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Cancer declines overall, but some types increase
Reported NEW YORK (Reuters Health) June 06, 2001
According to a report in the June 6th issue of the Journal of the National Cancer Institute, researchers led by Dr. Holly L. Howe of the North American Association of Central Cancer Registries in Springfield, Illinois., over much of the 1990s, deaths from cancer declined slightly in the US, but the number of Americans diagnosed with certain cancers--including breast, skin and liver cancer--inched up.
The most recent data from the American Cancer Society's annual report on cancer facts and figures, shows that the number of new cancer cases and deaths in the US for 2001 is predicted to increase slightly from last years figures. Although the total numbers are rising, it is being reported that cancer rates have been slowly dropping in the US throughout the 1990s. They say the increase in total cases reflects the fact that the US population is growing. The report indicates:
- The total number of people who will get a diagnosis of cancer is likely to reach 1,268,000 in 2001, marginally up from 1,220,100 predicted for 2000.
- Total deaths predicted for 2001 -- 553,400 -- is almost the same as last year's expected number, 552,200.
For more details, go to our Cancer Statistics page.
Alternative Medicine Here To Stay, Harvard Study Says
Will the demand for complementary and alternative medicine fade or is it here to stay? While U.S. medical schools are developing complementary and alternative medicine (CAM) course work, and managed care organizations are providing some coverage for CAM therapies, little data existed to answer this question. Until now.
A new study by Harvard Medical School researchers, looking at trends over the past half-century, suggests that CAM is indeed here to stay for the foreseeable future. The study, which appears in the August 21 Annals of Internal Medicine, examined trends in the use of 20 different CAMs, covering everything from acupuncture to yoga, among representative socio-demographic groups across the continental U.S.
"The findings dispel two ideas, namely that complementary and alternative medicine is just a passing fad, and that it is used by one particular segment of society," said Ronald Kessler, Harvard Medical School professor of health care policy.
Data compiled from over 2,000 interviews did show a trend towards the use of these therapies in younger respondents; by age 33, 7 out of 10 post-baby boomers (born 1965-79) had used some type of CAM, compared to 5 out of 10 baby boomers (born 1945-64), and 3 out of 10 pre-baby boomers (born before 1945). However, in all age groups the use of CAMs has steadily increased since the 1950s.
Some individuals reported using alternative therapies for many years. Of those respondents who had tried an alternative therapy, almost 50 percent were still using it 11 to 20 years later. This persistence is consistent with findings in a previous study that suggested most CAM therapies are used-at least in part-as preventative measures or as part of a regular fitness program.
While all therapies showed increased usage over the decades, the study yielded interesting insights into the timing of societal adoption of particular therapies. In the 1960s, four particular therapies increased markedly-commercial diet programs, lifestyle diet therapy, megavitamin therapy, and self-help groups. The 1970s showed increased use of biofeedback, energy healing, herbal medicine, and imagery. During the 1980s, massage and naturopathy increased, while yoga decreased in popularity. The 1990s showed particular increased adoption of aromatherapy, energy healing, herbal medicine, massage, and yoga.
The authors caution that while the data indicates that the demand for alternative medicine will continue and may well grow, their analysis cannot predict dramatic events that may tip prevalence patterns in one direction or another.
The study was supported by the National Institutes of Health, the John E. Ferzer Institute, the American Society of Actuaries, Friends of Beth Israel Deaconess Medical Center, the Kenneth J. Germeshausen Foundation, and the J.E. and Z.B. Butler Foundation. - By John Lacey
For more information, go to Http://www.unisci.com/stories/20013/0821016.htm.
Coping With Cancer: A Psychosocial Approach
Robert S. Mocharnuk, MD
European Cancer Conference, ECCO 11 - Day 1 - October 21, 2001
The events of September 11th at the World Trade Center and the Pentagon have affected every informed individual across the globe to some extent. Dr. David Spiegel, Professor of Psychiatry at Stanford University in California, compared the degree and the diversity of responses to the September 11th attacks to those reactions experienced by cancer patients at any given point in their illness. Cancer is a compendium of stresses, which includes the fear and the diagnosis of cancer, the nature of treatment decisions, confronting one's mortality, physical limitations as well as physical and emotional pain, the arduous treatments to be endured, and the changes that one's social and family environments undergo.
