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Wednesday, 23 January 2013

HOW DOES ALCOHOL RAISE CANCER RISK?


How does alcohol raise cancer risk?
The exact way in which alcohol affects cancer risk isn't completely understood. In fact, there may be several different ways in which it raises risk, and this may depend on the type of cancer.
Damage to body tissues: Alcohol may act as an irritant, especially in the mouth and throat. Cells that are damaged may try to repair themselves, which may lead to DNA changes in the cells that can be a step toward cancer.
In the colon and rectum, bacteria can convert alcohol into large amounts of acetaldehyde, a chemical that has been shown to cause cancer in lab animals.
Alcohol and its byproducts can also directly damage the liver, leading to inflammation and scarring. As liver cells try to repair the damage, they may acquire mistakes in their DNA.
Effects on other harmful chemicals: Alcohol may act as a solvent, helping other harmful chemicals, such as those found in tobacco smoke, to enter the cells lining the upper digestive tract more easily. This may help explain why the combination of smoking and drinking is much more likely to cause cancers in the mouth or throat than either smoking or drinking alone. In other cases, alcohol may slow the body's ability to break down and get rid of some harmful chemicals.
Lower levels of folate or other nutrients: Folate is a vitamin that cells in the body need to stay healthy. Alcohol use may lower the body's ability to absorb folate from foods. This problem can be compounded in heavy drinkers, who often do not get enough nutrients such as folate in their diet. Low folate levels may play a role in the risk of breast and colorectal cancers.
Effects on estrogen or other hormones: Alcohol may raise body levels of estrogen, a hormone important in the growth and development of breast tissue. This may have an effect on a woman's risk of breast cancer.
Effects on body weight: Too much alcohol can add extra calories to the diet, which can contribute to weight gain in some people. Being overweight or obese is known to increase the risks of many types of cancer.
Along with these mechanisms, alcohol may contribute to cancer in other, as of yet unknown, ways.
Source: American Cancer Society

Tuesday, 22 January 2013

TYPES OF CANCER LINKED TO ALCOHOL USE


Alcohol is a known cause of cancers of the:
·    Mouth
·    Throat (pharynx)
·    Voice box (larynx)
·    Esophagus
·    Liver
·    Colon and rectum
·    Breast

For each of these cancers, the risk increases with the amount of alcohol consumed.


Cancers of the mouth, throat, voice box, and esophagus: Alcohol use clearly raises the risk of these cancers. Drinking and smoking together raises the risk of these cancers far more than the effects of either drinking or smoking alone. This might be because alcohol can act as a solvent, helping harmful chemicals in tobacco to get into the cells lining the digestive tract. Alcohol may also slow down these cells' ability to repair DNA damage caused by chemicals in tobacco.
Liver cancer: Long-term alcohol use has been linked to an increased risk of liver cancer. Regular, heavy alcohol use can damage the liver, leading to inflammation. This, in turn, may raise the risk of liver cancer.
Colon and rectal cancer: Alcohol use has been linked with a higher risk of cancers of the colon and rectum. The evidence for such a link is generally stronger in men than in women, although studies have found the link in both sexes.
Breast cancer: Even a few drinks a week is linked with an increased risk of breast cancer in women. This risk may be especially high in women who do not get enough folate (a B vitamin) in their diet or through supplements. Alcohol can affect estrogen levels in the body, which may explain some of the increased risk. Drinking less alcohol may be an important way for many women to lower their risk of breast cancer.



