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SPECIAL STORIES
New step forward for prostate cancer treatment using HIFU
CANCERactive has been telling prostate patients about HIFU for nearly 7 years. Now a new study has been released on 5th April 2011. This is the press release:
A ’paradigm shift’ in the treatment of prostate cancer has been heralded following the findings of a recent trial of new focal therapy. It appears for the first time in print in the Journal of Urology on Monday 4 April 2011.
Researchers at UCL (University College London) and clinicians at University College London Hospitals NHS Foundation Trust (UCLH), backed by funding from the Pelican Cancer Foundation and other partners*, have successfully used High Intensity Focused Ultrasound, or HIFU treatment, to target only cancerous tumours and minimize the damage caused by traditional surgery or radiotherapy.
This is the first trial of its kind to test the idea of a ’male lumpectomy’ called focal therapy - for treating prostate cancer. The results showed significantly reduced harmful side effects and positive results in terms of cancer control.
In 20 men with low and medium risk prostate cancer, HIFU was used to target the side of the prostate that had the cancer. A larger study in over 120 men is now being run across the UK to test whether these results are reproducible across the NHS.
After 12 months, 90 per cent achieved the perfect result called the trifecta status - of having no urine leak, having good erections and cancer free. In fact, 95 per cent of the participants, all UCLH patients, were able to maintain erections sufficient for intercourse and no participants reported back-passage problems.
Early cancer control was also very promising. Ninety per cent of men had no cancer on tissue samples taken after treatment, while 100 per cent had no important cancer.
At present, men with low to medium risk prostate cancer choosing to have treatment, can undergo surgery or radiotherapy. Both of these destroy the whole prostate regardless of how much cancer there is. By so doing, considerable collateral damage can be caused to sensitive tissues like nerves, blood vessels, back-passage and muscles that control urine flow.
This leads to side-effects such as urine leakage needing pads (in 5-20 per cent of men), impotence (in 30-60 per cent) and back passage problems (diarrhoea, bleeding and pain in 5-20 per cent). Overall, only 50 per cent of men undergoing surgery can achieve the trifecta perfect result.
The lead author of the study, Hashim Uddin Ahmed, Clinical Lecturer in Urology at UCL, said, Prostate cancer has a long natural history this means that the cancer grows slowly. Current treatments cause a lot of harm so focal therapy offers the balance between treating the cancer and minimising the collateral tissue damage. It is the tissue damage to nerves, back-passage and blood vessels that causes the side-effects. By targeting and destroying only the cancer areas, damage is minimised. This marks a paradigm shift in how we diagnose and treat prostate cancer.
Professor Mark Emberton, chief investigator for the study and clinical director for cancer services at UCL, added, Our early trial results have shown that 95 per cent of men have none of the long term problems associated with the more invasive treatments such as leaking urine or poor sexual function. This cannot be achieved by any other standard treatments. Early cancer control was also very encouraging, but more work needs to be done to look at this.
* Other partners in the research included Medical Research Council, Prostate Action, Prostate Cancer Research Centre, St Peter’s Trust, University College Hospital, University College London and US HIFU.
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Cancer Research to edit Wikipedia cancer information
Wikipedia had over 3.5 million visitors from all over the world on its cancer pages in January 2011.
The online encyclopedia has not been without controversy after one founder quit claiming that editorial control was too loose and not as originally intended. One frequent assertion is that anyone can place information on to the web site and so it may be inaccurate. Equally, anyone seems to be able to enroll as an ’editor’ and adjust articles and even have them removed from the site. This has led to unproven allegations that drugs companies have used people to edit out unfavourable coverage and bias reporting on drugs.
CANCERactive was ’edited out’ off Wikipedia, as was our founder Chris Woollams in a separate article. Other complementary medicine proponents have met the same fate.
Now Cancer Research UK is turning its ’cancer specialists’ loose on Wikipedia with the stated intention of ’tidying up’ the online encyclopedia.
