Why did I get cancer when I do not smoke or drink?

Most of my male patients have used tobacco and/or alcohol and it has been blamed for their cancer. But, there are few patients both male and female who did not use the above carcinogens and have had cancer at an early age. They always have this question why did they get it when their friends with all the habits have been spared so far!
Cancer is a complex disease. It results from various factors at interplay. Ageing is the biggest risk factor!

VIRUSES, my dear friends are responsible for many cancers. Different viruses have been implicated in different cancers. HPV virus in carcinoma cervix and head and neck cancers, EBV virus in nasopharyngeal carcinoma, Hepatitis B and C virus in Hepatocellular carcinoma, HSV and HIV in Kaposi's sarcoma. We have vaccine for HPV virus which today is recommended for preventing carcinoma cervix. Who should take it, when they should take it, how many doses are better answered in the following link, Who and When?

Will discuss HPV positive head and neck cancer in the next post.

Tamoxifen 5 years or 10 years?

There is a recent trial result published in Lancet

Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61963-1/fulltext?_eventId=login

If you were a patient diagnosed of early breast cancer and had oestrogen positivity, in all likelihood you were/are taking tamoxifen(some of you may be on letrozole or anastrozole!). Your doctor would have suggested that you need to take this for 5 years. With the results of the above mentioned trial, now you will be recommended to take it for 10 years. Because the results suggest that 10 years of tamoxifen treatment can approximately halve breast cancer mortality during the second decade after diagnosis.

Consistency!

Lot has happened from the time I last wrote here. Significant advancements have happened in few cancers and others promise to catch up. I have had the good fortune of treating patients who have had good, moderate and bad outcomes. They have taught me a lot and i know my learning will never end. It has been a very emotional journey also. Malignancy makes one ponder more about life and death. It can make one philosophical or practical!
The bad part is my inconsistent writing. I am writing as if i have a great audience! Honestly a part of me desires for an audience. For feedback, but first for that i need to consistently post what i assimilate. But most of the writing and compilation is for self! As i read the previous posts i realized their relevance in terms of time and my own understanding.
My proposed way to catch up with myself is to write on each therapy area periodically. All views expressed here are personal and do not constitute medical advice.

How spicy foods can kill cancers

Scientists have discovered the key to the ability of spicy foods to kill cancer cells.

They found capsaicin, an ingredient of jalapeno peppers, triggers cancer cell death by attacking mitochondria - the cells' energy-generating boiler rooms.

The research raises the possibility that other cancer drugs could be developed to target mitochondria.

The Nottingham University study features in Biochemical and Biophysical Research Communications.

http://news.bbc.co.uk/1/hi/health/6244715.stm

Stem Cell Therapy Effective In Targeting Metastatic Cancer

Patients with advanced cancer that has spread to many
different sites often do not have many treatment options, since they would be unable to tolerate the doses of treatment they would need to kill the tumors.

Researchers at City of Hope and St. Jude Children’s Research Hospital may have found a way to treat cancers that have spread throughout the body more effectively. They used modified neural stem cells to activate and
concentrate chemotherapeutic drugs predominately at tumor sites, so that normal tissue surrounding the tumor and throughout the body remain relatively unharmed.

“This approach could significantly improve future treatment options for patients with metastatic cancer,” said Karen Aboody, M.D., assistant professor of Hematology/Hematopoietic Cell Transplantation and Neurosciences at City of Hope. “It not only has the potential to destroy residual tumor cells, but it should also improve patients’ quality of
life by minimizing toxic side effects such as nausea, diarrhea or bone marrow suppression.”

Patients with advanced cancer that has spread to many
different sites often do not have many treatment options, since they would be unable to tolerate the doses of treatment they would need to kill the tumors.

Researchers at City of Hope and St. Jude Children’s Research Hospital may have found a way to treat cancers that have spread throughout the body more effectively. They used modified neural stem cells to activate and
concentrate chemotherapeutic drugs predominately at tumor sites, so that normal tissue surrounding the tumor and throughout the body remain relatively unharmed.

