Cancer CarePoint Blog

Microsoft Entering Health Care Industry Software Market

The New York Times reports that Microsoft purchased a clinical health care software package that can share the data from different computer systems and software programs. Excerpts below.

Link: Microsoft to Offer Software for Health Care Industry - New York Times

Microsoft plans to offer software tailored for the health care industry, a change from its usual strategy of encouraging others to create industry-specific products using its operating system and programming tools. The company’s first step, announced yesterday, is to purchase clinical health care software developed by doctors and researchers at a nonprofit hospital in Washington, D.C. Microsoft is also hiring two of the three doctors who created the software system, and 40 members of the development team at Washington Hospital Center.

The purchase price, which was not disclosed, was most likely small by Microsoft’s standards. But the company has larger ambitions in the fast-growing market for health care information technology. Hospitals, doctors and policy makers worldwide have high hopes for saving money and improving the quality of care by moving health care into the digital age, handling patient records and tracking treatments electronically.

The software system Microsoft is buying, Azyxxi (pronounced ah-zik-see), is designed to retrieve and quickly display patient information from many sources, including scanned documents, E.K.G.’s, X-rays, M.R.I. scans, angiograms and ultrasound images. It was first used in Washington Hospital Center’s emergency department in 1996, and has since been adopted at six other hospitals, including the Georgetown University Hospital, that are part of the MedStar Health group, a nonprofit network in the Baltimore-Washington region.

Analysts and health care experts who have seen the software work in the Washington hospitals say it is impressive technology. Many hospitals and clinics, they say, have various kinds of patient information in electronic form, but the different computer systems and software programs cannot share the data. That is the principal problem the Azyxxi system addresses, analysts say.

The need to quickly collect, sort and display health information from many sources, they say, is a vital requirement in developing regional and national health information networks — a policy goal in the United States and dozens of other countries.

Exercise can reduce cancer treatment side effects

Reuters describes a study of the effects of exercise by cancer patients. Excepts below.

Link: Exercise can reduce cancer treatment side effects | Health | Reuters.com

Exercising can help cancer patients feel better mentally and physically, a new analysis of data from published research shows. But it remains unclear what type of exercise is most effective or how much a person needs to work out in order to benefit, lead author Dr. Vicki S. Conn of Missouri University-Columbia's Sinclair School of Nursing and her colleagues note. The benefits of exercise for healthy people are well known, but the growing body of research on whether exercise can help patients undergoing cancer treatment has produced mixed results, the researchers report in the July issue of Supportive Care in Cancer.

Exercise had the strongest effect on boosting patients' physical function, such as improving their ability to climb stairs or walk a certain distance. It improved patients' body composition, increasing the percentage of lean muscle mass to total weight.

Exercise reduced some symptoms, such as nausea and vomiting and pain, and modest improvements were seen in fatigue, mood and quality of life.

Given the relatively small benefits for exercise identified by their analysis, Conn and her colleagues suggest combining exercise with other inventions designed to improve cancer patients' physical and mental health.

Study finds stress worsens ovarian cancer

Yahoo! News reports on a study of stress and cancer by Dr. Anil Sood of The University of Texas M.D. Anderson Cancer Center and colleagues. Excerpts below.

Link: Study finds stress worsens ovarian cancer - Yahoo! News

Stress causes ovarian cancer tumors to grow and spread more quickly in mice, U.S. researchers reported on Monday in a study that provides one of the first biological links between stress and cancer.

In the mice, stress hormones attach directly to tumor cells and stimulate new blood vessel growth and other factors that lead to faster and more aggressive tumors, the researchers said.

The study published in the journal Nature Medicine also found that a blood pressure drug reverses the effect.

Studies aimed at finding out if stress causes cancer have not come up with a clear answer -- and some have clearly ruled out any link between stressful life events, such as divorce or job loss, and later cancer.

But many people believe stress can cause cancer.

This study provides a new understanding of how chronic stress and stress factors drive tumor growth," Sood said in a statement.

So then the researchers gave the mice a beta-blocker heart drug called propranolol, which lowers blood pressure using these same stress receptors, called beta adrenergic receptors.

"The concept of stress hormone receptors directly driving cancer growth is very new," Sood said.

"Not much had been known about how often these receptors are expressed in cancer, and more importantly, whether they had any functional significance. Our research opens a new area of investigation."

Tracing Cancer's Cause

Daniel de Vise at the Washington Post reports on firefighters exposed to PCBs while training more than 20 years ago. Excerpts below.

Link: Tracing Cancer's Cause

At least 120 firefighters who graduated from the fire training academy in Millersville between 1968 and 1985 have been diagnosed with cancer, and at least 40 have died, according to a Montgomery County legal team that is assembling a potential case.