One concern is that when internet users put subjects such as ’breast cancer’ into their search engine, Wikipedia appears in a more prominent position than Cancer Research UK.
And CRUK also feels there are problems with accuracy and clarity on some of the pages. Meanwhile Wikipedia said it encourages experts to edit the site as they have a lot to contribute.
Henry Scowcroft, scientific communications manager for Cancer Research UK, said: "It has been our intention for a long time to be involved in the online discussion outside of our own website."
"Wikipedia is nearly always at the top of an internet search for cancers. It’s not always that easy to understand and sometimes it can be inaccurate or not completely up to date. We want to increase the accuracy and clarity."
The charity has not decided how many staff should contribute to the site, or how much time they should spend doing it.
Mike Peel, from Wikimedia has been training staff from Cancer Research. He said: "Expert editors are really vital and have a lot to contribute.
(Ed: One wonders what American cancer patients, for example, feel about such ’unilateral’ editorial interference from a UK cancer drug-developing charity. Or people from countries with greater 5-year cancer survival figures than the UK, or people involved in Cancer Prevention (including chemicals, Pesticides, environmental Toxins etc) or Complementary and Alternative cancer treatments, who might be alarmed at CRUK’s track record in these areas. Few people understand the editorial issues with Wikipedia, yet millions trust its information. Shades of ’Big Brother’ will be felt by many people.)
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Stress shortens your telomeres in cancer
Edward Nelson, M.D., division chief of hematology/oncology at the University of California, Irvine, recently presented significant new results of a study into telomeres at the AACR 102nd Annual Meeting 2011 in America. Researchers know that telomeres shorten with ageing, but have now shown they shorten with stress and cancer. The full implications of cause and effect are not fully understood.
This particular study showed chronic stress was associated with accelerated telomere shortening in cancer patients. This stress might arise before the cancer; or it might arise due to the patient being diagnosed with such a life-threatening disease.
Importantly the research focused on stress management and complementary therapies - in cases where cancer patients had stress management sessions the telomeres re-lengthened.
(Ed: This early study is potentially huge, and is just another research indication that stress and cancer have important links. Equally anti-stress programmes as a part of your overall holistic treatment programme appear more and more important. The researchers also showed that the stress of the actual cancer could shorten the telomeres, further increasing the importance of anti-stress therapies. Previous research covered in Cancer Watch has shown the effect of Omega-3 from fish oils in maintaining telomere length.)
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YOUR CANCER
Faster genetic test for hereditary breast cancer risk
NewGene a specialist molecular diagnostic company jointly owned by Newcastle Hospitals NHS Foundation Trust and Newcastle University has developed an advanced gene sequencing process to successfully identify all mutations in the coding regions of two genes associated with inherited breast cancer BRCA1 and BRCA2.
In the first application of its type NewGene is successfully using the Roche 454 GS-FLX platform for complete sequencing of all BRCA genes. The breakthrough follows two years of assay development work with specially developed data analysis software to enable high volume testing of gene sequences to be undertaken at a level not previously possible.
This technology represents a much faster and higher capacity DNA sequencing process than the traditional Sanger technique used previously for this type of testing.
The availability of the advanced test to UK and European healthcare providers will mean the earlier identification of family members at risk of developing breast cancer. There are around 40000 new cases of breast cancer reported each year and between 5-10 per cent of cases are the hereditary form of the disease.
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New breast cancer drug breaks down cancer walls
A new drug Eribulin, a synthetic copy of natural chemicals called Halichondrin B found in sea sponges, was approved by the US FDA in 2010. Here it has just gone through Phase III Clinical Trials. The drug acts in the same way as the natural compound by stopping cancer cell division.
Women who took eribulin (brand name Halaven) in a phase III trial involving Leeds University lived for a median of 13.1 months, while those on standard treatments survived for a median of 10.6 months.
