12 June 2018
TUESDAY, June 12, 2018 (HealthDay News) — Eating a nutritionally balanced high-quality diet may lower a cancer patient’s risk of dying by as much as 65 percent, new research suggests. The finding that total diet, rather than specific nutritional components, can affect a cancer patient’s prognosis “was particularly surprising to us,” said the study’s lead author, Ashish Deshmukh. Total diet, he explained, was one that appeared to be “balanced” and “nutrient-rich” with a wide variety of vegetables, fruits, whole grains, proteins and dairy. Deshmukh is an assistant professor with the University of Florida’s College of Public Health and Health Professions. To explore the impact of nutrition on cancer, the researchers sifted through data collected between 1988 and 1994 by the Third National Health and Nutrition Examination Survey (NHANES III). Almost 34,000 people were included in the survey, which asked all participants to offer up a 24-hour diet diary. The team then used the U.S. Department of Agriculture’s (USDA) “Dietary Guidelines for Americans” as a yardstick for ranking the nutritional quality of the diets used by 1,200 people who had been diagnosed with cancer. The USDA guidelines specify serving recommendations for fruits, vegetables, whole grains, proteins, dairy, saturated fat, cholesterol and sodium. In turn, all 1,200 patients were then tracked for an average of 17 years, with researchers verifying all subsequent deaths — up to 2011 — through the U.S. National Center for Health Statistics Linked Mortality Files. By that point, half the cancer patients had died. But the research team found that those who had consumed the most nutritious diets overall had a 65 percent lower risk for dying — either from cancer or any other cause — than those who had consumed the worse diets. Deshmukh noted that the investigation did not assess the exact length of the survival benefit, nor did the researchers explore how exercise or other types of healthy behavior may impact cancer outcomes. Only an association was seen between diet and death risk, not a cause-and-effect link. But the researchers noted that the overall strength of the protective benefit of eating well held up even after digging deeper to look at the specific risk of dying from certain types of cancer, including skin cancer and breast cancer. “It is most critical that cancer survivors and their health care providers start talking about [a] balanced diet,” said Deshmukh. “It is also crucial that cancer survivors work with their dietitians to identify a balanced diet regimen, and then follow that regimen. “There are no harms [from] healthful eating,” he added. Marjorie Lynn McCullough is a senior scientific director of epidemiology research with the American Cancer Society. She noted that the “study had some limitations, such as not controlling for smoking, and evaluating older nutrition guidelines which have since been modified.” She was not involved with the study. But, she added, the findings are “generally consistent with growing evidence supporting recommendations to eat a healthy diet for cancer survivors.” Like the guidelines for cancer prevention, McCullough said, that means lowering the intake of sugar and empty calories by consuming “a mostly plant-based diet, including a variety of vegetables, whole fruits and whole grains, in addition to exercise and achieving and maintaining a healthy body weight. “However, nutrition needs can vary during treatment, recovery and over the long term,” she cautioned, “so cancer survivors should work with their health care practitioner to tailor advice on nutrition and physical activity to their situation.” The findings were published June 12 in the journal JNCI Cancer Spectrum. More information There’s more on nutrition and cancer at the U.S. National Cancer Institute.
