Tuesday, March 30, 2010

How Health Care Bill Helps Cancer Patients

Today President Obama signs sweeping legislation that will change our healthcare system. Exaggerations and the rhetoric of fear have obscured the debate to the point that people who will obviously benefit from this law are opposed to it. The bill is complex and easy to misunderstand. But for people with cancer, it offers important benefits.

It outlaws discrimination because of pre-existing conditions. The Big C makes you quite an unpopular risk for Big Insurance. This bill changes that. Starting immediately, individuals without insurance and with a preexisting condition will have access to insurance. Starting in 2014—too long in my estimation—that applies to all individuals with insurance.

It provides a cushion for those of us with high health costs.

• Beginning immediately, it limits the ability of insurance companies to charge higher rates because of health status.

• In January 2014, it will prohibit individual and group plans from placing annual limits on coverage.

• It prevents insurance companies from canceling your policy for any reason other than fraud.

It helps those over 65 with high prescription medicine expenses by reducing the “doughnut hole,” an odd little Medicare glitch that means that once seniors have spent $2,830 on drugs, they must cover the full cost of their medicines until their out-of-pocket expenses have reached $4,550. For more on how it helps seniors, check out the American Association of Homes and Services for the Aging blog.

This is not a budget buster. The Congressional Budget Office says the bill will reduce the deficit by $138 billion over the 2010-2019 period. Estimates are that it will cut it by $1.2 trillion in the ten years after that. This is a non-partisan group that took into account all aspects of the bill.

For a complete analysis of the bill, check out the Kaiser Family Foundation’s excellent summary.

And if you wonder how it might affect you financially, check out The Washington Post’s worksheet. What I find most compelling about this tool is its simplicity—no details on health status. That’s because, under this bill, that no longer is an issue.

Tuesday, March 23, 2010

Are You A Triple-Negative Survivor?

I am looking for TNBC survivors, or survivors of any form of hormone negative breast cancer, for short profiles in a book I am writing. I would like to talk to women who have survived more than three years. I am particularly interested in interviewing pre-menopausal and African-American women because this disease is especially prevalent in those groups.

Please respond through my email, which is included in my profile on the left. I would love to talk with you.

Thanks much!


Environmental Toxins Linked to Breast Cancer

Pregnant rats exposed to Bisphenol A (BPA) passed a cancer risk on to their offspring, according to research in the journal Proteomics (Feb 26, 2010).

Diethyl phthalate (DEP), used in many cosmetics, may be associated with an increased risk of breast cancer, based on research on Mexican women and published in Environmental Health Perspectives (December 9, 2009).

Ixempra plus Xeloda successful against triple-negative breast cancer

Ixempra (ixabepilone) plus Xeloda (capecitabine) doubled the progression-free survival (PFS) rate for women with triple-negative breast cancer (TNBC), according to research that analyzed the results of five Phase II and two Phase III studies. In all, 2,261 were evaluated, with 24.5 percent, or 556 of these having TNBC—cancers that are negative for estrogen, progesterone and Her2 (Human Epidermal growth factor Receptor 2).

In an overall analysis of all trials, women with TNBC who used both Ixempra and Xeloda saw an overall response rate (ORR) of 23 to 31 percent, with results varying from study to study.

The pathologic complete response for TNBC women on Ixempra was 26 percent, versus 15 percent in the non-triple-negative population.

Patients with metastatic breast cancer in the studies had a variety of treatments before Ixempra therapy, so their ORR varied significantly, from 6 to 55 percent; rates, though, were comparable to those in patients with non-triple-negative.

Progression-free survival (PFS) was significantly longer for triple-negative patients treated with Ixempra and Xeloda (4.2 months) compared with treatment with Xeloda alone (1.7 months).

Source: Perez, Edith, Patel, Tejal Moreno-Aspitia, Alvaro, 'Efficacy of ixabepilone in ER/PR/HER2-negative (triple-negative) breast cancer', Breast Cancer Research and Treatment (2010).

Saturday, March 13, 2010

Characteristics of Turkish TNBC Patients

Research in the Annals of Oncology (2007) defines the demographics of in a small cohort of Turkish women with triple-negative breast cancer. Patients with TNBC were (in comparison to those with non-triple-negative):

• younger (44 versus 47.5 years)

• premenopausal at diagnosis (70.6% versus 43.0%,)

• more likely to use oral contraceptives (35.3% versus 12.2%)

• less likely to have lymph node metastasis (29.4% versus 61.5%)

• more likely to have high-grade (grade III) tumors (52.9% versus 28.4%)

Tumor staging, status of the distant metastases, family history of breast cancer, and hormone replacement therapy were no different in the two groups..