Side effects included weakness, fatigue and lowered white cell counts. Five per cent of eribulin users stopped taking the drug because of numbness or pain.
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New immune vaccine starts with aggressive breast cancers
Seattle-based biotech company, TapImmune, may well be on to something very clever in their new work on immune vaccines. Their preliminary trials involve aggressive breast cancer and the Mayo Clinic.
Most new biotech drugs target some factor in the DNA set up of a cancer cell. The TapImmune technology bypasses this:
When a foreign body enters the body, the surface of that foreign cell expresses antigens. TAP (Transporters associated with Antigen Processing) provides a biochemical pathway for these antigens to be expressed on the rogue cell surface. Your T-cells can then ’see’ these and destroy them.
However in most solid cancers, TAP levels are reduced and the immune response is inhibited. The T-cells cannot burst into action.
The new ’vaccines’ stimulate and turn the TAP back on; the T-cells can then see the cancer cells and can destroy them as nature intended. We will keep you posted on results.
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PSA screening does not improve prostate cancer survival
A new study from the Karolinska Institute (Sandblom, Varenhorst, Rosell, Lofman, & Carlsson. Randomised prostate cancer screening trial: 20 year follow-up BMJ, 342 (March 3, 2011) concludes that population-wide screening using the PSA test would not help reduce the number of deaths from Prostate cancer.
There is much criticism of the test in the USA by cancer experts. Here, researchers analysed data on 9,026 men, aged 50 to 69 years, who took part in a trial that started in Sweden in 1987.
5.7 per cent of men in the screening group were diagnosed with prostate cancer, compared with 3.9 per cent in the control group. Tumours in men who were screened tended to be smaller and were less likely to have spread than those found in the control group. However, survival was not significantly longer or more likely for men in the screening group.
Researchers even suggested that screening could increase the risk of over-diagnosis and over-treatment (including the problem of harmful side-effects) because many of the small prostate tumours detected by screening are slow-growing and unlikely to cause any problems during the patient’s lifetime.
At present, there is no way of telling the difference between the majority of tumours which are harmless and slow-growing versus the more aggressive minority that need treatment. A previous study concluded that 1,410 men would need to be screened and 48 treated to prevent one death from prostate cancer.
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Prostate cancer 5,900 genes can be wrong!
A team of Harvard Medical School researchers have decoded the entire DNA in seven prostate cancer patients and compared the chromosome sequences to those of healthy patients. They found that tumours regularly contain DNA with thousands of spelling mistakes, the highest was over 5,900. (Nature)
(Ed: Of course the press release went on to mumble something about new drugs to tackle errant genes, but for me this just highlights my view that there never will be a single cure for cancer. The lead researcher even stated that they had not appreciated the complexity of the problem before. What patients need to do is build packages of treatments. Programmes that can offer complementary ways of tackling 5,900 faults. Readers might like to look at our ACTIVE8 Programme for inspiration.)
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MD Anderson now using HiFu for prostate cancer treatment
Ablative therapy (using hot or cold fluid to destroy tissue) is being used at UT MD Anderson Cancer Center as one option to treat prostate cancer. You can even listen to John Ward, M.D., assistant professor in the Urology Department, discussing HIFU, High Intensity Focused Ultrasound, (heat) and cryotherapy (cold) as effective minimally invasive treatment choices for prostate cancer patients. On ITunes - Download Heating and Freezing Used to Destroy Prostate Cancer Cells.
Whatever next?
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Light can make Chemotherapy more effective
Not just any light but ’red light’. According to Andre Sommer of the University of Ulm, Germany exposing cells to pulsed red laser light. decreases water density in the cell (pushing water out of the cell). Switching the laser off causes the water to rush back in to the cell.