26 April 2018
THURSDAY, April 26, 2018 (HealthDay News) — Many of the rescue workers who flooded the ruins of the World Trade Center after 9/11 now face their own private battles for survival, a pair of new studies shows. New York City Fire Department employees who worked at Ground Zero are expected to develop cancer at a greater rate than their fellow New Yorkers over the next decade, the first study found. For example, Ground Zero firefighters are being diagnosed with the pernicious blood cancer multiple myeloma years earlier than would be expected, and their cancer is more aggressive than is typical, the second study discovered. “We should continue to have cancer screening for those who were at the site, and we should have that for the next 15 to 20 years at least,” said Rachel Zeig-Owens, lead author of the first study and an epidemiologist with the FDNY World Trade Center Health Program. “We’re showing it will be valuable and necessary.” When the World Trade Center towers crumbled on Sept. 11, 2001, people were exposed to a brew of airborne toxins that included a number of known carcinogens, Zeig-Owens said. These included dangerous heavy metals, hydrocarbons and asbestos. “Think of an office building that was just pulverized, and everything that was in it,” Zeig-Owens said. “All of that is coming down, and people are breathing in that dust.” Zeig-Owens and her colleagues conducted the first study to help the World Trade Center Health Program plan its response to a possible wave of future cancer cases caused by these toxins. They estimated that in the 20 years following the 9/11 terrorist attacks, an estimated 2,960 new cancer cases will develop among rescue workers who responded to Ground Zero. The rescue workers are at increased risk of prostate cancer, thyroid cancer and melanoma in particular, the researchers found. The estimated cost of the first year of cancer treatment for those people will be more than $235 million over two decades, the researchers said. “The first year of treatment is the most expensive, normally, and that’s why we wanted to focus on that,” Zeig-Owens explained. A separate group of researchers undertook the second study after noting that New York City firefighters appeared to be developing aggressive forms of multiple myeloma at younger ages, said lead author Dr. Ola Landgren. He is chief of the Myeloma Service at Memorial Sloan Kettering Cancer Center in New York City. A review of 16 cases found that “the age of onset is about 10 to 15 years earlier than the general population,” Landgren said. “We also characterized the tumors in those patients, and we showed there are features of more aggressive biology than if we compare with [the] general population.” To predict future cases of multiple myeloma, Landgren and his colleagues analyzed blood taken from 781 Ground Zero firefighters as part of a screening program. The researchers looked for a disease called monoclonal gammopathy of undetermined significance (MGUS), a usually benign condition in which an abnormal protein shows up in the blood. MGUS is a precursor to multiple myeloma. “Among patients who do develop multiple myeloma, they always run through a proceeding precursor state,” Landgren said. Ground Zero workers have rates of MGUS nearly twice as high as a comparison group of people from Minnesota who were not exposed to the toxins, the researchers concluded. The results of both studies were published April 26 in the journal JAMA Oncology. It’s not clear exactly how much of this cancer risk results from the World Trade Center aftermath, said Dr. Otis Brawley, chief medical and scientific officer of the American Cancer Society. It’s tough to assess the direct impact of Ground Zero because firefighters typically have a higher cancer rate than average folks, said Brawley, who wrote an editorial accompanying the studies. “It’s been proven for years that firemen have a higher risk of multiple myeloma compared to the regular population,” Brawley said. “I’d love this World Trade Center population compared to firemen from Chicago or Philadelphia or Boston or Detroit, as opposed to a group of people who breathe that Midwestern unpolluted air.” Zeig-Owens agreed, noting that a follow-up study is underway that would establish a comparison group of firefighters who did not work at Ground Zero. More information The American Cancer Society has more about multiple myeloma.
15 February 2018
THURSDAY, Feb. 15, 2018 (HealthDay News) — In what researchers call a first step toward personalized vaccines for a multitude of cancers, a vaccine made from stem cells protected mice from tumors. The vaccine was composed of induced pluripotent stem cells (iPS cells) — which are adult cells that have been reverted back into stem cells. They are similar to the primitive cells found in embryos, and they have the potential to develop into any type of body tissue. Researchers have been studying iPS cells as a way to treat various diseases. The general idea is to take cells from an adult patient — from the skin, for instance — then genetically tweak them so they “rewind” into iPS cells. Those cells could then be used to generate healthy replacement tissues for those damaged by disease or injury. But it turns out that iPS cells also have similarities to tumor cells, explained senior researcher Dr. Joseph Wu, a professor at Stanford University School of Medicine. Specifically, both iPS cells and cancer cells share various antigens — or proteins — on their surfaces. So, Wu and his colleagues decided to see if iPS cells could serve as a vaccine against cancer: If the immune system is exposed to the cells, would it be primed to recognize and attack any tumor cells that later arise? They found that, at least in lab mice, the concept worked. “This is obviously just a first step,” stressed Dr. Nigel Kooreman, who also worked on the study. No one knows if the premise will pan out in humans. The next step will be to test the approach in human cells in the lab dish, according to Kooreman, who was a postdoctoral scholar at Stanford at the time of the study. The results, published Feb. 15 in the journal Cell Stem Cell, come on the heels of another cancer vaccine study conducted by some of the same researchers. In that trial, a shot of two compounds stimulated the immune system to seek and destroy several different kinds of cancer cells — again, in mice. The hope with the latest research, Kooreman said, is to eventually create personalized vaccines from an individual’s own iPS cells that could protect against a range of cancers. “I think this is a really exciting study,” said Dr. Sasha Stanton, of the University of Washington’s Cancer Vaccine Institute in Seattle. There are, of course, many unanswered questions, according to Stanton, who was not involved in the research. Any vaccine used for cancer prevention would have to be “very, very safe,” she pointed out. With iPS cells, Stanton explained, there is always some concern that they could develop into tumors. Beyond that, she said, there will be questions about how long would any immune response from vaccination would last. Would it protect people from cancer for 20 years, or would repeat “boosters” be needed, Stanton wondered. But these initial findings are promising, Stanton said. For the study, Wu’s team used four groups of mice: In one, the animals were injected with a control solution; another received an immune-boosting substance called an adjuvant; a third group received injections of iPS cells that were genetically matched to each animal; the fourth received iPS cells plus the adjuvant. All of the animals were later implanted with mouse breast cancer cells. While those tumors grew in most of the animals, the picture was different for mice that received iPS cells plus the adjuvant: Breast tumors shrunk in 7 of the 10 animals, and two completely rejected the cancer, the researchers said. Similar results were seen when mouse versions of melanoma and mesothelioma (a type of lung cancer) were studied. What happens to the iPS cells after they are injected into the body? The immune system destroys them, Kooreman said. And before the iPS cells were infused into the animals, they were treated with radiation. That, Kooreman explained, was to prevent them from developing into tumors. Another safety concern is that iPS cells could trigger an immune response against the body’s healthy tissue. But there were no signs of that in the lab mice, according to Kooreman. “So far, in our preclinical studies of mice, it appears safe,” he said. If a preventive cancer vaccine can be developed for humans, how would it be used? At first, Stanton said, it could be used to prevent recurrences in patients successfully treated for cancer. Kooreman added an iPS cell vaccine could also potentially aid cancer treatment. He envisioned it working this way: After a patient receives an initial cancer therapy, the vaccine could be used to “reactivate the immune system to attack any remnant cancer cells.” More information The U.S. National Cancer Institute has an overview on cancer vaccines.
31 January 2018
WEDNESDAY, Jan. 31, 2018 (HealthDay News) — Could a cancer “vaccine” fight more than one kind of malignancy? A new study in mice suggests it’s possible: A shot containing two compounds that stimulate the immune system was injected directly into tumors and killed those cancer cells. Not only that, it also destroyed rogue cells from the tumors that had already traveled to other sites in the rodents’ bodies, researchers reported. What’s more, they said this approach worked for lymphoma, breast cancer, colon cancer and the deadly skin cancer melanoma. How did the researchers accomplish the feat? “We found a way to get the body to reject cancer by putting stimulants of the immune system directly into the cancer,” said study author Dr. Ronald Levy, director of the lymphoma program at the Stanford Cancer Institute in California. “The immune system can recognize cancer and kill it, but the cancer is inhibiting the immune cells. If we stimulate the immune cells, we can get them to do their job at the tumor and do the job elsewhere,” he said. So will this approach work in humans? Levy said he has no reason to believe it wouldn’t. And because the treatment is injected directly into the tumor in very small doses, side effects would likely be minimal. But Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, was considerably more cautious about the treatment’s potential. “This study had excellent results. The mice had substantial responses, and the mice lived longer. But it’s important to remember that it’s a mouse study. Lab studies in animals don’t always translate to people,” said Lichtenfeld, who had no part in the study. He noted it’s a good sign that both agents used in the new treatment are already being tested in people. Levy and his colleagues explained that as cancer begins to develop, the immune