Brain Tumor Vaccine Shows Promise in Early Trial

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TUESDAY, April 17 (HealthDay News) -- A vaccine made from brain cancer patients' own tumor cells led to a nearly 50 percent improvement in survival times for those stricken with glioblastoma multiforme, the same malignancy that claimed the life of U.S. Sen. Edward Kennedy, a new study suggests.

A phase 2 multicenter trial of about 40 patients with recurrent glioblastoma -- an aggressive brain cancer that typically kills patients within 15 months of diagnosis -- showed that the vaccine safely increased average survival to nearly 48 weeks, compared with about 33 weeks among patients who didn't receive the treatment. The six-month survival rate was 93 percent for the vaccinated group, compared with 68 percent for 86 other glioblastoma patients, who were treated with other therapies.

"We've done a lot of things for this kind of tumor in the last 40 or 50 years, all variations on different chemotherapies that haven't really panned out," said Dr. Jonas Sheehan, director of neuro-oncology at the Penn State Cancer Institute, who was not involved in the study. "What we've known needed to happen for a while now is a revolution -- a totally new way of approaching these tumors. This is an example of a totally new paradigm."

The study is scheduled to be presented Tuesday at the annual meeting of the American Association of Neurological Surgeons (AANS), in Miami.

About a quarter of the 18,500 brain tumors diagnosed each year are glioblastomas, which are more common in men and typically occur between the ages of 50 and 70, according to the AANS. Kennedy died of the malignancy in 2009, 15 months after his diagnosis. Surgery, radiation and chemotherapy are among the standard treatment options.

The vaccine used in the trial, known as HSPPC-96, was created with tumor cells from patients who had undergone surgery to remove as much tumor as possible. The vaccine was then injected into their bodies to induce an immune response against the tumor, said lead investigator Dr. Andrew Parsa, vice chairman of neurological surgery at University of California, San Francisco. Side effects among participants were minimal.

"It's the concept of chronic therapy, to turn this into a chronic disease like hypertension and diabetes," said Parsa, who noted that no drug companies funded the study. "It's the only therapy in the clinical realm that has a reasonable chance of doing this, because we can't give patients chemotherapy [because of toxicity] for unlimited amounts of time."

Parsa said the vaccine's impact, if validated with a randomized study in the near future, could be a "total game-changer."

Added Sheehan: "The hope is that we'll go from a survival of 15 months to a meaningful difference. We're looking to go from 15 months to five years, a quantum leap forward."

Because this study was to be presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

Visit the American Association of Neurological Surgeons for more on glioblastomas.

SOURCES: Andrew Parsa, M.D., Ph.D., professor and vice chairman, neurological surgery, University of California, San Francisco; Jonas Sheehan, M.D., director, neuro-oncology, Penn State Cancer Institute, Hershey, Pa.; April 17, 2012, presentation, abstract, American Association of Neurological Surgeons, annual meeting, Miami

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Parents of Kids With Cancer No More Likely to Break Up

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THURSDAY, April 12 (HealthDay News) -- Even though a child's illness can cause severe stress, a new study from Denmark finds that the marriages and partnerships of parents of kids with cancer aren't more likely to fall apart.

The study debunks "a persistent myth that childhood cancer will have a destructive impact on one's marriage and family. This is simply not true," said Anne Kazak, professor of pediatrics at the University of Pennsylvania in Philadelphia.

Cancer in children is rare, although it's the leading disease-related cause of death in kids under 15. According to the National Cancer Institute, an average of one to two children out of 10,000 develop cancer each year.

In the new study, researchers studied the parents of 2,450 children (up to age 20) who received a diagnosis of cancer between 1980 and 1997. They compared them to the parents of 44,853 similar children who didn't have cancer, and followed them for up to 20 years.

The parents in both groups included both married and unmarried couples who lived together. (As of 1996, cohabiting but unmarried parents accounted for 60 percent of first-born children in Denmark.)

Even after adjusting the findings so they wouldn't be skewed by high or low numbers of people of certain income levels, the researchers found that having a child with cancer didn't affect the likelihood that a couple would separate.

The findings surprised study co-author Dr. Christoffer Johansen, who called the results "good news."

"You could imagine that you would find an increased risk for some cancers and in some marriages, but we didn't find that no matter how we analyzed the data," said Johansen, head of the Unit of Survivorship at the Danish Cancer Society in Copenhagen. "Having a child with cancer doesn't appear to be a risk factor for divorce."

Why are the couples so resilient? Johansen said it may have something to do with how a child's cancer isn't an inherent problem within a couple's relationship.

"It's inside the family, but it's an outside problem -- and now they have to stand together to cope with it," he said. "I think the relationships were able to handle the problems and take care of that strain because you simply need to do that in order to get through everyday life."

Johansen speculated that the findings would be similar in other Western countries like the United States, although they'll depend on factors including access to health insurance.

Kazak said having a child with cancer puts parents under intense strain.

"Learning that your child has cancer remains one of the most distressing experiences possible and distress under these circumstances is, of course, normal," she said. "Families must focus their energy on treatment and supporting the child and other children. But it's essential to remember that the couple's relationship is critical, too, and to think about specific ways of communicating, problem-solving and staying connected during this time."

The study appears in the May issue of the journal Pediatrics.

More information

For more about cancer in children, try the U.S. National Library of Medicine.

SOURCES: Christoffer Johansen, M.D., Ph.D., head, Unit of Survivorship, Danish Cancer Society, Copenhagen, Denmark; Anne Kazak, Ph.D., professor, department of pediatrics, University of Pennsylvania, and chief, section of behavioral oncology, The Children's Hospital of Philadelphia; May 2012 Pediatrics.

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Chemo + Radiation Best for Bladder Cancer, Study Finds

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WEDNESDAY, April 18 (HealthDay News) -- The addition of two well-tolerated chemotherapy drugs to radiation therapy led to significantly longer survival rates among patients with muscle-invasive bladder cancer.

In a new study splitting 360 patients into groups receiving radiation alone or radiation plus chemotherapy, British researchers found that those undergoing combined therapies had a 67 percent rate of local disease-free survival after two years, compared with 54 percent in the radiation group. Five-year overall survival rates were 48 percent in the chemo-radiation group, compared with 35 percent in the radiation-only group.

