Wednesday, August 25, 2010

Blueberries Reduce TNBC Tumor Growth and Spread

More good news about the berries we love: Researchers at the City of Hope say blueberries can control tumor growth, decrease metastasis, and kill the cells of triple-negative breast cancer-—cancers that are negative for estrogen and progesterone receptors and for the epidermal growth hormone Her2. In laboratory tests using blueberry extract on cell cultures, the equivalent of four ounces a day of blueberries (for a 130-pound woman) led to a reduction in weight of those tumors--they weighed 70 percent less than those without the steady blueberry intake. And these tasty disease fighters doubled the rate of cell death of TNBC. Check out the City of Hope’s story on the research. Researchers hope to broaden this research through clinical studies to see if the results hold up in the human body.

What a dandy way to self-medicate.

Alcohol Riskier for Hormone-Positive than for Hormone Negative

Alcohol intake may be a bigger risk factor for hormone-positive breast cancer than for hormone negative, according to new research to be published in September by the National Cancer Institute. And it is more correlated with lobular breast cancers than with the more common ductal tumors.

The relationship is strong, researchers say, with as little as one drink a day doubling the risk of lobular, hormone-positive cancer, but not increasing the risk of ductal or hormone-negative significantly.

The study evaluated nearly 3000 postmenopausal women diagnosed with breast cancer between 1993 and 1998. It is part of the Women’s Health Initiative. More than 80,000 women were initially enrolled in the research; of these, 2944 were diagnosed with invasive breast cancer by September 2005.

Check out Medpage Today for a more complete analysis.

I am still keeping myself at 2-3 drinks a week because I don't want to get any kind of cancer ever again.

Wednesday, August 18, 2010

A New Medical Adventure: No Stroke, No Cancer in the Brain, No Idea What Was Wrong

It’s about 170 miles from Walsenburg, Colorado to Denver. The trip takes less than an hour in a helicopter. I know, because I was airlifted from the Spanish Peaks Medical Center outside of Walsenburg to St. Anthony’s Hospital in downtown Denver on June 18, 2010. Docs thought I’d had a stroke. Ultimately, they decided I hadn’t, but they aren’t sure just what was wrong with me.

Two months later, I am still fine, although perplexed about what exactly happened.

As I flew over Pueblo and Colorado Springs that clear June night, my main worry was that the cancer had returned in my brain—which is a common site of recurrence of hormone-negative breast cancer. I was amazingly tranquil about the possibility—I was ready to accept the inevitable. That was probably the Valium they had given me, though. To skip ahead, the cancer had not returned.

Yea! But what the what was going on here?

The reason we headed to the emergency room in Walsenburg earlier that evening was that I was extremely lightheaded, weak on one side, had trouble breathing, and felt like I was about to pass out. This had been coming on for more than an hour while I puttered around our mountain cabin trying to hydrate myself, thinking it was dehydration and trying to snack, thinking it might be a blood sugar issue, although I had no reason for concern about either problem.

Once I was hooked up to the machines that became part of my body for the next 20 hours, another symptom popped up: My blood pressure, which normally is low (110/65) shot into the danger zone (145/109).

I also wasn’t terribly articulate—I kept telling the doc in Walsenburg that I felt “weird” and, when he asked for specifics, I repeated my weirdness. He asked my occupation and, when I told him I was a retired journalism professor and a health writer, he seemed to think I should speak clearer than that.

Weird, huh?

The doc asked me to say “Mississippi” and I remember working hard to articulate, as though I were drunk. He then asked me to say “Four forty four fours.” I told him I never have been able to pronounce “r”s well, and that my brother used to tease me when I said “poach.”

“But there are no ‘r’s in poach,” he said.

Later, I realized I should have clarified that my brother teased me because I had been trying to say “porch.”

So he added that illogic to my weirdness and my physical symptoms and told me I needed to go to a stroke center and the closest was in Denver.

“We’ll helicoper you,” he said.

“Yikes,” I said.

