Prostate awareness ‘dangerously low’ in British men

Gallagher, J. BBC News. Published online: 22 April 2016

Image source: Anne Weston, LRI, CRUK – Wellcome Image // CC BY-NC0ND 4.0

Image shows scanning electron micrograph of a single prostate cancer cell.

British men are dangerously ignorant of the prostate gland, according to a men’s health charity.

It is crucial for sex as it helps produce semen and is involved in ejaculation. But it is also the leading cause of cancer in men, with 40,000 diagnosed each year, Prostate Cancer UK says.

A survey by the charity showed nearly one in five men did not even know they had a prostate and men were “blind” to the risk of cancer. The gland, which is about the size of a walnut, sits below the bladder and in front of the rectum. It produces the fluid that nourishes sperm.

The survey of 1,900 men found:

• 92% were clueless about the gland’s role
• 54% did not know where it was
• 17% did not know they had a prostate

Read the full news story here

Relevance of internal time and circadian robustness for cancer patients

Ortiz-Tudela, E. et al. BMC Cancer. 2016. 16:285

Image source: Rowena Dugdale, Wellcome Images // CC-BY-NC-ND 4.0

Background: Adequate circadian timing of cancer treatment schedules (chronotherapy) can enhance tolerance and efficacy several-fold in experimental and clinical situations. However, the optimal timing varies according to sex, genetic background and lifestyle. Here, we compute the individual phase of the Circadian Timing System to decipher the internal timing of each patient and find the optimal treatment timing.

Methods: Twenty-four patients (11 male; 13 female), aged 36 to 77 years, with advanced or metastatic gastro-intestinal cancer were recruited. Inner wrist surface Temperature, arm Activity and Position (TAP) were recorded every 10 min for 12 days, divided into three 4-day spans before, during and after a course of a set chronotherapy schedule. Pertinent indexes, I < O and a new biomarker, DI (degree of temporal internal order maintenance), were computed for each patient and period.

Results: Three circadian rhythms and the TAP rhythm grew less stable and more fragmented in response to treatment. Furthermore, large inter- and intra-individual changes were found for T, A, P and TAP patterns, with phase differences of up to 12 hours among patients. A moderate perturbation of temporal internal order was observed, but the administration of fixed chronomodulated chemotherapy partially resynchronized temperature and activity rhythms by the end of the study.

Conclusions: The integrated variable TAP, together with the asynchrony among rhythms revealed by the new biomarker DI, would help in the personalization of cancer chronotherapy, taking into account individual circadian phase markers.

Read the full article here

Stomach cancer diagnostics: New insights on stage of tumor growth

Kazan Federal University. ScienceDaily. Published online 20 April 2016.

Image source: Wellcome Images // CC BY-NC-ND 4.0

Photomicrograph showing signet ring carcinoma of stomach.

Correlations have been found between the superoxide and nitric oxide generation rates, levels of active forms of MMP-2 and MMP-9 in tumor and adjoining tissues between each other and with the disease stages for gastric cancer patients.

Despite the reduction in incidence, stomach (gastric) cancer (SC) is still the second most frequent cause of cancer related death worldwide. According to the Russian national statistics, 38 318 new SC cases were diagnosed in 2011, and the most of them on the latest disease stages III-IV. In Ukraine in 2013 SC took the second and third places in the structure of men and women cancer related mortalities, correspondingly, though only the fourth (men) and the eights (woman) incidence places in the hierarchy of tumor diseases.

High levels of reactive oxygen (ROS) and nitrogen (RNS) species can lead to the destruction of extracellular matrix facilitating tumor progression. ROS can activate matrix metalloproteinases (MMP), damage DNA and RNA. Therefore, the levels of MMP, ROS and RNS can serve as additional prognostic markers and for the estimation of the effectiveness of tumor therapy.

Read the full commentary here

Precision prevention of colorectal cancer

Fred Hutchinson Cancer Research Center. ScienceDaily. Published online: 18 April 2016.

