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Do Metabolic Factors Increase Mortality in Prostate Cancer?

Wednesday, December 5, 2012

Hello. I am Dr. Gerald Chodak for Medscape. Today's topic is the role of metabolic syndrome in men with prostate cancer. Haggstrom and coworkers [1] published in Cancer a large cohort series on nearly 300,000 men who were followed over a course of about 12 years.

What they attempted to determine was whether having symptoms of metabolic syndrome was associated with an increased risk of developing prostate cancer. The authors found no such association. However, they did find that men who had metabolic syndrome were more likely to be dying from prostate cancer, the risk for which was associated with elevated body mass index, elevated blood pressure, or abnormal glucose or triglyceride blood levels.

The significance of this is the following. We know that many men who progress from prostate cancer are likely to develop metabolic syndrome as a consequence of androgen deprivation. Although we are getting better at treating men with progressive metastatic prostate cancer, the fact is that we may be falling far short of addressing potentially resolvable problems that contribute to their overall death.
I don't think that urologists are primed for evaluating patients for metabolic syndrome, monitoring it, or ensuring that patients are getting the care that they need to make sure that the syndrome is being addressed. What does that mean going forward? First, we need to alert our patients to these side effects and symptoms, encouraging them to try to moderate their weight, get exercise, monitor their glucose levels, get their blood pressure managed properly, and address triglyceride levels that may be abnormal.

That may be outside the realm of the urologist. However, it does require careful attention, and urologists need to do a better job of ensuring that their patients with progressive prostate cancer are receiving care in the area of addressing metabolic syndrome. That means that not only is better patient education needed, but physicians need to be tuned in to the seriousness of these side effects. As urologists, we tend to think more about the cancer with blinders on and don't address the peripheral association that happens as a result of the treatments that we administer.

But it is becoming clearer all the time that metabolic syndrome is serious. It contributes to the mortality of men with prostate cancer and, more than likely, there is a great opportunity for improving the management of our patients to address some of these problems. Hopefully you will find this information useful. I look forward to your comments. Thank you.
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Do Metabolic Factors Increase Mortality in Prostate Cancer?

Hello. I am Dr. Gerald Chodak for Medscape. Today's topic is the role of metabolic syndrome in men with prostate cancer. Haggstrom and coworkers [1] published in Cancer a large cohort series on nearly 300,000 men who were followed over a course of about 12 years.

What they attempted to determine was whether having symptoms of metabolic syndrome was associated with an increased risk of developing prostate cancer. The authors found no such association. However, they did find that men who had metabolic syndrome were more likely to be dying from prostate cancer, the risk for which was associated with elevated body mass index, elevated blood pressure, or abnormal glucose or triglyceride blood levels.

The significance of this is the following. We know that many men who progress from prostate cancer are likely to develop metabolic syndrome as a consequence of androgen deprivation. Although we are getting better at treating men with progressive metastatic prostate cancer, the fact is that we may be falling far short of addressing potentially resolvable problems that contribute to their overall death.
I don't think that urologists are primed for evaluating patients for metabolic syndrome, monitoring it, or ensuring that patients are getting the care that they need to make sure that the syndrome is being addressed. What does that mean going forward? First, we need to alert our patients to these side effects and symptoms, encouraging them to try to moderate their weight, get exercise, monitor their glucose levels, get their blood pressure managed properly, and address triglyceride levels that may be abnormal.

That may be outside the realm of the urologist. However, it does require careful attention, and urologists need to do a better job of ensuring that their patients with progressive prostate cancer are receiving care in the area of addressing metabolic syndrome. That means that not only is better patient education needed, but physicians need to be tuned in to the seriousness of these side effects. As urologists, we tend to think more about the cancer with blinders on and don't address the peripheral association that happens as a result of the treatments that we administer.

But it is becoming clearer all the time that metabolic syndrome is serious. It contributes to the mortality of men with prostate cancer and, more than likely, there is a great opportunity for improving the management of our patients to address some of these problems. Hopefully you will find this information useful. I look forward to your comments. Thank you.
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Immunotherapy for Lung Cancer

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Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses new ways in which lung cancer tumors are being used to create new treatments for lung cancer.

