One In Four Cancer Patients Has Anxiety Disorder, Australia

Main Category: Cancer / Oncology
Also Included In: Anxiety / Stress;  Mental Health;  Psychology / Psychiatry
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Significant numbers of cancer patients experiencing anxiety post diagnosis are seeing their condition escalate to a clinical disorder because they are not being picked up early enough and referred for treatment.

In a presentation today (9/11) to the Clinical Oncological Society of Australia's Annual Scientific Meeting, psycho-oncologist Jane Fletcher will explain that around 25% of cancer patients meet the criteria for an anxiety disorder, with 3% suffering post traumatic stress disorder.

"There is a lot of under-reporting, unmet need and high levels of morbidity," Ms Fletcher said. "The impact on cancer patients and family members can be significant and long-term."

Disorders range from general anxiety to panic and post traumatic stress, phobic reactions such as needle phobia and conditioned responses such as anticipatory nausea.

"Patients' conditions can rapidly escalate from general anxiety to more serious issues, such as panic attacks. In some cases they are incapable of leaving the house.

"Unfortunately, we don't have the clinical culture or training to readily identify and intervene early enough. Without encouragement and support from health professionals, patients won't raise issues and tend to think anxiety is something they just have to put up with."

Ms Fletcher said there was high level evidence to support a range of non-pharmacological interventions such as relaxation therapies, cognitive behavioural therapy and hypnosis. "But we need oncologists, GPs and other health professionals to be more adept at noticing when their patients exhibit signs of anxiety or distress and to take appropriate action."

Clinical Oncological Society of Australia President, Professor Bruce Mann, said the push by COSA and other clinical groups around the world to have 'distress' recognised as the sixth vital sign (after temperature, blood pressure, pulse, respiratory rate and pain) would ensure health professionals became more cognisant of the issue and incorporate it as a routine part of patient assessment.

"For those of us working in chronic diseases like cancer, the disease itself is often so debilitating, we sometimes neglect to pay enough attention to what can be very serious issues such as anxiety," he said.

Ms Fletcher will present at 5pm today (Nov 9) at the Clinical Oncological Society of Australia Annual Scientific Meeting. Room 204, Melbourne Convention and Exhibition Centre.

Source:
Clinical Oncological Society

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Depression Associated With Reduced Cancer Survival

Main Category: Cancer / Oncology
Also Included In: Depression;  Psychology / Psychiatry;  Mental Health
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New Australian research has found that psychological factors may have a significant impact on the survival of people with cancer.

The Australasian Gastro Intestinal Trials Group study, presented yesterday (9/11) at the Clinical Oncological Society of Australia Annual Scientific Meeting in Melbourne, researched 421 patients with bowel cancer.

The study measured survival rates against psychological factors, including hope, optimism, depression and anxiety, while controlling for other biomedical variables. It found there was a significant decrease in survival times for those with depression.

Peter MacCallum Cancer Centre Associate Professor, Penelope Schofield, said the research suggested psychological factors played a potentially significant role in health related behaviours.

"It is likely that feeling either depressed or hopeful impacts a cancer patient's behaviours, with those high in hope more likely to seek information, second opinions, different treatment options and take better care of themselves than those who are depressed or anxious and feel they have no control over their illness," she said.

"This research highlights the importance of empowering cancer patients to be able make choices about their treatment and providing emotional support throughout their cancer journey," she said. The study did not find a relationship between optimistic thinking (simply believing there will be a good outcome) and survival.

COSA President, Professor Bruce Mann, recommended health professionals encourage their patients to ask questions and become more involved in decision making around their treatment.

"This research also highlights the importance of health professionals being aware of signs of anxiety or depression and helping patients who exhibited symptoms get a proper diagnosis and appropriate treatment."

Source:
Cancer Council Australia

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News From The Journal Of Clinical Investigation: Nov. 8, 2010

Main Category: Cancer / Oncology
Also Included In: Blood / Hematology;  Diabetes;  Bones / Orthopedics
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ONCOLOGY: An Enigma for tumor suppression

One of the most well studied suppressors of tumor formation and development is the protein p53. A team of researchers, led by Dong-Soo Im, at the Korea Research Institute of Bioscience and Biotechnology, South Korea, has now provided new insight into how levels of this protein are regulated in human cell lines. Specifically, the team identified a mechanism by which the protein Enigma promotes p53 degradation. Among the several lines of evidence that this mechanism has a role in tumor development and progression was the observation that Enigma promoted human cancer cell line survival and resistance to chemotherapy by suppressing p53-induced cell death in a mouse xenograft model. The authors therefore suggest that Enigma could be new therapeutic target for selective activation of the tumor suppressor p53.

TITLE: Enigma negatively regulates p53 through MDM2 and promotes tumor cell survival in mice

DERMATOLOGY: Improving wound healing in diabetes

Individuals with diabetes are at increased risk of wounds not healing properly, and this leads to over 72,000 amputations each year. Impaired generation of new blood vessels at the wound site is a key factor behind poor wound healing in these patients. This in turn is in part because cells responsible for making new blood vessel-lining cells (endothelial progenitor cells) are functionally impaired. A team of researchers, led by Alex Chen, at the University of Pittsburgh School of Medicine, Pittsburgh, has now identified a reason why endothelial progenitor cells are defective in diabetic mice.

