MedicalResearch.com Interview with:Dr. Tetyana Kendzerska
Institute for Clinical Evaluative Science
Women's College Research Institute
Women's College Hospital
Department of Medicine
University of Toronto
Medical Research: What are the main findings of the study?Dr. Kendzerska: In a large cohort with varying degrees of obstructive sleep apnea (OSA), severity of obstructive sleep apnea was not found to be independently associated with either prevalent or incident cancer, except in one subgroup analysis in smoking-related cancer.
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MedicalResearch.com Interview with:Yung-Song Lin MD
Chi Mei Medical Center
Taipei Medical University
Medical Research: What are the main findings of the study?Dr. Lin: The risks of developing oral cavity cancer, oropharyngeal cancer, and nasopharyngeal cancer (NPC) were significantly higher in patients with diabetes.
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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: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 Interview with: Dr. Lu Wang MD PhD
Associate Epidemiologist, Brigham and Women's Hospital
Assistant Professor of Medicine, Harvard Medical School
Brigham and Women's Hospital
Department of Medicine Preventive Medicine
Boston, MA 02115
Medical Research: What are the main findings of the study?Dr. Wang: We found that vitamin E supplement 400 IU every other day and vitamin C supplement 500 mg daily had no effect on total cancers, the incidence of prostate cancer and other site-specific cancers during periods of intervention, post-trial observation, or overall.
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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. 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 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: 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: 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.
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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.
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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.
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MedicalResearch.com Interview with:Adetunji Toriola, MD, PhD, MPH
Assistant Professor Division of Public Health Sciences
Department of Surgery
Washington University School of Medicine
Siteman Cancer Center St. Louis, MO
MedicalResearch: What are the main findings of the study?Dr. Toriola: Very little is known about the impact of vitamin D in prognosis among cancer patients. This knowledge is of importance because of the increasing number of people living cancer and the high prevalence of vitamin D deficiency among cancer patients. We conducted a systematic review of studies published to date on the association of circulating vitamin D (25-OHD) levels with prognosis among cancer patients. This review suggests that higher circulating vitamin D levels may improve overall survival among breast and colorectal cancer patients but there is paucity of information on the role of circulating vitamin D levels in prognosis among patients with other cancer types.
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MedicalResearch.com Interview with: Wai-Nang Paul Lee, M.D.
Division Chief, Division of Pediatric Endocrinology and Metabolism
Professor of Pediatrics
Director of Biomedical Mass Spectrometry Laboratory
Harbor-UCLA
MedicalResearch: What are the main findings of the study?Dr. Wai-Nang Lee: The study reports that EGCG, the active biologic constituent in green tea, changed the metabolism of pancreatic cancer cells by suppressing the
expression of an enzyme associated with cancer, LDHA.
The researchers also compared the effects of EGCG with those of an enzyme
inhibitor, oxamate, which is known to reduce LDHA activity, and found that
they both operated in a similar manner by disrupting the pancreatic cancer
cells metabolic system.
Scientists had believed they needed a molecular mechanism to treat cancer,
but this study shows that they can change the metabolic system and have an
impact on cancer.
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MedicalResearch.com Interview with: Dr. Olivia Pagani
Institute of Oncology of Southern Switzerland
Ospedale San Giovanni, Switzerland
MedicalResearch: What are the main findings of the study?Dr. Pagani: The studies show that also in premenopausal women (as already proven in postmenopausal women), aromatase inhibitors (AIs) (in this case Exemestane) given as adjuvant treatment are more effective than Tamoxifen in women with hormone receptor positive early breast cancer who are given concomitantly ovarian suppression to lower estrogen production. The 28% improvement in disease free survival is comparable to that seen in postmenopausal women. In particular, outcomes in women who did not receive chemotherapy (43% of the entire population, 29% of whom with node positive disease) were strikingly good (<97% were breast cancer free at 5 years).
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MedicalResearch.com Interview with:Frank van Hees MSc
Erasmus University Medical Center
Rotterdam, the Netherlands and
Ann G. Zauber PhD
Memorial Sloan Kettering Cancer Center, New York
MedicalResearch: What are the main findings of the study?Answer:The main finding of our study is that colorectal cancer screening of individuals without previous screening is worthwhile well beyond age 75, which is the recommended age to stop screening in individuals with an adequate screening history. The exact age up to which screening should be considered in unscreened elderly depends on an individual's health status: in healthy individuals screening remains worthwhile up to age 86, whereas in individuals with a severe illness, such as heart failure, screening remains worthwhile up to age 80. (more…)
MedicalResearch.com Interview with:Recinda L Sherman, MPH, PhD, CTR
Program Manager, Data Use & Research
North America Association of Central Cancer Registries (NAACCR)
MedicalResearch: What is the context of the study?Dr. Sherman:
It has long been known that poverty is associated with adverse health conditions. In general, increasing poverty results in higher disease rates and higher mortality.
This study assessed the relationship between poverty and cancer incidence using national cancer data on nearly 3 million tumors from the North American Association of Central Cancer Registries (NAACCR).
