Most women undergoing conservative surgery for vulvar cancer maintain healthy body image and sex life

Jan. 17, 2014 — A new study finds that most women who undergo conservative surgery for vulvar cancer experience little to no long-term disruption to sexuality and body image. Published early online in the Journal of Advanced Nursing, the study also reveals factors that can increase women's risk of feeling negative emotions after surgery.

Women diagnosed with vulvar cancer are often treated with surgery that involves the removal of substantial sections of the external genitalia. Because survival rates are extremely high for women with early stages of the disease, it is important to understand the psychosocial issues that women experience following treatment.

Ellen Barlow, RN, of The Royal Hospital for Women in Australia, and her colleagues interviewed 10 women who had previously been treated for early stage vulvar cancer, with a focus on investigating the women's experiences of sexuality and body image.

The researchers found that the majority of women experienced little to no long-term disruption to sexuality and body image following conservative surgery to treat their cancer. Women's sexual satisfaction was affected more by intimacy and relationship status than physical arousal. Women tended to feel negative emotions if they experienced more radical vulvar excision, multiple vulvar procedures, and/or swelling of the lower limbs (a potential complication of surgery). Some women expressed fear of possible removal of their clitoris, and all sexually active women expressed fear of pain on resumption of sexual intercourse.

"The findings indicate surprisingly good outcomes for sexuality and body image in women having conservative surgery for early stage vulvar cancer and support the concept of performing the most conservative vulvar resection consistent with cure of their disease," said Barlow. The authors noted a need for improved communication about sexuality and body image, specifically about resumption of sexual intercourse. They also stressed that women should be counselled on how to prevent or alleviate sexual issues that may arise as a consequence of their treatment.

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The above story is based on materials provided by Wiley, via AlphaGalileo.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Journal Reference:

1. Ellen L. Barlow, Neville F. Hacker, Rafat Hussain, Glenda Parmenter. Sexuality and body image following treatment for early-stage vulvar cancer: a qualitative study. Journal of Advanced Nursing, 2014; DOI: 10.1111/jan.12346

Note: If no author is given, the source is cited instead.

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Shows promise for women with other drugs triple-negative breast cancer

In the nationwide survey of women with triple-negative breast cancer angiogenesis inhibitors led to rapid increase in number of carboplatin chemotherapy using drugs or with a standard chemotherapy drug Avastin off completely, the tumor shrank, adding investigators, reported at the San Antonio Breast Cancer Symposium 2013. In the study, cancer and leukemia Group B hosted by new Faber Cancer Institute, Brown University, University of Texas MD Anderson Cancer Center, UNC Lineberger comprehensive cancer include author from the Center. New York University, Washington University in St. Louis, hope comprehensive cancer center and Mount Sinai Medical Center.

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New combination therapy may improve outcomes for women with triple-negative breast cancer.

I-spy 2 trial, innovative multidrug resistance, phase II trial cancer led to a positive result in the first drugs to complete testing in breast cancer trial. Using the standard chemotherapy for women with triple-negative breast cancer improved outcomes I spy carboplatin combination chemotherapy and molecular targeted drugs veliparib 2 from trial (UCSF Helen Diller family comprehensive cancer led by researchers from the Center) in and results will be announced in 2013, according to the San Antonio Breast Cancer Symposium held 12/10-14.

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New health resource to improve access to family planning for women after childbirth

13 November 2013 | ADDIS ABABA, Ethiopia - A new resource for health programme managers and policy makers released today aims to improve access to family planning for women after childbirth and during the first 12 months of motherhood.

Closely-spaced and unintended pregnancies are a health risk to both mother and child: spacing pregnancies at least 2 years apart can avert 10% of infant deaths and about 1 in 5 deaths in children aged 1 to 4.

Launched at the International Conference on Family Planning in Addis Ababa, Ethiopia, "Programming strategies for postpartum family planning" provides interventions at all levels of health care to expand access to scientifically-sound family planning methods for new mothers.

