3-D Doppler May Reveal Malignant Breast Lesions

According to an article in MedPage Today, in a group of women with suspicious breast lesions, 3-D power Doppler assessment of lesion vascularity had a 100% sensitivity and 86% specificity, Gerald L. LeCarpentier, Ph.D., of the University of Michigan, and colleagues reported in the November issue of Radiology.

If the results are borne out in larger studies, the imaging technique has the potential to spare some women from biopsies.

"Using speed-weighted 3-D power Doppler ultrasound, higher flow velocities in the malignant tumor-feeding vessels may be detected, whereas vessels with slower flow velocities in surrounding benign masses may be excluded," said Dr. LeCarpentier.

While additional study is required to confirm the potential, the small study using the hand-held 3-D Dopper device showed promise for the elimination of some surgical biopsies.

You can read the rest of the article here.

Liver Cancer Survival Rates Predicted by Genes

In a study supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Cancer Institute, the Samuel Waxman Cancer Research Foundation, among others, it was found that in hepatocellular carcinoma, genetic analysis of the non-cancerous part of the liver can predict survival after surgery.

Gene-expression profiling of such tissue yielded gene signatures that were highly associated with both survival and late recurrence of the cancer, according to Todd Golub, M.D., of the Broad Institute, and colleagues.

On the other hand, the same approach applied to tumor tissue found no significant associations with survival, the researchers reported online in the New England Journal of Medicine.

The findings support the notion that late recurrence of liver cancer is not caused by proliferation of cancer cells left behind after surgery, but to a "field effect" in a liver damaged by environmental factors, Dr. Golub and colleagues said.

The research needs further validation before it's ready for the clinic, they said, but it may allow doctors to identify patients at the highest risk for recurrence and intervene earlier.

Read the rest of this article at MedPageToday.

Primary Care Relationship Impacts Cancer Screenings

According to MedPage Today, only about half of older Medicaid patients receive recommended screening for colorectal, breast, and cervical cancers, largely because their physicians don't recommend the tests, researchers here reported.

About half of eligible Medicaid patients had evidence of screening when medical record and claims data were analyzed together.

Previous studies have shown that Medicaid recipients are more likely to have an advanced stage of cancer at the time of diagnosis than patients with other sources of health insurance, the researchers said.

And other studies have found that patients with lower socioeconomic status have lower rates of cancer screening.

All patients in this study, however, had "access to primary care and full coverage of cancer screening services under Medicaid," the researchers said.

Read the rest of this article at MedPage Today.

Platinum Standard for Treatment of Small Cell Lung Cancer is Being Questioned

As reported by MedPage Today, platinum regimens caused significantly more nausea, vomiting, anemia, and thrombocytopenia, the investigators found.

"These data suggest nonplatinum chemotherapy regimens have a more advantageous risk-benefit profile," the authors concluded.

"This systematic review highlights the lack of quality-of-life data in trials involving chemotherapy treatment for [small-cell lung cancer]. With poor long-term survival associated with both treatment groups, the issue of the quality of the survival period takes on even more significance," they said.

Only three of more than two dozen studies included in the analysis reported data on quality of life, they added.

Read the rest of the article at MedPage Today.

Excess Weight and Insulin Increase Prostate Cancer Mortality

Multiple studies have indicated that obesity before or at the time of prostate cancer diagnosis increases the mortality risk. However, they have not attempted to explain the association, the authors said.

Among obesity-driven metabolic changes that could influence prostate cancer mortality, hyperinsulinemia stands out as a prime suspect, they continued.

Laboratory studies demonstrated that mice fed a high-energy diet gained weight, became hyperinsulinemic, had accelerated growth of prostate cancer xenografts, and had increased downstream signaling of the insulin receptor in neoplastic prostate tissue.

Read the rest of this article at MedPage Today.

Double Reading of Mammograms More Effective

The interpretation of screening mammograms by two readers (double reading) rather than by one reader increased the rate of cancer detection by 4 to 14% in several studies, and by 10% according to a meta-analysis. Double reading is standard practice in at least 12 European countries, but has not been widely adopted in the United States.

The use of computer-aided detection systems has the potential to increase cancer-detection rates. Thus, a single reader using computer-aided detection might be able to match the performance of two readers. Single reading with computer-aided detection could be an alternative to double reading and improve results of single reading.

Computer-aided detection systems use computer algorithms to analyze digital mammographic images. They identify and mark potentially suspicious regions to attract the reader's attention to features that might have been overlooked or dismissed as normal. In the United States, where single reading is standard practice, commercial computer-aided detection systems have been widely adopted to improve reader performance and are used in 25 to 30% of all mammogram readings. However, the benefit of computer-aided detection in screening mammography was recently questioned in an observational study by Fenton, et al, and remains controversial.

Read more about double reading and computer-aided detection at the New England Journal of Medicine

Hepatitis B Linked to Pancreatic Cancer

As reported by MedPage Today, a history of hepatitis B infection may be associated with the development of pancreatic cancer, researchers here said.

In a case-control study, patients with pathologically confirmed adenocarcinoma of the pancreas were more likely to have evidence of past hepatitis B than were matched controls, according to Manal Hassan, M.D., Ph.D., and colleagues at M.D. Anderson Cancer Center.

On the other hand, there was no association between pancreatic cancer and hepatitis C, Dr. Hassan and colleagues said in the Oct. 1 issue of the Journal of Clinical Oncology.

Dr. Hassan cautioned that the study shows only an association between the two diseases. "More research is needed to determine whether this relationship is one of cause and effect," she said in a statement.

To read the rest of this article, visit MedPage Today.