In the study, endothelial progenitor cells were found to express decreased levels of the protein manganese superoxide dismutase and this reduced their ability to contribute to new blood vessel generation, thereby impairing wound healing. Importantly, gene therapy to replace manganese superoxide dismutase in endothelial progenitor cells from diabetic mice improved their wound healing functionality. The authors therefore suggest that a similar gene therapy approach may be of benefit to patients with diabetes.

TITLE: Manganese superoxide dismutase expression in endothelial progenitor cells accelerates wound healing in diabetic mice

MUSCLE BIOLOGY: A complement to muscle wasting

Individuals with mutations in their dysferlin gene develop one of a group of muscle-wasting diseases sometimes referred to as dysferlinopathies. The exact mechanism(s) underlying the muscle wasting in these individuals is not completely understood. Now, a team of researchers, led by Kevin Campbell, at The University of Iowa, Iowa City, has identified a role for a component of the immune system that is involved in promoting inflammation (specifically, the complement system) in the muscle disease experienced by mice that lack dysferlin and thereby model dysferlinopathies. Among the several lines of evidence generated to support this conclusion was the observation that genetic manipulation of dysferlin-deficient mice such that the lacked the central complement protein C3 ameliorated the muscle wasting observed in dysferlin-deficient mice. These data lead the authors to suggest that targeting the complement system might provide a way to treat dysferlinopathies.

TITLE: Genetic ablation of complement C3 attenuates muscle pathology in dysferlin-deficient mice

PULMONARY BIOLOGY: Explaining a key aspect of an inherited lung disease

Some individuals inherit a defect in production of the protein alpha-1 antitrypsin (AAT). This causes a chronic lung disease that is characterized by excessive numbers of immune cells known as neutrophils in the lungs. A team of researchers, led by Emer Reeves, at the Royal College of Surgeons in Ireland, has now identified two mechanisms explaining why human neutrophils accumulate in the lungs of individuals with an AAT deficiency, something previously unknown. Of clinical interest, AAT augmentation therapy counteracted these mechanisms, providing insight into why it works to reduce the lung disease associated with AAT deficiency.

TITLE: alpha-1 Antitrypsin regulates human neutrophil chemotaxis induced by soluble immune complexes and IL-8

HEMATOLOGY: Rescuing red blood cell production after a bone marrow transplant

Bone marrow transplantation is used to treat some forms of cancer and some other diseases that affect blood cells. One complication after a bone marrow transplant is anemia, i.e., low levels of red blood cells. Robert Paulson and colleagues, at Pennsylvania State University, University Park, have now identified a pathway responsible for the production of new red blood cells shortly after bone marrow transplantation in mice. Specifically, they find that signaling initiated by the protein BMP4 promotes the development of red blood cell precursors in the spleen. These cells act to produce red blood cells in the immediate aftermath of bone marrow transplantation and function until the bone marrow transplant has taken hold and can take over the job of generating red blood cells. The authors point out that it might be possible to promote red blood cell production by targeting the BMP4 signaling pathway but that it will be necessary to determine whether or not this pathway functions in humans before its real clinical impact is known.

TITLE: Murine erythroid short-term radioprotection requires a BMP4-dependent, self-renewing population of stress erythroid progenitors

Source:
Karen Honey
Journal of Clinical Investigation

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Health Reform Updates: Biotech Grants, Privacy Issues And Birth Control Coverage

Main Category: Health Insurance / Medical Insurance
Also Included In: Pharma Industry / Biotech Industry;  Sexual Health / STDs;  Cancer / Oncology
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Firms vying to tap the fund a $1 billion fund meant to catalyze research on new biologic treatments for cancer and other diseases may be disappointed in the outcome, The Washington Post reports. "[W]ith so many companies applying for a share of the money, many firms got much smaller allotments than requested and said the financial boost won't go as far as they had initially hoped. Rockville [Md.]-based RegeneRx received three grants for work on therapies to repair tissue and organ damage, totaling just over $733,000. President and chief executive J.J. Finkelstein said the company sought $5 million, the most a single company was eligible to receive," though individual projects were limited to $244,479.24 (Overly, 11/8).

Meanwhile, American Medical News reports, the federal government's Office of Personnel Management, "which manages benefits for federal employees, intends to create a giant database of medical claims information about those employees and enrollees in two programs created by the Patient Protection and Affordable Care Act. In an Oct. 27 letter, the Center for Democracy & Technology, a nonpartisan Washington, D.C.-based group that advocates for health privacy, asked the OPM for more information about its intentions, raised preliminary concerns about the idea and asked the office to delay its launch from Nov. 15" (Berry, 11/8).

