Cancer - May 2012 Archives

ROCHESTER, Minn. — May 31, 2012.  High doses of the herb American ginseng (Panax quinquefolius) over two months reduced cancer-related fatigue in patients more effectively than a placebo, a Mayo Clinic-led study found. Sixty percent of patients studied had breast cancer. The findings are being presented at the American Society of Clinical Oncology's annual meeting. VIDEO ALERT: Audio and video resources available on Mayo Clinic News Network. Researchers studied 340 patients who had completed cancer treatment or were being treated for cancer at one of 40 community medical centers. Each day, participants received a placebo or 2,000 milligrams of ginseng administered in capsules containing pure, ground American ginseng root. "Off-the-shelf ginseng is sometimes processed using ethanol, which can give it estrogen-like properties that may be harmful to breast cancer patients," says researcher Debra Barton, Ph.D., of the Mayo Clinic Cancer Center. At four weeks, the pure ginseng provided only a slight improvement in fatigue symptoms. However, at eight weeks, ginseng offered cancer patients significant improvement in general exhaustion — feelings of being "pooped," "worn out," "fatigued," "sluggish," "run-down," or "tired" — compared to the placebo group. "After eight weeks, we saw a 20-point improvement in fatigue in cancer patients, measured on a 100-point, standardized fatigue scale," Dr. Barton says. The herb had no apparent side effects, she says. Ginseng has long been used in traditional Chinese medicine as a natural energy booster. Until this study, its effects had not been tested extensively against the debilitating fatigue that occurs in up to 90 percent of cancer patients. Fatigue in cancer patients has been linked to an increase in the immune system's inflammatory cytokines as well as poorly regulated levels of the stress-hormone cortisol. Ginseng's active ingredients, called ginsenosides, have been shown in animal studies to reduce cytokines related to inflammation and help regulate cortisol levels. Dr. Barton's next study will look closely at ginseng's effects on the specific biomarkers for fatigue. "Cancer is a prolonged chronic stress experience and the effects can last 10 years beyond diagnosis and treatment," she says. "If we can help the body be better modulated throughout treatment with the use of ginseng, we may be able to prevent severe long-term fatigue."

High doses of the herb American ginseng (Panax quinquefolius) over two months reduced cancer-related fatigue in patients more effectively than a placebo.  Mayo Clinic researchers ...

A top panel of medical experts, the U.S. Preventive Services Task Force, issued a decision this week in a long-debated men’s health controversy.  The panel concluded that no man of any ...

Three-fourths of men ages 40–49 could safely avoid annual prostate-specific antigen (PSA) screening for an additional 10 years if their baseline PSA falls in the lowest ...

ROCHESTER, Minn. — May 18, 2012.   Mayo Clinic researchers will present findings on prostate cancer risk, screening, treatment and other urological research at the annual meeting of the American Urological Association May 19–23 in Atlanta. Mayo Clinic urologists will also be available to provide expert comment for reporters covering the conference. Mayo Clinic studies that will be presented and their embargo dates include: No negative impact on overall survival from post-prostate surgery hormone therapy Embargoed until 10:30 a.m. ET Monday, May 21 In a first-of-its-kind study of adjuvant hormonal therapy (AHT) following radical prostatectomy, Mayo Clinic researchers found no adverse impact in overall survival of patients even when other health factors, specifically cardiovascular disease, were taken into account. AHT treatment controls testosterone production in patients who have undergone radical prostatectomy in order to prevent or slow the return of cancer cells. For the study, "Adjuvant Hormonal Therapy Does Not Adversely Impact Overall Survival Following Radical Prostatectomy for Men with High Risk Prostate Cancer When Stratified by Charlson Comorbidity Index or Cardiovascular Risk Factors," researchers reviewed the history of 1,247 patients who had prostate surgery at Mayo Clinic from 1988 to 2004. The review included the outcomes of patients who received AHT after prostate surgery and their cardiovascular disease history. "Knowing the cardiovascular disease history allowed us to distinguish which factor negatively impacted the overall survival — the cancer or the cardiovascular disease," says lead author Jeffrey Karnes, M.D., a Mayo urologist. The study found the 10-year overall survival rate among patients with cardiovascular disease who received AHT was 72 percent; it was 76 percent for those with cardiovascular disease who did not receive AHT. Similarly, for patients without cardiovascular disease the 10-year overall survival among patients who received ATH was 74 percent, compared to a 79 percent 10-year survival rate for those who did not receive AHT. Young men with low PSA level at very low risk of prostate cancer Embargoed until 1 p.m. ET, Monday, May 21 MULTIMEDIA ALERT: Video of interview excerpts is available on the Mayo Clinic News Network. Three-fourths of young men ages 40–49 could safely avoid annual prostate-specific antigen (PSA) screening for an additional 10 years if their baseline PSA falls in the lowest 75th percentile, according to a study led by Mayo Clinic urologist Christopher Weight, M.D. The study, "Men with a Single Baseline PSA below 1.0 ng/ml Between the Ages of 40-49, Can Safely Avoid Additional PSA Screening for at Least 10 Years: Results from a Prospectively Followed Population Cohort," looked at prostate outcomes in a random sample of 268 men, ages 40–49, in Olmsted County, Minn., since 1990. Each patient was evaluated by a urologist every two years, including PSA screening, an ultrasound examination and questionnaire. Among study participants, no one between 40 and 49 with a baseline PSA below 1 nanogram per milliliter developed an intermediate- or high-risk cancer during nearly 20 years of follow-up. The study also found that participants with low PSAs, below 1.0 ng/ml, were also very unlikely to develop even low-risk prostate cancer. One-third of kidney stone sufferers likely to have recurrence Embargoed until 8 a.m. ET, Tuesday, May 22 MULTIMEDIA ALERT: Video of interview excerpts is available on the Mayo Clinic News Network. Roughly one-third of people who suffer from kidney stones will experience symptomatic stone recurrence, a Mayo Clinic study finds. The 10-year study, "Symptomatic Stone Recurrence Following Ureteroscopy, Percutaneous Nephrolithotomy, and Shockwave Lithotripsy," monitored 333 patients for the reappearance of stones after their surgery in 1999–2000. Regardless of treatment method, "approximately one-third of patients undergoing a surgical procedure for stones will experience a recurrence. Patients with a previous history of stones, prior stone surgery, and positive family history are at increased risk," says lead author Amy Krambeck M.D., a Mayo Clinic urologist. Patients having shock wave lithotripsy were at highest risk of recurrence, while stones were least likely to return in those receiving percutaneous nephrolithotomy. Dr. Krambeck says patients and doctors should focus on treatment options most likely to leave the patient stone free with the least invasive and fewest surgical interventions.