Unlike other medical specialties in which the majority of physician interventions are designed to make patients feel better, the medical oncologist typically offers treatments that make the patient feel worse, no matter what the outcome. This places the medical oncologist at a great disadvantage, further complicating the physician/patient interaction. As a result, patients are conditioned to expect the worst from oncologists.
That being said, most cancer patients behave in ways reminiscent of posttraumatic stress disorder. Comparative data suggest that cancer patients react in the same fashion as sexual assault victims. The resulting depression is similar in nature, and is worse when faced alone. The ranks of the depressed grow from a general population baseline of 3%, to 6% among cancer outpatients, to 12% among cancer inpatients. Major depression characterized 1 of every 5 terminal ill patients, and 60% of individuals who requested assisted suicide are suffering from major clinical depression. The latter finding raises the provocative question of whether physicians ought to be treating the depression instead of supporting physician-assisted suicide.
While numerous individual and group psychosocial treatment models exist, Dr. Spiegel focused on the group supportive expressive treatment model, which he employs almost exclusively in managing cancer patients. This model is predicated upon building social bonds, allowing for the discussion of common problems. Patients collectively view their reactions as normal and learn to find meaning in their own tragedies. Patients often choose to overcome the social isolation of illness by helping others to feel better through the sharing of their own experiences. This model encourages emotional expression, rather than attempting to suppress or channel it.
This environment supports facing feelings directly while restructuring those feelings in a supportive social context. Emotion is valued as a source of closeness, and not a cause of isolation. Patients are taught that cancer is not deserved and that it's acceptable not to put on a false happy face. While individuals are conditioned to treat crying as if they are bleeding -- in other words, suppress with pressure -- the group dynamic allows one, in the words of Shakespeare's Macbeth to "give sorrow words." Studies have shown that those who suppress suffer much higher rates of depression than those who express.
Group members are taught how to detoxify dying by restructuring their fears into components, including the process of dying, separation from loved ones, loss of control, and pain. Active coping strategies are taught and existential discussions are not uncommon. As a result, life's priorities are often reordered, particularly for those individuals whose treatments are not, nor have been, curative. Given limited and finite time frames, individuals sometimes develop a life project, a goal to be achieved, an event to be attended, a task to be completed.
Cancer's effect on the patient's family is acknowledged and methods for coping with this burden are explored. Participants are taught to appreciate the differences between male and female approaches to the same problem.
Patients are guided in terms of what to expect when dealing with doctors. Communication, control, and caring are essential components. Physicians should use plain language in speaking with patients and answer questions up front. The presence of family members and friends should be allowed during important discussions. It's okay to write down questions and treatment options, and one has the right to expect timely diagnostic and treatment schedules.
Physicians should identify areas of patient choice and encourage patients to make those choices. Alternative treatment approaches and patient-initiated explorations should be open to discussion. Physicians should use direct eye contact, acknowledge patient distress, express concern, and allow for interruptions during discussion.
Finally, patients learn ways to control symptoms of cancer or of treatment. Self-hypnosis has been shown in several studies to reduce the need for pain medication by up to 50%. Patients are also taught the difference between good and poor coping strategies.
Does Group Therapy Work? The Evidence
In an ongoing study that has enrolled 103 of 125 women for randomization to group supportive expression therapy vs. no therapy, interim data show a greater decrease in the impact of events scale (ie., posttraumatic stress) index when compared with the control group. A multicenter study in which patients with primary breast cancer received 12 weeks of group therapy also showed a significant reduction in anxiety among patients with high baseline clinical anxiety.
Earlier data from Spiegel translate this reduction in anxiety to survival improvement among women with metastatic breast cancer. At 48 months, all control patients had died, while one third of those receiving group therapy were alive. With the advent of more modern therapies, the old survival data for both control and group therapy cohorts have been exceeded, but future data will likely show a continued benefit to group therapy.
Although some trials[3,4] support Spiegel's findings that group treatment improves survival in a number of cancer types, other studies[5,6] have shown no benefit.
