Stomach Bug Outbreak Linked to Salad Mix

Health officials are eyeing salad mix in a multi-state outbreak of cyclospora, a stomach-sickening parasite contracted through contaminated food.

The Nebraska Department of Health announced today that a prepackaged salad mix was the source of the stomach bug that has sickened 78 Nebraskans since mid-June. The Iowa Department of Health said the same, blaming a mixture of iceberg and romaine lettuce, carrots and red cabbage for the diarrhea-causing parasite contracted by at least 143 Iowans.

Read about how produce is a common culprit in food-borne illness.

At least 80 percent Iowa’s cyclospora patients had eaten the prepackaged salad mix, according to an investigation by the state’s health department. But officials have yet to name the salad’s manufacturer, emphasizing that it’s no longer on store shelves.

“Iowans should continue eating salads, as the implicated prepackaged mix is no longer in the state’s food supply chain,” Steven Mandernach, chief of the Food and Consumer Safety Bureau of the Iowa Department of Inspections and Appeals,?said in a statement.

More than 370 people have contracted the stomach bug in 15 states, according to the U.S. Food and Drug?Administration. The source of the infection in states other than Nebraska and Iowa, which include?Texas,?Wisconsin, Arkansas,?Connecticut, Florida, Georgia, Illinois, Kansas, Minnesota, Missouri, New Jersey, New York and Ohio, remains unclear.

“FDA will continue to work with its federal, state and local partners in the investigation to determine whether this conclusion applies to the increased number of cases of cyclosporiasis in other states,” the FDA said in a statement.?”Should a specific food item be identified, the FDA, the U.S. Centers for Disease Control and Prevention, state and local partners will work to track it to its source, determine why the outbreak occurred, and if contamination is still a risk,?implement preventive action, which will help to keep an outbreak like this from happening again.”

The infection, which beyond diarrhea can cause fatigue, weight loss, stomach cramps, vomiting, muscle aches and low-grade fever, can be cleared with antibiotics. But without treatment, the symptoms can linger for months.

People who are “in poor health or who have weakened immune systems” are more likely to have a severe or prolonged illness, according to the CDC.

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FDA Slaps 'Black Box' Warning on Malaria Drug Linked to Killings

The FDA has strengthened the warning on the malaria drug, mefloquine hydrochloride. (Image credit: drugsee.com)

A common malaria drug that has been linked to the case of Staff Sgt. Robert Bales, who has pleaded guilty to killing 16 Afghan civilians last year, will carry a “black box” warning, the Food and Drug Administration said Monday.

The FDA says the drug, mefloquine hydrochloride, which was once marketed in the United States as Lariam, could cause serious neurological and psychiatric side effects that might become permanent. Such a warning on the revised patient Medication Guide dispensed with each prescription and wallet card is the most serious kind of warning about these potential problems, the FDA says.

Bales, who is facing a possible life sentence by a military court for the rampage in Afghanistan, might have used the antimalarial drug given routinely to soldiers in that part of the world. His lawyer, John Henry Browne, has said that he has documents indicating that Bales took mefloquine while in Iraq, but medical records in Afghanistan were incomplete.

Mefloquine was developed by the U.S. military and has been used for more than three decades by the government to prevent and to treat malaria among soldiers and Peace Corps workers.

Its temporary side effects are well-known: vivid dreams or hallucinations, ringing in the ears, depression and hallucinations. But the FDA now says symptoms like dizziness and loss of balance could become permanent. Psychiatric symptoms could continue for months or years.

The drug can cause varying neurological side effects 5 to 10 percent of the time, according to Dr. David Sullivan, an infectious disease specialist at the? Johns Hopkins Malaria Research Institute in Baltimore.

The manufacturer also warns against prescribing it to anyone who has suffered a seizure or brain injury, according to the drug label.

An adverse-event report from the FDA recently emerged from March of 2012, written by an unidentified pharmacist, that cites a soldier-patient in the U.S. Army who “developed homicidal behavior and led to homicide killing 17 Afghanis.”

Bales is not named in that anonymous report, which, if it refers to the same man, erroneously lists 17 dead, rather than 16.

A study of FDA adverse-event reports from 2004 to 2009 published in the journal PLOS One lists mefloquine as a drug that has been associated with violent behavior.

Mefloquine was first developed in the 1970s at the U.S. Department of Defense’s Walter Reed Army Institute of Research as a synthetic analogue of quinine, the first effective treatment for malaria. It was licensed in 1989 by the FDA for use against chloroquine-resistant malaria.

