Author Interviews, Cancer Research / 30.11.2014

Charles Brenner, PhD Roy J. Carver Chair & Head of Biochemistry Departments of Biochemistry & Internal Medicine Carver College of Medicine University of Iowa Iowa City, IA  52242MedicalResearch.com Interview with: Charles Brenner, PhD Roy J. Carver Chair & Head of Biochemistry Departments of Biochemistry & Internal Medicine Carver College of Medicine University of Iowa Iowa City, IA  52242 Medical Research: What is the background for this study? What are the main findings? Dr. Brenner: KRAS mutations are extremely common in human malignancies. The KRAS gene is an oncogene that drives cell growth pathways and that leads to silencing and inactivation of tumor suppressor genes. It was known that KRAS mutant cancer cells silence tumor suppressor genes but the precise mechanism for gene silencing was not known. In this study, we discovered that KRAS mutations turn off the TET1 gene. TET1 functions as an "eraser" of gene silencing marks. When KRAS mutations occur, the TET1 eraser isn't expressed any longer, and a series of tumor suppressor genes become silenced. This is an essential part of the aggressiveness of KRAS-dependent cancers and is controlled by the ERK pathway that is turned on by KRAS. In short, KRAS turns on ERK, which turns off TET1. When TET1 is off, a set of tumor suppressor genes are also turned off, which drives cancer formation. (more…)
Author Interviews, Cancer Research, Lancet / 28.11.2014

Dr Claudia Allemani PhD FHEA MFPH Senior Lecturer in Cancer Epidemiology Cancer Research UK Cancer Survival Group Department of Non-Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine, London UKMedicalResearch.com Interview with: Dr Claudia Allemani PhD FHEA MFPH Senior Lecturer in Cancer Epidemiology Cancer Research UK Cancer Survival Group Department of Non-Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine, London UK Medical Research: What is the background for this study? Dr. Allemani:  Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. The first CONCORD study was published in 2008.1 It brought together data from 101 cancer registries in 31 countries, and included 1.9 million patients diagnosed during 1990-94 with a cancer of the colon, rectum, breast or prostate and followed up to the end of 1999. It revealed very wide international differences in five-year survival, and it confirmed the well-known racial discrepancy in cancer survival in the USA. CONCORD-2 is the most comprehensive international comparison of trends in population-based cancer patient survival to date. It extends the first study in three ways:
  • it covers 10 common cancers: collectively, these account for almost two-thirds (63%) of all cancer patients diagnosed each year in both developed and developing countries
  • it includes data on more than 25 million cancer patients, provided by 279 cancer registries in 67 countries, in 40 of which the data provide complete (100%) coverage of the national population
  • it examines trends in cancer survival for patients diagnosed over the 15-year period 1995-2009 (more…)
Author Interviews, Cancer Research, Cannabis / 19.11.2014

MedicalResearch.com Interview with: Dr Wai Liu Senior Research Fellow St George's University of London London,  SW17 Medical Research: What is the background for this study? What are the main findings? Dr. Liu: It has been known for some time that certain chemicals called cannabinoids that are isolated from the cannabis plant possess anticancer action through the ability to enhance/engage apoptosis and autophagy. These effects are both dependent and independent upon the cognate receptors. These are found at relatively high levels in brain cells. Brain tumors tend to express these at high levels and so we felt these would be good candidates. The main findings of the current study is the ability that combining the cannabinoids THC and CBD with irradiation can cause a reduction in tumor that is greater than the sum of the individual treatments. That is, when using doses of irradiation or cannabinoids individually, the effects were minimal; however, if they were used simultaneously, the effect was synergistic, and tumor growth was significantly impeded. (more…)
Author Interviews, Cancer Research, Omega-3 Fatty Acids / 13.11.2014