Demystifying the Immune System

"Lung cancer is a formidable foe with many ways of eluding the immune system--but we are developing multiple approaches to using immunotherapy as a treatment option." Gregory Beatty, MD, PhD

Our immune systems are sophisticated, highly evolved and multi-dimensional. They look for and attack invaders. They fight infections, heal wounds and maintain our body health. But do they recognize and fight cancer? And if not, why not?

The answer is complicated. The immune system does, at least in some instances, recognize and attack cancer cells, including lung cancer cells--but in many cases, it fails to eradicate these cells. New research indicates that cancer cells actually develop ways of co-opting the immune system, teaching it to help the cancer grow and spread. This says Dr. Beatty is "bad education," and the goal of immunotherapy research is to re-educate the immune system to attack cancer cells.

At Penn, researchers are using a number of approaches. These include:
  • Cancer cells have the ability to produce STOP signals that prevent the immune system from recognizing them. One approach to immunotherapy is to develop specific antibodies that go after these STOP signals and block them. One example is the PD-1 blocking antibody.
  • CAR-T or chimeric antigen receptors use specially engineered killer T-cells to attack cancer cells. These T-cells are harvested from the patients, go through an amazing process by which they are "re-programmed" to attack the patient's tumor, and then re-injected. The results for several cancers have been promising--with trials scheduled to begin for non small cell lung cancers.
Right now, there are no immunotherapy agents approved by the FDA to treat lung cancer, but clinical trials are underway in patients with advanced disease, and are planned as adjuvant therapy for patients who undergo potentially curative surgery as a means of reducing the risk if recurrence.

To learn more about immunotherapy clinical trials at Penn, call Abramson Cancer Center Clinical Trials Service Toll Free: 1-855-216-0098, Local: 1-646-354-4221 Monday through Friday, 8:30 am to 5:30 pm or email ACCStudies@emergingmed.com
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Brain Cancer Experts Behind the Scenes at the Abramson Cancer Center

Tuesday, December 4, 2012 · Posted in

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Brain Cancer Conference. In this blog, she discusses the experts behind the scenes at the Abramson Cancer Center.

"For 10 years, we have been talking more about hope than progress, but in the last couple of years, we are seeing big differences using new drugs and targeted therapies. We aren't really sure why this is occurring, but we know that our mission is to move from discovery to recovery."- Steven Brem, MD, Conference Chair, and Director of Neurosurgical Oncology.

In 2012, 23,000 people will be diagnosed with cancers of the brain and spinal cord. In adults, 75 percent of those will be glioblastomas.

Cancer treatment today depends on having a team of experts, working together, pooling their knowledge and insight to develop the best care plan for every individual patient. Patients get to know their surgeons and medical oncologists, even their radiation therapists, but seldom interact with other members of the team whose contributions are critical.

The Focus on Brain Cancer Conference offered patients and family members the opportunity to hear from those experts, the pathologist, the radiologist, and in this instance, a scientist who works with mathematical models to understand brain cancer. Their talks were a clear indication of the progress being made in understanding brain cancers--advances that translate directly into improvements in treatment.

Pathologists Identify Genetic Subtypes of Brain Cancers

Maria Martinez-Lage, MD, opened the conference by explaining the information that pathologists use to identify and classify brain cancers. She noted that brain cancers are not staged like other cancers, but rather assigned a grade from I to IV, with four being the most common and most aggressive adult brain tumor, glioblastoma. She also noted that glioblastoma is no longer viewed as one disease--rather there are four subtypes characterized by different molecular profiles.

Pathologists now look for several key factors in diagnosing and categorizing glioblastomas. These include:
  • IDH1 mutation: A gene mutation that occurs more often in lower grade tumor and indicates a favorable prognosis
  • MGMT: A genetic mutation that occurs in some glioblastomas that is an indicator or whether a tumor will respond to chemotherapy
  • ECFRvIII : A gene mutation found in some glioblastomas and other cancers that indicates a more aggressive tumor--but also responds to specific targeted therapy
This kind of information has a direct impact on the treatment decision-making process. Research is currently underway to find other genetic mutations that can be targeted. Penn has also opened a Center for Personalized Diagnostics a combined research and patient care facility that is focused on the next generation of gene sequencing for cancer.

