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Flu information for People with Diabetes and Caregivers of People with Diabetes

Diabetes | Influenza, often called the “flu” is a respiratory illness caused by the influenza virus. Flu spreads mostly by the coughing and sneezing of people who are sick with the flu.

If you have diabetes, you are more likely to get flu-related complications like pneumonia and even be hospitalized or die from the flu than other people. Influenza may also interfere with blood glucose management. People with diabetes should talk with their doctor now to discuss preventing and treating the flu.

Via: Flu information for People with Diabetes and Caregivers of People with Diabetes         

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Vitamin D Status Is Not Associated With Risk for Less Common Cancers

Health & Medicine News | Despite hopes that higher blood levels of vitamin D might reduce cancer risk, a large study finds no protective effect against non-Hodgkin lymphoma or cancer of the endometrium, esophagus, stomach, kidney, ovary, or pancreas. In this study, carried out by researchers from the National Cancer Institute (NCI), part of the National Institutes of Health, and many other research institutions, data based on blood samples originally drawn for 10 individual studies were combined to investigate whether people with high levels of vitamin D were less likely to develop these rarer cancers. Details of these analyses appear as a set of papers in the June 18, 2010, online issue of the American Journal of Epidemiology, and in print in the July 2010 issue.

Via: Vitamin D Status Is Not Associated With Risk for Less Common Cancers         

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Prostate Cancer Surgery Often Performed by Surgeons with Little Experience November 18, 2009 NEW YORK, NY - A new study from researchers at Memorial

A new study from researchers at Memorial Sloan-Kettering Cancer Center has found that the majority of surgeons treating prostate cancer in the United States have extremely low annual caseloads, potentially leading to increased rates of both surgical complications and cancer recurrence.

The research was published in the December issue of The Journal of Urology. Andrew Vickers, PhD, Associate Attending Research Methodologist in the Department of Epidemiology and Biostatistics at Memorial Sloan-Kettering Cancer Center, led an analysis of data on radical prostatectomy, the surgical removal of the prostate for men with prostate cancer. Of US surgeons treating prostate cancer patients in 2005, more than 25 percent performed only a single radical prostatectomy that year and approximately 80 percent of surgeons performed fewer than ten such procedures.

It is known that surgical volume is associated with improved patient outcomes, and fewer complications. Previous work from this team has indicated that a surgeon's lifetime experience with radical prostatectomy is strongly associated with cancer control; patients treated by experienced surgeons had a 40 percent lower risk of a cancer recurrence than patients treated by inexperienced surgeons. The importance of experience in cancer outcomes has been termed the "learning curve."

"We have previously shown that a surgeon needs to conduct an average of 250 radical prostatectomies to give patients the best chance of cure," said Dr. Vickers, "so we decided to look at how long it would take a typical surgeon to reach that number of procedures. While the learning curve is not the only factor in determining surgical skill, we found that the majority of surgeons who treat prostate cancer patients will not achieve that number of procedures in their entire career."

A high-volume surgeon is defined as one who performs 50 cases a year or more. According to Dr. Vickers and colleagues' research, only 2 percent of surgeons nationally and 4 percent of New York State surgeons fall into this category. Nationally, only about one in five prostate cancer patients are treated by high-volume surgeons; this rises to 40 percent in New York State, likely because of the large, specialized centers in New York City and elsewhere in the state.

There were two independent data sets used in this analysis. The first set was a nationally representative sample of hospitals, which was obtained from the 2005 Nationwide Inpatient Sample (NIS), available from the Agency for Healthcare Research and Quality. The second data set, the Statewide Planning and Research Cooperative System (SPARCS), includes all patient discharge records for New York State in 2005. More than 6,500 patients treated with radical prostatectomy in 2005 by one of 933 surgeons were identified. The study included radical prostatectomies that were performed laparoscopically and with robotics as well as more traditional open surgery.

On the basis of this research, Dr. Vickers said that, "prostate cancer patients considering surgery should be aware that most surgeons have very little experience treating this disease. They are likely to have a reduced risk of complications, and better chance of cure, if they are treated at a specialist cancer center by a surgeon who focuses on treating prostate cancer."

Funding for this study was provided by the Sidney Kimmel Center for Prostate and Urologic Cancers, by a SPORE grant from the National Cancer Institute, and by funds from David H. Koch provided through the Prostate Cancer Foundation.
        