"Overall, the results establish that the addition of chemotherapy to radiotherapy should become standard practice for organ-preserving treatments of bladder cancer," said Dr. Manish Vira, director of the fellowship program in urologic oncology at the Arthur Smith Institute for Urology in Lake Success, N.Y. "The tried-and-true treatment method is still [bladder removal] and certainly we are moving toward a more multi-disciplinary approach."

The study is published April 19 in the New England Journal of Medicine.

About 385,000 cases of bladder cancer are diagnosed annually worldwide, according to study authors, with the average age at diagnosis over 70. For those whose cancer has invaded the bladder muscle, five-year survival rates are about 45 percent regardless of treatment.

For younger, healthier patients, bladder removal -- known as radical cystectomy -- is considered the gold standard of care for invasive bladder cancer. But older patients with co-existing medical conditions may not be as well-equipped to tolerate complications of the procedure, experts said.

The new study, the largest late-stage trial of its kind, was conducted at 45 medical facilities in the United Kingdom. Patients were randomly assigned to undergo daily radiation alone or radiation along with two chemotherapy drugs, fluorouracil and mitomycin C. In addition to improved survival rates, the number of patients needing bladder removal as a "salvage therapy" -- because other treatments failed -- was lower among those receiving radiation plus chemotherapy.

Adverse effects from the chemotherapy -- including diarrhea, sore mouth or suppression of blood cell production -- were low among participants and were managed by lowering drug dosages, said study author Dr. Nicholas James, a professor of clinical oncology at the University of Birmingham. in England.

Cost of the chemotherapy drugs is relatively inexpensive, he said -- about $1,600, plus pharmacy and intravenous administration costs.

"We were pleasantly surprised by the overall results, particularly the low reported toxicity in the chemo-radiotherapy arm compared to the radiotherapy-only group," James said. "We feel the results are sufficient to change practice . . . the drugs are cheap and safety was good in an elderly population."

More information

The U.S. National Library of Medicine has more about bladder cancer.

SOURCES: Nicholas James, M.B., Ph.D., professor, clinical oncology, and co-director, Research and Development (Cancer) University Hospitals, University of Birmingham, England; Manish A. Vira, M.D., director, fellowship program in urologic oncology, the Arthur Smith Institute for Urology, Lake Success N.Y.; April 19, 2012, New England Journal of Medicine

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Healthy Lifestyle Choices Could Cut Cancer Rates: Report

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THURSDAY, April 19 (HealthDay News) -- Most people know what lifestyle choices will keep the chances of a cancer diagnosis low: Don't smoke, eat healthy, exercise and get the recommended screenings.

But, many Americans don't make those choices, and a new report suggests that lawmakers and private industry need to do more to help make those changes easier ones to make.

The report, released by the American Cancer Society Thursday, details the shortcomings that contribute to cancer deaths and notes that social, economic and legislative factors help shape health behaviors.

"With increased efforts toward more fostering of and support for cancer prevention and early detection activities, we can reduce incidence, death and suffering from cancer," report co-author Vilma Cokkinides said in a cancer society news release.

"The price and availability of healthy foods, incentives and opportunities for regular physical activity in schools and communities, advertising content, as well as the availability of insurance coverage for screening tests and treatment for tobacco addiction all influence individual choices. Improved collaboration among government agencies, private companies, nonprofit organizations, health care providers, policy makers and the American public can lead to continued improvements, and more favorable trends that reduce the risk of death from cancer and other chronic diseases," Cokkinides stated.

One expert agreed that the premise is sound.

"The [cancer society] report provides the public with valuable information about cancer risk and risk reduction. An informed public has the opportunity to make good decisions about lifestyle and modifiable risk factors, and other health behaviors," said Dr. Freya Schnabel, director of breast surgery at NYU Clinical Cancer Center in New York City. "The challenge for all of us is putting this information into use every day," she added.

"The ACS has emphasized the importance of smoking cessation programs in reducing the risk for smoking-related cancers," Schnabel noted. "The link between smoking and cancer is well-established, and an investment of resources into smoking cessation programs would be expected to translate into saving many lives, and relieving the burden of the related cancer from the affected individuals, and from society as a whole."

The report found that if comprehensive smoke-free laws were passed by states that currently don't have such laws, there would be 624,000 fewer cancer deaths over the long term and $1.32 billion less in cancer treatment costs over five years.

While there was a modest overall decline in cigarette smoking among adults between 2005 and 2010 (an estimated 21 percent of men and 17 percent of women smoked in 2010), decreases did not occur in all subgroups of smokers, the report said.

Among daily smokers, light smoking (less than 10 cigarettes a day) increased from 16 percent in 2005 to 22 percent in 2010, while heavy smoking declined from 13 percent to 8 percent.

In 2009, 19.5 percent of high school students were current smokers and 7.3 percent were frequent smokers. Smoking among high school students did not decrease between 2003 and 2009, but declined significantly among teen student smokers between 2010 and 2011 and among smokers aged 12 to 17 between 2008 and 2010.

Smoking is not the only area where lifestyle changes are still needed, the report authors said.

Increasing rates of obesity seen since the early 1980s appear to have slowed or leveled off since 2003, but an estimated 18 percent of adolescents and 36 percent of adults are still considered obese. Mississippi had the highest overall obesity rate, at nearly 35 percent.

The report also found that cancer screening rates are not always what they should be.

In a bit of good news, the proportion of girls aged 13 to 17 who started the human papillomavirus (HPV) vaccination series increased from 25 percent in 2007 to nearly 49 percent in 2010, and about one-third of those girls got all of the three doses required for full coverage. The vaccine protects against the two strains of the virus that cause 70 percent of all cervical cancers.

However, the use of mammograms has not increased since 2000. In 2010, 66.5 percent of women aged 40 and older had a mammogram in the past year. Women without health insurance had the lowest use of mammograms, at 31.5 percent.

And colon cancer screening rates present a mixed picture. In 2010, 59 percent of adults aged 50 and older were screened for colon cancer, but screening rates remain much lower among uninsured and poorer people. Currently, only 28 states and the District of Columbia have passed legislation ensuring coverage for colon cancer screening, the report noted.

Schnabel noted that any efforts to increase overall screening rates would make a difference in cancer death rates.

