New Drug For Late Stage Breast Cancer Shows Success

This is great news for those women who wait to have mammograms or the mammograms did not show the existing cancer.  When breast cancer is found in Stage 4 the prognosis has not been good.  So there is hope because of a successful drug trial.

Roche Holding AG ROG.VX +0.06% Friday reported positive results from a late-stage study that compared its experimental breast cancer drug trastuzumab emtansine to a rival product from GlaxoSmithKline GSK -0.11% PLC, paving the way to file the potential blockbuster drug for regulatory approval in Europe and the U.S. later this year.
The Basel-based drug maker said women whose breast cancer had spread despite earlier treatment lived longer without their disease getting worse when treated with Roche's trastuzumab emtansine, or T-DM1, compared with those who received Glaxo's Tykerb plus chemotherapy.
The study involved 991 women previously treated with another Roche drug Herceptin plus chemotherapy, whose cancer spread after this initial treatment.
"We believe this suggests that the observed benefit is likely to be a meaningful one and that at least a trend toward a survival improvement is likely," Deutsche Bank analysts said in a note to investors. Roche said data to show if the drug helps prolonging patients life wasn't available yet.

T-DM1 is an antibody drug which delivers the chemotherapy agent directly inside cancer cells, with the aim of causing fewer side effects. Roche said final results for overall survival aren't yet complete.
Analysts said the trial results, which were expected after a similarly good outcome of intermediate tests, are a sign that the company's strategy to improve standard care through innovative drug discovery is paying off. But they noted that, until the drug proves to work also as first-line treatment, market potential is limited.
"These results enable Roche to register the drug, but as a second-line treatment, the market opportunity is limited," said Andrew Weiss, an analyst in Zurich with Vontobel. "If the second set of data shows it also works as a first-line treatment, then that will open up the market," Weiss said, adding the drug carries a sales potential of 1.7 billion Swiss francs ($1.8 billion) if marketed globally. Another ongoing late-stage study, dubbed MARIANNE, is testing if T-DM1 also works on patients who weren't previously treated with established drugs. This trial's results are expected in 2014.
"We have significantly increased confidence that the front-line trial…will report positively," analysts at Deutsche Bank said, adding that annual sales could reach more than $1.5 billion if the drug was approved for this use.
Mr. Weiss, who has a buy rating on Roche, also said that T-DM1 results, coupled with "stellar" data on experimental compound pertuzumab can help Roche alleviate competitive pressure on its blockbuster breast cancer drug Herceptin. He said Roche is likely to present detailed results at the American Society of Clinical Oncology Annual ASCO meeting in June.
Roche is developing T-DM1 with ImmunoGen Inc. IMGN +4.73%

ImmunoGen's Chief Executive Daniel M. Junius said in an interview that the top-line results from Roche were symbolically significant because it validated the company's antibody technology.
He also said first-line study data on TDM-1 isn't expected until late 2013 into 2014, but a second-line application is important, representing the most immediate opportunity to make the drug available to patients. He said the current second-line treatment has a limited patient population and hasn't been very successful.
 
 http://online.wsj.com/article/SB10001424052702303404704577313483370438926.html

Quality of Life Parallels Length of Lung Cancer Survival

A new study indicates The way lung cancer patients feel around the time they're diagnosed may be related to how long they survive -- even after taking into account objective measures of the disease.

Researchers found that newly-diagnosed lung cancer patients who rated their quality of life higher generally lived longer with the disease: typically surviving nearly six years, versus less than two years among patients who'd reported a poor quality of life.
And objective measures -- like age, the stage and aggressiveness of the cancer and other health conditions -- did not fully explain the connection.
Quality of life is a "complex construct" that includes a person's feelings of physical, mental and emotional well-being, said Jeff A. Sloan, a professor of oncology and biostatistics at the Mayo Clinic in Rochester, Minnesota, who led the new study.

Blood work and other lab tests are one way of seeing how a patient is doing, according to Sloan. But, he said, doctors have long been aware that two patients can look the same as far as objective cancer-related measures go, yet fare differently.
A number of studies have now shown that quality of life seems to affect the long-term picture for cancer patients, Sloan said.
So doctors at Mayo have begun routinely assessing cancer patients' quality of life, and some other cancer centers are starting to do the same, he added.
The current study, published in the Journal of Clinical Oncology, included 2,442 patients treated for lung cancer at Mayo over 11 years.
Around the time of their diagnoses, patients rated their overall quality of life on a standard scale of zero to 100. The researchers found that 21 percent had a "deficit" in quality of life -- or a score of 50 or lower.
Those patients survived for substantially less time: 1.6 years, on average, versus 5.6 years in the group with a higher quality of life around the time of diagnosis.
There were other differences between the two groups, too. Patients with a poorer quality of life were more likely to be men, current smokers and have more-advanced cancer, for example.
But even when Sloan's team factored in those differences, quality of life was still a predictor of survival time. Overall, the death rate during the study period was 55 percent higher among patients who gave low ratings to their quality of life.
So what can be done when cancer patients have quality-of-life issues? That depends on what seems to be underlying the problem, according to Sloan.

