Treasury says Lew leaves hospital after surgery

WASHINGTON (Reuters) - U.S. Treasury Secretary Jack Lew was discharged from a hospital on Wednesday following a surgery to treat a benign enlarged prostate, a Treasury spokesperson said.

"(Lew) is now at home recuperating from his surgical procedure yesterday," Treasury spokeswoman Natalie Wyeth Earnest said in a statement. "He is in good spirits, talking with staff, and looks forward to being back in the office next week."

The spokeswoman had said on Tuesday the surgery went well but that Lew's doctor decided to keep him in the hospital overnight because he was running a low fever.

Lew, 58, was sworn in as Treasury secretary in February 2013 after serving as President Barack Obama's chief of staff.

(Reporting by Timothy Ahmann; Editing by Chizu Nomiyama)

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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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Tongue cancer strikes surgery chemotherapy

Less significantly more patients with tongue carcinoma underwent the first University of Michigan comprehensive cancer started their course of patients with chemotherapy treatment according to new research from the Center for study of. You elected a little better help the single administration of Larynx Cancer, chemotherapy patients chemotherapy or radiation and surgery for which patients it must determine the Protocol. Laryngeal cancer pioneer and widely research U M in, this approach leads to patient survival and functional outcomes. However, describes the JAMA society of Otorhinolaryngology Head and neck surgery displayed in this new study, a clear error.

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Unstable chromosomes linked to less favorable response to radiation therapy and surgery in prostate cancer patients

Sep. 25, 2013 — Detailed evaluation of a prostate cancer tumor biopsy may predict treatment outcomes for image-guided radiation therapy (IGRT) or surgery for prostate cancer, according to research presented today at the American Society for Radiation Oncology's (ASTRO's) 55th Annual Meeting. The study results indicate that patients who have abnormal levels of breaks at common fragile sites (CFSs), sites within the chromosomes that are sensitive to DNA damage, are more likely to have their cancer to return -- treatment failure. These CFS break abnormalities are usually associated with instability of the cell's DNA, a phenomenon that is particularly associated with cancer.

In this study, researchers assessed the outcomes of 280 prostate cancer (Cap) patients, and reviewed the DNA "fingerprints" of each patient's tumor (using the patient's initial diagnostic core biopsy) to determine if gene copy number alterations (CNAs), or breaks in CFSs, were related to a less positive response to treatment. Two groups were analyzed: 126 localized intermediate risk CaP patients who had received image-guided radiation therapy (IGRT) treatments, with a mean dose of 74.6 Gy; and 154 localized intermediate and high risk CaP patients who had undergone radical prostatectomy (RP), which is the surgical removal of the entire prostate gland.

Utilizing an array comparative genomic hybridization (aCGH), DNA from frozen needle biopsies of the RT patients was analyzed for 13 previously characterized CFSs: FRA2G, FRA3B, FRA4F, FRA6E, FRA6F, FRA7E, FRA7G, FRA7H, FRA7I, FRA7K, FRA8C, FRA9E, FRA16D. The effect of having at least one CNA in any CFS was assessed using the Kaplan-Meier method and Cox proportional hazard models.

The data revealed a pattern in which the patients who failed treatment had abnormal levels of CNAs at CFSs. In the IGRT group, CNAs in CFSs occurred frequently, with 80 of the patients (64 percent) having a CNA in one or more CFS locations (median was 1, and the range was 0 -- 10).

Each patient's biochemical relapse-free rate (bRFR) was gauged, because if a patient relapses biochemically, his prostate specific antigen level has risen significantly and this is a reasonable indicator that the cancer has recurred. Thus, a high bRFR is desirable. On univariate analysis, patients with a CNA in at least one CFS showed a decreased 5-year bRFR (64 percent), compared with the bRFR of patients without genetic alteration in CFSs (90 percent; HR = 2.13, 95% CI: 1.17-3.86, p = 0.011). After adjusting for clinical factors in a multivariate model, a CNA in a CFS was determined to be a significant independent predictor of decreased response to radiation therapy and higher incidence of recurring cancer. (HR = 2.94, 95% CI: 1.51-5.75, P = 0.0016).