"There are effective methods to screen for cervical cancer, breast cancer and colon cancer," Schnabel noted. "More widespread uptake of these screening strategies could alter the outcomes for these cancers in a very significant way."

More information

The U.S. National Cancer Institute has more about cancer prevention.

SOURCES: Freya Schnabel, M.D., director, breast surgery, NYU Clinical Cancer Center, New York City; American Cancer Society, news release, April 19, 2012

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Kidney Cancer Patients Fare Better With Tumor Removal Only

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TUESDAY, April 17 (HealthDay News) -- Kidney cancer patients who have only the tumor removed, not the entire kidney, have higher survival rates, a new study finds.

The research involved more than 7,000 Medicare patients with early-stage kidney cancer who underwent surgery to remove either the entire organ (radical nephrectomy) or only the tumor and a small margin of healthy tissue around it (partial nephrectomy).

After an average follow-up of five years, 25 percent of patients who had a partial nephrectomy had died, compared with 42 percent of those who had a radical nephrectomy, researchers at the University of Michigan Comprehensive Cancer Center reported.

The study appears in the April 18 issue of the Journal of the American Medical Association.

"For patients who are candidates for partial nephrectomy, it should be the preferred treatment option. We found that patients who were younger or had preexisting medical conditions benefited most from partial nephrectomy," lead author Dr. Hung-Jui Tan, a urology resident at the U-M Medical School, said in a university news release.

Early-stage kidney cancers are becoming more common and are often discovered by chance when patients receive an X-ray or CT scan for an unrelated condition.

"As more and more people are identified with these small, early-stage cancers, there's more interest in understanding how best to treat these patients," senior study author Dr. David Miller, an assistant professor of urology at the U-M Medical School and member of U-M's Institute for Health Care Policy and Innovation, said in the news release.

"This study does not suggest every patient with early-stage kidney cancer should get a partial nephrectomy. It supports the notion that we need to expand the use of partial nephrectomy and make it a preferred treatment choice for patients with small tumors as much as possible, to optimize long-term survival," Miller noted.

The American Cancer Society estimates that 64,770 people in the United States will be diagnosed with kidney cancer this year and 13,570 will die from the disease.

More information

The U.S. National Cancer Institute has more about kidney cancer.

SOURCE: University of Michigan Health System, news release, April 17, 2012

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HIV Raises Anal Cancer Risk in Women, Study Says

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MONDAY, April 16 (HealthDay News) -- Women with HIV are at increased risk for anal cancer, a new study finds.

Researchers at Montefiore Medical Center in New York City looked at 715 HIV-infected women and found that 10.5 percent had some form of anal disease and about one-third of those women had precancerous disease.

"Anal cancer was widely associated with HIV-infected men who have sex with men. But now, this study reveals anal precancerous disease in a high proportion of women with HIV," Dr. Mark Einstein, director of clinical research in the division of gynecologic oncology and a professor at Albert Einstein College of Medicine, said in a Montefiore news release.

The increased risk of anal cancer in HIV-infected women is likely because HIV is associated with human papillomavirus (HPV), which causes nearly all anal cancers, the researchers said.

The study appears May 1 in the Journal of AIDS.

The researchers said their findings suggest that all HIV-infected women who have abnormal findings on tests of anal tissue samples should be referred for high resolution anoscopy, a visual examination of the inside of the anus.

In addition, all HIV-infected women and men should be considered for anal cancer screening, the researchers said.

More information

The U.S. National Cancer Institute has more about anal cancer.

SOURCE: Montefiore Medical Center, news release, April 12, 2012

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Spouses of Cancer Patients May Have Raised Risk of Heart Disease, Stroke

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WEDNESDAY, April 11 (HealthDay News) -- The spouses of cancer patients are at increased risk of heart disease and stroke, a new study suggests.

Researchers said the explanation might be that stress takes a toll on the health of caregivers.

Using the national Swedish cancer registry and the Swedish inpatient registry, researchers found that risk for heart disease and stroke increased by 13 to 29 percent in people whose partner had cancer.

"Our study shows that preventive efforts aimed at reducing psychological stress and negative risk factors are important for people whose life partner has got cancer," Jianguang Ji, a researcher from the Centre for Primary Healthcare Research in Malmo, Sweden, said in a university news release. "Previous studies have shown that preventive work can considerably reduce stress and anxiety in close relatives of patients."

The study authors considered another explanation for the higher heart risks -- spouses may share lifestyle risk factors, such as tobacco and alcohol use as well as poor diet and lack of exercise. But the researchers found that spouses' added risk for heart disease was only slightly increased by about 3 to 5 percent right before their partner became sick.

The study is published in the March 13 issue of Circulation.

While the study uncovered an association between caring for a spouse with cancer and heart risks, it did not prove a cause-and-effect relationship.

More information

The U.S. National Cancer Institute has more about family caregivers for patients with cancer.

SOURCE: Lund University, news release, April 3, 2012

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Herbal Remedy Ingredient Tied to Cancer, Kidney Failure

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THURSDAY, April 12 (HealthDay News) -- A toxic component of a plant used in certain types of herbal remedies can cause kidney failure and upper urinary tract cancer, researchers warn.

Aristolochic acid is found in Aristolochia herbal remedies, which have been used for centuries and still are used in many countries.

This study of 151 patients with upper urinary tract cancer in Taiwan concluded that aristolochic acid is a primary contributor to the incidence of this cancer in Taiwan, where the incidence is the highest reported anywhere in the world and where Aristolochia herbal remedies are widely used.

The researchers found that 83 percent of the patients had evidence in their kidneys of DNA changes that are related to the plant toxin and associated with the development of cancer.

"We believe our latest research highlights the importance of a long-overlooked disease that affects many individuals in Taiwan, and, by extension, in China and other countries worldwide, where Aristolochia herbal remedies traditionally have been used for medicinal purposes," Dr. Arthur Grollman, a professor of pharmacological sciences at Stony Brook University School of Medicine, in New York, said in a university news release.

In previous research, Grollman and his colleagues linked the ingestion of Aristolochia clematitis (commonly known as birthwort) to widespread kidney disease in the Balkans.

The findings of the studies show that public health officials need to take action to stop kidney damage and upper urinary tract cancer related to aristolochic acid, Grollman said.

