Shock
"I can't believe it. It can't be true."
Feeling shocked is often the first reaction when mesothelioma is diagnosed. You may
Feel numb and not believe what is happening
Be unable to express any emotion
Find you can only take in small amounts of information
Ask the same questions or need to be told the same thing over and over again
Needing to have information repeated is a common reaction to shock.
Some people may find their feelings of disbelief make talking about their illness with family and friends difficult. Others feel the urge to talk about it as a way of helping them to accept the news themselves.
Fear
"Am I going to die?" "Will I be in pain?"
The first thing people ask about having mesothelioma cancer is: "Am I going to die?"
Remember - Mesothelioma patients can live for many years.
Mesothelioma clinical trials provides new hope. Today, many things can be done to help with any pain or discomfort or to slow the cancer down. (Look in Treating Pain Section for more information).
Many people are worried about their treatment and whether it will be very unpleasant. Remember that research into making treatments easier to cope with, and reducing and controlling side effects has been going on for years and will continue. Stories you hear about people being treated years ago will be out of date. It is best to talk to your doctor about your treatment before relying on rumor or other incorrect information.
Denial
"There's nothing really wrong with me. I don't have mesothelioma."
Some people choose to cope with their situation by
Not wanting to know anything about their mesothelioma cancer
Talking about it as little as possible
If that's how you feel, tell the people around you quite firmly that, for the time being, you don't want to talk about your illness.
But sometimes you may find it is the other way around. Your family and friends may
Deny your illness
Appear to ignore the fact that you have mesothelioma
Play down your anxieties and symptoms
Deliberately change the subject
These sorts of reactions may arise because people are frightened or embarrassed to talk about cancer, or because mesothelioma is such a rare form of cancer, they do not understand what it entails. Others may feel that if they don't talk about it, they can try to pretend it isn't happening. You may, however, want them to support you by sharing how you feel. If the reactions of others upset or hurt you,
Try telling them how you feel
Reassure them that you know what is happening
Explain that talking to them about your illness will help
Anger
Anger about your illness may be directed at
Those who are closest to you
The doctors and nurses who are caring for you
The companies that made the asbestos products and knew they were dangerous
God, if you are religious
You don't have to feel guilty about your angry thoughts or moods. But relatives and friends don't always realize that you are not angry with them but are angry with your illness. It may help to
Tell them this at a time when you are not feeling quite so angry
Ask them to read these pages, if talking is difficult
If you are finding it difficult to talk to your family, you may want to discuss this with a counselor.
Blame and Guilt
Sometimes in trying to find reasons why cancer has happened you may blame yourself or other people for your illness.
While asbestos exposure is the trigger, many factors must coincide to cause mesothelioma cancer. Chance plays a big part. Some people are more prone to developing a mesothelioma cancer because of their genes. Also, workers and other exposed to asbestos were never informed about the dangers; so there is no way that the average person could have avoided these dangers.
In addition, many experts believe a single tiny strand of asbestos is sufficient to trigger mesothelioma, which with the widespread use of asbestos, is impossible to avoid. Finally, you had to work to earn a living and provide for your family - that was not a choice. Nevertheless, it may be difficult to avoid blaming yourself, but talking about these feelings helps.
Why Me?
Having mesothelioma cancer can make you feel cross with people who are well. Why should this have happened to you and not to someone else? You may feel
Angry
Sad
Bad tempered
These feelings may crop up from time to time throughout your illness and treatment. Relatives may also be angry that your illness interferes with their lives.
It helps to express your feelings openly. Bottling it up may upset everyone.
Leave Me Alone
There may be times during your illness when you want to be left alone to sort out your own feelings. This can be hard for family and friends who may not understand how you feel, and want to share this difficult time with you. You can make it easier for them by telling them that
You don't feel like talking about your illness now, but you will talk to them when you do
You still care about them even if you do not want to talk about your illness
Depression
Depression is often triggered by a diagnosis of mesothelioma. You might not be able to think clearly or do things, or you might not want to get up in the morning. You may want to talk to your doctor or nurse who can
Explain to you that these feelings are common with mesothelioma patients
Prescribe a course of drugs that may help you
Refer you to a doctor or counselor who specializes in the problems of cancer patients
It is quite common for people with cancer to feel depressed, so don't feel you are different if you need to ask for help.