James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart InstituteMedicalResearch.com Interview with: James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart Institute Medical Research: What is the background for this study? What are the main findings? Dr. DiNicolantonio: Daily low-dose aspirin has been shown to decrease the risk for cancer in a meta-analysis of randomized controlled trials, which is likely attributable to its ability to modestly decrease the activity of cyclooxygenase-2 (cox-2), an enzyme which contributes importantly to the genesis and progression of adenocarcinomas. Adenocarcinomas are cancer of the glands, the most common type of breast cancer (invasive ductal carcinoma) is an adenocarcinoma, additionally many cancers of the lung, intestine, esophagus, colon are adenocarcinomas. We show that an ample dietary intake of long-chain omega-3 fats—the type prominent in fatty fish—would oppose cox-2 activity.  Additionally, we cite numerous evidence that a higher intake of long-chain omega-3 fats has been found to reduce the risk for numerous types of cancer - especially when looking at trials that excluded fried or preserved fish (or fish high in omega-6), excluded trials with a high background intake of omega-6, and included trials where the "high" intake group - actually ate 2 servings of fish or more per week. Additionally, basic science as well as randomized data showing that long-chain omega-3s can reduce the number and size of colon polyps supports this argument. (more…)
Author Interviews, Cancer Research, End of Life Care, JAMA / 12.11.2014

Ziad Obermeyer, MD, MPhil Emergency Medicine, Brigham & Women's Hospital Assistant Professor, Harvard Medical SchoolMedicalResearch.com Interview with: Ziad Obermeyer, MD, MPhil Emergency Medicine, Brigham & Women's Hospital Assistant Professor, Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Obermeyer: More patients with cancer use hospice today than ever before, but there are indications that care intensity outside of hospice is increasing, and length of hospice stay decreasing. We examined how hospice affects health care utilization and costs and found that, in a sample of elderly Medicare patients with advanced cancer, hospice care was associated with significantly lower rates of both health care utilization and total costs during the last year of life. Patients who did not enroll in hospice had considerably more aggressive care in their last year of life—most of it related to acute complications like infections and organ failure, and not directly related to cancer-directed treatment. Hospice and non-hospice patients had similar patterns of health care utilization until the week of hospice enrollment, when care began to diverge. Ultimately, non-hospice patients were five times more likely to die in hospitals and nursing homes. These differences in care contributed to a statistically-significant difference in total costs of $8,697 over the last year of life ($71,517 for non-hospice and $62,819 for hospice). (more…)
Author Interviews, Cancer Research, Case Western, Dental Research, JAMA / 07.11.2014

MedicalResearch.com Interview with: Brendan J. Perry, BSc, MBBS Princess Alexandra Hospital Brisbane, Queensland, Australia MedicalResearch: What is the background for this study? What are the main findings? Dr. Brendan J. Perry: Oral cavity cancer is usually attributed to the “Five S’s” - smoking, spirits (alcohol), spices, syphillis and sharp (or septic) teeth. Cigarettes and alcohol are the most important recognised factors. Spices, such as betel nut, and syphillis are known carcinogens but are not commonly seen in western practice. The role of chronic dental trauma on the mucosa of the mouth to cause cancer has only been examined in a limited number of studies previously and its importance has not been elucidated and has never really affected clinical practice. This retrospective review examined the position in the oral cavity where cancers occurred with respects to smoking status and other variables over a 10 year period in a major Australian hospital. The edge of the tongue, a site of potential dental trauma, was the most common site affected, accounting for 35% of oral cavity cancers in smokers. However, in lifelong non-smokers without other significant risk factors, 65% of cancers occurred on the edge of the tongue. A significant number also occurred on the buccal mucosa (inner lining of cheek) which is also exposed to dental trauma, but to a much lesser degree than the more mobile tongue. The floor of the mouth and the alveolar ridge (gums) were also common sites of cancer, but tended to occur in an older age group. This is possibly due to irritation caused by the movement of dentures in this age group against these areas of the mouth. In recent years, dentists have been recommending clients to get removable denture nyc to tackle down on discomfort. We also found that males had an equal chance of developing oral cavity versus oropharyngeal cancer (255 cases vs 265). However, females are almost twice as likely to develop an oral cavity cancer than an oropharyngeal cancer (135 cases vs 69), and this ratio jumps to 4 times the risk for lifelong non-smoking females (53 vs 12). Although a lot of attention has been given to HPV in causing oropharyngeal cancer, for non-smokers, especially females, it appears that oral cavity cancer is a more common disease, and also that chronic dental trauma may be a significant contributing factor. (more…)
Author Interviews, Colon Cancer, Cost of Health Care / 25.10.2014

Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann ArborMedicalResearch.com Interview with: Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann Arbor Medical Research: What is the background for this study? Dr. Veenstra: Nearly 50,000 patients are diagnosed with stage III colorectal cancer each year. Chemotherapy is known to increase survival by up to 20% and is the standard recommendation for these patients after surgery. However, use of chemotherapy may be associated with financial strain. In order to better understand the financial burden and worry associated with colorectal cancer treatment, we surveyed 956 patients being treated for stage III colorectal cancer. We asked patients to answer questions about financial burden such as whether they had used savings, borrowed money, skipped credit card payments, or cut back on spending for food, clothing or recreational activities because of their cancer treatment. We also asked patients how much they worry about financial problems because of their cancer or its treatment. (more…)
Author Interviews, Cancer Research, Journal Clinical Oncology, MD Anderson / 21.10.2014

MedicalResearch.com Interview with: Joanna-Grace M. Manzano, MD Assistant Professor Department of General Internal Medicine Maria E. Suarez-Almazor, MD, PhD Barnts Family Distinguished Professor Chief, Section of Rheumatology & Deputy Chair, Dept. of General  Internal Medicine UT MD Anderson Cancer Center Houston, TX Medical Research: What are the main findings of the study? Response: Our study established that unplanned hospitalization among elderly patients with GI cancer are very common – 93 events per 100-person years. Certain characteristics were found to have an increased risk for an unplanned hospitalization in our cohort, namely: older age, black race, advanced disease, higher comorbidity score, residing in poor neighborhoods and dual eligibility for Medicare and Medicaid. Esophageal and gastric cancer had the highest risk for unplanned hospitalization among all GI cancer types. Some of the observed reasons for unplanned hospitalization were potentially preventable and related to the patient’s comorbid illness. (more…)
Author Interviews, Cancer Research, MD Anderson / 17.10.2014

Steven J. Frank, M.D. Associate Professor of Radiation Oncology Medical Director of the Proton Therapy Center The University of Texas MD Anderson Cancer CenterMedicalResearch.com Interview with: Steven J. Frank, M.D. Associate Professor of Radiation Oncology Medical Director of the Proton Therapy Center The University of Texas MD Anderson Cancer Center MedicalResearch.com Editor’s Note: A recent research published in Oncology Payers, discusses the quality of life benefits and cost-savings of intensity modulated proton therapy (IMPT or proton therapy) with traditional x-ray therapy for advanced stage head and neck cancer. The senior author of the paper, Dr. Steven Frank, highlights two oropharyngeal cancer patients, one of whom received proton therapy and the other x-ray treatments. Both patients received chemotherapy. The study showed that although the upfront costs of proton therapy were three times that of standard x-ray treatments, the proton therapy patient was spared the necessity of a feeding tube, nutritional and supportive care and weight loss that accompanied the x-ray treatments. By the end of the treatment period, the total care costs for the proton therapy patient were 20% lower than the x-ray treatment plan. To evaluate the costs, Dr. Frank has been employing a costing tool used elsewhere at MD Anderson called Time-driven Activity-based Costing that places the emphasis on the value of medical care, both monetary and in terms of quality of life. Dr. Frank plans to enroll 360 patients over the next five years as well as to open the study to other cancer centers. He notes that the results will be especially valuable as health insurance companies look to further bundled insurance payments. Dr. Frank was kind enough to answer several questions regarding his work for the MedicalResearch.com audience. Medical Research: From a patient's perspective, what are the main differences between traditional x-ray therapy and proton therapy for cancer treatment? Dr. Frank: In proton therapy, the radiation hits the cancer, while with traditional x-ray the radiation hits the cancer and the normal tissues in the head and neck, causing more side effects during and after treatment. The main advantage is that proton therapy eliminates unnecessary radiation. As radiation oncologists, our primary goal is to effectively kill cancer while sparing the patient the side effects of excessive radiation. Proton therapy achieves this for many patients with a variety of cancers, including lymphoma, lung, head and neck, prostate, esophageal and pediatric cancers. (more…)
Author Interviews, Melanoma, PLoS / 16.10.2014

