Archive for December 29, 2011

Do viruses cause cancer?

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virus illustrationIn 1958, when scientists linked an aggressive form of leukemia to infection with a particular virus, some researchers took the discovery as evidence that nearly all cancers are caused by viruses. A cover story in Life magazine in 1962 proclaimed, “Cancer may be infectious.”

Today, it is estimated that viruses are responsible for almost 20 percent of cancer cases worldwide. Seven viruses have been connected to specific types of malignancies; it’s now known, for example, that the human papillomavirus (HPV) causes cervical cancer and some types of head and neck cancer.

While viruses can cause cancer in a variety of ways, the actual mechanisms fall into two broad categories. Read more

If a breast lump is painful, is it not cancer?

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Beth Overmoyer, MD, FACP

Many women who discover a lump in their breast confide in a friend or family member before talking to their doctor. They may be told that if a breast lump hurts or is sore, it probably isn’t cancer. To find out whether this urban legend holds any truth, we checked with Beth Overmoyer, MD, FACP, of the Susan F. Smith Center for Women’s Cancers.

If a lump in the breast does not feel sore or tender, does that mean it isn’t cancer?

Dr. Overmoyer: Between 2 and 7 percent of patients with a painful lump in their breast will be diagnosed with breast cancer. A lump is usually hard or firm compared with surrounding breast tissue. The presence of pain should not be reassuring – anyone who notices a new lump in her (or his) breast should contact a doctor. It’s unclear why some breast cancers are painful and others aren’t, but pain is not an indication of cancer being more or less aggressive. The most likely reason is that the cancer is irritating the nerves within the breast, but the true cause isn’t known. Read more

The benefits of vitamin D

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Activated by sunlight and present in some foods and supplements, vitamin D has been associated with healthy bones and reducing the risk of diabetes and cancer.

But a new study says that the recommended dose of vitamin D needed to reap these health benefits remains unclear. To help shed some light on the topic, we talked to Dana-Farber’s Kimmie Ng, MD, MPH, who has been studying the connection between cancer and vitamin D use, as well as other lifestyle factors.

What is the connection between cancer and vitamin D?

There is a large amount of scientific and observational data that links higher blood levels of vitamin D with a decreased risk of developing cancer, including colorectal cancer and breast cancer. It has also been found to improve cancer survival.

How do I know if I’m getting enough vitamin D?

Physicians can use a blood test, called a 25-hydroxy vitamin D test, to measure how much of the nutrient is in the body. While many consider a vitamin D level of around 30 ng/ml or higher sufficient, we’ve found that the protective effects come from 35-40 ng/ml.

What is the recommended vitamin D dose for an adult?

The Institute of Medicine recommends between 600 – 800 IU. We don’t know what the optimal doses of vitamin D are for cancer prevention and treatment, although we suspect that they’re much higher than this recommendation. It is important to ask your doctor about how much vitamin D is best for you.

Is it better to get vitamin D from a pill or other sources?

Supplements are the best way to take vitamin D. Diet accounts for only 20 percent of vitamin D. A glass of fortified milk, for example, only contains 100 IU of vitamin D and isn’t enough to raise your blood levels. And while spending 10 minutes in the sun without sunblock provides 20,000 IU of vitamin D, there are other health risks to consider, like skin cancer.

Learn more about cancer and vitamin D deficiency.

Are there any vitamin D and cancer clinical trials?

We hope to begin enrolling metastatic colorectal cancer patients in early 2012 for a clinical trial evaluating the effectiveness of high doses of vitamin D in combination with chemotherapy. We will be comparing the differences between a standard dose of 400 IU of vitamin D3 with chemotherapy, versus a higher dose of 8,000 IU of vitamin D3 for two weeks, followed by a maintenance dose of 4,000 IU vitamin D3 with chemotherapy.

 

The War on Cancer, 40 years later

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Friday, December 23, marks the 40th anniversary of President Richard Nixon’s declaration of a national “War on Cancer.”

On that date in 1971, Nixon signed the National Cancer Act, which allocated $1.5 billion over three years for cancer research and control. He declared, “I hope that in the years ahead we may look back on this day and this action as being the most significant action taken during this Administration.”

Forty years later, the War on Cancer can claim countless successes against one of the most resilient and recalcitrant enemies mankind has faced.

Some cancers that were once almost invariably fatal, such as pediatric leukemia, are now cured in the vast majority of cases. In kidney cancer, the five-year survival rate – the percentage of patients alive five years after diagnosis – has increased from about 50 percent in 1971 to more than 70 percent today. In colon cancer, the rate has increased from 52 to more than 66 percent over the same time period. Death rates for cancers of the breast, liver, lung, prostate, and several other organs and tissues have been declining for the past 10-20 years.

At Dana-Farber, we take special pride in the progress of the War on Cancer because our founder, Sidney Farber, MD, was one of the key figures in mobilizing support for it.

As a frequent speaker before Congressional subcommittees, he described the burden of cancer on patients and their families – and the promise of research – in a way that captured the imagination both of legislators and the public at large.