Positive Thinking
One of the things that people with mesothelioma are often encouraged to do is to "be positive". But that is not that easy. Living with mesothelioma and its treatment can be frightening. There will be times when you may feel low and fear for you future.
Most people with mesothelioma cancer are frightened about how they might die and what will happen to their families if they do die. There are obviously very trying emotions, and it is very difficult to "just take it your stride". Friends and family, however, may advise you to think positively. It may help to remember that being positive
Doesn't mean being cheerful and optimistic
Means recognizing some of the fearful possibilities that arise from having mesothelioma cancer
Nobody should expect you to feel good when confronting fear.
Being positive and thinking positively can even include
Feeling upset
Feeling frightened
Such feelings can be a sign of strength - and may reflect your courage in facing up to an uncertain future.
Being positive may include expressing your full range of emotions. It is, perhaps, more about being able to balance the bad with the good, and not allowing negative emotions overwhelm you.
Saturday, September 20, 2008
Mesothelioma Chrysotile
Chrysotile asbestos is the main cause of malignant pleural mesothelioma. The three most common forms of asbestos are chrysotile, amosite, and crocidolite. Chrysotile or white asbestos accounts for approximately 95% of the asbestos used in US production of asbestos products and is the only member of the serpentine group of minerals.
The fine fibers of asbestos made it a great source for insulation and as a fire retardant but they their entry into the human body can trigger the onset of mesothelioma. Sometimes the asbestos fibers enter the body through the air and are breathed into the lung area of the body. Once they are taken in through the respiratory passages these fibers lodge themselves in the mesothelial cells around the lungs. This can cause direct damage to the lungs by traveling to the ends of small passages and reach the pleura area around the lungs.
Once lodged in the plural area these fibers can injure lung cells and cause lung cancer or asbestosis which is a term used to describe replacing healthy lung tissue with damaged or scar tissue. In addition, asbestos fibers can also be directly swallowed by people working in close of confined spaces with exposed asbestos. These fibers can go directly to the stomach and abdominal cavity and may lead to the development of stomach cancer or peritoneal mesothelioma.
The most common way to get is through directly working with asbestos as part of a job or career. Many people get mesothelioma as a result of their jobs working in mining, construction, shipbuilding and any other job that required a regular exposure to asbestos fibers. It is possible as well to get mesothelioma from being exposed to asbestos fibers in your home of office. Many houses still contain asbestos lined insulation that can be a grave danger if it becomes opened or exposed to humans. As long as the asbestos remains in a sealed unit or wrapped around a pipe with its exterior sealant intact, there is little danger. But if any of these materials break out of their sealed units they could easily contaminate any one who comes into contact with them.
Finally it is also possible to develop mesothelioma through direct physical contact with the clothes of someone else that has come directly into contact with asbestos. There are numerous cases of wives and spouses of miners and construction workers who have developed mesothelioma from breathing in the fibers that their husbands or wives brought home with them from the plant, mine or construction site. If that person worked in the insulation industry at a time when asbestos use was at its peak they have a much higher chance of developing this deadly disease than others who may have had minimal exposure to asbestos fibers as a result of their daily working activities.
Today mesothelioma is one of the most commonly recognized industrial or workplace diseases and special programs have been developed to recognize mesothelioma symptoms and to provide support to those who suffer from this disease.
The fine fibers of asbestos made it a great source for insulation and as a fire retardant but they their entry into the human body can trigger the onset of mesothelioma. Sometimes the asbestos fibers enter the body through the air and are breathed into the lung area of the body. Once they are taken in through the respiratory passages these fibers lodge themselves in the mesothelial cells around the lungs. This can cause direct damage to the lungs by traveling to the ends of small passages and reach the pleura area around the lungs.
