Newswise — New York, NY (May 3, 2012) — Blacks and Hispanics have a significantly higher risk of developing precancerous colorectal polyps compared with whites, according to a study by researchers at NewYork – Presbyterian Hospital/Columbia University Medical Center. The findings appeared in the online edition of Alimentary Pharmacology and Therapeutics.

“Our data suggest that we need to redouble our efforts to increase colon cancer screening in areas with large numbers of racial and ethnic minorities,” said lead author Benjamin Lebwohl, MD, MS, assistant professor of clinical medicine and epidemiology at NewYork – Presbyterian Hospital/Columbia University Medical Center and Columbia University’s Mailman School of Public Health.

The study also found that blacks and Hispanics have a higher risk of developing polyps in the upper portion of the colon, compared with whites. “These lesions would have been missed had these patients undergone sigmoidoscopy, which examines only the lower half of the colon,” said Dr. Lebwohl. “Therefore, colonoscopy, which examines the entire colon, may be preferable to sigmoidoscopy as a screening test for blacks and Hispanics.”

Colorectal cancer caused an estimated 51,370 deaths in 2010 – the last year for which data are available. This type of cancer is largely preventable if caught early, in the form of precancerous polyps, or adenomas. Such polyps are effectively treated with removal during colonoscopy.

The researchers looked at rates of advanced adenomas — polyps 10 mm or larger that exhibited aggressive features under microscopic examination. “These are the kinds of polyps that we are most concerned may eventually develop into cancer,” said Fay Kastrinos, MD, MPH, assistant professor of clinical medicine at NewYork – Presbyterian Hospital/Columbia University Medical Center and senior author of the study. “We found that blacks and Hispanics were roughly twice as likely to have advanced adenomas, compared with whites, after adjusting for factors such as age and family history.”

Previous studies had shown that colorectal cancer incidence and mortality are higher in blacks than in whites, and that blacks are typically younger at the time of diagnosis than are whites. Little was known about the risk of adenomas among Hispanics.

In the current study, the first to compare adenomas in white, blacks, and Hispanics, the investigators analyzed data from 5,075 men and women age 50 or older who underwent first-time colonoscopy at NewYork – Presbyterian Hospital/Columbia University Medical Center from 2006 to 2010. The study population was 70 percent white, 18 percent Hispanic, and 12 percent black, with a mean age of 62. None of the subjects had signs or symptoms of colon cancer at the time of screening. At least one adenoma was detected in 19 percent of whites, 22 percent of Hispanics, and 26 percent of blacks, the researchers reported.

The findings run counter to existing statistics showing that Hispanics have a lower rate of colon cancer compared with whites. “Surprisingly, we found that Hispanics have a slightly higher rate of precancerous polyps,” said Dr. Lebwohl. “This adds to other recent evidence that the rate of colorectal cancer among Hispanics may be increasing with acculturation.”

Doctors generally advise patients to get an initial screening test at age 50, when overall rates of colon cancer begin to increase.

The research paper is titled, “Risk of colorectal adenomas and advanced neoplasia in Hispanic, black and white patients undergoing screening colonoscopy.” The other co-authors are Kristina Capiak and Alfred. I. Neugut, at NewYork – Presbyterian Hospital/Columbia University Medical Center.

This research was supported by the National Center for Research Resources (KL2 RR024157, BL) and the National Cancer Institute (K07 CA151769-01, FK).

Source: Newswise

Currently, Alzheimer’s disease can only be definitively confirmed through the detection of amyloid plaques and/or tangles in the brain during autopsy after death or with a brain tissue biopsy. The new method uses the drug florbetaben as a tracer during a PET scan of the brain to visualize amyloid plaques during life.

In order to prove that the florbetaben PET scan detects beta-amyloid in the brain, the global phase III study directly compared brain regions in the PET scan to respective brain regions after death during autopsy.

For the study, more than 200 participants nearing death (including both participants with suspected Alzheimer’s disease and those without known dementia) and who were willing to donate their brain underwent MRI and florbetaben PET scan. The amount of plaque found in the 31 participants who reached autopsy was then compared to the results of the scans. A total of 186 brain regions from these donors were analyzed along with 60 brain regions from healthy volunteers. Based on these 246 brain regions the study found florbetaben to detect beta-amyloid with a sensitivity of 77 percent and a specificity of 94 percent.

Comparison of the visual assessment method proposed for florbetaben for clinical practice with the post mortem diagnosis revealed a sensitivity of 100 percent and a specificity of 92 percent. Sensitivity is the percentage of actual positives that are correctly identified as positive, and specificity is the percentage of negatives that are correctly identified.

