Genetic testing for predisposition to certain cancers has really advanced in the past few years. The most popular genetic testing is for breast cancer called BRAC testing. Now the cancer that targets men which is prostate cancer can result of a gene mutation. Some men with prostate cancer have a strong hereditary predisposition due to the gene mutation.
Men with prostate cancer were 20.1 times more likely than controls (P=8.5×10−7) to carry a mutation in HOXB13, which plays a key role in prostate development, Kathleen A. Cooney, MD, of the University of Michigan in Ann Arbor, and colleagues found.
The HOXB13 G84E mutation was significantly more common in early-onset, familial prostate cancer than in cases that developed later in life in men without a strong family history of the disease (3.1% versus 0.6%, P=0.000002).
The mutation won't explain many prostate cancer cases but is a good start, the group noted in the Jan. 12 issue of the New England Journal of Medicine.
"Although the variant accounts for a small fraction of all prostate cancers, this finding has implications for prostate-cancer risk assessment and may provide new mechanistic insights into this common cancer," they wrote.
Men whose family has a history of prostate cancer can now be tested for the gene mutation. When the kit becomes available one need to see the cost and if insurance will pay for the testing.
For more inforamtion: www.medpagetoday.com
Thursday, January 12, 2012
Monday, January 9, 2012
Pathwork Tissue Origin Test Helps Prolongs Life Of Lung Cancer Patients
The Pathwork Tissue of Origin Test is the only FDA-cleared, Medicare-covered molecular diagnostic for identifying tissue of origin. It uses a tumor’s own genomic information to help pathologists and oncologists diagnose challenging cancer cases such as those that are metastatic or that have a complex clinical history.
“The Tissue of Origin Test significantly altered clinical practice patterns for treating metastatic cancer,” explained John Hornberger, M.D., M.S., CEO/President of Cedar Associates LLC and Principal Investigator of the study. “We saw an increase in overall survival and quality-adjusted life years, resulting in an expected cost per QALY of less than $50,000 per patient, which is within the generally accepted threshold of <$100,000 for cost-effectiveness in the United States.”1,2
The Pathwork Tissue of Origin Test, available through the Pathwork Diagnostics Laboratory, measures gene expression levels of 2,000 genes and uses proprietary algorithms to compare the tumor’s gene expression pattern to that of 15 tumor types, representing 58 morphologies and 90% of all solid tumors. The test provides objective genomic information to help the physician diagnose what type of cancer the patient has. An accurate diagnosis allows oncologists to match therapy to the cancer.
The Pathwork Tissue of Origin Test has been extensively evaluated in multiple independent studies involving more than 1,100 patient specimens, including large validation studies published in the Journal of Clinical Oncology and the Journal of Molecular Diagnostics.
A retrospective study of 111 cases from 66 academic and community oncology practices illustrates the use of the test in management of cancer patients. Over two thirds of the cases reviewed showed cancer management changed after the Pathwork Tissue of Origin Test result was received. The majority of the oncologists identified the Tissue of Origin Test results as influencing the decision to make a change in therapy.
For more information:
http://www.genengnews.com/industry-updates/pathwork-tissue-of-origin-test-cost-effective-for-increasing-cancer-patient-survival/139175622/
“The Tissue of Origin Test significantly altered clinical practice patterns for treating metastatic cancer,” explained John Hornberger, M.D., M.S., CEO/President of Cedar Associates LLC and Principal Investigator of the study. “We saw an increase in overall survival and quality-adjusted life years, resulting in an expected cost per QALY of less than $50,000 per patient, which is within the generally accepted threshold of <$100,000 for cost-effectiveness in the United States.”1,2
The Pathwork Tissue of Origin Test, available through the Pathwork Diagnostics Laboratory, measures gene expression levels of 2,000 genes and uses proprietary algorithms to compare the tumor’s gene expression pattern to that of 15 tumor types, representing 58 morphologies and 90% of all solid tumors. The test provides objective genomic information to help the physician diagnose what type of cancer the patient has. An accurate diagnosis allows oncologists to match therapy to the cancer.