Once lodged in the plural area these fibers can injure lung cells and cause lung cancer or asbestosis which is a term used to describe replacing healthy lung tissue with damaged or scar tissue. In addition, asbestos fibers can also be directly swallowed by people working in close of confined spaces with exposed asbestos. These fibers can go directly to the stomach and abdominal cavity and may lead to the development of stomach cancer or peritoneal mesothelioma.
The most common way to get is through directly working with asbestos as part of a job or career. Many people get mesothelioma as a result of their jobs working in mining, construction, shipbuilding and any other job that required a regular exposure to asbestos fibers. It is possible as well to get mesothelioma from being exposed to asbestos fibers in your home of office. Many houses still contain asbestos lined insulation that can be a grave danger if it becomes opened or exposed to humans. As long as the asbestos remains in a sealed unit or wrapped around a pipe with its exterior sealant intact, there is little danger. But if any of these materials break out of their sealed units they could easily contaminate any one who comes into contact with them.
Finally it is also possible to develop mesothelioma through direct physical contact with the clothes of someone else that has come directly into contact with asbestos. There are numerous cases of wives and spouses of miners and construction workers who have developed mesothelioma from breathing in the fibers that their husbands or wives brought home with them from the plant, mine or construction site. If that person worked in the insulation industry at a time when asbestos use was at its peak they have a much higher chance of developing this deadly disease than others who may have had minimal exposure to asbestos fibers as a result of their daily working activities.
Today mesothelioma is one of the most commonly recognized industrial or workplace diseases and special programs have been developed to recognize mesothelioma symptoms and to provide support to those who suffer from this disease.
Mesothelioma - Database
Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body's internal organs.
Microscopic view of the mesothelium
What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.
The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart.
What is mesothelioma? Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
How common is mesothelioma? Over 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. See statistics for more details.
What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in the majority of cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Click here to learn more about asbestos
Who is at increased risk for developing mesothelioma? Since the early 1940s, millions of American workers have been exposed to asbestos dust. An increased risk of developing mesothelioma was originally found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other trades people. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
There is evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers.
What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. Doctor looking at x-rays
How is mesothelioma diagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful.
A biopsy confirms a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist removes a sample of tissue for examination under a microscope by a pathologist. (See Pathology Diagnosis to learn why some patients request a second opinion.)
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
What is the conventional approach to treating mesothelioma? Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Standard treatment for all but localized mesothelioma is generally not curative. 1 (See survival rates for median survival rates with different treatments.)
Surgery - Extrapleural pneumonectomy in selected patients with early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown. Pleurectomy and decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumor. Operative mortality from pleurectomy/decortication is <2%, while mortality from extrapleural pneumonectomy has ranged from 6% to 30%. 2
Radiation/Chemotherapy - The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated; however, the duration of symptom control is short-lived. Single-agent and combination chemotherapy have been evaluated in single and combined modality studies. The most studied agent is doxorubicin, which has produced partial responses in approximately 15% to 20% of patients studied. Some combination chemotherapy regimens have been reported to have higher response rates in small phase II trials; however, the toxic effects reported are also higher, and there is no evidence that combination regimens result in longer survival or longer control of symptoms. 3
Alimta - The only FDA approved chemotherapy for malignant pleural mesothelioma (in combination with cisplatin) is pemetrexed (Alimta). In the key clinical trial that led to its approval, Alimta was combined with another chemotherapy drug (cisplatin) and compared with cisplatin alone. The patients who received the two drugs (Alimta and cisplatin) had their cancers progress (grow/spread) in 5.7 months (median). The patients who only received cisplatin had their tumors progress in 3.9 months (median). The median survival for the patients who received both drugs was 12.1 months versus 9.3 months for cisplatin only. 4
For some physicians, these therapeutic gains are not impressive. For example, some have written, "For the treatment of mesothelioma, there is little evidence that current therapies (chemotherapy, radiation, surgery) provide significant benefit for survival or quality of life.[R]adical treatments, occupying the 3 months after diagnosis, can take up the best 3 months that the patient might have had.Malignant mesothelioma has largely defeated treatment
Microscopic view of the mesothelium
What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.
The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart.
What is mesothelioma? Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
How common is mesothelioma? Over 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. See statistics for more details.