“These results confirm that florbetaben is able to detect beta-amyloid plaques in the brain during life with great accuracy and is a suitable biomarker,” said study author Marwan Sabbagh, MD, director of Banner Sun Health Research Institute in Sun City, Ariz., and a Fellow of the American Academy of Neurology. “This is an easy, non-invasive way to assist an Alzheimer’s diagnosis at an early stage. Also exciting is the possibility of using florbetaben as tool in future therapeutic clinical research studies where therapy goals focus on reducing levels of beta-amyloid in the brain.”

The study was supported by Bayer Healthcare Berlin.

“Anal cancer was widely associated with HIV-infected men who have sex with men,” said Mark H. Einstein, MD, MS, Director of Clinical Research, Division of Gynecologic Oncology at Montefiore Medical Center and Professor at Albert Einstein College of Medicine. “But now, this study reveals anal precancerous disease in a high proportion of women with HIV.”

Out of 715 asymptomatic HIV-infected women studied, 10.5% exhibited some form of anal disease and approximately one third of them were found to be true pre-cancerous disease. The researchers determined that this is likely due to the fact that HIV promotes human papillomavirus (HPV) persistence and consequently, which is known to cause nearly all anal cancers. HIV-infected individuals are also at increased risk for the development of many other HPV-associated neoplasms.

The incidence of anal carcinoma (AC) has been increasing despite the implementation of antiretroviral therapy (ART), which has not been shown to consistently alter the course of HPV–associated anogenital disease.

The women studied were Montefiore patients in the Bronx, which has one of the highest HIV prevalence rates in the United States. Data indicates that 1.8% of the Bronx population is known to be HIV infected, representing 3% of the total number of HIV patients in the entire country. Montefiore is the largest provider of medical services for people with HIV in the Bronx and has adopted routine screening for AC with annual anal cytology in all HIV-infected patients.

As a result of these findings, Dr. Einstein and his colleagues recommend that all HIV+ women who have any abnormal anal cytology be referred for high resolution anoscopy, particularly those with poorly controlled HIV who are significantly at even higher risk for harboring a high-grade AIN than women who are well controlled. Also, all HIV infected men and women should be considered for anal cancer screening. Given the lower high-grade anal disease prevalence in women with well-controlled HIV, other strategies to improve disease ascertainment, such as inclusion of HPV testing might be found to be useful for AC screening. This risk stratification might prove to be different for women than it is for men, where prevalence rates seem to be considerably higher. Given the high rate of high-grade anal precancerous lesions in screened HIV-infected women and an aging population of HIV-infected patients, measures to increase routine AC screening should be strongly considered. Depending on the size of the pre-cancerous legion, it can be removed long before it becomes cancer, thus being able to save lives.

For decades, treatments for type II diabetes have taken aim at insulin, but a new study suggests that a better approach may be to target glucagon’s sweetening effect.

The findings were published today in the online edition of Cell Metabolism.

“What we’ve found is a way to reduce glucagon’s influence on blood sugar without the side effects of global glucagon repression,” said Ira Tabas, MD, PhD, Richard J. Stock Professor and Vice Chair of Research in the Department of Medicine and professor of Anatomy & Cell Biology (in Physiology and Cellular Biophysics), who led the study with Lale Ozcan, PhD, associate research scientist.

Though glucagon was discovered at the same time as insulin, research on it has languished compared with that of its cousin, and treatments have almost exclusively targeted the latter.

In the last decade, the success of incretins, a new class of drugs for type II diabetes, has sparked a renaissance in glucagon research. When they were first introduced, incretins were known to stimulate insulin secretion. But recent studies show that a significant part of their clinical success can be attributed to previously unsuspected inhibiting effects on glucagon secretion.

The experience with incretin has led to a renewed search for other drugs that act against glucagon, including compounds that block glucagon in the liver, where it acts to free glucose. Drugs that block the glucagon receptor in the liver have been tested, but glucagon has multiple roles, and recent early clinical trials show that it can raise cholesterol and lead to fat accumulation in the liver.

The new study shows how glucagon’s effect on glucose could be disrupted without disturbing glucagon’s other duties, raising prospects for a safer anti-glucagon diabetes treatment.