The copter came from Pueblo with two excellent paramedics who strapped me onto a board and loaded me right next to the pilot. My feet were touching the front of the glass bubble. To my left was nothing but glass and sky; the pilot was to my right. I could see his GPS system showing us where we were and where we were headed.

Or, rather, I could have seen it if I’d had my glasses. I was blurry-eyed, though, because I could take nothing on board with me—not my purse, shoes, watch. The only possession I maintained was my underwear—and it, of course, was old and slightly tattered. I had been at a cabin in the wilderness and felt no need for fancy pants. Too bad. I was a stereotype—in the hospital with crummy undies.

I had multiple tests. A CAT scan in Walsenburg showed my brain was OK, but the doc worried that the machine was not precise enough and, if I were at risk of a stroke, he wanted to prevent it. In Denver I had a second scan, this one including the arteries in my neck. Then I had a brain MRI and an echocardiogram. All were normal.

At 2 a.m. I finally saw a doctor who told me he did not think I’d had a stroke, but that they wanted to keep me for observation because they didn’t know what the problem was. I was transferred from ER a hospital room where I fell happily asleep for an hour and a half—until a nurse came to draw my blood.

Meanwhile, my husband had driven up to Denver, stopping in Pueblo to pick up my sister, who I knew would keep him awake during the trip. They arrived pie-eyed from lack of sleep. My husband had had no dinner. He finally ate later in the morning, 16 hours after his last meal. My sister brought me a change of clothes, but my husband had the same work clothes he wore when he drove me to the hospital.

The neurologist finally visited in early afternoon and we talked about my medical history. I mentioned the breast cancer and he ordered a second MRI with a more precise reading, to see if the cancer had spread. It hadn’t.

As I said, “yea!” But I still had no idea what my problem was. Nor, apparently, did the doctors. The only out-of-whack reading in all my tests was a slightly low potassium level.

By 4 p.m. my blood pressure was back down to normal and the docs saw no more need for me to be hospitalized. The concluding diagnosis: a complex migraine. That sounds to me like a fallback position—better than saying, “We have no idea.” I did some research on complex migraines and remain unconvinced. I had only a slight headache—not migraine-level.

So, I was released and we headed back to our mountain cabin, subdued, concerned, and confused.

For several weeks afterward, I was leery of my health. As my husband and I hiked, I was haunted by the possibility that my head or my heart or my something would go out and—whap—I would die face down in a cow pie. I felt fine, though, and we intensified our hikes and I continued to feel fine.

I now have decided that I am, in fact, fine.

What happened? I will continue to ask that questions and, eventually, I might find an answer. Some speculations: I had fractured my arm three weeks before and the fracture contained some trapped blood. Had it come loose and moved toward my brain, but broken up before it did damage? The docs, though, seemed unconcerned about any connection between my symptoms and my arm.

Or another: We had been in town that day and I’d had more than my usual caffeine. I had three diet Cokes with lunch. Plus, I think the decaf coffee I ordered actually had caffeine—two shots. And the temperature was in the mid-90s. Could I have had dehydration plus excess caffeine? Low potassium is one sign of dehydration.

Because my symptoms were classic ones for stroke, I think the docs looked for the obvious and did not evaluate the more esoteric issues. That appears to be another medical mystery for me to solve.

I am on the case.

The total bill for the little event is not in yet, but so far the costs are a bit over $22,000—and that does not include the helicopter. I have great insurance, which will cover most of it. I do wonder if I would have been given less treatment if I were less well insured. And if that might have led to actually finding what was wrong.

Still, I now know the cancer has not spread to my brain.


Still, it really all was pretty weird.

Friday, August 13, 2010

Triple-negative progression to be studied

According to a joint news release, Life Technologies and the University of California at San Diego Moores Cancer Center will study the sequencing of triple-negative breast cancer in search of successful therapies to fight the disease:

CARLSBAD & LA JOLLA, Calif., Aug 05, 2010 (BUSINESS WIRE) -- Life Technologies Corporation and the University of California at San Diego Moores Cancer Center today announced a partnership to use SOLiD(TM) 4 genomic analysis technology in a research program to study chronic lymphocytic leukemia (CLL), a cancer of the white blood cells. The CLL research is made possible by funding from the National Institutes of Health and will enable scientists to survey the whole transcriptomes of 96 CLL tumor samples for potential biomarkers.