What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in the majority of cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Click here to learn more about asbestos
Who is at increased risk for developing mesothelioma? Since the early 1940s, millions of American workers have been exposed to asbestos dust. An increased risk of developing mesothelioma was originally found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other trades people. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
There is evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers.
What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. Doctor looking at x-rays
How is mesothelioma diagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful.
A biopsy confirms a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist removes a sample of tissue for examination under a microscope by a pathologist. (See Pathology Diagnosis to learn why some patients request a second opinion.)
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
What is the conventional approach to treating mesothelioma? Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Standard treatment for all but localized mesothelioma is generally not curative. 1 (See survival rates for median survival rates with different treatments.)
Surgery - Extrapleural pneumonectomy in selected patients with early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown. Pleurectomy and decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumor. Operative mortality from pleurectomy/decortication is <2%, while mortality from extrapleural pneumonectomy has ranged from 6% to 30%. 2
Radiation/Chemotherapy - The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated; however, the duration of symptom control is short-lived. Single-agent and combination chemotherapy have been evaluated in single and combined modality studies. The most studied agent is doxorubicin, which has produced partial responses in approximately 15% to 20% of patients studied. Some combination chemotherapy regimens have been reported to have higher response rates in small phase II trials; however, the toxic effects reported are also higher, and there is no evidence that combination regimens result in longer survival or longer control of symptoms. 3
Alimta - The only FDA approved chemotherapy for malignant pleural mesothelioma (in combination with cisplatin) is pemetrexed (Alimta). In the key clinical trial that led to its approval, Alimta was combined with another chemotherapy drug (cisplatin) and compared with cisplatin alone. The patients who received the two drugs (Alimta and cisplatin) had their cancers progress (grow/spread) in 5.7 months (median). The patients who only received cisplatin had their tumors progress in 3.9 months (median). The median survival for the patients who received both drugs was 12.1 months versus 9.3 months for cisplatin only. 4
For some physicians, these therapeutic gains are not impressive. For example, some have written, "For the treatment of mesothelioma, there is little evidence that current therapies (chemotherapy, radiation, surgery) provide significant benefit for survival or quality of life.[R]adical treatments, occupying the 3 months after diagnosis, can take up the best 3 months that the patient might have had.Malignant mesothelioma has largely defeated treatment
Risk factors
Doctors often cannot explain why one person develops cancer and another does not. But research shows that certain risk factors increase the chance that a person will develop cancer. These are the most common risk factors for cancer:
* Growing older
* Tobacco
* Sunlight
* Ionizing radiation
* Certain chemicals and other substances
* Some viruses and bacteria
* Certain hormones
* Family history of cancer
* Alcohol
* Poor diet, lack of physical activity, or being overweight
Many of these risk factors can be avoided. Others, such as family history, cannot be avoided. People can help protect themselves by staying away from known risk factors whenever possible.
If you think you may be at risk for cancer, you should discuss this concern with your doctor. You may want to ask about reducing your risk and about a schedule for checkups.
Over time, several factors may act together to cause normal cells to become cancerous. When thinking about your risk of getting cancer, these are some things to keep in mind:
* Not everything causes cancer.
* Cancer is not caused by an injury, such as a bump or bruise.
* Cancer is not contagious. Although being infected with certain viruses or bacteria may increase the risk of some types of cancer, no one can "catch" cancer from another person.
* Having one or more risk factors does not mean that you will get cancer. Most people who have risk factors never develop cancer.
* Some people are more sensitive than others to the known risk factors.
The sections below have more detailed information about the most common risk factors for cancer. You also may want to read the NCI booklet Cancer and the Environment.
* Growing older
* Tobacco
* Sunlight
* Ionizing radiation
* Certain chemicals and other substances
* Some viruses and bacteria
* Certain hormones
* Family history of cancer
* Alcohol
* Poor diet, lack of physical activity, or being overweight
Many of these risk factors can be avoided. Others, such as family history, cannot be avoided. People can help protect themselves by staying away from known risk factors whenever possible.
