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Cancer Newsletter
October 8, 2012
In this Issue
• Heavy Smokers, Drinkers May Face Pancreatic Cancer Earlier in Life
• Rural Colon Cancer Patients Fare Worse
• Indoor Tanning Causes Common Skin Cancers, Study Finds
• Might Smallpox Virus Help Fight a Lethal Breast Cancer?

Heavy Smokers, Drinkers May Face Pancreatic Cancer Earlier in Life

Study found diagnoses came almost a decade sooner than for people without those habits

FRIDAY, Oct. 5 (HealthDay News) -- Heavy smokers and drinkers may develop pancreatic cancer at an earlier age than other people, according to a new study.

The average age at which patients are diagnosed with pancreatic cancer is 72, according to the American Cancer Society.

But this study of more than 800 pancreatic cancer patients found that heavy smokers were diagnosed at about age 62 and heavy drinkers at age 61 -- a decade earlier than the average age at diagnosis.

Heavy smokers were defined as those who smoked more than one pack of cigarettes a day, and heavy drinkers were those who averaged three drinks per day.

The study also found that beer drinkers were diagnosed with pancreatic cancer at an earlier age than those who drank other types of alcohol, such as wine or liquor. But when the researchers took the amount of alcohol consumed into account, the type of alcohol did not affect the age at diagnosis.

The good news was that the harmful effects of heavy smoking and drinking can be reversed. Ten years after giving up their unhealthy habits, former smokers and drinkers did not have an increased risk of being diagnosed with pancreatic cancer at an earlier age.

The study was published online Aug. 28 in the American Journal of Gastroenterology.

The findings could help determine at what age screening for pancreatic cancer should begin, once widespread screening is available.

"As screening programs are developed, an understanding of how personal features influence the age of presentation will be important to optimize the timing of those screenings," lead study author and gastroenterologist Dr. Michelle Anderson, assistant professor of internal medicine at the University of Michigan Health System, said in a UMHS news release.

Although the study found associations between heavy drinking, smoking and pancreatic cancer diagnosis at younger ages, it did not prove cause-and-effect relationships.

More information

The American Cancer Society has more about pancreatic cancer  External Links Disclaimer Logo.

Rural Colon Cancer Patients Fare Worse

Study shows they are diagnosed later and get fewer treatments than urban patients

WEDNESDAY, Oct. 3 (HealthDay News) -- Colon cancer patients in rural areas of the United States are more likely to die than those in cities, a new study reports.

The study also found that rural patients with colon cancer tend to be diagnosed at a later stage and are less likely to receive chemotherapy or thorough surgical treatment.

Surgeons at the University of Minnesota and the Minneapolis Veterans Affairs Medical Center analyzed data from more than 123,000 patients in the California Cancer Registry who were diagnosed with colon cancer between 1996 and 2008. About 15 percent of the patients lived in rural areas.

Rural patients were 4 percent more likely than urban patients to be diagnosed with stage 3 or 4 cancer, the study found. Rural patients with stages 1 to 3 colon cancer were 18 percent less likely than urban patients to have an adequate number of lymph nodes removed during colon cancer surgery.

Inadequate lymph node removal can be a sign of a lower-quality cancer care team, according to the researchers.

They also found that rural patients with stage 3 colon cancer were 17 percent less likely than urban patients to receive chemotherapy, and were 5 percent more likely to die from cancer.

The study is scheduled for presentation Wednesday at the American College of Surgeons' Annual Clinical Congress in Chicago.

"These findings do not mean that if you're a rural patient and you've been diagnosed with colon cancer that you should move," study author Dr. Christopher Chow, a general surgery resident at the University of Minnesota, said in an ACS news release. "What they mean is that we as surgeons who treat both rural and urban patients need to start targeting rural patients to ensure that they receive care that is as high quality as urban patients."

The findings also show that further research is needed to determine the reasons for the differences in rural and urban colon cancer patient care, the researchers said.

"Future studies have to look at the reasons why," Chow said. "Are rural patients not traveling and missing appointments, or are they missing appointments because they are traveling? We have to address the underlying reasons, since we know from the start that these patients tend to fare worse."

Data and conclusions presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute has more about colon cancer treatment.

Indoor Tanning Causes Common Skin Cancers, Study Finds

While less deadly than melanoma, basal cell and squamous cell cancers can be disfiguring

TUESDAY, Oct. 2 (HealthDay News) -- Indoor tanning, already associated with an increased risk for the deadliest type of skin cancer, appears to increase the likelihood for other skin cancers as well.

Tanning beds lead to more than 170,000 cases of basal and squamous cell skin cancer each year in the United States. And the earlier you start, the worse the odds, researchers say.

"Not only do tanning beds cause melanoma, the most deadly form of skin cancer, but our study shows they also contribute to the most common cancer, basal and squamous cell skin cancer," said lead researcher Dr. Eleni Linos, an assistant professor of dermatology at the University of California, San Francisco.

"We could prevent hundreds of thousands of cancers each year by avoiding tanning beds," she added.

The report was published online Oct. 2 in the BMJ.

For the study, Linos' team analyzed 12 studies that included more than 9,000 cases of non-melanoma skin cancer, such as basal cell carcinoma and squamous cell carcinoma.

The use of tanning beds was associated with a 67 percent increased risk of squamous cell carcinoma and a 29 percent higher risk of basal cell carcinoma, compared with never using a tanning bed, the researchers found.

Linos' group estimated that indoor tanning in the United States accounts for about 3.7 percent of cases of basal cell carcinoma (more than 98,000 cases) and 8.2 percent of cases of squamous cell carcinoma (about 72,000 cases) each year.