Cancer registries do not collect economic information on cancer patients, so we used an area-based social measure: % of persons living below poverty within a census tract. This measure is a proxy for an individual’s economic status and also gives insight into the type of neighborhood in which an individual lives.
MedicalResearch.com Interview with: Yael Schenker, MD, MAS
Assistant Professor
Division of General Internal Medicine
Section of Palliative Care and Medical Ethics
University of Pittsburgh
Pittsburgh, PA 15213
MedicalResearch: What are the main findings of the study? Dr. Schenker: We analyzed the content of cancer center advertisements placed in top TV and magazine media markets in 2012. Out of 1427 advertisements that met our initial search criteria, we found 409 unique advertisements that promoted clinical services at 102 cancer centers across the country. These advertisements promoted cancer treatments (88%) more often than cancer screening (18%) or supportive services (13%). Provision of information about clinical services was scant.
For example, 27% of advertisements mentioned a benefit of advertised services and 2% quantified these benefits. 2% mentioned a risk of advertised services and no advertisements quantified these risks. 5% mentioned costs or insurance coverage and no advertisements mentioned availability under specific insurance plans. In contrast, use of emotional appeals was frequent (85%). Emotional appeals commonly evoked hope for survival, focused on treatment advances, used fighting language, and/or evoked fear. Nearly half of all advertisements included patient testimonials, overwhelmingly focused on stories about survival or cure. Only 15% of testimonials included a disclaimer (for example, “most patients do not experience these results”) and none described the outcome that a typical patient may expect.
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MedicalResearch.com Interview with Dr. Derek Radisky PhD
Associate Professor and Consultant
Mayo Clinic Cancer Center
MedicalResearch: What are the main findings of the study? Dr. Radisky: The study used human tissue biopsies to find that production of matrix metalloproteinse-3 (MMP3) in pancreatic cancer biopsies was associated with poorer patient prognosis, and showed through transgenic animal and cell culture experiments that this was due to activation of the oncogenic protein Rac1b. The study thus identifies an MMP3-Rac1b signaling axis that drives pancreatic cancer progression.
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MedicalResearch.com Interview with: Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE
Chief of Staff, John D. Dingell VA Medical Center
Associate Dean for Veterans Affairs & Professor of Surgery
Wayne State University School of Medicine
John D. Dingell VA Medical Center Chief of Staff
Detroit, MI 48201
MedicalResearch: What are the main findings of the study?Dr. Gruber: We successfully addressed the problem of inadequate intracellular delivery of tumor- specific antigens (TSAs) to dendritic cells (DCs) by using synthetic cell-penetrating domains or peptides (CPPs) to create fusion tumor antigens (Ags) that readily penetrate through the plasma membrane. We demonstrated cloning and purification of the TSA melanoma-associated antigen 3 (MAGE-A3) in frame with CPP, producing enhanced cytosolic bioavailability in dendritic cells without altering cell functionality. Further, we showed that recombinant bacterial proteins can be easily engineered to purify large amounts of CPP-MAGE-A3. Use of full-length proteins circumvents the need to define HLA class I allele binding before vaccination and increases the number of epitopes recognized by CD8+ cytotoxic T lymphocytes (CTLs) when compared with peptide-pulsed dendritic cells. Finally, the use of proteins rather than plasmids or viral vectors for in vitro dendritic cell vaccine preparation avoids the practical and theoretical safety concerns regarding genomic modification.
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MedicalResearch.com Interview with: Helmneh Sineshaw, MD, MPH
Senior Epidemiologist, Health Services Researcher
American Cancer Society
MedicalResearch: What are the main findings of the study?Dr. Sineshaw: We found that non-Hispanic black women had nearly twofold higher odds of being diagnosed with triple-negative (TN) breast cancer subtype than did their white counterparts, regardless of their socioeconomic group. We also found higher odds of presenting with human epidermal growth factor receptor 2(HER2)-overexpressing breast cancer in Asian/Pacific Islander women compared with white women at every level of socioeconomic status.
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MedicalResearch.com Interview with: Gregory J. Tsongalis, PhD, HCLD, CC, FNACB
Professor of Pathology
Director, Molecular Pathology
Co-Director, Translational Research Program
Department of Pathology
Dartmouth Hitchcock Medical Center and
The Audrey and Theodor Geisel School of Medicine at Dartmouth Lebanon, NH 03756
MedicalResearch: What are the main findings of the study?
Dr. Tsongalis: This was the first study of its kind looking at multiple genes and multiple mutations in tumors of the appendix. Many of the identified mutations may be clinically actionable with respect to response to therapy or selection of therapy.
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MedicalResearch.com Interview with:Arturo Araujo, PhD IMO
Moffitt Cancer Center
Tampa, FL 33612
MedicalResearch: What are the main findings of the study?Dr. Araujo: Using in vivo approaches it is often challenging to study the multiple simultaneous interactions occurring at various time points in the setting of bone metastasis. However, integrating biological data with a powerful computational model allowed us to build a tool that could not only mimic the in vivo growth of cancer in bone but also to determine how the disease was behaving at any given time point. The key finding for us was that the computational model demonstrated the phasic or cyclical nature of how the prostate cancers grow in bone. For example, a wave of osteoclast mediated bone resorption would be followed by sustained bone formation by osteoblasts, followed again by bone reposition. We think these findings could provide novel insights into when the best time to apply therapies might be in order to obtain maximum efficiency.
