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EARLY LUNG CANCER DETECTION NOW POSSIBLE FOR HIGH RISK PERSONS

Sunday, October 10th, 2010

Early Lung Cancer Detection:

Optical Technology Shows Potential

for Prescreening Patients at High Risk

Science (Oct. 9, 2010) — Researchers from Northwestern University and NorthShore University HealthSystem (NorthShore) have developed a method to detect early signs of lung cancer by examining cheek cells in humans using pioneering biophotonics technology.


Early detection is critical for improving cancer survival rates. Yet, one of the deadliest cancers in the United States, lung cancer, is notoriously difficult to detect in its early stages. Now, researchers have developed a method to detect lung cancer by merely shining diffuse light on cells swabbed from patients’ cheeks.

“By examining the lining of the cheek with this optical technology, we have the potential to prescreen patients at high risk for lung cancer, such as those who smoke, and identify the individuals who would likely benefit from more invasive and expensive tests versus those who don’t need additional tests,” said Hemant K. Roy, M.D., director of gastroenterology research at NorthShore.

The optical technique is called partial wave spectroscopic (PWS) microscopy and was developed by Vadim Backman, professor of biomedical engineering at Northwestern’s McCormick School of Engineering and Applied Science. Backman and Roy earlier used PWS to assess the risk of colon and pancreatic cancers, also with promising results.

The lung cancer findings are published online Oct. 5 by the journal Cancer Research. The paper will appear in print in the Oct. 15 issue.

Lung cancer is the leading cause of cancer deaths in the United States. Survival rates are high with surgical resection (removal of the tumor) but only if detected at an early stage. Currently there are no recommended tests for large population screening to detect lung cancer early. The disease is already advanced by the time most lung cancer patients develop symptoms. The five-year survival rate for lung cancer patients is only 15 percent.

PWS can detect cell features as small as 20 nanometers, uncovering differences in cells that appear normal using standard microscopy techniques. The PWS-based test makes use of the “field effect,” a biological phenomenon in which cells located some distance from the malignant or pre-malignant tumor undergo molecular and other changes.

“Despite the fact that these cells appear to be normal using standard microscopy, which images micron-scale cell architecture, there are actually profound changes in the nanoscale architecture of the cell,” Backman said. “PWS measures the disorder strength of the nanoscale organization of the cell, which we have determined to be one of the earliest signs of carcinogenesis and a strong marker for the presence of cancer in the organ.”

“PWS is a paradigm shift, in that we don’t need to examine the tumor itself to determine the presence of cancer,” added Hariharan Subramanian, a research associate in Backman’s lab who played a central role in the development of the technology.

After testing the technology in a small-scale trial, Roy and Backman focused the study on smokers, since smoking is the major risk factor related to 90 percent of lung cancer patients. “The basic idea is that smoking not only affects the lungs but the entire airway tract,” Roy said.

The study was comprised of 135 participants including 63 smokers with lung cancer and control groups of 37 smokers with chronic obstructive pulmonary disease (COPD), 13 smokers without COPD and 22 non-smokers. The research was not confounded by the participants’ demographic factors such as amount of smoking, age or gender. Importantly, the test was equally sensitive to cancers of all stages, including early curable cancers.

The researchers swabbed the inside of patients’ mouths, and then the cheek cells were applied to a slide, fixed in ethanol and optically scanned using PWS to measure the disorder strength of cell nanoarchitecture. Results were markedly elevated (greater than 50 percent) in patients with lung cancer compared to cancer-free smokers.

A further assessment of the performance characteristics of the “disorder strength” (as a biomarker) showed greater than 80 percent accuracy in discriminating cancer patients from individuals in the three control groups.

“The results are similar to other successful cancer screening techniques, such as the pap smear,” Backman said. “Our goal is to develop a technique that can improve the detection of other cancers in order to provide early treatments, much as the pap smear has drastically improved survival rates for cervical cancer.”

Additional large-scale validation trials are necessary for PWS. If it continues to prove effective in clinical trials at detecting cancer early, Backman and Roy believe PWS has the potential to be used as a prescreening method, identifying patients at highest risk who are likely to benefit from more comprehensive testing such as bronchoscopy or low-dose CT scans.

The paper is titled “Optical Detection of Buccal Epithelial Nanoarchitectural Alterations in Patients Harboring Lung Cancer: Implications for Screening.” In addition to Roy, Backman and Subramanian, other authors of the paper are Dhwanil Damania, Thomas A. Hensing, William N. Rom, Harvey I. Pass, Daniel Ray, Jeremy D. Rogers, Andrej Bogojevic, Maitri Shah, Tomasz Kuzniar and Prabhakar Pradhan.