Dr. Sidney Farber (far left) was a White House guest of Pat (second from right) and President Richard Nixon after the president declared his “War on Cancer” and passed the National Cancer Act of 1971. When the president appointed a National Cancer Advisory Board the following March, Dr. Farber was granted a four-year term.

 

 

 

 

 

 

 

 

 

 

 

 

With philanthropist and activist Mary Lasker, Dr. Farber was instrumental in creating the national will to fund and lead an unprecedented commitment to the defeat of cancer. Author and oncologist Siddhartha Mukherjee, MD, PhD, has described the campaign in his Pulitzer Prize-winning book, The Emperor of All Maladies: A Biography of Cancer.

In 1971, no one was under the illusion that the War on Cancer would be easily or quickly won. At the signing ceremony of the National Cancer Act, Nixon remarked, “We would not want to raise false hopes by simply the signing of an Act,” and time has borne out the complexity of the challenge that cancer represents.

Despite all the strides over the past 40 years, cancer remains one of the biggest health challenges we face. The good news is that advances in the understanding of cancer at the basic, molecular level have positioned us to make even greater progress in the years ahead.

What are the best vitamins for cancer patients?

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Vitamins and cancer

Walk down the vitamins and supplements aisle of a pharmacy or grocery store, and you’ll see a mind-boggling array of options. It can be hard to know which one is best. And if you’re a cancer patient looking for the right dietary supplement, there are even more issues to take into account. How do you know what’s the best – and safest – choice?

Whether you are a cancer patient or survivor, these tips can help you avoid unforeseen side-effects:

  •  Tell your doctor which vitamins you are taking. Studies have shown that some supplements can decrease the effectiveness of cancer treatment. St. John’s Wort, sometimes used for depression, has been shown to lower the effects of chemotherapy by more than half, while vitamin E, vitamin C, selenium, beta carotene, and other anti-oxidants might have similar effects on radiation and chemotherapy. Do you have a question about a particular vitamin? Ask our nutritionist, or check out our questions and answers section.
  • Read the package carefully. Vitamins and supplements bearing the label “USP” (United States Pharmacopoeia) or “NSF” (National Science Foundation) have been vetted by independent, quality control groups recognized by the U.S. government and are generally safer than those without the label.
  • “An apple a day” is still the best advice. Eating a balanced diet is still the best and safest way to ensure that your nutritional needs are met. Recently, a number of studies on supplements have been stopped because of concerning side effects. For example, a small preliminary study found that while selenium reduced the risk of ovarian cancer in women who eat foods rich in this anti-oxidant mineral, women who took selenium supplements, and other anti-oxidant vitamins, actually increased their risk of ovarian cancer.
  • Dietary supplements can be helpful in some cases. Vitamin D is well known for helping the body control calcium and phosphate levels and maintain healthy bones. Because food isn’t a great source of vitamin D (you’d need about 10 glasses of fortified milk to get 1,000 IUs) and too much sun exposure can damage skin, we recommend taking vitamin D supplements. Learn more about vitamin D.

If you’re going through cancer treatment, you may have special dietary restrictions, or you may need help managing side effects that make eating a challenge. Find out more about meal planning for cancer patients and survivors. Or, talk to a nutritionist or registered dietitian to explore options for healthy eating. Learn about Nutrition Services at Dana-Farber.

By Stacy Kennedy, MPH, RD, CSO, LDN. Kennedy is a senior clinical nutritionist for Dana-Farber/Brigham and Women’s Cancer Center and a Board Certified Specialist in Oncology Nutrition.


Blood cancer research may lead to new treatments

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At this year’s American Society of Hematology Annual Meeting, Dana-Farber scientists presented major findings that could one day improve diagnosis and treatment of blood cancers, extend life, or even cure some diseases.

Among the highlights:

Steven Treon, MD, PhD, and his colleagues identified a gene mutation that underlies the vast majority of cases of Waldenström’s macroglobulinemia, a rare form of non-Hodgkin lymphoma. The results suggest that new, effective treatments are now possible for people with Waldenström’s. Read more about Dr. Treon’s Waldenström’s macroglobulinemia research breakthrough.

Catherine J. Wu, MD, co-led investigators who discovered nine new gene mutations that could help doctors predict if and how chronic lymphocytic leukemia (CLL) will progress, and lead to new treatments for CLL. Take a closer look at Dr. Wu’s CLL research.

Corey Cutler, MD, MPH, and his colleagues reported on a new clinical trial that may improve the ability of stem cells from umbilical cord blood to take root in patients receiving a stem cell transplant more quickly and with a higher degree of success. Learn more about Dr. Cutler’s stem cell transplant clinical trial.

Breast cancer specialist discusses treatment advances

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Harold J. Burstein, MD, PhD, a Dana-Farber breast cancer specialist, discusses some of the important studies presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium.

The five-day meeting includes more than 1,000 scientific presentations, seminars, and posters, with a focus on emerging treatments in hard-to-treat populations, patients with metastatic breast cancer, and breast cancer prevention and risk.

Around 8,000 breast cancer experts from 90 countries are attending the symposium to learn about the latest developments in breast cancer care and research.