Archive for the ‘Rehabilitation’ Category

Knowledge is power: Men who are uneducated about their prostate cancer have difficulty making good treatment choices

UCLA researchers found that men who aren’t well educated about their disease have a much more difficult time making treatment decisions, called decisional conflict, a challenge that could negatively impact the quality of their care and their long-term outcomes.

The study should serve as a wake-up call for physicians, who can use the findings to target men less likely to know a lot about their prostate cancer and educate them prior to their appointments so they’re more comfortable making treatment decisions, said study first author Dr. Alan Kaplan, a resident physician in the UCLA Department of Urology.

“For prostate cancer, there is no one right answer when it comes to treatment. It comes down to the right answer for each specific patient, and that is heavily dependent on their own personal preferences,” Kaplan said. “Men in general, and specifically economically disadvantaged men, have a hard time deciding what their preferences are, how they feel about any possible complications and what the future after treatment might be like. If you don’t know anything about your disease, you’ll have a really tough time making a decision.”

The findings from the one-year study appear in the early online edition of the peer-reviewed journal Cancer.

The research team surveyed 70 men at a Veterans Administration clinic who were newly diagnosed with localized prostate cancer and had enrolled in a randomized trial testing a novel shared decision-making tool. They collected baseline demographic and clinical such as age, race, education, co-existing medical conditions, relationship status, urinary and sexual dysfunction and their prostate cancer knowledge.

UCLA researchers talked one-on-one with the men after they had received their cancer diagnosis, but before they consulted with a physician. Median age of the men in the study was 63 years, 49% were African American and 70% reported an annual income of less than $30,000.

Kaplan said the team found that a low level of prostate cancer knowledge was associated with increased decisional conflict and higher uncertainty about what treatment to choose. Low levels of prostate cancer knowledge also were associated with lower perceived effectiveness — meaning the less they knew about their cancer, the less confidence they had that the treatment would be effective.

“Knowledge about prostate cancer is an identifiable target. Interventions designed to increase a patient’s comprehension of prostate cancer and its treatments may greatly reduce decisional conflict,” Kaplan said, adding that further study is needed to better characterize this relationship and identify effective targeted interventions.

“If you get shot in the gut, there aren’t many options. You go into the operating room to get fixed up,” he said. “With prostate cancer, there are lots of options and not all are right for everybody.”

Men with prostate cancer might need to decide between surgery versus radiation or opting for active surveillance, in which patients are monitored closely for changes in the progression of their cancer and are tested at regular intervals. Prostate cancers can also be treated implantable radioactive seeds or tumors may be burned or frozen as treatment.

Another benefit to reducing decisional conflict is that patients who feel comfortable with their decision may regret their decisions less down the line, Kaplan said. They’re less likely to sue their doctors and generally experience better outcomes.

“In a way, it’s like buying a car. You prepare, you read reports, do your homework,” Kaplan said. “If something goes wrong with the car, you feel OK because you knew what you were getting into. When patients take ownership of the decision-making process, their outcomes are better.”

Kaplan said economically disadvantaged men may be having more difficulty because they may not have as much experience negotiating the healthcare system and are less confident when communicating with doctors.

“Doctors, we know intuitively, should spend more time with their patients, especially when they’re making an important decision,” he said. “But all of us are challenged with the numbers of patients we must see in a day. If you know beforehand that a patient has a poor knowledge about his cancer, that’s someone you need to spend more time with.”

Doctors may also want to provide these patients with educational information before their consultation so they can begin to increase their prostate cancer knowledge, Kaplan said.