The plan identifies three critical areas of work for countries to ensure successful implementation of the strategies:

• close tracking of postpartum contraceptive use to ensure a steady supply and distribution of contraceptives;
• high quality, easy-to-understand informational materials about family planning options to help women and families make informed choices; and
• health worker training of recommended practices so services are consistent with global standards of care.

Programming Strategies is being launched by WHO, the US Agency for International Development (USAID) and its implementing partner, the Maternal and Child Health Integrated Program (MCHIP).

“Virtually all women who have just had a baby are not ready to have another one right away, but too often they don’t have access to family planning,” says Dr Marleen Temmerman, director of the Department of Reproductive Health and Research at WHO. “Many women are not even aware that they can become pregnant within 12 months of giving birth.”

Demographic and Health Survey (DHS) data from 27 developing countries show that 95% of postpartum women want to avoid a pregnancy for at least 2 years, yet 65% do not use contraception. In Ethiopia, a similar analysis shows 81% of postpartum women are not using any contraception.

“There are many obvious, although often missed, opportunities to inform postpartum women on their options for healthy birth spacing and offer them an effective method of contraception,” said Patricia MacDonald, Senior Technical Advisor, Office of Population and Reproductive Health, USAID. “Antenatal care givers, birth attendants, child health providers and vaccinators should all take the time to ask a woman whether she is interested in family planning to protect herself from having another pregnancy too soon. This critical window may be the only chance to offer postpartum women the information they need for safe and healthy motherhood.”

“This document demonstrates the global health community’s response to the growing demand for postpartum family planning,” according to Koki Agarwal, MCHIP Director and moderator of the launch event. “Today we call on stakeholders across the spectrum – from health extension workers to midwives, nurses, medical doctors and policy makers – to ensure that every mother, every couple, are better able to safely plan their families.”

For more information please contact:

Elisa Scolaro
WHO
??lephone: +41 79 516 8872
E-mail: scolaroe@who.int

Colleen Barton Sutton
?elephone: +1 703 203 7843
E-mail: colleen@redjacketpr.com

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Anti-cancer drug benefits women with breast cancer who have failed previous treatments

Sep. 27, 2013 — First results from a phase III clinical trial of the combination drug, T-DM1, show that it significantly improves the length of time before the disease worsens in women with advanced HER2 positive breast cancer whose cancer has recurred or progressed despite previous treatments, including trastuzumab and lapatinib.

In a late-breaking presentation to the 2013 European Cancer Congress (ECC2013) [1] today, Professor Hans Wildiers will say: "This study shows that even in heavily pre-treated women, 75% of whom had cancer that has spread to the internal organs, T-DM1 nearly doubles progression-free survival -- the length of time before disease progression or death, whichever occurs first -- compared to standard therapy, and with a more favourable safety profile. Few drugs have been able to achieve both improved progression-free survival and a better toxicity profile. These results indicate this drug has important clinical benefit for patients."

T-DM1 is a conjugated monoclonal antibody in which trastuzumab [2] is combined with a cell-killing drug emtansine (DM1) to target and kill breast cancer cells that have large amounts of the protein HER2 on their cell surfaces -- known as HER2 positive breast cancer. T-DM1 has already been shown to benefit patients with HER2 positive breast cancer that has spread to other parts of the body (metastasised), and who have already been treated with trastuzumab and a taxane-based chemotherapy.

"Despite the availability of improved treatments, virtually all patients with HER2 positive metastatic breast cancer develop progressive disease and require additional therapies for palliation. Currently there is no clear standard of care for patients who progressed after two or more treatments for their disease, including the use of the anti-HER2 drugs trastuzumab and lapatinib, and new treatment options are needed for these patients," says Prof Wildiers, who is adjunct head of clinic at the department of medical oncology, and coordinator of the chemotherapy and related clinical trial programme in the multidisciplinary breast centre at the University Hospitals Leuven, Belgium.