Mediators of enhanced survival included improved patient self-care and health behavior, and increased adherence to treatment. There were also changes observed in biologic pathway; specifically, neurologic, immunoregulatory, and endocrine pathways. Indeed, McEwen has shown that a perpetual stressed state, termed an "allostatic load," does correlate with decreased immune status. Similarly, Sephton and colleagues noted reduced survival and flattened diurnal cortisol levels among breast cancer patients that correlated with an increase in anergy of the immune system and a decline in natural killer cell activity. Within the last year, additional studies have drawn a link between decreased cortisol levels and cancer progression.
Clearly, there is more to psychosocial therapy in the overall scheme of cancer management than meets the eye. The data presented above suggest that, particularly for individuals with high levels of anxiety and poor coping skills, group therapy may be more than an ancillary component in the great treatment plan.
- Spiegel D. Psychological aspects of cancer care. Eur J Cancer. 2001;37(suppl 6):149. Abstract 546.
- Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989;2:888-891.
- Fawzy FI, Fawzy NW, Hyun CS, et al. Malignant melanoma: effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Arch Gen Psychiatry. 1993;50:681-689.
- Kuchler T, Henne-Bruns D, Rappat S, et al. Impact of psychotherapeutic support on gastrointestinal cancer patients undergoing surgery: survival results of a trial. Hepatogastroenterology. 1999;46:322-335.
- Linn MW, Linn BS, Harris R. Effects of counseling for late stage cancer patients. Cancer. 1982;49:1048-1055.
- Cunningham AJ, Edmonds CV, Jenkins GP, Pollack H, Lockwood GA, Warr D. A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology. 1998;7:508-517.
- McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338:171-179.
- Sephton SE, Sapolsky RM, Kraemer HC, Spiegel D. Diurnal cortisol rhythm as a predictor of breast cancer survival. J Natl Cancer Inst. 2000;92:994-1000.
- Spiegel D, Sephton SE. Psychoneuroimmune and endocrine pathways in cancer: effects of stress and support. Semin Clin Neuropsychiatry. 2001;6:252-265.
New type of leukemia identified
WESTPORT, CT (Reuters Health) - Using whole-genome profiling, investigators have determined that a rare type of acute lymphoblastic leukemia (ALL) that affects infants and does not respond to standard chemotherapy is actually a unique type of leukemia.
Patients with "mixed-lineage leukemia" (MLL) carry a chromosomal translocation involving the mixed-lineage leukemia gene on chromosome 11. The investigators determined that MLL reflects a very early B-cell progenitor that has initiated transdifferentiation.
Dr. Scott A. Armstrong, of Dana-Farber Cancer Institute in Boston, and colleagues compared gene expression profiles of leukemic cells from 10 patients with conventional childhood ALL and 17 patients affected with the MLL gene translocation. The results appear in the advance online edition of Nature Genetics for December 3.
Approximately 1000 genes were underexpressed in MLL, many of which have a function in early B-cell development, Dr. Armstrong's team found. In addition, there were about 200 genes more highly expressed than in conventional ALL.
The researchers then carried out a principal component analysis using the gene expression profiles of MLL, ALL and acute myelogenous leukemia (AML) specimens. Again, their results showed the MLL samples to be largely genetically distinct from the other two types of leukemia.
Conventional ALL samples expressed high levels of lymphoid-specific genes, whereas AML samples expressed more myeloid-specific genes. MLL, on the other hand, expressed genes primarily associated with hematopoietic progenitors.
Dr. Armstrong's team conducted a cross-validation study using 20 ALL samples, 17 MLL samples, and 20 AML samples. The model they generated was 95% accurate in assigning samples to the appropriate class, reinforcing the strong distinctions among the three categories of leukemia.
"This finding is very exciting to us because it forces us to think about this as a separate disease and to think about other therapies" that could be designed to attack its specific weak points, Dr. Armstrong said in an Institute press release.
-Westport Newsroom 203 319 2700, Posting Date: December 3, 2001
as reported by oncolink.com http://www.oncolink.com/templates/resources/article.cfm?c=3&s=8&ss=23&Year=2001&Month=12&id=7812
NCI agrees to review the 714X treatment
Read how a small but dedicated group of cancer patient activists in Eastern Massachusetts helped to bring to light what they describe as a possible cover-up of promising, preliminary test results of 714X, a controversial unconventional cancer treatment from Canada, at the prestigious Dana-Farber Cancer Institute in Boston. A subsequent avalanche of media reporting about the story in the Boston area resulted in Dana-Farber calling on the National Cancer Institute (NCI) to undertake a formal review of 714X, which the NCI's Office of Cancer Complementary and Alternative Medicine (OCCAM) has agreed to do. Go to http://www.naturalhealthline.com/newsletter/1june01/714x.htm for an article written by Peter Chowka about this.
