WIN A COPY OF THE PROSTATE CANCER BOOK !

Just answering  the multiple choice question. Select the answer that you believe is correct. First three correct answers are winning!

What is true in prostate cancer?

1.   The prostate gland is a gland found in men exclusively

2.  A localized (no disseminated) prostate cancer have high probability to be cured with surgery or radiotherapy only

3.   The digital rectal examination and measurement PSA (prostatic specific antigen) levels are recommended strategies for early detection and prostate cancer screening

4.       All the above are correct.

Source: author of the blog

MANUAL OF PROSTATE CANCER

If you are a man 40+ years old, you should be aware that the risk of having a prostate cancer is increasing with the years. Everything that you should know about prostate cancer find in the educational book about it LINK

PREOCUPACIÓN EN LA LUCHA CONTRA CÁNCER DE PROSTATA

Según una encuesta llevada a cabo, los dos tercios de los hombres británicos no tienen ni idea de lo que realmente hace la próstata. Cada año, 35.000 hombres son diagnosticados con cáncer de próstata en el Reino Unido, por lo que es el tipo más común de cáncer en los hombres. Lo que todo hombre debe saber sobre el cáncer de próstata (prevención, factores de riesgo, prueba de PSA, tratamientos, etc) en el siguiente LINK (web del libro en español).

WHAT IS THE MOST SERIOUS AND FREQUENT COMPLICATION OF PATIENTS RECEIVING CHEMOTHERAPY?

Answer: Febrile neutropenia.

The word febrile means you have a fever.  A fever is defined as a single oral temperature of greater than or equal to 38.3°C (101 F), or a temperature of greater than 38.0°C (101.4 F) lasting at least an hour. NOTE: Patient may not present with fever, but may have symptoms such as hypotension, tachycardia or chills. Fever neutropenia occurs when a patient has a fever and a significant reduction in their white blood cells (neutropenia) that are needed to fight infections. Many patients when undergoing cancer treatment will have a reduction in their white blood cells that may be temporary or may persist for some time. The fever may be caused by an infectious agent, and when it is rapid treatment is required. A patient with febrile neutropenia needs assessment for the possible source and type of infection and treatment until the cause is found or it subsides.

What you should do if you have any of these signs?

Sometimes it is hard to tell if you have an infection. However, if you have any warning signs and your white blood cells count may be low, this is a medical emergency. Even if you feel fairly well, you must contact your doctor or nurse or go to your nearest hospital Emergency Room immediately!

What could happen if the physician confirms that you have a febrile neutropenia?

The first decision of the physician will be to hold the chemotherapy treatment. If the patient has febrile neutropenia then cultures and more blood tests will be taken to try to determine the presence and possible site of any infections. A decision will have to be made by the physician as to whether the patient should be admitted to a health care facility for observation and treatment. This decision will be based on the clinical state of the patient and the predicted length of the lowered white blood cell counts. Whether the patient is admitted or not treatment will usually include the use of antibiotics. Be aware that you physician may prescribe you the colony-stimulating factors (CSFs), which are glycoproteins that stimulate a fast repopulation of the white blood cells, for a faster control of the infection or febrile neutropenia .

What are the risks to develop a febrile neutropenia?

In addition to the risk of the chemotherapy treatment and the specific malignancy being treated, the following factors need to be considered when evaluating a patient’s overall risk for febrile neutropenia: Older patient, previous chemotherapy and radiotherapy, preexisting neutropenia or bone marrow dysfunction due to tumor involvement, poor performance status and poor renal and liver function.  If you are in one of such group of risk, your physician will recommend the use of CSF prophylactically in each cycle of treatment.

Luis Mendoza, MD, PHD

ANGELINA JOLIE´S DOUBLE MASTECTOMY

Actress and activist Angelina Jolie's recent decision to have a preventive double mastectomy highlights the difficult choices facing women who find out they have a high risk for breast cancer because of their genes.

Although relatively rare, mutations in the BRCA1 and BRCA2 genes raise the risk of breast cancer by as much as 80%, experts say. The mutations also raise the risk of ovarian cancer.

