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Cancer Statistics
Cancer declines
overall, but some types increase
Reported NEW YORK (Reuters
Health) June 06, 2001
According to a report in the June 6th issue of the Journal of the National
Cancer Institute, researchers led by Dr. Holly L. Howe of the North American
Association of Central Cancer Registries in Springfield, Illinois., over much of
the 1990s, deaths from cancer declined slightly in the US, but the number of
Americans diagnosed with certain cancers--including breast, skin and liver
cancer--inched up.
**********
The most recent data from the
American Cancer Society's annual report on cancer facts and figures, shows that
the number of new cancer cases and deaths in the US for 2001 is predicted
to increase slightly from last years figures. Although the total numbers are
rising, it is being reported that cancer rates have been slowly dropping in the
US throughout the 1990s. They say the increase in total cases reflects the fact
that the US population is growing. The report indicates:
-
The total number of people who
will get a diagnosis of cancer is likely to reach 1,268,000 in 2001,
marginally up from 1,220,100 predicted for 2000.
- Total deaths predicted for 2001 -- 553,400 --
is almost the same as last year's expected number, 552,200.
For more details, go to our Cancer
Statistics page.
Alternative Medicine
Here To Stay, Harvard Study Says
Will the demand for complementary and alternative
medicine fade or is it here to stay? While U.S. medical schools are developing
complementary and alternative medicine (CAM) course work, and managed care
organizations are providing some coverage for CAM therapies, little data
existed to answer this question. Until now.
A new study by Harvard Medical School
researchers, looking at trends over the past half-century, suggests that CAM
is indeed here to stay for the foreseeable future. The study, which appears in
the August 21 Annals of Internal Medicine, examined trends in the use of 20
different CAMs, covering everything from acupuncture to yoga, among
representative socio-demographic groups across the continental U.S.
"The findings dispel two ideas, namely
that complementary and alternative medicine is just a passing fad, and that it
is used by one particular segment of society," said Ronald Kessler,
Harvard Medical School professor of health care policy.
Data compiled from over 2,000 interviews did
show a trend towards the use of these therapies in younger respondents; by age
33, 7 out of 10 post-baby boomers (born 1965-79) had used some type of CAM,
compared to 5 out of 10 baby boomers (born 1945-64), and 3 out of 10 pre-baby
boomers (born before 1945). However, in all age groups the use of CAMs has
steadily increased since the 1950s.
Some individuals reported using alternative
therapies for many years. Of those respondents who had tried an alternative
therapy, almost 50 percent were still using it 11 to 20 years later. This
persistence is consistent with findings in a previous study that suggested
most CAM therapies are used-at least in part-as preventative measures or as
part of a regular fitness program.
While all therapies showed increased usage over
the decades, the study yielded interesting insights into the timing of
societal adoption of particular therapies. In the 1960s, four particular
therapies increased markedly-commercial diet programs, lifestyle diet therapy,
megavitamin therapy, and self-help groups. The 1970s showed increased use of
biofeedback, energy healing, herbal medicine, and imagery. During the 1980s,
massage and naturopathy increased, while yoga decreased in popularity. The
1990s showed particular increased adoption of aromatherapy, energy healing,
herbal medicine, massage, and yoga.
The authors caution that while the data
indicates that the demand for alternative medicine will continue and may well
grow, their analysis cannot predict dramatic events that may tip prevalence
patterns in one direction or another.
The study was supported by the National
Institutes of Health, the John E. Ferzer Institute, the American Society of
Actuaries, Friends of Beth Israel Deaconess Medical Center, the Kenneth J.
Germeshausen Foundation, and the J.E. and Z.B. Butler Foundation. - By John
Lacey
21-Aug-2001
For more information, go to Http://www.unisci.com/stories/20013/0821016.htm.
European Cancer Conference, ECCO 11 -
Day 1 - October 21, 2001
Introduction
The events of September 11th at the World Trade
Center and the Pentagon have affected every informed individual across the
globe to some extent. Dr. David Spiegel,[1] Professor of Psychiatry
at Stanford University in California, compared the degree and the diversity of
responses to the September 11th attacks to those reactions experienced by
cancer patients at any given point in their illness. Cancer is a compendium of
stresses, which includes the fear and the diagnosis of cancer, the nature of
treatment decisions, confronting one's mortality, physical limitations as well
as physical and emotional pain, the arduous treatments to be endured, and the
changes that one's social and family environments undergo.
