Symposium 6: Mouse Models for Cancer Prevention. "Chemoprevention of intestinal polyposis in Ape knockout mice", presented by Makoto Mark Takeo, Kyoto University Graduate School of Medicine. "Familial adenomatous polyposis (FAP) is an autosomal dominant disease characterized by colonic polyposis and predisposition to colon cancer. Patients of FAP carry germline mutations in the APC gene. Mutations in the APC are found not only in FAP patients, but also in the majority of sporadic colorectal cancer lesions." "Treatment of colonic polyposis with COX-2 inhibitors can be on of the most promising chemopreventive measures of colon cancer, at least for FAP patients." Symposium 7: Colon Cancer Prevention. "Sociocultural and behavioral issues related to colon cancer screening", presented by Sally Vernon, UT Houston School of Public Health, Houston, TX. "With the exception of cervical cancer, colorectal cancer is arguably the only cancer where screening can accomplish both primary and secondary prevention. Although effective screening tests or procedures are available, the proportion of adults 50 years of age and older who are adherent to colorectal cancer screening recommendations, is low overall (~20% for fecal occult blood testing with the past year and ~30% for sigmoidoscopy within the past 5 years) and varies by soci-demographic, medical history and other characteristics." "Clinical trials:Screening and chemoprevention", presented by Bernard Levin, UT, M.D. Anderson Cancer Center, Houston, TX. "Screening studies in progress or recently completed include molecular detection of gene mutations in the stool and also CT colonography (virtual colonoscopy). Chemoprevention studies include use of aspirin and other NSAIDs, specific COX-2 inhibitors, epithelial growth factor receptor antagonists, ursodiol, calcium, folate and other compounds. The targets of such studies usually are induction of adenoma regression or prevention or adenoma recurrence after polypectomy in those at moderate or high risk. In addition, biomarker modulation and pharmacogenomic correlates are under study." Symposium 8: The Potential Role of In Vivo Imaging Techniques in the Management of Early Cancer Patients. "Optical coherence tomography imaging for the assessment of preneoplastic changes", presented by James G. Fujimoto, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA. "Optical coherence tomography (OCT) is an emerging biomedical imaging technique that performs high resolution, cross-sectional imaging tomographic of microstructure in biological systems. OCT is analogous to ultrasound B mode imaging except that it uses light instead of sound. OCT can achieve image resolutions of 1-10 um with image penetration depths of 2-3 mm. OCT performs imaging by using low coherence interferometry to measure the optical backscattering of tissue as a function of echo delay and transverse position. The resulting two-dimensional data set can be displayed as a gray scale or false color image." "OTC is a promising imaging technology because it can provide images of tissue in situ and in real time, without the need for excision and processing of specimens". "Recently, many groups have begun preliminary clinical imaging studies including endoscopic OCT imaging of the GI tract, open field surgical imaging, and imaging of the female reproductive tract." Symposium 9: International Cancer Prevention Studies. "Prostate cancer prevention:The selenium and vitamin E cancer prevention trial (SELECT)", presented by Eric Klein, Cleveland Clinic Foundation, Cleveland, OH. (Other talks have covered the basis of this trial-using vitamin E and selenium either one with placebo or both together or two placebos. Any man in the trial can request a multivitamin, specially prepared without any more E or selenium. The amount of vitamin C is 60 mgs. All vitamins are the synthetic forms.)Every 6 months the men will visit to be assessed for adverse events, adherence, other medical events and the end points of the study. In the first year, there will be additional phone contact. From my notes: Based on the Clark trial in 1983-1989, vitamin E appears to be a free-radical scavenger both in food and as an antioxidant. The form used in the SELECT trial is the same dl-alpha tocopherol. Several audience members questioned the particular type of selenium chosen for the trial. I asked why a synthetic vitamin E was being used in light of what we (now) know about the value of delta, gamma tocopherol and tocotrienols (all part of the vitamin E family). Additionally synthetic vitamin E is known to be unable to enter the nucleus of a cell, yet natural vitamin E can. Dr. Klein suggested that since the Clark trial demonstrated the value of this type of vitamin E, and the SELECT trial was based on their results, no changes could be made. Yet at the same time, he acknowledged that they now knew that the vitamin had batch to batch differences. And if that is, so, why are they so 'set in stone' with the old format? There are many studies on vitamin E that could have served as an informer to this important, expensive, long-running trial. I truly do not understand why new information can not be utilized advantageously to improve the efficacy. "Breast cancer prevention:The Star study", presented by D. Lawrence Wickham, NSABP Operations Center, Pittsburgh, PA. "By July 1, 2002, 13, 647 women (20.7% of the risk-eligible group) had been