biomarker | Highlight HEALTH

Welcome to the 13th edition of the Cancer Research Blog Carnival, the blog carnival devoted to cancer research.

Everyone knows that cancer is a devastating disease. What many people don’t know is that cancer kills more than 1,500 people a day; that’s one person every minute. Tonight, Stand Up To Cancer, a one-hour fundraising event, will be simulcast on all three major U.S. networks. The goal of Stand Up To Cancer (SU2C) is to enable cutting-edge research aimed at finding a cure to all types of cancer and making cancer part of the national debate.

Since 2001, federal deficits resulting from a number of fiscal pressures, including the wars in Afghanistan and Iraq, increased national defense spending and hurricane Katrina, have together placed significant stress on the resources available for U.S. biomedical research. Between the fiscal years 2004 and 2007, the National Cancer Institute’s budget remained relatively flat. However, factoring in inflation (i.e. a Biomedical Research and Development Price Index (BRDPI) of ~3.8% per year) reveals a 12% loss of purchasing power [1].

This decrease in resources comes as patient demand is growing. There was an estimated 1.5 million new cancer cases in 2007, an increase of 14% since 2001 [2]. The U.S. spends roughly $12 billion dollars every month fighting the wars in Afghanistan and Iraq. That’s 33 times more than what is spent on cancer research annually. Imagine what we could do if just a fraction of those resources was dedicated to cancer research.

Join the fight against cancer!

We’re all connected through cancer. Indeed, everyone knows someone affected by the disease. Tonight and in the coming months, join the fight! I encourage you to tune in to Stand Up To Cancer and support the next generation of groundbreaking cancer research.

As we join together to fight cancer, let’s get the the research, discoveries and advances highlighted in this months edition of the Cancer Research Blog Carnival.

Cancer Research Blog Carnival #13

Science-based Medicine

With all the credible health information online, an equal or greater amount of misinformation also exists. Frequently, false or misleading propaganda or marketing claims result in misconceptions about common health matters. Dr. Steven Novella writes about Attitudes and Public Health, reviewing the results of a new global survey showing that the public is misinformed about the risk factors for cancer [3].

The Things I Wish My Mother Would Have Told Me

Mia Perovetz’s mother died of breast cancer. She created a short video for a Breast Cancer Film Festival and as the trailer for her upcoming New York play, contemplating The Things I Wish My Mother Would Have Told Me.

I wanted to follow in my mother’s footsteps. I knew how great she was. Everyone wanted to be her or even just be liked by her. But how far do I have to follow until I fear that her destiny will become mine?

The Medical Quack

There is a variety of anti-cancer drugs available to oncologists. However, before highly toxic drugs are given to a patient, it would be advantageous to know which drugs are effective against a their cancer cells. Barbara Duck describes a new test called the Microvessel Vascular assay, writing that a Cancer Physician Invents Test For New Drugs That Cut Off Tumor’s Blood Supply [4].

Medication Non-adherence

One in two patients do not take their medications as prescribed. Alex Sicre writes about patient medication adherence, republishing a recent study abstract showing that A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer [5].

Musings of a Distractible Mind

Zippy is a lobster friend of Dr. Rob (yes, I said lobster friend). Zippy’s goal is to raise money for brain cancer research and to have many adventures doing so. Dr. Rob asks readers to support Zippy the lobster and his Cancer Quest to raise funds for scientific and clinical research through the Childhood Brain Tumor Foundation.

BayBlab

Cancer biomarkers have been the focus of a great deal of research over the past few years. Dogs tell us there’s something detectable, as they can identify cancer patients by scent with startling accuracy. Kamel explores Early Cancer Detection: Dogs with Frickin’ Laser Beams [6].

Living the Scientific Life (Scientist, Interrupted)

GrrlScientist asks The Handmaid’s Tale: Fact or Fiction? as she discusses a Department of Health and Human Services (HHS) draft document proposing to redefine nearly all forms of birth control as a form of abortion. It would allow any federal grant recipient to obstruct a woman’s access to contraception and prevent women from accessing treatments for diseases such as cancer if those treatments could harm a fetus.

Think Gene

One type of gene therapy involves the introdution of a “good” gene into targeted cells to fight or prevent disease. However, done incorrectly, gene therapy can also cause cancer. Given the extremely low survival rates in pancreatic cancer patients, Josh suggests a gene therapy that may be worth trying, republishing a press release announcing that VCU Massey Cancer Researchers Find Gene Therapy that Kills Pancreatic Cancer Cells [7].