The brand-name drug, Lariam, is manufactured by the Swiss company Hoffmann-La Roche.

The company has not manufactured the drug in the United States since 1998 when generic forms of? mefloquine became available. But, according to Sullivan, Lariam is still available and “lingers on the market.”

Company senior spokesman Chris Vancheri told ABCNews.com earlier this month that generic mefloquine “distributed by other companies continues to be approved by the FDA as safe and effective medicines.”

Infectious disease expert Sullivan said mefloquine is largely safe and that he, too, takes a weekly dose of it when traveling and has “never had any side effects.”

Sullivan said the military widely uses antimalarial drugs in Afghanistan, but mefloquine is not the first choice.

The military has several drugs in its arsenal for prophylactic (preventive) treatment of malaria, a mosquito-borne disease that causes fever, chills and flu-like illness that, if left untreated, can cause death. An estimated 219 million cases of malaria occurred worldwide and 660,000 people died in 2010, most in Africa, according to the U.S. Centers for Disease Control and Prevention.

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Deadly Outbreak May Be Linked to Cheese

 

A deadly listeria outbreak, which may be linked to specialty cheeses, has sickened four people and killed one, according to the U.S. Food and Drug Administration.

The outbreak of the potentially deadly bacterial infection has been linked to cheeses produced by Crave Brothers Farmstead Cheese in Wisconsin. According to the FDA, the Minnesota Department of Agriculture is testing samples of the cheese and early results indicate that there is listeria bacteria present in the samples. Confirmation of these results is pending.

The company has voluntarily recalled certain cheeses that were made on or prior to July 1, 2013, including their les freres cheese, the petit frere cheese and the petit frere cheese with truffles.

"We are cooperating with the regulatory agencies' ongoing investigation of the cause of the potential health risks," George Crave, president of the company, said in a statement posted on the company's website.

Calls to Crave Brothers were not immediately returned. The FDA and the Wisconsin Department of Agriculture are investigating the company's processing facilities.

According to the FDA, five people between the ages of 31 and 67 have been hospitalized and one person has died as a result of the outbreak. One pregnant woman is believed to have suffered a miscarriage as a result of contracting the disease. Cases were reported in Minnesota, Illinois, Indiana and Ohio.

If ingested, the listeria bacteria can cause listeriosis, a rare and serious illness. The disease can cause fever, muscle aches, diarrhea or other gastrointestinal issues. In pregnant women it can cause miscarriages or stillbirths.

Read more about other deadly listeria outbreaks.

Older people, pregnant women, newborns or people with weakened immune systems are at the highest risk for contracting the disease and make up 90 percent of listeria infections, according to the Centers for Disease Control.

In 2011 a listeria outbreak related to tainted cantaloupes sickened 147 and killed 33 people.

Find out which foods are riskiest for foodborne illness.

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5 Hazards Linked to Sleepless Nights

Beyond leaving you drowsy and irritable, sleepless nights can take a serious toll on your physical and mental health.

"We know sleep is a critical biological function that influences a wide variety of physiological process," said Dr. Susan Redline, a sleep specialist at Brigham and Women's Hospital in Boston. "Sleep deficiency can affect mood and the ability to make memories and learn, but it also affects metabolism, appetite, blood pressure, levels of inflammation in the body and perhaps even the immune response."

Lack of sleep has been linked to stroke, obesity, diabetes, anxiety, depression and the country's No. 1 killers: heart disease and cancer. Read on to learn the health hazards of sleep deficiency and how you can sleep better.

Getting seven hours of shuteye after a day of healthy eating and moderate exercise can lower the risk of heart disease by up to 65 percent, according to a new study published in the European Journal of Preventive Cardiology.

"It is always important to confirm results," study author Monique Verschuren of the National Institute for Public Health and the Environment in the Netherlands said in a statement. "But the evidence is certainly growing that sleep should be added to our list of [cardiovascular disease] risk factors."

The study adds to mounting evidence that sleep is key to heart health. A 2011 study published in the European Heart Journal found people who slept fewer than six hours a night were 48 percent more likely to develop or die from heart disease.

6 Easy Ways to Boost Your Heart Health

A study of more than 5,600 people found those who slept fewer than six hours a night were more likely to suffer a stroke than their well-rested counterparts.