The firefighters believe they are a classic cancer cluster. A wave of premature deaths triggered memories of oil burned and fumes inhaled at the academy in the 1970s. The trainees didn't know then that the oil contained polychlorinated biphenyls, or PCBs, compounds later found to cause cancer.

The firefighters, joined by the Hopkins expert and U.S. Sen. Barbara A. Mikulski (D-Md.), seek a definitive study. More than that, though, they want help: cancer screenings for the healthy, medical coverage for the sick, burial for the dead.

A man of 20 has a 1 percent chance of contracting cancer by age 40 and a 3 percent chance by 50. Among the 2,000 recruits who trained at the fire academy between 1968 and 1985, most of whom were in their twenties, about 5 percent have contracted cancer, according to research by Cindy Ell, a retired firefighter who keeps a database of victims.

"Every time we bury somebody else, it creates a lot of anger and a lot of emotion," said Ell, a Delaware resident who has emerged as the Erin Brockovich of Anne Arundel firefighters. Much like the film and real-life heroine, Ell has almost single-handedly built a case for the firefighters while working for a lawyer sympathetic to her cause.

Accounts vary on exactly when the Anne Arundel firefighters came to regard PCBs as a ticking oncologic time bomb. Some say it was the day in 1997 that Fowler, then 43 and a robust engine driver, received his diagnosis.

The old Dollhouse still sits on the grounds of the training academy, set against a sweep of forest behind fire headquarters. The academy opened in 1968. Firefighters from Anne Arundel, Howard and Prince George's counties, Annapolis, Fort Meade and the U.S. Naval Academy trained there, according to Ell.

Starting in spring 1971, the academy accepted annual shipments of used transformer oil from Baltimore Gas and Electric Co. Trainers pumped oil into the Pit, a pool of water that would be set ablaze; the Christmas Tree, a rectangular steel structure that spat flame; and the Dollhouse.

International Anti-Tobacco Advocates Honored For Efforts To Reduce Global Tobacco Burden

The war against cancer includes many battles against tobacco use.

Link: International Anti-Tobacco Advocates Honored For Efforts To Reduce Global Tobacco Burden

[On July 17] the American Cancer Society will honor leaders from around the globe with the 2006 Luther L. Terry Awards in recognition of their efforts to prevent and control tobacco use. Sweden's Margaretha Haglund and the United Kingdom's Sir Richard Peto will be among those honored for their exemplary leadership of the world's tobacco control movement. The 2006 Luther L. Terry Awards will be presented during a special ceremony at the 13th World Conference on Tobacco OR Health. The award is named for former U.S. Surgeon General Luther L. Terry, the author of the landmark 1964 Surgeon General's Report that connected tobacco use to lung cancer and other illnesses.

-- Margaretha Haglund is well-known throughout the tobacco control movement, having worked in the field for more than 30 years. Among her many achievements, Haglund has played a visible and key role in bringing women and tobacco issues to the global forefront. She is co- founder and president of the International Network of Women Against Tobacco (INWAT), which boasts 1,500 members in 100 countries. Her fearlessness, energy and creativity inspire tobacco control advocates internationally.

-- Sir Richard Peto, FRS, is professor of Medical Statistics and Epidemiology and co-founder and co-director of the Clinical Trial Service Unit at the University of Oxford in England. With his commitment to sound science and his ability to communicate effectively, Sir Richard serves as both an inspiration to researchers and a resource for advocates. His tobacco research is among the most heavily used by non- governmental organizations all over the world, and his messages for individual smokers are the basis for countless public health campaigns. The 13th World Conference on Tobacco OR Health is taking place July 12-15 in Washington, D.C.

The American Cancer Society is dedicated to eliminating cancer as a major health problem by saving lives, diminishing suffering and preventing cancer, through research, education, advocacy, and service. Founded in 1913 and with national headquarters in Atlanta, the Society has 13 regional Divisions and local offices in 3,400 communities, involving millions of volunteers across the United States. For more information anytime, call toll free 1-800-ACS-2345 or visit http://www.cancer.org.

American Cancer Society
http://www.cancer.org

Panel urges EPA to reassess dioxin

MSNBC.com summarizes a report by experts assembled by the National Academies’ National Research Council on the chemical dioxin. Excerpts below.

Link: Panel urges EPA to reassess dioxin - Environment - MSNBC.com

The cancer risk from the chemical dioxin -- present in some U.S. soil, food supplies and most Americans’ bodies -- needs to be reassessed by the Environmental Protection Agency before it sets a new standard for cleanup, a U.S. scientific panel reported Tuesday.

Experts assembled by the National Academies’ National Research Council confirmed many of the findings of a 2003 EPA report on dioxin, which found dioxin causes cancer and reproductive and immune-system disorders in humans.

