Breast cancer

[Al-khiyal]

· Discovery may spare patients chemotherapy

· Clinical trials planned for 'targeted' treatment

Cancer specialists will announce today that they have discovered a gene which may hold the key to a treatment for up to 10% of all breast cancers. The development could - in time - lead to treatments that would make chemotherapy unnecessary.

Scientists at the Institute of Cancer Research have found that one in 10 breast cancers - including many lobular cancers, which are among the hardest to treat and fastest increasing - are linked to an overactive gene called FGFR1.

The gene provides the blueprint for a cancer-fuelling protein. The scientists report today in the journal Clinical Cancer Research that when the gene's activity was blocked, tumour growth was reduced.

Using a compound targeted at FGFR1, scientists reduced the growth of cells in laboratory tests and are now planning the first stage of clinical trials.

The discovery raises the hope of a "targeted" therapy which could lead to a sophisticated new age of treatments for women who test positive for FGFR1 and spare them chemotherapy, with its devastating side-effects.

Jorge Reis-Filho, of the molecular pathology laboratory at the Breakthrough Breast Cancer Research Centre at the institute, said: "Breast cancer is a complex disease made up of many sub-types. Currently, most breast cancers are treated similarly but we'd like to be able to tailor treatment for each type.

"To do this, it is important that we find new targets for drug development. The discovery of FGFR1 is the first step on the road to tailoring treatment for the 10-15% of women diagnosed with lobular breast cancer.

"The identification of FGFR1 in this sub-group of breast cancers is a very promising finding and although we are a few years away from clinical trials we are moving closer towards our vision of a future free from the fear of breast cancer."

Some 44,000 women are diagnosed with breast cancers every year and 10-15% of those have lobular cancers. FGFR1 is present in half of this subset of cancers, as well as in around 10% of all breast cancers, he said. The research echoes the work that led to the development of the breast cancer drug Herceptin.

Herceptin can be prescribed for women whose cancer is HER2 positive - around 20% of those diagnosed. The FGFR1 discovery, which is similar to the discovery of HER2, could lead to a therapy for women who are diagnosed with breast cancers that are HER2 negative but positive for FGFR1.

Separately, the same scientists are carrying out the first trials of a drug called a PARP inhibitor which could be beneficial for other women who have a family history of breast cancer and have developed it themselves.

The first trial of 50 women is nearing completion, the drugs are not showing signs of toxicity in patients, and the results are "very promising".

Herceptin has been at the centre of controversy over availability on the NHS owing to its high cost, but the National Institute for Health and Clinical Excellence has now approved its use on all suitable patients in England and Wales.

However, questions of cost and availability are still a long way off for the two new drugs.

Dr Reis-Filho stressed that both are still several years away from being available to women.

"In the future we hope to be able to provide several targeted therapies which will improve survival rates but also quality of life.

"It's an optimistic view and we couldn't say when it would happen, but this is heading in the direction of chemotherapy-free treatments," he said.

The new research comes shortly after a study published in the journal Science last week which found that a chemical used in the abortion pill also prevented the growth of breast and ovarian cancers. The drug Mifepristone is used to terminate early pregnancies, but by shutting down the hormone progesterone in breast tissue cells, the drug can also prevent tumours from forming.

Treatments

Surgery is usually followed by radiotherapy to reduce any remaining cells. Chemotherapy is prescribed to kill cells which have spread, but healthy cells are also caught. If the cancer grows in response to the female hormones oestrogen and progestrogen, tamoxifen is generally prescribed.

A new generation of aromatase inhibitors have a similar effect. About 20% of women with breast cancer are HER2 positive - they produce too much of the HER2 protein which feeds breast cancers. Herceptin, an antibody which binds to these proteins, is recommended for them.

Today's research opens the possibility that women who are HER2 negative but FGFR1 positive - a further 10% of the 44,000 diagnoses a year - will in future be able to access a new treatment.

Scientists find genetic key to some breast cancers

[Al-khiyal]

A dramatic decline in breast-cancer rates may be linked to a decrease in the number of women using hormone therapy. What women need to know about the new findings:

Dec. 15, 2006 - It was big news this week when researchers from the M. D. Anderson Cancer Center in Houston reported that breast-cancer rates dropped after millions of women stopped taking hormone therapy to relieve menopausal symptoms. But does that mean that these hormones (basically estrogen and sometimes a progestin) actually cause breast cancer? That’s the provocative question raised by the study. The researchers found an overall 7 percent decline in breast-cancer incidence in 2003, a year after a major study of hormones called the Women’s Health Initiative (WHI) was halted early because of increased breast cancer and heart disease among participants. The steepest decline, 12 percent, occurred in the number of women diagnosed with a kind of breast cancer that is especially sensitive to hormones.

Another recent study, by researchers in California, echoes these findings. Christina Clarke, an epidemiologist at the Northern California Cancer Center, and her colleagues found that breast-cancer rates in California dropped even more steeply after the WHI—12 percent fewer in 2003 and 2004. Clarke attributes the difference to the fact that California women were more likely to use hormones than women in other states. “We rarely see changes this dramatic over such a short time period,” Clarke says.

