Posts Tagged ‘king’

Family conflicts, other non-physical worries before cancer surgery raise patients’ complication risk

The findings are published in the Journal of Gastrointestinal Surgery.

“We know that quality of life is a very complex thing, but we can now measure it and work with it almost like blood pressure,” says lead author Juliane Bingener, M.D., a gastroenterologic surgeon at Mayo Clinic in Rochester. “We can say, ‘This is good, this is in the normal range, but this one here, that is not good, and maybe we should do something.'”

Quality of life as measured in the study is about more than happiness and how well people feel physically, Dr. Bingener says. It also includes the financial, spiritual, emotional, mental and social aspects of their lives and whether their needs are being met.

Researchers studied 431 colon cancer surgery patients and found that before surgery, 13 percent had a quality of life deficit, defined as an overall quality of life score of less than 50 on a 100-point scale.

Nearly three times as many patients who entered surgery with a quality of life deficit experienced serious post-surgery complications as those with a normal or good quality of life score. Patients with a postoperative complication spent 3.5 days longer in the hospital on average than those who didn’t.

“The question I’m exploring is whether, if we understand before surgery that someone is in the red zone for quality of life, can we do something to help them cope with the new stress that’s going to come, so they’re better equipped to go through surgery?” Dr. Bingener says.

Preventing complications by intervening with behavioral therapy or other assistance would likely cost much less than an ICU stay for an infection after major surgery, Dr. Bingener notes.

Stress can weaken patients’ immune response, putting them at higher risk of infection. A patient’s outlook on life can also influence how active they are in working to recover.

“You have a surgery, you’re lying there in pain, now you wonder, ‘Why should I even get up and walk around? Why do I have to do these deep-breathing exercises? I don’t feel like it.’ You might get pneumonia much faster than somebody who says, ‘Oh, I have to get up. There’s something worth living for, my quality of life is good and I need to get back to that,'” Dr. Bingener says.

The study is part of ongoing work by Mayo to identify and address factors that can influence patients’ recovery from cancer surgery, to help improve their outcomes. Years ago, physicians were just concerned with whether patients survived cancer, because survival was so hard to achieve, Dr. Bingener says. Now, there is growing awareness of the mind’s influence on the body’s health.

“We’re understanding much better now that patients are not just a body with a disease: There’s a whole person with that, and everything plays together,” Dr. Bingener says. “Now that survival is possible, we want to achieve it in a way that preserves normal life for patients as much as possible. And we think that’s probably also the most economical way to go.”

source : http://www.sciencedaily.com/releases/2014/09/140902114416.htm

Potential method to better control lung cancer using radiotherapy

Standard treatment for locally advanced non-small cell lung cancer is a combination of radiotherapy and chemotherapy. Traditionally this is planned in a one-size-fits-all manner but the radiation dose may not always be enough to stop tumor growth.

The potential to increase the radiation dose to the cancerous tissue varies between patients and depends on the size and location of the tumor in relation to sensitive organs such as the spinal cord and lungs. Now researchers at The University of Manchester and The Christie NHS Foundation Trust — both part of the Manchester Cancer Research Centre — have looked at ways to personalize and increase the dose to the tumor while minimizing the effect on healthy tissue.

Dr Corinne Faivre-Finn, researcher at The University of Manchester and Honorary Consultant at The Christie, who led the study, said: “Current standard options for the treatment of non-small cell lung cancer are associated with poor survival. We wanted to see if more advanced methods of planning and delivering radiotherapy treatment could potentially allow an increase in radiation dose.”

The group used data from 20 lung cancer patients to investigate whether a newer radiotherapy technique — intensity modulated radiotherapy (IMRT) — could potentially be used to increase the radiation dose to lung tumors, without harming healthy organs.

Their treatment planning methods ensured a safe radiation dose was delivered to the surrounding organs at risk. In an article recently published in the journal Clinical Oncology, they show that IMRT allowed an increase in radiation dose for non-small cell lung cancer.

“Our exploratory study suggests that using IMRT can allow radiation dose to be increased: calculations indicate that this could yield a 10% improvement in tumor control. We are starting a new clinical trial, funded by Cancer Research UK, investigating the delivery of this personalised IMRT treatment in patients with non-small cell lung cancer. We hope to demonstrate that the increase dose delivered to the tumor will lead to improved survival ” added Dr Faivre-Finn.

source : http://www.sciencedaily.com/releases/2014/08/140828091241.htm

Promising new cancer therapy uses molecular ‘Trash Man’ to exploit a common cancer defense

Cancer therapies cause unwanted proteins to accumulate in cancer cells, which can trigger a form of cell suicide known as apoptosis. To survive, the cells break down the excess proteins through autophagy, from a Greek term meaning “self eating.” In a study recently published in the journal Molecular and Cellular Biology, scientists induced autophagy using the anti-tumor drug obatoclax while simultaneously blocking the production of p62 using a drug known as a cyclin-dependant kinase (CDK) inhibitor. Several experiments involving animal models and cultured multiple myeloma cells demonstrated that blocking p62 disrupted autophagy and killed far more cancer cells than administering the anti-cancer agents alone.

“Therapies that are designed to block the early stages of autophagy do not offer the possibility of exploiting its potentially lethal effects,” says Steven Grant, M.D., Shirley Carter Olsson and Sture Gordon Olsson Chair in Cancer Research, associate director for translational research and program co-leader of Developmental Therapeutics at VCU Massey Cancer Center. “Our strategy turns autophagy from a protective process into a toxic one, and these results suggest it could increase the effectiveness of a variety of cancer therapies that induce autophagy.”

Critical to the success of this therapy is Bik, a protein that plays a significant role in governing cell death and survival. During cancer treatments, Bik accumulates in cancer cells until it triggers apoptosis. Normally, the cancer cells would induce autophagy and p62 would rid the cells of Bik by loading the proteins into degradation chambers known as auotophagosomes for disposal. However, blocking p62 production results in an inefficient form of autophagy and the accumulation of Bik eventually causes the cancer cells to undergo apoptosis.

This research builds upon more than a decade of work by members of Grant’s laboratory investigating novel treatment strategies and combination therapies that selectively kill multiple myeloma and other blood cancer cells. The technology in his study has been made available for licensing through the VCU Office of Research.

“We are now working to identify additional CDK inhibitors that can be used to disrupt autophagy,” says Grant. “The ultimate goal will be to translate these findings into a clinical trial to test the therapy in patients with various blood cancers.”

source : http://www.sciencedaily.com/releases/2014/08/140827112135.htm