“Using 3-D scans promises greater accuracy due to more consistent sampling over the entire tumor,” said lead author, Gerald L. LeCarpentier, Ph.D., assistant professor in the Department of Radiology at University of Michigan in Ann Arbor. “Our study shows that 3-D power Doppler ultrasound may be useful in the evaluation of some breast masses.”

Malignant breast masses often exhibit increased blood flow compared to normal tissue or benign masses. Using 3-D power Doppler ultrasound, radiologists are able to detect vessels with higher flow speeds, which likely indicate cancer.

For the study, Dr. LeCarpentier and colleagues studied 78 women between the ages of 26 and 70 who where scheduled for biopsy of a suspicious breast mass. Each of the women underwent a 3-D Doppler ultrasound exam followed by core or excisional biopsy of the breast.

The results showed that 3-D power Doppler ultrasound was highly accurate in identifying malignant breast tumors. When combined with age-based assessment and gray scale visual analysis, 3-D Doppler showed a sensitivity of 100 percent in identifying cancerous tumors and a specificity of 86 percent in excluding benign tumors.

“Using speed-weighted 3-D power Doppler ultrasound, higher flow velocities in the malignant tumor-feeding vessels may be detected, whereas vessels with slower flow velocities in surrounding benign masses may be excluded,” Dr. LeCarpentier said.

1. LeCarpentier et al. Suspicious Breast Lesions: Assessment of 3D Doppler US Indexes for Classification in a Test Population and Fourfold Cross-Validation Scheme. Radiology, 2008; 249 (2): 463 DOI: 10.1148/radiol.2492060888

Adapted from materials provided by Radiological Society of North America, via EurekAlert!, a service of AAAS.

IGF-1 levels are influenced by lifestyle factors such as diet, so the study could help in tailoring the advice given to men at high risk of developing prostate cancer.

An international team of researchers, funded by Cancer Research UK, analysed data from 12 previous independent studies on the relationship between blood concentrations of suspected prostate cancer risk factors, and subsequent onset of the disease.

Previously, some but not all studies had suggested a link between IGF-1 levels and increased risk of developing the disease.

‘There is a need to identify risk factors for prostate cancer, especially those which can be targeted by therapy and/or lifestyle changes,’ says lead author Dr Andrew Roddam of the Cancer Epidemiology Unit at the University of Oxford. ‘Now we know this factor is associated with the disease we can start to examine how diet and lifestyle factors can affect its levels and whether changes could reduce a man’s risk.’

Prostate cancer is the most common cancer in men in the UK, accounting for a quarter of all new cases of cancer diagnosed in men. More than 34,000 men in the UK are diagnosed with prostate cancer each year. The disease causes around 10,000 deaths a year and is the second most common cause of cancer death in UK men after lung cancer.

‘It is important to point out that there is no evidence to suggest that measurement of IGF-1 levels could be used to develop new prostate screening methods,’ adds Dr Roddam. ‘Other studies have shown that existing methods of detecting prostate cancer are not improved by also measuring IGF levels.’

The scientists looked at the data collected from blood samples of 3,700 men with prostate cancer and 5,200 men without the disease. The research found that men with higher levels of IGF-1 were more likely to go on to develop prostate cancer than those with lower levels of the protein.

‘While there are established risk factors associated with prostate cancer of age, family and ethnicity, there are no clear data on modifiable risk factors,’ says Dr Lesley Walker, Cancer Research UK’s director of cancer information.

‘Research like this is vital to further the work on prevention and treatment of the disease. The findings are also likely to be of interest to scientists who are looking at developing drugs to prevent prostate cancer.’

Due to the nature of the data collected for this collaboration, it is not possible to calculate an individual risk of prostate cancer. However, the results are important as they help in the understanding of the causes of prostate cancer.

1. A. W. Roddam, N. E. Allen, P. Appleby, T. J. Key, L. Ferrucci, H. B. Carter, E. J. Metter, C. Chen, N. S. Weiss, A. Fitzpatrick, A. W. Hsing, J. V. Lacey, Jr, K. Helzlsouer, S. Rinaldi, E. Riboli, R. Kaaks, J. A.M.J.L. Janssen, M. F. Wildhagen, F. H. Schröder, E. A. Platz, M. Pollak, E. Giovannucci, C. Schaefer, C. P. Quesenberry, Jr., J. H. Vogelman, G. Severi, D. R. English, G. G. Giles, P. Stattin, G. Hallmans, M. Johansson, J. M. Chan, P. Gann, S. E. Oliver, J. M. Holly, J. Donovan, F. Meyer, I. Bairati and P. Galan. Insulin-like Growth Factors, Their Binding Proteins, and Prostate Cancer Risk: Analysis of Individual Patient Data from 12 Prospective Studies. Ann Intern Med, 2008; 461-471 [link]

Adapted from materials provided by University of Oxford.