Gene Sherpas: Personalized Medicine and You

Like colorectal cancer, the survival rate of ovarian cancer improves greatly with early diagnosis. Dr. Steve Murphy reflects on some facts on ovarian cancer, announcing that September is Now Ovarian Cancer Month.

e-patients.net

E-patients are health consumers who use the Internet to gather information about a medical condition of particular interest to them. Guest posting at e-patients.net, cancer patient Monique tells why she doesn’t see herself as “e”.

Remember the Mayo Clinic study proving that optimists live longer then pessimists, which didn’t surprise the pessimists, not one bit? Well, somebody is going to prove what we already suspect: e- patients get better medical care, without being rich. C-patients get sub-standard care. E-patients live longer. And, e-vidently, e-ssentially, better.

Britannica Blog

Nanotechnology is the science and technology of building devices from single atoms and molecules. Tasha Moideen offers a video from the National Cancer Institue describing the applications of Nanotechnology & Cancer in cancer research, prevention and treatment.

Terra Sigillata

Methadone is a synthetic opioid, which is used medically as a pain reliever, cough suppressant and maintenance anti-addictive for use in patients on opioids. It was reported last month that methadone can kill leukemia cells and overcomes chemoresistance [8]. Abel Pharmboy comments on the development of Methadone For Cancer (No) and Cancer Pain (Yes).

OncoChat

Vytorin is a drug used to treat elivated lipids in the blood by inhibiting the absortipon of cholesterol by the small intestine. However, there’s insufficient data to prove that it reduces cardiovascular disease. Now, scientists are discussing a link between the cholesterol-fighting medicine and cancer [9]. Sally Church asks, Vytorin and Cancer - is there a link?

Conclusion

My thanks to everyone that contributed articles — it’s been great hosting the Cancer Research Blog Carnival for a second time this year. Be sure to take a moment and let your fellow bloggers know this issue is available so that everyone’s hard work can be appreciated and enjoyed by all.

The Cancer Research Blog Carnival is looking for future hosts. You can find both the hosting schedule and past editions at the Cancer Research Blog Carnival website.

For more information on the U.S. investment in cancer research, you can read the NCI’s plan and budget proposal for fiscal year 2009.

References

Niederhuber JE. A look inside the National Cancer Institute budget process: implications for 2007 and beyond. Cancer Res. 2007 Feb 1;67(3):856-62.
View abstract
The Nation’s Investment in Cancer Research. Connecting the Cancer Community. An Annual Plan and Budget Proposal for FY2009. National Cancer Institute. National Institutes of Health. U.S. Department of Health and Human Services. 2008 Jan.
Global Survey Highlights Need for Cancer Prevention Campaigns to Correct Misbeliefs. International Union Against Cancer. 2008 Aug.
Weisenthal et al. Cell culture detection of microvascular cell death in clinical specimens of human neoplasms and peripheral blood.
J Intern Med. 2008 Sep;264(3):275-287(13).
Kato et al. A video game improves behavioral outcomes in adolescents and young adults with cancer: a randomized trial. Pediatrics. 2008 Aug;122(2):e305-17.
View abstract
McCulloch et al. Diagnostic accuracy of canine scent detection in early- and late-stage lung and breast cancers. Integr Cancer Ther. 2006 Mar;5(1):30-9.
View abstract
Lebedeva et al. Chemoprevention by perillyl alcohol coupled with viral gene therapy reduces pancreatic cancer pathogenesis. Mol Cancer Ther. 2008 Jul;7(7):2042-50.
View abstract
Friesen et al. Methadone, commonly used as maintenance medication for outpatient treatment of opioid dependence, kills leukemia cells and overcomes chemoresistance. Cancer Res. 2008 Aug 1;68(15):6059-64.
View abstract
Rossebø et al. Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis. N Engl J Med. 2008 Sep 2. [Epub ahead of print]
View abstract

At the annual meeting of the American Association for Cancer Research (AACR) last month, researchers from GeneNews Corp. reported that the probability of colorectal cancer (CRC) in asymptomatic patients can be accurately stratified by RNA expression profiling of six genes in whole blood [1]. The company focuses on developing blood-based biomarker tests for the early detection of diseases and personalized health management.