Read more: http://www.foxnews.com/health/2012/03/29/quality-life-tied-to-lung-cancer-survival/#ixzz1qW7U8Gm2

Cancer, A Lab Tech 's Perspective: Waiting On The Pathology Report

Cancer, A Lab Tech 's Perspective: Waiting On The Pathology Report: We have heard these words "Waiting on the Pathology Report" many times in our lives. We have heard these words from doctors, friends, and fa...

Waiting On The Pathology Report

We have heard these words "Waiting on the Pathology Report" many times in our lives. We have heard these words from doctors, friends, and family. While we are waiting for results we become anxious by hoping for the best but dreading the worst.  Do you really know what is included in a Patholgy report?

                                                 Pathologist reviews biopsy slides under a microscope.

1. What is a pathology report? A pathology report is a document that contains the diagnosis determined by examining cells and tissues under a microscope. The report may also contain information about the size, shape, and appearance of a specimen as it looks to the naked eye. This information is known as the gross description.
   
   A pathologist is a doctor who does this examination and writes the pathology report. Pathology reports play an important role in cancer diagnosis and staging (describing the extent of cancer within the body, especially whether it has spread), which helps determine treatment options. 
2. How is tissue obtained for examination by the pathologist? In most cases, a doctor needs to do a biopsy or surgery to remove cells or tissues for examination under a microscope.
   Some common ways a biopsy can be done are as follows:
   
   • A needle is used to withdraw tissue or fluid.
     
   • An endoscope (a thin, lighted tube) is used to look at areas inside the body and remove cells or tissues.
     
   • Surgery is used to remove part of the tumor or the entire tumor. If the entire tumor is removed, typically some normal tissue around the tumor is also removed.
   Tissue removed during a biopsy is sent to a pathology laboratory, where it is sliced into thin sections for viewing under a microscope. This is known as histologic (tissue) examination and is usually the best way to tell if cancer is present. The pathologist may also examine cytologic (cell) material. Cytologic material is present in urine, cerebrospinal fluid (the fluid around the brain and spinal cord), sputum (mucus from the lungs), peritoneal (abdominal cavity) fluid, pleural (chest cavity) fluid, cervical/vaginal smears, and in fluid removed during a biopsy. 
3. How is tissue processed after a biopsy or surgery? What is a frozen section?
   The tissue removed during a biopsy or surgery must be cut into thin sections, placed on slides, and stained with dyes before it can be examined under a microscope. Two methods are used to make the tissue firm enough to cut into thin sections: frozen sections and paraffin-embedded (permanent) sections. All tissue samples are prepared as permanent sections, but sometimes frozen sections are also prepared.
   Permanent sections are prepared by placing the tissue in fixative (usually formalin) to preserve the tissue, processing it through additional solutions, and then placing it in paraffin wax. After the wax has hardened, the tissue is cut into very thin slices, which are placed on slides and stained. The process normally takes several days. A permanent section provides the best quality for examination by the pathologist and produces more accurate results than a frozen section (1).
   Frozen sections are prepared by freezing and slicing the tissue sample. They can be done in about 15 to 20 minutes while the patient is in the operating room (1). Frozen sections are done when an immediate answer is needed; for example, to determine whether the tissue is cancerous so as to guide the surgeon during the course of an operation. 
4. How long after the tissue sample is taken will the pathology report be ready? 

 The pathologist sends a pathology report to the doctor within 10 days after the biopsy or surgery is performed. Pathology reports are written in technical medical language. Patients may want to ask their doctors to give them a copy of the pathology report and to explain the report to them. Patients also may wish to keep a copy of their pathology report in their own records (1). 

1. What information does a pathology report usually include? The pathology report may include the following information (1):
   
   • Patient information: Name, birth date, biopsy date.
     
   • Gross description: Color, weight, and size of tissue as seen by the naked eye.
     
   • Microscopic description: How the sample looks under the microscope and how it compares with normal cells.
     
   • Diagnosis: Type of tumor/cancer and grade (how abnormal the cells look under the microscope and how quickly the tumor is likely to grow and spread).
     