Drs. Tabas and Ozcan found that once glucagon binds to its receptor, glucose is fully released only after an enzyme called CaMKII is activated. When activated, CaMKII sends a protein called FoxO1 into the cell nucleus, where it turns on the genes needed for glucose secretion. A related pathway, working in parallel to this one, sends a FoxO1 helper protein into the cell nucleus, as reported in a paper on which Dr. Tabas is a co-author, published online on April 8 in Nature (embargoed until that time).

“Even when their disease is well controlled, most patients with type II diabetes have excess glucagon action, so blocking CaMKII could potentially be a new way to lower blood sugar and better treat the disease,” said Dr. Tabas.

When the researchers blocked CaMKII in obese, diabetic mice, the animals’ blood sugar went down, with no negative side effects. Instead, cholesterol declined, insulin sensitivity improved, and the liver became less fatty.

“Until now, it has been difficult to block glucagon’s effect on blood sugar without interfering with glucagon’s other functions,” said Dr. Tabas, “but we think CaMKII is different.”

Dr. Tabas is now working on the possibility of developing a CaMKII inhibitor to treat diabetes.

Drs. Ozcan’s and Tabas’ paper is titled, “Calcium signaling through CaMKII regulates hepatic glucose production in fasting and obesity.” Domenico Accili, MD, Russell Berrie Foundation Professor of Diabetes (in Medicine) and a world-renowned diabetes expert, was a major contributor to this study.

Additional authors are: Catherine C.L. Wong (Scripps Research Institute); Gang Li (CUMC); Tao Xu (Scripps Research Institute); Utpal Pajvani (CUMC); Sung Kyu Robin Park (Scripps Research Institute); Anetta Wronska (CUMC); Bi-Xing Chen (CUMC); Andrew R. Marks (CUMC); Akiyoshi Fukamizu (University of Tsukuba, Japan); Johannes Backs (University of Heidelberg, Germany); Harold A. Singer (Albany Medical College); and John R. Yates, III (Scripps Research Institute).

The U.S. Food and Drug Administration (FDA) approved the device and treatment procedure on March 22 for patients with GERD who continue to have chronic reflux symptoms despite taking medication.

Mayo Clinic in Florida expects to offer the new treatment immediately, says C. Daniel Smith, M.D., chair of the Surgery Department at Mayo Clinic in Florida, and an internationally recognized expert on the treatment of GERD.

Dr. Smith is experienced in using the system because Mayo Clinic in Florida was one of only 14 centers nationally that participated in a clinical trial that led to the FDA’s approval of the device.

“Mayo has been a leader in the treatment of esophageal diseases, especially GERD, and we are pleased to be offering this new treatment to our patients immediately,” he says.

GERD is a condition in which liquid, or food, in the stomach flows back up into the esophagus due to the inability of a ring of muscle between the lower esophagus and the top of the stomach to close properly.

If drugs aimed at neutralizing the acid in the stomach fails to prevent GERD, an operation designed to correct the mechanical defect is considered. But between 1.5 million and 2 million patients of those patients could benefit from treatment that is much less complex than current surgical options, Dr. Smith says.

“The new system will offer a long-needed treatment option for a large group of underserved patients,” he says.

The results of the clinical study that led to approval of the device have not yet been published. But “the data presented to the FDA revealed striking results when compared to other GERD treatments that have been investigated over the past 20 years,” Dr. Smith says. “The system offers effective control of GERD with limited side effects and thus far an excellent safety record.”

The implanted device is a ring of tiny magnetic titanium beads that is wrapped around the junction between the stomach and esophagus, serving as a mechanical augmentation of the lower esophageal sphincter (the ring of muscle). The magnetic attraction between the beads is strong enough to keep the sphincter closed to refluxing acid, but weak enough so that food can pass through it into the stomach, Dr. Smith says. The device can be implanted using minimally invasive surgery methods.

Dr. Smith performs about 200 GERD-related surgeries a year and has been involved with many new treatments over the past several decades. “I expect this device to be a game changer for the treatment of GERD in select patients who have failed management with drugs,” says Dr. Smith.

Ken DeVault, M.D., chair of the Department of Internal Medicine at Mayo Clinic in Florida, also participated in these studies. “I have many patients who are searching for something more than medication for their reflux, but have been hesitant to undergo a traditional reflux surgery,” he says. “I think this procedure may well be a very attractive option for that group.”

Mayo Clinic physicians and scientists collaborated with Torax Medical in the development of this technology and Mayo Clinic licensed related technology to the company in exchange for equity. Drs. DeVault and Smith are paid consultants to Torax Medical.