The international phase III clinical trial, called TH3RESA, enrolled patients whose cancer was inoperable, or had recurred or metastasised after several treatments including trastuzumab and lapatinib. By February 2013, 602 patients had been randomised to receive 3.6 mg/kg intravenous infusion of T-DM1 every three weeks or a treatment of their physician's choice (TPC). The majority (75%) had visceral disease (cancer that had spread to internal organs) and they had received a median [3] of four previous treatment regimens (excluding single agent hormonal therapy).

Results showed that median progression-free survival increased by nearly three months from 3.3 months for the TPC patients to 6.2 months for patients receiving T-DM1. Among the T-DM1 patients, 31.3% showed a response to the drug, compared with 8.6% of the TPC patients. An interim analysis of overall patient survival showed a similar trend, but it did not reach the level at which a statistically significant benefit for T-DM1 treatment could be confirmed. Patients in the TPC group, whose disease progressed, were given the option of crossing over into the T-DM1 arm and 44 patients have done this so far. Generally, there were fewer serious adverse side-effects in the T-DM1 patients than in the TPC group.

"These data reaffirm the potential of T-DM1 as a treatment for HER2-positive metastatic breast cancer. They demonstrate that T-DM1 has the potential to be a new treatment paradigm for this group of patients who currently have few options," Prof Wildiers will say.

"In the earlier, EMILIA trial, T-DM1 was shown to be superior to capecitabine and lapatinib in patients who had previously received trastuzumab and a taxane. TH3RESA demonstrates that T-DM1 offers statistically significant and clinically meaningful improvement in delaying disease progression compared to a treatment of physician's choice, which was predominantly trastuzumab and chemotherapy combinations, in patients who have previously received trastuzumab and lapatinib.

"This trial will continue until the final overall survival analysis takes place or until the survival benefit for treatment with T-DM1 reaches statistical significance at an interim analysis. T-DM1 is also being tested both alone and in combination with pertuzumab in patients with previously untreated HER2 positive metastatic breast cancer in the MARIANNE trial," he will conclude.

ECCO President, Professor Cornelis van de Velde, commented: "These results from the TH3RESA trial are important because they confirm and extend the usefulness of T-DM1 for the treatment of women with advanced HER2 positive breast cancer. Once HER2 positive breast cancer has recurred and metastasised, there are few treatment options available that show any clear benefit for women who have probably undergone several previous treatments for the disease. The fact that T-DM1 extends progression-free survival is good news for these women."

View the original article here

Anti-cancer drug benefits women with breast cancer who have failed previous treatments

Sep. 27, 2013 — First results from a phase III clinical trial of the combination drug, T-DM1, show that it significantly improves the length of time before the disease worsens in women with advanced HER2 positive breast cancer whose cancer has recurred or progressed despite previous treatments, including trastuzumab and lapatinib.

In a late-breaking presentation to the 2013 European Cancer Congress (ECC2013) [1] today, Professor Hans Wildiers will say: "This study shows that even in heavily pre-treated women, 75% of whom had cancer that has spread to the internal organs, T-DM1 nearly doubles progression-free survival -- the length of time before disease progression or death, whichever occurs first -- compared to standard therapy, and with a more favourable safety profile. Few drugs have been able to achieve both improved progression-free survival and a better toxicity profile. These results indicate this drug has important clinical benefit for patients."

T-DM1 is a conjugated monoclonal antibody in which trastuzumab [2] is combined with a cell-killing drug emtansine (DM1) to target and kill breast cancer cells that have large amounts of the protein HER2 on their cell surfaces -- known as HER2 positive breast cancer. T-DM1 has already been shown to benefit patients with HER2 positive breast cancer that has spread to other parts of the body (metastasised), and who have already been treated with trastuzumab and a taxane-based chemotherapy.