Monday, 21 January 2013

SMOKING MARIJUANA LINKED TO INCREASED RISK OF TESTICULAR CANCER


Researchers at the University of Southern California (USC) have linked recreational marijuana use to an increased risk of developing testicular germ-cell tumors, the most frequent tumor type in men aged 15 to 45. The study results were published in the journal Cancer, a journal of the American Cancer Society.
The increase in risk for marijuana users was approximately twofold. The current study confirms two previous studies published in Cancer demonstrating a potential link between smoking marijuana and testicular cancer. The same study also found that men who used cocaine had a twofold reduction in risk of testicular cancer.
“The risk of testicular germ-cell tumors has been rising for decades, but exposures responsible for the increases have not been identified,” said Victoria Cortessis, MSPH, PhD, one of the authors of the study.
“A reason to suspect marijuana in particular,” explained Cortessis, “is that constituents of marijuana smoke have been shown to perturb hormone levels, and hormonal factors have been implicated in testis cancer etiology for some time.” Aside from the potential that marijuana smoke contains testicular carcinogens, previous population-based studies have suggested that those with testicular cancer were more likely to have smoked marijuana.
The results could have implications for providing marijuana and its derivatives as therapy for younger male patients.
Testicular cancer, specifically, testicular germ-cell tumors, are the most common cancer type in men between the ages of 15 and 45. The cancer type is becoming more common. The culprits are believed to be environmental factors, most of which are still unknown. It is important to try to understand the mechanisms that may facilitate development of germ-cell tumors as men with testicular cancer, following treatment, remain at risk for secondary primary tumors as well as cardiovascular disease. An established risk factor is undescended testicles or cryptorchidism.
Currently, evidence points to abnormal steroid levels and effects during both perinatal and peripubertal development as a potential culprit. These abnormalities could stem from exposure to maternal estrogens(Drug information on estrogens) or environmental hormones during development, for example. Animal studies have found cryptorchidism to be associated with exposure to environmental estrogen exposure. Higher risk of testicular cancer is also linked to severe acne and male pattern baldness, suggesting a man’s varied hormone levels also may play a part.
By Anna Azvolinsky, PhD1 | September 12, 2012
1Freelance Science Writer and CancerNetwork

Sunday, 20 January 2013

SEXUALITY IN ADULT CANCER SURVIVORS


Key Messages:
·    Sexuality is an important part of life for young adults.
·    The physical and emotional changes brought on by cancer and cancer treatment may affect sexuality, fertility, reproductive health, and sexual relationships.
·    Allowing yourself time to heal and adjust to body changes along with being open and honest with your partner can help your recovery and well being.
Physical changes and sexuality
Some cancers and cancer treatments directly affect sexuality through physical changes to sexual organs. For men, treatment can affect sperm production and the ability to get an erection. For women, chemotherapy and radiation therapy to the pelvis can damage the ovaries and reduce the amount of hormones they produce, causing early menopause or menopausal symptoms.
However, a cancer treatment does not have to directly involve reproductive organs to affect sexuality. For example, sexuality may be affected by colon cancer, especially if a temporary or semi-permanent ostomy bag is used to collect bodily elimination. Common side effects of chemotherapy and radiation therapy include fatigue, nausea, diarrhea and mouth sores, all of which lower sexual interest. In fact, loss of libido is the most common sexual concern for cancer survivors.
Emotions, body image, and sexuality
Emotional changes also affect sexual desire, performance, and satisfaction. Fear, anxiety, stress, and depression can reduce libido. Body image concerns can also affect sexuality. Cancer and cancer treatment may change the way a person looks and feels about his or her appearance. For instance, a person may feel less attractive after the loss of a breast (in women) or a testicle (in men). Even if cancer has not changed a person's physical appearance, many survivors say they feel differently about their attractiveness and sexual desirability.
Coping with sexual concerns
Sexuality is an important part of life for young adults. The following suggestions may help you cope with common sexual concerns during and/or after cancer treatment:
·    Give yourself time to adjust to body changes before resuming or beginning a sexual relationship. Honest, open communication is essential. Talk with your partner about your fears and concerns and let your partner know how he or she can help you.
·    In the same way, encourage your partner to share his or her concerns.
·    Remember that sexuality involves much more than intercourse. Explore other ways of building intimacy, arousal, and sexual gratification.
·    If you have scars or noticeable body changes, it may make you feel more comfortable to let your partner see and touch these areas of your body before any sexual activity.
·    Sexual activity may need to be less spontaneous at first. It may be helpful to plan around those times of the day when you are experiencing fatigue or pain.
·    Individual, couples, and/or sex therapy can help you and your partner address sexual and body image concerns in a comfortable setting.
·    Difficulties, such as loss of libido, pain during intercourse, and problems achieving orgasm, may have a medical cause. Talk with your doctor about this possibility and treatment options.