Since many cells repel chemotherapy agents at their membranes, Andre argues that this process will help ’suck’ chemotherapy agents into the cells. In the Journal of Controlled Release, 1 minute’s exposure was enough to find 70 per cent of cells absorbing the test drug, compared to just 31 per cent absorbing it normally (New Scientist Nov 13 2011)
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New UK Mistletoe Clinic opens
We have covered many research studies on mistletoe in Cancer Watch. It has a number of abilities, not least it seems to help detoxify the liver during chemotherapy. It has been used in the treatment of a number of cancers.
Dr Maurice Orange, MSc, formerly with the Park Attwood Clinic, Is opening an Integrative Cancer Centre in Kent with outreach clinics in Gloucestershire, Aberdeenshire, Derbyshire, Nottinghamshire and Devon.
More information on this treatment which is widely used in Germany from www.mistletoeclinic.co.uk
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New European collaboration on cancer research
Europe’s leading oncology organisations are combining forces in the global fight against cancer. The project, EurocanPlatform, has received 12 million from the European Union to streamline cross border research. The project will find more effective ways to ensure the prevention, early discovery and treatment of different forms of cancer.
Professor Ulrik Ringborg from the Karolinska Institute, who is coordinating the project, comments, "In a way, you could say that this initiative represents a paradigm shift in cancer research. The project will last five years, establishing a collaborative structure within the EU for cancer research."
(Ed: And how much of the money will go on the Prevention part?)
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Drug Clinical Trials questioned again by new evidence
We have covered the ’Placebo Effect’ before in some detail. It is an inconvenient truth that caused a behind-closed-doors meeting of top drug makers in the USA last year. Why? Because however clever the set up for a double blind, randomised clinical trial or whatever is, the patient’s own mind seems to have an increasingly ever-greater effect in the results.
New research, this time on analgesics from Oxford University (http://www.bbc.co.uk/news/health-12480310) has shown that the mind really does over- rule the pill.
22 healthy people were subjected to heat on their legs and asked to rank the pain on a scale of 1 100. They also had an intravenous drip in their arm, through which drugs could run.
At the outset the average pain rating was 66. When the patients were given remifentanil (a strong pain-killer) without their knowledge the score went down to 55. However, when they were told they were being given the painkiller the score fell to 39.
But when they were told that the pain killer had stopped and thus they might expect more pain, the score went back to 64, even though the drug was still being supplied.
Professor Irene Tracey told the BBC: "It’s phenomenal, it’s really cool. It’s one of the best analgesics we have and the brain’s influence can either vastly increase its effect, or completely remove it."
Importantly, brain scans used during the treatment even showed which parts of the brain were active under the different conditions.
But Professor Tracey can sum it all up better than most: "Doctors need more time for consultation and to investigate the cognitive side of illness, the focus is on physiology not the mind, which can be a real roadblock to treatment."
(ED: In other work we have covered in Cancer Watch, positive results were recorded just because some patients were given a new type of drug. Whereas in other research, patients who had tried and failed on many orthodox treatment programmes, viewed yet another drug with indifference. Moreover, in many clinical trials patients are recruited (advertised for) with an expectation that the drug will treat a certain type of condition.
The whole idea that a Clinical Trial is’ accurate’ and so a certain drug should be used, but an epidemiology study is wishy-washy and doesn’t prove a thing is just self-serving, pious, non-sense.
And Professor Tracey is absolutely right. UK Doctors cannot go on simply ignoring the mind in their patient treatment programmes. The UK is just going to fall further and further behind countries like America where top cancer centres like MD Anderson treat mind, body and soul with Integrative Programmes.
It is quite clear that your mind plays an important role in your health and your potential recovery. And it plays an important rolein the Clinical Trial process potentially even invalidating results)
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Cyberknife results impressive if you can afford it!
A treatment available around the world, and for which there are three highly expensive machines in the UK, is apparently being withheld from some patients due to cost of treatment. One centre offering cyberknife since August 2010 is the NHS Mount Vernon Cancer Centre. The original cost of the 2.7 million machine was paid for by charitable donations.
