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Women's Newsletter
October 13, 2008


In This Issue
• Tamoxifen Speeds Diagnosis of ER-Negative Breast Cancer
• Researchers ID Ovarian Cancer Biomarker
• Mom's Diet Can Alter Genes to Raise Babies' Asthma Risk
• Lidocaine Gel May Ease Mammography Discomfort
 

Tamoxifen Speeds Diagnosis of ER-Negative Breast Cancer


TUESDAY, Oct. 7 (HealthDay News) -- A treatment that helps prevent one type of breast cancer in women with an evaluated risk of the disease also appears to help doctors make an earlier diagnosis of another form of breast cancer, a new study reports.

Tamoxifen previously had been shown to reduce the risk of estrogen receptor (ER) positive breast cancer in women at high risk of the disease, but not to affect the chance of developing ER-negative disease.

However, the study by researchers at the University of Texas M.D. Anderson Cancer Center in Houston found that the treatment helped doctors diagnosis women who later developed estrogen receptor (ER) negative breast cancer an average of one year sooner than the same at-risk patients who instead took a placebo.

For the study, 13,388 women at high risk of breast cancer participated in the trial; 174 women were diagnosed with ER-positive tumors and 69 women with ER-negative tumors. The median time to diagnosis for ER-negative disease was 36 months in the placebo group but only 24 months in the tamoxifen group.

The median time to diagnosis for ER-positive disease was similar in the placebo and tamoxifen groups at 43 and 51 months, respectively, which is not statistically different.

It's not clear why the diagnosis time of ER-negative tumors is so different, but the authors hypothesized that the drug may make the tumors more detectable. No evidence was found that tamoxifen altered the growth rate of ER-negative disease.

The study was published online Oct. 7 in the Journal of the National Cancer Institute.

The findings should be investigated further, the researchers concluded.

More information

The National Cancer Institute has more about tamoxifen.


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Researchers ID Ovarian Cancer Biomarker


TUESDAY, Sept. 23 (HealthDay News) -- A genetic marker for the vascular (blood vessel) cells associated with ovarian cancer tumor growth has been identified by U.S. researchers, who said their finding may help improve diagnosis and treatment of the disease.

The team at the University of Pennsylvania Ovarian Cancer Research Center found that high levels of TEM1 are associated with decreased survival of ovarian cancer patients.

They also found that all 52 samples of ovarian cancer they examined tested positive for TEM1 in the vasculature, which suggests that TEM1 is a specific marker for ovarian cancer.

The findings were to be presented this week at the American Association for Cancer Research Molecular Diagnostics in Cancer Therapeutic Development meeting, in Philadelphia.

Researchers are working to develop drugs that target the vasculature that surround ovarian tumors in order to disrupt the blood supply that feeds tumor growth.

"This will have to be borne out in further studies, but if we can normalize the vasculature surrounding the tumor, we will have a better chance of eradicating the tumor," study author Chunsheng Li, a postdoctoral research fellow at the ovarian cancer research center, said in an American Association for Cancer Research news release.

Any breakthrough in the detection of ovarian cancer would be very significant because there are currently no reliable methods for detecting the disease at an early stage, when it is easiest to treat.

According to the American Cancer Society, ovarian cancer is the eighth most common cancer in women, skin cancer aside. It ranks fifth as the cause of cancer death in women. The society estimates that there will be about 22,430 new cases of ovarian cancer in this country this year, and about 15,280 women will die this year because of the disease. Around two-thirds of women with ovarian cancer are 55 or older; it's slightly more common in white women that black women.

More information

The American Cancer Society has more about ovarian cancer  External Links Disclaimer Logo.


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Mom's Diet Can Alter Genes to Raise Babies' Asthma Risk


THURSDAY, Sept. 18 (HealthDay News) -- Increasing use of folic acid and other dietary supplements by women may be one reason why the prevalence of asthma has nearly doubled in the past 25 years, U.S. researchers are suggesting.

They found that a pregnant woman's diet can cause gene regulation (epigenetic) changes that increase an offspring's risk of developing allergic asthma.

The study, by researchers at National Jewish Health and Duke University, found that pregnant mice fed diets high in supplements containing methyl-donors (folic acid, L-methionine, choline and genistein) had babies with more severe allergic airway disease than mice born to mothers that consumed diets low in methyl-containing foods.