If you think you may be at risk for cancer, you should discuss this concern with your doctor. You may want to ask about reducing your risk and about a schedule for checkups.
Over time, several factors may act together to cause normal cells to become cancerous. When thinking about your risk of getting cancer, these are some things to keep in mind:
* Not everything causes cancer.
* Cancer is not caused by an injury, such as a bump or bruise.
* Cancer is not contagious. Although being infected with certain viruses or bacteria may increase the risk of some types of cancer, no one can "catch" cancer from another person.
* Having one or more risk factors does not mean that you will get cancer. Most people who have risk factors never develop cancer.
* Some people are more sensitive than others to the known risk factors.
The sections below have more detailed information about the most common risk factors for cancer. You also may want to read the NCI booklet Cancer and the Environment.
Tuesday, September 2, 2008
Neuroblastoma
US scientists have discovered genetic faults that appear to be behind the majority of inherited cases of the childhood cancer neuroblastoma.
Neuroblastoma is the most common solid cancer in early childhood, accounting for around seven per cent of all childhood cancers and around one in six of all childhood cancer deaths.
The disease starts in the child's developing nerves and often appears as a tumour in the chest or abdomen.
*This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy.* - Dr John Maris, director, Children's Hospital of Philadelphia's Centre for Childhood Cancer Research
However, inherited neuroblastoma is relatively rare compared to non-hereditary forms of the disease.
Researchers at the Children's Hospital of Philadelphia have now discovered that many cases of inherited neuroblastoma involve faults in one particular gene, and that the same gene also plays a significant role in some forms of non-inherited neuroblastoma.
The researchers, whose findings are published in the journal Nature, identified the crucial gene while analysing DNA from ten families with a history of the disease.
They discovered a link between a region of DNA on chromosome 2 and the disease, and narrowed it down to a gene called anaplastic lymphoma kinase (ALK) in eight of the ten families.
The researchers then discovered that around one in eight tumour samples taken from non-inherited cases of neuroblastoma also had ALK mutations.
The findings could eventually lead to new prevention and treatment strategies. Study author Dr Yael Mosse, a paediatric oncologist at Children's Hospital, said that the discovery enables the first ever genetic tests for families affected by the inherited form of the disease.
She commented: "This finding means that it is possible to offer simple, non-invasive screening for patients with a family history of neuroblastoma.
"Furthermore, because there already are drugs in development that target the same gene in adult cancers, we can soon begin testing those drugs in children with neuroblastoma.
"As we increase our knowledge of ALK mutations, we will also offer specialised diagnostic testing for all newly diagnosed patients with neuroblastoma, to eventually allow oncologists to better customise treatment to a child's genetic profile."
Dr John Maris, director of Children's Hospital's Centre for Childhood Cancer Research, added: "This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy."
The team now plan to carry out clinical trials of drugs that target ALK in children with high-risk neuroblastoma.
Neuroblastoma is the most common solid cancer in early childhood, accounting for around seven per cent of all childhood cancers and around one in six of all childhood cancer deaths.
The disease starts in the child's developing nerves and often appears as a tumour in the chest or abdomen.
*This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy.* - Dr John Maris, director, Children's Hospital of Philadelphia's Centre for Childhood Cancer Research
However, inherited neuroblastoma is relatively rare compared to non-hereditary forms of the disease.
Researchers at the Children's Hospital of Philadelphia have now discovered that many cases of inherited neuroblastoma involve faults in one particular gene, and that the same gene also plays a significant role in some forms of non-inherited neuroblastoma.
The researchers, whose findings are published in the journal Nature, identified the crucial gene while analysing DNA from ten families with a history of the disease.
They discovered a link between a region of DNA on chromosome 2 and the disease, and narrowed it down to a gene called anaplastic lymphoma kinase (ALK) in eight of the ten families.
The researchers then discovered that around one in eight tumour samples taken from non-inherited cases of neuroblastoma also had ALK mutations.
The findings could eventually lead to new prevention and treatment strategies. Study author Dr Yael Mosse, a paediatric oncologist at Children's Hospital, said that the discovery enables the first ever genetic tests for families affected by the inherited form of the disease.
