Wednesday, February 1, 2012

Better Treatment Option Recently FDA Approved For Basal Cell Carcinoma



Basal cell carcinoma is the most common form of skin cancer and usually found on the upper body.  As this cancer advances it can become disfiguring and fatal.

After a few years of testing and clinical trials the FDA has approved a new drug called Erivedge.

Testing found that the drug, Erivedge, shrank tumors in 30 percent of patients whose disease had metastasized and spread in the body. Also, 43 percent of patients in which the disease had spread to surrounding tissue had a complete or partial response.
Erivedge, a pill taken once a day, works by blocking the signals in the cellular pathway that leads to cancer growth.
Scottsdale Healthcare and TGen began working on Phase 1 of the drug's clinical trial in 2007, through a partnership the entities have maintained for seven years.
It is amazing how those in cancer research are committed to improving the lives of cancer patients!

Monday, January 30, 2012

Living With Chronic Myelogenous Leukemia

Having worked with cancer patients I know the stages of grief that patients go through when hearing the diagnosis.  There is unbelief, sadness, anger and sometimes rebellion in compliance with treatment.  I am talking specifically now about CML patients.  There is a great amount of hope for these patients now. Right now CML patients are required to take their Gleevac every day for a  long life span.  This may one day change because researchers are having many breakthroughs with molecular studies. 
A great website for support and education is "The National CML Society".  This site is full of information and direct help for your needs.  Below is a video of testimonials of CML patients.


The hope for CML is great for there are great doctors who are adamant about continued clinical trials and research to continue to find a cure.  You can help yourself and others by volunteering to participate in clinical trials and lab testing.  Listen to the following video of one the most prominent hematology oncologists in America today.

                                                          Dr. Jorge Cortes

Be active in your treatment!  Research and join online support groups.  There is always hope!

Wednesday, January 25, 2012

United Kingdom Reveals DNA Testing For Individualized Treatment Of Cancer

This testing is a wonderful development because it focuses on the DNA of cancer patients which allows treatment to be personalized instead of treating everyone the same way depending on their diagnosis.


Health Secretary Andrew Lansley unveiled plans to give more cancer patients access to tests that screen their DNA.
The aim is to make the most of recent advances that enable cancer treatments to be tailored to individuals.
Increasingly, targeted drugs are being developed that work in small sub-groups of patients with specific genetic profiles. Future genetic tests will also show if a patient is more likely to respond to one treatment or another.

Mr Lansley said: "The new developments can help patients to get the best treatments to improve their chances of survival and their quality of life. We want to make sure that all patients can benefit from these tests - as soon as the tests are recommended by Nice (National Institute for health and Clinical Excellence). We have therefore been working to establish a new system to ensure speedy introduction of high quality tests. This is the way forward for the future."

For more information:  http://www.google.com/hostednews/ukpress/article/ALeqM5i-DSigwZkCOwNI32CB6h-inucDfg?docId=N0127971327500789606A

Monday, January 23, 2012

Waldenstrom Macroglobulinemia, A Rare and Complicated Disease

WM is a rare disorder with an incidence of approximately three per million people per year with 1400 new cases diagnosed in the United States each year . The median age at diagnosis is 64 years; less than 1 percent of patients are under 40 years of age, and approximately 60 percent are males. WM is much more common in Caucasians than in other ethnic groups . Specifically, it is uncommon in Blacks and those of Mexican descent who make up approximately 5 percent of cases.
The majority of patients with the histopathologic finding of lymphoplasmacytic lymphoma (LPL) have a circulating monoclonal IgM consistent with the diagnosis of WM. In the past, LPL and WM have been arbitrarily differentiated from each other based on the level of the monoclonal IgM protein. Currently, the preferred terminology in cases of LPL with circulating monoclonal IgM is WM, rather than lymphoplasmacytic lymphoma, regardless of the size of the monoclonal IgM protein.