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MedicalResearch.com Interview with:Rajeev Desai
SpR Gastroenterology, City Hospital Birmingham
Honorary Clinical Research Fellow
University Hospital Birmingham / NHS Blood and Transplant, Bristol
MedicalResearch: What are the main findings of the study?Dr. Desai: This study of a large national cohort of organ donors shows that, following careful assessment and selection, organs from some donors with a previous history of cancer can be used safely for transplantation. The risks of accepting such organs for transplantation should be balanced with risks of non-acceptance and its consequences including delayed transplantation or non-transplantation.
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MedicalResearch.com Interview with: Hui Wang, M.D., Ph.D., Professor
Principal Investigator
Director, Food Safety Research Center
Institute for Nutritional Sciences, SIBS, CAS
MedicalResearch.com: What are the main findings of the study? Dr. Wang: This meta-analysis has systematically reviewed 25 relevant studies composed of 17,332 cancer cases to give a comprehensive perspective on the relationship between vitamin D and cancer patient outcomes. Our result demonstrated that vitamin D levels are linked to better outcomes in several types of cancer patients. The strongest link was found in breast cancer, lymphoma and colorectal cancer. There was less evidence of a connection in people with lung cancer, gastric cancer, prostate cancer, leukemia, melanoma or Merkel cell carcinoma, but the available data were positive. We also found that a 10 nmol/L increase in vitamin D levels was tied to a 4 percent increase in survival among people with cancer.
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MedicalResearch.com Interview with:Danielle Blanch Hartigan, PhD, MPH
Cancer Prevention Fellow
National Cancer Institute
MedicalResearch.com: What are the main findings of the study?Dr. Blanch-Hartigan: Results from this nationally-representative survey of oncologists and PCPs suggest that discussion of survivorship care planning with cancer survivors does not always occur. Training and knowledge specific to survivorship care and coordinated care between PCPs and oncologists were associated with increased survivorship discussions with survivors.
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MedicalResearch.com Interview with:
Allison W. Kurian, M.D., M.Sc.
Assistant Professor of Medicine and of Health Research and Policy
Divisions of Oncology and Epidemiology
and
James M. Ford, MD
Associate Professor of Medicine
Pediatrics and Genetics, Division of Oncology,
Stanford University School of Medicine
MedicalResearch.com: What are the main findings of the study?Answer: We found that 11% of women who met standard clinical criteria for BRCA1 and BRCA2 (BRCA1/2) mutation testing, yet had tested negative, actually carried an actionable mutation in another cancer-related gene. We found that patients were highly motivated to learn about their genetic test results and new recommendations for cancer risk reduction. Over a short follow-up period, colonoscopy screening resulted in early detection of a tubular adenoma in a patient found to have a high-risk MLH1 mutation, and thus the multiple-gene testing in our study has likely prevented at least one cancer to date. We conclude that multiple-gene sequencing can benefit appropriately selected patients.
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MedicalResearch.com Interview with:Dr. Lorraine R. Reitzel Ph.D
Associate Professor in the Health Program of the Department of Educational Psychology
College of Education, University of Houston in Houston, Texas.
MedicalResearch.com: Please tell us about your study.Dr. Reitzel: The current study represented a secondary analysis of data that were collected by Dr. Lorna McNeill and colleagues at The University of Texas MD Anderson Cancer Center. The parent study was focused on better understanding factors associated with cancer risk among African American adults, and several faculty members including myself contributed ideas about the variables we thought might play a role. The current study represents one of several studies emerging from these data. The current study was led by Ms. Pragati S. Advani, a graduate student on my research team, who was interested in better understanding the associations between financial strain and modifiable behavioral risk factors for cancer among African American adults. Financial strain represents an unfavorable income to needs ratio and was assessed using a questionnaire that tapped into current difficulty affording things that represent pretty basic components of life, including suitable food, clothing, and housing for the respondent and their family. The modifiable behavioral risk factors for cancer examined included smoking cigarettes, at-risk alcohol use, being overweight/obese, getting insufficient physical activity, and having inadequate fruit and vegetable intake. We also included a tally of the total number of these factors (0 to 5) as an outcome variable of interest.
(more…)
MedicalResearch.com Interview with:
Julian Benito-Leon
University Hospital “12 de Octubre”,
Madrid, Spain
MedicalResearch.com: What are the main findings of the study?
Dr. Benito-León: It...
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MedicalResearch.com Interview with:
Dr. Tetyana Kendzerska
Institute for Clinical Evaluative Science
Women's College Research Institute
Women's College Hospital
Department of Medicine
University of Toronto
Medical Research: What are the main findings of the study?
Dr. Kendzerska: In a large cohort with varying degrees of obstructive sleep apnea (OSA), severity of obstructive sleep apnea was not found to be independently associated with either prevalent or incident cancer, except in one subgroup analysis in smoking-related cancer.
(more…)