Jolie describes in a New York Times op-ed piece why she decided to go through with the surgery. At 37, the mother of six wants to stay healthy and active for her family -- and to reassure them that she is doing everything possible to avoid the disease that took her mother's life: cancer.

“I wanted to write this to tell other women that the decision to have a mastectomy was not easy,” Jolie writes. “But it is one that I am very happy I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”

Why do women undergo a preventive double mastectomy?

In Angelina Jolie's case, she had a mutation that puts her at very high risk for getting breast cancer at some point in her life. Right now the most effective prevention that we have for [this] BRCA mutation carrier is a prophylactic double mastectomy.

It is always a double mastectomy because both breasts are at risk and you don’t know which breast is going to get breast cancer when women have a BRCA mutation.

How many women have the BRCA mutation?

Only about 5% of all breast cancers are in women who have this genetic mutation.

Is the breast cancer linked with this mutation more aggressive than others?

Yes, BRCA mutations are associated with a more aggressive breast cancer that is known as "triple negative."

Do some experts think that performing a double mastectomy is too radical for those who test positive for BRCA mutations?

I think most breast cancer experts would agree that the choice is really the patient's to make, and I really want to emphasize, it is a choice.

Preventive mastectomy is one very excellent choice. But another choice women can consider when they know they carry a BRCA mutation is early detection. And that comes with more active screening. If a woman knows she has a BRCA mutation and does not want to have a mastectomy, a good alternative is to have a mammogram and a breast MRI every year. You can do both at once or choose to alternate. [For my patients] I choose to alternate, doing one test every 6 months.

It's not as effective because by definition you are picking up cancer as it develops. But it is effective at picking up cancer at a very early stage.

If a woman has a preventive double mastectomy, what are the benefits and risks?

In women at higher risk -- those with BRCA mutations -- preventive surgery can reduce the risk of breast cancer by 90%. If the [increased] risk is 80% as it is for many BRCA carriers, this can reduce the risk of breast cancer by 90%.

In other words, this can reduce the risk to that lower than the general population. The risks [of the mastectomy] are not that great. Most women having preventive mastectomies are younger patients, and many choose to get reconstruction. A lot of the risk has to do with the implants, like implant complications, or other risks [linked with surgery] such as infections or bleeding.

Who should consider BRCA testing?

The women who should absolutely consider it are those who themselves have had a triple-negative breast cancer, the kind associated with BRCA mutations, at an early age, under 45, people who have had both ovarian and breast cancer in family members, and people who have breast cancer in the family and are of Ashkenazi Jewish descent.

What is involved in testing for BRCA mutations?

It is a simple blood test, or they can swab the inside of your cheek. The best way to get this test is to go for counseling from a genetic counselor. Have them talk to you about the possibility of testing positive. Women really need to be counseled about what this means, what the results mean, what their risk is, and then to make the decision about whether to get the test.

If you only get tested for the three most common mutations, results take about 2 weeks. The more comprehensive test, where they do gene sequencing, can take a month.

What is the cost and who pays?

The cost is about $3,000. The cost of testing is covered by many insurance companies [if you are deemed high risk].

By Kathleeen Doheny

WebMD Health News

Reviewed by Michael W. Smith, MD

STUDY: BIENNIAL MAMMOGRAMS MAY BE BETTER FOR SOME WOMEN

Research suggesting that annual mammograms may not be best for most women received a fair amount of coverage online, and was featured on two of last night's national news broadcasts. Most sources point to the fact that advice on mammogram frequency varies among medical groups, and that these findings back up recommendations from the US Preventive Services Task Force. Meanwhile, some sources mention that certain groups were critical of the study.

        The CBS Evening News (3/18, story 8, 2:30, Schieffer, 5.58M) reported that a new study has "found that doing mammography every two years rather than every year did not increase the risk of advanced breast cancer."