"We speculate that short sleep duration is a precursor to other traditional stroke risk factors, and once these traditional stroke risk factors are present, then perhaps they become stronger risk factors than sleep duration alone," Megan Ruiter of the University of Alabama at Birmingham said in a statement.

Stroke risk is also higher in people who are overweight, diabetic or hypertensive -- all conditions linked to poor sleep.

9 Ways To Prevent a Stroke

Sporadic and irregular sleep can raise blood sugar levels and slow the body's metabolism, increasing the risk of obesity and diabetes, according to an April 2012 study published in the journal Science Translational Medicine.

"The evidence is clear that getting enough sleep is important for health," said study author Orfeu Buxton, a neuroscientist at Brigham and Women's Hospital in Boston.

Sleep deficiency can also lead to bad food choices, according to a study that found the sight of unhealthy food activated reward centers in the brains of sleep-deprived people.

"The results suggest that, under restricted sleep, individuals will find unhealthy foods highly salient and rewarding, which may lead to greater consumption of those foods," said study author Marie-Pierre St-Onge from St. Luke's Roosevelt Hospital Center and Columbia University in New York. "Indeed, food intake data from this same study showed that participants ate more overall and consumed more fat after a period of sleep restriction compared to regular sleep."

7 Surprising Effects of Obesity

Sure, sleepless nights make for miserable mornings. But chronic sleep deficiency can lead to anxiety and depression -- both serious mood disorders.

"People feel more anxious, restless, irritable, less satisfied," said Dr. Mark Dyken, director of the University of Iowa's Sleep Disorders Center in Iowa City, adding sleep deficiency can impact careers and relationships. "They have difficulty focusing and sometimes feel like they just don't care anymore."

Brain imaging suggests sleep deprivation can boost activity in the brain's emotional centers, according to a study presented at the Associated Professional Sleep Societies in Boston.

"Our results suggest that just one night of sleep loss significantly alters the optimal functioning of this essential brain process, especially among anxious individuals," study author Andrea Goldstein from the Sleep and Neuroimaging Laboratory at the University of California, Berkeley, said in a statement. "This is perhaps never more relevant considering the continued erosion of sleep time that continues to occur across society."

9 Simple Steps to Happiness

Sleep deficiency has also been linked to an increased risk of cancer.

A 2008 study published in the British Journal of Cancer found women who slept fewer than six hours a night were more likely develop breast cancer, and a 2010 study published in the journal Cancer found those who slept fewer than six hours a night were more likely to have colorectal polyps, which can lead to colon cancer.

The biological mechanisms are unclear, but lack of sleep has been shown to boost levels of inflammation in the body and interfere with the immune response, both of which have been implicated in cancer.

"Sleep is restorative," said Dyken. "And if you don't get it, your health will suffer."

Know Your Risks for Breast Cancer

With hectic work and family schedules, getting a good night's sleep is no easy feat. But experts say a little planning can go a long way, helping you feel refreshed the next morning and for many to come.

"Make sure your bedroom is dark and quiet, and avoid reading anything that's going to make you excited or worried," said Dyken. "Try not to exercise or eat a big meal within three hours of your bedtime, but don't go to bed hungry, either."

Caffeine and alcohol can also interfere with sleep, according to Redline.

"Much of sleep deficiency is self-inflicted," she said. "But adults should do their best to get to bed at regular times and aim to have seven-and-a-half hours on average of sleep. Set your schedule such that you honor and respect your sleep needs."

16 Best and Worst Foods for Sleep

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Decline in Use of Menopausal Hormones Linked with Lower Breast Cancer Rates

According to the results of a study conducted in Canada, the sharp drop in use of combined (estrogen plus progestin) hormone therapy that occurred between 2002 and 2004 was accompanied by a decrease in breast cancer incidence. These results were published in the Journal of the National Cancer Institute.

As women reach menopause and beyond, more than 80% will experience symptoms such as hot flashes, night sweats, sleep disturbance, and vaginal dryness. Estrogen, with or without progestin, is an effective treatment for many of these symptoms. Over the last several years, however, studies have raised important concerns about the health effects of menopausal hormone therapy.

In 2002, a report from the Women’s Health Initiative indicated that combined hormone therapy increased the risk of breast cancer, heart disease, stroke, and blood clots.? Use of combined hormone therapy decreased the risk of fractures and colorectal cancer, but these benefits were thought to be outweighed by the risks for most women.