JACKSONVILLE, Fla. — May 18, 2012.  Recent studies have shown that palliative care interventions aimed at addressing patients' emotional, spiritual and social needs have a significant impact on cancer patients' quality of life and may even improve cancer patients' overall survival. Despite this, most cancer patients being cared for in their communities do not have access to these services. VIDEO ALERT: Additional audio and video resources, including comments by Dr. Colon-Otero, are available on YouTube. Most cancer patients also do not have advance directives addressed and are not aware of the benefits of hospice services. In order to address this issue, researchers at Mayo Clinic in Florida decided to test whether a nurse practitioner-driven consultation that used quality-of-life assessment tools and advance directives tools resulted in improvement in the cancer patients' quality of life. The researchers, who published their findings online in the Journal of Palliative Medicine, say their study suggests that a consultative visit between a nurse practitioner and a metastatic cancer patient goes a long way to improving that patient's emotional and mental well-being. The study results were strongly positive despite the fact that only 26 patients were enrolled. A total of 100 had been planned but accrual to the study was halted when other recently completed randomized studies had shown the benefit of similar nurse driven palliative interventions. Patients also frequently refused to enroll if they were randomized to the "control" arm, which did not include a discussion with an oncology advanced registered nurse practitioner about advance directives and how their symptoms could best be managed. The 12 patients who did receive intervention from a nurse had a significant improvement in their emotional health, compared to the 14 patients in the control arm. "The findings should be extremely helpful to oncologists in both community and academic medical practices concerned about how to incorporate palliative care, including discussions about advance directives in the outpatient management of their cancer patients," says the study's senior investigator, Gerardo Colon-Otero, M.D., an oncologist in the Division of Hematology/Oncology at Mayo Clinic in Florida. The study also demonstrates that oncology clinics are not doing enough to help improve their patients' quality of life because they are so focused on treating the cancer. As a result, there are missed opportunities to provide additional support and many patients end up enrolling in hospice care much too late and do not have advance directives completed in a timely fashion. "This study suggests that we shouldn't be afraid of these discussions, and that many of our patients actually welcome having advance directives and hearing about hospice services," Dr. Colon-Otero says. "This relatively simple strategy of having a nurse practitioner trained in palliative care and embedded within the oncology clinic to provide these consultation services is helpful, all the way around."