Stratification is a statistical method of sampling from a population, whereby members are grouped into subgroups that display a consistent feature. In the current study, the six-gene panel was able to stratify a population with average risk for CRC into three groups:

Increased probability (18% had a 3-fold increased probability of currently having CRC)
Average probability (20% had an average probability of currently having CRC)
Decreased probability (62% had a 4-fold decreased probability of currently having CRC)

The study comes after publication of their approach to detecting blood biomarker sets earlier this year in the journal Clinical Cancer Research [2]. The study evaluated blood RNA samples from an Asian population and identified five genes in patients with CRC that could be differentiated from controls.

photo credit: DimsumDarren

In the study, researchers screened 31 whole blood samples from patients without CRC (n = 15) or patients with CRC (n = 16) by DNA microarray, a technology that enables scientists to examine how active thousands of genes are at a given time. They identified 37 genes unrelated to age or gender that were significantly different between controls and patients with CRC. The 37 genes were then tested with a large training set of 115 samples (57 controls, 58 CRC) using real-time PCR. 17 of the 37 genes were validated as differentially expressed. Five of the 37 validated genes were selected for logistic regression analysis.

Logistic regression is a statistical model used for prediction of the probability of occurrence of an event, using predictor variables that may be either numerical or categorical.

The predictive power of the five genes was then validated with a third independent set of 92 samples (49 controls, 43 CRC). The validation correctly identified 88% of CRC samples and 64% of non-CRC samples.

In their most recent study, GeneNews examined more samples than previously analyzed, this time in a heterogeneous North American population. Researchers screened a training set of 243 whole blood samples from patients without CRC (n = 127) or patients with CRC (n = 116) by DNA microarray. Six genes whose expression could meaningfully discriminate between the two groups were identified [3]:

Annexin A3 (ANXA3), which plays a role in the regulation of cellular growth and in signal transduction pathways.
C-type lectin domain family 4, member D (CLEC4D), which has diverse functions, such as cell adhesion, cell-cell signalling, glycoprotein turnover, and roles in inflammation and immune response.
Lamin B1 (LMNB1), which is thought to be involved in nuclear stability, chromatin structure and gene expression.
Proline rich Gla (G-carboxyglutamic acid) 4 (PRRG4), function unknown.
Vanin 1 (VNN1), involved in the recycling of pantothenic acid (vitamin B5).
Interleukin 2 receptor, beta (IL2RB), which is involved in T cell-mediated immune responses.

The predictive power of the six genes was then validated in a blinded, independent set of 337 samples (171 controls, 166 CRC). The combined training/blind set had an average accuracy of 70.8%. GeneNews has announced plans to develop a laboratory test later this year based on the six-gene panel called ColonSentry [4]. Similar blood screening tests are under investigation by the GeneNews for prostate, breast and ovarian cancer.

Why is this important? Colorectal cancer (CRC) is the third most common cancer in both men and women with an estimated 49,960 deaths expected to occur in 2008, accounting for 9% of all cancer deaths [5]. A simple, noninvasive test that can classify average risk patients into more defined groups would help to assess an individual’s risk for CRC. Since CRC can often be treated if caught early enough, those having an increased probability could be screened more frequently. Screening can result in the detection and removal of colorectal polyps before they become cancerous. Additionally, screening can help to detect CRC that is at an early stage.

Consider these statistics: when CRC is detected early, the 5-year survival rate is 90%. If the cancer has spread locally, the 5-year survival rate decreases to 68%. For patients with advanced CRC that has metastasized, the 5-year survival rate is 10% [5].

The American Cancer Society (ACS) has published guidelines for the early detection of cancer. Beginning at age 50, men and women at average risk for developing CRC should be screened with one of the following tests:

Tests that find polyps and cancer

Flexible sigmoidoscopy every 5 years
Colonoscopy every 10 years
Double contrast barium enema every 5 years
CT colonography (virtual colonoscopy) every 5 years

Tests that mainly find cancer

Fecal occult blood test (FOBT) every year
Fecal immunochemical test (FIT) every year
Stool DNA test (sDNA), interval uncertain

Don’t underestimate the importance of regular cancer screening. One of the reasons for a decline in CRC incidence rates since 1998 is increased surveillance. If you’re at risk, get checked.