Author Interviews, JAMA, Prostate Cancer, Testosterone / 16.07.2014

Grace Lu-Yao PhD, MPH Professor of Medicine Robert Wood Johnson Medical School Rutgers, The State University of New Jersey Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903-2681 MedicalResearch.com Interview with: Grace Lu-Yao PhD, MPH Professor of Medicine Robert Wood Johnson Medical School Rutgers, The State University of New Jersey Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903-2681 Medical Research: What are the main findings of the study? Dr. Lu-Yao: Primary ADT (ie., use of androgen deprivation as an alternative to surgery, radiation or conservative management for the initial management of prostate cancer) is not associated with improved overall or disease specific survival. (more…)
Author Interviews, Cancer Research / 16.07.2014

John D'Orazio, M.D., Ph.D. Drury Pediatric Research Endowed Chair Associate Professor, Univ. KY College of Medicine Pediatric Hematology-Oncology The Markey Cancer Center Lexington, KY 40536-0096 MedicalResearch.com Interview with: John D'Orazio, M.D., Ph.D. Drury Pediatric Research Endowed Chair Associate Professor, Univ. KY College of Medicine Pediatric Hematology-Oncology The Markey Cancer Center Lexington, KY 40536-0096 Medical Research: What is the background for this study? Dr. D'Orazio: Malignant melanoma is the deadliest of skin cancers, and it’s incidence has increased enormously over the last several decades. In the 1930’s only one in every fifteen hundred Americans would get melanoma in his/her lifetime. Now it’s one in fifty or sixty. Plus, it often affects young adults in the prime of their lives. Altogether, nearly 10,000 Americans die of melanoma every year. However, risk is not equally shared. Fair-skinned people who tend to burn rather than tan from sun exposure have a much higher risk than dark skinned people. On the surface, it would appear that the amount of melanin in the skin would be the only determinant of melanoma risk but the truth is more complex. Our lab has been interested in a particular hormonal pathway in the skin that directly influences melanoma risk. When UV radiation (sunlight) hits the skin, it causes damage to the cells of the skin. Cells respond to this damage to protect themselves against further injury. One way in which they do this is by turning on a hormone called melanocyte stimulating hormone, abbreviated “MSH”. Made by keratinocytes, the most abundant cells in the epidermis, MSH is directly responsible for ramping up melanin production by melanocytes, the cells that make the pigment in the skin that gives us a tan. This pigment called melanin acts as natural sunscreen and blocks UV radiation from penetrating into the skin. This is very important because people who can tan are in a much safer state the next time they get sun exposure. Because they have more melanin in the skin, the UV won’t cause as much damage. The key is to realize that UV causes mutations in melanocytes, and with enough damage to the DNA, melanocytes can turn cancerous and become melanomas. People who have the melanoma-prone, “can’t tan” skin type often have problems in this MSH hormonal pathway. Specifically, they have inherited problems with the receptor on melanocytes that binds to MSH and makes the cells make more pigment. This protein, called the melanocortin 1 receptor (or “MC1R”), is the way that melanocytes sense that the skin has been injured and needs more melanin. If the MC1R won’t signal, then melanocytes just sit there and can’t be induced to make more melanin pigment. Surely this is a major reason why people with MC1R signaling defects are at high risk of melanomas. (more…)
Author Interviews, Cancer, Cancer Research / 16.07.2014

Rebecca H. Johnson, MD Assistant Professor, Clinical Genetics University of Washington Seattle, Washington MedicalResearch.com Interview with Rebecca H. Johnson, MD Assistant Professor, Clinical Genetics University of Washington Seattle, Washington Medical Research: What are the main findings of the study? Dr. Johnson: We observed that, over the past two decades, there has been an increase in the incidence of testicular cancer in Hispanic American adolescents and young adults (AYAs) between 15 and 39 years of age. This increase is seen in both major subtypes of testicular cancer and affects Hispanic AYA patients with all stages of disease at the time of diagnosis. No comparable increase was observed in non-Hispanic white AYA,s or in older American men regardless of Hispanic ethnicity. Between 1992 and 2010, the incidence of testicular cancer in AYA Hispanics has increased 58% in contrast to just 7% in non-Hispanic white AYAs. (more…)
Author Interviews, Depression, Journal Clinical Oncology, Metabolic Syndrome, Prostate Cancer / 14.07.2014