She commented: "This finding means that it is possible to offer simple, non-invasive screening for patients with a family history of neuroblastoma.
"Furthermore, because there already are drugs in development that target the same gene in adult cancers, we can soon begin testing those drugs in children with neuroblastoma.
"As we increase our knowledge of ALK mutations, we will also offer specialised diagnostic testing for all newly diagnosed patients with neuroblastoma, to eventually allow oncologists to better customise treatment to a child's genetic profile."
Dr John Maris, director of Children's Hospital's Centre for Childhood Cancer Research, added: "This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy."
The team now plan to carry out clinical trials of drugs that target ALK in children with high-risk neuroblastoma.
Cancer cells may spread earlier than thought
Cancer cells may spread around the body much earlier in the disease process than was previously thought, a new US study suggests.
Cancer spread (metastasis) was thought to only occur when the disease was advanced and cells had become more aggressive. But the latest study from the Memorial Sloan-Kettering Cancer Centre in New York suggests that apparently 'normal' cells may move away from the original tumour site and lie dormant in other parts of the body until cancer genes within the cells are switched on.
The researchers injected mice with breast cells that had been modified so that cancer genes could be switched on at various times.
*These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage.* - Liz Baker, senior science information officer, Cancer Research UK
They found that the cells travelled in the bloodstream to the lungs and were able to survive there in their 'normal' state for up to 16 weeks before the cancer genes were activated, after which the cells began to grow aggressively there.
According to the researchers, the finding could help to explain why breast cancer can spread in some people long after the initial tumour has been treated.
The discovery is likely to spark a rethink of the process by which cancer spreads around the body and could lead to new ways to treat the disease.
Lead researcher Dr Katrina Podsypanina commented: "These findings indicate that properties inherent in normal cells are sufficient for negotiating a significant portion of the metastatic cascade.
"The finding that metastatic disease can arise from untransformed mammary (breast) cells in the circulation refines our conception of cancer progression, and suggests that each step in the metastatic cascade should be examined to establish its functional requirements, including those performed by normal cells."
She added that recurrent cancers could be targeted by treatments that destroy cells that have moved away from the primary tumour site and are lying dormant before a secondary tumour begins to take hold.
Commenting on the study published in the journal Science, Liz Baker, senior science information officer at Cancer Research UK, said: "Learning more about the spread of cancer - or metastasis - is essential because it is harder to treat the disease once it has spread.
"These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage and improve the outcome for people affected by this disease."
Cancer spread (metastasis) was thought to only occur when the disease was advanced and cells had become more aggressive. But the latest study from the Memorial Sloan-Kettering Cancer Centre in New York suggests that apparently 'normal' cells may move away from the original tumour site and lie dormant in other parts of the body until cancer genes within the cells are switched on.
The researchers injected mice with breast cells that had been modified so that cancer genes could be switched on at various times.
*These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage.* - Liz Baker, senior science information officer, Cancer Research UK
They found that the cells travelled in the bloodstream to the lungs and were able to survive there in their 'normal' state for up to 16 weeks before the cancer genes were activated, after which the cells began to grow aggressively there.
According to the researchers, the finding could help to explain why breast cancer can spread in some people long after the initial tumour has been treated.
The discovery is likely to spark a rethink of the process by which cancer spreads around the body and could lead to new ways to treat the disease.
Lead researcher Dr Katrina Podsypanina commented: "These findings indicate that properties inherent in normal cells are sufficient for negotiating a significant portion of the metastatic cascade.
"The finding that metastatic disease can arise from untransformed mammary (breast) cells in the circulation refines our conception of cancer progression, and suggests that each step in the metastatic cascade should be examined to establish its functional requirements, including those performed by normal cells."
She added that recurrent cancers could be targeted by treatments that destroy cells that have moved away from the primary tumour site and are lying dormant before a secondary tumour begins to take hold.
Commenting on the study published in the journal Science, Liz Baker, senior science information officer at Cancer Research UK, said: "Learning more about the spread of cancer - or metastasis - is essential because it is harder to treat the disease once it has spread.