The Pathwork Tissue of Origin Test has been extensively evaluated in multiple independent studies involving more than 1,100 patient specimens, including large validation studies published in the Journal of Clinical Oncology and the Journal of Molecular Diagnostics.
A retrospective study of 111 cases from 66 academic and community oncology practices illustrates the use of the test in management of cancer patients. Over two thirds of the cases reviewed showed cancer management changed after the Pathwork Tissue of Origin Test result was received. The majority of the oncologists identified the Tissue of Origin Test results as influencing the decision to make a change in therapy.
For more information:
http://www.genengnews.com/industry-updates/pathwork-tissue-of-origin-test-cost-effective-for-increasing-cancer-patient-survival/139175622/
Wednesday, January 4, 2012
Chromogranin A :The Test
Chromogranin A test is a tumor marker. The oncologist may order this test along with other tests if they suspect a carcinoid tumor,pheochromocytoma, and neurendocrine tumor.
Carcinoid tumor are derived from primitive stem cells in the gut wall but can be seen in other organs,[1] including the lungs,[2] mediastinum, thymus,[3] liver, pancreas, bronchus, ovaries,[4] prostate,[5] and kidneys.[6] In children, most tumors occur in the appendix and are benign and asymptomatic.
Most carcinoid tumors are slow growing and indolent without symptoms. Nevertheless, aggressive and metastatic disease (eg, to the brain) does occur. Even tumors in the appendix can metastasize.[7, 8] Depending on the size and location, carcinoid tumors can cause various symptoms, including carcinoid syndrome. Carcinoid tumors of the ileum and jejunum, especially those larger than 1 cm, are most prone to produce this syndrome, at least in adults.
Pheochromocytoma is a neuroendocrine tumor of the medulla of the adrenal glands (originating in the chromaffin cells), or extra-adrenal chromaffin tissue that failed to involute after birth [1] and secretes excessive amounts of catecholamines, usually noradrenaline (norepinephrine), and adrenaline (epinephrine) to a lesser extent.[2] Extra-adrenal paragangliomas (often described as extra-adrenal pheochromocytomas) are closely related, though less common, tumors that originate in the ganglia of the sympathetic nervous system and are named based upon the primary anatomical site of origin.
Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. Many are benign, while some are cancers. They most commonly occur in the intestine, but are also found in the lung and the rest of the body.
Although there are many kinds of NETs, they are treated as a group of tissue because the cells of these neoplasms share common features, such as looking similar, having special secretory granules, and often producing biogenic amines and polypeptide hormones.[1]
The Chromogranin A may be ordered in combination with or in place of 5-HIAA to help diagnose carcinoid tumors. It is also used to help monitor the effectiveness of treatment and detect recurrence of this tumor. Sometimes it may be ordered with specific hormones, such as catecholamines, to help diagnose and monitor a pheochromocytoma. It may also be used to detect the presence of other neuroendocrine tumors, even those that do not secrete hormones.
For more information :www.medline.com, www.wikipeidia.com, www.labtestsonline.net
Carcinoid tumor are derived from primitive stem cells in the gut wall but can be seen in other organs,[1] including the lungs,[2] mediastinum, thymus,[3] liver, pancreas, bronchus, ovaries,[4] prostate,[5] and kidneys.[6] In children, most tumors occur in the appendix and are benign and asymptomatic.
Most carcinoid tumors are slow growing and indolent without symptoms. Nevertheless, aggressive and metastatic disease (eg, to the brain) does occur. Even tumors in the appendix can metastasize.[7, 8] Depending on the size and location, carcinoid tumors can cause various symptoms, including carcinoid syndrome. Carcinoid tumors of the ileum and jejunum, especially those larger than 1 cm, are most prone to produce this syndrome, at least in adults.