CLL is one of four main types of leukemia, which primarily affects adults averaging 70 years old, and causes a slow increase in the number of white blood cells called B cells in the bone marrow. The cancerous cells spread from the marrow to the blood, and can also affect the lymph nodes and other organs, such as the liver and spleen. CLL eventually causes the bone marrow to fail and weakens the immune system.

A multidisciplinary research team from Life Technologies and UCSD Moores Cancer Center, including physician scientists highly accomplished in clinical research, genomics, and bioinformatics/biostatistics, will approach the research with the goal to identify potential prognostic biomarkers to better understand progression of CLL. Dr. Kelly Frazer, founding chief of the new Division of Genome Information Sciences for the Department of Pediatrics at the UCSD School of Medicine, Dr. Thomas Kipps, Professor of Medicine and Deputy Director of Research Operation, and Dr. Dennis Carson, director of the Moores Cancer Center, lead a team focused on studying the predisposition for diseases starting in childhood but spanning the whole age spectrum, using genomic information.

In the first phase of this research, the team will use the SOLiD 4 System to explore the expression profiles of the 96 tumor samples in an effort to gain greater insight into the biological pathways and molecular mechanisms that regulate cell-fate decision, development and disease progression. By defining biomarkers that could help stratify patients into risk groups (patients that are likely to remain progression-free and patients that are likely to progress in the near future) the research could result in the facilitation of future clinical trials designs to evaluate new forms of treatment.

"The course of CLL is variable and its pathogenesis is poorly understood. While some patients have long-term inactive/pain-free disease prior to progression, others progress rapidly requiring therapy within a relatively short time after diagnosis," said Dr. Kipps.

"We anticipate the accuracy of SOLiD 4 and its ability to analyze whole transcriptomes will help us identify longitudinal biomarkers, which can signal development of progressive disease after a variable inactive or benign period of time," said Dr. Frazer.

The program aims to not only understand cancer progression, but to identify new potential targets for possible clinical trials in support of future targeted therapies in cancer. In addition to CLL, the UCSD Moores Cancer Center research program is currently sequencing triple negative breast tumors, lung tumors and primary central nervous system lymphomas using SOLiD technology in an effort to better understand these cancers.

"Life Technologies is proud to be working in conjunction with UCSD Moores Cancer Center, and supporting their biomarker research of hematological malignancies like CLL," said John L. Miller, President, Genetic Systems Division at Life Technologies. "Information generated from this research may lead to future studies and contribute to the development of new drug products with the intent to one day soon be able to treat these cancers in a more targeted approach."

The SOLiD 4 Sequencing System is one of the most advanced next-generation genomic analysis sequencing systems on the market and is used globally by researchers 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 up to 100 gigabases of high-quality mappable sequence data needed for the advancement of molecular medicine.

HRT Not a Proven Risk Factor for Triple Negative Breast Cancer

Hormone replacement therapy has once again been demonstrated to be a risk factor for hormone-positive breast cancer but not for triple negative (estrogen negative, progestin negative, and Her2 negative.)

Some details from a study published in the August 10, 2010 issue of Cancer Epidemiology, Biomarkers & Prevention as part of the California Teachers Study:

• Combined estrogen-progestin therapy was far more toxic than estrogen therapy alone. Those with combined therapy faced an 83 percent increase in risk of breast cancer while those with estrogen alone fact a 19 percent increase.

• Continuous use was more risky than intermittent.

• Neither combined estrogen-progestin or estrogen alone significantly affected the risk of triple negativeRead more on Medpage.

Source: Saxena T et al. "Menopausal hormone therapy and subsequent risk of specific invasive breast cancer subtypes in the California Teachers Study" Cancer Epidemiol Biomarkers Prev 2010; DOI: 10.1158/1055-9965.EPI-10-0162.