Editor’s Note: This article is not intended to provide medical advice, diagnosis or treatment.

Sourced & published by Henry Sapiecha


DEADLIEST FORM OF SKIN CANCERS LOCATED EARLY WITH 3D SCANNER

Friday, August 13th, 2010


3D imaging technique provides clearer roadmap to remove deadliest form of skin cancer

Even though melanoma is one of the less common types of skin cancer, it accounts for the majority of skin cancer deaths – around 75 percent. The five-year survival rate for early stage melanoma is very high (98 percent), but the rate drops precipitously if the cancer is detected late or there is recurrence. So a great deal rides on the accuracy of the initial surgery, where the goal is to remove as little tissue as possible while obtaining “clean margins” all around the tumor. So far no imaging technique has been up to the task of defining the melanoma’s boundaries accurately enough to guide surgery – until now. Read More

Received & published by Henry Sapiecha


THE TRUTHS ABOUT BOWEL CANCER EXPLAINED

Monday, May 17th, 2010

How much do YOU know about Bowel Cancer?


TRUE / FALSE

  1. Only men get bowel cancer.
  2. Only people with a family history of bowel cancer need be concerned.
  3. There’s nothing you can do to prevent getting bowel cancer.
  4. If you feel healthy and don’t have any symptoms then you don’t need to be tested

If you answered FALSE to ALL of these then congratulations!  You’re doing well!

If you answered TRUE to any of these then you need to brush up on your bowel facts!

Read on for more information on each of these statements.

  1. Only men get bowel cancer.

Although there is a higher incidence in men, women DO get bowel cancer.  In fact, 1 in 14 women will be diagnosed with bowel cancer before the age of 85. This compares to 1 in 10 for men.

In Queensland in 2006 (the latest statistics available), 2741 people were diagnosed with bowel cancer, 1491 of these were male and 1250 of these were female (Cancer Council Queensland, 2008).

  1. Only people with a family history of bowel cancer need be concerned.

Only around 5% of bowel cancers are attributed to a family history. Age and lifestyle choices are the main contributing factors. However, if you do have a family history of bowel cancer, it is important that you speak with your GP.

  1. There’s nothing you can do to prevent getting bowel cancer.

While you can never completely eliminate your risk of getting bowel cancer, there are a number of steps you can take to reduce the risk.  It is estimated that up to 75% of bowel cancers could be prevented through leading a healthy lifestyle.  Things like maintaining a healthy body weight, eating well, being active, limiting your alcohol intake and not smoking all contribute to reducing your risk of bowel cancer.

  1. If you feel healthy and don’t have any symptoms then you don’t need to be tested.

Bowel cancer often doesn’t show any symptoms until it is further advanced.  ‘Screening’ is about testing people with no symptoms who ‘feel healthy’ to find early signs of disease before it causes harm.  Bowel cancer is actually one of the most treatable cancers if detected early and can be prevented with regular screening.

The Australian Government is currently inviting men and women turning 50, 55 or 65 between 2008 and 2010 to participate in bowel cancer screening. Invitations, which include a simple screening test known as a Faecal Occult Blood Test (FOBT), are being sent directly to people in the mail. People who receive a kit are encouraged to participate.

If you are not yet eligible for the Program and if you have any concerns, speak to your GP about your options.

For more information about bowel cancer or bowel cancer screening phone your local Queensland Bowel Cancer Screening Program team on 1300 766 927 or visit www.health.qld.gov.au/bowelcancer.

Received and published by Henry Sapiecha 17th May 2010

SEE TUMORS WITH FLUORO COMPOUNDS BEFORE THEY BECOME A PROBLEM

Tuesday, May 4th, 2010

Fluorescent Compounds

Make Tumors Glow

Science (May 2, 2010) — A series of novel imaging agents could light up tumors as they begin to form — before they turn deadly — and signal their transition to aggressive cancers.


The compounds — fluorescent inhibitors of the enzyme cyclooxygenase-2 (COX-2) — could have broad applications for detecting tumors earlier, monitoring a tumor’s transition from pre-malignancy to more aggressive growth, and defining tumor margins during surgical removal.

“We’re very excited about these new agents and are moving forward to develop them for human clinical trials,” said Lawrence Marnett, Ph.D., the leader of the Vanderbilt University team that developed the compounds, which are described in the May 1 issue of Cancer Research.

COX-2 is an attractive target for molecular imaging. It’s not found in most normal tissues, and then it is “turned on” in inflammatory lesions and tumors, Marnett explained.

“COX-2 is expressed at the earliest stages of pre-malignancy — in pre-malignant lesions, but not in surrounding normal tissue — and as a tumor grows and becomes increasingly malignant, COX-2 levels go up,” Marnett said.