MedicalResearch.com with: Sandip M. Prasad MD Assistant Professor Medical University of South Carolina, Charleston, SC Sandip M. Prasad MD Assistant Professor Medical University of South Carolina, Charleston, SC and Scott E. Eggener, MD Associate Professor of Surgery Co-Director, Prostate Cancer Program Director of Translational and Outcomes Research, Section of Urology University of Chicago Medical Center, Chicago, IL; Scott E. Eggener, MD Associate Professor of Surgery Co-Director, Prostate Cancer Program Director of Translational and Outcomes Research, Section of Urology University of Chicago Medical Center, Chicago, IL; Medical Research: What are the main findings of the study? Answer: Depressed men with a diagnosis of intermediate- or high-risk prostate cancer have worse overall outcomes than those without baseline depression and are less likely to undergo definitive therapy. The difference in overall survival between men with and without a depression diagnosis was independent of prostate cancer treatment type. (more…)
Pancreatic / 10.07.2014

Andrea Wang-GillamMD, PhD Assistant Professor, Department of Medicine Oncology Division, Medical Oncology Section Washington University School of Medicine in St. Louis MedicalResearch.com Interview with: Andrea Wang-GillamMD, PhD Assistant Professor, Department of Medicine Oncology Division, Medical Oncology Section Washington University School of Medicine in St. Louis Medical Research: What are the main findings of the study? Dr. Wang-Gillam: This is a global randomized phase III trial of MM398 plus 5FU/LV vs. MM398 vs. 5FU/LV in patients with metastatic pancreatic cancer who had received prior gemcitabine-based therapy. The primary endpoint was overall survival (OS). The secondary endpoints included progression-free survival (PFS), response rate (RR), biochemical response and safety. The trial achieved its primary endpoint. The median overall survival was statistically longer with the combination of MM398 plus 5FU/LV compared with 5FU/LV alone (6.1 months vs 4.2 months; HR of 0.67; p=0.0122). A superior progression-free survival was also seen in the MM398 plus 5FU/LV group compared with the 5FU/LV alone group (3.1 months vs 1.5 months; HR of 0.56; p=0.0001). A higher response rate was observed in the combination regimen compared with the 5FU/LV group (16% vs 1%). There were no differences in overall survival or PFS between the MM 398 monotherapy and 5FU/LV groups. (more…)
Author Interviews, Breast Cancer, NEJM / 10.07.2014

Dr. Olivia Pagani Institute of Oncology of Southern Switzerland Ospedale San Giovanni, Switzerland MedicalResearch.com Interview with: Dr. Olivia Pagani Clinical Director of the Breast Unit of Southern Switzerland Ospedale San Giovanni, Switzerland Medical Research: What are the main findings of the study? Dr. Pagani: The study showed that the aromatase inhibitor Exemestane is superior to Tamoxifen (both given together with ovarian function suppression) in preventing breast cancer recurrence in premenopausal women with oestrogen receptor positive early breast cancer. (more…)
Breast Cancer, Lipids / 07.07.2014

Dr. Rahul Potluri Honorary Clinical Lecturer in Cardiology School of Medical Sciences, Aston University Birmingham UK; MedicalResearch.com Interview with: Dr. Rahul Potluri Honorary Clinical Lecturer in Cardiology School of Medical Sciences, Aston University Birmingham UK; Medical Research: What are the main findings of the study? Dr. Potluri: Study was conducted by a retrospective analysis of more than 1 million anonymous patient records across the UK between 2000 and 2013 using the Algorithm for Comorbidities, Associations, Length of stay and Mortality (ACALM) protocol. There were 664,159 women and of these, 22 938 had hyperlipidaemia and 9 312 had breast cancer. Some 530 women with hyperlipidaemia developed breast cancer. A statistical model to study the association between hyperlipidaemia and breast cancer. They found that having hyperlipidaemia increased the risk of breast cancer by 1.64 times (95% confidence interval 1.50-1.79). (more…)
Author Interviews, Cancer Research, Lancet, Mayo Clinic, Radiation Therapy / 03.07.2014