The study was published online April 9 in the journal Proceedings of the National Academy of Sciences.

More information

The U.S. National Kidney Disease Education Program explains how to keep your kidneys healthy.

SOURCE: Stony Brook Medicine, news release, April 9, 2012

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Even Young Teens Show Signs of Sun Damage

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FRIDAY, April 13 (HealthDay News) -- In a new study that used a special type of photography to unveil hidden signs of sun damage, middle schoolers showed evidence of levels of UV exposure that could raise their risk for melanoma later in life.

Not only can the technology spot who is most vulnerable to the ravages of too much time spent tanning, the researchers noted, but it could also be used as a powerful deterrent to teenagers who think basking in UV rays is a healthy habit.

"There's two issues here," explained study co-author Dr. Robert Dellavalle, from the University of Colorado Cancer Center in Denver. "One is that there's nothing better for keeping teenagers out of the tanning booth than showing these pics. What we didn't know before was if these ugly pics were just ugly pics that scare people, or if they actually correlated with skin cancer. Now we've found that they do. When you have lots of moles, have blue eyes or are a redhead -- all things we know are associated with greater melanoma risk -- you have uglier UV photos," he said.

"And another surprising thing," Dellavalle added, "is that at age 12 and 13 we're already seeing a lot of sun damage. And because seeing this damage in UV photo form is sort of like meeting your inner zombie, this could be a great tool in getting kids to think about sun safety in a more personal way."

Dr. Ryan Gamble, who conducted the study while a postdoctoral researcher in Dellavalle's lab and who is now a dermatology resident at the university, and colleagues released their findings online in advance of publication in an upcoming print issue of the Journal of the American Academy of Dermatology.

Gamble pointed out that one in 50 Americans will face a melanoma diagnosis in their lifetime.

UV photography makes visible so-called "mottled pigmentation," dark spots and freckling that indicate sun damage that is otherwise invisible to the naked eye.

The authors noted that the technology has already been used to focus attention on sun safety and the dangers of overexposure among college students and middle schoolers.

However, only one small study of just eight children has explored how the sun damage revealed in such photos correlates with known risk factors (having fair skin, blue eyes, red hair, and/or visible facial freckling) for melanoma.

In this latest study, the researchers focused on 585 boys and girls who were born in 1998, and were 11 or 12 at the study's start. Almost 80 percent were non-Hispanic white youths.

The faces of all the children were photographed with eyes closed and without sunscreen, make-up or moisturizer in three formats: standard photography; so-called cross-polarized photography (using filters to block unwanted light reflection); and UV photography.

At the same time, full-body skin exams were conducted by a team comprised of a dermatologist, pediatrician, medical student and pediatric nurse. Eye color was noted, alongside indications of freckling, and skin and hair color assessments.

The results: sun damage severity revealed in the UV photographs was found to line up very closely with factors that have long been linked to a higher melanoma risk.

In other words, boys and girls who had light-colored skin, blue eyes, red hair, and/or freckles did indeed show more skin damage on the UV photographs than those who did not.

This, the researchers said, means that UV photography does not lie: the more damage the technology highlights, the greater the cancer risk.

"We hope that our research will help make the use of these photographs more mainstream, whether in a clinic setting or as a public health intervention," said Gamble. "With greater awareness of melanoma and increased use of sun prevention and early detection strategies, much of the occurrence of the disease and its complications can be prevented."

Dr. David Leffell, a professor of dermatology and otolaryngology and plastic surgery at the Yale School of Medicine, said that if it were priced right, the technology could indeed help "lead to a recognition that sun protection is important." Currently, such systems cost about $20,000.

"It is true that the appearance of sun-damaged skin in these images is frightening, and patient response is often shock," Leffell noted. "The pediatric population of course is especially important to communicate this message to, and the photographs -- if the price can be brought down -- is a good idea."

But, for the time being, price remains an issue, said Dr. David Pariser, past president of the American Academy of Dermatology Association and a professor of dermatology at Eastern Virginia Medical School in Norfolk, Va.

"It's not an inexpensive modality. So, I'm not sure about the practicality of rolling this out as a screening tool," Pariser said.

"I've used UV photography myself during clinical research, and it certainly is a very dramatic way to show sun damage," Pariser added. "It's sort of like looking at yourself 15 or 20 years later. In fact, I've never had anyone who's seen a photograph of himself who's not reacted by saying they will stop exposing themselves to the harmful effects of the sun."

More information

For more on melanoma, visit the U.S. National Library of Medicine.

SOURCES: Robert Dellavalle, M.D., Ph.D., M.S.P.H., investigator, University of Colorado Cancer Center, and associate professor, dermatology, University of Colorado School of Medicine, Denver; Ryan G. Gamble, M.D., dermatology resident, University of Colorado, Denver; David Pariser, M.D., F.A.A.D., past president, American Academy of Dermatology Association, and professor, dermatology, Eastern Virginia Medical School, Norfolk, Va.; David J. Leffell, M.D., professor, dermatology, and professor, surgery (otolaryngology and plastic), Yale School of Medicine, New Haven, Conn.; March 12, 2012, Journal of the American Academy of Dermatology, online

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Huntington's Disease Linked to Reduced Cancer Risk in Study

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WEDNESDAY, April 11 (HealthDay News) -- People who have Huntington's disease are much less likely to develop cancer than people without the inherited disorder, according to a new study that suggests the diseases share a common genetic mechanism.

The Swedish researchers found that those with Huntington's had a 53 percent lower risk of being diagnosed with cancer compared to the general population.

Besides Huntington's disease, the lower cancer risk applies to the other eight rare neurodegenerative disorders known as polyglutamine (polyQ) diseases. Those diseases, which result in the progressive degeneration of neurons involved in motor control, include spinobulbar muscular atrophy (also known as Kennedy's disease); dentatorubral-pallidoluysian atrophy; and six types of spinocerebellar ataxia.

From 1969 through 2008, the researchers identified 1,510 patients with Huntington's disease; 471 people with spinobulbar muscular atrophy; and 3,425 with hereditary ataxia, a substitute for spinocerebellar ataxia.

Cancer was diagnosed in 6 percent of the Huntington's patients, 7 percent of the spinobulbar muscular atrophy patients and 12 percent with hereditary ataxia.

