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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Promising Study of Shorter Course of Radiation Therapy After Mastectomy

MedicalResearch.com Interview with:

Bruce G. Haffty, MD Professor and Chair, Department of Radiation Oncology Rutgers Cancer Institute of New Jersey Rutgers Robert Wood Johnson Medical School and Rutgers New Jersey Medical School

Dr. Haffty

Bruce G. Haffty, MD
Professor and Chair, Department of Radiation Oncology
Rutgers Cancer Institute of New Jersey
Rutgers Robert Wood Johnson Medical School and
Rutgers New Jersey Medical School

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

Response: Shorter courses of radiation for patients treated by lumpectomy are now commonly employed. For patients receiving radiation to the chest wall and lymph nodes after mastectomy, the standard 5 to 6 week course is used and shorter courses have not been adopted.

We initiated this trial of a shorter course of radiation to the chest wall and lymph nodes after mastectomy to test its feasibility, safety and outcome.
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70-Gene Signature Changes 50% of Breast Cancer Chemotherapy Advice

MedicalResearch.com Interview with:
Anne Kuijer, MD

Departments of Surgery and Radiology
University Medical Center Utrecht and
Thijs van Dalen, PhD
Department of Surgery
Netherlands Cancer Institute, Amsterdam

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

Response: In recent years it has become evident that clinicopathological factors fail to accurately determine prognosis in hormone receptor positive early stage breast cancer patients at intermediate risk of developing metastases. Gene-expression profiles, such as the 70-gene signature (MammaPrint) are therefore increasingly used for chemotherapy decision-making. In the current multicentre study we assessed the impact of 70-gene signature use on chemotherapy decisions in these patients. We demonstrated that, without the use of the 70-gene signature, half of patients was advised chemotherapy, which reflects the current controversy regarding chemotherapy benefit. Use of the 70-gene signature changed the chemotherapy advice in half of all patients and adherence to the 70-gene signature result was high.

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Shorter Term Precision Radiation Found Effective For Prostate Cancer

MedicalResearch.com Interview with:

Charles N Catton, MD, FRCPC Cancer Clinical Research Unit (CCRU) Princess Margaret Cancer Centre UHN

Dr. Catton

Charles N Catton, MD, FRCPC
Cancer Clinical Research Unit (CCRU)
Princess Margaret Cancer Centre
UHN 

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

Response: Prostate cancer is a very common malignancy which is frequently treated with external beam radiotherapy. A typical standard treatment course can extend over 7.5-8.5 weeks.

The introduction of high-precision radiotherapy treatment techniques provided the opportunity to compress treatment courses by delivering fewer, but more intensive daily treatments. The concerns with giving fewer and larger daily treatments (hypofractionation) is that toxicity may increase and that cancer control may become worse.

This international randomized trial enrolled 1206 men with intermediate risk prostate cancer and compared a standard 8 week course of external beam radiation treatment with a novel hypofractionated treatment course that was given over 4 weeks. Cancer control as measured by PSA control and clinical evidence of failure, bowel and bladder toxicity and quality of life were compared.

At a median follow-up of 6 years the hypofractionated regimen was found to be non-inferior to the standard regimen for cancer control. There was no difference early or late bladder toxicity between the two treatments. There was slightly worse early bowel toxicity during and immediately after treatment with the hypofractionated regimen, but there was actually slightly less long-term bowel toxicity with this same regimen.

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Taking Testosterone Doesn’t Increase Prostate Cancer Risk

MedicalResearch.com Interview with:

Dr. Stacy Loeb, MD, MScDepartment of Urology, Population Health, and Laura and Isaac Perlmutter Cancer CenterNew York University, New York

Dr. Stacy Loeb

Dr. Stacy Loeb MD Msc
Assistant Professor of Urology and Population Health
New York University Langone Medical Center

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

Response: The association between exposure to testosterone replacement therapy and prostate cancer risk is controversial.  The purpose of our study was to examine this issue using national registries from Sweden, with complete records on prescription medications and prostate cancer diagnoses.  Overall, we found no association between testosterone use and overall prostate cancer risk. There was an early increase in favorable cancers which is likely due to a detection bias, but long-term users actually had a significantly reduced risk of aggressive disease.

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Maternal Cancer During Pregnancy Linked To Stillbirths and Infant Mortality

MedicalResearch.com Interview with:

Donghao Lu. PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institute

Dr. Donghao Lu

Donghao Lu PhD student
Department of Medical Epidemiology and Biostatistics
Karolinska Institute

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

Response: Cancer during pregnancy is a rare event. Whether prenatal exposure to a maternal malignancy and its treatment during pregnancy impair fetal development and neonatal health is, however, of great clinical concern. The risks of fatal outcomes such as stillbirth and infant mortality, however, have rarely been successfully explored in pregnancies complicated with cancer, in either clinical or population-based studies.

MedicalResearch.com: What are the main findings?

Response: Maternal cancer diagnosed during pregnancy was associated with increased risk of stillbirth (Incidence Rate Ratio, IRR, 2.5; 95% CI, 1.2 to 5.0), mainly stillbirths assessed as small for gestational age (SGA), and with increased risk of preterm SGA births (relative risk 3.0; 95% CI, 2.1 to 4.4). Maternal cancer diagnosed during pregnancy or the year after pregnancy were associated with increased risks of both neonatal mortality (deaths within 0 to 27 days; IRR, 2.7; 95% CI, 1.3 to 5.6 and IRR, 2.0; 95% CI, 1.2 to 3.2, respectively) and preterm birth (IRR, 5.8; 95% CI, 5.3 to 6.5 and IRR, 1.6; 95% CI, 1.4 to 1.8, respectively). The positive association with preterm birth was due to iatrogenic instead of spontaneous preterm birth. Preterm birth explained 89% of the association of maternal cancer during pregnancy with neonatal mortality.

