care for this population," said the study's lead author," said Shirley M. Bluethmann, PhD, MPH, a cancer prevention fellow at the National Cancer Institute in Bethesda, Md., and author of a study recently published in Cancer Epidemiology, Biomarkers & Prevention (2016:25;1029), a journal of the American Association for Cancer Research. 

Methodology & Results

Bluethmann and colleagues based their study on incidence and survival data from 1975-2012, obtained from the Surveillance, Epidemiology, and End Results (SEER) Program.

They projected U.S. cancer prevalence from 2016 to 2040 by using U.S. Census Bureau data, and applying the Prevalence Incidence Approach Model. SEER data linked with Medicare claims were used to estimate comorbidities commonly experienced in older adults, including health conditions such as heart disease, lung disease, or diabetes. The study showed:

  • In 2016, there are approximately 15.5 million cancer survivors in the United States, and 62 percent of that group is 65 or older. By 2040, the study projects, there will be 26.1 million cancer survivors, and 73 percent of them will be 65 or older.
  • The oldest age groups will come to represent a larger proportion of the population of cancer survivors. In 2040, survivors ages 65-74 will account for 24 percent of all survivors, those 75-84 will account for 31 percent of all survivors, and those 85 and older will represent 18 percent of all survivors. Compared with the prevalence estimates for 1975, the projected prevalence estimates in 2040 show a 6-fold increase for those 65-74 years, a 10-fold increase for those 75-84 years, and a 17-fold increase for those 85 years and older.
  • Overall current cancer prevalence is similar between men and women of all ages. However, in older age groups, the disease is more prevalent among men. In the 65-69 age group, 14 percent of men and 12 percent of women have been diagnosed with cancer. The gap widens consistently as people age, and in the oldest group, age 90 and up, 37 percent of men and 25 percent of women have been diagnosed with cancer. Bluethmann said this gap is most likely related to higher numbers of prostate cancer survivors, which is typically diagnosed in men at older ages.
  • Increasing age increases the chance that cancer survivors will suffer from one or more comorbid conditions. Among cancer survivors ages 65-69, 27 percent had a history of severe comorbidity. Among cancer survivors ages 85 and older, 47 percent had severe comorbid conditions.

Study Limitations

Bluethmann noted that that the population projections are estimates, based on current cancer control efforts. Further, the researchers considered steady rates of incidence and survival to generate prevalence estimates.

A shift in either of these trends over the long term could mean that that these results under- or over-estimate the true impact. However, these projections are believed to be the first to project cancer prevalence in an aging context to 2040.​

Practice Impact

Bluethmann said older adults are understudied, presenting challenges in delivering effective and age-appropriate cancer care. For example, she said, the comorbid conditions that many older adults experience may make them ineligible to participate in clinical trials.

"Because of this, we lack key data which would inform how geriatric populations would react to or benefit from precise cancer treatments or interventions," she said. Bluethmann said her study adds to evidence that shows that older adults often have complex health needs that must be addressed in efforts to deliver high-quality health care.

"We have known about the potential impact of the maturing baby boom generation for some time, but this study provides compelling, specific evidence of the impact of cancer on older Americans, now and in the future," Bluethmann said. "The changing demographics of this country are unmistakable, and it's time to rethink our approach to aging and cancer."

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