"Despite the availability of improved treatments, virtually all patients with HER2 positive metastatic breast cancer develop progressive disease and require additional therapies for palliation. Currently there is no clear standard of care for patients who progressed after two or more treatments for their disease, including the use of the anti-HER2 drugs trastuzumab and lapatinib, and new treatment options are needed for these patients," says Prof Wildiers, who is adjunct head of clinic at the department of medical oncology, and coordinator of the chemotherapy and related clinical trial programme in the multidisciplinary breast centre at the University Hospitals Leuven, Belgium.

The international phase III clinical trial, called TH3RESA, enrolled patients whose cancer was inoperable, or had recurred or metastasised after several treatments including trastuzumab and lapatinib. By February 2013, 602 patients had been randomised to receive 3.6 mg/kg intravenous infusion of T-DM1 every three weeks or a treatment of their physician's choice (TPC). The majority (75%) had visceral disease (cancer that had spread to internal organs) and they had received a median [3] of four previous treatment regimens (excluding single agent hormonal therapy).

Results showed that median progression-free survival increased by nearly three months from 3.3 months for the TPC patients to 6.2 months for patients receiving T-DM1. Among the T-DM1 patients, 31.3% showed a response to the drug, compared with 8.6% of the TPC patients. An interim analysis of overall patient survival showed a similar trend, but it did not reach the level at which a statistically significant benefit for T-DM1 treatment could be confirmed. Patients in the TPC group, whose disease progressed, were given the option of crossing over into the T-DM1 arm and 44 patients have done this so far. Generally, there were fewer serious adverse side-effects in the T-DM1 patients than in the TPC group.

"These data reaffirm the potential of T-DM1 as a treatment for HER2-positive metastatic breast cancer. They demonstrate that T-DM1 has the potential to be a new treatment paradigm for this group of patients who currently have few options," Prof Wildiers will say.

"In the earlier, EMILIA trial, T-DM1 was shown to be superior to capecitabine and lapatinib in patients who had previously received trastuzumab and a taxane. TH3RESA demonstrates that T-DM1 offers statistically significant and clinically meaningful improvement in delaying disease progression compared to a treatment of physician's choice, which was predominantly trastuzumab and chemotherapy combinations, in patients who have previously received trastuzumab and lapatinib.

"This trial will continue until the final overall survival analysis takes place or until the survival benefit for treatment with T-DM1 reaches statistical significance at an interim analysis. T-DM1 is also being tested both alone and in combination with pertuzumab in patients with previously untreated HER2 positive metastatic breast cancer in the MARIANNE trial," he will conclude.

ECCO President, Professor Cornelis van de Velde, commented: "These results from the TH3RESA trial are important because they confirm and extend the usefulness of T-DM1 for the treatment of women with advanced HER2 positive breast cancer. Once HER2 positive breast cancer has recurred and metastasised, there are few treatment options available that show any clear benefit for women who have probably undergone several previous treatments for the disease. The fact that T-DM1 extends progression-free survival is good news for these women."

View the original article here

Women in Appalachia have higher rates of late stage breast cancer

Sep. 26, 2013 — Older women living in the poorest areas of Appalachia in the U.S. fail to get regular breast cancer screening and have a higher incidence of later stage breast cancer, reports a new study in Health Services Research.

About 25 million people live in the 13 states that make up the Appalachian region, a 205,000-square-mile region that follows the spine of the Appalachian Mountains from southern New York to northern Mississippi. The National Cancer Institute has recently publicized Appalachia's higher rates of cancer and poorer outcomes for residents diagnosed with cancer.

To examine regional disparities in breast cancer screening and diagnosis, researchers evaluated Central Cancer Registry and Medicare claims data from three Appalachian states (Kentucky, Ohio, and Pennsylvania) to measure the incidence of later stage breast cancer in the region's poorest counties compared with its more affluent counties. The counties' economic statuses were compared based on factors such as unemployment rates, average home values and average monthly wages.