A Cyberknife works by sending multiple beams of high dose radiation onto a tumour from a wide variety of angles using a robotic arm. This accuracy enables tumours to be treated that are in difficult or dangerous to treat positions, such as near the brain and spinal cord.
X-ray cameras monitor the patient’s breathing and re-position the radiotherapy beam in order to minimise damage to healthy tissue.
The treatment, which has few side effects, is widely used in many countries, because it can treat patients who otherwise could not be helped, but there is limited research about how long it can extend survival.
Yet with PCTs across the East of England refusing to fund routine requests, and those in Kent, Sussex and Surrey rejecting all referrals, just 26 NHS patients - mostly from London - have been funded for Cyberknife at the centre.
Consultant clinical oncologist and the Trust’s clinical chair for cancer services, Dr Peter Ostler, said the treatment was the only hope for some patients, who could otherwise not be treated, either because of the siting of the tumour, or because they were too sick to undergo other treatments.
A single procedure can cost at least 10,000. (Source Daily Telegraph)
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Duke Medical Centre cautions on drug trials and misuse
Researchers from World famous Duke University Medical Center (Journal of Clinical Oncology) reviewed 172 different cancer drug trials and found that less than one third offered a drug improving patient survival. However, two-thirds of the trials produced side-effects that were ’severe’ or ’life-threatening’.
Researchers went on to state that the true figures may be even worse as poor clinical trials are often not even published.
The study went on to express further concerns over the mis-use of approved drugs. Apparently once a drug is approved for use in the USA (for example for breast cancer), doctors may use it however they wish and, in at least 20 per cent of cases, use it to treat a condition for which it has absolutely no research support. I’m sure no UK Oncologist would dream of such quackery.
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Genome sequencing to grow to trillion dollar business
The declining cost of genomic sequencing has paved way for the clinical application of genetic sequencing technology, while the tremendous growth in drug discovery and molecular diagnostics will promote its usage. New analysis from Frost & Sullivan, ’European Next Generation Sequencing Markets’, concludes that this new technology earned $278.3 million of business in 2010 and estimates this to grow to a staggering $1,042.2 billion by 2017 due to the increased focus on human genome sequencing and the application of this technology to disease prediction.
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NUTRITION AND LIFESTYLE
Good cholesterol seems to kill cancer cells
We all know about ’good’ cholesterol and fats, and the ’bad’ versions too; ’good’ olive oil versus ’bad’ saturated animal fat and so on. One function of ’good’ cholesterol is known to be the transport of excess cholesterol to liver cells for disposal.
Now it seems that HDL receptor sites thought to be unique on liver cells, also exist on cancer cells too.
High-density lipoprotein (HDL) has now been tested as a transporter for small ’interfering’ RNA molecules. The HDL can take these into the cancer cell and thus shrink or even destroy tumours (University of Texas MD Anderson Cancer Center and the University of North Texas Health Science Center Neoplasia; April).
"RNA interference has great therapeutic potential but delivering it to cancer cells has been problematic," said Anil Sood, M.D., the study’s senior author and MD Anderson’s director of Ovarian Cancer Research. Sood and Andras Lacko, Ph.D., professor of Molecular Biology and Immunology at UNT Health Science Center, jointly developed the nanoparticles, which build on Lacko’s original insight about HDL’s potential for cancer drug delivery.
The next step is to prepare for human clinical trials. "If we can knock out 70, 80 or 90 percent of tumours without drug accumulation in normal tissues in mice, it is likely that many cancer patients could benefit from this new type of treatment in the long run," Lacko said.
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52 gms of cheese a day doubles ovarian cancer risk
Our anti-cows’ dairy views at CANCERactive have been justified again with research by Belgian and Dutch groups (European Journal of Cancer) stating that eating just 52 gms of cheese a day doubles the risk of ovarian cancer. Last year we published similar research which showed two cups of milk a day had the same sort of effect.