In the first research involving people, the acai (ah-sigh-EE) berry has proven its ability to be absorbed in the human body when consumed both as juice and pulp. That finding, by a team of Texas AgriLife Research scientists, was published in a recent issue of the Journal of Agricultural and Food Chemistry.

Showing the berry’s absorption in humans is important because it is known to contain numerous antioxidants. The berry is heavily marketed in the U.S. as a health food.

The study involved 12 healthy volunteers who consumed a single serving of acai juice or pulp. Researchers believe the results point to the need for continued research on the berry which is commonly used in juices, beverages, smoothies, frozen treats and dietary supplements.

“Acai is naturally low in sugar, and the flavor is described as a mixture of red wine and chocolate,” said lead investigator Dr. Susanne Talcott, “so what more would you want from a fruit?”

Talcott, who also is assistant professor with the Texas A&M University’s nutrition and food science department, said that previous studies have shown the ability of the human body to absorb target antioxidants (from other produce), but “no one had really tested to see if acai antioxidants are absorbed in humans.”

Sales of acai products have increased dramatically in the U.S. where it has been touted as a metabolism booster, weight reducer and athletic enhancer. Advertisements use buzzwords such as health, wellness, energy, taste and organic.

About the only buzzword not used with acai is “local.” The berries are harvested in the Brazilian rainforest from acai palms that may reach heights in excess of 60 feet - one of the same palms used to harvest edible hearts of palm.

The fruit is about the size of a large blueberry yet only the outermost layers of the fruit, the pulp surrounding a large internal seed, are edible, Talcott noted.

Talcott and her co-researcher and husband Dr. Steve Talcott began studying the palm- berry in 2001. His first scientific report on acai, apparently the first such study in English, was published in 2004.

Initially, their studies on the berry examined antioxidant and nutritional components in pulp and juice. Later studies showed the berry’s activity against cancer cells, Talcott noted.

With that background, the researchers then decided to find out whether those elements were actually being absorbed into the human body or being eliminated unused as waste.

“Like vitamin C, the body can only absorb so much at a time,” Steve Talcott explained.

He said the researchers now “need to determine potential disease-fighting health benefits, so we can make intelligent recommendations on how much acai should be consumed.

For the clinical trial, people were given acai pulp and acai juice containing half the concentration of anthocyanins as the pulp and each compared to the control foods: applesauce and a non-antioxidant beverage.

Blood and urine samples at 12 and 24 hours after consumption showed significant increases in antioxidant activity in the blood after both the acai pulp and applesauce consumption, she said. Both acai pulp and acai juice showed significant absorption of antioxidant anthocyanins into the blood and antioxidant effects. The research couple said future studies hopefully will help determine whether the consumption of acai will result in any disease-preventing health benefit and the proper serving sizes for a beneficial dose for people.

“Our concern has been that it is sold as a super food – and it definitely has some good attributes – but it is not a solution to all diseases,” she said. “There are a great number of foods on the market, and this could just be part of a well-balanced diet.”

The study was presented September 24 at the 50th annual American Society for Therapeutic Radiology and Oncology conference in Boston.

Principal investigator Marka Crittenden, M.D., Ph.D., and colleagues designed the study in order to look at the effects of stereotactic body radiation therapy (SBRT) on the immune system. This type of radiation is delivered in three large doses over several days. The extreme precision of this technology helps to spare normal, healthy tissue, more accurately targeting the cancerous tumor.

“We studied the consequences of SBRT radiation doses in preclinical tumors and found that there were fewer of the cells that turn off the immune system and more of the good ‘killer’ immune cells following these radiation doses,” said Crittenden, OHSU Department of Radiation Medicine, OHSU School of Medicine.

Researchers then selected a form of immunotherapy that could boost the immune response while working with the immune response generated by the SBRT. Cancer immunotherapy works to boost the body’s own immune system to attack tumor cells. They found that SBRT combined with immunotherapy was much more effective at clearing the tumor than either used alone.

