In the fight against cancer, scientists are searching for every advantage they can find.
One of the most encouraging trends in cancer prevention has been the increased awareness and cutting-edge research seen in the field of genetic counseling.
On Wednesday, The Associated Press released a story detailing a “huge international effort involving more than 100 institutions and genetic tests on 200,000 people has uncovered dozens of signposts in DNA that can help reveal further a person’s risk for breast, ovarian or prostate cancer.”
The central idea is that if the world’s top scientists learn the mechanisms that lead to cancer, then in the not-so-distant future, “there may be genetic tests that help identify women with the most to gain from mammograms, and men who could benefit most from PSA tests and prostate biopsies.”
At the University of Arizona Cancer Center, our High-Risk Cancer Genetics Clinic is at the forefront of this global effort to identify and apply these genetic markers. Christina Laukaitis, MD, PhD, FACP, is an Assistant Professor in Internal Medicine and Medical Genetics. She explains what the UA Cancer Center is able to provide for these patients — specifically, services patients can’t find anywhere else in Arizona:
The UACC High-Risk Cancer Genetics Clinic performs personalized cancer risk evaluation based on genetic and non-genetic risk factors. We are the only clinic in the state to go beyond risk-assessment to help people to minimize their risk of developing and dying from cancer through long-term cancer risk management.
We maintain a long-term relationship with our high-risk patients, coordinating screening and prevention efforts and ensuring that we are implementing the most current evidence-based prevention strategies. Our multi-disciplinary team includes genetic counselors, medical and gynecologic oncologists, geneticists, surgeons, nurses, social workers and nutritionists and provides cancer prevention care for more than 300 patients with an elevated cancer risk.
The number of cancer survivors currently in the United States is estimated at just under 14 million people. Expect to see that number continue to rise throughout the next decade.
The American Association for Cancer Research released its second Annual Report on Cancer Survivorship in the United States in advance of the AACR Annual Meeting 2013, and one of the major pieces of research in this report is the expected 31 percent increase in cancer survivors by 2022.
“The increase in the number of survivors will be due primarily to an aging of the population. By 2020, we expect that two-thirds of cancer survivors are going to be age 65 or older,” Julia Rowland, PhD, Director of the Office of Cancer Survivorship at the National Cancer Institute, a part of the National Institutes of Health, told the ASCO Post.
Another noteworthy item is how survivorship is not equal among different types of cancer:
In addition to providing estimates of future cancer survival trends, the report shows that survival is not uniform across cancer subtypes. Currently, women with breast cancer account for 22% of survivors, while men with prostate cancer make up 20%. People with lung cancer, the second most common cancer in terms of diagnosis, only represent 3% of survivors.
The data lays out a pretty clear need for an increase in the quality of lung cancer treatments, as well as the need for improved survivorship care.
“How to ensure that these patients lead not only long lives, but healthy and productive lives, will be a vital challenge to all of us,” said Dr. Rowland.
Read the full story here.
March 22 was Lynch Syndrome Heredity Awareness Day, and Arizona was one of 12 states
to establish that day as a way to increase public awareness of the condition.
However, many people still might not be familiar with the genetic condition. Given how it’s responsible for roughly 3-5 percent of all cases of colorectal cancer, it’s important for people to know all they can about Lynch syndrome and how to get tested for it.
Fortunately, the folks at the National Institute of Health released this podcast over the weekend. Episode 187 of NIH Research Radio covered Lynch syndrome with cancer geneticist Henry Lynch, MD, the person who Lynch syndrome is named after.
Dr. Lynch is the director of the hereditary cancer center and professor of medicine at the Creighton University Medical Center. He’s also an NIH grantee who’s been studying this condition since the early 1960s.
Host Joe Balintfy spoke to Dr. Lynch about what Lynch syndrome is and what kinds of tests are available to see if a patient has it.
Dr. Lynch emphasizes the importance of cancer screening for anyone with the genetic markers, or even anyone with a close relative that has the markers of Lynch syndrome. He not only recommends a full colonoscopy for example, but an early start.