The study, published online April 11 in The Lancet Oncology, determined those with spinobulbar muscular atrophy had a 35 percent lower risk of cancer, and patients with hereditary ataxia had a 23 percent lower risk. Before being diagnosed with a polyQ disease, the patient's risk of cancer was even lower, the researchers said.

"Our findings suggest a common mechanism in patients with polyQ diseases that protects against the development of cancer," Dr. Jianguang Ji and colleagues from Lund University and Skane University Hospital, in Sweden, wrote in a journal news release. "Future studies should investigate the specific biological mechanisms underlying the reduced cancer risk in patients with polyQ diseases," they concluded.

More information

The U.S. National Institutes of Health has more about Huntington's disease.

SOURCE: The Lancet Oncology, news release, April 11, 2012

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Exercise May Boost Breast Cancer Patients' Quality of Life

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SATURDAY, April 14 (HealthDay News) -- Exercise can help improve breast cancer patients' quality of life while they undergo treatment, a new study indicates.

University of Miami researchers examined the physical activity levels and mental/physical health of 240 women with non-metastatic breast cancer (it hadn't spread to other parts of the body) who were recruited for the study four to 10 weeks after surgery.

The women who were physically active had less depression, less debilitating fatigue and a better quality of life during cancer treatment after surgery.

"Women who are physically active may also have more confidence in their own ability to continue with family-related, household, work-related or social activities, which bring meaning and satisfaction to their lives. This may lead to appraisals of lower fatigue, heightened quality of life and less depression," study author Jamie Stagl, a doctoral student in clinical health psychology, said in a university news release.

The same researchers previously found that stress management improves breast cancer treatment.

The study was slated for presentation Friday at the Society of Behavioral Medicine's annual meeting, in New Orleans.

Data and conclusions presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

SOURCE: University of Miami, news release, April 13, 2012

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Here Are Fruits, Veggies That Offer Best Bang for Your Buck

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FRIDAY, April 13 (HealthDay News) -- Studies suggest that eating a diet that contains lots of fresh fruits and vegetables may reduce the risk of heart disease, high blood pressure and certain cancers.

So which ones should you choose this spring? Some of your best choices are strawberries, pineapple, spinach, broccoli and mustard greens, which are in season and among the most economical this time of year, experts say.

"Eating a plant-based diet rich in vegetables, fruits, whole grains and beans can reduce your risk for cancer," Clare McKindley, a clinical dietitian at University of Texas MD Anderson Cancer Center in Houston, said in a university news release. "And buying what's in season keeps your diet fresh and helps you build confidence in your food choices, while supporting your long-term health goals."

Although the price of fresh produce depends on where it's purchased, McKindley offered these tips on buying five affordable springtime fruits and vegetables:

Strawberries One cup of strawberries contains 46 calories and costs 89 cents. This fruit offers protection from breast, skin, bladder, esophageal and lung cancers. Choose strawberries that are red, firm, still have their green cap attached and are free of mold or damage.Pineapple One cup of pineapple contains 82 calories and costs 70 cents. This fruit is fat-free, low in sodium and rich in vitamin C. Look for pineapples that don't have soft or dark spots or dry-looking leaves. Spinach One cup of raw spinach contains 7 calories and costs 52 cents. Spinach is high in fiber, folate and antioxidants that may protect the body from cancers of the mouth, pharynx and larynx. Choose spinach that's crisp and green, and avoid leaves with insect damage. Mustard Greens One cup of mustard greens cooked without salt or added fats contains 21 calories and costs 81 cents. An alternative to spinach, mustard greens offer the same cancer-fighting properties. Look for leaves that are fresh, tender and free of discoloration and damage. Broccoli One cup of chopped broccoli cooked without salt contains 30 calories and costs 63 cents. This vegetable is packed with folate, fiber and antioxidants that may reduce the risk of colorectal cancer. Broccoli should be odorless with tight, bluish-green florets.

More information

The American Cancer Society provides more on the benefits of fruits and vegetables.

SOURCE: University of Texas MD Anderson Cancer Center, news release, April 10, 2012

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Study Casts Doubt on Value of Pricey Prostate Cancer Therapy

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TUESDAY, April 17 (HealthDay News) -- A new study raises questions about the value of proton therapy, an expensive new kind of radiation treatment, in patients with prostate cancer.

Those who received the treatment instead of the standard radiation therapy were more likely to suffer from gastrointestinal side effects, the researchers found. There also did not appear to be any extra benefit for those who got proton therapy.

Study co-author Dr. Ronald Chen, an assistant professor of radiation oncology at the University of North Carolina at Chapel Hill, didn't go as far as to say proton therapy is a waste of money. But he did suggest that more research needs to be done to confirm its value.

"The bottom-line message is: Let's study more, let's do a clinical trial," Chen said. "Patients and physicians should be cautious about new therapies and look for research data before they switch to a newer treatment."

A variety of radiation treatments have become available to prostate cancer patients in recent years.

Up until about 12 years ago, conformal radiation treatment was commonly used. It relied on pinpointed X-rays to kill the cancer in the prostate while trying to avoid harming nearby organs, said Dr. Louis Potters, chair of the department of radiation medicine at North Shore University Hospital in Manhasset, N.Y., and Long Island Jewish Medical Center in New Hyde Park.

Scientists then developed a more sophisticated therapy called intensity-modulated radiation therapy (IMRT) that aims to do an even better job of avoiding radiation exposure to organs that are near the prostate. As of 2008, 96 percent of patients who received one of the two treatments got the newer therapy; that's a huge change from 2000, when hardly any received IMRT.

Meanwhile, proton therapy appeared on the scene. In proton therapy, physicians try to kill cancer with a radioactive particle.

Medical centers have built proton centers around the country -- they cost about $150 million each, Chen said -- and have tried to convince patients to undergo the therapy.

In the new study, researchers examined the medical records of nearly 13,000 men who received conformal radiation, IMRT or proton therapy for prostate cancer that hadn't spread.

The investigators found that patients who received IMRT, compared to conformal therapy, were 9 percent less likely to have gastrointestinal side effects and 22 percent less likely to have the rare side effect of hip fracture; they were also 19 percent less likely to need more cancer treatment.

