Heavy Cigarette Smoking On the Decline

A recent report from researchers at the University of California at San Diego has revealed that the habit of smoking at least one pack (20 cigarettes) a day has severely declined over the last fifty years. Investigators observed that the rate of decline was particularly noteworthy in California, where lung cancer rates also fell in proportion to the reduction in smoking rates. The data and the corresponding interpretation of the study were printed in the Journal of the American Medical Association’s March 2011 issue.

The UCSD study showed how much smoking has declined since the early 1960s. According to reports, more than fifty percent of all adult smokers in the US smoked at least one pack per day. That number fell to just over forty percent by 2007. “Moderate” smoking (10 to 20 cigarettes a day) rates also fell. In California, the number of moderate smokers fell from 11.1 percent of all adults in 1965, down to 3.4 percent in 2007. In other states, the number fell from 10.5 percent of all adults down to 5.4 percent.

The study credits much of the decline to smoking education programs. In 1964, the US Surgeon General released the first major findings on the correlation between cigarette smoking and lung cancer. Two years later, the Food and Drug Administration required mandatory warning labels on all cigarette packaging. Today, most cigarette packs and cartons carry warning labels, including warnings about how smoking can complicate pregnancy and lead to low birth rates in pregnant women who smoke.

Another factor attributed to the reduction in smoking rates is the development in new technologies to combat nicotine addiction. One of the primary reasons that smokers find quitting so difficult is the intense nicotine addiction that smoking brings. The invention of nicotine patches, lozenges and gums as part of a smoking cessation program has helped millions of smokers quit the habit over the last twenty years.

In addition to federal mandates requiring the addition of warning labels to cigarette packaging, many state and municipal jurisdictions created anti-smoking laws and ordinances. Several states added higher taxes to cigarettes, with California among the first to enact such statutes. Also, many cities passed local laws prohibiting smoking in bars, restaurants and public buildings.

Public awareness campaigns, such as those conducted by the American Heart Association, the American Lung Association and the American Cancer Society, also helped bring the issues of cigarette smoking to the attention of the American public. The campaigns highlighted many of the dangers that surround cigarette smoking, including lung cancer, throat cancer and emphysema.

As California took the lead in many of the anti-smoking efforts, the study also showed how lung cancer incidence rates declined in the state well before other states saw the same results. Deaths from lung cancer peaked in 1987 in California, with 109 per 100,000. The death rate fell to 77 per 100,000 in 2007. In other states, the lung cancer death rate peaked in 1993 at 117 per 100,000 and fell to 102 per 100,000 in 2007.


Lung Cancer Rates Increase Among British Women

A new report by the group Cancer Research UK compares lung cancer rates in the British population from 1975 to 2008. The report showed that the number of women over sixty years of age diagnosed with lung cancer jumped from 5,700 in 1975 to 15,100 in 2008, an increase of nearly 165 percent in just over thirty years.

Also, the number of women overall diagnosed with lung cancer increased by 125 percent, from 7,800 in 1975 to 17,500 in 2008. By comparison, the number of men over sixty diagnosed with the disease actually fell, from 23,400 in 1975 to 15,100 in 2008.

The report cites the increase in the number of women taking up smoking in the 1960s and 1970s as the reason for the sharp increase. Statistics have shown that between 80 and 90 percent of all instances of lung cancer are tied to smoking.

Dr. Stephen Spiro, a spokesman for the British Lung Foundation, said that lung cancer has surpassed breast cancer as the leading cause of cancer deaths for women in Britain and several European nations. Dr. Spiro praised the efforts of government officials to raise the public’s awareness of the dangers of smoking, but also cited the fact that up to ten million adult Britons, about 20 percent of the population, still smoke.

Jean King, the director of tobacco control for Cancer Research UK, said that the group would continue to support smoking cessation programs. Also, Cancer Research UK is attempting to have advertisements for cigarettes covered or removed from stores that young people might frequent. Ms. King said that the advertising ban would “protect young people from being recruited into an addiction that kills half of all long term smokers”.