Waldenström macroglobulinemia, one of the malignant monoclonal gammopathies, is a chronic, indolent, lymphoproliferative disorder.It is characterized by the presence of a high level of a macroglobulin (immunoglobulin M [IgM]), elevated serum viscosity, and the presence of a lymphoplasmacytic infiltrate in the bone marrow. (See Pathophysiology, Etiology, and Workup.)
A clonal disease of B lymphocytes, Waldenström macroglobulinemia is considered to be a lymphoplasmacytic lymphoma, as defined by the Revised European American Lymphoma Classification (REAL) and World Health Organization (WHO) classification.
The clinical manifestations of Waldenström macroglobulinemia result from the presence of the IgM paraprotein and malignant lymphoplasmacytic cell infiltration of the bone marrow and other tissue sites. The clinical presentation is similar to that of multiple myeloma except that organomegaly is common in Waldenström macroglobulinemia and is uncommon in multiple myeloma and  lytic bony disease and renal disease are uncommon in Waldenström macroglobulinemia but are common in multiple myeloma. (See Pathophysiology, Presentation, and Workup.)

Complications

Complications of Waldenström macroglobulinemia include the following:
  • Hyperviscosity syndrome
  • Visual disturbances secondary to hyperviscosity syndrome
  • Diarrhea and malabsorption secondary to gastrointestinal (GI) involvement
  • Renal disease (less common)
  • Amyloidosis of the heart, kidney, liver, lungs, and joints
  • Bleeding manifestations secondary to platelet dysfunction and coagulation factor and fibrinogen abnormalities due to interaction with  plasma IgM
  • Raynaud phenomenon secondary to cryoglobulinemia
  • Increased predisposition to infection due to B-cell dysfunction (disease related) or T-cell dysfunction (therapy related, particularly after nucleoside analogues)
  • Cardiac failure
  • Increased incidence of lymphomas, myelodysplasia, and leukemias
  •  
     
    Initially this disease may look like Multiple Myeloma, but one can see that extensive testing is required for diagnosis. Of course, a bone marrow biopsy is important so the pathologist can look for abnormalities in the bone marrow tissue.
     

    Blood counts

    The complete blood count (CBC) is a test that measures the levels of red cells, white cells, and platelets in the blood. If the lymphoma cells occupy too much of the bone marrow, these levels will be low.

    Quantitative immunoglobulins

    This test measures the blood levels of the different antibodies. There are several different types of antibodies in the blood: IgA, IgE, IgG, and IgM. The levels of these immunoglobulins are measured to see if any are abnormally high or low. In WM the level of IgM is high but the IgG level is often low.

    Electrophoresis

    The immunoglobulin produced in WM (IgM) is abnormal because it is monoclonal -- meaning that it is just many copies of the exact same antibody. Serum protein electrophoresis (SPEP) is a test that measures the total amount of immunoglobulins in the blood and finds any abnormal (monoclonal) immunoglobulin. Then, another test, such as immunofixation or immunoelectrophoresis, is used to determine the type of antibody that is abnormal (IgM or some other type). Finding a monoclonal IgM immunoglobulin in the blood is necessary to make a diagnosis of WM. The abnormal protein in WM is known by several different names, including monoclonal immunoglobulin M, IgM protein, IgM spike, IgM paraprotein, and M-spike. Other types of monoclonal immunoglobulins, like IgA or IgG, are seen in different disorders (like multiple myeloma and some lymphomas).
    Sometimes pieces of the IgM protein are excreted by the kidneys into the urine. The procedure used for finding a monoclonal immunoglobulin in the urine is called urine protein electrophoresis (UPEP).

    Viscosity

    Viscosity measures how thick the blood is. If the IgM level is too high, it will cause the blood to become thick (viscous) so that it can't flow freely. Think about pouring honey compared to pouring water. If the blood becomes too thick, the brain doesn't get enough blood and oxygen. This can be treated with plasmapheresis (see below).

    Cryocrit

    This tests the blood for a cryoglobulin (a protein that causes the blood to clump together in cool temperatures).

    Beta-2-microglobulin

    This is another protein produced by the malignant lymphoplasmacytoid cells. This protein itself doesn't cause any problems, but it is a useful indicator of a patient’s prognosis (outlook). High levels mean a poor outlook.