system recognizes cancer cells as foreign invaders and sends cells to attack and destroy the invader. Specifically, T-cells often infiltrate and attack cancer cells. But as the tumor grows, the cancer cells may come up with ways to suppress the activity of the T-cells, according to the researchers. This allows cancers to grow at the original site, and to release cells that allow cancer to spread to other parts of the body. The two agents used in the experimental vaccine act on the immune system in different ways, according to Levy. One makes immune system cells work better and prompts them to call in reinforcements, while the other triggers the immune cells to multiply and migrate. By injecting the two immune-stimulating agents directly into the tumor, the treatment only boosts immune cells that have learned to fight against that particular cancer. So when the immune cells leave the tumor, they only seek out cells from that specific cancer, Levy said. So far, the researchers were able to eliminate four types of cancer in the mouse study. In the majority of those cases, one treatment was enough to eliminate the cancer. The researchers expect to start a small human trial including 15 people with lymphoma soon. Levy said he imagines that this treatment would be one tool against cancer, and that it would likely be combined with other treatments to overwhelm the disease. He noted that when treatments such as surgery and radiation are combined, some cancers can already be treated successfully. Lichtenfeld pointed out that there are still a lot of unknowns about this treatment: Will it work on everyone? How many cancers might be impacted? Does it have the potential to overstimulate the immune system? The bottom line, he said, is that this is an interesting, and certainly important, study, but further research is needed. “Hopefully, this research will move forward quickly,” Lichtenfeld added. The study was published Jan. 31 in the journal Science Translational Medicine. More information Learn more about immunotherapy for cancer treatment from the American Cancer Society.
15 December 2017
FRIDAY, Dec. 15, 2017 (HealthDay News) — A new drug that targets a genetic flaw common to most cancer cells is showing potency against many tumor types. The preliminary trial of a drug called ulixertinib was conducted with 135 patients who had already failed treatments for one of a variety of advanced, solid tumors. Researchers led by Dr. Ryan Sullivan, of Massachusetts General Hospital, said ulixertinib did seem to spur at least a “partial response” to the therapy or “disease stabilization,” regardless of cancer type. “It was exciting to see responses in some patients,” said Sullivan, an oncologist and member of the Termeer Center for Targeted Therapies at the Boston hospital. “The results of this study can be built upon to develop better treatment regimens for these patients,” he said in a news release from the American Association for Cancer Research (AACR). One cancer specialist explained how ulixertinib works on the cellular level. “It inhibits the MAPK/ERK pathway, which is a chain of proteins in the cell that communicates a signal from a receptor on the surface of the cell to the DNA in the nucleus of the cell,” said Dr. Maria Nieto. “When one of the proteins in the pathway is mutated, it can become stuck in the ‘on’ or ‘off’ position, which is a necessary step in the development of many cancers,” said Nieto, a medical oncologist at Northwell Health’s Huntington Hospital in Huntington, N.Y. Ulixertinib effectively inhibits this broken cellular pathway, and that inhibition “can be therapeutically exploited in multiple different cancers such as melanoma, lung, colon, and low-grade ovarian cancer,” she explained. Sullivan said that because ulixertinib targets the “final regulator” in the MAPK/ERK pathway, it might avoid cancer cells’ typical resistance to drug treatment. “A great number of cancers — including melanoma and lung cancers — have mutations in the MAPK/ERK pathway, and while current therapies target proteins in this cascade, many patients develop resistance to current drugs,” he explained. “The common denominator in these failed therapies is that the cancer has found a way to activate ERK. Therefore, the development of ERK inhibitors is a crucial next step to target this aberrant pathway,” Sullivan said. When it came to side effects, ulixertinib appeared to have a “tolerable” profile, with most issues not particularly severe, the researchers said. But this was still a small phase 1 trial, Sullivan noted, so larger trials are needed. The study was funded by the drug’s developer, Biomed Valley Discoveries, and published Dec. 15 in the AACR journal Cancer Discovery. Dr. Stephanie Bernik is chief of surgical oncology at Lenox Hill Hospital in New York City. She agreed that the new medicine has great potential. “Ulixertinib halts the message at the last stop before the signal can make it into the nucleus and creates a second roadblock, therefore halting growth of the cancer cell,” Bernik explained. “This kind of therapy shows great promise and allows drugs to work synergistically, making it much harder for the cancer cell to figure out a way to continue to multiply and spread.” According to the study team, the U.S. Food and Drug Administration has fast-tracked ulixertinib for development and potential approval. More information There’s more on cancer cells at the U.S. National Cancer Institute.
