Rowan T. Chlebowski, M.D., Ph.D., a principal investigator at the Los Angeles Biomedical Research Institute (LA BioMed), provided his assessment of the seeming contradictions between a previous Women's Health Initiative (WHI) study and a new abstract to be presented June 4 at the 2011 American Society of Clinical Oncology.
The abstract reports on the National Cancer Institute of Canada MAP.3 trial, the first study to evaluate an aromatase inhibitor for primary breast cancer prevention. Aromatase inhibitors lower the amount of estrogen in the body and are used for advanced and adjuvant breast cancer management in postmenopausal women. In the MAP.3 trial, the aromatase inhibitor exemestane reduced breast cancer incidence by a statistically significant 65% (P=0.002).
Dr Chlebowski, a co-author of the MAP.3 study, also was a co-author of a WHI report in JAMA this year on April 6th which provided updated follow-up of the WHI trial evaluating estrogen alone in post-menopausal women with prior hysterectomy. There, estrogen addition, as conjugated equine estrogens, surprisingly resulted in a statistically significant 23% reduction in breast cancer incidence (P=0.02).
Dr. Chlebowski noted "it seems paradoxical that both estrogen reduction with exemestane and estrogen addition result in lower breast cancer incidence but there is supportive underlying biology. Apparently, breast cancers which are driven by estrogen can only tolerate estrogen levels in a fairly narrow range. Thus, substantial change in the estrogen environment in either direction can influence breast cancer growth."
Dr. Chlebowski is a medical oncologist who has led several prior reports focusing on hormone effects on malignancies, including breast, lung and colorectal cancer.
Source
LA BioMed
суббота, 27 августа 2011 г.
суббота, 20 августа 2011 г.
Intensity-Modulated Radiation Therapy Reduces Side Effects For Cervical Cancer
Preliminary results from a University of Pittsburgh study evaluating extended-field intensity-modulated radiation therapy (IMRT) for cervical cancer found that it resulted in significantly reduced side effects and outcomes comparable to standard radiotherapy. The findings were presented 7-Nov-2006 at the 48th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in Philadelphia.
"We have been limited in our ability to treat women with cervical cancer with optimal doses of radiotherapy because of debilitating side effects that greatly impact their quality of life," said Dwight E. Heron, M.D., study co-author and associate professor of radiation oncology, University of Pittsburgh School of Medicine. "Our study demonstrates that with IMRT, we can target high-energy beams directly to the tumor site and the areas of concern where the cancer cells may travel, resulting in less side effects and enabling us to give a full therapeutic dose."
Extended-field radiotherapy (EFRT) is the method of radiotherapy used with advanced cervical cancer in which the pelvis and abdominal region are irradiated to destroy cancer cells that travel up to the abdominal lymph nodes that drain from the tumor. According to Dr. Heron, standard EFRT causes serious side effects in as many as 40 percent of patients. These side effects can include frequent urination and pain, diarrhea and bowel obstruction and tend to worsen when chemotherapy is given at the same time as radiotherapy.
In the current study, 36 patients with cervical cancer were treated with extended-field IMRT and the chemotherapy agent cisplatin to determine the efficacy of treatment and treatment-related side effects. Of these patients, 34 had a complete response to treatment. Only two patients developed higher-grade gastrointestinal and urinary side effects and 10 developed myelotoxicity, a slowdown of blood cell production that is common with chemotherapy. The overall survival rate at two-year follow-up was 54 percent.
"We found that by using extended-field IMRT and chemotherapy, we were able to effectively reduce the toxic effects of treatment," said Sushil Beriwal, M.D., principal investigator and assistant professor at the University of Pittsburgh School of Medicine and medical director of radiation oncology at Magee-Womens Hospital of UPMC. "This is important because it means there are less treatment interruptions and more patients are able to complete the treatment within the prescribed time period. This, in turn, increases the efficacy of treatment, giving us encouraging evidence that these cervical cancer patients can benefit from IMRT."
Unlike standard radiation therapy, IMRT administers a radiation field that consists of several hundred small beams of varying intensities that pass through normal tissue without doing significant damage but converge to give a precise dose of radiation at the tumor site. IMRT can potentially limit the adverse side effects from radiation while increasing the intensity of doses that can be given to effectively destroy cancer cells.