Source: cancer.net

Wednesday, 16 January 2013

WHAT EVERY MAN SHOULD KNOW. A MANUAL OF PROSTATE CANCER JUST RELEASED !

This publication about prostate cancer is part of a continuing public and professional education program. The manual has an up-to-date information about prostate cancer and therapeutic options. The author of the book, Dr. Luis Mendoza, is a certified European medical oncologist with two decades of professional experience and renown physician in the field of clinical research of new anticancer drugs. 

More Information about the book HERE

A Breath Test to Screen for Colorectal Cancer?



Researchers have developed a relatively simple breath analysis test that may one day be used as a way to screen for colorectal cancer. Researchers at the University Aldo Moro of Bari in Italy, including Donato F. Altomare, MD, of the department of emergency and organ transplantation, have developed a way to analyze the volatile organic compounds (VOCs) found in cancer patients, but not in their healthy counterparts. This pilot study has demonstrated a different metabolite profile of those subjects with colon cancer compared to healthy subjects. The research is published in theBritish Journal of Surgery.
Using recently developed tools that can analyze different micromolecules that reflect the body’s cellular metabolic processes, the study authors analyzed the unique metabolite profiles of subjects using breath samples. In contrast to other types of samples from which metabolites can be processed including stool, urine, serum, and sputum, breath samples are noninvasive and are projected to have a high patient compliance.

Because cell metabolism is altered in cancer cells, the molecular products and byproducts they produce are different from normal cells, in quality and quantity.
The Study Design
Altomare and colleagues first identified specific VOCs that may differ between patients with colon cancer and those who are cancer-free. The most likely VOCs among cancer patients are likely reactive oxygen species, among others. These metabolites, in theory, travel from their origin within the body to the lungs where they are exhaled, according to the authors.
Almost all the molecules the researchers identified “can be found in the breath of healthy people,” said Altomare, but in cancer patients, “their proportion or pattern is changed.”
Breath samples were collected from 37 patients with colon cancer prior to their undergoing surgery for their cancer. Patients with comorbidities such as diabetes and other diseases were excluded so as to not confound the metabolite analysis. The samples of these patients were compared to 41 healthy controls who had undergone a colon cancer screening and found to be disease-free. All samples were analyzed using gas chromatography linked to mass spectrometry.
The initial analysis identified 15 different VOCs, out of 58 total, that could differentiate between cancer-positive and negative individuals. There were no sex-based differences among the VOC profiles nor did the profiles distinguish between early- and late-stage colon cancer patients.
Statistical analysis showed that the VOC profile had an 85% predictive accuracy, an 86% sensitivity, and a specificity of 83%. The analysis resulted in five false negatives and seven false positives.
Using a follow-up, independent and blinded cohort of 15 colorectal cancer patients and 10 noncancer controls, the accuracy of the test was 76%. Three false positives and three false negatives occurred.
Lower cost, easy to execute screening procedures are needed for colon cancer that could rival the sensitivity and specificity of colonoscopies. Colon cancer is the third leading cause of death from cancer in the United States and the second in Europe.
“We do hope this proportion could further improve with the availability of new devices to collect the breath sample and with further studies to understand the specificity of the pattern of VOCs identified compared to the disease's state,” Altomare said. Altomare added that this accuracy is already better than traditional screening tests such at the fecal occult blood test and immunochemistry-based tests.
While differential VOC patterns have been demonstrated for lung, prostate, breast, and colorectal cancers as well as for melanoma and hepatocellular carcinoma, among others, this is the first clinical assessment of VOCs in colorectal patients compared with their non-cancer counterparts, according to Altomare. This study is also the first to identify a specific pattern of VOCs in cancer patients.
The collected breath samples need to be analyzed within a few days using specialized equipment including gas chromatography and mass spectrometry as well as computer statistical software.
This study provides early support for this screening method, but this technique is still in the early stages of development, in part because the field of analyzing many metabolic molecules, called “metabolomics” is fairly new. Further development of the technique and much more testing is necessary. A recent study has also demonstrated that the breath of cancer patients—breast, lung, colorectal, and prostate—is distinct from noncancer subjects.
The authors of the current study note that this tool could also be useful to diagnose benign gastrointestinal disorders such as lactose intolerance and cystic fibrosis, among others. However, since each disease appears to have a different VOC profile, analysis of these different diseases will be distinct.
A larger study is being planned that will also look for new ways to analyze the results, according to Altomare. A comparison of the breath test with the fecal occult blood test as well as developing the test to detect colonic polyps are also in the works.
“Studies to set up an electronic nose is underway in collaboration with Gianluigi de Gennaro from the chemical department of University of Bari, which we hope will further make the colorectal cancer screening by breath analysis easier and available as a screening tool for the general population,” said Altomare.