Dr. Robert Foote MD Chair, Department of Radiation Oncology Mayo Clinic, Rochester, MN MedicalResearch.com Interview with: Dr. Robert Foote MD Chair, Department of Radiation Oncology Mayo Clinic, Rochester, MN MedicalResearch: What are the main findings of the study? Dr. Foote: Charged particle therapy (mainly protons and carbon ions) provide superior overall survival, disease-free survival and tumor control when compared to conventional photon therapy. In particular, it appears that proton beam therapy provides superior disease-free survival and tumor control when compared to the state of the art intensity modulated radiation therapy using photons. (more…)
Author Interviews, Breast Cancer / 03.07.2014

Dr. Katja Pinker MD Department of Radiology Medical University of Vienna · MedicalResearch.com Interview with: Dr. Katja Pinker MD Department of Radiology Medical University of Vienna · MedicalResearch.com: What are the main findings of the study? Dr. Pinker: We hypothesized that by imaging multiple key processes involved in cancer development and growth with multiparametric PET/MRI an improved non-invasive diagnosis of breast tumors is possible. To test this hypothesis, we conducted this first clinical feasibility study. Mutliparametric PET/MRI allows an improved non-invasive differentiation of benign and mailgnant breast tumors than currently used contrast-enhanced MRI alone. By its use unnecessary breast biopsies in benign tumors can be avoided without missing cancer. (more…)
Author Interviews, Breast Cancer, JNCI, MD Anderson, Weight Research / 02.07.2014

Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas 77230-1402 MedicalResearch.com Interview with Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas 77230-1402 MedicalResearch: What are the main findings of the study? Dr. Yeung: We believe that this study has bridged a significant gap in knowledge between epidemiological data (the association of obesity and poor breast cancer prognosis) and biological mechanisms mediating the impact of obesity on cancer. This study provides an important mechanistic insight into the causal relationship between obesity and breast cancer growth.
  1. Direct evidence for the links between obesity-associated changes in the biological processes and hallmarks of cancer in human estrogen receptor-positive (ER+) breast cancer.
It is well known that obesity is associated epidemiologicaly with decreased survival in ER+ breast cancer patients. Although a body of experimental literature exists to suggest important roles for estrogen, insulin/IGF-1 and adipokine signaling and inflammation in the mechanisms mediating the impact of obesity on cancer, direct evidence for these mechanisms and their importance relative to one another is lacking in cancers from obese humans. Functional transcriptomic analysis of a prospective observation cohort with treatment-naïve ER+ breast cancer samples identified the insulin/PI3K signaling and secretion of cytokines among the top biological processes involved. Many of the obesity-associated changes in biological processes can be linked to cancer hallmarks. Upstream regulator analysis identified estrogen (?-estradiol), insulin (INS1), insulin-like growth factor-1 (IGF1), and adipokines [vascular endothelial growth factor A (VEGFA), tissue necrosis factor (TNF), interleukin-6 (IL6), oncostatin-M (OSM), chemokine ligand 5 (CCL5), leptin (LEP), leukemia inhibitory factor (LIF), C-reactive protein (CRP), adiponectin (ADIPOQ), and interleukin-10 (IL10)] in mediating the impact of obesity on human ER+ breast cancer.
  1. Experimental evidence that obesity causes accelerated oncogene-driven ER+ breast cancer carcinogenesis.
While it is not possible to conduct a human experiment to prospectively examine the causal relationship between obesity and breast cancer, we created a transgenic mouse model with genetically induced obesity and oncogene-driven breast cancer. With this model we found strong in vivo evidence using both longitudinal experiments and cross-sectional experiments that obesity accelerated oncogene-driven breast carcinogenesis. (more…)
Author Interviews, Colon Cancer, JNCI / 01.07.2014