But while the connection may seem clear, researchers caution that they really won’t understand the meaning of the drop until they see national numbers for 2004, which are expected next spring, and analyze these and other statistics more carefully. Scientists need to know whether there’s a difference in breast-cancer rates between women who’ve been on hormone therapy and those who haven’t and what happens to former hormone users years after they quit. It’s possible that stopping hormone therapy merely slowed the growth of tumors that will eventually emerge — which means breast-cancer rates could rise again. Without all that data, the current numbers show only an association, not causation, says Marcia Stefanick, chair of the WHI steering committee and a professor of medicine at Stanford University.

Doctors who treat menopausal women say the new numbers shouldn’t be the only basis for a decision on whether or not to use hormones. “This isn’t a cause for alarm,” says Dr. JoAnn Manson, chief of the Division of Preventative Medicine at Brigham and Women’s Hospital in Boston. “It has been known for a while that estrogen plus progestin increases the risk of breast cancer.” But, she adds, that shouldn’t necessarily stop women with severe symptoms from using low-dose hormones for two or three years. “I think it underscores the importance of looking at your personal risk factors for breast cancer and cardiovascular disease,” says Manson, author of Hot Flashes, Hormones & Your Health, “and whether the benefits are likely to outweigh the risks.”

That emphasis on balancing risks and benefits is an important legacy of the WHI, says Clarke. “I think we’re really moving into an era in science where medicine is going to become personalized. It really depends on you and how bad your symptoms are and what your personal risk is for breast cancer. Do you have a history? Have you been diagnosed with a benign breast tumor before? I think you have to put all those things together with your doctor to come up with a decision.”

Since the WHI, pharmaceutical companies have begun offering many more different forms and dosages of hormone therapy — not just pills, but also lotions, patches and local therapy for symptoms like vaginal dryness. All these give women many more choices. But researchers say that if you do take hormones, it’s important to reconsider that decision regularly with your doctor — at least once a year if not more. “We don’t know how long you can go before your risk exceeds some benefits,” says Brenda K. Edwards, associate director of the surveillance research program at the National Cancer Institute. “Women and their physicians need to keep that in mind.” When it comes to hormone therapy, about the only thing that’s certain is that we need more information.

Good news ... and lots of questions

[Al-khiyal]

The occurrence of breast cancer is lower among women who have had infertility problems because of an ovulation disorder, than among women who have not had difficulty conceiving, according to findings from a study involving more than 116,000 women.

Dr Kathryn L Terry of Harvard School of Public Health, Boston and colleagues evaluated data from the Nurses' Health Study II, which enrolled female nurses aged 25 to 42 years at baseline.

Information on infertility and ovulation was assessed every two years starting in 1989, and cases of breast cancer were included through 2001.

During follow-up, 1357 cases of invasive breast cancer were diagnosed, the investigators report in the Archives of Internal Medicine.

Overall, women who had ovulatory disorders had a 25 per cent lower likelihood of developing breast cancer than those who did not.

Moreover, the risk of breast cancer was lowest in women who underwent induced ovulation for treatment of infertility.

"Our findings are reassuring since many women and their clinicians are concerned about the long-term implications of infertility treatment," Dr Terry told Reuters Health.

"However, it is difficult to tease apart the true effect of infertility drugs and infertility, since women who have the most difficultly getting pregnant will most likely be taking infertility drugs the longest," she added.

Ovulation issues linked to breast cancer

[Al-khiyal]

Archives of Internal Medicine

[Bent_Bladi]

"Our findings are reassuring since many women and their clinicians are concerned about the long-term implications of infertility treatment," Dr Terry told Reuters Health.

Well, it may reduce the chance for breast cancer, but doesn't it have other (possibly more dangerous) side effects?

[Cheba_Mami]

Deodorants and cancer

There is no convincing evidence that antiperspirants and deodorants cause breast cancer.

An e-mail hoax
Concerns about deodorants and cancer were started by an e-mail hoax. The e-mail claimed that antiperspirants stop your body from sweating out poisons. It suggested that these toxins build up in the lymph glands under the arm and cause breast cancer. But the details of this are wrong. Breast cancers start in the breast and only later spread to lymph glands. Your body also has several ways of getting rid of toxins, and while sweating is one of them, it is a different system to the lymph glands.

A large study in 2002 looked for links between antiperspirant use and breast cancer in 1,600 women. The researchers found that neither antiperspirants nor deodorants increased breast cancer risk.

Parabens and breast tumours
Another study found traces of parabens, a chemical found in some deodorants, in some breast tumours. Parabens is similar to oestrogen, the human hormone that can promote breast cancer development at high levels. But finding parabens in tumours is a far cry from saying that it causes breast cancer. In fact, breast tumours have large blood supplies and are likely to have traces of everything in our bloodstream. And more than 90% of modern deodorants are parabens-free anyway!

Aluminium salts and breast screening
Some cancer units advise women not to use deodorants containing aluminium salts before going for breast screening. This is not because aluminium salts are dangerous, but because they can obscure the results of screening tests. This can make breast cancers harder to detect.

Cancer Research UK : Deodorants and cancer

[liberte]

I'm still wary... sometimes 'no convincing evidence' eventually emerges as concrete evidence when it's all a bit late, especially where chemicals in products are concerned. After all, there are natural-based deodorants available that contain no aluminum, so why not err on the safe side and purchase those?