        ABC World News (3/18, story 5, 2:05, Sawyer, 7.43M) reported that the study "revealed 60% of abnormal mammograms turn out to be false positives, not cancer at all, even though they can lead to biopsies, even surgery." During a second segment on the topic on ABC World News (3/18, story 6, 0:50, Sawyer, 7.43M), ABC's Dr. Richard Besser said, "I think this is one of the most important things you can do, with whatever serious illness you have. It's to ask this question. Say to your doctor, 'Before we go forward with any treatment, let's get a second opinion. And is there someone you can refer me to?' The best doctors are going to welcome another set of eyes, another way of looking at it."

        CBS News (3/19) reports on its website, "The results, which were published on March 18 in JAMA Internal Medicine, follow the 2009 recommendation by the US Preventive Services Task Force that advocated for biennial mammography for women in this age group instead of the previous suggestion of getting screened every one to two years." In the new study, "the researchers looked at data from 11,474 women with breast cancer and 922,624 women without breast cancer who underwent screenings at US facilities involved in the long-running Breast Cancer Surveillance Consortium (BCSC) from January 1994 to December 2008." The researchers fond that "women who went every two years for a screening were not associated with an increased risk of advance stage breast cancers or large tumors, even if the woman had dense breasts or used hormone replacement therapies, when compared with women who were screened every year."

        Bloomberg News (3/19, Cortez) reports, "The study found an exception for women 40 to 49 years old with extremely dense breasts." These individuals "were about twice as likely to be diagnosed with large tumors or advanced cancer if they skipped mammograms." Additionally, "they...had higher rates of false-positive results."

        Reuters (3/19, Steenhuysen) reports, however, that some groups, including the American College of Radiology, criticized the study, arguing that its methodology was flawed.

        False-Positive Mammograms May Have Negative Psychological Effects. The Los Angeles Times (3/19, Brown, Times, 692K) reports, "Long after learning that a troubling reading on a screening mammogram was just a false alarm, women continued suffering negative psychological effects, researchers in Denmark have reported" in the Annals of Family Medicine. Researchers found that, "six months after hearing they did not have breast cancer, women with these false positives experienced changes in 'existential values' and 'inner calmness' as great as for women who had cancer."

        On its website, ABC News (3/19, Moisse) reports that additionally, "women who had false positives were...more likely to report disturbances in sleep and sexuality, according to the study."

        The NBC News (3/19, Fox) "Vitals" blog reports that the researchers wrote, "False-positive findings on screening mammography causes long-term psychosocial harm: Three years after a false-positive finding, women experience psycho-social consequences that range between those experienced by women with a normal mammogram and those with a diagnosis of breast cancer."

UTILITY OF ADJUVANT ASPIRIN IN CRC NOW HAS BIOMARKER

A recent study points to a useful biomarker for patients with colorectal cancer who might benefit from adjuvant aspirin therapy.

Previous published studies have confirmed anecdotal observations of the benefit of aspirin therapy in improving outcomes in certain cancers. Researchers in Boston and Japan analyzed data obtained from the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) to determine if the regular use of aspirin had a significant effect on survival among patients with colorectal cancer.

Xiauyun Liao, PhD, and colleagues at the Dana-Farber Cancer Institute in Boston, selected 964 patients who had been diagnosed with rectal or colon cancer, reviewing data on survival, aspirin use before and after diagnosis, and tumor tissue data, including the presence of the PIK3CA mutation, present in 15%-20% of colorectal cancers. Biomarkers also were examined, including PTGS2 (i.e., cyclooxygenase-2), phosphorylated AKT, KRAS, BRAF and microsatellite instability. Results were published in The New England Journal of Medicine (2012;367:1596-1606, PMID 23094721).

Researchers hypothesized that regular aspirin use (defined as a standard dose taken two or more times a week during most weeks) may inhibit cancer cell growth and induce apoptosis by blocking the PI3K pathway. The results showed patients with thePIK3CA mutation who took regular aspirin had an increased survival rate compared with patients with wild-type PIK3CA, regardless of whether the aspirin therapy began before or after diagnosis.