"These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage and improve the outcome for people affected by this disease."
Radiofrequency Ablation
Radiofrequency Ablation (RFA) of Lung Tumors
RFA is a promising local therapy that has evolved rapidly in recent years for the treatment of primary and secondary cancers in the lung. The feasibility and safety profile in humans are well established. Complications following RFA are similar to those of CT-guided lung biopsies. However, sufficient long term results beyond 5 years are not yet available due to the relatively short time that this technology has been in use. Patients with smaller tumors (less than or equal to 3 cm) and fewer tumor nodules (less than or equal to 5 lesions) who are considered poor surgical candidates or who develop residual or recurrent disease despite maximal conventional therapy, and have tumors that are away from vital structures are the best candidates for RFA. Hence, RFA can be safely offered to patients who cannot undergo surgical resection. However the role of RFA in patients who are candidates for surgical resection is unproven, and there is no evidence on whether RFA is more or less effective that focused radiation (sterotactic body radiation therapy). Overall, RFA is a highly promising modality that may be used to our patients' advantage either as a solitary treatment or in combination with conventional therapy.
RFA is a promising local therapy that has evolved rapidly in recent years for the treatment of primary and secondary cancers in the lung. The feasibility and safety profile in humans are well established. Complications following RFA are similar to those of CT-guided lung biopsies. However, sufficient long term results beyond 5 years are not yet available due to the relatively short time that this technology has been in use. Patients with smaller tumors (less than or equal to 3 cm) and fewer tumor nodules (less than or equal to 5 lesions) who are considered poor surgical candidates or who develop residual or recurrent disease despite maximal conventional therapy, and have tumors that are away from vital structures are the best candidates for RFA. Hence, RFA can be safely offered to patients who cannot undergo surgical resection. However the role of RFA in patients who are candidates for surgical resection is unproven, and there is no evidence on whether RFA is more or less effective that focused radiation (sterotactic body radiation therapy). Overall, RFA is a highly promising modality that may be used to our patients' advantage either as a solitary treatment or in combination with conventional therapy.
10 Tips
1. Stay away from smoking and chewing of tobacco products to reduce risk of lung cancer, Mouth, colon cancer and urinary bladder cancer incidence.
2. Regular screening for major cancers. We can prevent cancers of breast, prostate, colon, skin and cervix by screening.
3. Reduce alcohol consumption to prevent cancers of breast, colon, pancreas, oesophagus and head-neck.
4. Use sunscreen to prevent skin cancer or reduce incidence.
5. Regular exercise for 3-4 hours per week will reduce cancer incidence by 30-50%.
6. Control your weight by making proper diet changes and with regular exercise to prevent cancers of colon, breast, pancreas, kidney, liver and endometrium. Junk foods are major culprits for rise in obesity incidence.
7. Women should not post-menopausal hormonal therapy to reduce risk for cancers of breast, ovary and endometrial cancers.
8. Avoid exposure to carcinogens and radiation.
9. Vegetarians have low risk of getting cancer. Eat foods and green leafy vegetables and stay away from high calorie foods like soft drinks.
10. One should take proper medication to reduce cancer risk by consulting oncologist.
2. Regular screening for major cancers. We can prevent cancers of breast, prostate, colon, skin and cervix by screening.
3. Reduce alcohol consumption to prevent cancers of breast, colon, pancreas, oesophagus and head-neck.
4. Use sunscreen to prevent skin cancer or reduce incidence.
5. Regular exercise for 3-4 hours per week will reduce cancer incidence by 30-50%.
6. Control your weight by making proper diet changes and with regular exercise to prevent cancers of colon, breast, pancreas, kidney, liver and endometrium. Junk foods are major culprits for rise in obesity incidence.
7. Women should not post-menopausal hormonal therapy to reduce risk for cancers of breast, ovary and endometrial cancers.
8. Avoid exposure to carcinogens and radiation.
9. Vegetarians have low risk of getting cancer. Eat foods and green leafy vegetables and stay away from high calorie foods like soft drinks.