“We hope to translate this to patient studies and develop therapies combining the potent tumor destruction of SBRT with the patient’s own immune system to further improve the efficacy of radiation therapy for cancer,” Crittenden said.

The presentation is titled: “Development of a Preclinical Model to Test Adjuvant Immunotherapy in Combination With SBRT.”

Not only this but they can help with side effects from chemotherapy such as aiding sleep, stimulating appetite, combating pain and avoiding depression.

Antidepressants work by affecting levels of chemicals known as prostaglandins. These are ephemeral, infinitesimal signallers self-regulating every cell in the body, including those serving mood and immunity. When first discovered they were perceived as a master switch, but are now believed to regulate every component of cellular microanatomy and physiology, including those of the organelles, cytoskeleton, proteins, enzymes, nucleic acids and mitochondria.

Prostaglandins are responsible, paradoxically, for both cell function and dysfunction. Excessive prostaglandin synthesis depresses immune function and may induce cancer.

An ideal anticancer agent would inhibit prostaglandins in such a manner as to shut down the pathogenesis of cancer. The article indicates that antidepressants have such properties.

Report author, Dr Julian Lieb of Vermont, USA, concludes that antidepressants have the potential to arrest, prevent, reverse and palliate cancer. He also points out that short of that they have many other uses in cancer care.

Antidepressants can reduce the severity and frequency of hot flushes in patients treated with chemotherapy, and venlafaxine (Effexor) remit acute neurosensory symptoms secondary to oxaliplatin chemotherapy. The monoamine oxidase inhibitors deprenyl and clorgyline protect nonmalignant cells from ionizing radiation and chemotherapy toxicity, and such antidepressants as nefadazone are capable of reversing chemotherapy-induced vomiting.

The report notes that as the response to antidepressants is highly specific, many patients require multiple trials before responding. It found that some subjects are non-responsive to all antidepressants, and some may relapse due to getting used to the drug. However, adjusting prostaglandins can induce both pro and anti-cancer actions. The constant presence of this paradox means that antidepressants may be capable of initiating or accelerating cancer and thus maintaining close clinical observation and limiting the duration of drug trials is essential.

The review also points out that epidemiological studies have failed to confirm the suspicion that antidepressants may induce breast cancer. However, breast cancer has been reported in three men taking selective serotonin reuptake inhibitors.

Dr Lieb added: “Wherever prostaglandin-synthesizing enzymes convert arachidonic acid to prostaglandins there are possible sites of action of antidepressants. By maintaining these enzymes within physiological limits, antidepressants shut down the mechanisms of carcinogenesis. Considerable evidence now shows that antidepressants are cytotoxic, cytostatic, convert multidrug resistant cells to sensitive, and protect nonmalignant cells from ionizing radiation and chemotherapy.

Antidepressants have potent pain relieving properties alone, or through enhancing narcotics, and they enhance sleep, appetite and occasionally energy. Their immuno-stimulating and antimicrobial properties may help with infection secondary to chemotherapy or radiation. Alleviation of anxiety, depression, fear of death, recrimination and remorse by antidepressants can be very beneficial, though care must be taken to monitor for negative effects such as intensification of depression or pain. Overall, the positive effects of antidepressants in cancer therapeutics far outweigh the negatives.”

Because most patients with metastatic melanoma fail to respond to available therapies, the discovery of a viable investigational treatment with an established safety profile could address a serious unmet need in oncology. Effectively sidestepping the prohibitive costs and long lead times typically required to discover new cancer medicines, the NYU team screened a library of already approved drugs for activity against the most deadly form of skin cancer.

Their report, which was selected for advance online publication by Molecular Cancer Research, is published in the August issue of the journal. Since submitting the article for publication, the authors have conducted additional pre-clinical studies of mebendazole in an in vivo model of chemotherapy-resistant melanoma and are now preparing a phase I clinical trial, expected to begin next year at NYU Cancer Institute.

“While rational drug design remains a perfectly valid way to develop cancer therapies, we also need approaches that are less costly and more productive of new effective treatments,” said lead author Seth J. Orlow, M.D. Ph.D., Chair of the Ronald O. Perelman Department of Dermatology at New York University School of Medicine. “You could say this is more of a guerrilla approach. Instead of screening millions of untested compounds for an agent that inhibits or stimulates a particular molecular target, we chose to screen a large library of already approved drugs for novel activity against melanoma cells, and then advance the most promising candidate rapidly to clinical practice.”

