Saturday, December 17, 2011

New Anti-Cancer Vaccine Developed by University of Georgia

The Atlanta Journal-Constitution
Researchers from the University of Georgia have developed a vaccine that has shown promising results against cancer, the UGA News Service is reporting.
The vaccine dramatically reduced the size of tumors in laboratory mice and was particularly successful against breast and pancreatic tumors, two of the deadliest forms of cancer, the researchers reported.
"This vaccine elicits a very strong immune response," UGA researcher Geert-Jan Boons wrote. "It activates all three components of the immune system to reduce tumor size by an average of 80 percent."
The vaccine trains the immune system to distinguish and attack cancer cells based on their different chemical structures, said Sandra Gendler, a researcher at the Mayo Clinic in Arizona, which was also involved in the research.
"We are beginning to have therapies that can teach our immune system to fight what is uniquely found in cancer cells," Boons said. "When combined with early diagnosis, the hope is that one day cancer will become a manageable disease."
After further testing in the laboratory, clinical testing could begin in 2013, the researchers said.

Liver Cancer Video

This is a very informative video of liver cancer. You will learn about the functions of the liver,symptoms of liver cancer and treatment.


                                                             Video For Health

Friday, December 16, 2011

Histology of Bone Marrow Video

In the video you will learn what the pathologist is viewing in the bone marrow to determine the diagnosis of cancer or blood disorder.

Thursday, December 15, 2011

New Study Shows That HPV Test Is Better Than Pap Test for Cervical Cancer

HPV stands for Human Papillomavairus which is s the most common sexually transmitted virus in the United States. At least 50% of sexually active people will have genital HPV at some time in their lives.

A test that looks for the virus that causes most cases of cervical cancer may be the best way to screen women over age 30 for the disease, a new study shows.
The study followed 45,000 women ages 29 to 56 in the Netherlands who were split into two groups. The first group got a traditional Pap test to look for cervical cancer. The second group got a Pap test along with a newer test for human papillomavirus (HPV). Studies have shown that HPV causes more than 90% of all cervical cancers.
Five years after they were first screened, all women were rescreened using both Pap and HPV tests.
In the first round of testing, HPV tests detected significantly more precancerous changes to cervical cells than Pap testing alone.
Because doctors caught and treated those changes sooner, women who initially got HPV tests were less likely to have full-blown cervical cancer when they were tested again five years later compared to women who got Pap tests alone.
The study found that women who got an initial HPV test had about a 27% reduced risk of having advanced precancerous lesions five years later compared to women who had a Pap test alone.
HPV virus
They were also less likely to have cervical cancer. There were 14 cases of cancer found in the group that only got a Pap test at the start of the study compared to four cases in the women who also got an HPV test.

Mayo Clinic image of a woman with HPV
 For more info:
http://www.webmd.com/cancer/cervical-cancer/news/20111215/hpv-test-beats-pap-test-cervical-cancer-screening





Wednesday, December 14, 2011

Blood Disorder: Pernicious Anemia (Vitamin B12 Deficiency)

Pernicious Anemia is not a cancer but blood disorder.  This disorder is treated by a hematologist oncologist or a family physician.






Above an image of a patient's blood smear that has been stained showing classic pernicious anemia


Pernicious anemia is a disease that begins slowly and make take several years to realize what is happening in your body. This disease is classified as autoimmune.  The definition of autoimmune arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the immune system mistakes some part of the body as a pathogen and attacks its own cells. This may be restricted to certain organs (e.g. in autoimmune thyroiditis) or involve a particular tissue in different places (e.g. Goodpasture's disease which may affect the basement membrane in both the lung and the kidney). The treatment of autoimmune diseases is typically with immunosuppression—medication which decreases the immune response.
Pernicious anemia is a decrease in red blood cells that occurs when the body cannot properly absorb vitamin B12 from the gastrointestinal tract. Vitamin B12 is necessary for the proper development of red blood cells.
Pernicious anemia is a type of megaloblastic anemia. Megaloblastic anemia is a blood disorder in which there is anemia with larger-than-normal red blood cells.

The body needs vitamin B12 to make red blood cells. To provide vitamin B12 to your blood cells, you need to eat enough foods containing vitamin B12, such as meat, poultry, shellfish, eggs, and dairy products.To absorb vitamin B12, your body uses a special protein called intrinsic factor, which is released by cells in the stomach. The combination of vitamin B12 bound to intrinsic factor is absorbed in the last part of the small intestine.
When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12.
Very rarely, infants and children are born without the ability to produce enough intrinsic factor, or the ability to absorb the combination of intrinsic factor and vitamin B12 in the small intestine. Pernicious anemia that occurs at birth (congenital) is inherited. You need the defective gene from each parent to get it.
Common causes of pernicious anemia include:
  • Weakened stomach lining (atrophic gastritis)
  • The body's immune system attacking the cells that make intrinsic factor (autoimmunity against gastric parietal cells) or intrinsic factor itself
 RISK FACTORS
 