By Anna Azvolinsky, PhD1 | December 7, 2012
1Freelance Science Writer and CancerNetwork Contributor. 

Tuesday, 15 January 2013

Advances of Immunotherapy Against Malignant Melanoma



Malignant melanoma (MM) is the most aggressive and deadly type of skin cancer. MM is also among the most immunogenic of all solid cancers, as supported by the presence of melanoma antigen-specific antibodies and tumour-specific cytotoxic T cells in melanoma patients. The ability of CD8+ T lymphocytes to prevent the melanoma formation has been shown in preclinical and clinical studies and their presence within the tumour is positively correlated with better prognosis in melanoma patients. Therefore, the immunotherapy has been of interest studied in this tumour model for decades.

The current management of MM depends greatly on the location and depth of the primary lesion and on its stage of presentation. Surgical resection with/out lymph node sampling is the standard of care and if a thin MM is treated with the appropriate surgical management, > 97% of all patients are cured. However, prognosis is poor for patients with advanced disease, with a median survival of 6.2 months. The long-term survival for metastatic MM patients is a relatively rare event (5) and the use of chemotherapy for advanced MM continues to be highly unsatisfactory.
Between 1995 and 2004, 442 patients with metastatic MM were treated with more than 500 different cancer vaccines at the Surgery Branch of the National Cancer Institute (NCI) and there was found to be a scarcely overall response rate around 3%. In the field of immunotherapy, currently just Interleukin-2 (IL-2) is the approved immunetherapeutic agent for treatment of patients with metastatic MM and Interferon alpha (IFN-α) for adjuvant therapy in the treatment of high-risk melanoma patients. Despite the fact that initial clinical results with high-dose IL-2 was promising, subsequent trials demonstrated that it provides a low but consistent overall response rate of 13-17%. The high-dose of INF-α prolongs disease-free survival and recently published meta-analysis in patients with high-risk cutaneous melanoma, showed that IFN-α is able to significantly improve the overall survival as adjuvant therapy.
The prior experience with immunotherapies has failed to produce significant levels of objective responses in MM. Currently, the results of novel agents and new immunotherapeutic approaches are renewing the optimism of the researchers. The goal of this short communication is briefly to illustrate to the readers the latest results of the most promising agents and newest immunological alternative approaches against metastatic disease being tested in clinical trials.

Nonspecific stimulation of the immune system
In the group of novel immunotherapy agents, the Pegylated interferon alfa-2b (Pegintron, Schering-Plough), which has a substantially longer half-life than its IFN unconjugated molecule, has shown a significant clinical response when it is used in combination with temozolomide in patients with advanced disease. The efficacy and safety of Pegintron was assessed in a large European randomized trial. In this trial 1.256 resected stage III melanoma patients, Pegintron (N=627) arm and observational arm (N=629), were enrolled. The median relapse-free survival was 34.8 months in the Pegintron arm vs. 25.5 months in the observational arm (p-value 0.01). The Oncologic Drugs Advisory Committee of the Food and Drug Administration (FDA) recently recommended for Pegintron approval as an adjuvant treatment in patients with Stage III MM.