“This approach could significantly improve future treatment options for patients with metastatic cancer,” said Karen Aboody, M.D., assistant professor of Hematology/Hematopoietic Cell Transplantation and Neurosciences at City of Hope. “It not only has the potential to destroy residual tumor cells, but it should also improve patients’ quality of
life by minimizing toxic side effects such as nausea, diarrhea or bone marrow suppression.”

For more ...
http://www.rxpgnews.com/cancer-research/Stem-Cell-Therapy-Effective-In-Targeting-Metastatic-Cancer_9759.shtml

Bonding with bacteria Ananda M Chakrabarty

From Business Standard Gargi Gupta / New Delhi December 14, 2006

RESEARCH: Ananda M Chakrabarty is in India, scouting for a pharma company that will help him develop a bacteria-based cancer drug.

Few Indians have heard of Ananda M Chakrabarty, but in biotechnology circles the distinguished professor of immunology and microbiology at the University of Illinois at Chicago is something of a hero.

His invention — a transgenic bacteria which breaks down crude oil into simpler substances easily consumed by marine animals — is, by itself, significant.

But Chakrabarty will go down in history as the first man to get a patent for a living micro-organism. It was in 1979, when he was working for General Electric in the United States, that Chakrabarty developed the oil-eating bacteria.

He applied for a patent, proposing to use his invention in mopping up oil spills. The application was turned down by the Patent Office Board of Appeals, but the battle went up to the US Supreme Court, which favoured Chakrabarty, saying that “A live, human-made micro-organism is patentable subject matter”.

That was 25 years ago and Chakrabarty has since moved on. His present interest is in using bacterial proteins to combat killer diseases like malaria, HIV and cancer using what he calls bacteria’s “evolutionary knowledge”.

“Unlike modern pharmaceutical industry which is content with arresting cancer along one pathway, bacteria consider cancer cells as intruders and work to stop them in their tracks,” explains Chakrabarty with the lucidity of a teacher.

He has even developed a potential drug for melanoma and breast cancer that has shown 60-80 per cent results in mice. “I don’t know if it’ll work in dogs and cats, much less monkeys before the FDA will allow me to use it on humans.”

In India to deliver a series of lectures, Chakrabarty will also make time to meet captains of the Indian drug industry to tell them, “Let’s do some of that here”. His proposal — “You put in the resources to set up a lab to develop a new generation of drugs. Let’s do clinical trials and design products for the global market”.

Chakrabarty is optimistic that the corporate houses will be more forthcoming than the academics and researchers, whom he’d talked to last year for collaborative research to check whether his promising drug could be used against cervical cancer, one of the most common cancers in India.

He even had a tentative funding commitment from the department of biotechnology for a small business innovative research company, formed for the project. But nothing came of it.

“Indians want to just publish papers on how cancers grow, how they proceed... they want to be known in the United States and Japan. But no one talks about trying to develop a drug against cervical cancer... Merck comes up with a vaccine but nobody in India does it.”

What Chakrabarty would ideally like is for India to have something like the Bayh-Dole Act in the US, which allows universities and small businesses to hold intellectual property rights over inventions resulting from government-funded research.

“I want to introduce the concept of academic start-ups which has contributed so much to the economic might of the US,” he says.

Like Genentech, Kyron and Biogen, all started by university professors, Chakrabarty too is a beneficiary of Bayh-Dole. It is his company, CDG Therapeutics, in which the University of Illinois has some equity, that is conducting the research into this potentially revolutionary drug and which will tie up with any Indian pharma company which is willing to check it out. Now if only Indian researchers saw the point.

Courtesy Business Standard.

Lamps 'used for cancer surgery'

Cancer sufferers in the developing world could soon have Western standards of surgery at a fraction of the cost, scientists in Israel have said.
A technique using an off-the-shelf lamp and fibre optics is being developed as an alternative to expensive laser surgery, New Scientist reports.