Nanoparticles Communicate to Deliver Chemotherapy Drugs

Teams of researchers at opposite ends of the country have recently developed an improved system to deliver chemotherapy drugs to attack malignant cells. Scientists at both the Massachusetts Institute of Technology and the University of California at Sand Diego have devised a method involving microscopic machines known as nanoparticles. Although cancer researchers have used nanoparticles for several years to deliver chemotherapy treatments, this new method employs an added layer of accuracy.

While some cancer-fighting efforts with nanoparticles involve a single nanoparticle, the cooperative effort at MIT and UCSD involves a two-stage delivery system.  The first stage acts as a “scout”, locating the cancerous cells by tracking their protein emissions, which differ from those of health cells. Once the scout particle locates an area of malignant activity, it sends a signal to the second-stage nanoparticles. The second-stage particles deliver the chemotherapy drug and shrink the tumor.

Most methods that use nanoparticles to administer chemotherapy drugs are highly inefficient, with only one percent of the injected medication reaching the target. In tests on laboratory mice, the scientists found that the two-stage system delivered the drugs at 40 times the rate found in most single-stage methods. Geoffrey von Maltzahn, the lead author of the paper on this method, said that the dual-stage method “can improve the efficiency with which (nanoparticles) find and treat diseases like cancer.”

One of the keys to the success of the dual-stage system is that the “scout” particles are actually rod-shaped, microscopic gold particles. In addition to its connotations of wealth, gold is also highly conductive to both heat and electricity. When researchers shone a bright light on areas affected by the gold nanoparticles, the gold heated up and damaged the blood vessels around the tumor.

As the tumor began to bleed, the body sent a signal to its blood-clotting agents to create a protein known as fibrin. The second-stage nanoparticles also picked up on that signal and sent the drug to the bleeding tumor. The particles followed the signal deployed the drug to the tumor site. The blood clot closed around the malignant cells and sealed in the drug. This method improved both the accuracy and efficacy of the drug delivery system.

The method has shown great promise in the laboratory, as it improves the concentration of drugs delivered to the tumor site while greatly reducing the side effects associated with conventional chemotherapy treatments. However, much more research and effort will need to be done to see if it can be applied to human patients. One problem could be that the system could create blood clots in other areas of the body away from the tumor. Blood clots in the brain are often the source of strokes, and clots in the heart can cause pulmonary embolism and death.

“If you’re going to trigger coagulation, you want to be very selective, so that you don’t cause damage in other parts of the body,” said Dr. Anil Sood, an oncology specialist at the MD Anderson Cancer Center in Houston.

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Massachusetts Helps Vets Quit Smoking

State health officials in Massachusetts are developing measures to help the state’s military veterans quit smoking.  The new campaign is the second effort launched since 2008 to help veterans with this growing health problem.  Massachusetts Lieutenant Governor Tim Murray released a statement praising “the brave men and women” in uniform and said that the campaign would help to “provide (veterans) with the opportunity to live long, healthy lives”.

A report from the office of Governor Deval Patrick showed that nearly one-fourth of all Massachusetts veterans smoke cigarettes.  The US Centers for Disease Control and Prevention in Atlanta estimates that less than one-sixth of all adults in the Bay State smoke.  A related report from the Institute of Medicine showed that nearly one in three people on active military duty smoke, with the number rising to half or more among those veterans who have been deployed to war zones in Iraq and Afghanistan.

Coleman Nee, a veteran of the US Marine Corps during Operation Desert Storm in 1991, is now the Massachusetts Secretary of Veterans’ Services.  Mr. Nee also spoke out about the anti-smoking campaign, saying that smoking among veterans is “a very serious problem”.  He said that smoking is an issue for veterans’ services agencies as well as public health groups.  He called the addiction to smoking among service members “a real shame”.