Pheochromocytoma is a neuroendocrine tumor of the medulla of the adrenal glands (originating in the chromaffin cells), or extra-adrenal chromaffin tissue that failed to involute after birth [1] and secretes excessive amounts of catecholamines, usually noradrenaline (norepinephrine), and adrenaline (epinephrine) to a lesser extent.[2] Extra-adrenal paragangliomas (often described as extra-adrenal pheochromocytomas) are closely related, though less common, tumors that originate in the ganglia of the sympathetic nervous system and are named based upon the primary anatomical site of origin.
Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. Many are benign, while some are cancers. They most commonly occur in the intestine, but are also found in the lung and the rest of the body.
Although there are many kinds of NETs, they are treated as a group of tissue because the cells of these neoplasms share common features, such as looking similar, having special secretory granules, and often producing biogenic amines and polypeptide hormones.[1]
The Chromogranin A may be ordered in combination with or in place of 5-HIAA to help diagnose carcinoid tumors. It is also used to help monitor the effectiveness of treatment and detect recurrence of this tumor. Sometimes it may be ordered with specific hormones, such as catecholamines, to help diagnose and monitor a pheochromocytoma. It may also be used to detect the presence of other neuroendocrine tumors, even those that do not secrete hormones.
Chromogranin A concentrations are normally low. An increased level in a symptomatic person may indicate the presence of a tumor but will not tell the doctor what type it is or where it is. The quantity of CgA is not associated with the severity of a person's symptoms but is associated with the tumor burden - the mass of the tumor.
If concentrations of CgA are elevated prior to treatment and then fall, then treatment is likely to have been effective. If monitored levels begin to rise, then the person may have a recurrence of the tumor.
If concentrations of CgA are elevated prior to treatment and then fall, then treatment is likely to have been effective. If monitored levels begin to rise, then the person may have a recurrence of the tumor.
For more information :www.medline.com, www.wikipeidia.com, www.labtestsonline.net
Tuesday, January 3, 2012
Pancreatic Cancer
Pancreatic cancer is an adenocarcinoma . Adenocarcinoma is a cancer of the epithelium but begins in the glandular tissue. Epithelium is the tissue the is the layer that is in our skin ,glands and is in the tissue lining that covers our major organs. For cancer to be diagnosed an adenocarcinoma it does not have to be a part of a gland but have excretory properties. It is easier to determine adenocarcinoma if the tissue resembles the tissue from which the tissue from which the glandular tissue it came from. Some adenocarcinoma is difficult to know if determine so there must be a biopsy in which the pathologist through staining procedures determine the diagnosis. As long as the cells of the tissue have and exocrine characteristic then it is considered glandular and therefore is malignant.
Above it an image of pancreatic cancer. Inside are the tumors that were determined by the pathologists and radiologists.
Above is tissue that has been processed by histology and this view is what is seen by the pathologist under the microscope. This image was taken by cure byte. This was used to diagnosed adenocarcinoma pancreas.
This is a video by Dr.Mark Fraiman explaining Pancreatic cancer.
Pancreatic cancer is highly lethal. It is hard to diagnosed and usually cannot be diagnosed until later in the course of the disease.
The conditions that may put people at risk include tobacco use, obesity, a sedentary lifestyle, a history of diabetes, chronic pancreatic inflammation (pancreatitis), and a fatty (or Western) diet. Prior stomach surgery may moderately increase one's risk as can certain chronic infections such as hepatitis B and H. pylori (an infection of the stomach lining). Certain types of pancreatic cysts may put individuals at risk of developing pancreatic cancer. Despite these associated risks, no identifiable cause is found in most people who develop pancreatic cancer.
The tests for diagnosis of Pancreatic Cancer are the following:
For more information :www.medicinenet.com or www.mayoclinic.com
Above is tissue that has been processed by histology and this view is what is seen by the pathologist under the microscope. This image was taken by cure byte. This was used to diagnosed adenocarcinoma pancreas.
Pancreatic cancer is highly lethal. It is hard to diagnosed and usually cannot be diagnosed until later in the course of the disease.