Unlike other medical specialties in which the
majority of physician interventions are designed to make patients feel better,
the medical oncologist typically offers treatments that make the patient feel
worse, no matter what the outcome. This places the medical oncologist at a
great disadvantage, further complicating the physician/patient interaction. As
a result, patients are conditioned to expect the worst from oncologists.
That being said, most cancer patients behave in
ways reminiscent of posttraumatic stress disorder. Comparative data suggest
that cancer patients react in the same fashion as sexual assault victims. The
resulting depression is similar in nature, and is worse when faced alone. The
ranks of the depressed grow from a general population baseline of 3%, to 6%
among cancer outpatients, to 12% among cancer inpatients. Major depression
characterized 1 of every 5 terminal ill patients, and 60% of individuals who
requested assisted suicide are suffering from major clinical depression. The
latter finding raises the provocative question of whether physicians ought to
be treating the depression instead of supporting physician-assisted suicide.
Group Therapy
While numerous individual and group psychosocial
treatment models exist, Dr. Spiegel focused on the group supportive expressive
treatment model, which he employs almost exclusively in managing cancer
patients. This model is predicated upon building social bonds, allowing for
the discussion of common problems. Patients collectively view their reactions
as normal and learn to find meaning in their own tragedies. Patients often
choose to overcome the social isolation of illness by helping others to feel
better through the sharing of their own experiences. This model encourages
emotional expression, rather than attempting to suppress or channel it.
This environment supports facing feelings
directly while restructuring those feelings in a supportive social context.
Emotion is valued as a source of closeness, and not a cause of isolation.
Patients are taught that cancer is not deserved and that it's acceptable not
to put on a false happy face. While individuals are conditioned to treat
crying as if they are bleeding -- in other words, suppress with pressure --
the group dynamic allows one, in the words of Shakespeare's Macbeth to
"give sorrow words." Studies have shown that those who suppress
suffer much higher rates of depression than those who express.
Group members are taught how to detoxify dying
by restructuring their fears into components, including the process of dying,
separation from loved ones, loss of control, and pain. Active coping
strategies are taught and existential discussions are not uncommon. As a
result, life's priorities are often reordered, particularly for those
individuals whose treatments are not, nor have been, curative. Given limited
and finite time frames, individuals sometimes develop a life project, a goal
to be achieved, an event to be attended, a task to be completed.
Cancer's effect on the patient's family is
acknowledged and methods for coping with this burden are explored.
Participants are taught to appreciate the differences between male and female
approaches to the same problem.
Patients are guided in terms of what to expect
when dealing with doctors. Communication, control, and caring are essential
components. Physicians should use plain language in speaking with patients and
answer questions up front. The presence of family members and friends should
be allowed during important discussions. It's okay to write down questions and
treatment options, and one has the right to expect timely diagnostic and
treatment schedules.
Physicians should identify areas of patient
choice and encourage patients to make those choices. Alternative treatment
approaches and patient-initiated explorations should be open to discussion.
Physicians should use direct eye contact, acknowledge patient distress,
express concern, and allow for interruptions during discussion.
Finally, patients learn ways to control
symptoms of cancer or of treatment. Self-hypnosis has been shown in several
studies to reduce the need for pain medication by up to 50%. Patients are also
taught the difference between good and poor coping strategies.
Does Group Therapy Work? The Evidence
In an ongoing study that has enrolled 103 of 125
women for randomization to group supportive expression therapy vs. no therapy,
interim data show a greater decrease in the impact of events scale (ie.,
posttraumatic stress) index when compared with the control group. A
multicenter study in which patients with primary breast cancer received 12
weeks of group therapy also showed a significant reduction in anxiety among
patients with high baseline clinical anxiety.
Earlier data from Spiegel translate this
reduction in anxiety to survival improvement among women with metastatic
breast cancer.[2] At 48 months, all control patients had died,
while one third of those receiving group therapy were alive. With the advent
of more modern therapies, the old survival data for both control and group
therapy cohorts have been exceeded, but future data will likely show a
continued benefit to group therapy.
Although some trials[3,4] support
Spiegel's findings that group treatment improves survival in a number of
cancer types, other studies[5,6] have shown no benefit.