Mr. Nee recalled that, during his time in the Marine Corps, he and other service personnel would receive cigarettes and smokeless tobacco as part of their care packages from home, a tradition that started back in World War I.  He remarked that this practice has since stopped; especially in light of the numerous health problems that smoking is now understood to cause.

A report from the state public health office revealed that cigarette smoking is the number-one cause of preventable disease and death in Massachusetts.  The report also estimates that health care costs for smokers add up to over $4.3 billion annually.

The public awareness campaign for veterans includes a toll-free number that offers support and information on smoking cessation programs.  When the first campaign started in 2008, thousands of veterans called the support hotline and obtained nicotine patches to help them quit the habit.  Massachusetts State Representative James E. Valle, chairman of the Joint Committee on Veterans and Federal Affairs, said that the program shows the state’s commitment to “helping those who have served” in uniform to lead healthier lives.

The moves to help veterans quit smoking come in light of a study commissioned by the Department of Defense in 2009.  The study examined the feasibility of banning smoking among all service personnel within the next decade.  All military bases prohibit smoking indoors, but the study also considers banning the sale of tobacco products on bases, as well as stopping troops in the field from smoking.

However, some military personnel are opposed to any ban on smoking.  Many see smoking as a stress reliever, especially during the heat of battle.  The Defense Department study also found that bases generate millions of dollars from tobacco sales, most of which goes toward covering the costs of programs for dependents and for recreation.


Personalized Vaccines May Help Fight Cancer

Individualized vaccines created from a patient’s own cancer tumor may help boost the immune system’s response to the illness, according to a study conducted at Dartmouth-Hitchcock Medical Center. Early trials of the innovative new treatment option suggest that patient survival can be greatly improved through such vaccinations.

For the study, researchers (led by Richard Barth Jr, chief of general surgery at Dartmouth-Hitchcock) used dendritic cells culled from a patient’s blood to develop a personalized vaccine. Dendritic cells are an integral part of the immune system that seek out hostile antigens. By programming these dendritic cells to target a patient’s unique cancer cell manifestation, the result is an induced immune response to tumors.

As witnessed in the study, the injection of such a vaccine resulted in an effective anti-tumor response in a majority of patients.

The study included 26 patients who had tumors that had spread from the colon to the liver. All patients were surgically treated to remove the tumors. However, metastasized colon tumors are notorious for spawning regrowth following surgery. In an attempt to reduce the chances for the cancer to return, Barth and associates injected the vaccine into patients one month after surgery.

Study representatives report that 60 percent of all patients who received a vaccination displayed a favorable T-cell immune response to their tumors. Of those with a favorable response, 63 percent were alive and free of any signs of cancer after five years of treatment.

In comparison, only 18 percent of patients who did not respond to the immunization were alive and free of cancer during the same time period.

The study shows for the first time that dendritic vaccines may be useful in the treatment of cancer. Previous research efforts have attempted to show that such vaccines may be helpful in fighting larger tumor deposits. While previously unsuccessful, the vaccines may be used in conjunction with surgery to improve a patient’s chances for survival.

Additional studies are required before the efficacy and effectiveness of the treatment option can be validated. According to Barth, “This study isn’t definitive enough for us to say that everyone with colon cancer that spreads to the liver should get the vaccine. A next possible step would be to compare this vaccine with just dendritic cells which have not been pulsed with tumor antigens as a control.”

Findings of the study were published in the November issue of Clinical Cancer Research.


Scientists Find Potential New Skin Cancer Treatments

Scientists at Fred Hutchinson Cancer Research Center in Seattle have found a new method for the treatment for a common form of skin cancer. Researchers at the laboratory, under the direction of Dr. Valeri Vasioukhin, have detected that a protein, known as alpha-catenin, that functions acts as a suppressive agent for squamous cell carcinoma tumors. The research team has also discovered the process by which this protein keeps tumor cell growth in line.