After this report, use of combined hormone therapy declined markedly. Studies from several countries—including the United States—suggest that this decline in hormone use was followed by a decline in breast cancer incidence rates.

To evaluate trends in hormone use and breast cancer in Canada, researchers collected information about women between the ages of 50 and 69 who participated in the National Population Health Survey between 1996 and 2006.

Between 2002 and 2004, the percent of women who used combined hormone therapy decreased from 12.7% to 4.9%. During this same period, the rate of breast cancer declined.Since 2005 there has been some rebound in breast cancer rates. This suggests that avoidance of hormone therapy may act primarily by slowing the growth of breast cancer (rather than preventing breast cancer). Mammography rates remained stable throughout the study period.The study did not have information about the hormone receptor status of the breast cancers that were diagnosed, nor was information available about duration of hormone use.

The researchers conclude that between 2002 and 2004, a decline in hormone therapy use in Canada was accompanied by a decline in breast cancer incidence.

Additional research is warranted to determine the biologic link between hormone therapy and breast cancer. The results of the current study suggest that combined hormone therapy may speed the growth of breast cancers.

Reference: De P, Neutel I, Olivotto I, Morrison H. Breast cancer incidence and hormone replacement therapy in Canada. Journal of the National Cancer Institute [early online publication]. September 23, 2010.

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BRCA1/2 Mutations Linked with Better Outcome in Triple-negative Breast Cancer

According to the results of a small study, approximately 20% of women with triple-negative breast cancer are carriers of a BRCA1 or BRCA2 gene mutation. Triple-negative breast cancer patients with these mutations appear to have better survival than patients without these mutations. These results were recently presented at the 2010 Breast Cancer Symposium.[i]

Some breast cancers display different characteristics that require different types of treatment. The majority of breast cancers are hormone receptor-positive, meaning that the cancer cells are stimulated to grow by exposure to the female hormones estrogen and/or progesterone. These cancers are typically treated with hormonal therapy that reduces the production of these hormones or blocks their effects.? Other cancers are referred to as HER2-positive, which means that they overexpress the human epidermal growth factor receptor 2, part of a biologic pathway that is involved in replication and growth of a cell. HER2-positive breast cancers account for approximately 20-25% of breast cancers and are treated with agents that target the receptor to slow growth and replication.

Triple-negative breast cancer refers to cancers that are estrogen receptor-negative, progesterone receptor-negative, and HER2-negative. Triple-negative breast cancers tend to be more aggressive than other breast cancers and have fewer treatment options. Research is ongoing to determine prognostic factors such as gene mutations that may impact prognosis and help to individualize care.

In the current study, researchers from the M. D. Anderson Cancer Center evaluated the frequency and effects of BRCA1 and BRCA2 gene mutations among 77 women with triple-negative breast cancer. Inherited mutations in these genes can be passed down through either the mother’s or the father’s side of the family and greatly increase the risk of breast and ovarian cancer.

15 of the 77 patients (20%) had a BRCA1 or BRCA2 mutation. Five-year relapse-free survival was 86% for patients with a BRCA mutation compared with 52% for patients without a BRCA mutation.

The researchers concluded that triple-negative breast cancer patients with BRCA mutations experienced a significantly lower recurrence rate. These findings were unexpected because previous studies had not shown a difference in recurrence rates.

Patients with triple-negative breast cancer may wish to speak with their healthcare team regarding the risks and benefits of genetic testing.

It should be noted that other studies have not found as high a rate of BRCA mutations in women with triple negative breast, so it is possible that the results of this study represent an overestimate.

[i] Gonzalez-Angulo M, Chen H, Timms K, et al. Incidence and outcome of BRCA mutation carriers with triple receptor-negative breast cancer (TNBC). Presented at the 2010 Breast Cancer Symposium, Washington, DC, October 1-3, 2010. Abstract 160.

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Alcohol Linked with Lobular Breast Cancer

Although alcohol is a well-established risk factor for breast cancer, it may be more strongly linked with lobular breast cancer than with ductal breast cancer. These results were published in the Journal of the National Cancer Institute.

Research suggests that each 10 gram (slightly less than one drink) increase in daily alcohol consumption increases the risk of breast cancer by roughly 7%-10%.[1] [2] This is a fairly modest increase in risk, but breast cancer is a common cancer; even a small increase in risk may translate into many additional cases on a population level.