“Mutations or variations in the MLH1, MSH2, MSH6, and PMS2 genes increase the risk of developing Lynch syndrome. All of these genes are involved in the repair of mistakes made during DNA replication – that’s when DNA is copied in preparation for cell division. Mutations in any of these genes prevent the proper repair of DNA replication mistakes. As the abnormal cells continue to divide, the accumulated mistakes can lead to uncontrolled cell growth and possibly cancer. Dr. Lynch says these genes are technical markers for diagnosing, but there’s a low tech approach to identifying Lynch syndrome as well,” Dr. Lynch said.
Go to the NIH website to download the MP3 file or read the full transcript.
• NIH Podcast, Episode 0187 (NIH.gov, March 22, 2013)
• March 22 is Lynch Syndrome Hereditary Cancer Awareness Day in Arizona (ArizonaCancerCenter.org, March 20, 2013)
Victor Gonzalez, MD
University of Arizona Cancer Center physicians are on the cutting edge of developing safer, more targeted therapies for breast cancer
patients undergoing radiation therapy for their disease.
With recent studies showing potentially dangerous links between breast cancer patients who undergo radiation therapy and develop heart problems later in life, the development of targeted therapies is among the top priorities of today’s radiation oncologists.
Last week, we spoke to Baldassarre Stea, MD, PhD, FASTRO, the UA Cancer Center’s Head of Radiation Oncology, about the department’s use of a technique known as respiratory gating, a technology that enables clinicians to track a tumor’s position in relation to the patient’s respiratory cycle. This targeted therapy technique spares the heart and focuses the radiation beam specifically on cancerous cells. Read that story on the UA Cancer Center’s official website.
Today, Victor Gonzalez, MD, discusses the UA’s ongoing efforts to protect breast cancer patients.
This study is important for several reasons. On one hand, it shows us how far radiation techniques have advanced in breast cancer. The doses of radiation to the heart with modern techniques are dramatically lower than they were twenty years ago, when most of the women in this study were treated.
At the same time, it emphasizes the need for continued improvement and ongoing research. Right now, we don’t know what dose of radiation is 100 percent safe for the heart. We can assume that the risk to the heart is going to be less with modern techniques, but we don’t know if that will be enough to completely eliminate the risk.
Techniques offered at the UACC to reduce radiation doses to the heart include intra-operative radiation therapy (where just a single dose of radiation is given to the tumor bed at the time of surgery), prone treatment (where the patient lies face down for the treatment and breast hangs down away from the heart), and respiratory gated treatment.
Patients who may see the greatest risk for treatment are women with left-sided tumors and women who require radiation to the lymph nodes close to the heart. In this situation, the heart can temporarily be moved away from the ribcage by having the patient take a deep breath, moving the ribcage and the breast away from the heart. Special cameras located in the radiation treatment room track the patient’s breathing cycle, which is displayed to the patient on special video goggles. The radiation beam is automatically turned on only after the heart had moved safely out of the way.
Dr. Gonzalez emphasized that the UACC is the only center in Tucson, and among only a handful of Cancer Centers in the United States, with this technology.
It is important to point out that the risk of heart injury from breast radiation is still small. As an example, 4-5 of every 100 women who are 50 years old and without any risk factors for heart disease would have a heart attack by age 80 without radiation. If this same group of 100 women received a typical course of breast radiation, one additional patient would have a heart attack. For comparison, smoking, diabetes and obesity each increased the risk of heart disease more than radiation therapy.
We have to balance the potential risks of treatment with the known benefits. After breast cancer surgery, radiation cuts the odds of the cancer returning in half. For most women, that’s going from a 30 percent chance of cancer without radiation to a 15 percent chance of cancer with radiation. There is no doubt that radiation therapy for breast cancer is a life-saving treatment. Overall, the benefits far outweigh the risks.
The future of cancer treatment tends to come down to these two words: targeted therapy. How can doctors fight and eliminate cancerous cells without doing harm to the surrounding healthy cells/tissues.
Michael Bookman, MD, appeared on Tuesday’s edition of AZ Illustrated to explain how the University of Arizona Cancer Center is at the forefront of the targeted therapy movement, specifically how to deliver cancer-fighting drugs to cancerous cells.
Dr. Bookman is the chief of Hematology/Oncology for the UA Cancer Center, as well as the director of clinical research.
