Study Finds Only 1/3 of Melanomas Arise in Pre-Existing Moles

MedicalResearch.com Interview with:

Riccardo Pampena MD and  Caterina Longo, MD, PhD Dermatology Unit University of Modena and Reggio Emilia Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia Italy

Mole or Nevus
Wikipedia

Riccardo Pampena MD and
Caterina Longo, MD, PhD
Dermatology Unit
University of Modena and Reggio Emilia
Arcispedale Santa Maria Nuova-IRCCS
Reggio Emilia Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: High heterogeneity has been reported in previous studies on the ratio of melanoma associated with moles (nevus-associated melanomas).

Despite this heterogeneity, researchers agree that some melanomas may develop in conjunction with a pre-existing mole.

We know that nevus-associated melanomas are usually located on the trunk and more frequently occur in younger patients than de novo melanomas (not nevus-associated).

Defining the risk for a melanoma to arise in association with a pre-existing mole is important in order to define the best strategies for early melanoma diagnosis.

The main finding of our study is that only one third of melanomas arose from a pre-existing mole, in fact the majority were de novo.

We also found that nevus-associated melanomas were less aggressive than de novo.

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In the Age of Antiretrovirals for HIV, New Secondary Tumors Have Emerged

MedicalResearch.com Interview with:

Fahad Mukhtar MD MPH Department of Epidemiology and Biostatistics College of Public Health University of South Florida, Tampa

Dr. Mukhtar

Fahad Mukhtar MD MPH
Department of Epidemiology and Biostatistics
College of Public Health
University of South Florida, Tampa

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Studies done in the 80s and 90s showed that patients with Kaposi sarcoma may be at risk of having secondary tumors. As a result of changes that have taken place in the demographics of patients affected with HIV/AIDS as well as Kaposi’s sarcoma, we hypothesized that tumors that follow Kaposi sarcoma might have also changed. We analyzed the incidence of second tumors developing after Kaposi sarcoma using the Surveillance Epidemiology and End Result (SEER) data.

Our result indicated that the incidence of secondary tumors following Kaposi sarcoma have decreased after the emergence of antiretroviral therapy. However, we observed a significantly higher than expected number of cancer of the anus, liver, tongue, penis lymphomas, and acute lymphocytic leukemia developing in patients with Kaposi sarcoma in the era of antiretroviral therapy.

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Oropharyngeal Cancer Rising In Incidence and Costs to Over $140,000

MedicalResearch.com Interview with:

David R. Lairson, PhD Professor of Health Economics Division of Management Policy and Community Health Co-Director, Center for Health Services Research School of Public Health The University of Texas Health Science Center at Houston (UTHealth)

Dr. Lairson

David R. Lairson, PhD
Professor of health economics
Department of Management, Policy, and Community Health
The University of Texas Health Science Center at Houston (UTHealth) School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study of oropharyngeal cancer treatment cost was initiated by the Head and Neck Cancer Surgery Department at the University of Texas MD Anderson Cancer Center as part of a larger study of the economic and health consequences of human papillomavirus (HPV) related conditions in Texas.  State specific information is required for policy-makers to consider future investments in cancer prevention based on HPV immunization and cancer screening.  The cost estimates at $140,000 per case for the first two years of treatment are substantially higher than previous estimates.  They indicate the potential savings associated with cancer prevention and partially justify increased investment in immunization efforts.

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DNA Analysis Identifies Subtype of Pancreatic Cancer With Good Prognosis

MedicalResearch.com Interview with:

Nancy You, MD, MHSc, FACS Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston

Dr. You

Nancy You, MD, MHSc, FACS
Department of Surgical Oncology
The University of Texas MD Anderson Cancer Center
Houston 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study was motivated by the emerging promise of precision medicine and the emerging evidence that immunotherapy may have phenomenal efficacy in particular molecular subtypes of cancers.  This specific molecular subtype shows deficiency in DNA mismatch repair mechanisms and therefore is thought to be more immunogenic.  DNA mismatch repair deficiency can arise from germline defects such as in the case of patients with Lynch Syndrome, an inherited cancer syndrome, or from epigenetic inactivation DNA mismatch repair genes.

Overall, pancreas cancer has seen limited success with conventional chemotherapy.  In our study, we demonstrated that there is a particular molecular subtype of pancreas cancer that is characterized by defect in DNA mismatch repair genes and by microsatelie instability that has a different prognosis than other pancreas cancers.  This subtype of pancreas cancer is suspected to also respond to immunotherapy.

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High Doses of B Vitamins Linked to INCREASED Lung Cancer in Male Smokers

MedicalResearch.com Interview with:

Theodore M. Brasky, PhD Research Assistant Professor The Ohio State University – James Comprehensive Cancer Center Columbus, OH 43201

Dr. Brasky

Theodore M. Brasky, PhD
Research Assistant Professor
The Ohio State University – James Comprehensive Cancer Center
Columbus, OH 43201

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prior literature has been suggestive of both a protective and harmful effect of certain B vitamins on lung cancer risk. We wanted to examine the association of intakes of vitamins B6, folic acid (B9), and B12 from supplements –which are typically taken at very high doses– and lung cancer risk in a large, prospective study of 77,000 men and women living in Washington State. The study is unique as it was designed specifically to examine associations of dietary supplements with cancer occurrence. We found that men who took high doses of vitamin B6 and B12 from individual supplements over a long period of time (meaning, doses much higher than the US RDA and much greater than what one would receive from taking a multivitamin over the long term) were at nearly 2-fold increased risk of lung cancer compared to men who did not have B6 or B12 intake from any supplemental source. This finding of increased risk appeared to be specific to men who were current smokers. Among them, long term high-dose supplementation was associated with 3-4 fold increases in lung cancer risk. We observed no increased risk for any of the supplements – B6, B12, or folic acid – with lung cancer risk in women or women who smoked.