Mediators of enhanced survival included
improved patient self-care and health behavior, and increased adherence to
treatment. There were also changes observed in biologic pathway; specifically,
neurologic, immunoregulatory, and endocrine pathways. Indeed, McEwen has shown
that a perpetual stressed state, termed an "allostatic load," does
correlate with decreased immune status.[7] Similarly, Sephton and
colleagues[8] noted reduced survival and flattened diurnal cortisol
levels among breast cancer patients that correlated with an increase in anergy
of the immune system and a decline in natural killer cell activity. Within the
last year, additional studies have drawn a link between decreased cortisol
levels and cancer progression.[9]
Clearly, there is more to psychosocial therapy
in the overall scheme of cancer management than meets the eye. The data
presented above suggest that, particularly for individuals with high levels of
anxiety and poor coping skills, group therapy may be more than an ancillary
component in the great treatment plan.
References
- Spiegel D. Psychological aspects of cancer
care. Eur J Cancer. 2001;37(suppl 6):149. Abstract 546.
- Spiegel D, Bloom JR, Kraemer HC, Gottheil E.
Effect of psychosocial treatment on survival of patients with metastatic
breast cancer. Lancet. 1989;2:888-891.
- Fawzy FI, Fawzy NW, Hyun CS, et al.
Malignant melanoma: effects of an early structured psychiatric
intervention, coping, and affective state on recurrence and survival 6
years later. Arch Gen Psychiatry. 1993;50:681-689.
- Kuchler T, Henne-Bruns D, Rappat S, et al.
Impact of psychotherapeutic support on gastrointestinal cancer patients
undergoing surgery: survival results of a trial. Hepatogastroenterology.
1999;46:322-335.
- Linn MW, Linn BS, Harris R. Effects of
counseling for late stage cancer patients. Cancer. 1982;49:1048-1055.
- Cunningham AJ, Edmonds CV, Jenkins GP,
Pollack H, Lockwood GA, Warr D. A randomized controlled trial of the
effects of group psychological therapy on survival in women with
metastatic breast cancer. Psychooncology. 1998;7:508-517.
- McEwen BS. Protective and damaging effects
of stress mediators. N Engl J Med. 1998;338:171-179.
- Sephton SE, Sapolsky RM, Kraemer HC, Spiegel
D. Diurnal cortisol rhythm as a predictor of breast cancer survival. J
Natl Cancer Inst. 2000;92:994-1000.
- Spiegel D, Sephton SE. Psychoneuroimmune and
endocrine pathways in cancer: effects of stress and support. Semin Clin
Neuropsychiatry. 2001;6:252-265.
New type of
leukemia identified
WESTPORT, CT (Reuters Health) - Using whole-genome profiling,
investigators have determined that a rare type of acute
lymphoblastic leukemia (ALL) that affects infants and does not
respond to standard chemotherapy is actually a unique type of
leukemia.
Patients with "mixed-lineage
leukemia" (MLL) carry a chromosomal translocation involving the
mixed-lineage leukemia gene on chromosome 11. The investigators
determined that MLL reflects a very early B-cell progenitor that has
initiated transdifferentiation.
Dr. Scott A. Armstrong, of
Dana-Farber Cancer Institute in Boston, and colleagues compared gene
expression profiles of leukemic cells from 10 patients with
conventional childhood ALL and 17 patients affected with the MLL
gene translocation. The results appear in the advance online edition
of Nature Genetics for December 3.
Approximately 1000 genes were
underexpressed in MLL, many of which have a function in early B-cell
development, Dr. Armstrong's team found. In addition, there were
about 200 genes more highly expressed than in conventional ALL.
The researchers then carried out a
principal component analysis using the gene expression profiles of
MLL, ALL and acute myelogenous leukemia (AML) specimens. Again,
their results showed the MLL samples to be largely genetically
distinct from the other two types of leukemia.
Conventional ALL samples expressed
high levels of lymphoid-specific genes, whereas AML samples
expressed more myeloid-specific genes. MLL, on the other hand,
expressed genes primarily associated with hematopoietic progenitors.
Dr. Armstrong's team conducted a
cross-validation study using 20 ALL samples, 17 MLL samples, and 20
AML samples. The model they generated was 95% accurate in assigning
samples to the appropriate class, reinforcing the strong
distinctions among the three categories of leukemia.
"This finding is very exciting
to us because it forces us to think about this as a separate disease
and to think about other therapies" that could be designed to
attack its specific weak points, Dr. Armstrong said in an Institute
press release.
http://genetics.nature.com
-Westport Newsroom
203 319 2700, Posting Date: December 3, 2001
as reported by oncolink.com http://www.oncolink.com/templates/resources/article.cfm?c=3&s=8&ss=23&Year=2001&Month=12&id=7812
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NCI agrees to review the 714X
treatment
Read how a
small but dedicated group of cancer patient activists in Eastern Massachusetts
helped to bring to light what they describe as a possible cover-up of promising,
preliminary test results of 714X, a controversial unconventional cancer
treatment from Canada, at the prestigious Dana-Farber Cancer Institute in
Boston. A subsequent avalanche of media reporting about the story in the Boston
area resulted in Dana-Farber calling on the National Cancer Institute (NCI) to
undertake a formal review of 714X, which the NCI's Office of Cancer
Complementary and Alternative Medicine (OCCAM) has agreed to do.