Several studies have suggested that the relationship between alcohol and breast cancer varies by the hormone receptor status of the breast cancer. Alcohol tends to be more strongly linked with hormone receptor-positive breast cancer than with hormone receptor-negative breast cancer.

Fewer studies have explored whether the relationship between alcohol and breast cancer varies by type of breast cancer (ductal or lobular). Ductal carcinomas account for roughly 70% of invasive breast cancers in the United States, and lobular carcinomas account for 15%-20% of invasive breast cancers.???

To assess the relationship between alcohol and type of breast cancer, researchers evaluated information from the Women’s Health Initiative (WHI) Observational Study.[3] Among more than 87,000 postmenopausal women enrolled in the study, 2,944 developed breast cancer during follow-up.

Information about alcohol intake was collected by questionnaire at the time of study enrollment. ?

As expected, alcohol intake was more strongly linked with hormone receptor-positive breast cancer than hormone receptor-negative breast cancer. Compared with never drinkers, women who consumed seven or more drinks per week had an almost two-fold increase in risk of hormone receptor-positive breast cancer, but no significant increase in risk of hormone receptor-negative breast cancer. When looking at type of breast cancer, alcohol increased the risk of lobular carcinoma but did not appear to significantly increase the risk of ductal carcinoma. The rate of hormone receptor-positive, lobular breast cancer was 5.2 per 10,000 women per year among never drinkers and 8.5 per 10,000 women per year among current drinkers. By comparison, the rate of hormone receptor-positive, ductal carcinoma was 15.2 per 10,000 per year among never drinkers, and 17.9 per 10,000 per year among current drinkers.

An important limitation of the study is that information about alcohol intake was collected only at the time of study enrollment. The analysis did not account for changes in alcohol intake that may have occurred after study enrollment.

The researchers conclude “Although one of the well-known risks of alcohol is an increased risk of breast cancer, this study suggests that alcohol primarily increases risk of lobular and hormone receptor-positive breast cancer.”

References:

[1] Collaborative Group on Hormonal Factors in Breast Cancer. Alcohol, tobacco and breast cancer – collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 without the disease. British Journal of Cancer. 2002;87:1234-1245.

[2] Key J, Hodgson S, Omar RZ et al. Meta-analysis of alcohol and breast cancer with consideration of the methodological issues. Cancer Causes & Control. 2006;17:759-70.

[3] Li C, Chlebowski RT, Freiberg M et al. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women’s Health Initiative Observational Study. Journal of the National Cancer Institute. Early online publication August 23, 2010.

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Depressive symptoms are linked to premature death among Cancer Survivors

Main category: Cancer / Oncology
Also included in: Depression;??Colorectal cancer;??Lymphoma / leukemia / myeloma
Article Date: 20 may 2013-0:00 PDT current ratings for:
Depressive symptoms are linked to premature death among Cancer Survivors

Surviving cancer depressed are twice as likely to die prematurely than those who do not suffer from depression, regardless of the site of the cancer. This is according to a new study, Floortje Mols and his colleagues, from the University of Tilburg in the Netherlands. Their work is published online in the Journal from Springer to Cancer survival.

The prevalence of cancer is on the rise, as are the number of people who are cured of their cancer or live with it as a chronic disease. This is partly due to the aging of the population and more effective treatments. Thus, many of these survivors face persistent problems due to cancer and its treatments, such as a high prevalence of depression.

Mols and the team considered whether symptoms of depression observed between one and ten years after the diagnosis of cancer were related to an increased risk of premature death of two or three years later. Their work focused on endometrial cancer survivors, colorectal, lymphoma or multiple myeloma, where little work by watching this possible link was made so far.

They analyzed data collected from several major surveys on the population in 2008 and 2009. A total of 3,080 cancer survivors completed questionnaires to identify the symptoms of depression.

The authors found that depression increased the risk of death: high levels of depressive symptoms clinically were more common in those who died than those who survived. Overall, after controlling for treatment, cancer type, comorbidity, and metastasis, cancer one-to-ten years suffering from depression survivors were two times more likely to have died at the beginning.

The researchers conclude: "attention to the recognition and treatment of depressive symptoms in this group of patients is the key. The next step is to study possible mechanisms that could explain the association between depressive symptoms and the death from cancer. We also need to better understand if the treatment of depressive symptoms in cancer patients have effects extend the life. ?