randomized, which represents 62% of the required sample size of 22,000 women. The median age of the women randomized is 58 years, and their median five-year risk of breast cancer is 3.3%. A family history of breast cancer is the most common risk factor, with 74% of the participants reporting one or more first-degree female relatives with breast cancer. Twenty percent of the randomized women had a prior breast biopsy showing atypical hyperplasia, and 8.4% had a history of lobular carcinoma in situ that was treated by excisional biopsy alone." "We anticipate that the definitive analysis of the trial will be completed approximately one and a half years after the accrual goal is achieved." From my notes and discussion with Dr. Wickham: He mentioned during his talk, follow-up of women from the BCPT1 trial (Tamoxifen versus placebo) but agreed upon questioning that many are of course, lost to follow up. Many were offered or went on Tamoxifen after the trial. Because of this and the fact that some went on to the STAR trial, there can be NO long-term follow-up of this healthy, at high risk population. "HRT opposed by Tamoxifen (H.O.T. Study):Rationale and design", presented by Andrea U. Decensi, European Instate of Oncology, Milan, Italy. "A new phase III trial has ...recently been launched:the HOT study (Hormone replacement therapy Opposed by low dose Tamoxifen) where a total of 8500 women on HRT for a maximum of three years will be randomized to either placebo or tamoxifen 5 mg/day for 5 years. The study is powered to detect a 40% reduction in the incidence of invasive breast cancer and ductal carcinoma in situ in the tamoxifen arm." "Recent studies suggest that the standard dose of tamoxifen may be reduced to one quarter (5 mg/day) without significant loss of beneficial effects on circulating biomarkers, mostly reflecting cardiovascular risk. Since the endometrial effect of tamoxifen is dependent on treatment duration and dose, a dose reduction might reduce the risk of endometrial malignancies, including rare forms of uterine sarcomas, while retaining its preventive efficacy." Reference is:Jordan, VC. Tamoxifen:too much of a good thing? J Clin Oncol, 1999, 17, 2629-2630. "While the preliminary results of the Italian Tamoxifen Prevention Study in hysterectomized women showed no difference between arms, a recent update after 7 years of follow-up suggests that the combination of HRT and tamoxifen has a favorable effect and might even be synergistic." (Veronesi U, Maisonneuve P, Sacchini V, Rotmensz N, Boyle P and the Italian Tamoxifen Study Group:Lancet 2002;359:1122-24). "Management of women at high risk for breast cancer", presented by Alberto Costa, Maugeri Foundation, Pavia, Italy. "Alterations in BRCA 1 and BRCA 2 may be responsible for only a half of all inherited cases of breast cancer, and the automated test performed by Myriad, the company which holds the exclusive rights to perform diagnostic testing, misses some 10-20% of the expected BRCA 1 mutations. Hence the importance of a careful clinical assessment in pre-defining subjects at very high risk: individuals who have two or more close relatives with breast cancer, cases in more than one generation of the family, one case of male breast cancer, several members with ovarian cancer. What presently can be offered to these women is: a)lifestyle changes like weight control through diet and physical exercise; b) accurate surveillance with mammography, ultrasound and new tools that technology is developing; like measurement of cell proliferation with electropotentials (BDS) or measurement of neo-angiogenesis with dynamic optical imaging (DOBI), c) participation in chemoprevention clinical trials and d) risk-reducing surgery like prophylactic mastectomy." From my notes: Dr. Costa mentioned the use of fenretinide (a vitamin A analogue) for chemoprevention. Symposium 10: Vaccines and Cancer Prevention. "Cervical cancer prevention by HPV vaccines", presented by W. Martin Kast, Loyola University Chicago, Maywood, IL. "Persistent human papillomavirus (HPV) infection is linked to the development of cervical cancer. Virtually all cervical cancers are HPV DNA positive. Cervical cancer is preceded by easily identifiable pro-cancerous stages of hyperproliferative disease called cervical intraepithelial neoplasis (CIN 1-3). This gives a unique opportunity to explore vaccine strategies against HPV before cancer is yet apparent. These types of vaccines are therapeutic as they have to work after virus infection but also preventive as they might interfere with cancer development. Apart from these therapeutic vaccines there is a rapid progress in the area of HPV vaccines that might prevent virus infection and therefore the development of CIN and eventually cervical cancer." "Shared tumor antigens as vaccines for cancer prevention", presented by Olivera J. Finn, University of Pittsburgh School of Medicine, Pittsburgh, PA. "Molecular characterization and isolation of tumor antigens that are potentially immunogenic in humans is an important goal of tumor immunologists" This abstract discusses the future possibility of a vaccine against colon cancer due to the fact that tumors aberrantly express Cyclin B1 with functionally inactive p53 which are very early changes in the transformational process and characteristics of premalignant lesions as well as fully developed tumors. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.