The mice born to mothers fed high methyl-donor diets had greater asthma severity, more airway hyperactivity, more allergic inflammation in the airways, higher levels of IgE in their blood, and their immune system T-cells were more likely to be the type associated with allergy. Male offspring also transmitted a higher predisposition to allergy airway disease to their pups.

There was no link between high methyl-donor diets during lactation or adulthood and increased risk of allergic asthma, the researchers said.

The study was published online Sept. 18 in the Journal of Clinical Investigation.

"Our findings suggest that a mother's diet that alters DNA methylation can affect the development of the fetus's immune system, predisposing it to allergic airway disease," senior author Dr. David Schwartz, a professor of medicine at National Jewish Health, said in a news release.

"It also suggests the dramatic increase in asthma during the past two decades may be related in part to recent changes in dietary supplementation among women of childbearing age," he added.

"There seems to be a crucial stage, during development in utero, when a young mouse is susceptible to epigenetic changes that can alter its immune system," study co-author John W. Hollingsworth, assistant professor of medicine at Duke University School of Medicine, said in the news release.

"These epigenetic changes may partially explain why it has been so difficult to definitively identify genes that contribute to asthma risk; the effect of genetic variations can be masked or further complicated by epigenetic changes," he noted.

More information

The U.S. Centers for Disease Control and Prevention has more about asthma.


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Lidocaine Gel May Ease Mammography Discomfort


TUESDAY, July 22 (HealthDay News) -- There's just no getting around the fact that mammograms are uncomfortable, but a new study suggests that applying a topical analgesic before the test could significantly ease the discomfort associated with the test.

And a test that's less painful may encourage more women to get screened, the researchers suggest.

"Mammography saves lives, and we would like women to know that if they're delaying or avoiding mammograms because they expect higher discomfort, they should try this product and see if it can become a better experience. It makes mammograms much more tolerable," said study author Colleen Lambertz, a nurse practitioner in the radiation oncology department at St. Luke's Mountain States Tumor Institute in Boise, Idaho.

Results of the study were in the July 22 online issue of Radiology, and were expected to be published in the journal's September print edition.

The American Cancer Society (ACS) recommends women over 40 receive an annual mammogram, because breast cancer that's caught early is easier to treat, and potentially to cure. If breast cancer is discovered before it has spread to the lymph nodes, the five-year survival rate is 98 percent. If cancer isn't found until it has spread to other areas of the body, the five-year survival rate is just 27 percent, according to the ACS.

Despite its lifesaving potential, as many as one-half to two-thirds of women don't follow screening guidelines, according to the study. A big factor, said Lambertz, may be the pain and discomfort associated with the test.

In an attempt to make the procedure less painful, Lambertz and her colleagues recruited 418 women between the ages of 32 and 89 who expected mammography to be painful and unpleasant. This group was randomly divided to receive pre-mammography acetaminophen, ibuprofen, a topical 4 percent lidocaine gel, or an oral or topical placebo. The gel was applied to the breast and chest wall between 30 minutes and 65 minutes before the test.

Women who used the lidocaine preparation reported significantly less breast discomfort, according to the study.

However, Dr. Julia Smith, director of the Breast Cancer Screening and Prevention Program at the New York University Lynne Cohen Breast Cancer Preventive Care Program, pointed out that the lidocaine didn't make a dramatic difference. She said that although women reported less discomfort with the lidocaine gel, they didn't report significantly higher satisfaction.

"What this study does highlight is that women shouldn't have to undergo this kind of pain. We should have an improvement in technology. Mammograms are unpleasant, and it's going to take more than giving people Tylenol; we need better technology," Smith said.

Smith also expressed concern that the gel might affect the quality of the mammogram, and that no large-scale study has been done to assess whether or not such a gel could interfere with image quality.

Lambertz said they found no difference in image quality for the women they studied.

What's most important, Lambertz said, is that women feel empowered. "We know that breast tenderness, anxiety and expectation of discomfort are all directly correlated with the amount of discomfort that women experience during their mammogram. Women can take measures to reduce breast tenderness -- pick a time for their mammogram when they expect their breast tenderness to be lowest, and apply the lidocaine gel one hour before their mammogram. They can then feel more confident that they will have a good experience and hopefully undergo more regular screening," she said.

Smith added that if you're very anxious about the test, you should let your doctor know so that you can discuss ways to ease your concerns.

The study was not funded by any pharmaceutical manufacturers.

More information

To learn more about mammography, visit the American Cancer Society  External Links Disclaimer Logo.


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