Now, environmental scientists at the University of Miami (UM) and at Northern Illinois University have created a reference guide for potentially harmful germs in sand, similar to the guidelines set by the US Environmental Protection Agency for marine water. The report is published in the American Chemical Society journal Environmental Science & Technology.

“These values can be used by beach managers to make decisions concerning sand quality,” says Helena Solo-Gabriele, professor in the Department of Civil, Architectural and Environmental Engineering at the UM College of Engineering and principal investigator of this project. “That way, when regulators are faced with a decision about a potential health risk, there is a guideline available with which to decide whether or not the levels of microbes found in the sand are cause for concern.”

Dogs, birds and cats visiting a beach are common sources of bacteria in the sand. “Exposures to high levels of certain microorganisms could cause gastrointestinal illness in humans, while infectious risks vary in different microorganism,” says Tomoyuki Shibata, assistant professor in the Public Health Program and Institute for the Study of the Environment, Sustainability, & Energy, at Northern Illinois University and first author of the study.

The researchers wanted to determine what levels of bacteria, or pathogens, found in beach sand could pose a health risk for beachgoers, explains Solo-Gabriele, who is also Co-PI of the Oceans and Human Health Center at the UM Rosenstiel School of Marine and Atmospheric Science (RSMAS).

“The environments in the sand and water are very different,” said Solo-Gabriele. “The sand provides more protection against the effects of solar radiation, which has a tendency to inactivate microbes in water. Sand may also protect microbes from predators (other microbes) that are found exclusively in water.”

“The environments in the sand and water are very different,” said Solo-Gabriele. “The sand provides more protection against the effects of solar radiation, which has a tendency to inactivate microbes in water. Sand may also protect microbes from predators (other microbes) that are found exclusively in water.”

To develop the guidelines, the scientists ran one million simulations of the number of microbes in each gram of sand, the transfer of sand from hand to mouth and the ingestion rate. The researchers determined the risk of having 19 cases per 1,000 beachgoers–the level used by the EPA for swimming in marine recreational waters.

The team also documented the levels of pathogens found in the sand at Hobie Cat Beach, in Miami. The findings indicate that levels of harmful microbes at the beach site were low, when compared to the reference levels and therefore safe for beachgoers.

However, studies have shown that children have a higher illness risk than adults from beach and sand exposures. For that reason, the researchers will now focus on studies of kids’ play behavior in sand, to better estimate the acceptable levels of microbes that can cause diseases in children.

“Parents of young children don’t need to overreact to our findings and they can reduce their child’s infectious risk by basic hygiene practices such as hand washing before eating or drinking and taking a shower,” said Shibata.

The report is titled “Quantitative Microbial Risk Assessment of Human Illness from Exposure to Marine Beach Sand.” The study was funded by the National Science Foundation through the Oceans and Human Health Center, at UM RSMAS.

The largest study ever of such pediatric ALL patients identified a subset of young children who achieved 10-year survival rates of 72 percent after additional chemotherapy rather than bone marrow transplantation. The patients are among the estimated 85 percent of children with ALL whose cancer begins in white blood cells destined to become B cells.

The results appear in the April 12 edition of the New England Journal of Medicine. The study involved researchers from 14 research groups in the U.S., Europe and Asia.

“Induction failure is a rare event, affecting just 2 to 3 percent of all pediatric ALL patients. But these children are at very high risk for a bad outcome and were always considered candidates for bone marrow transplantation,” said Ching-Hon Pui, M.D., chair of the St. Jude Children’s Research Hospital Department of Oncology. “These results tell us that induction failure should no longer be considered an automatic indication for a transplant.” Pui is the study’s corresponding author.

Improvements in both chemotherapy and transplantation prompted investigators to revisit the question of optimal care for these patients. But no single institution or nation had enough patients to answer it. “This study shows the importance of international collaboration to advance the treatment outcome for these patients,” said first author Martin Schrappe, M.D., University Medical Center Schleswig-Holstein, Kiel, Germany.

Investigators evaluated the outcomes of 44,017 ALL patients age 17 and younger whose cancer was discovered during a 15-year period ending in December 2000. Each was treated on a clinical trial at one of the centers participating in this international collaborative analysis. St. Jude patients were part of the study. Researchers tracked 1,041 patients whose cancer did not go into remission following four to six weeks of induction therapy.

Historically, the prognosis has been grim for patients who fail induction therapy. While overall long-term survival for childhood ALL patients climbed to 80 percent during the 15 years covered in this study, it was just 32 percent for patients who did not enter remission after the first intense weeks of treatment. The definition of induction failure differed slightly among the clinical trials included in this analysis.