Plant Hormones Offer New Weapon Against Cancer
May 2001 - Reuters and Health Media Ltd
Prof Peter Wardman of the Gray Cancer Institute/Cancer Research Campaign (CRC) in the UK, has found that the plant molecule indole acetic acid (IAA) could be converted to produce toxic oxygen radicals, which destroy 99.9 per cent of cancerous cells while leaving healthy cells undamaged. This means IAA treatment could result in fewer side effects, such as hair loss, than other cancer treatments.
Using an enzyme from horseradish - horseradish peroxidase - researchers were able to convert IAA to its toxic radicals. They were then able to target the IAA activation against malignant cells by attaching an antibody against cancer to the peroxidase molecule. Other researchers found a second route of activation using gene therapy, whereby IAA killed cells transfected with the gene for the peroxidase.
The third and promising activation route discovered by Prof Wardman's team involved covering cancerous cells with a photosensitising dye and exposed them to red light. This produced an excited state to activate the IAA, even in hypoxic conditions, which commonly exist with cancers. However, the technique would be limited to tumors that are accessible to light.
The work has been successful in many tumour cell lines in the laboratory. Human trials are still some years away. We'll report news as we hear more.
Scientists discover how key gene checks cancer
Source: www.cancerfacts.com - Friday, June 08, 2001
CHAPEL HILL, N.C. -- June 8, 2001 -- New research published in the journal Science explains how the tumor suppressor gene, p53, is activated in response to DNA damage to keep tumors from forming. About half of all human cancers possess defective copies of the p53 gene. Thus, the new findings may have implications for the development of drugs aimed at boosting p53 activity in cancer patients.
Led by Dr. Yue Xiong, scientists at the University of North Carolina's Lineberger Comprehensive Cancer Center discovered an amino acid sequence within p53 that is responsible for transporting the protein from the cell nucleus to the cytoplasm, where it would get degraded or broken down. Moreover, they discovered how this transport is blocked when DNA damage occurs. According to Xiong, "P53 is not needed in normal cell growth under conditions of no DNA damage. Otherwise, the cell won't be able to grow. So the cell handles that by exporting p53 from the nucleus to the cytoplasm for degradation."
The gene normally monitors biochemical signals indicating the occurrence of DNA damage or mutations associated with tumor development. When such signals occur, the transport pathways are blocked and the p53 protein accumulates in the cell nucleus where it can either trigger the cell to self-destruct or stop its cycle of growth. The new study shows the mechanism underlying P53 activation induced by DNA damage. They found that the addition of the phosphate inhibits the export of p53 to the cytoplasm. "When that gene is broken, DNA damage cannot be repaired because P53 is continually exported to the cytoplasm and getting degraded there," Xiong says.
It is hoped that they can develop a compound to block p53 export to restore p53 function in tumor cells with mutated kinase genes.
Indian cancer researchers have been studying Methylglyoxal for treating late stage cancers. However, studies in the U.S. are not as promising. If we find out any additional information on this drug, we will put it on our News Page.
Study indicates oily fish might ward off prostate cancer
June 01, 2001
LONDON (AP) - Eating even moderate amounts of oily fish such as mackerel, tuna, salmon and sardines might cut the risk of prostate cancer. Omega-3 fatty acids, plentiful in dark, oily fish, have shown promise in protecting against cancers of the colon, rectum and ovary.
A study published in The Lancet medical journal, found that Swedish men who ate greasy fish only occasionally or not at all were twice as likely to develop prostate cancer as those who made it a moderate or large part of their diet.
Dr. Regina G. Ziegler, a nutritional epidemiologist at the National Cancer Institute, was cautious about the Swedish findings. Ziegler feels that people who seldom or never eat fish tend to substitute with more red meat and scientists believe animal fat - butter, cream, beef, pork and processed meats - may encourage prostate cancer.