The results using granulocyte-macrophage colony stimulating factor (GM-CSF) has also shown promise. The GM-CSF also reduces the risk of melanoma recurrence in patients with extirpated disease with a better safety profile than Pegintron. An ongoing phase III study (ECOG E 4697) is comparing a 1-year course of GM-CSF, with or without melanoma-antigen peptide vaccination, to placebo in patients completely resected advanced melanoma. The preliminary data from 735 patients demonstrated that adjuvant GM-CSF improves disease-free survival (11.8 months) as compared with patients not receiving GM-CSF (8.8 months). The overall survival (OS) was improved less but without achieving a statistical significance.

Intratumoral gene transfer therapy
OncoVEXGM-CSF is a 2nd generation oncolytic herpes simplex type 1 virus vaccine encoding human GM-CSF. OncoVEXGM-CSF represents an improvement over previous vaccine as the virus has been genetically reprogrammed to attack cancerous cells, while healthy cells remain undamaged. While OncoVEXGM-CSF is administered locally by intra-tumoral injection, it provides systemic benefit by the induction of a potent anti-tumor immune response. Primary viral infection of melanoma cells followed by virus replication and further infection and replication by progeny virons result in robust tumor cell lysis and the expression of GM-CSF in the local tumor environment serves to achieve several biologic goals inducing a local inflammation, enhancing dendritic cell activity, and increases HLA class II expression. Interest has been generated by the 13 objective systemic (eight complete response (CR) and five partial response (PR)) responses observed in a recent phase II study with intratumoral injections of OncoVEXGM-CSF into 50 stage IIIc and IV melanoma patients. Injected tumours routinely responded, often with local CR, within 2 months of therapy. A randomized Phase 3 study began in 2009 to assess the efficacy and safety of treatment with OncoVEXGM-CSF as compared to subcutaneously administered GM-CSF in patients with unresectable metastatic MM.

Anti-CTLA-4 antibodies
A group of novel monoclonal antibodies anti-cytotoxic T-lymphocyte antigen (CTLA)-4 has been evaluated in clinical trials and has shown encouraging results. The most promising agent is ipilumumab (also known as MDX-010 or MDX-101), which is a human monoclonal antibody developed by Bristol-Myers Squibb. By relieving negative regulation, this antibody effectively takes the brake off of the immune system, allowing immune cells to attack melanoma cells more effectively. A recent phase III, randomized double blind clinical trial evaluated the safety and efficacy of ipilimumab in inoperable pretreated advanced stage melanoma patients. Ipilimumab improved the median overall survival from 6.4 months to 10.1 months. After one year, 46% of patients with ipilimumab alone group and 44% of patients who received ipilimumab and gp100 vaccine were alive in comparison to 25% of patients in the gp100 control group. After 2 years, 24% patients treated with ipilimumab alone and 22% of patients of the ipilimumab-combined group were alive as compared with 14% of patients treated with gp100 vaccine alone. The ipilimumab application has been submitted for marketing authorization approval to the FDA.