Wednesday, March 10, 2010

Plan a Diet High in Anti-inflammatory Foods

Some nutritionists now label foods according to their inflammation, or IF, rating, meaning how likely they are to cause inflammation. As inflammation is one of the culprits in the formation of breast cancer, and is especially implicated in estrogen-negative disease, focusing on anti-inflammatory foods should be part of our cancer prevention strategy.

Foods cause inflammation because of a chemical reaction in the body, which can be measured with the C-reactive protein (CRP). Omega 3s, especially docosahexaenoic acid (DHA); antioxidants; monounsaturated fat; selenium; and folate can reduce inflammation.

Foods with positive IF ratings are anti-inflammatory; those with negative can cause inflammation. The banana, blueberries, and yogurt I have with my morning smoothie are all mildly inflammatory. The flaxseeds I include are anti-inflammatory, however.

Throughout the day, I focus on other anti-inflammatory treats, such as peppers, carrots, spinach, cabbage, kale, onions, and lettuce.

Get a Good Start with a Cancer-Fighting Smoothie

I have a fruit smoothie most mornings: fat-free plain yogurt, a banana, blueberries, a little pure fruit juice, ground flaxseeds, and filtered water. How many goodies to I actually get from this drink? It contains two servings of fruit, so first thing in the morning I already have 2/5 of the suggested daily amount of these cancer-fighting goodies. And it is high in antioxidants, fiber, and calcium, all good for combatting the Big C. It's also low in fat (1 gram of saturated) and in calories (317)—important because a low-fat diet can reduce the risk of recurrence, especially for estrogen-negative breast cancer.

A smoothie is a quick and easy way to get a healthy start to your day—if I know I'll have a rushed morning, I make it the night before and sip it while I get dressed.

According to the National Weight Control Registry, 78 percent of the people who have lost more than 30 pounds and kept it off for more than a year regularly eat breakfast.

The breakdown on the nutrients in this particular smoothie:

One medium banana

Calories: 105

Total fat: 1 gram (saturated)

Serving of fruit: 1

Nutrients: Dietary Fiber, Vitamin C, Potassium and Manganese, and Vitamin B6.

But: high in sugars—14 grams.

One-half cup frozen blueberries

Calories: 39

Total fat: 0

Serving of fruit: 1

Nutrients: Manganese, Dietary Fiber and Vitamin K.

But: High in sugar—6.5 grams

One-half cup yogurt, plain, fat-free organic (Horizons brand)

Calories: 55

Total fat: 0

Nutrients: Protein, Riboflavin, Vitamin B12 and Potassium, Calcium, and Phosphorus.

But: high in sugar—7.5 grams

One-quarter cup black cherry juice—Knudsen brand

Calories: 80

Total fat: 0

Nutrients: Potassium and iron

But: 12.5 grams of sugar

One tablespoon flaxseed

Calories: 37

Nutrients: Magnesium, Phosphorus and Copper, Dietary Fiber, Thiamin, and Manganese.

Tuesday, March 9, 2010

Triple Negative Genetic Sequencing To Be Studied

From a new release from Life Technologies:

CARLSBAD, Calif., PHOENIX & THE WOODLANDS, Texas, Mar 05, 2010 (BUSINESS WIRE) -- Life Technologies Corporation today announced that it is collaborating with the Translational Genomics Research Institute (TGen) and US Oncology to sequence the genomes of 14 patients afflicted with triple negative breast cancer whose tumors have progressed despite multiple other therapies. The goal of this first-of-its-kind research collaboration is to demonstrate whether genomic sequencing of cancer tissue can provide clues for treatment strategies for these individuals.

While genomic sequencing has made great strides in helping researchers understand human disease, its clinical utility is not fully known. This research study brings together the accuracy of the Applied Biosystems SOLiD(TM) System, with US Oncology's expertise in cancer trials and TGen's Cancer Genome and Oncology programs, to provide additional information for oncologists and their patients. Triple negative tumors, which make up nearly 20 percent of breast cancers, do not respond to treatment with common targeted breast cancer therapies such as Herceptin.

"This study could provide insight into how cancers can be potentially treated in the future," said Daniel D. Von Hoff, M.D., Physician-in-Chief, Senior Investigator for TGen and Chief Scientific Officer for US Oncology & Scottsdale Healthcare's Virginia G. Piper Cancer Center. "Current clinical trials are aimed at showing how one new drug can be safe and effective across hundreds of people. This study flips that concept by using sequencing data from one individual to evaluate which anti-cancer drugs could be most effective based on normal and tumor genetic makeup. This is truly the definition of genomic medicine."

Cancer is caused by mutations across the genome that affect genes coding for proteins involved in cellular processes. Understanding these mutations and their impact on biological pathways and processes becomes critical in the selection of treatment when cancers are not responsive to conventional anti-cancer therapies.