MedicalResearch.com: What should readers take away from your report?

Response: Maternal cancer diagnosed during pregnancy was associated with increased risks of stillbirths assessed as SGA and preterm SGA live birth, suggesting that cancer and its treatment during pregnancy may impair fetal growth. Maternal cancer diagnosed during or shortly after pregnancy was associated with an increased risk of neonatal mortality, largely attributable to iatrogenic preterm birth. Although stillbirth and neonatal death are rare outcomes, the absolute risks of SGA and preterm birth are not small in pregnancies complicated with cancer. Careful monitoring of fetal growth and cautious decision making on the choices as well as the timing of preterm delivery should therefore be reinforced in these pregnancies.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Sweden is among the high-income countries with the lowest stillbirth and infant mortality rates, and these rates have decreased over time in many populations. Future studies in other populations are warranted to confirm our findings. Our data have also highlighted several cancer types, such as blood cancer, ovarian cancer, and cervical cancer, which entail highly increased risk of SGA or preterm birth and might be worthy of further exploration. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Maternal Cancer During Pregnancy and Risks of Stillbirth and Infant Mortality

Donghao Lu, Jonas F. Ludvigsson, Karin E. Smedby, Katja Fall, Unnur Valdimarsdóttir, Sven Cnattingius, and Fang Fang

Journal of Clinical Oncology
DOI: 10.1200/JCO.2016.69.9439 Journal of Clinical Oncology – published online before print March 6, 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Prostate Cancer: No Association Between Androgen Deprivation Therapy and Dementia

MedicalResearch.com Interview with:
Farzin Khosrow-Khavar, M.Sc. Ph.D. Candidate
Department of Epidemiology, Biostatistics and Occupational Health, McGill University
Center for Clinical Epidemiology – Jewish General Hospital
Montreal, QC 

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

Response: Previous studies have shown an association between androgen deprivation therapy (ADT) and risk of dementia and Alzheimer’s disease. However, these studies had methodological limitations that may account for this positive association. Using appropriate study design and methodology, we found no association between androgen deprivation therapy and risk of dementia (including Alzheimer’s disease) in patients with prostate cancer. These results were consistent by cumulative duration of  androgen deprivation therapy use and by ADT modality.

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Losing Some Weight May Reduce Risk of Endometrial Cancer

MedicalResearch.com Interview with:

Juhua Luo, PhD Associate professor of epidemiology and biostatistics Indiana University School of Public Health

Dr. Juhua Luo

Juhua Luo, PhD
Associate professor of epidemiology and biostatistics
Indiana University School of Public Health

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

Response: We already know obesity increases risk of endometrial cancer. However, information on whether weight loss reduces risk of endometrial cancer is limited.

MedicalResearch.com: What are the main findings?

Response: Women losing 5% or more weight reduced risk of getting endometrial cancer by 29%. This was observed for any weight loss but risk was even lower for obese women with intentional weight loss. Obese women intentionally losing their weights by 5% or more reduced risk of getting endometrial cancer by 56%.

MedicalResearch.com: What should readers take away from your report?

Response: Among post-menopausal women, intentional weight loss reduces risk of getting endometrial cancer, especially for obese women. Our findings suggest that weight loss in postmenopausal women may not be too late for potential health benefit.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Additional research on intentional weight loss in relation to risk for other obesity-related cancer types and for mortality from cancer or other diseases are needed.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Intentional Weight Loss and Endometrial Cancer Risk

Juhua LuoRowan T. ChlebowskiMichael HendryxThomas RohanJean Wactawski-WendeJ, Cynthia A. ThomsonAshley S. FelixChu Chen, …

JCO Jan 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Cancer Susceptibility Gene Mutations in Individuals With Colorectal Cancer

MedicalResearch.com Interview with:
Matthew B Yurgelun, M.D

Instructor in Medicine, Harvard Medical School
Dana-Farber Cancer Institute

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

Response: It has long been known that hereditary factors play a key role in colorectal cancer risk. It is currently well-established that approximately 3% of all colorectal cancers arise in the setting of Lynch syndrome, a relatively common inherited syndrome that markedly increases one’s lifetime risk of colorectal cancer, as well as cancers of the uterus, ovaries, stomach, small intestine, urinary tract, pancreas, and other malignancies. Current standard-of-care in the field is to test all colorectal cancer specimens for mismatch repair deficiency, which is a very reliable means of screening for Lynch syndrome. The prevalence of other hereditary syndromes among patients with colorectal cancer has not been known, though other such factors have been presumed to be quite rare.

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Specialized Surveillance Clinic For Patients At High Risk of Melanoma Reduced Procedures and Costs

MedicalResearch.com Interview with:

Caroline Watts| Research Fellow

Dr. Caroline Watts

Caroline Watts| Research Fellow
Cancer Epidemiology and Prevention Research
Sydney School of Public Health
The University of Sydney 

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

Response: A clinic for people at high risk of melanoma was established at the Royal Prince Alfred Hospital, Sydney in 2006 as part of a research project to look at the impact of surveillance regime which included regular full body skin examination supported by dermoscopy and total body photography at 6 monthly intervals. If a suspicious lesion was identified, the lesion was either removed or an image of the lesion was captured using digital dermoscopy and the patient returned in 3 months for review.

This study aimed to estimate the costs and benefits from a health system perspective associated with specialised surveillance compared with current routine care high risk people would receive in the community.  Continue reading