JACKSONVILLE, Fla. — May 17, 2012.  By simply shining a tiny light within the small intestine, close to that organ's junction with the pancreas, physicians at Mayo Clinic's campus in Florida have been able to detect pancreatic cancer 100 percent of the time in a small study. The light, attached to a probe, measures changes in cells and blood vessels in the small intestine produced by a growing cancer in the adjoining pancreas. VIDEO ALERT: Video of Dr. Michael Wallace discussing the study is available on the Mayo Clinic News Network, our new method for delivering embargoed media content. The network requires a username and password, which can be obtained at http://NewsNetwork.MayoClinic.org. Learn about this new network by watching this short video. This minimally invasive technique, called Polarization Gating Spectroscopy, will now be tested in a much larger international clinical trial led by the Mayo Clinic researchers. The preliminary study suggests it may be possible, one day, to use a less invasive endoscope to screen patients for early development of pancreatic cancer. The findings are being highlighted in a special address by Mayo Clinic gastroenterologist Michael Wallace, M.D., at the international Digestive Disease Week 2012, the world's largest gathering of physicians and researchers who treat, and study, disorders of the gastrointestinal tract. The pancreas is notoriously hard to reach and see due to its very deep location in the abdomen, surrounded by intestines. The study investigators theorized that there may be changes in the nearby "normal appearing" tissue of the small intestine which is much more accessible. "No one ever thought you could detect pancreatic cancer in an area that is somewhat remote from the pancreas, but this study suggests it may be possible," says Dr. Wallace, the chairman of the Division of Gastroenterology at Mayo Clinic in Florida. "Although results are still preliminary, the concept of detection field effects of nearby cancers holds great promise for possible early detection of pancreatic cancer." Pancreatic cancer is one of the most deadly of human tumors. It is only curable in 5 percent of cases, and even when it is surgically removed, 70 percent of patients have a recurrence that is fatal, Dr. Wallace says. There are no ways currently to detect the cancer early enough to cure a substantial number of patients, he says. Pancreatic cancer is now usually detected through an imaging scan, followed by an invasive biopsy. Tumors found in this way are usually at an advanced stage. In this study, the Mayo Clinic physicians tested a light probe developed by their long-time collaborators at Northwestern University.

Shining a tiny light in the small intestine, close to where it meets with the pancreas, can help detect pancreatic cancer.  In a small study at the Mayo ...

ROCHESTER, Minn. — The 25th annual National Cancer Survivors Day event will be held on Sunday, June 3, 2012. The event is sponsored by Mayo ...

The “on-off” switches of genes that occur early in the development of prostate cancer could be used as biomarkers to detect the disease months or even ...

ROCHESTER, Minn. — May 14, 2012.  Alterations to the "on-off" switches of genes occur early in the development of prostate cancer and could be used as biomarkers to detect the disease months or even years earlier than current approaches, a Mayo Clinic study has found. These biomarkers — known as DNA methylation profiles — also can predict if the cancer is going to recur and if that recurrence will remain localized to the prostate or, instead, spread to other organs. The study, published in the journal <ahref="http://www.aacr.org/home/scientists/meetings--workshops/educational-workshops--special-courses.aspx?utm_source=googlegr&utm_medium=searchad&utm_campaign=2012workshops"> Clinical Cancer Research, is the first to capture the methylation changes that occur across the entire human genome in prostate cancer. MULTIMEDIA ALERT: Video of interview excerpts is available on the Mayo Clinic News Network. The discovery could someday help physicians diagnose prostate cancer earlier and make more effective treatment decisions to improve cure rates and reduce deaths. It also points to the development of new drugs that reverse the DNA methylation changes, turning the "off" switch back "on" and returning the genetic code to its normal, noncancerous state. "Our approach is more accurate and reliable than the widely used PSA (prostate-specific antigen) test," says senior author <ahref="http://mayoresearch.mayo.edu/mayo/research/staff/Donkena_KV.cfm"> Krishna Donkena, Ph.D., a Mayo Clinic molecular biologist. The PSA test detects any prostate abnormality, whether inflammation, cancer, infection or enlargement, while the DNA methylation changes are specific to prostate cancer, she says. Though the instructions for all the cell's activities lie within the genes, whether a particular gene is turned "off" or "on" is determined by the presence or absence of specific chemical tags or methyl groups — methylation — along the underlying DNA of cells. When this process of DNA methylation turns off the activity of tumor suppressor genes, cancer develops. Dr. Donkena and her colleagues analyzed the methylation status of 14,495 genes from 238 prostate cancer patients. The patients included people who remained cancer-free after treatment, those who had a localized tumor recurrence and those whose cancer spread. The researchers found that the DNA methylation changes that occurred during the earliest stages of prostate cancer development were nearly identical in all patients. Having discovered DNA methylation patterns that could distinguish between healthy and cancerous tissue, the researchers then searched for similar biomarkers that could distinguish between patients with varying levels of recurrence risk. They found distinct methylation alterations that corresponded to whether a patient had a slow-growing tumor known as an indolent tumor, or had a more aggressive one.

Instead of stimulating immune cells to battle cancerous tumors, treatment with a protein called interleukin-12 (IL-12) is having the opposite effect, driving the cells to exhaustion. The results ...