However, the experts said EPA may have overstated cancer risk at extremely low doses of dioxin, and researchers could consider looking at existing data in new ways to check their findings.

The 2003 report’s assessment indicated that even slight exposure to dioxin could constitute a health risk, and safe levels of the chemical could be as much as 10 times lower than EPA’s previous assessment, made in 1985.

Dioxin and related chemicals have raised concern since the 1970s, when they were found in the herbicide Agent Orange, used by U.S. forces in the Vietnam War. These chemicals also are byproducts of various industries, including paper and pulp production, incinerators and businesses that use chlorine.

Dioxin and dioxin-like compounds stay in the environment, allowing them to build up in the food chain. Most Americans ingest dioxin when they eat fatty foods including beef, pork, fish and dairy products, and others are exposed to the chemical on the job or by accident, the National Academies panel noted.

The Boston-based Center for Health, Environment and Justice hailed the National Academies report in a statement and accused industries that use chlorine of stalling enforcement of higher cleanup standards.

A Key New Ally In The Cancer War

BusinessWeek magazine describes how China and the U.S. are working together to advance the knowledge of treating cancer. Excerpts below.

Link: A Key New Ally In The Cancer War - BusinessWeek

Enlightened self-interest is driving Western medical companies and research institutes to join China's war on cancer. Naturally, they want to help upgrade patient care at a time when cancer rates are soaring. With pollution fouling the air and the tobacco industry booming, the lung cancer toll alone could triple within two decades from the current 340,000 per year. At the same time, the researchers want access to China's pool of talented scientists and its enormous patient population.

Technology helps with the first part of the agenda, as the new breast cancer program demonstrates. Using an approach called digital mammography that is just starting to catch on in the U.S., doctors gather test results in a central database in Beijing, which is open to researchers around the country. Chinese are also experimenting with new forms of ultrasound screening. "They are moving at warp speed, relative to what would happen in the U.S.," says Dr. Stephen F. Sener, a surgeon at Evanston Northwestern Healthcare who advised the Chinese on the new program. "We would still be having committee meetings."

In exchange for helping the Chinese in such efforts, Western experts gain the freedom to work in China, where doctors and patients can help them test the latest drugs and procedures.

China's vast patient population is a big draw for clinical oncologists around the world. For one thing, researchers can study forms of the disease that are rare in the U.S. or Europe, says Dr. Zhang Shangwen, a professor at the Beijing Medical University School of Oncology. What's more, some drugs may work best on Asian patients. Dr. Tony Mok, a professor of clinical oncology at the Chinese University of Hong Kong, is enrolling 1,200 patients in China and several other Asian countries to assess new uses for AstraZeneca's drug Iressa. The treatment has a disappointing track record with Western lung cancer patients but is showing greater success in Asians, possibly because of genetic differences in the populations. Ten years ago, such a trial would have been unthinkable. "The quality of the researchers wasn't high enough," says Dr. Mok, "but now a good number of sites in China are competent to carry out this research."

In general, recruitment for clinical trials is easier in China. Because of poverty and the lack of medical infrastructure in many parts of the country, patients often jump at the chance to enroll. They're willing to take part "because they don't have any other option," explains Dr. Zhang. For many reasons, both inspiring and sad, China may be the brightest hope for breakthroughs against this disease.

Lung cancer more likely for women smokers

Nightly News with Brian Williams and MSNBC.com describe a new study of women smokers. Excerpts below.

Link: Lung cancer more likely for women smokers - Nightly News with Brian Williams - MSNBC.com

Dr. Claudia Henschke of Weill Cornell Medical College has been following almost 17,000 smokers and former smokers for eight years or more. She uses sophisticated scans to look for the earliest signs of lung cancer.

"If you match them age by age by pack-year, women get more cancers, twice as many," Henschke says.

The one small piece of good news that women more often survive.

"They are more likely to get it but less likely to die of it," Henschke says.

Still lung cancer will kill 73,000 American women this year — more than will die from breast and ovarian cancer combined.

Scientists do not know why women are affected differently by cigarette smoke. It appears the cells in women's lungs respond differently to the toxins in cigarettes. But the public health message is clear.

"Young women need to understand that they are more likely to get lung cancer, so they really should not start smoking," Henschke says.

Enzyme Inhibitor May Slow Cancer Growth

Cancer cells apparently require high levels of methionine. A U Of Illinois scientist has found that slowing methionine's production could result in a treatment that will selectively inhibit cancer growth. Excerpts from Medical News Today below.