COPD In African Americans Increases Risk of Lung Cancer

According to an article in HealthDay News, a new lung cancer risk assessment designed specifically for black Americans suggests that chronic obstructive pulmonary disease (COPD) is a much greater lung cancer risk factor for blacks than for whites.

Researchers at the University of Texas M.D. Anderson Cancer Center in Houston analyzed data from 491 black lung cancer patients and 497 blacks without lung cancer to identify risk factors for the disease.

A comparison of risk factors for blacks with a previously established risk prediction model for whites revealed that black men with a prior history of COPD have a more than six-fold increased risk of lung cancer, similar to the increased risk associated with smoking. The lung cancer risk among black men with COPD is about two times greater than among white men with COPD.

The findings were published in the September issue of the journal Cancer Prevention Research.

Read the rest of the article at AOL News.

Diagnosis of Prostate Cancer Sparks Heart Trouble

According to an article in MedPage Today, stress and anxiety after receiving a diagnosis of prostate cancer may trigger cardiovascular events, researchers said here.

Men were at a 50% elevated risk of fatal cardiovascular events in the year after prostate cancer diagnosis and a 30% greater risk of a nonfatal event, according to a large population-based study presented here at the American Society of Clinical Oncology Genitourinary Cancers Symposium.

Events were most likely in the first week after diagnosis and in younger men and those without cardiovascular risk factors, reported Fang Fang, M.D., of the Karolinska Institutet in Stockholm, and colleagues.

These findings may not be surprising because of the well-established link between emotional stress and cardiovascular events, said Bruce J. Roth, M.D., of Vanderbilt-Ingram Cancer Center in Nashville, Tenn., who commented on the study as chair of the conference program committee.

Although it's likely that the same effect would be seen in patients diagnosed with any type of cancer, Dr. Roth said there are implications for prostate cancer screening.

Read the rest of the article at MedPage.

Cancer Drug Tarceva Linked to Kidney and Liver Problems

OSI Pharmaceuticals and Genentech, makers of Tarceva, said in a letter sent to physicians that the new safety information comes from a pharmacokinetic study in patients with advanced solid tumors and moderate hepatic impairment, as measured by Child-Pugh criteria.

In the study, 10 of 15 patients died on treatment or within 30 days of the last erlotinib dose.

Eight of the patients died of progressive disease, but the deaths from hepatorenal syndrome and rapidly progressing liver disease prompted today's notice.

Erlotinib is approved for monotherapy of locally advanced or metastatic non-small-cell lung cancer. It is also approved in combination with gemcitabine (Gemzar) for first-line treatment of locally advanced, unresectable, or metastatic pancreatic cancer.

Read more about this at MedWatch

Locally Advanced Prostate Cancer Mortality Cut

According to a long-term study in Sweden, 18% of men given hormone therapy for locally advanced prostate cancer died of their tumor after a median follow-up of 10 years, said Anders Widmark, M.D., of Umea University in Umea, Sweden.

Surprisingly, he added, the cancer mortality was reduced to 8.5% for those who also had localized radiation therapy, Dr. Widmark said at the American Society for Therapeutic Radiology and Oncology meeting here.

"External beam radiation treatment should be used along with hormone therapy to increase survival for men with locally advanced prostate cancer," Dr. Widmark said before his late-breaking plenary presentation.

The study didn't just focus on longevity, but also on quality of life. It monitored and measured factors not commonly considered like erectile dysfunction and other side effects experienced by prostate cancer patients both during and following treatment.

To read the rest of the article, go to MedPage.

Drug Combination Shows Hope for Ovarian Cancer

According to an article in the Washington Post this week, the anti-cancer drug trabectedin shows promise in treating women with recurrent ovarian cancer, according to a study led by researchers at the University of California, Irvine.

With more than 20,000 women diagnosed with ovarian cancer each year, and more than 15,000 deaths from the disease yearly, early detection and treatment are imperative. In cases where the cancer is caught early and confined to the ovaries, survival rates are as high as 90% for five years following treatment. Once the cancer has spread beyond the ovaries, the survival rate drops to 30%.

Trabectedin (brand name Yondelis) is used in Europe and South Korea to treat advanced soft tissue sarcoma. It's also being tested for treatment of prostate, breast and pediatric cancers.

The international Phase III study included 672 ovarian cancer patients whose disease had progressed after first-line treatment. Half the women received standard treatment with the chemotherapy drug pegylated liposomal doxorubicin, while the other half received the chemotherapy drug and trabectedin.

Women who received the combination therapy had no cancer progression for an average of 7.3 months, compared to 5.8 months for those who received the chemotherapy drug alone.

Read more about this at the Washington Post.

X-Rays for Detecting Colon Cancer

The New England Journal of Medicine revealed a federal study of an x-ray alternative to colonoscopies. The colonography method was confirmed as effective at spotting most cancers.

The study, the largest of its kind, identified 9 out of 10 people who had cancers or large growths diagnosed previously by standard colonoscopy by using the "virtual colonoscopy" (x-ray method). Though better at ruling out cancer rather than detecting it, the virtual colonoscopy has real value in showing who needs a regular colonoscopy.

By utilizing the x-ray detection method, more people may opt to be screened as the procedure is non-invasive and involves none of the embarassment of a regular colonoscopy. Since early detection is vital in treating the various forms of colon cancers, this new screening may help many people who have shied away from the standard form of colon cancer screenings.

With costs of colonoscopies running about $3,000 per test, and x-rays costing just $300-$800, Medicare is considering paying for the cheaper, less intrusive option.

More information is available through the New England Journal of Medicine.