   • Tumor size: Measured in centimeters.
     
   • Tumor margins: There are three possible findings when the biopsy sample is the entire tumor:
     
     • Positive margins mean that cancer cells are found at the edge of the material removed.
       
     • Negative, not involved, clear, or free margins mean that no cancer cells are found at the outer edge.
       
     • Close margins are neither negative nor positive.
       
   • Other information: Usually notes about samples that have been sent for other tests or a second opinion.
     
   •  Pathologist’s signature and name and address of the laboratory. 
2. What might the pathology report say about the physical and chemical characteristics of the tissue? After identifying the tissue as cancerous, the pathologist may perform additional tests to get more information about the tumor that cannot be determined by looking at the tissue with routine stains, such as hematoxylin and eosin (also known as H&E), under a microscope (2). The pathology report will include
   
   1. The results of these tests. For example, the pathology report may include information obtained from immunochemical stains (IHC). IHC uses antibodies to identify specific antigens on the surface of cancer cells. IHC can often be used to:
      
      • Determine where the cancer started.
      • Distinguish among different cancer types, such as carcinoma, melanoma, and lymphoma.
      • Help diagnose and classify leukemias and lymphomas (3).
      The pathology report may also include the results of flow cytometry. Flow cytometry is a method of measuring properties of cells in a sample, including the number of cells, percentage of live cells, cell size and shape, and presence of tumor markers on the cell surface. (Tumor markers are substances produced by tumor cells or by other cells in the body in response to cancer or certain noncancerous conditions.) Flow cytometry can be used in the diagnosis, classification, and management of cancers such as acute leukemia, chronic lymphoproliferative disorders, and non-Hodgkin lymphoma (2).
      Finally, the pathology report may include the results of molecular diagnostic and cytogenetic studies. Such studies investigate the presence or absence of malignant cells, and genetic or molecular abnormalities in specimens. 
   2. What information about the genetics of the cells might be included in the pathology report? Cytogenetics uses tissue culture and specialized techniques to provide genetic information about cells, particularly genetic alterations. Some genetic alterations are markers or indicators of a specific cancer. For example, the Philadelphia chromosome is associated with chronic myelogenous leukemia (CML). Some alterations can provide information about prognosis, which helps the doctor make treatment recommendations (3). Some tests that might be performed on a tissue sample include:
      
      • Fluorescence in situ hybridization (FISH) determines the positions of particular genes. It can be used to identify chromosomal abnormalities and to map genes.
        
      • Polymerase chain reaction (PCR) is a method of making many copies of particular DNA sequences of relevance to the diagnosis.
        
      • Real-time PCR or quantitative PCR is a method of measuring how many copies of a particular DNA sequence are present.
        
      • Reverse-transcriptase polymerase chain reaction (RT-PCR) is a method of making many copies of a specific RNA sequence.
        
      • Southern blot hybridization detects specific DNA fragments.
        
      • Western blot hybridization identifies and analyzes proteins or peptides.
      • 
        
        1. Can individuals get a second opinion about their pathology results? Although most cancers can be easily diagnosed, sometimes patients or their doctors may want to get a second opinion about the pathology results (1). Patients interested in getting a second opinion should talk with their doctor. They will need to obtain the slides and/or paraffin block from the pathologist who examined the sample or from the hospital where the biopsy or surgery was done.
           Many institutions provide second opinions on pathology specimens. National Cancer Institute (NCI)-designated cancer centers or academic institutions are reasonable places to consider. Contact information for NCI-designated cancer centers can be found in the NCI-Designated Cancer Centers database at https://cissecure.nci.nih.gov/factsheet/FactSheetSearch1_2.aspx on the Internet. Patients should contact the facility in advance to determine if this service is available, the cost, and shipping instructions. 
        2. What research is being done to improve the diagnosis of cancer? NCI, a component of the National Institutes of Health, is sponsoring clinical trials that are designed to improve the accuracy and specificity of cancer diagnoses. Before any new method can be recommended for general use, doctors conduct clinical trials to find out whether it is safe and effective. 
           People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from NCI’s Cancer Information Service (CIS) (see below) at 1–800–4–CANCER and in the NCI fact sheet Cancer Clinical Trials at http://www.cancer.gov/cancertopics/factsheet/Information/clinical-trials on the Internet. This fact sheet includes information about types of clinical trials, who sponsors them, how they are conducted, how participants are protected, and who pays for the patient care costs associated with a clinical trial. Further information about clinical trials is available at http://www.cancer.gov/clinicaltrials on NCI’s Web site. The Web site offers detailed information about specific ongoing studies by linking to PDQ®, NCI’s comprehensive cancer information database. The CIS also provides information from PDQ.
      • http://www.cancer.gov/cancertopics/factsheet/detection/pathology-reports