Researchers at Ben Gurion University in Beersheva say the method could be used for operating on malignant tumours.

A UK expert said the technique could have some uses in the developing world.

http://news.bbc.co.uk/1/hi/health/6162899.stm
Source: BBC News | Health | World Edition
© Copyright: (C) British Broadcasting Corporation, see http://news.bbc.co.uk/2/hi/help/rss/4498287.stm for terms and conditions of reuse

Abstract:
We report the first realization of interstitial surgery by ultrabright lamp light, on the kidneys and livers of live animals. A high-flux optic concentrates lamp emissions into an optical fiber for power delivery inside the body. The trials reveal surgical efficacy comparable to corresponding laser fiber optic treatments, as well as pronounced delayed tissue death.

Answers for few questions asked on yahoo answers

What is a Stem Cell Vaccine, its used to kill lung cancer?

Answer Stem Cell Vaccine is a type of vaccine where it is given as a prophylaxis. That is u vaccinate to prevent the disease. So it is incorrect to say that it kills lung cancer.
The experiment has been carried on mouse and it is long way away from being used in human beings.


Is there a treatment for Adenocarcinoma of G.E. junction (stoamch cancer). The cyst is of size 12/8/7 cm.?

Patient's age: M

Answer -

There is a treatment for adenocarcinoma of stomach.
First a list of investigations need to be done to determine the stage of the patient. Once it is staged , UR oncologist will be able to tell whether it immediately operable or not.
The treatment will include depending on the stage Surgery, Radiotherapy and Chemotherapy.
It will be advisable to get a PET-CT done or atleast a CT scan.
If it can be operated upon then, after the operation , depending on the histopathological report, post op radiotherapy and chemotherapy will be adviced.
Please consult an Oncologist.

Cancer Link: Gene regulates progesterone effect on breast cells

Since its discovery in 1994, the BRCA1 gene has given up its secrets grudgingly. Early on, scientists recognized that it kept cancer at bay. Women carrying a mutation in the gene face an extremely high risk of breast and ovarian cancer. Researchers have struggled to understand how the protein encoded by a normal BRCA1 gene works.

A study in mice now suggests one possibility: The BRCA1 protein moderates the hormone progesterone's effect in breast cells. The protein appears to calm those cells when progesterone urges them to divide and grow.

To read more....http://www.sciencenews.org/articles/20061202/fob1.asp

Quit Smoking

Quit Smoking

Poverty and Dilemma

Any person suffering from cancer has tremendous disadvantages. The financially well endowed atleast have resources to search and seek some answers. At times cancer makes a person poor, especially in India.
Yesterday I came across a 60 year old prostate cancer patient. He had underwent Prostatectomy in 2002 and Orchidectomy in 2005 and was put on Bicalutamide. From the time of initial diagnosis the tumor had invaded the bladder. Last month he underwent P-32 treatment for bone metastases with no pain relief. He was reffered to me by an urologist for possible consideration for hemostatic radiation. When I reportedly saw him he had bled for more than 12 hours, his Hb was less than 4 gm%, his platelet count was less than 80,000 and had deranged PT, BT.
I explained the grave prognosis and offered them hemostatic radiation as only a palliative measure. The need for blood transfusion was also explained. Initially the relatives agreed to do whatever possible but with in restricted financial considerations. I offered not to take any charges for radiation but they said they cannot afford the cost of blood transfusion and they decided to go without taking any treatment. I am still to recover from the whole episode. I have no judgements but as a Doctor it is difficult to reconcile with the fact that "nothing was done for the patient".

In Transit

My hibernation got extended on account of me shifting base from Mumbai to a peripheral cancer hospital at Belgaum.
I am amazed by the number of rural patients and the dearth of adequate facilities to treat them. We are developing a multidisciplinary team to offer our services in North Karnataka.

IN hIBERNATION

till jule end

WE ARE HERE TO HELP YOU

Well it is known that any disease causes anxiety and depression, cancer in particular is far more devatating.