Professor Robert Insall CR-UK Beatson Institute for Cancer Research Glasgow UKMedicalResearch.com Interview with: Professor Robert Insall CR-UK Beatson Institute for Cancer Research Glasgow UK Medical Research: What are the main findings of the study? Prof. Insall: The principal message is that melanoma cells make their own steering signals, and thus drive themselves out of the tumour and into the bloodstream.  This comes in two parts: (a) The principal steering signal when we assay melanoma spread in vitro is lysophosphatidic acid, LPA.  LPA steers cells with really remarkable accuracy; blocking LPA receptors stops them from spreading without hurting their health or ability to move. (b) Where does the LPA gradient come from?  They make it themselves.  There seems to be lots of LPA around; they break down the LPA near them, leading to a gradient that's low near the cells and high further away.  This is the gradient that steers the tumour cells. (more…)
Author Interviews, Cancer Research, Lancet, Thromboembolism / 08.10.2014

MedicalResearch.com Interview with: Prof Martin H Prins MD Maastricht University Medical Centre, Maastricht, Netherlands Medical Research: What are the main findings of the study? Dr. Prins: Patients with active cancer, i.e. a cancer that was diagnosed or treated within 6 months before the episode, that was recurrent or metastatic, or that was diagnosed during treatment, who had a symptomatic episode of venous thromboembolism, were included in this pooled subgroup analysis of the Einstein DVT and PE studies. The incidence of recurrent venous thromboembolism was similar between groups. It occurred in 16 (5%) of 354 patients allocated to rivaroxaban and 20 (7%) of 301 patients allocated to enoxaparin and vitamin K antagonist (hazard ratio [HR] 0•67, 95% CI 0•35 to 1•30). Clinically relevant bleeding was also similar and occurred in 48 (14%) of 353 patients receiving rivaroxaban and in 49 (16%) of 298 patients receiving standard therapy (HR 0•80, 95% CI 0•54 to1•20). However, major bleeding was less frequent among rivaroxaban recipients and occurred in eight (2%) of 353 patients receiving rivaroxaban and in 15 (5%) of 298 patients receiving standard therapy (HR 0•42, 95% CI 0•18 to 0•99). Mortality was also similar. (more…)
Author Interviews, Cancer Research, JNCI, Lung Cancer, UT Southwestern / 02.10.2014

Dr. David Gerber MD Associate Professor of Internal Medicine Division of Hematology and Oncology Harold C. Simmons Cancer Center at UT Southwestern Medical CenterMedicalResearch.com Interview with: Dr. David Gerber MD Associate Professor of Internal Medicine Division of Hematology and Oncology Harold C. Simmons Cancer Center at UT Southwestern Medical Center Medical Research: What are the main findings of the study? Dr. Gerber: Fewer than 3% of adult cancer patients in the United States are enrolled in clinical trials.  Increasingly numerous and stringent eligibility criteria are a major factor limiting participation in clinical trials.  We examined the longstanding and widespread practice of excluding patients with prior cancer from oncology clinical trials.  This policy presumably reflects concerns that a prior cancer would interfere with the conduct, outcomes, or interpretation of a clinical trial, although there is no clear evidence supporting that assumption. We examined more than 50 National Cancer Institute (NCI)-sponsored lung cancer clinical trials.  We found that 80% excluded patients with prior cancers.  This exclusion criterion was applied broadly, including to more than two-thirds of trials with non-survival endpoints.  We then examined national Surveillance Epidemiology and End Results (SEER)-Medicare linked data to estimate the proportion of patients who would be excluded from these trials due to prior cancer.  We found that up to 18% of potential patients are excluded for this reason alone.  In large phase 3 clinical trials, that corresponds to more than 200 patients. (more…)
Author Interviews, Breast Cancer, Cancer Research / 02.10.2014