Dr. Vasioukhin’s team studied mice that were genetically engineered not to create the alpha-catenin protein, which is typically found in hair follicles. The scientists noted that the mice without the protein developed squamous cell carcinoma tumors at a faster rate than the control group. Dr. Vasioukhin noted that the cells in the alpha-catenin-deficient mice grew at such a rapid rate that “they become very crowded in the Petri dish”.

The rapid rates of cell growth and proliferation are some of the primary characteristics of cancer cells. Dr. Vasioukhin also said that the fact that the mice without the protein experienced such accelerated rates of cell growth “is an important event in cancer development.” The research team found that alpha-catenin also limits the production of another protein, labeled Yap1. Scientists believe that the Yap1 protein acts as a triggering agent for cells to become malignant.

Dr. Vasioukhin also remarked on the connection between alpha-catenin and Yap1. He noted that, in the mice with alpha-catenin deficiencies, the Yap1 protein was activated. “Therefore, Yap1 is likely to be an excellent target for the treatment of patients with squamous cell carcinoma,” he said. If further tests are successful in isolating the Yap1 protein, future research efforts may be devoted to developing a treatment for squamous cell carcinoma patients based on the alpha-catenin protein.

What is squamous cell carcinoma?

Squamous cell carcinoma is the second-most common form of skin cancer, behind basal cell carcinoma and ahead of melanoma.  According to reports from public health officials, more than 700,000 cases of squamous cell carcinoma are diagnosed each year. The disease affects areas of the skin that receive more exposure to the sun’s harmful ultraviolet rays, including the face, arms, neck and legs.

Treatments for the disease range from topical chemotherapy and radiation therapy to surgical removal of the tumors. Dr. Ian Frazer, an Australian cancer researcher who helped develop the human papilloma virus (HPV) vaccine, is also developing a vaccine to protect patients from squamous cell carcinoma. The vaccine is currently undergoing trials and may be ready for the mass market by 2020.


Vaccine Stops Cancer Before It Starts

The biotechnology company OncoPep is developing a vaccine against a deadly form of cancer before it becomes evident in patients at risk to contract the disease.  The vaccine is designed to prevent the onset of multiple myeloma, a type of cancer that attacks the bone marrow and forms tumors inside the bone.  The disease also strikes the immune system, increasing the production of antibodies and leading to pain and excess bleeding.

The vaccine represents a new step in the growing field of immunotherapy. Scientists who research immunotherapy treatments for various cancers develop methods for the body’s own immune system to combat cancer.  Immunotherapy research had led to the creation of vaccines that can prevent cancer, such as the human papillomavirus (HPV) vaccine that prevents cervical cancer in women. The field has also produced vaccines by programming antibodies to fight cancer as they would fight infections or other diseases.

The myeloma vaccine fits in an intermediate stage in cancer treatment. The primary treatment group would consist of patients who have a preliminary, pre-cancer stage of the disease, known as smoldering multiple myeloma (SMM).  Patients with SMM have abnormal growth rates in the plasma cells that create antibodies, but do not have the tumors and other symptoms that come with the full onset of the disease.

A team of researchers at the Dana Farber Cancer Institute in Boston developed a method to administer a vaccine made up of a mix of protein molecules called peptides.  The peptides contain protein molecules that myeloma tumors require for sustained life and growth.  As the antibodies attack the peptides, they also attack the myeloma cells. The immune system then robs the cancer cells of the proteins they need to survive.

Just as with blood types, doctors have classified patients into different types of immune systems, called “human leukocyte antigen (HLA) types”.  Doctors commonly use HLA typing to match donors and recipients in bone marrow transplants.  Researchers on the myeloma vaccine will target the treatment at patients with the most common HLA type, known as HLA type A2. Doris Peterkin, CEO of OncoPep, said that the peptides were more likely to trigger the needed antibodies in patience with the most common HLA type, and would be more effective in preventing SMM from becoming full myeloma.

As promising as the preliminary results have been, the road to a vaccine for multiple myeloma is still a long one.  Although patients with SMM develop full myeloma in almost 80 percent of all cases, only 10 percent of those cases progress to that stage each year.  OncoPep and the research team will still need to collect data for several years on the effectiveness of the vaccine before it will be ready for the wider marketplace.