Moreover, using tanning beds before age 25 appears to significantly increase the risk for basal cell carcinoma, the researchers noted.

Although considered non-malignant, basal cell skin cancer can grow into nearby bone or tissue if not treated. Squamous cell carcinomas spread more than basal cell cancers and can reach the lymph nodes or distant parts of the body, although this is uncommon.

"This study should go a long way to undermining the arguments from tanning bed proponents in the United States regarding studies out of Europe that were criticized by claiming the amount of radiation in Europe is far higher than in the United States," said Dr. Jeffrey Salomon, an assistant clinical professor of plastic surgery at Yale University School of Medicine in New Haven, Conn.

"This United States-based study shows even if the radiation was less in this country than Europe, the risk remains that tanning beds, on either continent, is an invitation to increase one's risk of skin cancer," he said.

Indoor tanning became popular in the 1970s, and studies have shown women, whites and young adults are common patrons. A 2011 survey by the U.S. Centers for Disease Control and Prevention found that nearly 30 percent of white high school girls reported tanning under artificial light.

The practice continues even though major health groups have sounded alarms. The World Health Organization says ultraviolet tanning devices cause cancer, and the International Agency for Research on Cancer lists indoor tanning as a Class 1 carcinogen, along with tobacco and asbestos.

A European study published in the July 24 issue of the BMJ, concluded people who use tanning beds face a 20 percent increased risk of skin cancer, and that raised risk reaches 87 percent if indoor tanning starts before age 35.

"Indoor UV tanning devices are real carcinogenic devices, and people should be advised not to attend indoor tanning parlors or to buy them for private use," said the lead author of that study, Philippe Autier, director of the International Prevention Research Institute in Lyon, France.

John Overstreet, executive director of the Washington, D.C.-based Indoor Tanning Association, which represents the tanning bed industry, noted in a statement Tuesday that basal cell and squamous cell cancers are easily treated.

He added that studies such as these focus on the negatives, and never the positives of indoor tanning.

"While indoor tanning is generally considered a cosmetic activity, there are also proven and published health benefits of vitamin D production, which many researchers believe outweigh the overall health risks of skin cancer and even melanoma," Overstreet said.

However, he added that tanning, whether indoors or outside, needs to be done in moderation.

Some indoor-tan proponents maintain that the tanning technology has improved over time, but the researchers say both UVA and UVB exposure are dangerous.

More information

For more information on skin cancer, visit the American Cancer Society  External Links Disclaimer Logo.

Might Smallpox Virus Help Fight a Lethal Breast Cancer?

Promising results for triple-negative form of disease seen in tests with mice

MONDAY, Oct. 1 (HealthDay News) -- New animal research suggests it may be possible to use a form of smallpox virus to infect and kill the tumor cells of a particularly virulent form of breast cancer.

To date, this novel approach to attacking what's known as triple-negative breast cancer has centered exclusively around work with mice.

By loading up the live "vaccinia" virus in the smallpox vaccine with a specific type of protein, researchers from Memorial Sloan-Kettering Cancer Center in New York City and Stanford University Medical Center in Palo Alto, Calif., found they could target and disable these particular cancer cells.

"One of the reasons I wanted to focus on [triple-negative breast cancer] is that there aren't many long-term treatment options for these patients," lead author Dr. Sepideh Gholami explained in an American College of Surgeons news release.

The findings were scheduled for presentation Monday at a meeting of the American College of Surgeons in Chicago.

Triple-negative breast cancer is an aggressive form of breast cancer that accounts for between 10 percent and 20 percent of all cases. Younger women (under 35) are the most vulnerable, as are black and Hispanic women.

Although chemotherapy has been shown to have some impact, standard breast cancer hormone and immune therapies are ineffective against triple-negative breast cancer, given that this type of cancer lacks normal hormone receptor cells. The result: Patients often experience cancer recurrence.

According to the researchers, expression of vascular endothelial growth factor -- which is thought to predict cancer spreading to distant sites and shorter survival -- is higher in triple-negative breast cancers than in other types of breast cancer.

That led the team to outfit a vaccinia virus called GLV-1h164 with a protein to see if it could target and kill vascular endothelial growth factor.

In infected mice, the team observed that roughly 60 percent of the triple-negative breast cancer tumors shrank following the smallpox therapy, while the other 40 percent showed evidence of tumor cell death with very little tumor activity remaining.

"The reason we used the vaccinia virus is that it is a member of the smallpox family and, as we know, smallpox vaccine has been given to millions of people to eradicate smallpox," Gholami said. As such, it should be safer than other agents, she said.

Commenting on the study, Dr. Julie Gralow, director of breast medical oncology at the University of Washington's Seattle Cancer Care Alliance, suggested that the smallpox virus strategy "is promising and makes sense."

However, while some of the laboratory animals had some substantial benefit, not all the mice benefitted, she cautioned. "So while they've shown that the idea works, and that this could do something for a subset of triple-negative breast cancer patients, it's probably not going to work in all patients," Gralow said.

Nevertheless, Dr. Laura Kruper, director of the Cooper Finkel Women's Health Center and co-director of the Breast Oncology Program at the City of Hope National Medical Center in Duarte, Calif., chose to accent the positive.

"If the results of this study can be translated into a form which can be given to women with triple-negative breast cancer, this would be a huge advance in breast cancer therapies," Kruper said.

Gholami said the researchers hope to evaluate the safety of this new virus in real patients. However, results achieved in laboratory settings aren't always repeated in humans.

Data and conclusions of research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute explains triple-negative breast cancer.

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