First, the NYU researchers screened a library of 2,000 well-known drugs [Spectrum Collection (Microsource Discovery Systems)] and identified members of the benzimidazole family for their ability to inhibit melanoma growth and induce programmed cell death (apoptosis) of malignant melanoma cells without affecting normal melanocytes (pigment-producing cells). Of the identified benzimidazoles, the team selected mebendazole for further study because it was known to be a well-tolerated, orally available drug with anti-cancer properties.

In a surprising discovery, the team found that mebendazole takes advantage of a special difference between a melanoma cell and normal melanocytes. Melanomas produce high levels of a protein called Bcl-2, which is known to protect certain cancer cells from apoptosis. The team saw that when a melanoma cancer cell was exposed to mebendazole, it resulted in inactivation of Bcl-2, allowing apoptosis to occur.

Mebendazole, sold as a generic drug in the United States, has been used since the 1970s to treat roundworm, hookworm, pinworm, whipworm, and other worm-based parasitic infections. Previous research has shown it to have some antitumor activity in lung and adrenocortical cancer.

“Our ability to identify novel treatments for melanoma and advance them rapidly into the clinic very much depends on NYU’s multidisciplinary approach to melanoma care and research,” Dr. Orlow said. “To be effective, translational medicine cannot be unidirectional. Discovery moves continuously back and forth between the clinic and the bench. We are now focused on determining the range of doses to be tested in the clinic, whether specific types of melanomas will respond better than others, and whether combining mebendazole with other agents will be of further benefit”

The authors of this study are NYU Cancer Institute researchers Nicole Doudican, Adrianna Rodriguez, Iman Osman, and Seth J. Orlow. The study was supported by private philanthropic grants.

(more…)

Protect your health

There are things you can do to protect the health of your lungs. Start today.

• If you are a smoker—stop smoking now. In addition to mesothelioma, research indicates that those who suffer from asbestos exposure and smoke are at a much greater risk of developing lung cancer.

• Keep yourself in good physical condition. Most doctors and health professionals recommend up to thirty minutes of activity at least three or four days a week. Physical fitness is essential for healthy lungs.

• Make healthy food choices. Filling your meals with leafy greens that are full of fiber, along with whole grains and fruits can help prevent other types of cancers. There is not direct evidence linking a good diet to a decreased risk of mesothelioma, but it is a good idea to eat healthy regardless.

If you’ve been exposed

If you believe that you were exposed to asbestos at all in your lifetime, you should talk to your doctor immediately. While there is no cure for mesothelioma, early detection has been proven to slow the progression of this fatal disease.

Mesothelioma is a very aggressive form of cancer, and one of the reasons that it has such a low survival rate is because it is not typically diagnosed until it is in the advanced stages.

If you worked in an industry that has a high rate of asbestos exposure, you should consider yourself at risk of developing an asbestos related disease. Professions with a high exposure rate include:
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• Ship builders

• Petroleum plant workers

• Power plant workers

• Construction workers

In your home

If there is any concern that you might have asbestos in your home, you should research the best possible remediation methods right away. You can also hire an experienced contractor to assess you home for you. Remediation is not difficult, but you must be incredibly careful and follow specific guidelines to reduce chance of becoming accidentally exposed.

Factors to consider

Several factors can help to determine how asbestos exposure could affect you. These include:

• The amount of asbestos you were exposed to

• How long you were exposed to it

• The size, shape, and chemical makeup of asbestos fibers

• The source of exposure

• Individual risk factors like smoking and pre-existing lung disease

While every form of asbestos is deemed hazardous, different types of asbestos fibers may be associated with different health risks. Some particles, for example, tend to stay in your system longer than others. But all common commercial types of asbestos have been linked to lung cancer.

If you or a family member has been diagnosed with mesothelioma or asbestosis, please contact the experienced mesothelioma lawyers in Baltimore, Maryland and Washington, D.C. for a free initial consultation.

Important: The material on Best Syndication is for informational purposes only and is not meant to be advice. You should always seek professional advice before making financial or medical decisions.

The two studies will be published online in advanced of the June 2008 issue of Cancer Prevention Research, a journal of the American Association for Cancer Research.