On the other hand, IMRT patients were 12 percent more likely to suffer from erectile dysfunction, the findings showed.

The design of the study didn't allow the researchers to determine the specific likelihood that a patient would suffer from these side effects or need more treatment.

The researchers also compared IMRT to proton therapy. Those who received IMRT had a 34 percent lower risk of gastrointestinal side effects.

Proton therapy costs about $50,000 per patient, roughly twice as much as IMRT, study co-author Chen said.

But the new treatment does have its supporters. In a statement released Tuesday, Dr. Eugen Hug, medical director and chief medical officer of ProCure Treatment Centers, took issue with the findings. He said the UNC study "is firmly contradicted by a number of well-regarded, peer-reviewed studies that found protons reduce -- not increase -- gastrointestinal side effects."

According to Hug, "the UNC study runs counter to what we know from these studies, from research being carried out by ProCure and other proton centers and from our firsthand experience treating hundreds of patients with this important cancer therapy."

Hug also pointed to prior prospective studies (which follow patients over time) that he said support the superiority of proton therapy. "Prospective studies like these are in general considered 'higher level' evidence than retrospective studies like the UNC study," he said.

Still, the new findings should make people think twice about proton therapy, said Potters, the New York radiation physician.

"Proton therapy is marketed as something that's new, big and expensive. In the eyes of the public, it's easy to become wowed by proton beams," Potters said. "But it might not be better and may be adverse in terms of side effects."

Chen put it this way: "There is a newer technology out there, but right now we don't know that it is better."

The study is published in the April 18 issue of the Journal of the American Medical Association.

More information

For more about prostate cancer, try the U.S. National Library of Medicine.

SOURCES: Ronald C. Chen, M.D., M.P.H., assistant professor, radiation oncology, University of North Carolina, Chapel Hill; Louis Potters, M.D., chair, department of radiation medicine, North Shore University Hospital, Manhasset, N.Y., and Long Island Jewish Medical Center, New Hyde Park, N.Y.; ProCure Treatment Centers news release, April 17, 2012; April 18, 2012, Journal of the American Medical Association

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Childhood Obesity May Raise Odds of Adult Liver Cancer

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FRIDAY, April 20 (HealthDay News) -- Adults who were obese as children are at increased risk for liver cancer, a new study suggests.

Researchers looked at the birth weight and body-mass index (a measurement of body fat based on height and weight commonly called BMI) of more than 165,000 men and 160,000 women in Denmark born between 1930 and 1989.

Of those participants, 252 developed hepatocellular carcinoma, the most common form of liver cancer in adulthood.

The study authors calculated that at age 7, the risk of developing hepatocellular carcinoma increased by 12 percent for every one-point increase in BMI. By age 13, that risk increased to 25 percent. Therefore, as units of BMI increased into adulthood, so did the risk of developing hepatocellular carcinoma. This was consistently similar across both genders and all ages.

Other factors associated with liver cancer include alcoholism, infection by hepatitis B and C, and other liver diseases. But the study results did not change when participants with these factors were removed from the study, which indicates that childhood obesity was the major factor in the development of hepatocellular carcinoma, the researchers said.

The study was slated for presentation Thursday at the International Liver Congress in Barcelona.

"Childhood obesity not only leads to the development of many adverse metabolic conditions -- such as type 2 diabetes and heart disease -- but also fatty liver disease, which may subsequently result in liver cancer," Dr. Frank Lammert, a scientific committee member of the European Association for the Study of the Liver, said in an association news release.

"The importance of maintaining a healthy childhood BMI cannot be underestimated," Lammert said in the release. "These alarming study results point to a potential correlation between childhood obesity and development of liver cancer in adulthood."

Data and conclusions presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The American Liver Foundation has more about liver cancer.

SOURCE: European Association for the Study of the Liver, news release, April 19, 2012

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Study Shows New Option for Kids With Tough-to-Treat Leukemia

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WEDNESDAY, April 11 (HealthDay News) -- Additional chemotherapy may a better option than bone marrow transplant for some children with acute lymphoblastic leukemia who don't respond to an initial intense regimen of chemotherapy called "induction therapy," a new study says.

Acute lymphoblastic leukemia, or ALL, is a cancer of the blood and bone marrow.

According to study co-author Dr. Ching-Hon Pui, failure to improve after induction therapy is rare, happening in just 2 percent to 3 percent of children with ALL. But when it does happen, these children's risk for a bad outcome rises considerably, so they often then become candidates for a bone marrow transplant.

However, the new study suggests that that option may not always be the only one.

"Some patients and their parents will be relieved to know that transplantation is not necessary for cure," said Pui, chair of the oncology department at St. Jude Children's Research Hospital in Memphis, Tenn. His team published their findings in the April 12 issue of the New England Journal of Medicine.

In the study, Pui and his colleagues tracked more than 1,000 children with ALL who did not go into remission after four to six weeks of induction therapy. The patients' cancer was diagnosed when they were between the ages of 1 to 5 years.

The overall survival rate for children with ALL who fail to go into remission following induction therapy was 32 percent. However, the rate was 72 percent in a subset of patients who had additional chemotherapy instead of a bone marrow transplant.

Pui's group noted that this type of patient had a form of ALL that begins in white blood cells destined to become B cells (B-lineage ALL). They accounted for about 25 percent of the more than 1,000 patients who did not go into remission following induction therapy.

Patients who fail induction therapy but may not require transplant, therefore, "are the patients who have B-cell precursor leukemia with no other adverse features," Pui said. "The remaining patients [who failed induction therapy] will be certain that transplantation is their best treatment for cure."

Another expert in leukemia care said the study offers valuable information.

"The study shows that even in these patients who have a poor response, there are a few subgroups that ultimately do well while there are other subgroups that do poorly and need bone marrow transplantation," said Dr. Arlene Redner, associate chief of oncology at Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park, N.Y.

"This study will allow us to tailor our therapy in these patients and know that some of the patients who don't go into remission after the first month of therapy need bone marrow transplantation while others do not," she explained.

Still, the study did have its limits, Redner added. "The problems with the study are that the children were not all treated the same way and were treated over a long time period from 1985 and 2000. We now subdivide patients and treat them differently than during that time period."