CONTACT:
Michele Baum
Co-authors of the study include Greg Gan, Joseph L. Kelley, M.D., and Robert P. Edwards, M.D., all with the University of Pittsburgh School of Medicine.
Contact: Clare Collins
University of Pittsburgh Medical Center
"We have been limited in our ability to treat women with cervical cancer with optimal doses of radiotherapy because of debilitating side effects that greatly impact their quality of life," said Dwight E. Heron, M.D., study co-author and associate professor of radiation oncology, University of Pittsburgh School of Medicine. "Our study demonstrates that with IMRT, we can target high-energy beams directly to the tumor site and the areas of concern where the cancer cells may travel, resulting in less side effects and enabling us to give a full therapeutic dose."
Extended-field radiotherapy (EFRT) is the method of radiotherapy used with advanced cervical cancer in which the pelvis and abdominal region are irradiated to destroy cancer cells that travel up to the abdominal lymph nodes that drain from the tumor. According to Dr. Heron, standard EFRT causes serious side effects in as many as 40 percent of patients. These side effects can include frequent urination and pain, diarrhea and bowel obstruction and tend to worsen when chemotherapy is given at the same time as radiotherapy.
In the current study, 36 patients with cervical cancer were treated with extended-field IMRT and the chemotherapy agent cisplatin to determine the efficacy of treatment and treatment-related side effects. Of these patients, 34 had a complete response to treatment. Only two patients developed higher-grade gastrointestinal and urinary side effects and 10 developed myelotoxicity, a slowdown of blood cell production that is common with chemotherapy. The overall survival rate at two-year follow-up was 54 percent.
"We found that by using extended-field IMRT and chemotherapy, we were able to effectively reduce the toxic effects of treatment," said Sushil Beriwal, M.D., principal investigator and assistant professor at the University of Pittsburgh School of Medicine and medical director of radiation oncology at Magee-Womens Hospital of UPMC. "This is important because it means there are less treatment interruptions and more patients are able to complete the treatment within the prescribed time period. This, in turn, increases the efficacy of treatment, giving us encouraging evidence that these cervical cancer patients can benefit from IMRT."
Unlike standard radiation therapy, IMRT administers a radiation field that consists of several hundred small beams of varying intensities that pass through normal tissue without doing significant damage but converge to give a precise dose of radiation at the tumor site. IMRT can potentially limit the adverse side effects from radiation while increasing the intensity of doses that can be given to effectively destroy cancer cells.
CONTACT:
Michele Baum
Co-authors of the study include Greg Gan, Joseph L. Kelley, M.D., and Robert P. Edwards, M.D., all with the University of Pittsburgh School of Medicine.
Contact: Clare Collins
University of Pittsburgh Medical Center
суббота, 13 августа 2011 г.
Eastern Philosophy Promises Hope For Western Women With Eating Disorders
A psychological technique based on Buddhist philosophy and practice may provide a solution for women who struggle with binge eating and bulimia.
The technique known as 'mindfulness' is being taught to Queensland women to help them understand and deal with the emotions that trigger their binges.
Unlike many therapies for eating disorders, there is less focus on food and controlling eating and more on providing freedom from negative thoughts and emotions.
Griffith University psychologists Michelle Hanisch and Angela Morgan said women who binged were often high-achievers and perfectionists.
When such women perceived they didn't measure up to self-imposed standards or were not in control of situations, they indulged in secretive eating binges. A typical late-night binge could involve four litres of icecream and a couple of packets of chocolate biscuits, Ms Hanisch said.
"Many women develop elaborate methods of hiding the evidence of their binges and some feel so guilty afterwards they also induce vomiting, overuse laxatives or exercise excessively to counteract the effects of the binge," she said.
"Binge eating is largely a distraction - a temporary escape from events and emotions that nevertheless can cause long-term physical problems including electrolyte imbalances. Instead, women need to learn how to react in a different way."
Mindfulness involves exercises similar to meditation that could help people live more in the moment, develop a healthy acceptance of self and become aware of potentially destructive habitual responses.