In this collaboration, US Oncology will help enroll patients in the study to have both tumor and healthy tissue sequenced using the SOLiD system to identify mutations, which will be validated by CLIA-certified Caris Life Sciences. Scientists and oncologists will then leverage this information to more intelligently evaluate potential therapies that target the affected pathways responsible for the cancer.

"Metastatic triple negative breast cancer is an aggressive cancer for which few effective therapies exist," says Joyce O'Shaughnessy, M.D., Co-Chair of the US Oncology Breast Cancer Research Committee, Associate Director for US Oncology clinical research and Co-Director of the Breast Cancer Research Program at Baylor-Charles A. Sammons Cancer Center and Texas Oncology, a US Oncology affiliate in Dallas, Texas. "US Oncology has conducted a number of clinical trials aimed at advancing the biologic understanding and therapeutic efficacy for these patients, and we are very excited to have the opportunity to fully sequence patients' triple negative breast cancers towards these ends."

Additionally, scientists from TGen and Life Technologies will collaborate in the development of novel computational and informatics software paving the way for the use of whole genomic sequencing data for querying, identifying and interpreting mutations to provide for more effective therapeutic decisions. These capabilities will potentially have a significant impact on the treatment of cancer and other complex diseases for which numerous targeted therapeutic choices are available.

"Life Technologies' highly accurate SOLiD system is the appropriate tool to carry out this type of study," said Mark Stevenson, President and Chief Operating Officer for Life Technologies. "With an accuracy greater than 99.94%, we will be confident that any differences between the tumor DNA and DNA from healthy tissue will be the result of mutations as opposed to errors introduced in the sequencing itself. Life Technologies is proud to be part of such groundbreaking research, which is paving the way for a new paradigm in cancer treatment."

The SOLiD System is used globally in experiments to better understand the genetic nature of diseases such as cancer, diabetes, and neurological disorders. Its throughput, accuracy, speed and flexibility allow researchers to generate the high quality data needed for the advancement of molecular medicine. More.

Saturday, March 6, 2010

Treatment kills large breast cancers, reduces mastectomies

From the University of Oklahoma Health Sciences Center: 
A new treatment developed and tested by University of Oklahoma researchers not only killed large cancer tumors, but reduced the need for mastectomies by almost 90 percent. The study results appear in the journal Annals of Surgical Oncology.  Building on this success, researchers at the OU Health Sciences Center plan to start the next phase of clinical trials this year to test the therapy on even larger tumors.  
“This therapy is a major advancement for women with later stage breast cancer. Right now, most patients with large tumors lose their breast. With this treatment along with chemotherapy, we were able to kill the cancer and save the breast tissue,” said William Dooley, M.D., a researcher at the OU Cancer Institute and the director of surgical oncology at OU Medicine.  
Dooley is leading a group of researchers from OU, the Massachusetts Institute of Technology, the Los Angeles Biomedical Research Institute, the Comprehensive Breast Center in Florida and St. Joseph’s Hospital in California. They are working on a treatment called Focused Microwave Thermotherapy. The technique, which was approved by the U.S. Food and Drug Administration, uses a modified version of the microwave technology behind the “Star Wars” defense system.  In the most recent study, researchers tested the therapy on tumors that were an inch to an inch and a half in size. 
These large tumors usually require mastectomies. When researchers used the heating therapy within two hours of patients receiving chemotherapy, the tumor was more susceptible to the chemotherapy and shrunk rapidly. The percentage of patients needing mastectomies was reduced from 75 percent to 7 percent.  
“The trial was very successful. We were able to completely reverse those odds,” Dooley said. “We redesigned the machine and will begin clinical trials this year to determine whether the therapy works on tumors that are larger than one and a half inches and smaller than 5 inches in size.”  In theory, Dooley said the technique could be used on any organ that could be “held relatively still.” Scientists are now working to integrate heat-sensitive nanotechnology that would more precisely target cancer cells. 
They also plan to study a byproduct of the rapid disintegration of the tumor – a boosted immune system. Dooley said it looks like the rapid release of cancer proteins into the blood stream is causing an immune response that could reduce the chance of cancer recurrence. 

Healthy diet and exercise can fight Alzheimer's

A couple of years ago, I wrote an article on chemobrain for MAMM. What I learned in writing that piece was that chemo may not be the culprit in brain lapses during cancer--the cancer itself can cause changes in the brain. I also learned that spending time in nature can help counter the effects. I just recently finished writing an article on Alzheimer's disease for Transitions magazine and, as always, learned as much as my readers—probably more so because I can't put everything into the published piece. The biggest lesson for me from the article: A diet high in antioxidants (blueberries and spinach were specifically studied), plus physical activity both can combat the effects of Alzheimer's, just as they combat cancer. More reason to head out and enjoy this emerging Spring weather (finally!) and focus on that healthy diet.