The study found long-term survival rates of 72 percent among some young patients with B-lineage ALL treated with additional chemotherapy following induction therapy failure. The patients were ages 1 through 5 when their cancer was found and many had more than 50 chromosomes in their leukemia cells, rather than the normal number of 46 chromosomes. Together they accounted for about 25 percent of patients whose disease did not go into remission following induction therapy.

The children who benefited from additional chemotherapy also had no other markers of high risk, including high white blood cell counts or chromosomal rearrangements involving the MLL gene.

The study found transplants remain the best hope for many other young ALL patients who fail induction therapy. The patients included those whose cancer originated in white blood cells known as T cells. T cell ALL accounts for 12 to 15 percent of childhood ALL, but about 38 percent of patients in this study. The transplants involve killing the patient’s own diseased bone marrow and replacing it with blood-producing stem cells from a genetically matched donor. The procedure leaves patients at risk for a variety of immediate and chronic health problems.

Patients with a chromosomal rearrangement known as the Philadelphia chromosome were not included in the analysis because new drugs have led to a dramatic improvement in their outcome. About 13 percent of ALL induction treatment failures involved patients with the genetic alteration.

The other authors are Stephen Hunger, University of Colorado School of Medicine; Vaskar Saha, University of Manchester, U.K.; Paul Gaynon, Children’s Hospital Los Angeles; Andre Baruchel, Hospital Robert Debre, Paris; Valentino Conter, University of Milan-Bicocca, Italy; Jacques Otten, Brussels University Hospital, Belgium; Akira Ohara, Toho University, Tokyo; Anne Birgitta Versluys, University Medical Center Utrecht, the Netherlands; Gabriele Escherich, University Medical Center Eppendorf, Germany; Mats Heyman, Astrid Lindgren Children’s Hospital, Sweden; Lewis Silverman, Dana-Farber Cancer Institute, Boston; Keizo Horibe, Nagoya Medical Center, Japan; Georg Mann, St. Anna Children’s Hospital, Vienna; Bruce Camitta, Medical College of Wisconsin, Milwaukee; Jochen Harbott, Justus-Liebig-University, Giessen, Germany; Hansjorg Riehm and Martin Zimmermann, both of Medical School Hannover, Hannover, Germany; Sue Richards, University of Oxford, England; and Meenakshi Devidas, University of Florida, Gainesville.

In the U.S., the work was supported in part by National Cancer Institute grants to the Children’s Cancer Group, Pediatric Oncology Group and ALSAC.

In a six-month study, Prof. Amital and his colleagues found that patients who had a vitamin D deficiency lived an average of 8.9 days less than those who were found to have sufficient vitamin D. Vitamin D levels also correlated with the level of white blood cells which fight disease.

The study, which was published in the journal QJM: An International Journal of Medicine, demonstrates further research into giving patients vitamin D could confirm that it will improve their survival outcomes.

To measure the impact of vitamin D levels on the survival of critically ill patients, the researchers designed an observational study. Over the course of six months, 130 patients over the age of 18 admitted to an intensive care unit of a TAU-affiliated hospital and requiring mechanical ventilation were admitted to the study. Patients who had taken vitamin D supplements prior to admittance were excluded from the study population.

Upon admittance, patients were divided into two groups based on vitamin D concentration: those who had 20 nanograms or more of the vitamin — the amount defined as the National Institute of Health as sufficient — and those who were vitamin D deficient based on the same criteria. In total, 107 patients suffered from vitamin D deficiency.

Survival curves indicate that while patients with sufficient vitamin D survived an average of 24.2 days, those who were deemed to be deficient in vitamin D survived an average of only 15.3 days — patients with sufficient vitamin D levels survived an average of 8.9 days longer. They were also found to have a better WBC count.

Seek out sun — or supplements

These findings merit further investigation, Prof. Amital says. He suggests that the effects of vitamin D supplementation in critically ill patients be further assessed in future studies. The initial results indicate only that vitamin D concentration may be an indicator of survival, he says.

But don’t wait until you’re in poor health to start taking vitamin D, suggests Prof. Amital. Vitamin D appears to enhance the function of the immune system in numerous ways, and it’s becoming clear that it does have an impact on overall health and well-being.

According to research, including an article in the New England Journal of Medicine, the majority of those who live in North America and other Western countries are known to be vitamin D deficient due to limited exposure to the sun. But even if the springtime skies are gray, supplements from the pharmacy shelf will have the same benefits, Prof. Amital says.