    WM is a rare disorder with an incidence of approximately three per million people per year with 1400 new cases diagnosed in the United States each year. The median age at diagnosis is 64 years; less than 1 percent of patients are under 40 years of age, and approximately 60 percent are males . WM is much more common in Caucasians than in other ethnic groups . Specifically, it is uncommon in Blacks and those of Mexican descent who make up approximately 5 percent of cases .
    The majority of patients with the histopathologic finding of lymphoplasmacytic lymphoma (LPL) have a circulating monoclonal IgM consistent with the diagnosis of WM. In the past, LPL and WM have been arbitrarily differentiated from each other based on the level of the monoclonal IgM protein. Currently, the preferred terminology in cases of LPL with circulating monoclonal IgM is WM, rather than lymphoplasmacytic lymphoma, regardless of the size of the monoclonal IgM protein.

  • For more information:  www.medscape.com, www.uptodate.com, www.cancer.org




     
     

Saturday, January 21, 2012

Good News In The Advancement of A Breast Cancer Vaccine

Over the past few years scientists have worked on a vaccine to help breast cancer patients. This new E75 vaccine that is in the final phases of clinical trials. Through the testing it has shown that women injected with E75, who have experienced the trauma of breast cancer, prevented recurrence in 50% of the patients. U.S. Army Col. George Peoples, chief of surgical oncology, at San Antonio Military Medical Center is the developer of this vaccine.
This is what Peoples has said in a recent interview:
"What I have been the most interested in doing in how to engage the engage the patients immune response, to help the patient's immune system to fight off the cancer,” said Col. George Peoples, a cancer surgeon and director of SAMMC's cancer vaccine development program, who's leading the study.
Like any vaccine, E75 primes the immune system to recognize a target — in this case a substance called human epidermal growth factor receptor 2, or HER2. Most breast cancers produce some level of HER2, which fuels their growth.
And most breast cancer patients are tested for HER2, because those with the highest levels — about 20 percent of patients — can be helped by a drug called Herceptin.
But E75 seems to work best in patients who produce low to medium levels of HER2 — a group that makes up maybe 60 percent of breast cancer patients, and who usually aren't eligible for Herceptin.
Peoples has been studying different parts of the HER2 protein as potential vaccine targets since 1995, first as a civilian and then after a return to Army medicine at Walter Reed Army Medical Center and SAMMC.

“Within the first year or two of starting that trial, we could tell there was a benefit because the control arm (the comparison group that didn't get the real vaccine) started having recurrences, and the vaccine group was not,” Peoples said.
“The promise of cancer vaccines for many years has been solely a promise,” said Dr. Kim Lyerly, director of the Duke Comprehensive Cancer Center in Durham, N.C., and a scientific adviser to Susan G. Komen for the Cure. “Our understanding of what it takes to mount an immune-system response and to create a vaccine is getting better and better. So that's why this (E75) study, based on really solid Phase 2 data, is very exciting.”
Most experimental drugs and vaccines are first tested in very sick people. Peoples focused instead on healthy women — those successfully treated but at high risk of seeing their cancers return.
“The whole point of the vaccine is to engage the host immune system to get an immune response against a cancer,” Peoples said. “Well, an end-stage patient's immune system is not healthy.”
Early studies also showed the vaccine's protection waned over time. It was a group of Peoples' own patient volunteers who insisted he include a booster shot in the trial. He agreed, adding booster shots at six-month intervals that have kept immunity strong.
“It was breast cancer advocacy at its best,” Peoples said. “They came to me as a group and said, with every other vaccine we know of you have to get a booster inoculation. Why aren't we? I said, it's not part of the trial. They said, make a part.”
If the current study confirms the vaccine is effective in preventing a recurrence of cancer, the next question would be if it can prevent the disease in the first place.
“Eventually if we can prove that a vaccine can work in that situation, then hopefully during my lifetime we will go and do a true prevention trial,” he said.
And HER2 isn't only found in breast cancer. Other tumors, including prostate, ovarian and colon also produce medium amounts."

Read more: http://www.mysanantonio.com/news/local_news/article/E75-vaccine-s-final-tests-start-in-S-A-2653101.php#ixzz1k77aXtqo