DR-70 Test Detects Most Cancers

DR-70 is a simple blood test that screens for 13 different cancers at the same time. It is highly specific and catches cancer long before you would suspect anything was amiss. It runs about $100. Cancers that can be detected by the test are of the lung, colon, breast, stomach, liver, rectum, ovary, cervix, esophagus, thyroid, and pancreas, and trophoblast and malignant lymphoma. AMDL has also received clearance from the FDA to market the PyloriProbe™ test, which can detect the presence of Helicobacter Pylori in the stomach, the primary cause of ulcers and a potential cause of stomach cancer. For more info on the test, contact AMDL Inc., in Tustin, California by calling 714-505-4460, or email them at: info@amdl.com, or go to their website at www.amdl.com. We are attempting to get information on the accuracy of this test.

 

• diagnose early cancer development – that is the ability to diagnose cancer in those with little or no symptoms or signs;
• confirm the diagnosis of cancer in those with uncertain results of conventional tests such as blood tests or X-rays;
• monitor the effect of treatment, including conventional treatment such as surgery, chemotherapy or radiotherapy, or complementary and alternative treatments such as nutritional approaches or herbal medicine; and
• detect early recurrence in those who have had cancer in the past but are now in remission.

Who Should Have the Test?

The test is available to everyone.

It would be particularly valuable for:

• those who have a strong family history of cancer, but are fit and well; 
• those who have had suspicious test results from their doctors, but do not know whether they have cancer or not; 
• those who have had cancer diagnosed and are about to embark upon a course of treatment; and
• those who have had cancer in the past, and want to make sure they are clear.

For fit and healthy people, over the age of 40, it could be argued that they should have the test every 2 years or so.  For fit and healthy people over the age of 55 – 60 it could be argued that they should have the test every 12 months.

For people with cancer, or a history of cancer, or a family history of cancer, it could be argued that the test should be carried out more frequently.

How Is It Done?

The DR-70 test is carried out on a a fasting blood sample – that is a blood sample taken after fasting (not eating) for a period of 12 hours or longer.

We ask people to come to the clinic to have a blood sample taken in the mornings, having had nothing to eat after tea or supper the night before.

The blood sample is then sent off to a laboratory in Harley Street, London, where it is analysed.

The results are available to us after around 14 – 21 days, and we usually arrange a follow-up appointment in a month to discuss your results.

How Accurate are the Results?

No test can be 100% accurate. This test is probably as accurate as can be.

At Better Health we have always approached new treatments, new tests and new therapies with an analytical, scientific approach – are they as good as they claim to be?

Currently available and previous tests for cancer have been vague and of limited accuracy or limited usefulness. For example, the PSA test for prostate cancer is accurate, but only for prostate cancer, X-rays are useful in a large number of cancers but may miss many cancers, and is not specific enough to confirm the diagnosis.

A low DR-70 level is normal, and implies that there is no cancer in the body; a medium level of DR-70 implies the presence of early cancer, but the test should be repeated to confirm the result and to look for an upward trend (which would be much more indicative of cancer); high DR-70 levels are highly indicative of invasive cancer, and further tests should be done to search for the cancer site.

What Advice Do You Get?

If the DR-70 levels are low or normal, then the presence of cancer is highly unlikely. A follow up test should be carried out in 12 – 24 months.

If the DR-70 levels are moderately raised then the test should be repeated, possibly with other tests looking for other signs of cancer.

If the DR-70 levels are high, then further tests should be carried out, looking for signs of cancer.

Further tests should include physical / clinical examination, blood tests, and possibly X-rays or other imaging tests. Further tests may be indicated according to individual requirements.

In the presence of high, or moderately raised, DR-70 tests, we would advise that you seek further advice from your own doctor or GP. We will provide you with the test results and explanation of the test results to show your doctor, and any further information that he or she needs.

We would expect that further tests would be carried out to investigate the presence of cancer as above.

Further advice is available from Better Health on request, and we would also give you advice regarding diet and lifestyle in relation to cancer, the use of diet and nutritional supplements, and the use of herbal and other complementary and alternative medicines in cancer support.

How Much Does it Cost?

The cost of the DR-70 test is £125, which includes taking and processing the blood test prior to sending forward to the laboratory, and a follow up consultation for the test result.

Further charges apply for any further consultations, tests or treatments, and these will be discussed with you fully as necessary.

http://www.users.globalnet.co.uk/~bhealth/cancertest.htm