In patients with the mutated PIK3CA gene who did not use aspirin, 23 of 90 died within five years of diagnosis, whereas only two of 62 died who had used aspirin (P<0.001). These patients had significantly increased cancer-specific survival (multivariate hazard ratio [HR] for death, 0.18; 95% confidence interval [CI], 0.06-0.61; P<0.001) and superior overall survival. Regular use of aspirin after diagnosis in patients with wild-type PIK3CA was not associated with cancer-specific survival (multivariate HR, 0.96; 95% CI; 0.69-1.32; P=0.076) or overall survival.

The authors noted the exact mechanism that causes these results needs to be clarified and that the heterogeneous nature of colon cancers may also affect outcomes. They conclude that colorectal cancer patients with the PIK3CA mutation would derive a benefit from aspirin as an adjuvant therapy, and that the mutation might provide a useful biomarker for such therapy.

From The New England Journal of Medicine

SOY CONSUMPTION LINKED TO BETTER LUNG CANCER SURVIVAL IN WOMEN

On its website, NBC News (3/25, Fox) reports, "Soy foods, long shown to help lower the risk of cancer, may also help people survive at least some forms of cancer better," according to research published in the Journal of Clinical Oncology. This finding, "lends support to the idea that adding soy foods to the diet can help people in multiple ways, says Dr. Jyoti Patel, a lung cancer specialist at Northwestern University in Chicago, who was not involved in the study." According to Patel, "Although the risks are probably different for American women for developing lung cancer, I do think it is a call to action for more research about how we develop lung cancer." NBC News adds, "For the study, Gong Yang and colleagues at Vanderbilt University Medical Center, Shanghai Cancer Institute, and the National Cancer Institute looked at data from a large study of Chinese women called the Shanghai Women's Health Study."

        The Tennessean (3/25, Wilemon, 120K) reports that, among those in the study diagnosed with lung cancer, women "who had a history of eating soy-rich diets were 20 percent more likely to be alive a year after diagnosis than those who had not." The Tennessean points out that the "study received federal funding from the National Cancer Institute."

        Medscape (3/26, Mulcahy) reports, "'This is the first scientific evidence that soy has a favorable effect on lung cancer survival,' said Dr. Patel, who is a spokesperson for the American Society of Clinical Oncology, and provided independent comment on the study." Dr. Patel told Medscape Medical News that "soy may have a mechanism of action similar to drugs like tamoxifen."

Source: ASCO news

ON-THE-JOB STRESS WON´T RAISE YOUR RISK FOR CANCER

The hassles and deadlines at work may leave you frazzled, but they won't raise your risk for cancer, new research suggests.

Despite earlier studies suggesting an association between work stress and cancer, an international team of researchers found that it wasn't linked to colorectal, lung, breast or prostate cancers.

"We already know from other studies that work-related stress is associated with many adverse health outcomes, such as heart disease and depression," said lead researcher Katriina Heikkila, from the Finnish Institute of Occupational Health in Helsinki.

"Our findings suggest that stress at work is unlikely to be an important cancer risk factor. Though reducing work stress would undoubtedly improve the psychological and physical well-being of the working people, it is unlikely to have a marked impact on cancer," Heikkila said.

Commenting on the new report, Dr. Lidia Schapira, associate editor for psychosocial oncology at the American Society of Clinical Oncology's Cancer.Net, said, "I am encouraged that there is now some evidence that uncouples job strain and life stresses from cancer."

People worry a lot when they are under stress, and they then worry that their worrying is going to impact their health, she noted.

"We know stress can affect the body's reactions [and] increase inflammation, which is associated with an increased risk of cancer, so there is good reason to worry," said Schapira, who is also an assistant professor in the department of medicine at Harvard Medical School in Boston.

"I think people should address stress just because stress is uncomfortable and impacts on one's wellness and well-being and quality of life," Schapira said. "But good scientists have given it a hard look, and we really can't connect the dots [between] being stressed at work to getting cancer."

The analysis was published online Feb. 7 in the BMJ.