The Macmillan Cancer Support study found 49% of respondents experienced depression and 75% felt anxiety.
Some 24% said they had nobody to talk to, 19% felt isolated, and 45% said the emotional effects of cancer were harder to handle than the physical ones.


http://news.bbc.co.uk/1/hi/health/4877070.stm


I personally would like to listen to you.

Aspartame risk

I advice moderation in usage of everything, but this bit of news is welcome for people using aspartame

http://www.businessweek.com/ap/financialnews/D8GPCGOG2.htm?campaign_id=apn_home_down&chan=db


http://www.chicagotribune.com/business/chi-0604050193apr05,1,3540934.story?coll=chi-business-hed&ctrack=1&cset=true

To Eat or Not To Eat

Abstract from Lancet Oncology
People who eat large amounts of meat might be at increased risk of dev eloping some types of gastric cancer, European researchers report (J Natl Cancer Inst 2006; 98: 345–54). The risk is higher if they are also infected with Helicobacter pylori. “The most important thing we found
is an association between red meat and processed-meat intake and non-cardia gastric cancer”, says lead researcher Carlos González, Catalan Institute of Oncology, Barcelona, Spain. “The risk was much larger in people who ate a lot of red [meat] and processed meat and who were also infected with H pylori".

Patients who had the highest meat intake had other characteristics that
could contribute to risk of developing cancer, she says, such as a greater
possibility that they were current or former smokers, or that they had low
consumption of fresh fruit and vegetables. “It may be across the board that those with the highest consumption were the unhealthiest in many areas, all of which could infl uence their cancer risk”, Cline-Burkhardt adds.

Apology

First I apologise for going into hibernation without informing.

Artificial Sweeteners and Cancer?

An elderly couple on train asked me whether artificial sweeteners can cause cancer. The fact is that there is no proven data to say that, "yes they cause cancer".
The doubts were raised when animals(rats) were fed with these seeteners in large quantities and they were found to have cancer.
No study in human beings has established this relation. Inspite of all this, can I categorically say that they do not cause cancer. The available evidence may not be all that correct and tomorrow some other evidence may come up. So the right think to say would be that, as of today I cannot say that they cause cancer but in an individual with increased risk it may potentiate.

Cancer is a multifactorial disease and therefore it is difficult to gather evidence and say this is harmful.
Long back I had heard a saying, "Everything under the sun is poison, only the quantity, quality and the person who takes it makes the difference."

Living a diciplined life and consuming things in moderation is a best way to keep most of the diseases away.
For those who arer interested in the FDA reply the following links will help

http://www.cancer.gov/cancertopics/factsheet/Risk/artificial-sweeteners

http://www.cfsan.fda.gov/~lrd/tpaspart.html

http://ntp.niehs.nih.gov/ntp/roc/eleventh/append/appb.pdf

Malignant Mesothelioma

Malignant mesothelioma is an aggressive, treatment-resistant tumour, which is increasing in frequency throughout the world. Although the main risk factor is asbestos exposure, a virus, simian virus 40 (SV40), could have a role. Mesothelioma has an unusual molecular pathology with loss of tumour suppressor genes being the predominant pattern of lesions, especially the P16INK4A, and P14ARF, and NF2 genes, rather than the more common p53 and Rb tumour suppressor genes. Cytopathology of mesothelioma effusions or fine-needle aspirations are often sufficient to establish a diagnosis, but histopathology is also often required. Patients typically present with breathlessness and chest pain with pleural effusions. Median survival is now 12 months from diagnosis. Palliative chemotherapy is beneficial for mesothelioma patients with high performance status. The role of aggressive surgery remains controversial and growth factor receptor blockade is still unproven. Gene therapy and immunotherapy are used on an experimental basis only.

For further information the following links are helpful

http://www.cancer.gov/cancerinfo/types/malignantmesothelioma/

http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_malignant_mesothelioma_29.asp

http://www.nci.nih.gov/cancerinfo/pdq/treatment/malignantmesothelioma/patient/

http://www.emedicine.com/radio/topic449.htm