Gary Ulaner, MD, PhD Assistant Attending Radiologist Memorial Sloan Kettering Cancer Center Assistant Professor of Radiology, Weill Cornell Medical School Chair, Radiology Research CommitteeMedicalResearch.com Interview with: Gary Ulaner, MD, PhD Assistant Attending Radiologist Memorial Sloan Kettering Cancer Center Assistant Professor of Radiology, Weill Cornell Medical School Chair, Radiology Research Committee Medical Research: What are the main findings of the study? Dr. Ulaner: FDG PET/CT revealed distant metastases in 17% of asymptomatic stage IIB breast cancer patients below 40 years of age.   Although NCCN guidelines recommend against systemic staging in patients with stage II disease, our data suggests that PET/CT might be valuable in younger patients at earlier stages of disease than previously expected. (more…)
Author Interviews, Cancer Research, HPV, Vaccine Studies / 01.10.2014

Elmar A. Joura, MD Department of Gynaecology and Obstetrics Medical University of Vienna, Comprehensive Cancer Center Vienna, AustriaMedicalResearch.com Interview with: Elmar A. Joura, MD Department of Gynaecology and Obstetrics Medical University of Vienna, Comprehensive Cancer Center Vienna, Austria Medical Research: What are the main findings of the study? Dr. Joura: The upcoming ninevalent vaccine has the potential to prevent 85% of the cervical precancers and surgeries such as LEEP (conization) (more…)
Author Interviews, Cancer Research, Esophageal, Gastrointestinal Disease / 28.09.2014

Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA.MedicalResearch.com: Interview with: Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA. Medical Research: What are the main findings of the study? Dr. Thrift: We conclude that height is inversely associated with risk of esophageal adenocarcinoma, both in men and women. The association is not due to confounding from known risk factors or bias. (more…)
General Medicine / 26.09.2014

MedicalResearch.com Interview with: Dr Fergus Hamilton University of Bristol, Centre for Academic Primary Care, School of Social and Community Medicine, Canyngne Hall, Bristol UK. Medical Research: What are the main findings of the study? Dr. Hamilton: The findings of this study showed a stepwise increase in risk of cancer as calcium levels increase above the normal range, most notably in men. This relationship did occur in women, but was much less strong (more…)
Author Interviews, Melanoma / 21.09.2014

Mario Mandalà, MD Unit of Clinical Research Department of Oncology and Haematology Papa Giovanni XXIII Hospital Piazza OMS 1, 24100, Bergamo, ItalyMedicalResearch.com Interview with: Mario Mandalà, MD Unit of Clinical Research Department of Oncology and Haematology Papa Giovanni XXIII Hospital Piazza OMS 1, 24100, Bergamo, Italy Medical Research: What are the main findings of the study? Dr. Mandalà: We evaluated PD-L1 expression by IHC in 81 consecutive metastatic melanoma patients, with well-defined demographic and clinical characteristics. Protein expression levels were correlated with clinical outcome. PD-L1+ and PD-L1- subsets of the A375 cell line were stabilized in vitro and compared using gene expression profiling and functional assays. Results were confirmed using xenograft models. In our study PD-L1 membrane positivity was an independent negative prognostic marker. Furthermore PD-L1 expression defined a subset of the BRAF-mutated A375 cell line characterized by a highly invasive phenotype and by enhanced ability to grow in xenograft models. If confirmed, our clinical and experimental data suggest that PD-L1+ melanomas should be considered a disease subset with distinct genetic and morpho-phenotypic features, leading to enhanced aggressiveness and invasiveness. (more…)
Author Interviews, Cancer Research, Lancet / 17.09.2014