"Women who have been through the program report less dissatisfaction with their bodies, increased self-esteem and improved personal relationships," Ms Morgan said.
"They learn that thoughts and emotions don't have any power over us as they are just passing phenomena and aren't permanent."
Mindfulness has already been shown to be effective as a treatment for anxiety and depression, substance abuse, and the stress associated with physical conditions such as trauma, chronic pain or cancer.
The eight-week program is being offered at no charge at Griffith University campuses on the Gold Coast and in Brisbane.
Contact: Mardi Chapman
Research Australia
The technique known as 'mindfulness' is being taught to Queensland women to help them understand and deal with the emotions that trigger their binges.
Unlike many therapies for eating disorders, there is less focus on food and controlling eating and more on providing freedom from negative thoughts and emotions.
Griffith University psychologists Michelle Hanisch and Angela Morgan said women who binged were often high-achievers and perfectionists.
When such women perceived they didn't measure up to self-imposed standards or were not in control of situations, they indulged in secretive eating binges. A typical late-night binge could involve four litres of icecream and a couple of packets of chocolate biscuits, Ms Hanisch said.
"Many women develop elaborate methods of hiding the evidence of their binges and some feel so guilty afterwards they also induce vomiting, overuse laxatives or exercise excessively to counteract the effects of the binge," she said.
"Binge eating is largely a distraction - a temporary escape from events and emotions that nevertheless can cause long-term physical problems including electrolyte imbalances. Instead, women need to learn how to react in a different way."
Mindfulness involves exercises similar to meditation that could help people live more in the moment, develop a healthy acceptance of self and become aware of potentially destructive habitual responses.
"Women who have been through the program report less dissatisfaction with their bodies, increased self-esteem and improved personal relationships," Ms Morgan said.
"They learn that thoughts and emotions don't have any power over us as they are just passing phenomena and aren't permanent."
Mindfulness has already been shown to be effective as a treatment for anxiety and depression, substance abuse, and the stress associated with physical conditions such as trauma, chronic pain or cancer.
The eight-week program is being offered at no charge at Griffith University campuses on the Gold Coast and in Brisbane.
Contact: Mardi Chapman
Research Australia
суббота, 6 августа 2011 г.
Attendees At Conference Say Contraception Promotes Promiscuity, Harms Relationships, Devalues Children
About 250 people last weekend attended a two-day conference titled "Contraception Is Not The Answer" in Rosemont, Ill., hosted by the Pro-Life Action League, the Chicago Tribune reports. According to the Guttmacher Institute, 98% of 15- to 44-year-old girls and women who have had sex said they have used at least one method of contraception, and more than 40 million women in the U.S. in the age group currently use a form of birth control. In addition, about 91% of likely U.S. voters say couples should "have access to birth control options," according to a July Harris Interactive poll of 1,001 likely voters. Some attendees at the conference planned to say that contraception promotes "sexual promiscuity," leads to a decrease in birth rates, damages relationships between men and women and "devalues children," according to the Tribune. Some experts say that opponents of contraception likely will attempt to restrict access to its use by calling for cuts to federal family planning programs and allowing pharmacists to refuse to fill prescriptions to which they have a "conscience" objection, the Tribune reports. Thomas Euteneuer, president of Human Life International, at the conference called for funding to be "tak[en] away" from Planned Parenthood Federation of America for contraception and sex education services, adding that he believes contraception "doesn't prevent abortions, it causes abortion." Steve Trombley, president of Planned Parenthood Chicago Area, said he does not think contraception opponents' argument that women and men should have sex "only within marriage and only for the purpose of procreation" is "sellable in any corner of America." Some antiabortion advocates disagree with "making contraception an ideological or political target," according to the Tribune. "I'm here to stop abortions, ... and we're coming close to winning on this issue," John Willke, head of the International Right to Life Federation, said, adding, "If we take up an anti-contraception agenda, we won't win the abortion fight in the foreseeable future." However, Libby Gray Macke -- director of Project Reality, an Illinois-based abstinence program -- said advocacy against contraception use is "not just a side issue from pro-life, it's the core issue" (Graham, Chicago Tribune, 9/24).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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