Kaspar Truninger, MD, FMH Gastroenterology and Internal Medicine Langenthal, Switzerland MedicalResearch.com Interview with: Kaspar Truninger, MD, FMH Gastroenterology and Internal Medicine Langenthal, Switzerland MedicalResearch: What are the main findings of the study? Dr. Truninger: In our study, we investigated the effect of lifestyle exposure on DNA methylation. We measured genome-wide promoter CpG methylation in 1092 normal colon biopsies from 546 healthy females. We observed that fewer CpGs acquired age-dependent methylation in users of aspirin and hormonal replacement therapy compared with nonusers, whereas more CpGs were affected in smokers and individuals with a body mass index > 25 compared with nonsmokers and less obese females. Half of the CpGs showing age-dependent methylation gain were hypermethylated in tissue of colorectal cancer. These loci gained methylation with a higher rate and were particularly susceptible to lifestyle exposure compared to age-only methylated CpGs. In addition, these CpGs were enriched for polycomb regions. Finally, all effects were different according to the anatomic location along the colon. (more…)
Author Interviews, Cancer Research, Mayo Clinic / 27.06.2014

dr_john-copland MedicalResearch.com Interview with: Dr. John A. Copland, PhD Associate Professor of Biochemistry/Molecular Biology Professor of Cancer Biology Cancer Basic Science Mayo Clinic, Jacksonville, Florida MedicalResearch: What are the main findings of the study? Dr. Copland: In our study we identified a pro-cancerous role for a novel protein- neuronal pentraxin 2 (NPTX2). This protein, normally found expressed in brain and nervous system tissues, is highly overexpressed in kidney tumors at all stages of disease. It has never previously been associated with kidney cancer, nor has it been associated with an oncogenic function in any other cancer. NPTX2 appears to play a significant role in not only tumor cell survival, but it also promotes tumor cell migration through activation of the ionotropic glutamate receptor 4 (GluR4). GluR4, also commonly associated with nervous system tissues, appears to be manipulating the flow of calcium into the tumor cell. Both NPTX2 and GluR4 are not components of normal kidney cell function. Because calcium is an important co-factor for many signaling pathways controlling cell growth, survival, and mobility, unconstrained calcium levels in a cell can promote malignancy. We show that calcium calmodulin kinase and AKT, two oncogenic signaling pathways are activated by NPTX2 via calcium influx. (more…)
Breast Cancer / 25.06.2014

Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN Advanced Practice Nurse Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ 08901 MedicalResearch.com Interview With Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN Advanced Practice Nurse Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ 08901 MedicalResearch: What are the main findings of the study? Answer: The main findings from the study were:
  1. Nineteen patients out of 24 (79%) reported lymphedema (LE) symptoms. Majority reporting symptoms received chemotherapy and were 50 years of age and older.
  2. The most commonly reported symptoms were limb tenderness (n=10), swelling (n=9), firmness/tightness (n=8), numbness (n=6), heaviness (n=5), impaired movement of the shoulder (n=5), and finger (n=4).
  3. Overall, the participants had low to moderate lymphedema knowledge. The mean knowledge score was 11.9 with a range from zero to 20.
  4. Patients beginning radiation therapy for breast cancer often had not received any lymphedema information from health care providers prior to therapy; Lymphedema knowledge is moderate to weak.
(more…)
Author Interviews, Cancer Research, Exercise - Fitness, Mayo Clinic / 24.06.2014