Judith Trotman MBChB, FRACP, FRCPA Associate Professor Concord Hospital University of Sydney, AustraliaMedicalResearch.com Interview with: Judith Trotman MBChB, FRACP, FRCPA Associate Professor Concord Hospital University of Sydney, Australia Medical Research: What are the main findings of the study? Dr. Trotman: That PET-CT (applying the cut-off of ≥4 on the now internationally recommended 5 Point Scale) is a more powerful predictor of both Progression Free and Overall Survival than conventional CT in patients responding to first line immunochemotherapy for advanced follicular lymphoma.  It is also a much stronger predictor than the pre-treatment prognostic indices FLIPI and FLIP2. Patients who achieve PET-negative status have a median PFS over 6 years compared to only 17 months in those who remain PET-positive. (more…)
Author Interviews, Cancer Research, CDC, Pediatrics / 16.09.2014

Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health PromotionMedicalResearch.com Interview with: Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Medical Research: What are the main findings of the study? Dr. Li: Using the 2001 to 2009 National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) data, which represent 94.2% of the US population, we identified 120,137 pediatric cancer cases with an incidence rate of 171 cases per million children and adolescents. Overall cancer incidence rates were stable from 2001-2009. However, we found rates were increasing significantly at 1.3% per year in African American children and adolescents.  This increase might be partially attributed to the rise among renal tumors and thyroid cancer. We also found rising incidence in thyroid cancer and renal carcinoma among children and adolescents. As has been previously established, pediatric cancer is more common in males, in white, in adolescents, and in the Northeast. Leukemia is the most common pediatric cancer, followed by central nervous system (CNS) neoplasms, and then lymphomas. (more…)
Author Interviews, Cancer Research, Dartmouth, Melanoma, Nature / 12.09.2014

Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at DartmouthMedicalResearch.com Interview with: Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at Dartmouth Medical Research: What are the main findings of the study? Dr. Brinckerhoff: The genetic mutation BRAFV600E , frequently found in metastatic melanoma, not only secretes a protein that promotes the growth of melanoma tumor cells, but can also modify the network of normal cells around the tumor to support the disease’s progression. Targeting this mutation with Vemurafenib reduces this interaction, and suggests possible new treatment options for melanoma therapy. (more…)
Author Interviews, Cancer Research, Genetic Research, University of Pennsylvania / 12.09.2014

Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of PennsylvaniaMedicalResearch.com Interview with: Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of Pennsylvania   Medical Research: What are the main findings of the study? Dr. Rawlings-Goss: We found genetic mutations in key gene regulators that have been linked to ethnic disparities in cancer. Our investigation identified more than 30 previously undescribed mutations in important regulatory molecules called microRNAs. Individual microRNA molecules can regulate large numbers of genes in some cases over 6000 genes at once. Therefore, mutations in these genes have been linked to numerous diseases. By and large, however, microRNA mutations have not been studied in people of diverse ethnic backgrounds. (more…)
Author Interviews, Cancer Research, Diabetes, Diabetologia / 09.09.2014

Professor Yuli Huang The First People's Hospital of Shunde, Daliang Town, China, and colleaguesMedicalResearch.com Interview with: Professor Yuli Huang The First People's Hospital of Shunde, Daliang Town, China, and colleagues Medical Research: What are the main findings of the study? Professor Huang: In this meta-analysis of 16 prospective cohort studies comprising more than 890,000 individuals, we found that the presence of prediabetes at baseline associated with a 15% increased risk of cancer overall. The results were consistent across cancer endpoint, age, duration of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes (impaired fasting glucose [IFG] and/or impaired glucose tolerance [IGT]). (more…)
Author Interviews, Cancer, Cancer Research, End of Life Care / 09.09.2014