Article adapted by Medical News Today press release original. Click on "references" tab above for the source.
Visit our cancer / Oncology section for the latest news on this subject. Mols, f. et al. (2013), depressive symptoms are a risk factor for all-cause mortality: results of a prospective study on the population among 3,080 cancer survivors from the register of profiles, Journal of Cancer survival. DOI 10.1007/s11764-013-0286-6
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Fish Oil Linked to Reduction in Breast Cancer Risk

A recent study suggests that regular use of fish oil supplements may reduce the risk of breast cancer. These findings were published in the journal of Cancer Epidemiology, Biomarkers & Prevention.[1]

Dietary supplements are a booming business—Americans are spending approximately $25 billion a year to supplement their diets with products containing vitamins, herbs, and botanicals, as well as other supplements such as glucosamine, probiotics, and fish oils. A variety of studies have shown essential fatty acids to be beneficial; the omega-3 fatty acids found in fish oil—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—are especially good. Fish oil has previously been reported to reduce heart disease risk, making its implications in cancer prevention an area of interest. Researchers from the Fred Hutchinson Cancer Research Center recently evaluated what, if any, impact specialty supplements have on breast cancer risk.

In this study, more than 35,000 postmenopausal women completed a 24-page questionnaire to evaluate their use of non-vitamin, non-mineral “specialty” supplements. The women in this study did not have a history of breast cancer and did not have breast cancer when they enrolled in the study. During six years of follow-up, 880 study participants developed breast cancer. Of the specialty supplements used by the women in this study, only fish oil was associated with a reduced risk of breast cancer. Risk of breast cancer was 32% lower among women who regularly used fish oil supplements.

The results of this study will need to be confirmed by additional studies. The researchers note: “Fish oil is a potential candidate for chemoprevention studies. Until that time, it is not recommended for individual use for breast cancer prevention.” Because the full range of effects of many dietary supplements is not well understood, patients should talk with their doctor about any dietary supplements that they are using or considering.?

Reference:

[1] Brasky TM, Lampe JW, Potter JD et al. Specialty Supplements and Breast Cancer Risk in the VITamins And Lifestyle (VITAL) Cohort, Cancer Epidemiology, Biomarkers & Prevention. 2010; 19(7):1696–708.

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Lynch Syndrome Also Linked with Breast and Pancreatic Cancer

A study of families with Lynch Syndrome has expanded the list of cancers related to the condition: carriers of a Lynch Syndrome gene mutation also appear to have an increased risk of breast cancer and pancreatic cancer. These results were published in the Journal of Clinical Oncology.?

Lynch Syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), results from inherited mutations in genes involved in DNA mismatch repair. These mutations greatly increase the risk of developing colorectal cancer. In individuals with Lynch Syndrome, the average age at diagnosis of colorectal cancer is about 44 years, compared with 64 years in the general population. Overall, roughly 3% to 5% of all colorectal cancers are thought to result from Lynch Syndrome. Several other types of cancer are also known to be more common in people with Lynch Syndrome, including cancers of the endometrium (the lining of the uterus), ovary, small intestine, ureter, and renal pelvis.????

To further explore cancer risk in families with Lynch Syndrome, researchers conducted a study among 446 people with a Lynch Syndrome gene mutation, and 1,029 family members who did not carry a gene mutation.????

Study subjects were followed for a median of five years.????

Compared with the general population, people with a Lynch Syndrome gene mutation were 20 times more likely to develop colorectal cancer, 31 times more likely to develop endometrial cancer, 19 times more likely to develop ovarian cancer, 11 times more likely to develop kidney cancer, 11 times more likely to develop pancreatic cancer, 10 times more likely to develop stomach cancer, 10 times more likely to develop bladder cancer, and 4 times more likely to develop female breast cancer.?Family members without the gene mutation did not have an increased risk of cancer (cancer risk was similar to that of the general population).???

This study confirms that people with Lynch Syndrome have an increased risk of several types of cancer, including some (breast and pancreatic cancer) that were not previously known to be linked with Lynch Syndrome.?????

People who come from a family with Lynch Syndrome but who do not carry the gene mutation themselves do not appear to be at increased risk of cancer.?

Reference: Win AK, Young JP, Lindor NM et al. Colorectal and other cancer risks for carriers and noncarriers from families with a DNA mismatch repair gene mutation: a prospective cohort study. Journal of Clinical Oncology. Early online publication February 13, 2012.?