13 December 2017
WEDNESDAY, Dec. 13, 2017 (HealthDay News) — Exposure to firefighting chemicals may be one reason why Florida firefighters have a higher-than-normal rate of skin cancer, a new study suggests. The researchers analyzed data from almost 2,400 firefighters statewide who’d participated in a cancer survey. They found that 4.5 percent — 109 firefighters — had been diagnosed with skin cancer. That included 17 cases of melanoma, 84 cases of other types of skin cancer and 18 of an unknown type of skin cancer. The melanoma rate among the firefighters was 0.7 percent, compared with 0.011 percent in the general population, according to the researchers. “We believe there are chemicals in the work environment that, when firefighters come into contact with them, might be increasing the risk for specific kinds of cancer,” study leader Dr. Alberto Caban-Martinez, said in a University of Miami news release. He’s with the university’s Sylvester Comprehensive Cancer Center. The study noted that other factors also could be involved, such as: Increased ultraviolet radiation exposure when firefighters respond to an emergency during daylight hours Improper decontamination of safety gear after an emergency call Exposure to diesel exhaust from fire trucks engines idling while firefighters prepared to respond to a call A major surprise in the study was the younger ages that skin cancer occurred among the firefighters, Caban-Martinez said. The firefighters’ average age when diagnosed with skin cancer was 42 for melanoma, 38 for non-melanoma and 42 for unknown skin cancer types. The findings were published online Dec. 13 in the journal JAMA Dermatology. “If a primary care physician has a patient who is a firefighter, the findings suggest that they make it a point to do a full body skin exam and provide health education on skin cancer protection,” Caban-Martinez said. He noted that some firefighters may not consider skin cancer screenings until they’re older, but this study suggests it’s wise to begin full body skin examinations at an earlier age. “Firefighters are already at risk for developing and dying from other cancers, so it’s not surprising to me that our research has now identified that the risk of skin cancer among firefighters is elevated, particularly within the South Florida context,” said senior study author Erin Kobetz, associate director of the Sylvester Center. “There are certain occupational-vulnerable groups, including firefighters, who may need more regular skin cancer screening or to start earlier,” Kobetz added. More information The U.S. National Cancer Institute has more on skin cancer.
05 December 2017
TUESDAY, Dec. 5, 2017 (HealthDay News) — Your chances of surviving cancer may depend on the type of insurance you have. Researchers from the Cancer Prevention Institute of California found significant improvements in survival among cancer patients with private insurance or Medicare, but not among those who have public insurance such as Medicaid, or are uninsured. The investigators analyzed data on more than 1.1 million patients in California diagnosed with the five most common types cancer in the state — breast, colon, lung, melanoma and prostate — between 1997 and 2014. Compared with people who had private insurance, those who had no insurance had a much higher death rate for all cancers except prostate. Those with Medicaid had a much higher death rate for all cancer types except lung cancer, the researchers found. Also, they found that Medicaid patients had higher survival rates than uninsured people with breast, lung or prostate cancer, but there was little or no difference for colon cancer or melanoma. “A lack of access to preventative health care is likely to have played a key role in these survival disparities, especially for breast and colorectal cancer, for which established screening practices exist,” lead researcher Libby Ellis said in an institute news release. She also noted that people without insurance or with public insurance such as Medicaid also may also trouble getting high-quality cancer care. The findings were published online Nov. 30 in the journal JAMA Oncology. More information The U.S. National Cancer Institute has more on cancer.