Women living in the most economically deprived counties -- located in eastern Kentucky and southeastern Ohio -- had 3.31 times as many late-stage tumors compared to those in the least deprived counties. Appalachian women in the study over age 65 had a 17.3 percent incidence of later stage breast cancer compared to a national average of 16 percent for women of the same age.

The degree of disparity between the counties was stronger than the researchers had suspected, said lead author Roger T. Anderson, Ph.D., from the department of public health science at Pennsylvania State University College of Medicine.

"Overall, we found counties that are struggling economically tend to have inadequate health care resources or infrastructure and have the highest rates of later-stage breast cancer," said Anderson.

There were also disparities in how often women received recommended mammography screening. Although area women over the age of 65 had Medicare insurance coverage, only 53 percent had mammography screening within the 2 years before their cancer diagnosis compared with the national average of 67 percent.

Anderson explained that counties that struggle economically may set up a "perpetuating cycle of few services to promote cancer prevention and early detection in communities and less overall use of preventive services."

Clement Gwede, Ph.D., associate director of diversity at the Moffitt Cancer Center in Tampa, agreed, saying that solutions to the disparities in late stage breast cancer in the nation's more distressed communities must include improved access to mammography screening resources, education and awareness, and related resources.

"Without these broad and sustained strategies, the vicious cycle will persist," Gwede added.

View the original article here

Young women with breast cancer overestimate the benefit of having second breast removed

Sep. 16, 2013 — Young women with breast cancer often overestimate the odds that cancer will occur in their other, healthy breast, and decide to have the healthy breast surgically removed, a survey conducted by Dana-Farber Cancer Institute investigators indicates. The survey also shows that many patients opt for the procedure -- known as a contralateral prophylactic mastectomy, or CPM -- despite knowing it will be unlikely to improve their chance of survival.

The study, published in the Sept. 17 issue of the Annals of Internal Medicine, shows a certain disconnect between what many patients know on an abstract, intellectual level -- that CPM has little impact on survival rates for most women -- and the choices they make after receiving the anxiety-inducing diagnosis of breast cancer, the authors say.

"An increasing percentage of women treated for early-stage breast cancer are choosing to have CPM," says the study's lead author, Shoshana Rosenberg, ScD, MPH, of the Susan F. Smith Center for Women's Cancers at Dana-Farber. "The trend is particularly notable among younger women."

The survey results, explains Rosenberg, suggest that many patients are going into this decision with an unrealistic sense of the benefits of CPM, and of the risks. "Improving the communication of those risks and benefits -- together with better management of anxiety surrounding diagnosis -- and providing patients with the support they need to make decisions based on solid evidence -- are worthwhile steps," says Rosenberg.

In the survey, researchers canvassed 123 women age 40 or younger who had undergone a bilateral mastectomy -- the removal of both breasts -- despite having cancer in only one breast. Respondents answered questions about their reasons for having the procedure, their knowledge of its risks and benefits, and their satisfaction with the outcome.

Almost all the women said they opted for CPM out of a desire to improve their chances of survival and prevent the cancer from spreading to other parts of the body. At the same time, however, most understood that removing both breasts does not extend survival for women who are free of an inherited genetic predisposition to breast cancer.

To explain this apparent contradiction, the authors write, "Most women acknowledge that CPM does not improve survival, but anxiety and fear of recurrence probably influence them during the decision-making process."

The survey also indicated that women who don't inherit an increased genetic risk of breast cancer tend to overestimate the chance that cancer will develop in both breasts. They estimated that 10 out of 100 women with cancer in one breast would develop cancer in the other breast within five years. The actual risk of that happening is approximately 2 to 4 percent.

By contrast, respondents who did have an inherited predisposition to breast cancer -- as a result of a mutation in the genes BRCA1 or BRCA2, for example -- more accurately perceived their risk for cancer in both breasts.