The original study, the Prostate Cancer Prevention Trial (PCPT), had randomized 18,822 men to receive either a placebo or an agent known as finasteride, currently approved to control prostate growth, for seven years. Results showed that while finasteride reduced prostate cancer risk by 25 percent, it appeared to increase development of more aggressive prostate cancer in some men. Because of this finding and concerns that tumors detected had low PSA values and might be of little risk to patients, since the study’s original publication in 2003, few doctors have recommended finasteride for prostate cancer prevention.

From a new analysis of PCPT data using advanced statistical modeling techniques and a complete assessment of prostate tissue biopsies, they concluded that these concerns are now resolved: finasteride actually reduced the risk of developing prostate cancer more than researchers had originally thought, did not increase development of more aggressive cancers, and the majority of tumors prevented were those that could spread and cause death.

These new findings suggest that men should take an “individualized” approach to prostate cancer prevention, said Ian M. Thompson, M.D., Chair of the Department of Urology at the University of Texas Health Sciences Center at San Antonio, who is senior author on both studies, and was also lead author for the Southwest Oncology Group (SWOG) on the original PCPT results paper, which was published in July 2003.

“Because we now know that men with even low PSAs can develop prostate tumors, if a man is worried about his risk, regardless of PSA score, he can take an agent that is now proven to be effective in lowering that risk,” Thompson said.

Researchers looked at whether finasteride actually increased aggressive cancers in some men, and by studying biopsies and prostate gland tissue that had been removed, concluding that it did not. “Finasteride actually shrank the prostate gland, so it appeared in initial studies that more cancer was being found in biopsies of men who took the drug,” said Mary Redman, Ph.D., a biostatistician at the Fred Hutchinson Cancer Research Center.

“What that means is that the cancer took up more prostate tissue in men who were treated, and that is why it was easier to find in a biopsy. Cancer was probably missed more often in biopsies of men on a placebo drug because the prostate gland itself was larger,” Redman said.

Redman found that in addition to a 25 to 30 percent reduction in prostate cancer development overall in men taking finasteride, there was no evidence that the drug increased the rate of aggressive tumors and likey decreased their rate by 27 percent.

“We think men should not be concerned about finasteride increasing their risk of these aggressive tumors” she said.

The second study examined whether the cancers detected in the men in the trial who had a low PSA level had clinically significant disease. With about 75 percent of the tumors detected on the study were classified as those which could potentially take a man’s life, researchers concluded that there is no clear-cut PSA threshold that can be considered normal.

All patients in PCPT were to have a biopsy of their prostate gland at some point during the seven-year trial, so investigators evaluated characteristics of the biopsy in relation to each man’s PSA score. Current practice is to consider a PSA score of below four as normal and above four as abnormal.

What they found, according to lead author Scott Lucia, M.D., a pathologist at the University of Colorado, Denver, was that while a large majority of the participants diagnosed with prostate cancer had a PSA that was considered normal, 72 percent of all tumors diagnosed from biopsies in both treated and untreated men were considered significant. In short, the finding of significant disease couldn’t be predicted by the PSA score, he said. Most patients in the study who had a PSA score of four or less and then had prostate cancer diagnosed by a routine biopsy were found to have significant prostate cancer, while some men who had a high PSA were found to have insignificant cancer.

That doesn’t mean that the researchers support reducing the level by which PSA scoring should trigger therapeutic intervention, Lucia said. “Over 90 percent of men in the country diagnosed with prostate cancer opt for treatment, yet we also found that even at higher PSA levels, men are being treated for tumors that would not have threatened their health,” he said. “This is the dilemma of PSA screening. While lower cut-off levels, those below four, increase risk of detection of insignificant disease, cure is more likely; conversely, more significant disease is detected with higher levels but at a greater risk of incurable disease.”

It does mean that men need to speak with their physicians about their PSA, when they should be biopsied, and about potential use of finasteride, which can reduce their risk, so that they will make a decision that is right for them, researchers say. For example, Lucia says, a man whose family members have been diagnosed with the disease may decide to have a biopsy even though his PSA is below four. If cancer is found then may opt to undergo treatment; if cancer is not found, he may choose to use finasteride to prevent the cancer from developing. Another man may decide to put off a biopsy, regardless of PSA score, if he is worried about side effects of treatment.

“These are not easy decisions, especially when we know now that we cannot rely on what the PSA looks like it is telling us,” Lucia said.

Emphasizing the importance of prevention, “if given the option of having my prostate cancer found early, getting it treated and then getting over the side effects of treatment or never getting cancer in the first place, I’d choose prevention any day,” said Thompson.