  • Family history of the disease
  • History of autoimmune endocrine disorders, including:
  • Scandinavian or Northern European descent

    SYMPTOMS

    People with mild anemia may have no symptoms or very mild symptoms. More typical symptoms of vitamin B12 deficiency anemia include:
  • Diarrhea or constipation
  • Fatigue, lack of energy, or light-headedness when standing up or with exertion
  • Loss of appetite
  • Pale skin
  • Problems concentrating
  • Shortness of breath, mostly during exercise
  • Swollen, red tongue or bleeding gums
  • Nerve damage caused by vitamin B12 deficiency that has been present for a longer time may cause:
    • Confusion or change in mental status (dementia) in severe or advanced cases
    • Depression
    • Loss of balance
    • Numbness and tingling of hands and feet

      LAB TESTING
       1. Complete blood count which is where blood is drawn and the lab tech will process the specimen through an analyzer that will measure the blood counts which include white counts,red counts,hemoglobin,hematocrit,platelets and indices .
      2. Serum holotranscobalamin II 
              Circulating homocysteine is a risk factor of cardiovascular and cerebrovascular events.    Hyperhomocysteinemia may be an early indicator for vitamin B12 disorders because cobalamin is a cofactor in the remethylation process of homocysteine. Serum holotranscobalamin (holoTC II) becomes decreased before the development of metabolic dysfunction. In this study, we assessed circulating holoTC II to estimate the diagnosis of vitamin B12 deficiency in the first ischemic cerebrovascular attack.       
                  3. Reticulocyte Count measures the amount of red cells that are being produced from the bone 
                       marrow. 


                 4.  Schilling test is a medical investigation used for patients with vitamin B12 deficiency. The                        patient is given radiolabeled B12 to drink. An intramuscular B12 injection an hour later.
                     24 hours later a urine sample is collected and is measured for B12 absorption.
                 
                5.  Methylmalonic Acid level is a blood test that is performed by gas chromotographic Mass
                     spectrometry. An elevated level may indicate a Vitamin B12 deficiency.


Treatment
 The treatment for pernicious anemia requires a monthly injection of vitamin B12 . This treatment brings great relief for the patient.  Fatigue and other symptoms are relieved.

For more information:  
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001595/

Tuesday, December 13, 2011

News on Prostrate Screening test

This following article was found at http://kansas.com in the Doc Talk section. 
There has been a lot of controversy regarding prostate cancer screening of late.
Most recently, the United States Preventive Services Task Force (USPSTF) made the recommendation that PSA (prostate specific antigen) screening should be stopped as there can be more harm than benefit from using this practice.
What is prostate cancer? The prostate is a gland in men that produces fluid to carry sperm during ejaculation. In some men, this gland develops cancer. This typically occurs in men older than 50. Risk factors for prostate cancer include increasing age and ethnicity (black men are more likely to develop prostate cancer than Hispanic or white men).
Commonly, prostate cancer screening involves two tests: The PSA and a rectal examination. This is typically done annually in men age 50 and older. Prostate cancer screening is not recommended for men who are 75 and older as the risks of screening outweigh the benefits.
First, we should talk about what PSA is. PSA is a protein made by the prostate gland. It can be measured in a blood sample. PSA may be elevated in prostate cancer, and this is why it has been used to screen for the condition. PSA can be elevated in other conditions as well, so a high PSA level does not necessarily mean that a man has prostate cancer.
Rectal examination involves checking the prostate via the rectum where it can be assessed for nodules or enlargement that may suggest cancer.
The controversy has risen from the review of some medical studies that have shown no benefit of screening. Many medical organizations have made recommendations and statements about this topic, including the American Urological Association, USPSTF and the American Cancer Society. It should be noted that, at this time, there is no consensus by experts on whether PSA testing should be done.
Finding prostate cancer early has the benefit for some men of increasing their life span, but this is not the case for everyone. Early diagnosis can also limit the morbidity of advanced disease (or the spread of cancer). However, PSA testing also can lead to false positive tests, which can then lead

Read more: http://www.kansas.com/2011/12/13/2138279/doc-talk-prostate-cancer-screenings.html#ixzz1gQUUEYD4