Even as they overestimated the benefits of CPM, many of the participants underestimated the severity of some of its side effects. Many respondents said the effect of CPM on their appearance was worse than they had expected. A substantial proportion of the respondents -- 42 percent -- reported that their sense of sexuality after CPM was worse than expected, although other studies have not found sexual problems to be prevalent.

"Our findings underscore how important it is that doctors effectively communicate the risks and benefits of CPM to women," Rosenberg says. "We need to be sure that women are making informed decisions, supported decisions, based on an accurate understanding of the pros and cons of the procedure, and in a setting where anxiety and concerns can be addressed."

View the original article here

Childbirth risks not the same for all obese women

Sep. 10, 2013 — Obesity raises the chances of complications and medical interventions in childbirth. But a new study by Oxford University shows the risks are not the same for all obese women.

For otherwise healthy women, the increase in risk with obesity may not be as great as previously suspected.

'The increased risk was fairly modest for obese women who did not have conditions such as high blood pressure, diabetes or a previous caesarean section, and the risks were quite low if the woman had given birth previously,' says lead researcher Dr Jennifer Hollowell of the National Perinatal Epidemiology Unit at Oxford University.

'It is important to appreciate that we are not saying that obesity isn't important or that obesity doesn't increase a woman's risks during pregnancy,' she adds. 'We found that around half of very obese women giving birth in obstetric units have medical problems or pregnancy complications when admitted. But our study focused on women who were obese but otherwise healthy when they went into labour, and some of them had much lower risks than might have been expected.'

The Oxford University researchers point out that, among healthy women with a straightforward pregnancy, childbirth risks are influenced more by whether someone is a first-time mum than whether they are obese.

They found that the chances of first-time mums of normal weight having medical interventions or complications during childbirth are greater than for 'very obese' but otherwise healthy women having a second or subsequent child. The findings are published in the British Journal of Obstetrics and Gynaecology.

Dr Hollowell comments: 'This finding does highlight a possible anomaly in the guidance given to women on where to give birth.'

First-time mothers with low-risk pregnancies can plan to have their child in hospital, at home, in a free-standing midwife-led unit or an alongside midwifery unit connected to a hospital -- according to what is available where they are.

However, current guidelines suggest all women with a body mass index (BMI) over 35 should be advised to have the birth in an obstetric unit to reduce risk.

Guidelines on assessing risks for women in planning births take no account of whether a woman is having their first child or has already had children.

'We think that the guidelines might need to be reviewed to take account of this more nuanced understanding of the effect of obesity,' says Dr Hollowell. 'We think it's worth considering whether it might be safe to allow some healthy obese women having a second baby the option of a birth in an alongside midwifery unit where obstetric and neonatal care is available on site if needed.'

The researchers investigated the influence of BMI on the chances of healthy women having any type of complication during labour and childbirth that would need hospital care -- either in an obstetric unit for the mother or a neonatal unit for the baby.

This included a range of medical interventions and complications that varied in urgency and severity, ranging from being given drugs to help with labour progressing slowly, through to having a caesarean section or assisted delivery by forceps or ventouse, significant loss of blood resulting in a blood transfusion, and the baby being admitted to a neonatal unit.

The researchers included data for 17,230 women who'd had straightforward pregnancies and had no medical conditions that might influence risks at labour and birth.

Around half of obese women planning a normal birth after a straightforward pregnancy have no medical or obstetric risk factors such as diabetes or high blood pressure, so this is an important group to study.

The risks of complications during childbirth did go up with increasing body mass index among these healthy women. But the researchers found the increase was modest. Overweight, obese or very obese women showed a relative increase in risk of 6-12% compared to women with a normal BMI.

Most of the additional risk of needing treatment was accounted for by giving drugs for slow labour among those with a high body mass index, though risks of serious outcomes for mother and baby were also increased.

However, whether a woman has had a previous baby plays a larger role in influencing the chances of needing hospital care. 53% of women of normal weight having their first baby had an intervention or a complication at birth. The figure was 21% for very obese but otherwise healthy women having a second or subsequent baby.