Sardines have the most omega-3 oil in them, while the concentration in tuna is quite a lot less, Wolk said, adding that it doesn't matter if the fish is canned.
Flaxseed and a Low-Fat Diet Offer Protection Against Prostate Cancer
As reported on Scientific American's website http://www.sciam.com/news/071101/1.html
Prostate cancer is the leading cancer among American men. A pilot study suggests that flaxseed, in conjunction with a low-fat diet, may have a protective effect against the disease. The report, from researchers at Duke University Medical Center, appears in the July issue of the journal Urology.
Twenty-five men with prostate cancer who were awaiting surgery ate a low-fat diet and consumed three tablespoons (about 30 grams) of finely-ground flaxseed a day for an average of 34 days. The scientists found that both the testosterone and cholesterol levels of the men decreased over the course of the study. And, although PSA levels in the general sample population did not decrease, when the men were classified according to the severity of their cancers, those with early-stage prostate cancer did show a decrease in PSA levels as well. For the men on the diet, their tumor cells did not divide as quickly and there was a greater rate of apoptosis (tumor cell death) in this group."
The authors caution that the study's data "must be interpreted with caution" because it is impossible to determine if the benefits seen in this small, short trial were due to the flaxseed, the low-fat diet or a combination of the two.
(Note: Many find that Budwig's Diet of flaxseed oil and cottage cheese are helpful with many cancers including prostate cancer.)
UNC-CH Study Offers Evidence That Garlic Protects Against Cancers - See our cancer-fighting foods page.
Another Down Side of Chemotherapy
July 16, 2001 (Ivanhoe Newswire) reports that although The National Institutes of Health recommends women with breast tumors greater than 1centimeter be treated with adjuvant chemotherapy, a new study finds this chemotherapy increases the risk of ovarian failure and along with it, significant bone loss. You may have to go to their archives to read additional information about this report.
Prescription for Danger - Nutrient depletion from common medicines
This links to an older article, but if you haven't read it and you or anyone in your family takes any common drugs, be sure to read this article.
Alternative Products that recently approved by FDA
- Wobe-Mugos has been approved as an orphan drug as an adjunct therapy for multiple myeloma.
- Anti-cancer herbal medicine put under human test in USA
- Kanglaite injection, an anti-cancer Chinese traditional medicine, has been approved by the Food and Drug Administration of the United States to be used for clinical human experiment, according to sources with the State Administration of Traditional Chinese Medicine. This is the first time that a traditional Chinese medicine has been approved for clinic experiment in the USA, the sources said.
- Last month, the injection, invented by Zhejiang Kanglaite Pharmaceutical Co Ltd in Hangzhou, East China's Zhejiang Province, went through a four-month clinical experiment on 15 to 18 volunteers in a hospital located in Salt Lake City, Utah in the USA. The first group of people who received the injection as part of the clinical experiment have showed satisfactory results, and the medicine is considered effective and safe.
- Kanglaite injection is developed from the liquid distilled from the seeds of Job's tears, which is a kind of herbal medicine. It is targeted to effectively kill cancer cells while upgrading the immune capacity of the human body.
- In China, the medicine has been used in thousands of clinical experiments and by more than 200,000 tumor patients. The results show that the medicine is effective in its anti-cancer actions and has no apparent side effects.
Key Breast Cancer Study Was a Fraud
By Thomas H. Maugh II and Rosie Mestel, LA Times Medical Writers
April 27, 2001
A key study pointing to the effectiveness of high-dose chemotherapy and bone marrow transplants in treating metastatic breast cancer was based on faked data, cancer experts said Thursday.
The American Society of Clinical Oncology announced that an unscrupulous South African researcher, Dr. Werner Bezwoda, has led thousands of women with breast cancer to undergo expensive, debilitating and often fatal bone marrow transplants. His data were fraudulent, suggesting the controversial procedure was more effective than it actually is, the society concluded.
Bezwoda was fired from his post at the University of Witwatersrand in Johannesburg in 1999 after revelations that he had faked data in a preliminary report of another study on the use of high-dose chemotherapy and bone marrow transplants in patients where the malignancy had spread to lymph nodes.
For details go to http://my.webmd.com/content/article/1728.54920.