Xuemei Sui, MD, MPH, PhD Assistant Professor Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208 MedicalResearch.com Interview with: Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208 MedicalResearch: What are the main findings of the study? Dr. Sui: In the present study, cancer survivors who reported performing resistance exercise (RE) at least 1 day of the week had a 33% lower risk of all-cause mortality compared with individuals who did not report participation in resistance exercise. Further, there was an inverse relationship between resistance exercise and all-cause mortality in those who were physically active, but not in those who were physically inactive. Although leisure-time physical activity was not associated with a lower risk of all-cause mortality, the present results support the benefits of resistance exercise and physical activity was during cancer survival. (more…)
Author Interviews, Cancer Research, CHEST, Critical Care - Intensive Care - ICUs, University of Michigan / 22.06.2014

Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of Michigan MedicalResearch.com Interview with: Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of Michigan MedicalResearch: What are the main findings of the study? Dr. Cooke: There were three primary findings from our study. First, we determined that between 1992 and 2005 there was almost a 40% increase in the number of admissions to an intensive care unit (ICU) among patients with lung cancer who were hospitalized for reasons other than surgical removal of their cancer. Second, most of this increase was because doctors were admitting these patients to intermediate intensive care units. These are units that provide greater monitoring and nurse staffing than typically available in general hospital wards, but usually also have less ability to provide life support measures than full service ICUs. Third, over the same period the reasons for ICU admission have changed. Although the most common reason for admission continues to be for problems related to the patients’ lung cancer, problems such as breathing difficulties requiring a ventilator and severe infections are increasingly common. These findings suggest that although overall use of the ICU for patients with lung cancer is increasing over time, providers may be shifting some of the intensive care for lung cancer patients toward less aggressive settings such as the intermediate care unit. (more…)
Author Interviews, Johns Hopkins, Pancreatic / 21.06.2014

Lei Zheng, M.D., Ph.D. Assistant Professor of Oncology and Surgery Gastrointestinal Cancer Program Division of Immunology The Sidney Kimmel Comprehensive Cancer Center and Department of Oncology Johns Hopkins University School of Medicine The Bunting-Blaustein Cancer Research Building (CRB1) Baltimore, MD 21231 MedicalResearch.com Interview with: Lei Zheng, M.D., Ph.D. Assistant Professor of Oncology and Surgery Gastrointestinal Cancer Program Division of Immunology The Sidney Kimmel Comprehensive Cancer Center and Department of Oncology Johns Hopkins University School of Medicine The Bunting-Blaustein Cancer Research Building (CRB1) Baltimore, MD 21231 MedicalResearch: What are the main findings of the study? Dr. Zheng: This study shows for the first time that treatment with a vaccine-based immunotherapy directly re-programs the pancreatic cancer microenvironment, allowing the formation of lymphoid aggregates, which are organized, lymph node-like, functional immune structures and which convert an immunologically quiescent tumor into an immunologically active tumor. (more…)
Author Interviews, Cancer Research, End of Life Care / 20.06.2014

Daniel Rocke, MD Medical School University of Michigan Medical School Ann Arbor, 2009. MedicalResearch.com Interview with Daniel Rocke, MD Duke Medicine Department Otolaryngology MedicalResearch: What are the main findings of the study? Dr. Rocke: I think the main point is that, to quote the paper, "end-of-life decision making by patients with cancer and their caregivers is significantly affected by their preference for quality of life or quantity of life, but OHNS physicians’ decision making is not." This is important because physicians counseling patients making end-of-life decisions are coming at these decisions from a different perspective that may not line up with their patients. If physicians recognize this, I think that these end-of-life discussions can be more productive (more…)
Author Interviews, Breast Cancer, JAMA, MD Anderson, Race/Ethnic Diversity / 20.06.2014

Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston MedicalResearch.com Interview with: Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston MedicalResearch: What are the main findings of the study? Dr. Black: This is a retrospective study from 2002 - 2007 using the SEER/Medicare database of over 31,000 women with node negative breast cancer evaluating the utilization of sentinel node biopsy (SNB) as it transitioned from an optional method for axillary staging to the standard of care instead of complete axillary lymph node dissection (ALND). We found that SNB use increased each year in both white and black breast cancer patients throughout the study period. However, SNB was less often performed in black patients (62.4%)compared to white patients (73.7%) and this disparity persisted through 2007 with a 12% difference. Appropriate black patients more often had an ALND instead of the minimally invasive sentinel node biopsy which resulted in worse patient outcomes with higher lymphedema rates in black patients. However, when black patients received the minimally invasive SNB, their rates of lymphedema were low and comparable to white patients who received SNB. (more…)
Author Interviews, Cancer Research / 20.06.2014

John L. VandeBerg PhD Southwest National Primate Research Center Texas Biomedical Research Institute San Antonio, TX 78245-0549 MedicalResearch.com Interview with: John L. VandeBerg PhD Southwest National Primate Research Center Texas Biomedical Research Institute San Antonio, TX 78245-0549 MedicalResearch: What are the main findings of this study? Dr. VandeBerg: Despite the increasing use of sunscreen in recent decades, the incidence of melanoma continues to rise by 3% annually, leading to concerns that sunscreen may not be effective in preventing melanoma despite its efficacy in preventing sunburn. Our results established in the laboratory opossum, which is the only natural mammalian model of UVB-induced melanoma, that SPF 15 sunscreen applied to infants prior to low dose UVB radiation leads later in life to a 10-fold reduction in pre-melanotic lesions, which are known to progress to malignant melanoma. (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease / 18.06.2014

Nynne Nyboe Andersen, MD, PhD student Department of Epidemiology Research Statens Serum Institut 2300 Copenhagen, Denmark MedicalResearch.com Interview with: Nynne Nyboe Andersen, MD, PhD student Department of Epidemiology Research Statens Serum Institut 2300 Copenhagen, Denmark MedicalResearch: What are the main findings of the study? Dr. Andersen: Previous studies evaluating the risk of cancer associated with the use of TNF-α antagonists are mainly based on data from randomized clinical trials with a short follow up time. Consequently, we used the national Danish registries to conduct a nationwide population-based cohort study assessing the risk of cancer in patients with inflammatory bowel disease (IBD) exposed to these drugs from their introduction in 1999 until 2012. We included more than 56.000 patients with IBD and among those 4500 were exposed to TNF-α antagonists, contributing with almost 20.000 person-years of follow-up. Our main results revealed that the risk of overall cancer was significantly increased in the analysis adjusted for propensity score and potential confounders except for azathioprine, however, when we additionally adjusted for azathioprine use the relative risk decreased markedly leaving no significant increased risk of cancer. Given the upper limit of the confidence intervals, this study could rule out a more than 36% relative increase in the risk of overall cancer over a median follow-up of 3.7 years among TNF-α antagonist-exposed patients with 25% of these followed for 6 years or longer. We also did some stratified analyses according to cumulative number of TNF-α inhibitor doses, and time since first TNF-α inhibitor dose, but these results did not reveal any significantly increased risk of cancer nor did the analyses on site-specific cancers. (more…)
Author Interviews, Cancer Research, Journal Clinical Oncology / 18.06.2014

MedicalResearch.com Interview with: Yosuke Uchitomi, MD, PhD Professor and Chairman, Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan MedicalResearch: What are the main findings of the study? Dr. Uchitomi: This study demonstrated the effect of communication skills training (CST) consisted of didactic lecture, role-plays, and peer discussion for oncologists with extensive experience in comprehensive cancer center hospitals in improving the psychological distress of cancer patients as well as oncologist performances and confidence in communicating with patients, using a randomized design. Reasons for this positive result might include that the communication skills training program had been developed based on patient preferences regarding the communication of bad news and oncologists’ needs. (more…)
Author Interviews, Breast Cancer / 17.06.2014

Jack Cuzick PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University of London, London UK MedicalResearch.com Interview with: Jack Cuzick PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University of London, London UK Dr. Cuzick offers the manuscript below to put the results of the Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial in focus for MedicalResearch.com.