More information

The U.S. National Cancer Institute has more about childhood acute lymphoblastic leukemia.

SOURCES: Ching-Hon Pui, M.D., chair, oncology department, St. Jude Children's Research Hospital, Memphis, Tenn.; Arlene Redner, associate chief, oncology, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; St. Jude Children's Research Hospital, news release, April 11, 2012

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Avastin No Benefit to Older Lung Cancer Patients: Study

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TUESDAY, April 17 (HealthDay News) -- Medicare patients who have advanced non-small cell lung cancer appear to get no survival benefit from adding the drug Avastin to standard chemotherapy, researchers from the Dana-Farber Cancer Institute report.

An earlier trial had found that Avastin (bevacizumab) did improve survival, but not in patients aged 65 and older. Even so, the researchers noted, most patients diagnosed with non-small cell lung cancer are 65 and older and Medicare still covers the cost of the drug.

"A drug that we were just ecstatic about in 2006, we have to be more circumspect about," said lead researcher Dr. Deborah Schrag, an oncologist at Dana Farber, in Boston.

Avastin should be used judiciously, she added, noting that "older patients should discuss it with their doctors, but we cannot say it provides a survival advantage based on these data."

However, Schrag does not think Medicare needs to reconsider funding Avastin. "It may be that it helps some patients," she said. "But we should not assume that Avastin needs to be part of the treatment package."

Genentech, the maker of Avastin, said in a statement Tuesday that while the study "is well-conducted, retrospective analyses that use administrative information to determine clinical outcomes have limitations."

"Genentech agrees that certain people, such as those older than 65, are typically underrepresented in randomized, controlled clinical trials used for regulatory submissions. To address this, we collect and present data on the 'real world' use of medicines through large phase 4 prospective observational studies, which even when well-designed, also have limitations, including non-randomization of study participants."

The cost of the medication is also a factor in considering the use of Avastin, experts have said.

In 2011, published reports pegged the cost of the drug at somewhere between $4,000 and $9,000 a month, depending on co-pay assistance that's available from Genentech, Avastin's manufacturer.

This latest report was published in the April 18 issue of the Journal of the American Medical Association. The U.S. National Cancer Institute funded the study.

For the study, Schrag's team randomly assigned more than 4,000 Medicare patients with advanced non-small cell lung cancer to one of two groups.

One group received Avastin plus chemotherapy, while the other group was treated with chemotherapy alone. The researchers compared survival between the groups.

They found average survival for patients receiving Avastin plus chemotherapy was 9.7 months, compared with as much as 8.9 months for patients on chemotherapy alone.

In terms of one-year survival, it was 39.6 percent for those getting Avastin and chemotherapy and 40.1 percent for chemotherapy alone.

When they took into account demographic and clinical characteristics in adjusted models, the researchers did not find a significant difference in overall survival between patients treated with Avastin and chemotherapy and those treated only with chemotherapy.

Dr. Norman Edelman, chief medical officer of the American Lung Association, said, "As I pointed out in the past, it is important to study ways to extend quality of life in advanced lung cancer."

This study shows that a drug that was useful in a general age group is not effective in an older age group, he added. "Thus, it may save older patients exposure to an ineffective drug with side effects," he said.

"It is critical that, to the extent possible, we study treatments separately in groups known to differ in responses, rather than subject all to average responses," he said.

More information

For more information on lung cancer, visit the U.S. National Cancer Institute.

SOURCES: Deborah Schrag, M.D., M.P.H., Adult Oncology, Dana-Farber Cancer Institute, Boston; Norman Edelman, M.D., chief medical officer, American Lung Association; April 17, 2012, news release, Genentech; April 18, 2012, Journal of the American Medical Association

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Nonsurgical Method to Measure Brain Pressure Shows Promise

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WEDNESDAY, April 11 (HealthDay News) -- A new nonsurgical method for monitoring brain pressure might help improve treatment of head injury patients, according to a new study.

Head injuries, including concussions, and brain tumors can lead to increased pressure inside the skull, which can crush brain tissue or cut off the brain's blood supply.

Monitoring brain pressure can help doctors determine the best treatment for these patients. However, this requires drilling a hole in the skull so it is done only in the most serious cases. Risks include infection or damage to the brain, study co-author George Verghese, a distinguished professor of electrical engineering at MIT, said in an institute news release.

This new method is much less invasive and may enable doctors to measure brain pressure in patients who have milder head injuries, but would benefit from close monitoring, the MIT researchers said.

"It's still at the validation stage. To convince people that this works, you need to build up more [data] than we currently have," Verghese said.

They developed a technique based on a computer model of how blood flows through the brain. The researchers found that they can calculate brain pressure from two less-invasive measurements: arterial blood pressure and an ultrasound measurement of how quickly blood flows through the brain.

This approach enables changes in brain pressure to be monitored over time so that doctors can detect problems that might develop gradually, the researchers said.

They describe the technique in the April 11 issue of the journal Science Translational Medicine.

"It's a holy grail of clinical neurosurgery to find a noninvasive way to measure (brain) pressure," James Holsapple, chief of neurosurgery at Boston Medical Center, said in the news release. "It would be a big step if we could get our hands on something reliable."

He said the MIT technique shows promise and added that the next major step is to incorporate the technology into a system that's easy for hospital staff to use and that can record data over many hours or days.

More information

The Brain Injury Association of America has more about brain injury treatment.

SOURCE: MIT, news release, April 11, 2012

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Obesity's Health Costs Double Earlier Estimates

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THURSDAY, April 12 (HealthDay News) -- A new study finds that obesity accounts for nearly 21 percent of U.S. health care spending, which is more than twice as high as previous estimates.

The findings strengthen the case for government intervention to prevent obesity, said the researchers from Cornell University in Ithaca, N.Y.

The researchers found that an obese person's medical costs are $2,741 a year higher (in 2005 dollars) than if they were not obese. That works out to $190.2 billion a year nationally, or 20.6 percent of total U.S. health spending.

Previous estimates had put the cost of obesity at $85.7 billion a year, or 9.1 percent of total health spending.

"Historically, we've been underestimating the benefit of preventing and reducing obesity," study author John Cawley, a professor of economics and policy analysis and management at Cornell, said in a university news release.