To see what role job stress might play in the risk of developing cancer, Heikkila's group collected data on 116,000 men and women, aged 17 to 70, from Finland, France, the Netherlands, Sweden, Denmark and the United Kingdom.

All of these people had taken part in one of 12 studies where they were asked about the amount of stress on their job.

The researchers defined several types of job stress: high-stress jobs, with high work demands and low control over work; active jobs, with high demands and high control; passive jobs, with low demands and low control; and low stress jobs, with low demands and high control.

The investigators then turned to cancer death registries and hospital records to see how many people developed or died from cancer. They further refined their search by taking age, sex, socioeconomic factors, smoking and alcohol use into account.

In addition, the researchers excluded anyone who was extremely overweight or underweight.

Over an average 12 years of follow-up, more than 5,700 people developed some type of cancer.

Heikkila's team didn't find any connection, however, between cancer and job stress. It is possible that other studies that found a connection between job stress and cancer found the association by chance or included other work-related factors that went beyond work, the Finnish researchers said.

For this type of study, called a meta-analysis, researchers comb through already published studies looking for patterns in the data. Often, the patterns they find go beyond the original intent of the studies they are examining.

The downside of a meta-analysis is that the data the researchers choose is only as good as the data in the studies they use, and their conclusions can't always take into account problems with the original research.

Elizabeth Ward, national vice president of intramural research at the American Cancer Society, said it is hard to conclude from this analysis that work stress doesn't play a role in cancer.

"One way job stress could impact cancer is if people who have stress are more prone to be smokers or drink more alcohol, or be obese," she explained.

When the researchers tried to eliminate these factors from their data, they could be hiding a substantial number of people for whom stress leads directly to behaviors known to increase the risk for cancer, Ward noted.

SOURCES: Katriina Heikkila, Ph.D., Finnish Institute of Occupational Health, Helsinki; Lidia Schapira, M.D., associate editor, psychosocial oncology, Cancer.Net, American Society of Clinical Oncology, and assistant professor, department of medicine, Harvard Medical School, Boston; Elizabeth Ward, Ph.D., national vice president, intramural research, American Cancer Society; Feb. 7, 2013, BMJ, online

 

Source: HealthDay News

 

HPV VACCINATION HITS 70% UPTAKE

Some 70% of 12-to-13-year-olds in England have been fully vaccinated against cervical cancer in the first year of the programme, figures show. In the last school year 87% had at least one of the three doses needed to protect against HPV - the virus linked with most cervical cancers. The Department of Health says 80% coverage is needed to achieve "herd immunity" but it has not set a target. A staggered catch-up campaign is planned for older schoolgirls. The HPV vaccine had attracted some controversy as it works by making girls immune to a sexually transmitted infection. It was initially offered to all 12-to-13-year-olds across the UK but a staggered catch-up campaign for 14-to-18-year-olds is due to get underway in England, Wales and Northern Ireland when schools go back in September. In Scotland, vaccination of older girls has already started. Robert Music, director of the Jo's Trust cervical cancer charity, said: "Given the HPV vaccine was only introduced last September, it is a positive start to this important programme for 70% of eligible girls to have received all three doses of the vaccine. "The programme's biggest challenge is to ensure that all girls who are eligible for the catch-up vaccine are immunised." Other vaccines The NHS Information Centre report also showed that in 2008-09 uptake levels of MMR vaccine for two-year olds remained at around 85% for the third year running - still short of the 90% target. By age five, when children are recommended to have a second dose, the latest uptake figures are 78% - the highest level since the data was first collected in 1998. There are still many children out there who were not vaccinated as toddlers over the past decade and remain unprotected Since 2005, the number of cases of measles has been rising year on year. The figures also show that 74% of over 65s received the seasonal flu vaccine last winter. A Department of Health spokesman said: "Uptake of the vaccine against cervical cancer has reached high levels since its introduction a year ago and it is encouraging to see an increase in the number of children who have received two doses of MMR by their 5th birthday. "But we cannot afford to be complacent - the number of children getting MMR vaccine still falls short of the levels needed for universal protection."   Source: bbc.co.uk       Source: google.com