Disseminated cancer cells in bone marrow of breast cancer patients have putative cancer stem cell phenotype

Tumor cell dissemination to bone marrow is an early event in progression of breast cancer and is associated with poor prognosis. Disseminated tumor cells (DTC) are easily detected by immunohistochemistry for epithelial antigens , such as cytokeratins (CK). However, the biology of these cells is not well understood and is critical for ther-     

Mind and cancer. do psychological factors cause cancer?

We have reviewed the evidence for an association between major life events, depression and personality factors and the risk for cancer. We identified and included only those prospective or retrospective studies in which the psychological variable was collected independently of the outcome. The evidence failed to support the hypothesis that major life events are a risk factor for cancer. The evidence was inconsistent for both depression and personality factors. Chance, bias or confounding may explain this result, as many of the studies had methodological weaknesses. The generally weak associations found, the inconsistency of the results, the unresolved underlying biological mechanism and equivocal findings of dose-response relationships prevent a conclusion that psychological factors are established risk factors. However, certain intriguing findings warrant further studies, which must, however, be well conducted and large and include detailed information on confounders.     

Pancreatic cancer–Endosonography

EUS is the most sensitive imaging procedure for the detection of small solid pancreatic masses and is accurate in determining vascular invasion of the portal venous system. Even compared to the new CT-techniques EUS provides excellent results in preoperative staging of solid pancreatic tumors. Compared to helical CT-techniques EUS is less accurate in detecting tumor involvement of superior mesenteric artery. EUS staging and EUS-guided FNA can be performed in a single-step procedure, to establish the diagnosis of cancer. There is no known negative impact of tumor cell seeding due to EUS-FNA. Without FNA EUS and additional methods are not able to reliably distinguish between inflammatory and malignant masses.     

Mistletoe for cancer?

Mistletoe extracts are widely used in the treatment of cancer. The results of clinical trials are however highly inconsistent. We therefore conducted a systematic review of all randomised clinical trials of this unconventional therapy. Eight databases were searched to identify all studies that met our inclusion/exclusion criteria. Data were independently validated and extracted by 2 authors and checked by the 3rd according to predefined criteria. Statistical pooling was not possible because of the heterogeneity of the primary studies. Therefore a narrative systematic review was conducted. Ten trials could be included. Most of the studies had considerable weaknesses in terms of study design, reporting or both. Some of the weaker studies implied benefits of mistletoe extracts, particularly in terms of quality of life. None of the methodologically stronger trials exhibited efficacy in terms of quality of life, survival or other outcome measures. Rigorous trials of mistletoe extracts fail to demonstrate efficacy of this therapy.     

Are you a cancer survivor? A review on cancer identity

Purpose

Individuals diagnosed with cancer have been shown to interpret the term “cancer survivor” differently and this may have implications for how they cope with their illness. This article reviews the empirical research conducted in the field and aims to formulate recommendations for future research.

Methods

A literature search was conducted on PubMed, PsycInfo, Embase and CINAHL using search strategies customized for each database: standardized subject terms and a wide range of free-text terms for “cancer”, “survivor”, and “identity”. Data from 23 eligible papers were extracted and summarized.

Results

Analysis of the studies revealed that individuals diagnosed with cancer could be categorized into five groups based on their attitudes towards being a cancer survivor: embracing, constructive, ambiguous, resisting and non-salient. Identification as “cancer survivor” was found to be highly prevalent within the breast cancer community (77.9 %) and least among individuals diagnosed with prostate cancer (30.6 %). Self-identifying as a cancer survivor was related to better quality of life and mental wellbeing, with those having a childhood diagnosis more likely to transition successfully into adult care.

Conclusions

The findings show that, for a substantial group of individuals, “cancer survivor” is not a title earned upon receiving a cancer diagnosis or completion of treatment, but an identity that may be embraced in time after deliberation. Future studies should examine the endorsement rate in less common cancers and whether choice of cancer identity varies over time.

Implications for Cancer Survivors

Researchers and healthcare professionals should use caution when using the term “cancer survivor” so as not to alienate anyone who has been diagnosed with cancer but does not identify with it.