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H. pylori May Increase Risk of Stomach Cancer By Turning On Subset of Stem Cells

MedicalResearch.com Interview with:
Michael Sigal PhD

Clinical scientist of the Charité — Universitätsmedizin Berlin
Investigator at the Max Planck Institute for Infection Biology 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have previously found that H. pylori can colonize gastric glands and that in colonized glands the epithelial turnover was increased. We wanted to characterize the mechanisms that control the gland turnover in the stomach.

We found that Axin2, a classic Wnt target gene, marks two different subpopulations of cells with stem cell properties, one of which is Lgr5-positive and the other one Lgr5-negative. Both populations are affected by Rspondin 3, that is produced in myofibroblasts right beneath the stem cell compartment. Rspondin is crucial for stem cell signaling and knockout of Rspondin 3 in myofibroblasts results in loss of Lgr5 and Axin2 expression. Once we increased the bioavailability of Rspondin, that now could also interact with cells outside of the stem cell compartment, we noticed that the number of Axin2 positive stem cells dramatically increased. Of interest, only Lgr5-negative cells expanded in number and proliferate more, while the Lgr5-positive cells remained silenced.

Infection with Helicobacter pylori leads to an expansion of Axin2-positive cells which is driven by increased expression of Rspondin3. Expansion of the long lived stem cell pool could be an explanation for how H. pylori infection increases the risk for gastric cancer.

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Could Nicotinamide Be A Tool In Fight Against Skin Cancer?

MedicalResearch.com Interview with:
Prof. Gary M. Halliday

Discipline of Dermatology, Bosch Institute
Central Clinical School
University of Sydney
Sydney, NSW, Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The recently published article is a review paper- we reviewed previous laboratory studies of the effects of nicotinamide on normal pigment cells and on melanoma, and also the previous studies showing that nicotinamide can reduce rates of non-melanoma skin cancer (basal cell and squamous cell carcinoma) in high risk patients. We have not done any clinical investigations of nicotinamide as a preventive agent for melanoma.

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Many Young Adults Have One or More Modifiable Cancer Risk Factors

MedicalResearch.com Interview with:

Mary C. White, ScD MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control CDC Atlanta GA 30341

Dr. White

Mary C. White, ScD MPH
Epidemiology and Applied Research Branch
Division of Cancer Prevention and Control
CDC
Atlanta GA 30341

MedicalResearch.com: What is the background for this study?

Response: Most cancers are caused not by just one thing, but instead by a combination of different factors over many years. Early adulthood is a time of many life changes and stresses, and exposure to harmful products and unhealthy habits during early adulthood can set the stage for developing cancer at older ages. We analyzed responses from a national sample of young adults to questions about diet, physical activity, tobacco products, alcohol, indoor tanning, sleep, the HPV vaccine, and obesity. These factors have been linked to higher risks of different types of cancer.

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Increase in HPV+ Oropharyngeal Cancers Suggests Both Sexes Should Be Vaccinated

MedicalResearch.com Interview with:

Steven Habbous MSc, PhD candidate Ontario Cancer Institute Scarborough, Ontario, Canada

Steven Habbous

Steven Habbous MSc, PhD candidate
Ontario Cancer Institute
Scarborough, Ontario, Canada

MedicalResearch.com: What is the background for this study?

Response: Human papillomavirus (HPV) is a strong risk factor for oropharyngeal cancers (a subset of head and neck cancers). Because HPV-related oropharyngeal cancers generally respond well to treatment and may be prevented through HPV vaccination, it is critical to be able to accurately estimate the incidence and prevalence of this disease. Only recently, however, has testing for HPV become routine at most cancer centres across Canada.  As a result, attempts to estimate the growth of HPV-related oropharyngeal cancer over time may be inaccurate.

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Financial Distress Common Among Cancer Patients, Especially Underinsured

MedicalResearch.com Interview with:

Dr. Fumiko Chino, MD Duke Radiation Oncology Duke School of Medicine

Dr. Chino

Dr. Fumiko Chino, MD
Duke Radiation Oncology
Duke School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The financial burden of cancer treatment is a growing concern. Out-of-pocket expenses are higher for patients with cancer than for those who have other chronic illnesses. Fifty percent of elderly cancer patients spend at least 10% of their income on treatment-related out-of-pocket expenses. Additionally, high financial burden is associated with both increased risk of poor psychological well-being and worse health-related quality of life. A cancer diagnosis has been shown to be an independent risk factor for declaring personal bankruptcy, and cancer patients who declare personal bankruptcy are at greater risk for mortality. These potentially harmful outcomes resulting from financial burden have been recognized as the financial toxicity of cancer therapy, analogous to the more commonly considered physical toxicity.

We conducted an IRB approved study of financial distress and cost expectations among patients with cancer presenting for anti-cancer therapy. In this cross-sectional, survey based study of 300 patients, over one third of patients reported higher than expected financial burden. Cancer patients with highest financial distress are underinsured, paying nearly 1/3 of income in cancer-related costs. In adjusted analysis, experiencing higher than expected financial burden was associated with high/overwhelming financial distress (OR 4.78; 95% CI 2.02-11.32; p<0.01) and with decreased willingness to pay for cancer care (OR 0.48, 95% CI 0.25-0.95, p=0.03).

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