Adoptive cell transfer (ACT)
ACT has emerged as the most effective treatment for patients with metastatic MM. Researchers at the NCI Surgery Branch have been working in the ATC-based immunotherapy since 1988, but significant progress in insights and results came in 2002 with the introduction of an inmunodepleting preparative regimen before the ACT. In the latest NCI Surgery Branch trials multiple tumour-infiltrating lymphocytes (TILs) were used from freshly resected metastatic melanomas. As soon as anti-tumour activity was detected in vitro, against specific unique or shared antigens, they underwent a rapid expansion using T-cell stimulating antibody OKT3 and Il-2. Approximately 5×1010 cells were infused after the myeloablative chemotherapy with cyclophosphamide with/out 2 or 12 Gy of total body irradiation. IL-2 was administrated for 2-3 days after the ACT for in vivo expansion of the TILs. Objective responses consisted of CR and PR were observed in 21 of 43 patients (49%), who received no total body irradiation, in 13 of 25 patients (52%) who received 2 Gy and 18 of 25 patients (72%) who received 12 Gy. The responses were durable and were seen in all organ sites, including the brain. The 3-year survival of patients receiving ACT with chemotherapy regimen alone or with 2 Gy is 25% and 42% respectively, compared with 14% for the no lymphodepletion group. The high rates of cancer regression have convinced the researchers of the anti-tumour efficacy of ACT therapy and confirmatory studies outside the NCI are ongoing.

Conclusion
Eliminating both the tumour and lymphocyte-mediated immune suppressive mechanism without adversely affecting the necessary antitumour effector cells has resulted in a new paradigm in the immunotherapy against MM. Many novel immunotherapeutic agents appear promising, however they still need to be tested in clinical trials. Despite great success using the ACT-based therapy a major problem is that personalized treatment is labour-intensive and requires strong laboratory expertise which makes it difficult to be adopted by the cancer centers. A more simple technique for producing large number of efficient TILs and its treatment in combination with immunotherapeutic agents such as IL-2, anti-CTLA-4 and other vaccines are under clinical research.

Author: Dr. L. Mendoza

Monday, 14 January 2013

NEW DISCOVERY ABOUT MELANOMA

After recently announcing success in eliminating melanoma metastasis in laboratory experiments, scientists at Virginia Commonwealth University Massey Cancer Center have made another important discovery in understanding the process by which the gene mda-9/syntenin contributes to metastasis in melanoma (the spread of skin cancer) and possibly a variety of other cancers.
(Feed: sciencedaily.com)

Complete information HERE.

Friday, 11 January 2013

Tobacco facts

100 million deaths were caused by tobacco.Tobacco use is one of the biggest public health threats the world has ever faced.

  • There are more than one billion smokers in the world.
  • Globally, use of tobacco products is increasing, although it is decreasing in high-income countries.
  • Almost half of the world's children breathe air polluted by tobacco smoke.
  • The epidemic is shifting to the developing world.
  • More than 80% of the world's smokers live in low- and middle-income countries.
  • Tobacco use kills 5.4 million people a year - an average of one person every six seconds - and accounts for one in 10 adult deaths worldwide.
  • Tobacco kills up to half of all users.
  • It is a risk factor for six of the eight leading causes of deaths in the world.
Because there is a lag of several years between when people start using tobacco and when their health suffers, the epidemic of disease and death has just begun.
Source: gone-ta-pott.com

Thursday, 10 January 2013

Pap Test Could Help Find Cancers of Uterus and Ovaries



The Pap test, which has prevented countless deaths from cervical cancer, may eventually help to detect cancers of the uterus and ovaries as well, a new study suggests.