Prostate cancer is the most frequently diagnosed cancer in men aside from skin cancer. An estimated 233,000 new cases of prostate cancer will occur in the United States in 2014. Of those, nearly 30,000 men will die.

source : http://www.sciencedaily.com/releases/2014/08/140827090136.htm

Preclinical development of tumor therapeutic agent begins

amcure, one of the partners of which is KIT, now plans to use the funds acquired for the further development of candidate agents identified by the team of Dr. Veronique Orian-Rousseau, KIT, for the treatment of metastatic tumors. The candidate substances bind specifically to a certain so-called isoform of the surface molecule CD44 and, thus, specifically interfere with central signal paths of tumor growth, while other types of cells remain unaffected. New formation of blood vessels supplying the tumor (angiogenesis) and migration of cancer cells and their invasion into other organs (development of metastases) are inhibited. “Data from animal tests reveal that our molecules do not only stop the growth of primary tumors, but may also prevent metastasis development and cause the regression of existing metastases,” says Dr. Alexandra Matzke, Chief Scientific Officer of amcure. The clinical studies that are to start in the next years will show whether these positive effects will also occur in human patients without any side effects.

The target molecule of amcure’s development candidates, CD44v6, plays a significant role for many types of tumors. It was discovered in the 1990s by Professor Helmut Ponta and his team at KIT. CD44 and its isoforms are increasingly considered significant factors for the spreading and formation of metastases. Blocking the receptor CD44v6 might open up opportunities for a wide-ranging application in tumor therapy.

“If these observations will be confirmed by clinical trials with patients, amcure can lay the foundation for treating tumors much more effectively and with far fewer side effects,” emphasizes Dr. Harald Poth, Senior Investment Manager of LBBW Venture Capital.

The next development steps will be funded by a consortium headed by LBBW Venture Capital, with participations from KfW, MBG Mittelst√§ndische Beteiligungsgesellschaft Baden-W√ľrttemberg, S-Kap Beteiligungen Pforzheim, BioM AG as well as private investors. In addition, the company receives funding by the Federal Ministry of Education and Research (BMBF) under the special program Spinnovator managed by Ascenion GmbH. The funds are so-called series A funds provided by venture capital investors to support growth of the young KIT spinoff in the next years. Prior to and during the establishment of the company, amcure was financed by its partner KIT and the Helmholtz Association as well as from federal funds.

“The consortium around LBBW Venture consists of experienced investors having extensive networks. We are happy to have convinced them of our development approach so that now the next steps in the preclinical and clinical stages can be financed,” says Dr. Matthias Klaften, Chief Executive Officer of amcure.

source : http://www.sciencedaily.com/releases/2014/08/140827091948.htm

Fighting prostate cancer with tomato-rich diet

With 35,000 new cases every year in the UK, and around 10,000 deaths, prostate cancer is the second most common cancer in men worldwide.

Rates are higher in developed countries, which some experts believe is linked to a Westernised diet and lifestyle.

To assess if following dietary and lifestyle recommendations reduces risk of prostate cancer, researchers at the Universities of Bristol, Cambridge and Oxford looked at the diets and lifestyle of 1,806 men aged between 50 and 69 with prostate cancer and compared with 12,005 cancer-free men.

The NIHR-funded study, published in the medical journal Cancer Epidemiology, Biomarkers and Prevention, is the first study of its kind to develop a prostate cancer ‘dietary index’ which consists of dietary components — selenium, calcium and foods rich in lycopene — that have been linked to prostate cancer.

Men who had optimal intake of these three dietary components had a lower risk of prostate cancer.

Tomatoes and its products — such as tomato juice and baked beans — were shown to be most beneficial, with an 18 per cent reduction in risk found in men eating over 10 portions a week.

This is thought to be due to lycopene, an antioxidant which fights off toxins that can cause DNA and cell damage. Vanessa Er, from the School of Social and Community Medicine at the University of Bristol and Bristol Nutrition BRU, led the research.

She said: “Our findings suggest that tomatoes may be important in prostate cancer prevention. However, further studies need to be conducted to confirm our findings, especially through human trials. Men should still eat a wide variety of fruits and vegetables, maintain a healthy weight and stay active.”

The researchers also looked at the recommendations on physical activity, diet and body weight for cancer prevention published by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR).

Only the recommendation on plant foods — high intake of fruits, vegetables and dietary fibre — was found to be associated with a reduced risk of prostate cancer. As these recommendations are not targeted at prostate cancer prevention, researchers concluded that adhering to these recommendations is not sufficient and that additional dietary recommendations should be developed.

source : http://www.sciencedaily.com/releases/2014/08/140827100218.htm