The cause of glioblastoma is generally unknown. There are some very rare familial syndromes that increase the risk, and some association with toxins and high doses of ionizing radiation, but most cases occur without an identifiable cause.

Watch a video about how the Center for Personalized Diagnostics is changing the way tumors are targeted.

Radiologists Pinpoint Critical Differences in Tumors


MRIs are the mainstay of brain cancer diagnosis and treatment assessment--a reality illustrated by the fact that the great majority of patients at the Penn Medicine Conference have had 10 or more MRIs. MRIs provide more information than CT scans without using radiation. According to Ronald Wolf, MD,PhD new approaches to imaging, however, are yielding rich new information about biology, anatomy and functioning of brain cancers that is changing treatment for many patients. These include:
  • Angiogenesis: The formation of blood vessels by the cancer
  • Cellularity: The cellular composition of the tumor
  • Metabolism: The rate at which the tumor is consuming nutrients
  • Anatomy: The exact shape and location of the tumor
Why are these important? These factors help predict how the tumor will behave. A brain cancer with a high tumor blood volume, for example, is generally higher grade and more aggressive than those with lower blood volume. They are also more likely to be the tumors that are positive for the EGFRvIII mutation.

Powerful imaging tools also allow for more precise "mapping" of specific areas of brain, those that control motor skills or language--which guide the surgeon in removing as much of the tumor while sparing normal tissue.

"These new tools," says Dr. Wolf, "give us a more accurate clinical profile, which allow us to tailor treatment decisions to the individual."

"The Big Tent": Science and Medicine Today: Engineers, Physicists and Mathematicians for Brain Cancer Treatment


Most cancer patients don't think of engineers, physicists and mathematicians as having anything to do with their treatment, but today's medicine often involves scientists from a broad range of disciplines. Christos Davatzikas, Ph.D., is one of them, an engineer at Penn, who is developing sophisticated mathematical models of the location, grade, type and size of glioblastomas to help understand more precisely how these tumors grow. His analysis provides critical data that helps predict which brain cancers will recur. One key finding confirmed by Davatzikas's data is that certain parts of the brain are more likely to develop high grade, aggressive tumors than others.

"We are using this information to inform clinicians as well as patients," he says. " If we can predict recurrence, we can provide more effective therapy to patients who need it and stop ineffective therapy for patients who are not benefitting from it."
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Soursop The Cure For Cancer

Monday, December 3, 2012

Soursop

CANCER IS a scourge for which there seems to be no wholesale antidote. It attacks and kills just about anyone. No respecter of race, politics, religion and social status it is. It has decimated familial ties and relationships, and even attempted to destroy the love affair between Ray and Yvonne Kirlew of Discovery Bay, St Ann.

Diagnosed with lymphatic cancer (Hodgkin's lymphoma) in late 2002, Yvonne went through an agonising period of chemotherapy which twisted and wracked her being with pain and nausea, in its efforts to kill the cancer cells. It was killing her instead, and so she planned her own funeral. But Ray was determined that the woman he loves was not going to leave him, and he nursed her back to good health. By December 2004, it seemed that Yvonne was cancer-free.

The Gleaner told their story in a two-part instalment in July 2007, and we also updated readers in January last year with the news that the cancer had returned between December 2008 and March 2009. Yvonne got ill again, and the dreaded chemotheraphy was suggested. Around the same time, Ray got an email about the cancer-curing properties of the soursop tree. He did some further research, and was mesmerised by what he read. Not having any empirical evidence, he set out to make the leaves and bark of the soursop tree into a concoction that would kill Yvonne's cancer cells.
After much encouragement from Ray, Yvonne drank the potion. She got sicker initially, and refused to drink any more, but Ray urged her on. After a month of being on the dose, Yvonne's health improve tremendously. Tests in September 2009 to determine when chemo-therapy would commence showed that the movement of the cancer cells had stopped. Amazingly! More tests were done, and up to Monday, January 18, 2010, when The Gleaner reported that 'Raymond Kirlew 'cures' wife cancer with soursop leaves', Yvonne, who gets tested regularly, but had no cancer.
There were many sceptics, some of whom said it was a matter of time before the cancer cells return. Some readers even questioned Ray's wisdom, or lack thereof, for administering the soursop concoctions to his wife, despite the fact that he is not a medical doctor. But now, Ray is saying since the story broke, many people, including medical doctors themselves, have contacted him seeking advice on how to prepare the potion.
"Everyone who has called me regarding this soursop treatment, I have never ever asked for a penny, nor have I got a penny, and was not expecting any. I know for a fact that this thing has saved my wife, and whosoever wants to know how to make it, I would be happy to give them that information," Ray said.
Living cancer-free