For the first time, researchers have found genetic material from uterine or ovarian cancers in Pap smears, meaning that it may become possible to detect three diseases with just one routine test.
But the research is early, years away from being used in medical practice, and there are caveats. The women studied were already known to havecancer, and while the Pap test found 100 percent of the uterine cancers, it detected only 41 percent of the ovarian cancers. And the approach has not yet been tried in women who appear healthy, to determine whether it can find early signs of uterine or ovarian cancer.
On the other hand, even a 41 percent detection rate would be better than the status quo in ovarian cancer, particularly if the detection extends to early stages. The disease is usually advanced by the time it is found, and survival rates are poor. About 22,280 new cases were expected in the United States in 2012, and 15,500 deaths. Improved tests are urgently needed.
Uterine cancer has a better prognosis, but still kills around 8,000 women a year in the United States.
These innovative applications of the Pap test are part of a new era in which advances ingenetics are being applied to the detection of a wide variety of cancers or precancerous conditions. Scientists are learning to find minute bits of mutant DNA in tissue samples or bodily fluids that may signal the presence of hidden or incipient cancers.
Ideally, the new techniques would find the abnormalities early enough to cure the disease or even prevent it entirely. But it is too soon to tell.
“Is this the harbinger of things to come? I would answer yes,” said Dr. Bert Vogelstein, director of the Ludwig Center for Cancer Genetics and Therapeutics at Johns Hopkins University, and a senior author of a report on the Pap test study published on Wednesdayin the journal Science Translational Medicine. He said the genomes of more than 50 types of tumors had been sequenced, and researchers were trying to take advantage of the information.
Similar studies are under way or are being considered to look for mutant DNA in blood, stool, urine and sputum, both to detect cancer and also to monitor the response to treatment in people known to have the disease.
But researchers warn that such tests, used for screening, can be a double-edged sword if they give false positive results that send patients down a rabbit hole of invasive tests and needless treatments. Even a test that finds only real cancers may be unable to tell aggressive, dangerous ones apart from indolent ones that might never do any harm, leaving patients to decide whether to watch and wait or to go through surgery,chemotherapy and radiation with all the associated risks and side effects.
“Will they start recovering mutations that are not cancer-related?” asked Dr. Christopher P. Crum, a professor at Harvard Medical School who was not involved in the research.
But he also called the study a “great proof of principle,” and said, “Any whisper of hope to women who suffer from endometrial or ovarian cancer would be most welcome.”
DNA testing is already performed on samples from Pap tests, to look for the human papillomavirus, or HPV, which causes cervical cancer. Dr. Vogelstein and his team decided to try DNA testing for cancer. They theorized that cells or DNA shed from cancers of the ovaries and the uterine lining, or endometrium, might reach the cervix and turn up in Pap smears.
The team picked common mutations found in these cancers, and looked for them in tumor samples from 24 women with endometrial cancer and 22 with ovarian cancer. All the cancers had one or more of the common mutations.
Then, the researchers performed Pap tests on the same women, and looked for the same DNA mutations in the Pap specimens. They found the mutations in 100 percent of the women with endometrial cancer, but in only 9 of the 22 with ovarian cancer. The test identified two of the four ovarian cancers that had been diagnosed at an early stage.
Finally, the team developed a test that would look simultaneously for cancer-associated mutations in 12 different genes in Pap samples. Used in a control sample of 14 healthy women, the test found no mutations — meaning no false-positive results.
Dr. Luis A. Diaz, the other senior author of the report and an associate professor of oncology at Johns Hopkins, called the research a step toward a screening test that at first blush appears very effective at detecting endometrial cancer, though obviously less so at finding ovarian cancer.
“Probably one of the most exciting features of this approach,” Dr. Diaz said, “is that we wanted a test that would seamlessly integrate with routine medical practice that could be utilized with the same test that women get every day all over the world, the Pap smear.”
But, he added: “We can’t say it’s ready for prime time. Like all good science, it needs to be validated.”
He and other members of the team said it might be possible to improve the detection rate for ovarian cancer by looking for more mutations and by changing the technique of performing Pap tests to increase the likelihood of capturing cells from the ovary. The change might involve timing the test to a certain point in a woman’s monthly cycle, using a longer brush to collect cells from deeper within the cervix or prescribing a drug that would raise the odds of cells being shed from the ovary.
The technique also needs to be tested in much larger groups of women, including healthy ones, to find out whether it works, particularly at finding cancers early enough to improve survival. And studies must also find out whether it generates false positive results, or identifies cancers that might not actually need to be treated.
Michael H. Melner, a program director in molecular genetics and biochemistry for the American Cancer Society, called the research “very promising,” in part because it is based on finding mutations.
“It tells you not just that cancer is there, but which mutation is there,” Dr. Melner said. “As we learn more and more about which mutations are associated with more or less severe forms of cancer, it’s more information, and possibly more diagnostic.”