The results of the 154 patients in the RP group were compiled using the publically available Memorial Sloan-Kettering Cancer Center (MSKCC) aCGH database of patients. CNAs in CFSs were also frequent in the RP group, with 81 patients (53 percent) having a CNA in one or more location (median was 1, and the range was 0 -- 6). These results also correlated to decreased 5-year bRFR rates of 68 percent, compared to 82 percent for RP patients without genetic alterations in CFSs (HR = 1.79). Despite this strong trend, after adjusting for clinical factors in a multivariate model, a CNA in a CFS was not a statistically significant predictor of cancer recurrence (HR = 1.52, 95% CI: 0.77-3.02, P = 0.23).

"We thought that patients who have CFS breaks might be more sensitive to radiation therapy-induced DNA damage," said the lead author of the study, Robert G. Bristow, MD, PhD, a Professor within the radiation oncology and medical biophysics departments at the University of Toronto; and a Clinician-Scientist at the Princess Margaret Cancer Centre in Toronto. "We now think that the CFS breaks are a signal that the cancer cell has acquired numerous genetic changes that lead to more aggressive cancer cells that can spread early and outside the prostate gland. Our data suggest that the patients failing treatment are due to early metastatic (distant spread) disease. If we validate this study in similar, but larger groups of patients, we can develop a test based for CFS breaks; the results would allow us to place patients in one of two categories: those whose tumors do not have CFS breaks and who would likely do well with local treatment alone (e.g. radiotherapy or surgery); and, those patients whose tumors do have CFS breaks and would need a more complex treatment protocol, in addition to RT or surgery, to combat distant spread."

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Speeding up cancer diagnosis during surgery

Sep. 17, 2013 — Experts at The University of Nottingham have developed a highly accurate prototype technique which can produce a detailed 'spectroscopic fingerprint' of each tissue layer removed during surgery. This technique -- which can produce detailed maps of the tissue rich in information at the molecular level -- has the potential to speed up and improve the diagnosis of cancer tissue during the operation as well as reduce unnecessary surgery.

Tissue-conserving cancer surgery is a highly skilled procedure which involves time-consuming tissue preparation to detect the margins of cancerous tissue. The goal is to remove as much of the tumour as possible while sparing healthy tissue.

With funding from the National Institute for Health Research (NIHR), experts at The University of Nottingham have developed a highly accurate prototype technique which can produce a detailed 'spectroscopic fingerprint' of each tissue layer removed during surgery. This technique -- which can produce detailed maps of the tissue rich in information at the molecular level -- has the potential to speed up and improve the diagnosis of cancer tissue during the operation as well as reduce unnecessary surgery.

The research has been published in the journal Proceedings of the National Academy of Sciences and the team, led by Dr Ioan Notingher in the School of Physics and Astronomy, are now looking to build an optimised instrument that can be tested in the clinic. Dr Notingher said: "By refining our prototype instrument to make it more user-friendly and even faster to use. Diagnosis of each tissue layer could be obtained in just a few minutes -- rather than hours. Such developments have the potential to revolutionise the surgical treatment of cancers. This technology will provide a fast and objective way for surgeons to make sure that all the cancer cells have been removed whilst at the same time preserving as much healthy tissue as possible."

The challenges of tissue-conserving surgery

Typically, skin conserving surgery involves cutting away one thin layer of tissue after another and each layer after another is carefully examined to make sure that all the cancer has been removed. This lengthy process is stopped when only health tissue is left. Successful removal of all cancer cells is the key to achieving lower rates of the cancer returning but there is always a balance to be struck between making sure all the cancer is removed and preserving as much healthy tissue as possible in order to reduce scarring and disfigurement.

Dr Notingher said: "The real challenge is to know where the cancer starts and ends when looking at it during an operation so that the surgeon knows when to stop cutting. Our technique can also diagnose the presence or absence of skin cancer in thick chunks of skin tissue, making it unnecessary to cut the tissue up further into thin slices."

Scientific research in this field started around two decades ago and only now are scientists starting to publish the results of their work. The use of lasers and high-sensitivity light detection technologies allows faster and more sensitive imaging of tissues and discrimination of tumours.