10. One should take proper medication to reduce cancer risk by consulting oncologist.
Breast Cancer
Breast Cancer Death Rates Differ by Race
On whole, the report shows the continuation of a welcome trend -- a steady decrease each year in the rate of breast cancer deaths. Thanks to better methods of detecting cancers early and treatment advances, American women today are less likely to die of breast cancer than they have been in decades, said Harmon J. Eyre, MD, chief medical officer of the American Cancer Society.
Looking at the issue of race -- and the socioeconomic and genetic factors associated with race -- it becomes clear that this good news is better for some groups of women than for others. "Perhaps most troubling," said Eyre, "is the striking divergence in long-term mortality trends seen between African-American and white females that began in the early 1980s and that by 2004 had led to death rates being 36% higher in African-American women."
Other key statistics included in the report:
* An estimated 178,480 new cases of invasive breast cancer in women will be diagnosed in 2007, and approximately 40,460 deaths will be recorded. Only lung cancer accounts for more cancer deaths in women.
* In 2004 (the latest year for which figures are available), approximately 2.4 million women living in the US had a history of breast cancer. Breast cancer accounts for more than 1 in 4 cancers in US women.
* On average, the breast cancer death rate decreased by 2.2% each year between 1990 and 2004. Younger women saw an even more significant decline during that period.
* Breast cancer incidence among white women -- that is, the rate at which new breast cancers are diagnosed in this group -- fell by 3.7% a year during 2001-2004. Also declining during this time: the use of mammography and hormone replacement therapy (HRT) by white women. There was no significant change in breast cancer incidence among African-American women during this time, coinciding with stable mammography rates and HRT use.
* Among women 50 and older, incidence rates have been on a steep decline (by 4.8% per year) since 2001. Among women under age 50, incidence rates have remained stable since 1986.
* Since 2000, the incidence rate of smaller tumors has declined by 3.8% per year. In contrast, the incidence rate of larger tumors (>5.0 cm) has increased by 1.7% per year since 1992. (Larger tumor size at diagnosis is associated with decreased survival.) Both trends may be tied to an increase in obesity in postmenopausal women, HRT use, or both.
On whole, the report shows the continuation of a welcome trend -- a steady decrease each year in the rate of breast cancer deaths. Thanks to better methods of detecting cancers early and treatment advances, American women today are less likely to die of breast cancer than they have been in decades, said Harmon J. Eyre, MD, chief medical officer of the American Cancer Society.
Looking at the issue of race -- and the socioeconomic and genetic factors associated with race -- it becomes clear that this good news is better for some groups of women than for others. "Perhaps most troubling," said Eyre, "is the striking divergence in long-term mortality trends seen between African-American and white females that began in the early 1980s and that by 2004 had led to death rates being 36% higher in African-American women."
Other key statistics included in the report:
* An estimated 178,480 new cases of invasive breast cancer in women will be diagnosed in 2007, and approximately 40,460 deaths will be recorded. Only lung cancer accounts for more cancer deaths in women.
* In 2004 (the latest year for which figures are available), approximately 2.4 million women living in the US had a history of breast cancer. Breast cancer accounts for more than 1 in 4 cancers in US women.
* On average, the breast cancer death rate decreased by 2.2% each year between 1990 and 2004. Younger women saw an even more significant decline during that period.
* Breast cancer incidence among white women -- that is, the rate at which new breast cancers are diagnosed in this group -- fell by 3.7% a year during 2001-2004. Also declining during this time: the use of mammography and hormone replacement therapy (HRT) by white women. There was no significant change in breast cancer incidence among African-American women during this time, coinciding with stable mammography rates and HRT use.
* Among women 50 and older, incidence rates have been on a steep decline (by 4.8% per year) since 2001. Among women under age 50, incidence rates have remained stable since 1986.
* Since 2000, the incidence rate of smaller tumors has declined by 3.8% per year. In contrast, the incidence rate of larger tumors (>5.0 cm) has increased by 1.7% per year since 1992. (Larger tumor size at diagnosis is associated with decreased survival.) Both trends may be tied to an increase in obesity in postmenopausal women, HRT use, or both.
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