Posted February 20, 2012

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Older Chemotherapy Regimen for Breast Cancer Linked with Persistent “Chemo Brain”

Women who received CMF chemotherapy for breast cancer between 1976 and 1995 scored slightly lower than women with no history of cancer on tests of word learning, memory, and information processing. These results were published in the Journal of Clinical Oncology.?

Studies of “chemo brain”—the foggy thinking and forgetfulness that patients may experience after chemotherapy—have suggested that the condition often improves with time. Some patients, however, may experience persistent problems.?

CMF is a chemotherapy regimen that was once commonly used in the treatment of breast cancer. It involves a combination of cyclophosphamide, methotrexate, and 5-fluorouracil. ?

To explore long-term effects of CMF on cognitive function, researchers in Europe conducted a study among 196 breast cancer survivors who had been treated with CMF between 1976 and 1995. The cognitive function of these women was compared with the cognitive function of more than 1,500 women who had never had cancer.?????

The cognitive test scores of the women who had been treated with CMF were slightly lower than the scores of the women who had never had cancer. Scores were lower in the areas of word learning, memory, and information processing speed. ?The reduction in test scores among the CMF-treated women was comparable to roughly six years of age-related cognitive decline.?

Although CMF is given less frequently than in the past, it is still used in some patients.? It is not known how other chemotherapy regimens affect long term cognitive function.? For women who are experiencing subtle but persistent cognitive problems, coping strategies—such as developing systematic daily routines and preparing well for activities such as work or travel—may be helpful.????

Some people appear to be more likely than others to experience long-term cognitive problems after chemotherapy, and researchers are looking into the reasons for this.?

Reference: Koppelmans V, Breteler MMB, Boogerd W, Seynaeve C, Gundy C, Schagen SB. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy. Journal of Clinical Oncology. Early online publication February 27, 2012.?

Posted March 1, 2012

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Breast Brachytherapy Linked with More Complications and Higher Mastectomy Rate

Among women with early-stage breast cancer, use of brachytherapy to administer radiation therapy may result in more post-operative complications than conventional external beam radiation therapy, and may also increase the likelihood that a woman will later require a mastectomy. These results were presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium.????

For women with early-stage breast cancer who are treated with breast-conserving surgery (lumpectomy), surgery is generally followed by radiation therapy in order to reduce the risk of cancer recurrence. Radiation therapy is often delivered to the whole breast from a machine outside the body (external beam radiation therapy). This treatment is commonly delivered on a daily basis for several weeks.????

Breast brachytherapy is an alternative to traditional external beam radiation therapy for women who choose breast-conserving surgery. A specialized catheter that contains radioactive material is placed directly into the area of the breast where the cancer was removed. This is often done twice daily over a period of a week or so. Because this approach requires many fewer weeks of treatment than conventional external beam radiation therapy, it may be a much more convenient option for the patient. Information about the safety and efficacy of breast brachytherapy is somewhat limited, however, and clinical trials to address these issues are underway.?????

While awaiting the results of ongoing clinical trials, researchers at the MD Anderson Cancer Center conducted an analysis of Medicare claims data. The analysis included information about more than 130,000 female Medicare beneficiaries who were diagnosed with invasive breast cancer between 2000 and 2007. All of the women included in the analysis had been treated with breast-conserving surgery followed by either breast brachytherapy or whole-breast external beam radiation therapy.????

Use of brachytherapy increased over time. In 2000, less than 1% of the women had been treated with brachytherapy. By 2007, 13% of women were being treated with brachytherapy.?Postoperative complications were more common in the brachytherapy group. Infectious complications, for example, developed in 16% of women treated with brachytherapy and 10% of women treated with external beam radiation therapy. ?By five years after treatment, 4% of women treated with brachytherapy had required additional treatment with a mastectomy, compared with 2.2% of women who had received external beam radiation therapy. The researchers note that the higher rate of mastectomy in the brachytherapy group could be due to breast cancer recurrence or breast complications.?

These results raise the possibility that breast brachytherapy may be less effective and more apt to cause breast complications than whole-breast external beam radiation therapy. This was not a randomized trial, however, and the results should not be viewed as definitive. Ongoing trials of breast brachytherapy will provide more conclusive information about the risks and benefits of this approach.?

Reference: Smith GL, Xu Y, Buchholz TA, Giordano SH, Smith BD. Partial breast brachytherapy is associated with inferior effectiveness and increased toxicity compared with whole breast irradiation in older patients. Presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. December 6-10, 2011. Abstract S2-1.?

Posted December 13, 2011?

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