Monday, December 12, 2011

Blood Disorder: Paroxysmal Nocturnal Hemoglobinuria

PNH is not a cancer but blood disease and is treated at cancer facility. PNH is a rare disease and can become life threatening. Another name for PNH is Marchiafava-Micheli syndrome characterized by complement-induced intravascular hemolytic anemia , red urine and thrombosis. 
Since this is a blood disease it will be usually treated by a Hematology Oncologist.  The disease,PNH, is different from other hemolytic anemias because the cause is from an intrinsic defect.  Intrinsic defect means that in the cell membrane (deficiency of glycophosphatidylinositol) leading to absence of protective proteins on the membrane.
Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in a hematopoietic stem cell; the mutated cell then expands in the bone marrow. This mutation is usually acquired in adulthood, and the disorder is not inherited or passed down to children.
The disease causes the breakdown of circulating red cells (hemolysis), which can produce symptoms including red or darkened urine and a low red blood cell count (anemia). PNH patients can also develop aplastic anemia, which is accompanied by a decreased platelet and/or white blood count in addition to anemia. Conversely, patients with aplastic anemia sometimes develop PNH. Patients are also at increased risk of developing blood clots, which cause symptoms such as severe leg, abdominal, or chest pain, shortness of breath, jaundice, or headache.
Physicians diagnose PNH using one of two blood tests — either a Ham test or flow cytometry. Treatments for PNH patients with hemolytic anemia include transfusion, folic acid, and if appropriate, iron supplements. Low red blood cell, platelet, and white cell counts can be treated with steroids or with the same immunosuppressive drugs used to treat aplastic anemia. Blood clots are usually treated with anticoagulants, and sometimes, if severe, with tissue plasminogen activator (TPA). PNH can be cured by bone marrow transplantation; this procedure should be considered on an individual basis, based on the patient’s age and symptoms.

TESTING FOR DIAGNOSIS OF PNH

Bone marrow samples can be obtained by aspiration and trephine biopsy. Sometimes, a bone marrow examination will include both an aspirate and a biopsy. The aspirate yields semi-liquid bone marrow, which can be examined by a pathologist under a light microscope as well as analyzed by flow cytometry, chromosome analysis, or polymerase chain reaction (PCR). Frequently, a trephine biopsy is also obtained, which yields a narrow, cylindrically shaped solid piece of bone marrow, 2mm wide and 2 cm long (80 μL), which is examined microscopically (sometimes with the aid of immunohistochemistry) for cellularity and infiltrative processes. An aspiration, using a 20 mL syringe, yields approximately 300 μL of bone marrow.[1] A volume greater than 300 μL is not recommended, since it may dilute the sample with peripheral blood.[1]



In a bone marrow analysis detection of the red cells will produce a defective protective layer. The white cell and platelets will be lower than normal . This result will decrease immunity in the body and therefore decrease resistance against disease. 

The Ham Test is also used in the diagnosis of PNH. 
HAM test is used to evaluate patients with suspected PNH (Paroxysmal Noctural Hemoglobinuria) or suspected congential dyserythropoietic anemia, especially with hemosiderinuria, Pancytopenia, decreased RBC acetyl cholinesterase, decreased leukocyte alkaline phosphatase, negative direct Coomb’s test, and/or apparent marrow failure.
Patients red cells show a high sensitivity to complement mediated hemolysis .

 LDH ( lactate dehydrgenase) is a blood test that is used to monitor tissue damage. The most important measure of hemolysis — can help provide a more complete clinical picture of PNH when performed in conjunction with other laboratory tests and patient-reported assessments. Monitoring of hemolysis in patients with PNH can be done by measuring LDH levels. LDH levels in PNH can be frequently elevated, in some cases exceeding 20 times the upper limit of normal during severe exacerbations.3 It is important to establish a baseline LDH level and continue monitoring over time. Static or “snapshot” measurements of LDH may not reflect the chronic and progressive course of the disease.








TREATMENT

Some of the supportive therapies that are currently being used to help ease the symptoms of PNH include transfusions and anticoagulants (Blood thinners)
Transfusions are recommended during times of severe haemoglobin depletion when your body cannot generate enough new cells to make up for those lost to haemolysis. It may be used on a periodic basis when your haemoglobin level is steadily decreasing.
Your physician may prescribe anticoagulants to you, in order to either reduce the risk of getting blood clots or may need to dissolve a clot when it happens.

Complement Inhibition:

When unregulated, the complement can lead to various severe diseases causing damages in multiple organs. Complement inhibitors are compounds which bind to enzymes in the complement system. Their role is to suppress or reduce the activity of complement.

Bone Marrow Transplantation:

Bone marrow transplantation (BMT) is the only known treatment that may cure PNH. It involves replacing the body’s defective blood stem cells by new healthy ones from a donor. However, bone marrow transplantations carry significant risks which should be discussed with your doctor.
It is important to remember that symptoms of PNH may vary from patient to patient, and a plan to manage your PNH may work for you but may not work for someone else. This is why it is so important to discuss treatment options with your doctor.


 The following websites are helpful.

http://www.pnhsource.eu/Diagnosing%20PNH/Flow%20Cytometry/Default.aspxhttp://www.mskcc.org/cancer-care/adult/rare-hematologic-disorders/paroxysmal-nocturnal-hemoglobinuria
http://www.medindia.net/bloodtest/hematology/pnh_test.htmhttp://pnhsource.eu/Treatment%20Options/Default.aspx