     

Pancreatic cancer–Pathology

IntroductionsPancreatic ductal adenocarcinoma (frequently simply being referred to as “pancreatic cancer”) represents the most frequent neoplasm of the pancreas, accounting for 85% to 90% of all pancreatic tumors [1, 2]. According to the definition of the World Health Organization [1], it “prob-ably arises from and is phenotypically similar to pancre     

What do cancer survivors believe causes cancer? (United States)

Objective: To describe cancer survivors beliefs about the causes of prostate, colorectal or breast cancers.Methods: A survey of beliefs about cancer causation was completed by 670 cancer survivors (416 with breast cancer, 165 with prostate cancer and 89 with colorectal cancer) enrolled in a population-based study in Colorado. Categorical analysis was used to describe associations between participants beliefs about the cause of their cancer type, both in themselves and in others, and personal characteristics, including gender, age, and familial cancer risk.Results: Cancer survivors most frequently reported genetic factors, smoking, environmental factors (e.g., pollutants or occupation), and psychosocial factors (e.g., stress) as causing their type of cancer. Respondents underestimated the importance of behavioral factors that are known to be associated with increased cancer risk, such as obesity and physical inactivity, while overestimating the importance of stress and environmental pollution.Conclusions: Cancer survivors beliefs about what causes cancer are substantially different than those of experts. Because those affected by cancer should be well informed about the causes of cancer, educational efforts are needed, especially regarding the importance of factors that can be modified to reduce cancer risk.     

Immunotherapy for cervical cancer: Can it do another lung cancer?

Cervical cancer, although preventable, is still the second most common cancer among women worldwide. In developing countries like India, where screening for cervical cancer is virtually absent, most women seek treatment only at advanced stages of the disease. Although standard treatment is curative in more than 90% of women during the early stages, for stage IIIb and above this rate drops to 50% or less. Hence, novel therapeutic adjuvants are required to improve survival at advanced stages. Lung cancer has shown the way forward with the use of Immunotherapeutic interventions as standard line of treatment in advanced stages. In this review, we provide an overview of mechanisms of immune evasion, strategies that can be employed to boost the immune system in order to improve the overall survival of the patients and summarize briefly the clinical trials that have been completed or that are underway to bring therapeutic vaccines for cervical cancer to the clinics.     

Can national cancer registration support clinical databases and clinical cancer research?

Can national cancer registration support clinical databases and clinical cancer research? The short answer is: Yes, it can. A longer version is: Yes, it can and if it cannot substantially help now, we will have to make sure that it can in the future. In many countries and regions for decades there has been a mandatory registration of new and incident cancers. In many of these countries and regions there is also a rapidly growing interest in keeping clinical databases for clinical audit and research. The discussion about how to marry these two systems is growing, not least because both are time and resource demanding and it is important to get priorities right.     

Pancreatic cancer–Curative resection

Resecting pancreatic cancer is the only chance for cure for this devastating disease [1–3]. It increases survival significantly and may also contribute to a better quality of life [4]. While median survival for patients with unresect-able pancreatic cancer is only about 4–8 months, resective surgery improves prognosis to a median survival of 14–20 months and 5-year survival rates of up to 25% [1, 5]. A few     

Pancreatic cancer–Neoadjuvant therapy

In spite of the high mortality in pancreatic cancer, significant progress is being made. This review discusses multimodality therapy for patients with pancreatic cancer. Surgical therapy currently offers the only potential monomodal cure for pancreatic adenocarcinoma. However only 10%–20% of patients present with tumors that are amenable to resection, and even after resection of localized cancers, long term survival is rare. The addition of chemoradiation therapy significantly increases median survival. To achieve long-term success in treating this disease it is therefore increasingly important to identify effective neoadjuvant/adjuvant multimodality therapies. Preoperative chemoradiation for potentially resectable pancreatic cancer has the following advantages: (1) neoadjuvant treatment would eliminate the delay of adjuvant treatment due to postoperative complications; (2) neoadjuvant treatment could avoid unnecessary surgery for patients with metastatic disease evident on restaging after neoadjuvant therapy; (3) downstaging after neoadjuvant therapy may increase the likelihood for negative surgical margins; and (4) neoadjuvant treatment could prevent peritoneal tumor cell implantation and dissemination caused during surgery. This review systematically summarizes the current status, controversies, and prospects of neoadjuvant treatment of pancreatic cancer.     

Pancreatic cancer–Adjuvant therapy

Pancreatic cancer ranks tenth in terms of newly diagnosed cases, but just 10%–15% of these patients can undergo resection. Survival after curative surgery is dismal, as recurrences occur either locally or in the liver. Adjuvant treatment with either chemotherapy or chemoradiation (with or without maintenance chemotherapy) has been employed, to improve the poor prognosis. Justification for the use of chemoradiation, with follow on chemotherapy, is based on the results of an underpowered 1987 GITSG study, which closed prematurely and compared intervention to observation. There has been no survival advantage demonstrated in the one randomized controlled trial that examined chemoradiation compared to chemotherapy. There is a clear cut survival advantage however with chemotherapy compared to observation, based on the results from two large randomized controlled trials, and supported by an individual patient data meta-analysis. The standard of care for adjuvant therapy based on level I evidence (from the ESPAC-1 trial) is post operative chemotherapy using 5-Fluorouracil with folinic acid providing a best estimate of 29% five years survival.