He has even told the story of a woman, known personally to him, who had lung cancer and was sent home to die because the cancer had spread to other organs. She is now living her life cancer-free after drinking the soursop potion. Another gentleman who was suspected of having a tumour in his brain is now doing well too. Some of those who refused to drink the concoction, Ray said, are now dead.
Ray and Yvonne have no regrets. They are convinced that Yvonne is alive because of the soursop tree, which bears that 'jucky-jucky' fruit that gives us that after-Sunday dinner belch. But what does Yvonne have to say to people who are still of the view that she is using a concoction not prescribed by doctors or approved by the authorities?

"I would say to them that the same way chemotherapy is used in treating cancer patients, it was more than likely discovered by people who were trying to find a cure. By testing these treatments over a long period of time, people were healed, even temporarily ... . I am one of the lucky ones, I think, because I tried something that may not have been proven, may not be in the medical books, but I tried it and it works for me."
And it seems to have work wonders for Yvonne in other ways. "I also had a problem with my blood pressure. I have a tendency to have high blood pressure, and whenever I take the soursop drink, my pressure is down ... . I am convinced that the soursop helps to kill the cancer cells, lower my blood pressure, and to repair the damaged nerves," she said. The chemotherapy that she went through in 2003 had damaged some of her nerves, and thus she was having problems with her coordination.
It is almost 10 years since Yvonne, whose mother, father and brother had died of cancer, was diagnosed, and almost two years since she had started drinking the soursop concoction. Very recently, she went to New York to do some more tests. A week before she left, she was feeling pain in some major lymph nodes. So, she was a bit nervous upon leaving the island. Well, she is back, with a clean bill of health, and the pain is gone.

She still has the dress she had planned to spend eternity in. It's in her closet, still clean, still stylish, but she has no plan to wear it anytime soon. And even so, it might just be too small, she said.
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How To Get Rid Of Belly Fat

Sunday, December 2, 2012


Many people find that they have problem areas where they just cannot get fat to budge.  Hand’s up if you’re one of the millions who find themselves with a stubborn layer of fat around their waist?
It’s frustrating that, although you may be making an effort with your diet and trying to exercise more, sometimes it feels impossible to reduce fat around your belly. With an active lifestyle there are several steps you can take to help you become or remain trim all over.

Breaking down the fat loss myth

I’m sorry to say that there is no such thing as spot reduction, we just don’t get to choose where our body stores fat and we can’t remove it from particular places when we decide we don’t want it.  It’s a disheartening fact but hundreds of sit-ups and stomach crunches on their own won’t immediately help you lose that spare tire. The good news is that with diet and exercise together, you can burn your excess fat and by following my  three belly fat busting tips that spare tire will soon deflate.

