Cancer - November 2013 Archives

DEAR MAYO CLINIC: My wife is 31 and was diagnosed with type 1 diabetes at age 7. She had a baby three months ago, and her blood sugar levels were never really controlled. Doctors tested her kidney function and said there is “a little damage” but nothing to worry about. They said a pancreas transplant might be an option. How risky is this? What medications will she need to take following the transplant? ANSWER: Most patients with type 1 diabetes do not require a pancreas transplant, because newer insulin regimens can keep their blood sugar under control. However, someone in your wife’s situation should consider a pancreas transplant, especially if she has frequent “insulin reactions” — meaning her blood sugar goes very low without her realizing it.

November is Pancreatic Cancer Awareness Month Join #pancreaticchat  Tuesday, November 26 1-2 pm ET With experts from @MayoClinic and @PanCAN  Moderated by @USAToday’s @LizSzabo     Topics will include: Scope of problem and who it impacts Warning signs, screening and risk factors Why is it so hard to predict and often caught so late Treatments Biomarkers Promising research and therapies on the horizon If you’ve never participated in a Twitter chat, be sure to watch this how-to video before jumping in. We recommend you use a website such as Tweetdeck.com or Twubs.com to more easily follow the flow of the conversation. Questions? Send them to Nick Hanson.

November is National Hospice and Palliative Care Awareness Month. On Saturday, Nov. 16, Timothy Moynihan, M.D., and Jacob Strand, M.D., will join us to discuss what are important conversations each patient needs to have with their family and health care team. What is palliative care and how is it different from hospice? Join us.   Myth or Matter of Fact:  Palliative care is the same as hospice care.  Note: You can hear the program LIVE Saturdays at 9 am CT on I Heart Radio via KROC AM. The show is taped for rebroadcast by some affiliates. On Twitter follow #MayoClinicRadio and tweet your questions. Listen to this week’s Medical News Headlines: News Segment, November 16, 2013 (right click MP3). Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The Blood and Marrow Transplantation Program of Mayo Clinic; Nemours Children’s Clinic, Jacksonville; and Wolfson Children’s Hospital has been awarded a three-year accreditation renewal by the Foundation for the Accreditation of Cellular Therapy (FACT). The foundation awarded the accreditation renewal after thorough site visits at all collection, transplantation and laboratory facilities at the three locations. The joint program was created in 2001 to allow for greater collaboration in physician and staff expertise, research and clinical protocols.  Since it was established, the combined program has transplanted patients with a variety of illnesses including leukemia, neuroblastoma, sickle cell disease, bone marrow disorders, multiple myeloma, lymphoma, brain tumors, Ewing’s sarcoma and amyloidosis. “We are excited to receive this accreditation. It is a welcome recognition and ‘badge of honor’ for our program. It also informs and assures our patients, referring physicians and insurance companies of the highest standards of patient care and laboratory practices in our program,” said Vivek Roy, M.D., hematologist/oncologist at Mayo Clinic in Florida and medical director of the adult Blood and Marrow Transplant Program. Click here to read the entire news release. To hear more from Dr. Roy, click on the video below.  Journalists, this video is also available in the downloads below. http://www.youtube.com/watch?v=gHrBkkdDEdw

JACKSONVILLE, Fla. — Nov. 7, 2013 — Use of a minimally invasive endoscopic procedure to remove superficial, early stage esophageal cancer is as effective as surgery that takes out and rebuilds the esophagus, according to a study by researchers at Mayo Clinic in Florida. The research, published in Clinical Gastroenterology and Hepatology, examined national outcomes from endoscopic treatment compared to esophagectomy, surgical removal of the esophagus. VIDEO ALERT: Video resources including an interview with Dr. Wallace describing the study can be found on the Mayo Clinic News Network. It found that endoscopic therapy offered long-term survival rates similar to those for esophagectomy, says lead author, Michael B. Wallace, M.D., a gastroenterologist at Mayo Clinic in Florida.

ROCHESTER, Minn. — Mayo Clinic researchers have shown that a molecule called Cul4 helps to deposit DNA-packaging histone proteins onto DNA, an integral step in cramming yards of genetic code into compact coils that can fit into each cell. When DNA isn't packaged correctly, it can lead to the genomic instability characteristic of many forms of cancer. MULTIMEDIA ALERT: Images are available on the Mayo Clinic News Network. The research is published in the Nov. 7 issue of the journal Cell. The results explain on a molecular level how Cul4 enables the handoff of histones from the proteins escorting them from their birthplace in the cell to their workplace on the DNA, where they can begin wrapping DNA up into tidy units called nucleosomes. "We suggest that cancer cells may have evolved a mechanism to disrupt proper nucleosome assembly by altering Cul4 and other factors, which in turn could affect the stability of the genome and promote the formation of tumors," says senior study author Zhiguo Zhang, Ph.D., a molecular biologist at Mayo Clinic. To protect the integrity of the genome, DNA is packaged tightly, first around spools of histone to form nucleosomes, then stacked on top of each other to form chromatin and finally looped and coiled to form chromosomes. Depending on whether and how histones interact with a given genetic sequence, the DNA is either closed up tightly within this package or lies open so that the underlying genes can be read and become active. Researchers have long known that special proteins — called histone chaperones — escort histones around the cell, but how they finally let go of the histones to deposit them onto DNA was unclear. Dr. Zhang wondered if Cul4, which is altered in a number of human cancers, including breast cancer, squamous cell carcinomas, adrenocortical carcinomas, and malignant mesotheliomas, might be involved. So he and his colleagues developed a series of cellular assays in yeast and in human cells to investigate the role of Cul4 in nucleosome assembly. They found that Cul4 modifies the chemical entities on the surface of the histones, weakening the interaction between them and the histone chaperones charged with their care. They noticed that the same observations held true in the yeast indicating that the role of Cul4 in nucleosome assembly and genome stability is likely conserved between yeast and human cells. "We uncovered a novel molecular mechanism whereby Cul4 regulates nucleosome assembly," says Dr. Zhang. "Our finding underscores the fact that proper regulation of the nucleosome assembly pathway is a key step in maintaining genome stability and epigenetic information."