And, Minnesota Public Radio notes that as "health insurance companies try to determine what the new health care reform law will require them to cover, birth control is emerging as one of the more controversial issues at stake. A panel of experts meets for the first time next week to determine whether both public and private health plans should cover the entire cost of contraception. Several medical and women's groups say women should have access to free birth control, but the Catholic church is fighting the idea" (Stawicki, 11/8).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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Researchers Discover Expanded Role For Cancer-Causing Gene

Main Category: Cancer / Oncology
Also Included In: Genetics
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Researchers at the Hebrew University of Jerusalem have discovered that Vav1 - an oncogene (cancer-causing gene) found in recent years to be one of the factors in tumorous tissue growth - plays a wider role in several types of cancer than had previously been thought. The discovery has implications for further concentration on targeting this gene in cancer research.

The work of the researchers, led by Dr. Shulamit Katzav-Shapira of the Institute for Medical Research Israel-Canada at the Hebrew University of Jerusalem Faculty of Medicine, was published recently in the Journal of Biological Chemistry.

Vav1 has been known to be involved in alterations in gene expression in the immune system, where it is physiologically expressed. Vav1 was discovered a few years ago by Katzav-Shapira when she was working in the National Cancer Institute laboratory of Dr. Mariano Barbacid in the US. Since this newly identified gene represented the sixth oncogene detected in Dr. Barbacid's laboratory, it was designated by Katzav-Shapira as Vav (six in Hebrew) 1.

Vav1 is involved in the process whereby cells are "triggered" into action. When receptors on the surface of a cell, known as growth factor receptors, receive signals for growth, they relay this information into the cell. This chain of command is often called a "signal transduction cascade" or a "pathway." Signal transduction cascades play a fundamental role in controlling normal cell proliferation, differentiation, cell adhesion, spontaneous movement, and programmed cell death.

Mutations in the proteins driving this signal transduction process are among the main causes for driving cells to develop into cancer. Thus, identification of the signal transducers that are involved in malignant transformation is a prerequisite for understanding cancer and improving its diagnosis and treatment. Since Vav1 was shown to be involved in events leading to alterations in gene expression in the immune system, it is a "key player" in this process.

Now, mutated Vav1 has been shown by Dr. Katzav-Shapira and others to be highly expressed also in neuroblasoma (a cancer that forms in nerve tissue), pancreatic and lung cancer. Indeed, it was surprisingly found to be expressed in 44% of malignant human lung cancer tissue samples that were studied. Since, say the researchers, Vav1 has now been shown to play a role in the process of abnormal tissue growth in several human cancers, it has become an even more highly important potential therapeutic target for cancer therapy.

Working with Katzav-Shapira on this project have been Galit Lazer, a doctoral student; Liron Pe'er, a master's degree student; Dr. Marganit Farago, a research associate; and Dr. Kazura Machida and Prof. Bruce J. Mayer of the University of Connecticut Health Center.

Source:
Jerry Barach
The Hebrew University of Jerusalem

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Physical Activity Link To Breast Cancer Recovery

Main Category: Breast Cancer
Also Included In: Cancer / Oncology;  Sports Medicine / Fitness
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Physical activity in breast cancer survivors has been found to be important in reducing the risk of breast cancer recurrence and improving quality of life, according to new research to be released today (9/11).

Researchers from the Peter MacCallum Cancer Centre in Melbourne, will release preliminary results today of research based on a structured physical activity program, to the Clinical Oncological Society of Australia's Annual Scientific Meeting.

Principal Investigator, Annabel Pollard, said physical activity levels declined during treatment and most breast cancer survivors did not engage in physical activity at recommended levels. "Enabling cancer survivors to recover or improve their health after cancer treatment is perhaps as important as treating the disease," Ms Pollard said. "Cancer survivors are often motivated to have a healthier lifestyle, but many do not carry out their good intentions."

Staff at Peter Mac have developed a program which, on preliminary testing, shows promise for increasing physical activity and improving quality of life in breast cancer survivors over 12 weeks.

Ms Pollard said the results of the pilot study suggested that, compared to women who receive usual care, successful lifestyle change after breast cancer was more likely in women who received a targeted structured intervention that aimed to increase physical activity behaviours. "The research indicates that simply providing information alone does not change behaviour; a structured approach is more conducive to change.

"While still part of a pilot study, these results reveal that we need to facilitate better ways of supporting women in the recovery process. There is value in incorporating cancer rehabilitation interventions as part of the continuum of treatment and care."

Clinical Oncological Society of Australia President, Professor Bruce Mann, said health professionals needed to motivate and support their patients to make lifestyle changes that could reduce the risk of recurrence.

"Rehabilitation after breast cancer is a challenging process for patients and their families," Professor Mann said. "Physical activity is not usually high on the list of priorities for patients, but we should be encouraging and supporting them to undertake structured programs."

Ms Pollard will present her research at 4pm today (Nov 9) at the Clinical Oncological Society of Australia Annual Scientific Meeting. Room 211, Melbourne Convention and Exhibition Centre.

Source:
Clinical Oncological Society

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