Dr. Kenneth Anderson, one of the research team leaders who developed the vaccine, said that he hopes it could be used as a preventative measure for patients with SMM, who currently do not have treatment options available until the disease becomes full-blown myeloma.  “The idea (behind the vaccine) would be to prevent the development of an active cancer, ” Dr. Anderson said.


Breast Cancer Drug May Help Fight Lung Cancer

A new study from researchers at the University of Geneva shows that the breast cancer drug Tamoxifen may also be useful in combating lung cancer. The study found that women who were undergoing treatment for breast cancer, with Tamoxifen as part of their chemotherapy routines, also showed a reduced death rate from lung cancer. The research team examined data from women who received Tamoxifen from 1980 to 2003 and found that the death rate from lung cancer in those patients was eighty-seven percent lower than those who did not take the drug.

Tamoxifen has been used for decades to suppress the production of estrogen, a female sex hormone. Previous research efforts have tied the production of estrogen to breast cancer. Recent studies have also linked hormone replacement therapy, often prescribed to post-menopausal women, to an increased incidence of lung cancer. One of the premises of the Geneva study was to learn if suppressing hormones could be used as a therapy to treat lung cancer.

The study data did not show a decrease rate in the appearance of lung cancer in women who took Tamoxifen, but the results did show a remarkable reduction in the mortality rate from the disease. Dr. Elisabetta Rapiti, the study’s team leader, said that the data shows clear signs, “that there is a hormonal influence on lung cancer”. She also cited earlier findings that showed that lung cancer cells have receptors for estrogen and progesterone, another female sex hormone, which suggests that the mutated cells could feed off the hormones.

Oliver Childs, the senior science information officer at the British research facility Cancer Research UK, told reporters that it was “possible” that Tamoxifen and other anti-estrogen drugs could also have a positive effect on lung cancer patients. However, he also said that the results from the Geneva study were inconclusive since “the number of women who developed lung cancer (in the study) was small”.

In Dr. Rapiti’s study, out of more than six thousand patient records examined, only forty of the women showed signs of lung cancer. Less than half of the Geneva study patients underwent treatment with Tamoxifen or other hormone suppressants, and only one-third of the patients had ever smoked. The study data shows that nearly as many smokers used Tamoxifen as underwent other kinds of chemotherapy for their breast cancer.

The study authors also mentioned that the data was incomplete in places, including how the breast cancer diagnosis affected the women’s smoking behaviors. They also mentioned that they often lacked specific information on the types and dosages of anti-estrogen therapies the women received during their chemotherapy treatments.

Mr. Childs said that “large-scale clinical trials” would be necessary to determine how Tamoxifen could be used as a potential weapon against lung cancer. Dr. Rapiti also mentioned “prospective studies” to examine the findings further. She also said that, if any new studies confirm the earlier findings, it “could have substantial implications for clinical practice” in the treatment of lung cancer.

Sources: http://www.bbc.co.uk/news/health-12243206 http://www.medpagetoday.com/HematologyOncology/LungCancer/24487 http://www.financialexpress.com/news/Breast-cancer-drug-may-also-cut-lung-cancer-deaths–Study/741687/

Scientists Attempt to Widen Range of Targeted Cancer Drugs

The development of new chemotherapy drugs that target cancerous tumor cells – while leaving healthy cells alone – has been a breakthrough in the cancer treatment field. However, these treatments have been shown to work only on a select few patients. Even when they do work, the tumor can create a resistance to the drugs, leaving the patient with fewer options. Several scientific research teams are working on new drugs that will work with a wider range of patients and target tumors before they can develop a resistance to the treatments.

The main component in the research behind these new cancer drugs comes from a deeper knowledge of how cancer cells come into being, grow, multiply and spread throughout the body.  One study at the Massachusetts Institute of Technology examines lung cancer cells and how scientists can synthesize drugs that can target the tumors.  The treatments can also be modified to help the patient as they proceed through the chemotherapy routines.