The conditions that may put people at risk include tobacco use, obesity, a sedentary lifestyle, a history of diabetes, chronic pancreatic inflammation (pancreatitis), and a fatty (or Western) diet. Prior stomach surgery may moderately increase one's risk as can certain chronic infections such as hepatitis B and H. pylori (an infection of the stomach lining). Certain types of pancreatic cysts may put individuals at risk of developing pancreatic cancer. Despite these associated risks, no identifiable cause is found in most people who develop pancreatic cancer.
The tests for diagnosis of Pancreatic Cancer are the following:
- Ultrasound. Ultrasound uses high-frequency sound waves to create moving images of your internal organs, including your pancreas. The ultrasound sensor (transducer) is placed on your upper abdomen to obtain images.
- Computerized tomography (CT) scan. CT scan uses X-ray images to help your doctor visualize your internal organs. In some cases you may receive an injection of dye into a vein in your arm to help highlight the areas your doctor wants to see.
- Magnetic resonance imaging (MRI). MRI uses a powerful magnetic field and radio waves to create images of your pancreas.
- Endoscopic retrograde cholangiopancreatography (ERCP). This procedure uses a dye to highlight the bile ducts in your pancreas. During ERCP, a thin, flexible tube (endoscope) is gently passed down your throat, through your stomach and into the upper part of your small intestine. Air is used to inflate your intestinal tract so that your doctor can more easily see the openings of your pancreatic and bile ducts. A dye is then injected into the ducts through a small hollow tube (catheter) that's passed through the endoscope. Finally, X-rays are taken of
- Endoscopic ultrasound (EUS). EUS uses an ultrasound device to make images of your pancreas from inside your abdomen. The ultrasound device is passed through an endoscope into your stomach in order to obtain the images. Your doctor may also collect a sample of cells (biopsy) during EUS.
- Percutaneous transhepatic cholangiography (PTC). PTC uses a dye to highlight the bile ducts in your liver. Your doctor carefully inserts a thin needle into your liver and injects the dye into the bile ducts. A special X-ray machine (fluoroscope) tracks the dye as it moves through the ducts.
- Removing a tissue sample for testing (biopsy). A biopsy is a procedure to remove a small sample of tissue from the pancreas for examination under a microscope. A biopsy sample can be obtained by inserting a needle through your skin and into your pancreas (fine-needle aspiration). Or it can be done using endoscopic ultrasound to guide special tools into your pancreas where a sample of cells can be obtained for testing.
- the ducts. A tissue or cell sample (biopsy) can be collected during ERCP.
What is the treatment for locally advanced unresectable pancreatic cancer?
If a pancreatic cancer is found when it has grown into important local structures but not yet spread to distant sites, this is described as locally advanced unresectable pancreatic cancer (stage III). The standard of care in the United States for the treatment of locally advanced cancer is a combination of low-dose chemotherapy given simultaneously with radiation treatments to the pancreas and surrounding tissues. Radiation treatments are designed to lower the risk of local growth of the cancer, thereby minimizing the symptoms that local progression causes (back or belly pain, nausea, loss of appetite, intestinal blockage, jaundice). Radiation treatments are typically given Monday through Friday for about five weeks. Chemotherapy given concurrently (at the same time) may improve the effectiveness of the radiation and may lower the risk for cancer spread outside the area where the radiation is delivered. When the radiation is completed and the patient has recovered, more chemotherapy is often recommended. Recently, newer forms of radiation delivery (stereotactic radiosurgery, gamma knife radiation, cyberknife radiation) have been utilized in locally advanced pancreatic cancer with varying degrees of success, but these treatments can be more toxic and are, for now, largely experimental.What is the treatment for metastatic pancreatic cancer?
Once a pancreatic cancer has spread beyond the vicinity of the pancreas and involves other organs, it has become a problem through the system. As a result, a systemic treatment is most appropriate and chemotherapy is recommended.For more information :www.medicinenet.com or www.mayoclinic.com
Thursday, December 29, 2011
New Diagnostic Technology Helps Oncologists Diagnosis In Colon Cancer
Rapid molecular testing in the laboratories has greatly helped oncologists to diagnose cancers of the breast, lymphoma and leukemia.