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New Targeted Therapy Effective in Treating Advanced Prostate Cancer

An experimental drug is showing promise for the treatment of men with an aggressive form of advanced prostate cancer. A new multicenter study has concluded that the targeted therapy MDV3100 is safe and effective for patients with castration-resistant prostate cancer (CRPC), known for its poor prognosis and limited treatment options. The research, led by investigators at Memorial Sloan-Kettering Cancer Center, appears early online and in an upcoming edition of The Lancet.

According to the findings of the Phase 1-2 study, MDV3100 not only shrank patients' tumors, but also reduced serum levels of the tumor marker prostate-specific antigen (PSA), stabilized disease that had spread to soft tissues and the bone, and reduced the number of circulating tumor cells in the blood.

"We were encouraged to see antitumor activity in men whose disease had spread to other parts of the body after either becoming resistant to previous hormone treatments or progressing following chemotherapy," said the study's lead author Howard Scher, MD, Chief of the Genitourinary Oncology Service at Memorial Sloan-Kettering. "These findings strengthen the drug's potential to change the outlook for a group of patients who currently have limited effective treatment options from which to choose."

According to the research, MDV3100 slows tumor growth and induces tumor cells to die in men with CRPC, or hormone-refractory disease, which depends on male hormones to grow, but is unresponsive or becomes resistant to standard therapies used to lower or block those hormones. MDV3100 works by blocking testosterone from binding to the androgen (male hormone) receptor, stopping the movement of the androgen receptor to the nucleus of prostate cancer cells, preventing the receptor from binding to DNA, and inducing cancer cell death, even when the expression of the androgen receptor is elevated.

"This study validates what our preclinical studies have suggested: that sustained androgen receptor signaling drives CRPC and that a substantial number of CRPC tumors that progress despite multiple hormone and chemotherapy treatments remain dependent on androgen receptor signaling for growth," said study co-author, Charles Sawyers, MD, Chair of Memorial Sloan-Kettering's Human Oncology and Pathogenesis Program and a Howard Hughes Medical Institute investigator.

The drug was co-invented by Dr. Sawyers and Michael Jung, PhD, Professor of Chemistry at the University of California, Los Angeles. Their research originally demonstrated that CRPC cells have increased expression of the androgen receptor and that elevated expression of this receptor may contribute to disease progression due to a developed resistance to hormone treatment. Their collaboration led to the discovery of a number of nonsteroidal, small molecule antiandrogen compounds, including MDV3100.

In the current study, 140 patients were treated with doses of MDV3100 ranging from 30 to 600 mg daily. PET imaging, bones scans, and blood tests were used to assess the antitumor effects of the drug, which were observed at all dosages. Investigators reported declines in PSA of at least 50 percent in more than half of the patients and tumor regressions in 22 percent of the patients. Overall, two-thirds of patients had partial remissions or stable disease in tumors that had spread to soft tissue or bone.

The findings also showed that the number of circulating tumor cells fell in 49 percent of patients, and 91 percent of patients who initiated therapy with favorable counts retained favorable counts during treatment. This is important because previous research shows that changes in circulating tumor cell counts after treatment were more predictive of survival than were changes in PSA, with favorable post-treatment counts associated with a 21-month median survival.

The drug was generally well tolerated, with nausea, constipation, diarrhea, and anorexia being the most common mild side effects reported. The most frequently reported Grade 3 side effect at higher doses was fatigue. The researchers determined that the maximum tolerated dose for sustained treatment was 240 mg daily.

Based on the positive results of the current study, a multinational randomized Phase 3 clinical trial has begun to examine MDV3100 versus a placebo for the treatment of men with advanced prostate cancer who were previously treated with chemotherapy. Information about patient eligibility and enrollment can be obtained by visiting www. affirmtrial .com or by calling the AFFIRM study's toll free hotline at 888-782-3256.

The research was supported by Medivation; the Prostate Cancer Foundation, the National Cancer Institute, the Howard Hughes Medical Institute, and the Department of Defense Prostate Cancer Research Program Clinical Consortium (which includes Memorial Sloan-Kettering, the Oregon Health and Science University Knight Cancer Institute, The University of Washington, the Dana-Farber Cancer Institute, and M. D. Anderson Cancer Center).
        

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