MedicalResearch.com Interview with: Sara Tartof, PhD, MPH
Post-doctoral research fellow
Kaiser Permanente Southern California Department of Research & Evaluation.
Medical Research: What are the main findings of the study?Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease.
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MedicalResearch.com Interview with:Isaac J. Powell MD
Wayne State University/Karmanos Cancer Inst
University Health Center
Detroit, MI 48201.
Medical Research: What is the background for your study?Dr. Powell: During the PSA testing era for prostate cancer, which is responsible for early treatment, survival disparity between African Americans and European Americans has been eliminated.
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MedicalResearch.com Interview with:Marianne Berwick, PhD, MPH for the GEM Study Team
Professor, Division of Epidemiology
University of New Mexico, Department of Internal Medicine
New Mexico Cancer Research Facility
University of New Mexico, Albuquerque, NM 87131
Medical Research: What are the main findings of this study?Dr. Berwick: In our study of Sun Exposure and Melanoma Survival: A GEM Study we found that there is little strong evidence that sun exposure at any time in life influences melanoma-specific survival. This study took place in Australia, Italy, Canada and the United States among 3,578 individuals newly diagnosed with melanoma, who we followed for a mean of 7.4 years.
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MedicalResearch.com Interview with: Estee L. Williams, MD
SUNY Downstate Medical Center, Brooklyn, New York
Madfes Integrated Dermatology, New York, New York
[email protected]Medical Research: What are the main findings of the study?
Dr. Williams: In our retrospective review of all melanomas diagnosed at the Veterans’ Affairs Hospital in Brooklyn since 2000, we discovered that although a majority of the melanomas (63%) were found by the dermatologist during a yearly “full body” screening examination (versus detection by the patient), melanomas found by the dermatologist were not necessarily thinner (hence, earlier, more curable) than those found by the patient.
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MedicalResearch.com Interview with: Tomasz M. Beer, M.D. FACP
OHSU Knight Cancer Institute
Oregon Health and Science University
OR 97239
Medical Research: What are the main findings of the study?Dr. Beer: In the study, we found that compared to placebo, enzalutamide improves overall survival, progression-free survival, quality of life, and delays the need for chemotherapy. Enzalutamide is superior to placebo with respect to all planned endpoints, across all subsets of the patient population in the study. Enzalutamide treatment is associated with an excellent safety profile.
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MedicalResearch.com Interview withSteven M. Hill, Ph.D.
Professor, Structural & Cellular Biology
Edmond & Lily Safra Chair for Breast Cancer Research
Co-Director, Molecular Signaling Program, Louisiana Cancer Research Consortium
Director, Tulane Circadian Biology Center
Medical Research: What are the main findings of the study?Dr. Hill: The main findings of our study are that exposure to even dim light at night can drive human breast tumors to a hyper metabolic state, activating key tumor cell signaling pathways involved in tumor cell survival and proliferation, leading to increased tumor growth, all resulting in a tumor which is completely resistant to tamoxifen therapy. Our work shows that this effect is due to the repression of nighttime melatonin by dim light at night. When nighttime melatonin is replace the tumors become sensitive to tamoxifen resulting in cell death and tumor regression.
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MedicalResearch.com Interview with: Rajkumar Lakshmanaswamy, PhDBasic Science Research Director of the Center of Excellence in Cancer Research.
The Paul L. Foster School of Medicine
Texas Tech University Health Sciences Center
Medical Research: What are the main findings of the study?Dr. Lakshmanaswamy: Our study supports a growing body of research suggesting a safe and effective role for natural steroid hormones in treating postmenopausal breast cancer, with fewer detrimental side effects and an improved health profile than with standard anti-hormone therapies. Using a mouse model mimicking human breast cancer after menopause, we found that treatment with estrogen, progesterone, and testosterone was associated with greater physical activity, improved cognition, and better cardiovascular and bone health, which demonstrates the potential significance of hormone treatment in postmenopausal women.