In work presented at the American Association for Cancer Research’s annual meeting in New Orleans, Hsu and other researchers from Fred Hutch, the University of Michigan and other research groups debuted their latest progress in precision prevention — an in-the-works method to predict risk of colorectal cancer that integrates genetic, lifestyle and environmental risk factors.

This research is not yet ready to move into clinical practice, said Fred Hutch epidemiologist Dr. Ulrike “Riki” Peters, one of the study authors. But it’s the first attempt at combining so many different areas of colorectal cancer risk into one convenient risk predictor.

Read the commentary here

Taking aspirin could increase cancer survival by 20 percent

Study prompts call for more research into aspirin as an additional cancer treatment – ScienceDaily, 20 April 2016

Patients receiving cancer treatment could increase their chance of survival by up to 20% and help stop their cancer from spreading by taking a low-dose of aspirin, new research suggests.

In a systematic review of the available scientific literature a team from Cardiff University’s School of Medicine found a significant reduction in mortality and cancer spread by patients who took a low-level dose of aspirin in addition to their cancer treatment (average study follow-up length over 5 years).

The review looked at all of the available data including five randomised trials and forty two observational studies of colorectal, breast and prostate cancers.

As a result of the review, the team say their study highlights the need for randomised trials to establish the evidence needed to support low-dose aspirin as an effective additional treatment of cancer.

Image of aspirin crystals. Source: Annie Cavanagh, Wellcome Images.//CC BY-NC-ND 4.0

Professor Elwood added: “While there is a desperate need for more detailed research to verify our review and to obtain evidence on less common cancers, we’d urge patients diagnosed with cancer to speak to their doctor about our findings so they can make an informed decision as to whether or not they should take a low-dose aspirin as part of their cancer treatment.”

Full reference: Elwood, P. et al. Aspirin in the Treatment of Cancer: Reductions in Metastatic Spread and in Mortality: A Systematic Review and Meta-Analyses of Published Studies. PLOS ONE, 2016; 11 (4):

 

Commissioning better cancer services

Image source: www.england.nhs.uk

NHS England has published guidance to support commissioners and strategic clinical networks to ensure every person affected by cancer will have access to a recovery package and follow-up pathways by 2020, as set out in the cancer strategy.

The guidance includes checklists for developing service specifications, practical examples and templates to use and adapt locally.

Full reference: Implementing the Cancer Taskforce Recommendations: Commissioning person centred care for people affected by cancer

Monitoring sugar metabolism in liver may be a key to cancer diagnosis

ScienceDaily. Published online: 18 April 2016

Scientists may have discovered a significant new diagnostic marker for liver cancer, according to a paper published in the April 18 online issue of Nature Cell Biology.

A study led by The University of Texas MD Anderson Cancer Center found that a gene known as KHK (ketohexokinase or fructokinase) is expressed differently in normal liver tissues versus liver tumors. The findings reveal that liver cancer cells had a much reduced level of fructose metabolism versus healthy cells.

View the full commentary here

View the original research abstract here

The relationship between coping strategies, quality of life, and mood in patients with incurable cancer

Nipp, R.D. et al. Cancer. Published online: 18 April 2016

Background: Patients with incurable cancer face many physical and emotional stressors, yet little is known about their coping strategies or the relationship between their coping strategies, quality of life (QOL), and mood.

Methods: As part of a randomized trial of palliative care, this study assessed baseline QOL (Functional Assessment of Cancer Therapy–General), mood (Hospital Anxiety and Depression Scale), and coping (Brief COPE) in patients within 8 weeks of a diagnosis of incurable lung or gastrointestinal cancer and before randomization. To examine associations between coping strategies, QOL, and mood, we used linear regression, adjusting for patients’ age, sex, marital status, and cancer type.