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Irregular periods in young women can be cause for concern

Sep. 10, 2013 — While irregular periods are common among teenage girls, an underlying hormonal disorder may be to blame if this problem persists.

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder that is characterized by an excess of androgens or male hormones in the body. The imbalance of hormones interferes with the growth and release of eggs from the ovaries, which can prevent ovulation and menstruation.

Menstruation begins on average at age 12, and a normal menstrual cycle is approximately 28 days. Dr. Kavic reports that girls should have a regular menstrual cycle within approximately two years after they get their first period or by age 17 at the latest.

"PCOS can be overlooked because irregular periods are normal in teens," said Suzanne Kavic, MD, division director, Reproductive Endocrinology, Loyola University Health System (LUHS). "However, if erratic menstrual cycles persist later into the teen years, girls should see a specialist to determine if something else might be causing this issue."

Other symptoms associated with PCOS can include weight gain, hair growth on the body and face, thinning of the hair on the head, acne and infertility. Women with PCOS are at risk for high blood pressure, high cholesterol and endometrial cancer. People with PCOS also tend to become resistant to insulin, which can lead to diabetes.

"Symptoms associated with this syndrome can be concerning to young girls particularly during the teen years, which is already a stressful time," Dr. Kavic said. "The good news is we can identify PCOS at an early age and begin managing symptoms to alleviate some of the anxiety for these girls."

Treatments for PCOS can include a combination of exercise, diet modifications and medication. Weight loss helps to regulate male hormones and blood sugar levels, which can restore ovulation and menstruation. Birth control pills also may be prescribed to control the menstrual cycle while other hormone therapies can decrease androgen levels and curb symptoms.

View the original article here

Young Men Less Likely to Survive Melanoma Than Women: Study

WEDNESDAY, June 26 (HealthDay News) -- White male teens and young adults are more likely to die of melanoma skin cancer than their female counterparts, a new study finds.

Researchers looked at data from more than 26,000 white patients, aged 15 to 39, in the United States who were diagnosed with melanoma between 1989 and 2009 and followed for an average of seven and a half years.

During the follow-up, there were nearly 1,600 melanoma-related deaths. Although males made up about 40 percent of the melanoma patients, they accounted for more than 63 percent of the deaths, according to the study, which was published June 26 in the journal JAMA Dermatology.

After adjusting for various factors, the investigators concluded that males were 55 percent more likely to die of melanoma than females.

Continued public health efforts are needed to raise young men's awareness of the dangers of melanoma, said Dr. Christina Gamba, of the Stanford University Medical Center, and colleagues.

"This alarming difference in the outcome highlights the urgent need for both behavioral interventions to promote early detection strategies in young men and further investigation of the biological basis for the sex disparity in melanoma survival," the study authors concluded.

Melanoma is the third most common type of cancer in American teens and young adults.

More information

The American Cancer Society has more about melanoma.

SOURCE: JAMA Dermatology, news release, June 26, 2013

Copyright c 2013 HealthDay. All rights reserved.

View the original article here

African-American women less likely to receive HPV vaccine than whites, even with access to health care

AppId is over the quota
AppId is over the quota

Even with access to health care, African-American women are less likely to receive the vaccine for human papillomavirus (HPV), which reduces the risk for cervical cancer, according to a study by researchers at the University of Pittsburgh School of Medicine (home of the University of Pittsburgh Cancer Institute). The findings, published in the Journal of Adolescent Health, suggest a need for health care providers to both bolster HPV vaccination recommendations and address negative attitudes toward the vaccine among this vulnerable patient population.

Click here to read full press release.

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Among the research institutions NCI funds across the United States, it currently designates 68 as Cancer Centers. Largely based in research universities, these facilities are home to many of the NCI-supported scientists who conduct a wide range of intense, laboratory research into cancer’s origins and development. The Cancer Centers Program also focuses on trans-disciplinary research, including population science and clinical research. The centers’ research results are often at the forefront of studies in the cancer field.