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MedicalResearch.com Interview with: Jason D. Wright, M.D.
Levine Family Assistant Professor of Women's Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032
Medical Research: What are the main findings of the study?Dr. Wright:This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
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MedicalResearch.com Interview with: Qiuyin Cai, M.D., Ph.D.
Associate Professor of Medicine
Vanderbilt University
Medical Research: What are the main findings of the study?Dr. Cai: We conducted a genome-wide association study in East Asians to search for additional genetic changes that are linked to breast cancer development. The study was conducted as part of the Asia Breast Cancer Consortium, which includes 22,780 women with breast cancer and 24,181 control subjects. We found DNA sequence changes in two genes, PRC1 and ZC3H11A, and a change near the ARRDC3 gene were associated with breast cancer risk. These results were also replicated in a large consortium, including 16,003 breast cancer cases and 41,335 control subjects of European ancestry.
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MedicalResearch.com Interview with:Allison Lipitz-Snyderman, PhD
Assistant Attending Outcomes Research Scientist
Center for Health Policy and Outcomes
Department of Epidemiology and Biostatistics
Memorial Sloan Kettering Cancer Center New York, NY 10065
Medical Research: What are the main findings of the study?Dr. Lipitz-Snyderman:Long-term central venous catheters are used to administer intravenous fluids and treatments such as chemotherapy. These catheters can also be a source of bloodstream infections which can be harmful to cancer patients. However, this risk is not well understood. In our study, we found that the use of these catheters was associated with an increased risk of infections for patients with cancer. We used a population-based dataset, SEER-Medicare, to study this issue in older adult cancer patients. This dataset allowed us to study patients treated in different institutions and follow them over time.
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MedicalResearch.com Interview with Dr Lim Weng Khong
Research Fellow, National Cancer Centre Singapore.
Medical Research: What are the main findings of the study?Dr Lim Weng Khong: This study uncovered the genetic cause fibroadenomas, which are very common benign breast tumours in women. The team from National Cancer Centre Singapore, Singapore General Hospital and Duke-NUS Graduate Medical School identified a critical gene called MED12 that has frequent durations in a remarkable 60 per cent of fibroadenomas studied. Their findings have been published in the top-ranked journal Nature Genetics.
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MedicalResearch.com Interview with: Florien Boel MSc
VU University Medical Center
Department of Medical Psychology
Amsterdam, The Netherlands
Medical Research: What are the main findings of the study?Answer: In postmenopausal breast cancer patients, endocrine therapy is widely used, and often for many years on end. Endocrine therapy is thought to have an effect on cognitive functioning, but previous studies have not yet accounted for the possible influence of the diagnosis of cancer and subsequent anxiety, depression or fatigue on cognitive performance. In addition, the cognitive effects of endocrine therapy after long-term use are still mostly unknown.
Therefore, we compared cognitive functioning of postmenopausal breast cancer patients who underwent surgery and/or radiotherapy (N=43) with the cognitive performance of women who also received adjuvant endocrine therapy (tamoxifen) (N=20) and a group of healthy matched individuals (N=44). In accordance with the literature, we found that especially cognitive domains that rely heavily on verbal abilities (verbal memory and fluency) seem to be at risk for deterioration during long-term treatment (~2.5 years) with tamoxifen.
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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.
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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.
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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.
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MedicalResearch.com with: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;
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.
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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.
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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.
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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).
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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.
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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.
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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.
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.
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.
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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.
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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.
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MedicalResearch.com Interview WithDorothy 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:
Nineteen patients out of 24 (79%) reported lymphedema (LE) symptoms. Majority reporting symptoms received chemotherapy and were 50 years of age and older.
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).
Overall, the participants had low to moderate lymphedema knowledge. The mean knowledge score was 11.9 with a range from zero to 20.
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.
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.
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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.
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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…)
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
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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…)
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