https://www.youtube.com/watch?v=2R-aKCLoz3g Use of a minimally invasive endoscopic procedure to remove superficial, early stage esophageal cancer is as effective as surgery that takes out and rebuilds the esophagus. This is according to a study by researchers at Mayo Clinic in Florida. Lead author Michael Wallace, M.D., says, “Endoscopic resection in the esophagus is similar to how we remove polyps in the colon, although it is much more technically complex. Esophagectomy is a major surgical procedure that cuts out the entire esophagus and pulls the stomach into the neck to create a new food tube. Patients now have the option to preserve their esophagus when only early stage cancer is present.” The research, published in Clinical Gastroenterology and Hepatology, examined national outcomes from endoscopic treatment compared to esophagectomy, surgical removal of the esophagus. Click here for news release.  Journalists: Broadcast quality video and audio are available in the downloads.

ROCHESTER, Minn. — A new study at Mayo Clinic is using genomic sequencing to develop customized treatments for men with castration-resistant prostate cancer, a progressive and incurable stage of prostate cancer, which no longer responds to hormone therapies that stop or slow testosterone production. "Men with castration-resistant prostate cancer have abysmal survival rates, typically living an average of two years once hormone therapies fail," says Manish Kohli, M.D., a Mayo Clinic oncologist and principal investigator of the Prostate Cancer Medically Optimized Genome-Enhanced Therapy (PROMOTE) study. Dr. Kohli says the poor prognosis for men with this cancer highlights the need for studies like PROMOTE, which seek to match new targeted drugs with the genomic characteristics of individual patients' tumors. Several new therapies have recently been approved by the FDA for use in treating castration-resistant prostate cancer, offering new hope for men with this disease. However, many questions remain over which medications to use in individual cases. In the PROMOTE study, researchers and doctors are using exome sequencing and RNA profiling to identify molecular fingerprints within prostate cancers that can be used to identify the optimal drug for the individual patient. In addition to identifying individualized treatment plans, PROMOTE will uncover new targets in the cancer genome that investigators and drug companies can use to develop new therapies. These new targets will be identified largely through mouse "avatars," which will carry the individual tumors of PROMOTE study participants. These avatar mice also will help doctors identify and test new drugs against the patients' tumors before introducing the toxic and potentially harmful agents into the patients, themselves. "The approach we are taking with PROMOTE is exactly what we are working toward across Mayo Clinic through our Center for Individualized Medicine," says Gianrico Farrugia, M.D., director of the Mayo Clinic Center for Individualized Medicine. "We're offering individualized care and tailored treatment options for our patients." Prostate cancer is the most commonly diagnosed solid organ malignancy in the U.S with more than 238,000 new diagnoses annually and an estimated 29,720 deaths. It is the second leading cause of cancer deaths among American men, according to the Surveillance Epidemiology and End Results Program of the National Cancer Institute. The PROMOTE study is a collaboration of the Mayo Clinic Center for Individualized Medicine and the Mayo Clinic Cancer Center. For more information about enrollment in PROMOTE contact 507-284-3067. The Center for Individualized Medicine discovers and integrates the latest in genomic, molecular and clinical sciences into personalized care for each Mayo Clinic patient. Visit http://mayoresearch.mayo.edu/mayo/research/center-for-individualized-medicine/ for more information.

A new study at Mayo Clinic is using genomic sequencing to develop customized treatments for men with castration-resistant prostate cancer, a progressive and incurable stage of prostate cancer, which no longer responds to hormone therapies that stop or slow testosterone production. Oncologist and principal investigator of the Prostate Cancer Medically Optimized Genome-Enhanced Therapy (PROMOTE) study, Manish Kohli, M.D., says, “Men with  castration-resistant prostate cancer have abysmal survival rates, typically living an average of two years once hormone therapies fail." Dr. Kohli says the poor prognosis for men with this cancer highlights the need for studies like PROMOTE, which seek to match new targeted drugs with the genomic characteristics of individual patients’ tumors. Click here for news release. Watch this educational animation about pharmacogenomics: http://www.youtube.com/watch?v=fGjG_9EEeeA

Mayo Clinic researchers have shown that a molecule called Cul4 helps to deposit DNA-packaging histone proteins onto DNA, an integral step in cramming yards of genetic code into compact coils that can fit into each cell. When DNA isn’t packaged correctly, it can lead to the genomic instability characteristic of many forms of cancer. Senior study author Zhiguo Zhang, Ph.D., professor of biochemistry and molecular biology, says, “We suggest that cancer cells may have evolved a mechanism to disrupt proper nucleosome assembly by altering Cul4 and other factors, which in turn could affect the stability of the genome and promote the formation of tumors.” The research is published in the Nov. 7 issue of the journal Cell. Click here for news release.