View the original article here

Diabetes Drug Metformin May Cut Breast Cancer Risk in Older Women

AppId is over the quota
AppId is over the quota

MONDAY, June 11 (HealthDay News) -- A widely prescribed drug, metformin, may lower the risk of invasive breast cancer in postmenopausal women with diabetes, a new study indicates.

The research, published online June 11 in the Journal of Clinical Oncology, echoes other recent studies that have suggested the diabetes drug may help cut the chances of prostate, pancreatic, liver and oral cancer, as well as certain forms of melanoma.

The researchers found that the incidence of invasive breast cancer was 25 percent lower in women with diabetes who were taking metformin than it was in women who weren't taking the drug.

Approximately 25.8 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention. Between 90 percent and 95 percent of these cases are type 2 diabetes, in which the body's ability to make and use insulin deteriorates.

"Type 2 diabetes is a disease of insulin resistance," said study co-author Dr. Rowan Chlebowski, a medical oncologist with the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, in Torrance, Calif.

Insulin is a hormone that helps regulate the level of glucose (sugar) in the body. With type 2 diabetes, the body manufactures larger quantities of insulin to maintain normal levels of glucose in the blood.

Metformin, commonly used to treat type 2 diabetes, increases insulin sensitivity and improves the control of blood sugar. "It makes the insulin you have more effective," Chlebowski explained. The drug, approved in the United Kingdom in 1958 and in Canada in 1972, was introduced in the United States in 1994.

The new research looked at relationships among diabetes, metformin use and breast cancer among over 68,000 women between 50 and 79 years old in the national Women's Health Initiative project. In this group, 3,401 had diabetes and 3,273 invasive breast cancers were diagnosed during the study.

Because of the design of the Women's Health Initiative trials, detailed information was available for this large and diverse population in many areas, including breast cancer risk factors, baseline mammograms, clinical breast exams and verification of breast cancers when they occurred. Researchers were also able to know which participants had diabetes -- along with their use of diabetes medication.

The trials excluded women who had already had breast cancer. Women who had developed diabetes before adulthood (suggesting they were type 1 diabetics) were also excluded from the study.

How can a drug that treats people with high blood sugar play a role in reducing breast cancer risk? Chlebowski suggested that metformin "may inhibit the master regulator of the cell, 'mTOR,' changing critical pathways involved in cancer."

The mTOR pathway is affected by a wide range of cellular signals, including growth factors, hormones such as insulin, nutrients including glucose and amino acids, cellular energy levels and stress. A key cell pathway associated with mTOR is critically involved in cell reproduction and survival.

Chlebowski and other experts cautioned against looking to metformin as a cancer prevention drug just yet.

"It's too soon to change clinical practice," said Jennifer Ligibel, a medical oncologist in the Women's Cancer Program at the Dana-Farber Cancer Institute in Boston. "While a number of other studies have suggested metformin has a role in preventing breast cancer and its recurrence, I would not recommend women take metformin for breast cancer prevention based on the data we have now."

As to the question of whether metformin could ever be used more broadly beyond diabetic patients to reduce the risk of breast cancer, Chlebowski said the answer is unclear and more studies are necessary to further analyze the linkage.

While the study uncovered an association between metformin use and lower breast cancer risk in diabetic postmenopausal women, it did not prove a cause-and-effect relationship.

The U.S. Food and Drug Administration has issued warnings about metformin in recent years. It requires product inserts for physicians and patients to say that the drug has been associated with increased cardiovascular risks, including heart attack and stroke, and lactic acidosis, which causes fatigue, muscle pain, difficulty breathing and other symptoms. The FDA also stipulates that the drug literature include a warning that the drug should only be used by patients with type 2 diabetes who cannot control their blood sugar with lifestyle or other medications.

More information

The U.S. National Library of Medicine has more on type 2 diabetes.

Copyright c 2012?HealthDay. All rights reserved.