The Prevention of Breast Cancer

The first human evidence that drug treatment might reduce the incidence of breast cancer was reported in 19851, where it was found that use of tamoxifen in a trial of women with breast cancer to reduce recurrence of existing tumours also had a major impact on new tumours in the opposite breast, reducing them from 10 to 3. That observation has subsequently been confirmed in several other adjuvant trials and an overview of all such trials indicates that after an average of about 8 years of follow up, 5 years of tamoxifen reduced new contralateral tumours by 39%, with similar effects in years 0-5 and 5-10 in women with oestrogen receptor positive or unknown primary tumours2. These observations and positive results from animal studies3, led to the evaluation of 5 years of tamoxifen in women without breast cancer, but at high risk in 4 large trials. A recent overview4 indicates a 33% reduction in all breast cancer after a 10 years follow up, with a larger reduction in years 0-5 (48%), when treatment was given, and a continuing (22%) effect in years 5-10. Reductions were seen for oestrogen receptor positive invasive cancer (44%) and DCIS (28%), but no effect was seen for both oestrogen receptor negative invasive cancer, where in fact a non-significant 13% (P=0.4) increase was observed. Somewhat larger effects were seen for these other selective estrogen receptor modulators (SERMs) – raloxifene, lasofoxifene and arzoxifene – in trials of osteoporotic women, where the primary endpoint was fracture reduction4. A subsequent head-to-head trial of raloxifene vs tamoxifen, showed tamoxifen to be about 20% more effective, but raloxifene had fewer side effects5. Lasofoxifene not only showed benefits for breast cancer reduction but also reduced fracture rates and heart disease6, and this multi-dimensional set of benefits makes it an attractive candidate for prevention. (more…)
Melanoma, Sloan Kettering / 17.06.2014

Dr. Richard D. Carvajal MD Director, Developmental Therapeutics; Elizabeth and Felix Rohatyn Chair for Junior Faculty Memorial Sloan Kettering Cancer Center MedicalResearch.com Interview with: Dr. Richard D. Carvajal MD Director, Developmental Therapeutics; Elizabeth and Felix Rohatyn Chair for Junior Faculty Memorial Sloan Kettering Cancer Center MedicalResearch: What are the main findings of the study? Dr. Carvajal: This is the first study to show that a systemic therapy provides significant clinical benefit in a randomized fashion to patients with advanced uveal melanoma, a population of patients who have very limited treatment options. This clinical benefit has never previously been demonstrated with other agents, both conventional or investigational. (more…)
Author Interviews, Cancer Research, Infections / 14.06.2014

Dr. Stuart Gordon MD Gastroenterologist Henry Ford Hospital Detroit, MI 48202. MedicalResearch.com Interview with Dr. Stuart Gordon MD Gastroenterologist Henry Ford Hospital Detroit, MI 48202. MedicalResearch: What are the main findings of the study? Dr. Gordon: In a large American cohort of Hepatitis B patients, those who took antiviral therapy had a significantly lower risk of developing liver cancer than those who did not take such therapy. (more…)
Author Interviews, Breast Cancer, MD Anderson, Surgical Research / 11.06.2014

Dr. Benjamin D. Smith MD Associate Professor Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch.com Interview with: Dr. Benjamin D. Smith MD Associate Professor Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch: What are the main findings of the study? Dr. Smith: Although use of needle biopsy to diagnose breast cancer increased during the time period we studied, it remained lower than targeted benchmarks. The patient’s surgeon seemed to exert a major influence on use of needle biopsy. (more…)
Author Interviews, Cancer Research, Occupational Health / 11.06.2014

