The Inside Edge (June 2008)

Researchers in Sweden have shown that the length of telomeres (essential for chromosomal stability) in blood cells can indicate prognosis in breast cancer.The relative telomere length of blood cells was measured among 265 newly diagnosed breast cancer patients and 446 female controls. The breast cancer patients had longer telomeres on average than controls. Among breast cancer patients, those with advanced (node positive) disease and telomeres shorter than the median length among the group had better survival than those with telomeres longer than the median length. The researchers suggest relative telomere length could be a useful prognostic indicator in these patients. (Svenson U, Nordfjall K, Stegmayr B et al. Cancer Res 2008;68:3618-23)

A team in Germany has evaluated the impact of exercise on cancer-related fatigue. A consecutive series of 32 cancer patients participated in a three-week programme of endurance and resistance/co-ordination exercises for the major muscle groups. At the end of the programme, exercise capacity increased an average 28 per cent and overall fatigue decreased an average 25 per cent, although there was no reduction in cognitive fatigue, anxiety or depression. (Dimeo F, Schwartz S, Wesel N et al. Ann Oncol 2008; doi 10.1093/annonc/mdn068)

Another study from Germany has reported on the successful reimplantation of healthy ovarian tissue taken from a cancer patient before treatment. The patient was diagnosed with anal cancer in 2004 and chemotherapy followed by radiotherapy was recommended. Before this commenced, ovarian tissue was removed laparoscopically and cryopreserved. Treatment resulted in ovarian failure. After 2.5 years of cancer remission, the cryopreserved ovarian tissue was replaced orthotopically. Five months later, serum oestradiol had risen from below 20pg/mL to 436pg/mL, three ovarian follicles were detected on ultrasound and the patient reported menstruation. The authors are hopeful that pregnancy may be possible. (Dittrich R, Mueller A, Binder H. Dtsch Arztebl Int 2008;105(15):274-8)

MRI falsely detects breast cancer in five out of six positive scans in women with a high hereditary risk of the disease. Researchers in The Netherlands screened 196 BRCA mutation carriers annually with mammography and MRI between 1991 and 2005; median follow-up was two years. Four out of 10 women had at least one positive MRI or mammogram; cancer was detected in 17 women (11 from scanning, four during prophylactic mastectomy and two during the interval between surveillance visits). The probability that a positive MRI result was a false positive was 83 per cent. But this did not influence the decision about prophylactic mastectomy. (Hoogerbrugge N, Kamm YJ, Bult P. Ann Oncol 2008;19:655-9)

Mistletoe extracts have been claimed to improve survival and quality of life for cancer patients. However, a Cochrane review of 80 studies, involving 3,484 cancer patients, has concluded that the evidence for this is weak. Of 13 trials investigating survival, six showed some evidence of benefit, but none was of high methodological quality. Two trials showed no improvement in survival for melanoma and head and neck cancer. Of 16 trials investigating quality of life, psychological measures, performance, symptoms or adverse effects following chemotherapy, 14 showed some evidence of benefit, but only two were of higher methodological quality. (Horneber MA, Bueschel G, Huber R et al. Cochrane Database Syst Rev 2008;2:CD003297)

A colour X-ray technique has been developed that could be used to detect human cancers, hidden explosives or drugs. Tomographic energy dispersive diffraction imaging (TEDDI) uses all wavelengths in the X-ray beam to create three-dimensional colour images from a single scan. Researchers from Manchester University note that current imaging systems, such as spiral CAT scanners, do not use all of the information contained in an X-ray beam. They say TEDDI could be used to identify specific tissue in humans. (Cernik RJ, Khor KH, Hansson C. J R Soc Interface 2008;5(21):477-81)

Originally published in the June 2008 edition of MIMS Oncology & Palliative Care.

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