“With conventional chemotherapy, an advantage of giving a drug intravenously is that it goes everywhere. It can reach the cancer, whether it’s in the lung, liver, lymph nodes, or other parts of body. The disadvantage is also that it goes everywhere, so it can also affect the intestinal tract or bone marrow and cause toxicity,” Dr. Bookman said.
The idea behind targeted therapy is to reduce the likelihood of toxicity and deliver the cancer-fighting drugs precisely where they need to go.
Dr. Bookman’s story begins at the 3-minute mark. Watch it below.
A regular aspirin dose has been shown to combat a number of illnesses for many individuals.
Can we now add melanoma to that list?
Researchers at the Stanford University School of Medicine have discovered that women who took aspirin on a regular basis reduced their risk of developing this skin cancer, and those who took aspirin longer had even lower risk. The findings were first published in the March 11 edition of Cancer.
“There’s a lot of excitement about this because aspirin has already been shown to have protective effects on cardiovascular disease and colorectal cancer in women,” said Jean Tang, MD, PhD, an assistant professor of dermatology and senior author of the study. “This is one more piece of the prevention puzzle.”
From the study
: “The Stanford study focused on the data of roughly 60,000 Caucasian women who were selected because less skin pigment is a risk factor for melanoma. The Stanford researchers found that those who took aspirin decreased their risk of developing melanoma by an average of 21 percent. Moreover, the protective effect increased over time: There was an 11 percent risk reduction at one year, a 22 percent risk reduction between one and four years, and as much as a 30 percent risk reduction at five years and beyond.”
It’s still premature to say that aspirin can prevent melanoma. It it not yet known exactly how much aspirin is the ideal dose, and the researchers are still trying to determine potential side effects. However, these initial results are encouraging and worth keeping an eye on.
• Study finds aspirin reduces risk of melanoma in women (Stanford School of Medicine)
The Tucson Festival of Books
is happening this weekend (March 9-10), and it promises to be one of the best local events of the year. More than 100,000 passionate readers are expected to attend the two-day event at the UA Mall, with guests such as R.L. Stine, John Sayles, David Wood, Jodi Picoult, and Ted Danson (yes, Sam Malone himself!) headlining the festival.
Even though the weather report calls for occasional rain showers, the bright Tucson sun is expected to make many appearances throughout the TFOB, as well. The UA Cancer Center’s Skin Cancer Institute has you covered.
The SCI will have four free sunscreen stations set up throughout the UA Mall for any attendee who might need a little extra protection from the sun’s harmful ultraviolet rays — the No. 1 cause of skin cancer.
“With more than 100,000 people attending the event it’s important for us to help our community and visitors be sun safe,” said Robin Harris, PhD, deputy director of the Skin Cancer Institute.
There will also be free sunscreen and skin cancer information available at the University of Arizona Cancer Center Booth No. 515 in Science City.
Other helpful tips to remember while attending the TFOB:
• Dress in long-sleeved shirts and long pants. Darker colors and tighter weaves work best.
• Wear a wide-brimmed hat that covers your head, face, ears and neck.
• Protect your eyes with sunglasses that have large frames and 99-100 percent UVA/UVB protection.
• Tucson Festival of Books attendees: Be careful of the sun (Arizona Daily Star, March 4, 2013)
Are you wearing blue today?
March is Colon Cancer Awareness month, and to kick off the next 31 days, we’re wearing blue today to show our support for the myriad noble efforts to raise awareness about this devastating disease.
From our friends at the Colon Cancer Alliance:
In February 2000, President Clinton officially dedicated March as National Colorectal Cancer Awareness Month. Since then, it has grown to be a true rallying point for the colon cancer community. Every year, thousands of patients, survivors, caregivers and advocates throughout the country join together to spread colon cancer awareness by wearing blue, holding fundraising and education events, talking to friends and family about screening and so much more.
The CCA also includes links to let folks now how to get involved, as well as information on the various screening methods and the importance of knowing one’s family history.
According to the CCA, “[t]he American Cancer Society estimates that in 2013, 142,820 people will be diagnosed with colon cancer and 50,830 people will die from this disease in the United States.” Let’s do what we can to change that.
• March 1 is ‘Dress in Blue’ day (Colon Cancer Alliance, March 1, 2013)