Results: There were 350 participants (mean age, 64.9 years), and the majority were male (54.0%), were married (70.0%), and had lung cancer (54.6%). Most reported high utilization of emotional support coping (77.0%), whereas fewer reported high utilization of acceptance (44.8%), self-blame (37.9%), and denial (28.2%). Emotional support (QOL: β = 2.65, P < .01; depression: β = –0.56, P = .02) and acceptance (QOL: β = 1.55, P < .01; depression: β = –0.37, P = .01; anxiety: β = –0.34, P = .02) correlated with better QOL and mood. Denial (QOL: β = –1.97, P < .01; depression: β = 0.36, P = .01; anxiety: β = 0.61, P < .01) and self-blame (QOL: β = –2.31, P < .01; depression: β = 0.58, P < .01; anxiety: β = 0.66, P < .01) correlated with worse QOL and mood.

Conclusions: Patients with newly diagnosed, incurable cancer use a variety of coping strategies. The use of emotional support and acceptance coping strategies correlated with better QOL and mood, whereas the use of denial and self-blame negatively correlated with these outcomes. Interventions to improve patients’ QOL and mood should seek to cultivate the use of adaptive coping strategies

Read the abstract here

Vitamin D and patients with palliative cancer

Björkhem-Bergman, L. & Bergman, P. BMJ Supportive & Palliative Care. Published Online: 15 April 2016

Vitamin D is a hormone that is synthesised in the skin in the presence of sunlight. Sufficient vitamin D levels are important—not only for a healthy skeleton—but also for a healthy immune system.

Many patients with cancer have insufficient vitamin D levels, and low vitamin D levels are associated with increased ‘all-cause mortality’ and especially mortality due to cancer. Low vitamin D levels have also been associated with increased risk of infections, increased pain, depressive disorders and impaired quality of life.

We review the role of vitamin D in the immune system, in relation to cancer disease, pain and depression. We have recently performed an observational study in 100 patients with palliative cancer in Sweden.

The main result was that low vitamin D levels were associated with higher opioid dose, that is, more pain. We also describe a case report where vitamin D supplementation resulted in radically decreased opioid dose, less pain and better well-being.

Vitamin D supplementation is not connected with any adverse side effects and is easy to administrate. Thus, we hypothesise that vitamin D-supplementation to patients with palliative cancer might be beneficial and could improve their well-being, decrease pain and reduce susceptibility to infections. However, more clinical studies in this field are needed before firm conclusions can be drawn.

Read the full article here

A tunable delivery platform to provide local chemotherapy for pancreatic ductal adenocarcinoma

Indolfi, L. et al. Biomaterials. Volume 93, July 2016, Pages 71–82.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most devastating and painful cancers. It is often highly resistant to therapy owing to inherent chemoresistance and the desmoplastic response that creates a barrier of fibrous tissue preventing transport of chemotherapeutics into the tumor. The growth of the tumor in pancreatic cancer often leads to invasion of other organs and partial or complete biliary obstruction, inducing intense pain for patients and necessitating tumor resection or repeated stenting.

Here, we have developed a delivery device to provide enhanced palliative therapy for pancreatic cancer patients by providing high concentrations of chemotherapeutic compounds locally at the tumor site. This treatment could reduce the need for repeated procedures in advanced PDAC patients to debulk the tumor mass or stent the obstructed bile duct. To facilitate clinical translation, we created the device out of currently approved materials and drugs. We engineered an implantable poly(lactic-co-glycolic)-based biodegradable device that is able to linearly release high doses of chemotherapeutic drugs for up to 60 days. We created five patient-derived PDAC cell lines and tested their sensitivity to approved chemotherapeutic compounds.

These in vitro experiments showed that paclitaxel was the most effective single agent across all cell lines. We compared the efficacy of systemic and local paclitaxel therapy on the patient-derived cell lines in an orthotopic xenograft model in mice (PDX). In this model, we found up to a 12-fold increase in suppression of tumor growth by local therapy in comparison to systemic administration and reduce retention into off-target organs. Herein, we highlight the efficacy of a local therapeutic approach to overcome PDAC chemoresistance and reduce the need for repeated interventions and biliary obstruction by preventing local tumor growth. Our results underscore the urgent need for an implantable drug-eluting platform to deliver cytotoxic agents directly within the tumor mass as a novel therapeutic strategy for patients with pancreatic cancer.

Read the abstract here