"Obesity raises the risk of cancer, stroke, heart attack and diabetes," Cawley said. "For any type of surgery, there are complications [for the obese] with anesthesia, with healing. Obesity raises the costs of treating almost any medical condition. It adds up very quickly."

The study was published recently in the Journal of Health Economics.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases outlines the health risks of being overweight.

SOURCES: Cornell University, news release, April 9, 2012

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Warren Buffett Has Early Stage Prostate Cancer

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WEDNESDAY, April 18 (HealthDay News) -- U.S. billionaire investor Warren Buffett says he has prostate cancer and will undergo radiation treatment in the coming months.

The 81-year-old chairman and chief executive of Berkshire Hathaway Inc. said in a letter to investors on Tuesday that he has stage 1 cancer, an early form of the disease that is treatable.

"The good news is that I've been told by my doctors that my condition is not remotely life- threatening or even debilitating in any meaningful way," Buffett said.

After receiving the diagnosis last Wednesday, Buffett said he had other tests that "showed no incidence of cancer elsewhere in my body."

In his letter, Buffett said he expects to begin two months of daily radiation treatment in mid-July. It will restrict his travel, "but will not otherwise change my daily routine."

He added that, "I discovered the cancer because my PSA level [an indicator my doctors had regularly checked for many years] recently jumped beyond its normal elevation and a biopsy seemed warranted."

Experts noted that prostate cancer that is caught at stage 1, when it is localized to the prostate, is highly curable. According to the American Cancer Society, four of five prostate cancers are caught at stages 1 or 2, and the overall 10-year survival rate for men diagnosed with prostate cancer is 98 percent. About 242,000 men are diagnosed with prostate cancer in the United States each year, and about 28,000 die from the disease annually.

"Many patients can be cured if their prostate cancer has not spread," the U.S. National Cancer Institute noted on its website, and even "some patients whose cancer has not spread very much outside the prostate gland can also be cured."

Typical treatments include surgical removal of the tumor, hormone-depletion therapy (male hormones are thought to act as "fuel" for prostate tumors) and radiation treatments.

If the tumor is deemed to be slow-growing, based on changes in levels of prostate-specific antigen (PSA), doctors often advise forgoing treatment and doing "watchful waiting" instead.

One expert said that, given his age, Buffett's diagnosis is not surprising. "Most men will eventually present with prostate cancer," noted Dr. Louis Kavoussi, chairman of urology at North Shore-LIJ Health System, The Arthur Smith Institute for Urology in Lake Success, N.Y. He added that, "the vast majority of men don't succumb to the disease even without treatment."

And while there's not enough information available for Kavoussi to accurately assess Buffett's prognosis, the "statistics are definitely on his side," he said.

Another urologist said each patient must weigh the pros and cons of treatment options.

"Some men have greater fear of the disease, while others are more fearful of the complications of treatment," explained Dr. Herbert Lepor, chairman of urology at NYU Langone Medical Center and a professor of urology at NYU School of Medicine in New York City. "Therefore, a very healthy 81-year-old man with an intermediate or highly aggressive prostate cancer is likely to live long enough to develop significant complications from their cancer and succumb to the disease. If the goal is to avoid the consequences of the [progression of] prostate cancer in this setting, curative treatment with surgery or radiation is reasonable, providing the complications of treatment are clearly delineated."

In his letter to investors, Buffett noted that his condition at the present time is good. "I feel great -- as if I were in my normal excellent health -- and my energy level is 100 percent," he said.

More information

For more on prostate cancer, go to the U.S. National Library of Medicine.

SOURCES: Warren Buffett, letter to Berkshire Hathaway Inc., investors, April 17, 2012; Herbert Lepor, M.D., chairman, urology, NYU Langone Medical Center, and The Martin Spatz Professor of Urology, NYU School of Medicine, New York City; Louis Kavoussi, M.D., chairman, urology, North Shore-LIJ Health System, The Arthur Smith Institute for Urology in Lake Success, N.Y.

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Surgery Rates Rising for Non-Melanoma Skin Cancer: Study

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MONDAY, April 16 (HealthDay News) -- Surgery for non-melanoma skin cancer in the United States increased substantially from 2001 to 2006, mainly due to the increased use of a specific surgical procedure, a new study suggests.

Non-melanoma skin cancer forms in the outer layer of the skin or in skin squamous cells, but not in the cells that make pigment, according to the U.S. National Cancer Institute.

More than 3 million non-melanoma skin cancers are diagnosed in the United States each year. Treatment options include surgical excision (removal) and Mohs micrographic surgery, which examines the entire surgical margin during the procedure.

According to the American College of Mohs Surgery, the procedure "treats skin cancer through a highly specialized and precise technique that removes the cancer in stages, one tissue layer at a time."

The new study, by Dr. Kate Viola of the Albert Einstein College of Medicine in New York City and colleagues, analyzed the medical records of nearly 27,000 Medicare patients who had either surgical excision or Mohs micrographic surgery. The findings are published in the April issue of the journal Archives of Dermatology.

There is debate about whether surgical excision or Mohs micrographic surgery is more effective for primary non-melanoma skin cancer and about the cost-effectiveness of the Mohs procedure, Viola pointed out in a journal news release.

Among the study patients, about 64 percent had surgical excision and 36 percent had Mohs micrographic surgery to treat these skin cancers between 2001 and 2006. During that time, the rate of surgical excision increased from 1.8 to 2.1 per 100 patients while the rate of the Mohs surgery doubled from 0.75 to 1.5 per 100 patients.

Mohs micrographic surgery was more likely than surgical excision to be used for skin cancers on the lip (60 percent versus 40 percent) and eyelid (57 percent versus 43 percent). Atlanta had the largest proportion of non-melanoma skin cancer patients treated with the Mohs procedure -- about 45 percent -- and a larger proportion were performed in younger patients, the study found.

"Patient age and lesion location were significantly associated with the type of surgery (Mohs micrographic surgery versus surgical excision), yet there were wide variations in regional [Mohs procedure] use and geographical disparity that warrant further investigation. Additional large, prospective studies are needed to further identify surgical treatment outcomes for non-melanoma skin cancer," the authors concluded.

More information

The U.S. National Cancer Institute has more about skin cancer.

SOURCE: Archives of Dermatology, news release, April 16, 2012

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