Compounds that bind selectively to COX-2 — and carry a fluorescent marker — should act as “beacons” for tumor cells and for inflammation.

Marnett and his colleagues previously demonstrated that fluorescent COX-2 inhibitors — which they have now dubbed “fluorocoxibs” — were useful probes for protein binding, but their early molecules were not appropriate for cellular or in vivo imaging.

“It was a real challenge to make a compound that is COX-2 selective (doesn’t bind to the related COX-1 enzyme), has desirable fluorescence properties, and gets to the tissue in vivo,” Marnett said.

To develop such compounds, Jashim Uddin, Ph.D., research assistant professor of Biochemistry, started with the “core” chemical structure of the anti-inflammatory medicines indomethacin and celecoxib. He then tethered various fluorescent parts to the core structure, ultimately synthesizing more than 200 compounds. The group tested each compound for its interaction with purified COX-2 and COX-1 proteins and then assessed promising compounds for COX-2 selectivity and fluorescence in cultured cells and in animals. Two compounds made the cut.

In studies led by senior research specialist Brenda Crews, the investigators evaluated the potential of these compounds for in vivo imaging using three different animal models: irritant-induced inflammation in the mouse foot pad; human tumors grafted into mice; and spontaneous tumors in mice.

In each case, the two fluorocoxibs — injected intravenously or into the abdominal cavity — accumulated in the inflamed or tumor tissue, giving it a fluorescent “glow.”

To move the agents toward human clinical trials, the team will conduct additional toxicology and pharmacology testing and develop the tools for particular settings that are amenable to fluorescence imaging, such as skin or sites accessible by endoscope (e.g., esophagus and colon).

In the esophagus, for example, a pre-malignant lesion called Barrett’s esophagus can transition to a low-grade dysplasia, then to a high-grade dysplasia, and finally to malignant cancer, which has a one-year survival of only 10 percent. For a patient with Barrett’s esophagus, detecting the transition to dysplasia is critical. The problem is that dysplasia is not visibly different from the pre-malignant Barrett’s lesion, so physicians collect random biopsy samples — which might miss areas of dysplasia.

“If instead, the physician could look through the endoscope and see a nest of cells lighting up with these fluorocoxibs — that is where they could biopsy,” Marnett said.

“Because COX-2 levels increase during cancer progression in virtually all solid tumors, we think these imaging tools will have many, many different applications.”

The investigators also are exploring using the compounds to target delivery of chemotherapeutic drugs directly to COX-2-expressing cells — by tethering an anti-cancer drug instead of a fluorescent marker to the COX-2 inhibitor core.

The National Institutes of Health, the Medical Free-Electron Laser Program of the U.S. Department of Defense, XL TechGroup and the New York Crohn’s Foundation supported the research. The Vanderbilt Cell Imaging Shared Resource and the Vanderbilt University Institute of Imaging Science enabled the cellular and animal imaging.

Marnett is director of the A. B. Hancock, Jr. Memorial Laboratory for Cancer Research, director of the Vanderbilt Institute of Chemical Biology, Mary Geddes Stahlman Professor of Cancer Research, and professor of Biochemistry, Chemistry, and Pharmacology.

Sourced and published by Henry Sapiecha 4th May 2010

SPEAK UP OR DIE

Saturday, May 1st, 2010

How Silence Can Be Bad For Your Health


No doubt that loud noises are bad for you, wrecking your hearing and even driving up your blood pressure. But silence can hurt you, too — at least when it’s what you don’t say to your doctor. Don’t fall into these clam-up traps:

1. You think something “isn’t worth bothering anyone about.” We know a 50-something guy who kept hoping that the shortness of breath he had while walking up the hill to work was just going to go away. Fortunately, he got himself to the hospital … where he survived his heart attack. We know you don’t want to hear that something’s amiss, but it’s better to hear it when you’re standing than for others to hear it when you’re about to go 6 feet down.

2. You think your appointment is over when you leave. You don’t get to ask your doc questions only after you’ve forked over your co-pay. Too many people leave their appointment and then say, “I wish I’d asked … whether I can have wine/when can I have sex,” and other essentials. Don’t rely on Dr. Google! Smart patients call or e-mail and ask!

3. You think that if the doctor didn’t bring it up, it’s not important. We can do lots of things, but mind reading isn’t one of them. We don’t know that you’ve been having erectile dysfunction, chest pains or an overwhelming desire to speak in Klingon unless you tell us. We don’t know what that last one means, either, but if it’s bothering you, mention it. Speaking up may be the healthiest move you’ve made.

Sourced and published by Henry Sapiecha 1st May 2010