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Broccoli’s anti-cancer activity explained
New research from the University of Illinois confirms the cancer-fighting abilities of sulphorophanes, but only in the presence of an enzyme called myrosinase. According to Nutrition Professor Elizabeth Jeffrey overcooking broccoli destroys the enzyme. In tests, consumption of dried broccoli and broccoli sprouts saw the test subjects with much higher blood levels of sulphorophanes that those people who had boiled the broccoli. Steaming is good too.
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MD Anderson behind use of curcumin
We have covered turmeric, (curcuma Longa) extensively on our web site. We are not alone in our views on this anti-oxidant and powerful anti-inflammatory agent.
Professor Bharat Aqqarwal Ph. D. in MD Anderson’s Department of Therapeutics has conducted a number of studies, for example showing that in pancreatic cancer patients having no chemotherapy, it reduced tumour size. He believes it is effective against many types of cancer because it suppresses angiogenesis (the growth of blood vessels essential to a tumour).
Indeed he goes further: "No cancer has been found, to my knowledge, which is not affected by curcumin," Aggarwal says. "The reason curcumin is so effective against cancer is that it hits not just a single target or cell signalling pathway but dozens of targets implicated in cancer."
(Ed: No doubt our UK Oncologists will be suggesting you take it sometime soon.)
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CHEMICAL WORLD
Should we be worried about the new Airport Scanners?
Yes, according to the very top experts from UCLA. In a published letter from Drs John Sedat Ph.D., David Agard, Ph.D., Marc Shuman, M.D., Robert Stroud, Ph.D., all from the University of California, you will read:
"We are writing to call your attention to serious concerns about the potential health risks of the recently adopted whole body backscatter X-ray airport security scanners. This is an urgent situation as these X-ray scanners are rapidly being implemented as a primary screening step for all air travel passengers."
Our overriding concern is the extent to which the safety of this scanning device has been adequately demonstrated. This can only be determined by a meeting of an impartial panel of experts that would include medical physicists and radiation biologists at which all of the available relevant data is reviewed.
The physics of these X-rays is very telling. The X-rays are Compton-Scattering off outer molecule bonding electrons and thus inelastic (likely breaking bonds).
Unlike other scanners, these new devices operate at relatively low beam energies (28keV). The majority of their energy is delivered to the skin and the underlying tissue. Thus, while the dose would be safe if it were distributed throughout the volume of the entire body, the dose to the skin may be dangerously high."
Basically, their concerns are that the scanners are being implemented in the USA (and so we will get them round the rest of the world without quibble), and they were approved by less than qualified experts who don’t seem to have understood the type of radiation being used, which just affects your surface skin and tissue and seems to be of too high a dosage. Hardly a worry at all, then!
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Mineral oils from recycled paper packaging cause concerns
Your healthy breakfast cereal just may be contaminated, according to research from a Government lab in Zurich, Switzerland. Dr Koni Grob and his team have shown that mineral oil hydrocarbons can leach from the recycled paper used to make the cardboard boxes. The only thing stopping this contaminating the food contents is the inner plastic bag. Of 119 products tested, only 30 had no food contamination, the rest had up to ten times safety limits. The poorer linings would allow the leaching to continue throughout the shelf life, with calculations showing some reaching 50 to 100 times safety limits. Only last year in the USA Kelloggs removed 28 million boxes of children’s cereals from supermarket shelves. Customers complained of foul smell and sickness.
The UK Food Safety Authority described the Swiss results as ’interesting’. However, they added that the results ’have not demonstrated that mineral oils in food packaging represent a food safety risk’.
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Lack of regulation makes some home improvement products unsafe
A new report from HealthyStuff.org shows toxic chemicals in all manner of home improvement products. The Ecology Center highlights problems with all manner of products from vinyl flooring to wallpaper, and chemicals such as phthalates, organic hydrocarbons and even lead.
Chemicals that have been banned in other products turn up in home improvement products as the market seems virtually unregulated. (http://www.healthystuff.org/departm...)
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