Go to http://www.naturalhealthline.com/newsletter/1june01/714x.htm
for an article written by Peter Chowka about this.
Plant Hormones Offer New Weapon Against Cancer
May 2001 - Reuters and Health Media Ltd
Prof Peter Wardman of the Gray Cancer
Institute/Cancer Research Campaign (CRC)
in the UK, has found that the plant molecule indole acetic acid (IAA) could be
converted to produce toxic oxygen radicals, which destroy 99.9 per cent of
cancerous cells while leaving healthy cells undamaged. This means IAA treatment
could result in fewer side effects, such as hair loss, than other cancer
treatments.
Using an enzyme from horseradish - horseradish
peroxidase - researchers were able to convert IAA to its toxic radicals. They were then able to target the IAA
activation against malignant cells by attaching an antibody against cancer to
the peroxidase molecule. Other researchers found a second route of activation
using gene therapy, whereby IAA killed cells transfected with the gene for the
peroxidase.
The third and promising activation route
discovered by Prof Wardman's team involved covering cancerous cells with a photosensitising dye and exposed
them to red light. This produced an
excited state to activate the IAA, even in hypoxic conditions, which commonly exist with cancers. However, the
technique would be limited to tumors that are accessible to light.
The work has been successful in many tumour cell
lines in the laboratory. Human trials are still some years away. We'll report
news as we hear more.
Scientists discover how key gene checks cancer
Source: www.cancerfacts.com -
Friday, June 08, 2001
CHAPEL HILL, N.C. -- June 8, 2001 -- New research published in the journal Science explains how the tumor suppressor gene, p53, is activated in
response to DNA damage to keep tumors from forming. About half of all human cancers possess defective copies of the p53 gene.
Thus, the new findings may have implications for the development of drugs
aimed at boosting p53 activity in cancer patients.
Led by Dr. Yue Xiong, scientists at the University of North Carolina's
Lineberger Comprehensive Cancer Center discovered an amino acid sequence
within p53 that is responsible for transporting the protein from the cell
nucleus to the cytoplasm, where it would get degraded or broken down.
Moreover, they discovered how this transport is blocked when DNA damage
occurs. According to Xiong, "P53 is not needed in normal cell growth under conditions of no DNA
damage. Otherwise, the cell won't
be able to grow. So the cell handles that by exporting p53 from the nucleus to
the cytoplasm for degradation."
The gene normally monitors biochemical signals indicating the occurrence of
DNA damage or mutations associated with tumor development. When such signals
occur, the transport pathways are blocked and the p53 protein accumulates in
the cell nucleus where it can either trigger the cell to self-destruct or stop
its cycle of growth. The new study shows the mechanism underlying
P53 activation induced by DNA damage. They found that the addition of the phosphate inhibits the export of
p53 to the cytoplasm. "When that gene is broken, DNA damage cannot be repaired because P53
is continually exported to the cytoplasm and getting degraded there,"
Xiong says.
It is hoped that they can develop a compound to block p53 export to restore p53 function in tumor cells with mutated
kinase genes.
Indian
cancer researchers have been studying Methylglyoxal for treating late stage cancers.
However, studies in the U.S. are not as promising. If we find out any additional
information on this drug, we will put it on our News Page.
Study indicates oily fish might ward off prostate
cancer
June 01, 2001
LONDON (AP) - Eating even moderate amounts of oily fish such as mackerel,
tuna, salmon and sardines might cut the risk of prostate cancer. Omega-3
fatty acids, plentiful in dark, oily fish, have shown promise in protecting
against cancers of the colon, rectum and ovary.
A study published in The Lancet medical journal, found that Swedish men who
ate greasy fish only occasionally or not at all were twice as likely to develop
prostate cancer as those who made it a moderate or large part of their diet.
Dr. Regina G. Ziegler, a nutritional epidemiologist at the National Cancer
Institute, was cautious about the Swedish findings. Ziegler feels that people
who seldom or never eat fish tend to substitute with more red meat and
scientists believe animal fat - butter, cream, beef, pork and processed meats -
may encourage prostate cancer.