Three simple tips to help you reduce the appearance of belly fat

Here are my three go-to belly busters that help keep me stress free and in control of my figure.
Belly buster tip 1:  Make time to be active
Although you can’t spot reduce and only target a flabby tummy, you shouldn’t discount the benefits of general exercise.  If you can find time for a physical activity every day, then you’ll soon find yourself firming up all over.
I know you’ve heard it before but being active and becoming physically fit is also wonderful way to cut through the stress in your life.  Spending time exercising can give you a time out and help you reprioritize.   Even better, the time you spend exercising is time when you can’t be eating!
Belly buster tip 2:  Take a deep breath
Practice conscious breathing by inhaling through your nose and letting the air expand into your tummy, then breathe out through your mouth. Stopping work and taking 5-10 conscious breaths can calm your mind and give you a rejuvenating time out. Don’t let stress creep up and leave you feeling frazzled by the end of the day, that way may lead to comfort eating.  Try this breathing technique as often as  you remember (you may even want to stick up a post-it note to yourself).  Take the time to think about your body and how you want it to look.  This mindful technique may help you avoid a donut or re-prioritize a trip to the gym.
Belly buster tip 3:  Pull your shoulders back and your tummy in
Schedule a stretching break instead of a coffee break. You can do simple stretches and exercises from the comfort of your office chair or while you’re on the phone.  Try pulling in your tummy when your sitting or standing for 30 seconds at a time and you’ll be strengthening your core stomach muscles. And, if you have a minute, then take a moment to stand up straight, pull your shoulders back and walk tall. Improving your posture can help make you feel more alert and in better shape.
***
Although there are no quick-fix solutions, you’ll instantly feel better if you begin to exercise, take control of your figure and make the time to think about you.  Whatever your problem area – be it a wobbly belly, thunder thighs or a double chin – with a consistent exercise routine and patience you can improve your physique.
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Ways To Make Money Online

Saturday, December 1, 2012




Yes, many "online jobs" promising quick riches and little effort are really scams. While the tasks below won't make you rich, they can earn you a little pocket money on the side—and these days that can make a big difference.

Most of these online money making opportunities only require you have a computer, a decent internet connection, and some sort of marketable skill (or the ability to provide valuable consumer insight to marketers). You'll be operating as a free agent and can choose when, where, and how much to participate.
Sound too good to be true? It's not, because as mentioned earlier, you won't likely be able to quit your day job with any of these programs, which typically pay way less than regular part-time gigs. But if you're a student, insomniac, or just someone who wants an occasional cash boost without the commitment required by a typical job, these are some of the best tasks you can do online in your spare time.
Also beware: because specialized skills aren't always required, you do have to be wary of scams. Before you sign up to become a virtual focus group participant, paid survey taker, mystery shopper or any online worker, keep in mind this important rule of thumb: you should never have to pay to work. Also, read the fine print.

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That out of the way, here are a few sources of legitimate online single-task jobs:

Research Study/Survey Participant: Harvard Business School Computer Lab for Experimental Research (CLER): Participate in research studies at Harvard Business School and you can earn $15 to $40 or more per on-site study (in Cambridge, MA) or do one of their occasional online studies, which typically take less than 15 minutes to complete and usually compensate you with a $5 electronic gift certificate. The studies ask you about decisions you would make in various business-related disciplines, such as economics and psychology. Additional options: Lightspeed Consumer Panel, Pinecone Research, SurveySpot.

Focus Group Participant: 20|20 Panel: Since 1986, 20|20 Research has been providing companies with qualitative research from focus groups. Recent calls for focus group participants include: an online study of cell phones usage that pays $60 (adults 18-44) and an online study of household products purchases that pays $150 (adults 25-65). Additional options: Focus Forward, Hagen Sinclair, AlphaBuzz.

Artificial Artificial Intelligence: Amazon Mechanical Turk: Yeah, that's a weird title. As a Mechanical Turk Worker (or MTurk), you complete odd jobs like looking up companies' hours of operation, checking translations, coming up with ideas for marketing projects, and so on. The pay can be extremely low — a couple of cents even — but the tasks can usually be done quickly and some tasks pay more. Additional option: ShortTask.

User Tester: UserTesting.com: Get $10 for visiting a website and providing live, honest feedback about it. Your reactions as you traipse the site are recorded by UserTesting's software. Additional option: uTest.

Tech Support Expert: FixYa.com: Put your knowledge to good use at FixYa and earn $2 to $6 for answering a posted question, $6 to $10 for helping someone in chat, $10-$15 if you do it by phone, or a variable amount for written tips and how-to's. Additional options: Support Space, JustAnswer.

Blogger: Commission Junction: If you maintain a blog already, you can monetize it by inserting advertising links or affiliate links from Commission Junction, LinkShare, Chitika, Smorty, and, of course, Google AdSense. There's no set amount you can make (and no guarantee you'll make anything at all), but if you write often and get a decent following, you can generate some nice supplemental income.


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