One type of cancer that is a high-profile target for improved diagnostic testing is colon cancer. It is one of the most common malignancies in men and women. The National Cancer Institute estimates that 141,210 new cases of colon and rectal cancers will be reported and an estimated 49,380 Americans will die of these diseases this year. Anytime time a lab presents new testing it requires financial,clinical and operational resources. Since there is a high rate of colon cancer it is important to have more accurate testing. Past testing such occult blood and sigmoidoscopy are variable and can have false positives. The new testing is using monoclonal and polyclonal antibodies to detect only human blood in stool, this technology has improved specificity, sensitivity, accuracy, the White Paper reported.
In conclusion, the ability of new technologies to contribute to improved performance of assays used in screening individuals for colorectal cancer demonstrate how swiftly the standard of care in laboratory medicine can be changed for the better. New generation FOB lab tests are one example of the types of changes now occurring across the entire range of testing services offered by clinical laboratories and pathology groups.
One type of cancer that is a high-profile target for improved diagnostic testing is colon cancer. It is one of the most common malignancies in men and women. The National Cancer Institute estimates that 141,210 new cases of colon and rectal cancers will be reported and an estimated 49,380 Americans will die of these diseases this year. Anytime time a lab presents new testing it requires financial,clinical and operational resources. Since there is a high rate of colon cancer it is important to have more accurate testing. Past testing such occult blood and sigmoidoscopy are variable and can have false positives. The new testing is using monoclonal and polyclonal antibodies to detect only human blood in stool, this technology has improved specificity, sensitivity, accuracy, the White Paper reported.
In conclusion, the ability of new technologies to contribute to improved performance of assays used in screening individuals for colorectal cancer demonstrate how swiftly the standard of care in laboratory medicine can be changed for the better. New generation FOB lab tests are one example of the types of changes now occurring across the entire range of testing services offered by clinical laboratories and pathology groups.
Tuesday, December 27, 2011
Skin Cancer-Squamous Cell Carcinoma
Squamous Cell Carcinoma is the second most common skin cancer. This cancers results from the uncontrolled rapid growth of abnormal cells.
The main symptom is a growing bump that may have a rough, scaly surface and flat reddish patches.
Below is a slide of a histology slide after biopsy of squamous cell carcinoma.
Squamous Cell Carcinoma is caused by UV rays over a period of a lifetime. Although SCC is usually found on the skin that has been exposed to the sun SCC can also be found in the mucus membranes and genitals.
Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a small needle. You will likely feel a small pinch and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy. Any biopsy is likely to leave a scar. Since different methods produce different types of scars, you should ask your dermatologist about biopsies and scarring before the procedure is done.
Diagnosis begins with a biopsy of the suspicious growth on skin. This procedure needs to be performed by a dermatologist. Shave biopsy uses a thin surgical blade to shave off the top layers of skin. This is the most common method for diagnosing squamous cell skin cancer. Punch biopsy uses a round, cookie cutter-like tool. It is used to take a deeper skin sample.
Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a small needle. You will likely feel a small pinch and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy. Any biopsy is likely to leave a scar. Since different methods produce different types of scars, you should ask your dematologist about biopsies and scarring before the procedure is done.
The main symptom is a growing bump that may have a rough, scaly surface and flat reddish patches.
 | ||
| Squamous Cell Carcinoma under the nail |
Below is a slide of a histology slide after biopsy of squamous cell carcinoma.
Squamous Cell Carcinoma is caused by UV rays over a period of a lifetime. Although SCC is usually found on the skin that has been exposed to the sun SCC can also be found in the mucus membranes and genitals.
Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a small needle. You will likely feel a small pinch and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy. Any biopsy is likely to leave a scar. Since different methods produce different types of scars, you should ask your dermatologist about biopsies and scarring before the procedure is done.
Diagnosis begins with a biopsy of the suspicious growth on skin. This procedure needs to be performed by a dermatologist. Shave biopsy uses a thin surgical blade to shave off the top layers of skin. This is the most common method for diagnosing squamous cell skin cancer. Punch biopsy uses a round, cookie cutter-like tool. It is used to take a deeper skin sample.
Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a small needle. You will likely feel a small pinch and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy. Any biopsy is likely to leave a scar. Since different methods produce different types of scars, you should ask your dematologist about biopsies and scarring before the procedure is done.
Above is a video of the histology of a squamous cell carcinoma by Washington Deceit. This explains how pathologists view cancerous tissue under the microscope to properly diagnosis the cancer for the doctor.
Below is a video of the treatment options of SCC by Dr. Shane Chapman
Sunday, December 25, 2011
Skin Cancer- Basal Cell
The chance of getting skin cancer needs to be taken seriously. Laying in tanning beds on a regular basis or not using protection when exposed to the sun such as hats,sunscreen ,etc will greatly increase the probability of skin cancer. Skin cancer is abnormal growth of skin cells. There are three types of skin cancer which are basal cell, squamous cell and melanoma. Basal cell cancer is the easiest to treat.
Basal Cell Carcinoma
Skin cancer is divided into two major groups: nonmelanoma and melanoma. Basal cell carcinoma is a type of nonmelanoma skin cancer, and is the most common form of cancer in the United States. According to the American Cancer Society, 75% of all skin cancers are basal cell carcinomas.
Basal cell carcinoma starts in the top layer of the skin called the epidermis. It grows slowly and is painless. A new skin growth that bleeds easily or does not heal well may suggest basal cell carcinoma. The majority of these cancers occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation. They may also appear on the scalp. Basal cell skin cancer used to be more common in people over age 40, but is now often diagnosed in younger people.
Your risk for basal cell skin cancer is higher if you have:
Basil Cell Cancer
Basal cell carcinoma may look only slightly different than normal skin. The cancer may appear as skin bump or growth that is:
You may have:
Basal Cell Carcinoma
Skin cancer is divided into two major groups: nonmelanoma and melanoma. Basal cell carcinoma is a type of nonmelanoma skin cancer, and is the most common form of cancer in the United States. According to the American Cancer Society, 75% of all skin cancers are basal cell carcinomas.
Basal cell carcinoma starts in the top layer of the skin called the epidermis. It grows slowly and is painless. A new skin growth that bleeds easily or does not heal well may suggest basal cell carcinoma. The majority of these cancers occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation. They may also appear on the scalp. Basal cell skin cancer used to be more common in people over age 40, but is now often diagnosed in younger people.
Your risk for basal cell skin cancer is higher if you have:
- Light-colored skin
- Blue or green eyes
- Blond or red hair
- Overexposure to x-rays or other forms of radiation
Basil Cell Cancer
Basal cell carcinoma may look only slightly different than normal skin. The cancer may appear as skin bump or growth that is:
- Pearly or waxy
- White or light pink
- Flesh-colored or brown
You may have:
- A skin sore that bleeds easily
- A sore that does not heal
- Oozing or crusting spots in a sore
- Appearance of a scar-like sore without having injured the area
- Irregular blood vessels in or around the spot
- A sore with a depressed (sunken) area in the middle
If your doctor is suspicious of skin cancer then they will cut out the abnormal section of skin which is called a biopsy.
Skin Cancer Nodular Basal Cell Carcinoma Cancer presented by Dr. Shane Chapman
Treatment
- Excision cuts the tumor out and uses stitches to place the skin back together.
- Curettage and electrodesiccation scrapes away the cancer and uses electricity to kill any remaining cancer cells.
- Surgery, including Mohs surgery, in which skin is cut out and immediately looked at under a microscope to check for cancer. The process is repeated until the skin sample is free of cancer.
- Cryosurgery freezes and kills the cancer cells.
- Radiation may be used if the cancer has spread to organs or lymph nodes or for tumors that can't be treated with surgery.
- Skin creams with the medications imiquimod or 5-fluorouracil may be used to treat superficial basal cell carcinoma.
- For more information go to: www.mayoclinic.com ; www.nih.gov
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