Sardines have the most omega-3 oil in them, while the concentration in tuna
is quite a lot less, Wolk said, adding that it doesn't matter if the fish is
canned.
Flaxseed and a Low-Fat Diet Offer Protection Against Prostate Cancer
As reported on Scientific American's website http://www.sciam.com/news/071101/1.html
Prostate cancer is the leading cancer among American men. A pilot study
suggests that flaxseed, in conjunction with a low-fat diet, may have a
protective effect against the disease. The report, from researchers at Duke
University Medical Center, appears in the July issue of the journal Urology.
Twenty-five men with prostate cancer who were awaiting surgery ate a low-fat
diet and consumed three tablespoons (about 30 grams) of finely-ground flaxseed a
day for an average of 34 days. The scientists found that both the
testosterone and cholesterol levels of the men decreased over the course of the
study. And, although PSA levels in the general sample population did not
decrease, when the men were classified according to the severity of their
cancers, those with early-stage prostate cancer did show a decrease in PSA
levels as well. For the men on the diet, their tumor cells did not divide as
quickly and there was a greater rate of apoptosis (tumor cell death) in this
group."
The authors caution that the study's data "must be interpreted with
caution" because it is impossible to determine if the benefits seen in
this small, short trial were due to the flaxseed, the low-fat diet or a
combination of the two.
(Note: Many find that Budwig's Diet of
flaxseed oil and cottage cheese are helpful with many cancers including
prostate cancer.)
UNC-CH Study Offers Evidence That Garlic Protects Against Cancers - See
our cancer-fighting foods page.
Another Down Side of Chemotherapy
July 16, 2001 (Ivanhoe
Newswire) reports that although The
National Institutes of Health recommends women with breast tumors greater than
1centimeter be treated with adjuvant chemotherapy, a new study finds this
chemotherapy increases the risk of ovarian failure and along with it,
significant bone loss.
You may have to go to their archives to read additional information about this
report.
Prescription for Danger - Nutrient depletion from common medicines
http://www.alternativemedicine.com/whatshot/whatshot29.shtml.
This links to an older article, but if you haven't read it and you or anyone
in your family takes any common drugs, be sure to read this article.
Alternative
Products that recently approved by FDA
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Wobe-Mugos
has been approved as an orphan drug as
an adjunct therapy for multiple myeloma.
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Anti-cancer
herbal medicine put under human test in USA
Kanglaite injection, an anti-cancer Chinese
traditional medicine, has been approved by the Food and Drug
Administration of the United States to be used for clinical human
experiment, according to sources with the State Administration of
Traditional Chinese Medicine. This is the first time that a traditional Chinese
medicine has been approved for clinic experiment in the USA, the sources
said.
Last month, the injection, invented by Zhejiang
Kanglaite Pharmaceutical Co Ltd in Hangzhou, East China's Zhejiang
Province, went through a four-month clinical experiment on 15 to 18
volunteers in a hospital located in Salt Lake City, Utah in the USA.
The first group of people who received the injection
as part of the clinical experiment have showed satisfactory results, and
the medicine is considered effective and safe.
Kanglaite injection is developed from the liquid
distilled from the seeds of Job's tears, which is a kind of herbal
medicine. It is targeted to effectively kill cancer cells
while upgrading the immune capacity of the human body.
In China, the medicine has been used in thousands of
clinical experiments and by more than 200,000 tumor patients. The results
show that the medicine is effective in its anti-cancer actions and has no
apparent side effects.
Key
Breast Cancer Study Was a Fraud
By Thomas H. Maugh II and Rosie Mestel, LA Times Medical Writers
April 27, 2001
A key study pointing to the effectiveness of high-dose
chemotherapy and bone marrow transplants in treating metastatic breast cancer
was based on faked data, cancer experts said Thursday.
The American Society of Clinical Oncology announced
that an unscrupulous South African researcher, Dr. Werner Bezwoda, has led
thousands of women with breast cancer to undergo expensive, debilitating and
often fatal bone marrow transplants. His data were fraudulent, suggesting the
controversial procedure was more effective than it actually is, the society
concluded.
Bezwoda was fired from his post at the University of
Witwatersrand in Johannesburg in 1999 after revelations that he had faked data
in a preliminary report of another study on the use of high-dose chemotherapy
and bone marrow transplants in patients where the malignancy had spread to lymph
nodes.
For details go to http://my.webmd.com/content/article/1728.54920.
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