The MIT study takes a close look at a class of drugs known as “epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors”. Tyrosine kinase is a protein that functions as an “on/off” switch for many cell functions. When the proteins that regulate cell growth are permanently set in the “on” position, the cells can grow quickly and in uncontrolled ways, a common occurrence in cancer cells. Tyrosine kinase inhibitors act to slow down or stop the wild cell growth and stabilize or reduce the size of lung cancer tumors.

EGFR inhibitors are effective in less than 40 percent of all lung cancer patients. The drug’s effectiveness varies widely based on the patient’s medical history, smoking habits, race, gender and ethnicity. Dr. Philip Sharp, Professor at the Koch Institute for Integrative Cancer Research at MIT, said that laboratories around the world have “hundreds of drugs” that are in various stages of testing and development. “To personalize cancer care, we must interpret changes in (tumors) to predict the correct drug combination to use.”

Another factor in customizing cancer treatments is that some patients carry a mutation in the gene for EGFR, which makes the drugs more effective. The MIT study examined the differences between those patients and patients that did not respond to the drug. MIT researcher Doug Lauffenburger, along with a team of researchers, developed mathematical models to simulate the behavior of different types of cancer cells. The models revealed that the cancer cells that responded to the drug had a slower uptake of EGFR than the less responsive tumors.

While these methods require further verification, scientists are hopeful that the findings can lead to a possible screening test for lung cancer patients to determine the effectiveness of EGFR inhibitors in individual cases. Lauffenburger and his team also learned that the EGFR inhibitors could be more effective in certain cases when combined with another class of chemotherapy drug known as MEK inhibitors, which are often used to treat melanoma. In terms of tailoring drug combinations to individual patients, Dr. Sharp remarked that these findings “indicate that this is beginning to become possible.”

Sources: Technology Review, Medscape.com

Daily Aspirin May Lower Risk for Cancer

The simple act of taking aspirin once a day may dramatically reduce an individual’s likelihood of dying from cancer, according to a study conducted at the John Radcliffe Hospital in Oxford.

The primary focus of the Oxford study was to look at how aspirin affects death rates associated with stroke and heart attack. However, the team also decided to look at how many patients involved in the study eventually died from cancer. Remarkably, a comparison of patients given around 50 mg of aspirin daily and patients given a placebo shows that those given aspirin were 21 percent less likely to die from cancer.

This percentage is based off the participation of 25,570 patients that took part in eight different aspirin-related trials. Each trial lasted for four to eight years. Of all patients who took part in the study, 674 eventually died from cancer.

Interestingly, cancer death rates remained low for aspirin-taking patients long after the trials were completed. Five years after the trials, cancer-related deaths were 35 percent lower for all types of cancer and 54 percent lower for gastrointestinal cancers. After a full 20 years after the completion of the study, results show that aspirin-taking participants still displayed a 20-percent reduction in cancer deaths.

The study also shows that the positive effects of aspirin in relation to cancer take several years to show a measurable advantage. Specifically, it is estimated that aspirin must be take every day over a five-year period to reduce the probability of being diagnosed with lung, brain, pancreatic and esophageal cancers. Positive effects related to stomach and colorectal cancer require ten years of daily intake and prostate cancer requires 15 years.

Scientists are as of yet unclear as to how aspirin may help ward off cancer. However, it has been proposed that the medicine may inhibit specific enzyme functions that spur tumor growth.

Though researchers stop short of recommending the daily use of aspirin for everyone, they do suggest it may be helpful for some individuals. Through the research, it was found that taking aspirin doses above 75 mpg daily does not result in added health benefits. However, it was determined that individuals in their 40s and 50s responded most effectively to the effects of daily aspirin consumption.

Though the potential benefits of a daily aspirin may spur some to begin a daily regimen, it should be noted that the risk of internal bleeding increases with frequent aspirin consumption.