A huge step forward for the patient

One particular technique, known as Mohs surgery -- microscopically controlled surgery -- is used for the treatment of difficult cases of a type of skin cancer called basal cell carcinoma (BCC). BCC is the commonest cancer in humans with more than 60,000 new patients diagnosed each year in the UK. The incidence of BCC continues to increase each year because we have an aging population who have had a lot of sun exposure in the past. Mohs surgery provides the highest cure rates for BCC, but the procedure takes a lot of time because each new tissue layer has to be frozen and examined during the operation. Typically, this takes around 1-2 hours per layer so an operation can take as long as five to seven hours in total. So, from a patient's perspective, there is a need to reduce the Mohs surgery time by developing faster and objective ways of seeing whether the cancer has been completely removed during a shorter operation under a single local anaesthetic. Dr Notingher's technique uses an integrated optical technique based on auto-fluorescence (natural fluorescence from the tissue) and Raman spectroscopy (a highly sensitive technique using lasers to identify the molecules in a tissue sample).

Dr Notingher said: "Our technique does not rely on time consuming and laborious steps of tissue fixation, staining, labelling or sectioning. The beauty is that it can be automated and very objective. To make this new technique suitable for use in the middle of an operation such as Mohs surgery for BCC, we have combined tissue auto-fluorescence, which is quick and good at picking out all the cancer cells (but not at excluding normal tissue) as a first step, followed by Raman scattering, a rather slow but good at separating normal from cancer tissue. By combining these two methods into one technique high accuracy diagnosis of BCC can be obtained in only a few minutes."

Professor Hywel Williams, one of the dermatologists working in the team and Director of the Centre for Evidence Based Dermatology (CEBD) at The University of Nottingham, said: "I am now convinced that this technique is reliable and potentially fast enough to replace conventional methods that determine tumour clearance for basal cell carcinoma removed during Mohs micrographic surgery -- an advance that will increase the accessibility of Mohs to many more people across the world."

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Discovery May Help Pinpoint Risk of Lung Cancer Returning After Surgery

WEDNESDAY, Aug. 7 (HealthDay News) -- Certain characteristics of tumors in lung cancer patients are associated with a strong risk of cancer recurrence after surgery, according to a new study.

The researchers said these findings could help identify patients who will benefit from more extensive lung surgery, potentially reducing the risk of lung cancer recurrence by 75 percent. It could also help identify patients most likely to benefit from lung-sparing surgery.

The study authors examined tumors from more than 700 patients who had surgery for early-stage adenocarcinoma, the most common type of non-small cell lung cancer. Tumors in 40 percent of the patients had an abnormal cell pattern that was strongly associated with cancer recurrence after surgery.

Limited lung surgery may not be appropriate for patients with this micropapillary (MIP) pattern, the Memorial Sloan-Kettering Cancer Center researchers said. They found that patients with the MIP pattern had a 34 percent risk of their lung cancer returning within five years after lung-sparing surgery, or limited resection, in which the tumor is removed by minimally invasive means and lung function is preserved.

In contrast, patients with the MIP pattern who had up to one-third of the lung removed along with the tumor, or lobectomy, had a 12 percent risk of cancer recurrence within five years.

The findings will appear in the Aug. 20 issue of the Journal of the National Cancer Institute.

Only a handful of cancer centers in the United States have the expertise to identify the MIP pattern during surgery. Patients whose tumors are later found to have the MIP pattern after lung-sparing surgery may require further, more extensive surgery to reduce their risk of recurrence, the researchers said in a Memorial Sloan-Kettering news release.

They are working to develop new technology that can be used to identify which tumors have the MIP pattern before or during surgery.

Almost 250,000 patients are diagnosed with non-small cell lung cancer each year in the United States.

More information

The American Lung Association has more about lung cancer.

SOURCE: Memorial Sloan-Kettering Cancer Center, news release, Aug. 7, 2013

Copyright c 2013 HealthDay. All rights reserved.

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New laser-based tool could dramatically improve the accuracy of brain tumor surgery

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AppId is over the quota

A new laser-based technology may make brain tumor surgery much more accurate, allowing surgeons to tell cancer tissue from normal brain at the microscopic level while they are operating, and avoid leaving behind cells that could spawn a new tumor. In a new paper, featured on the cover of the journal Science Translational Medicine, a team of scientists from the University of Michigan Medical School (home of the University of Michigan Comprehensive Cancer Center) and Harvard University (a component of the Dana-Farber Cancer Institute) researchers describes how the technique allows them to “see” the tiniest areas of tumor cells in brain tissue.

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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.

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