Link: Enzyme Inhibitor That May Slow Cancer Growth Developed By U Of I Scientist

University of Illinois scientist Tim Garrow, in collaboration with Jiri Jiracek of the Czech Academy of Sciences, has applied for a provisional patent on a class of chemicals that has future therapeutic uses in medicine, specifically in cancer treatment, an enzyme inhibitor that may slow cancer growth.

Methionine, an essential amino acid, is required for several important biological processes, including synthesis of a compound that cancer cells require more than other cells. "When scientists restrict dietary methionine in animals with cancer, cancer cells are more acutely affected than others," Garrow said.

Many drugs work by inhibiting the action of an enzyme, including the statin drugs used to lower cholesterol, he added.

Garrow became interested in BHMT, which is abundant in the liver and present in lesser amounts in the kidneys, because elevated levels of blood homocysteine have been linked with a number of diseases, including vascular disease and thrombosis.

Garrow's work with BHMT in mice was published in the June issue of the Journal of Nutrition. Co-authors include Michaela Collinsova, Jana Strakova, and Jiri Jiracek of the Academy of Sciences of the Czech Republic.

An article detailing the development of the BHMT inhibitor was published in the June issue of the Journal of Medicinal Chemistry. Other authors include Jiri Jiracek, Michaela Collinsova, Ivan Rosenberg, Milos Budesinsky, Eva Protivinska, and Hana Netusilova of the Academy of Sciences of the Czech Republic.

Garrow's funding was provided by the National Institutes of Health. He and Jiracek have just received an NIH grant specifically to continue their study of BHMT inhibitors.

Attacking Cancer’s Sweet Tooth Is Effective Strategy Against Tumors

Newswise describes research published in the June Cancer Cell publication that may lead to relatively safe anti-glycolytic therapies cancer treatments. Excerpts below.

Link: Newswise | Attacking Cancer’s Sweet Tooth Is Effective Strategy Against Tumors

An ancient avenue for producing cellular energy, the glycolytic pathway, could provide a surprisingly rich target for anti-cancer therapies. A team of Harvard Medical School (HMS) researchers knocked down one of the pathway’s enzymes, LDHA, in a variety of fast-growing breast cancer cells, effectively shutting down glycolysis, and implanted the cells in mice. Control animals carrying tumor cells with an intact glycolytic pathway did not survive beyond 10 weeks. In striking contrast, only two of the LDHA-deficient mice died, one at 16 weeks, another at just over 18 weeks. Eighty percent of the mice outlived the four month experiment. The findings by Valeria Fantin, Julie St-Pierre, and Philip Leder appear in the June Cancer Cell.

As a tumor grows, cells crowd one another and may be cut off from oxygen-carrying blood vessels—a distinct disadvantage since most cells require oxygen to produce the bulk of their energy-storing adenosine triphosphate (ATP). In the 1920s, Otto Warburg proposed that some cancer cells evolved the ability to switch over to an ancient, oxygen-free route, the glycolytic pathway. What is more, they continue to use this pathway even when access to oxygen is restored. Though the so-called Warburg effect has since been confirmed, the role played by glycolysis in cancer has been largely ignored. Few have attempted to attack specific points along the glycolytic pathway to gain a therapeutic effect.

What may excite the growing band of researchers who are studying the Warburg effect, and cancer metabolism more generally, is the way the study resolves a long-standing debate about how and why cells switch to glycolysis in the first place. Warburg speculated that cancer cells change over to glycolysis, which occurs in the cytoplasm, because the mitochondria, where oxygen-dependent ATP synthesis occurs, are defective. But the mitochondria of cancer cells appear to be mostly intact, which led many researchers to minimize the importance of the glycolytic switch.

What makes the prospect of anti-glycolytic therapies even more attractive is their potential safety.

Healthy cells meet 90 percent of their energy needs through OXPHOS. People who lack the LDHA enzyme appear to function normally though they cannot be pushed toward anaerobic exercise.

Also appealing is the idea of combining anti-glycolytic therapies with anti-angiogenic ones.

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Harvard Medical School has more than 7,000 full-time faculty working in eight academic departments based at the School's Boston quadrangle or in one of 47 academic departments at 18 Harvard teaching hospitals and research
institutes. Those Harvard hospitals and research institutions include Beth
Israel Deaconess Medical Center, Brigham and Women's Hospital, Cambridge
Health Alliance, the CBR Institute for Biomedical Research, Children's
Hospital Boston, Dana-Farber Cancer Institute, Forsyth Institute, Harvard
Pilgrim Health Care, Joslin Diabetes Center, Judge Baker Children's Center,
Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital,
Massachusetts Mental Health Center, McLean Hospital, Mount Auburn Hospital,
Schepens Eye Research Institute, Spaulding Rehabilitation Hospital, and VA
Boston Healthcare System.