MedicalResearch.com Interview with: Karin Jors MA Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Freiburg, Germany Medical Research: What are the main findings of the study? Answer: The findings of our study shed light on the current circumstances for dying in cancer centers. Physicians and nurses in our study reported that they rarely have enough time to care for dying patients. In addition, only a minority of staff members felt that they had been well-prepared during their training to care for dying patients and their families. Overall, only 56% of participants indicated that it is usually possible for patients to die in dignity on their ward. This is likely the result of various factors such as: inadequate rooms for dying patients and their families (i.e. shared rooms), poor communication with patients regarding burdensome treatments, an overuse of life-prolonging measures, etc. Striking differences were found between the responses of palliative care staff and staff from other wards (e.g. general care, oncology, intensive care). For example, palliative care staff reported that they usually have enough time to care for dying patients. In addition, 95% of palliative care staff indicated that it is usually possible for patients to die in dignity on their ward. Overall, nurses perceived the situation for dying patients more negatively than physicians. Whereas 72% of physicians reported that patients can usually die a dignified death on their ward, only 52% of nurses shared this opinion. Although only slightly more than half of participants believed that patients can usually die in dignity on their ward, this is a considerable improvement to the situation 25 years ago. In a similar study published in 1989, researchers found that 72% of physicians and nurses experienced the situation for patients dying on their hospital ward as undignified. (more…)
Author Interviews, Cancer Research / 19.08.2014

Dr. Mangesh Thorat MBBS, MS(Surgery), DNB(Surgery), MNAMS Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Barts & The London School of Medicine and Dentistry, London EC1M 6BQ Queen Mary University of Londonm Honorary Clinical Lecturer Division of Surgery and Interventional Science Whittington Hospital, LondonMedicalResearch.com Interview with: Dr. Mangesh Thorat MBBS, MS(Surgery), DNB(Surgery), MNAMS Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Barts & The London School of Medicine and Dentistry, London Queen Mary University of Londonm Honorary Clinical Lecturer Division of Surgery and Interventional Science Whittington Hospital, London Medical Research: What are the main findings of the study? Dr. Thorat : Accumulating evidence supports an effect of aspirin in reducing cancer incidence and mortality. Our analyses show that for average-risk individuals aged 50-65y taking aspirin for 10 years, there would be a relative reduction of between 7% (women) and 9% (men) in the number of cancer, myocardial infarction or stroke events over a 15 year period and an overall 4% relative reduction in all deaths over a 20 year period. The benefits of aspirin use would be most visible in the reduction in deaths due to cancer. If the findings of our study are applied to the UK general population aged 50-64 taking aspirin for next 10 years, on an average more than 6000 lives will be saved every year. (more…)
Author Interviews, Cancer Research, Erasmus, JAMA / 19.08.2014

Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The NetherlandsMedicalResearch.com Interview with: Frank van Hees MSc Erasmus University Medical Center Rotterdam, the Netherlands   Medical Research: What are the main findings of the study? Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened. (more…)
Annals Internal Medicine, Author Interviews, Colon Cancer, Erasmus / 18.08.2014

Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The NetherlandsMedicalResearch.com Interview with: Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The Netherlands Medical Research:   What are the main findings of the study? Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened. (more…)
Author Interviews, Cancer Research / 16.08.2014