Gabriella Johansson Occupational and Environmental Medicine Lund University Hospital Lund, Sweden MedicalResearch.com Interview with: Gabriella Johansson Occupational and Environmental Medicine Lund University Hospital Lund, Sweden   MedicalResearch: What are the main findings of the study? Answer: Our main focus was to study hairdressers’ exposure to carcinogenic aromatic amines. We found that the concentrations of the carcinogenic compound o-toluidine in blood increased with the number of treatments per week of light color permanent hair dyeing and hair waving treatments. Another aromatic amine, m- toluidine (assessed as not classifiable as carcinogenic to humans owing to a lack of data) in blood, increased with the number of treatments per week of light color hair dyeing and all other hair dyeing. (more…)
Author Interviews, BMJ, Breast Cancer, Brigham & Women's - Harvard, Nutrition / 11.06.2014

MedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate Arofessor MedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate Arofessor Senior author: Prof Walter Willett Department of Nutrition, Harvard School of Public Health, Boston, MA, MedicalResearch: What are the main findings of the study? Dr. Farvid: Compared to women who had one serving per week red meat, those who consumed 1.5 serving per day red meat had a 22 percent higher risk of breast cancer. Red meat intake is associated with breast cancer risk in a dose-response manner. Each additional serving/day increase in total red meat was associated with a 13% increase in risk of breast cancer. Furthermore, each additional serving/day of poultry was associated with a 25% lower risk of postmenopausal breast cancer. Substituting one serving/day of legumes for one serving/day of red meat was associated with a 15% lower risk of breast cancer, substituting one serving/day of poultry for one serving/day of red meat was associated with a 17% lower risk of breast cancer overall, and substituting one serving/day of combined legumes, nuts, poultry, and fish for one serving/day of red meat was associated with a 14% lower risk of breast cancer. (more…)
Author Interviews, Melanoma / 09.06.2014

Dr. Juliet A. Usher-Smith Clinical Lecturer in Primary Care The Primary Care Unit, University of Cambridge Strangeways Research Laboratory Cambridge, United Kingdom MedicalResearch.com Interview with: Dr. Juliet A. Usher-Smith Clinical Lecturer in Primary Care The Primary Care Unit, University of Cambridge Strangeways Research Laboratory Cambridge, United Kingdom MedicalResearch: What are the main findings of the study? Dr Usher-Smith: Our systematic review identified 25 risk models that have the potential to identify individuals at higher risk of developing melanoma. Comparison between the different models was difficult due to the lack of validation studies and heterogeneity in choice and definition of variables. We were, however, able to show that most include well established risk factors and that, despite including a range of different variables, there is very little heterogeneity in the discriminatory ability of the models. There was also little difference in model performance between those scores suitable for self-assessment and those requiring a health care professional, suggesting potential for use at a population level to identify people at higher risk of melanoma. (more…)
Author Interviews, Cancer Research, Cost of Health Care, Journal Clinical Oncology / 09.06.2014

Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MA MedicalResearch Interview with: Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MA MedicalResearch: What are the main findings of the study? Dr. Aizer: We studied Americans between the ages of 20-40 using the SEER Database (a national cancer registry) and found that patients who had insurance were more likely to present with localized (curable) versus metastatic (generally incurable) cancer. Patients with localized tumors were more likely to receive the appropriate treatment and, most importantly, survived longer than patients without insurance. Our analysis accounted for demographic and socioeconomic differences between patients who were insured versus uninsured. Our results indicate that insurance status is a powerful predictor of outcome among young adults with cancer. The Affordable Care Act, which will likely improve insurance coverage nationally, may yield improved cancer outcomes among Americans. (more…)
Author Interviews, Cancer Research, HPV / 08.06.2014

Dr. Christian S Hinrichs MD Assistant Clinical Investigator Center for Cancer Research National Cancer Institute Bethesda, MD 20814 MedicalResearch.com Interview with: Dr. Christian S Hinrichs MD Assistant Clinical Investigator Center for Cancer Research National Cancer Institute Bethesda, MD 20814 MedicalResearch: What are the main findings of the study? Dr. Hinrichs: Objective tumor regression occurred in 3/9 patients with metastatic cervical cancer. Two responses were complete and are ongoing 22 and 15 months after treatment with a single infusion of T cells targeting the HPV oncoproteins. (more…)