Source: Eurekalert April 3 2012

JUPITER, FL — Scientists from the Florida campus of The Scripps Research Institute have synthesized a pair of small molecules that dramatically alter the core biological clock in animal models, highlighting the compounds’ potential effectiveness in treating a remarkable range of disorders—including obesity, diabetes, high cholesterol, and serious sleep disorders.

The study was published on March 29, 2012, in an advance, online edition of the journal Nature.

The study showed that when administered in animal models the synthetic small molecules altered circadian rhythm and the pattern of core clock gene expression in the brain’s hypothalamus, the site of the master cellular clock that synchronizes daily rhythms in mammals; circadian rhythms are the physiological processes that respond to a 24-hour cycle of light and dark and are present in most living things.

When given to diet-induced obese mice, these same small molecules decreased obesity by reducing fat mass and markedly improving cholesterol levels and hyperglycemia—chronically high blood sugar levels that frequently lead to diabetes.

“The idea behind this research is that our circadian rhythms are coupled with metabolic processes and that you can modulate them pharmacologically,” said Thomas Burris, a professor at Scripps Florida who led the study. “As it turns out, the effect of that modulation is surprisingly positive—everything has been beneficial so far.”

Burris stressed that these compounds were first generation—the first to hit their targets in vivo with room for improvement as potential treatments. “In terms of therapeutics, this is really the first step,” he said.

In the new study, the team identified and tested a pair of potent synthetic compounds that activate proteins called REV-ERBα and REV-ERBβ, which play an integral role in regulating the expression of core clock proteins that drive biological rhythms in activity and metabolism.

In the study, the scientists observed clear metabolic effects when the synthetic compounds were administered twice a day for 12 days. Animals displayed weight loss due to decreased fat mass with no changes in the amount of food they ate. The animals followed the human model of obesity closely, eating a standard Western diet of high fat, high sugar foods, yet still lost weight when given the compounds.

In one of the study’s more striking findings, both synthetic compounds were shown to reduce cholesterol production. Cholesterol in the blood of treated animal models decreased 47 percent; triglycerides in the blood decreased 12 percent.

The circadian pattern of expression of a number of metabolic genes in the liver, skeletal muscle, and in fat tissue was also altered, resulting in increased energy expenditure, something of a surprise. In the study, the scientists observed a five percent increase in oxygen consumption, suggesting increased energy expenditure during the day and at night. However, these increases were not due to increased activity—the animals displayed an overall 15 percent decrease in movement during those same time periods.

In addition to its impact on metabolism, the two compounds also affected the animals’ activity during periods of light and darkness, suggesting that this class of compound may be useful for the treatment of sleep disorders, including the common problem of jet lag.

The first authors of the study, “Regulation of Circadian Behavior and Metabolism by Synthetic REV‐ERB Agonists,” are Laura A. Solt and Yongjun Wang of Scripps Research. Other authors include Subhashis Banerjee, Travis Hughes, Douglas J. Kojetin, Thomas Lundasen, Youseung Shin, Jin Liu, Michael D. Cameron, Romain Noel, Andrew A. Butler, and Theodore M. Kamenecka of Scripps Research; and Seung Hee Yoo and Joseph S. Takahashi of the Howard Hughes Medical Institute and University of Texas Southwestern Medical Center.

Researchers are constantly conducting studies to determine the most effective breast cancer treatment that also reduces the incidence of potential side effects, including skin inflammation, swelling and infection.

Researchers in this study sought to compare standard WBI to WBI with IMRT (using both a typical treatment time and an accelerated treatment time) in terms of toxicity levels for patients. In a retrospective review, over 300 patients treated with one of the forms of radiation therapy were looked at and it was determined that radiation therapy using IMRT, regardless of the length of treatment, is associated with greatly reduced toxicities compared with the older, more standard radiation therapy technique.

A side analysis determined that larger breasted women had higher toxicity levels than smaller breasted women, however they still had reduced toxicities with IMRT over standard radiation, even though these levels were higher than smaller breasted women. This included IMRT with a shorter treatment time; previous trials usually exclude larger breasted women from receiving radiation using an accelerated treatment schedule.

“Our data support the increasing role of IMRT in delivering not only whole breast irradiation but also whole breast irradiation using an accelerated treatment time,” Frank Vicini, MD, a radiation oncologist with Michigan Healthcare Professionals/21st Century Oncology in Farmington Hills, Mich., said. “This is great news for breast cancer patients who, if eligible, can not only receive their radiation treatment in a shorter amount of time but also reduce their risk of many side effects.”