Devanand Sarkar, M.B.B.S., Ph.D Harrison Scholar at VCU Massey Cancer Center, Blick Scholar and Associate Professor Department of Human and Molecular Genetics Member of the VCU Institute of Molecular Medicine Virginia Commonweath School of MedicineMedicalResearch.com Interview with: Devanand Sarkar, M.B.B.S., Ph.D Harrison Scholar at VCU Massey Cancer Center, Blick Scholar and Associate Professor Department of Human and Molecular Genetics Member of the VCU Institute of Molecular Medicine Virginia Commonweath School of Medicine Medical Research: What are the main findings of the study? Dr. Sarkar: Retinoic acid (Vitamin A) is an anti-cancer drug for a number of cancers including liver cancer. However, all patients do not respond to retinoic acid. Astrocyte elevated gene-1 (AEG-1) is overexpressed in a large percentage of cancer patients and promotes development and progression of cancer. In this study we document that AEG-1 inhibits retinoic acid function. Combinatorial strategy involving AEG-1 inhibition and retinoic acid synergistically blocks growth of human liver cancer cells in animal models. (more…)
Author Interviews, Cancer Research, Lancet, Weight Research / 16.08.2014

Dr Krishnan Bhaskaran MSc PhD. Senior Lecturer in Statistical Epidemiology & National Institute for Health Research Postdoctoral Fellow London School of Hygiene and Tropical Medicine London WC1E 7HTMedicalResearch.com Interview with: Dr Krishnan Bhaskaran MSc PhD. Senior Lecturer in Statistical Epidemiology & National Institute for Health Research Postdoctoral Fellow London School of Hygiene and Tropical Medicine London WC1E 7HT Medical Research: What are the main findings of the study? Dr. Bhaskaran: Body mass index was associated with the majority of cancer types studied, and for 10 cancers, including some of the most common like colon cancer and postmenopausal breast cancer, higher body mass index was clearly associated with higher risk. The cancer type that was most strongly related to BMI was uterine cancer, the 4th most common cancer in women. For a woman of average height, each 2 stone (13kg) increase in weight increased risk by over 60%. Body mass index also had particularly large effects on risk of kidney and gallbladder cancers. In total, we estimated that over 12,000 cases of the 10 affected cancers may be caused each year by excess weight, and that if average body mass index in the population continues to increase, there may be several thousand more cases of these cancers each year as a result. (more…)
Author Interviews, Colon Cancer, JAMA, Transplantation / 15.08.2014

MedicalResearch.com Interview with: Øyvind Holme, MD Department of Medicine, Sorlandet Hospital Kristiansand, Kristiansand, Norway Institute of Health and Society, University of Oslo, Oslo, Norway Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Harvard-MIT Division of Health Sciences and Technology Boston, Massachusetts Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway Medical Research: What are the main findings of the study? Dr. Holme: In this population-based trial, we found that once-only flexible sigmoidoscopy screening in asymptomatic 50-64 year old individuals reduces colorectal cancer mortality by 27% and colorectal cancer incidence by 20% after 11 years of follow-up. We found that the incidence reduction is as great in 50-54 year old individuals as in 55-64 old individuals. Addition of a once-only fecal occult blood test to flexible sigmoidoscopy did not lead to a larger reduction in colorectal cancer incidence or mortality compared to flexible sigmoidoscopy screening alone. (more…)
Author Interviews, Erasmus, Lancet, Prostate Cancer / 10.08.2014

Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, NetherlandsMedicalResearch.com Interview with: Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, Netherlands Medical Research: What are the main findings of the study? Professor Schröder: I consider as the main finding that we could report a continuing effect of PSA driven screening on prostate cancer mortality for men aged 55 – 69 years in the screen arm of our study after 13 years of follow-up. The absolute reduction in the risk of death from prostate cancer amounts to 1.28 per 1000 men randomized to the screening arm. This translated into numbers to be invited to screening and numbers needed to be diagnosed to save one prostate cancer death of 781 and 27. These figures show an increasing effect with increasing time of follow-up. The relative risk reduction related to the control arm has remained unchanged with respect to the 11 year follow-up period. For men who actually participated and were screened the relative risk reduction amounted to 27%, the figure most applicable to men who consider to be tested. (more…)