Low-fat, High-fiber, High-fruit & -veg eating Affects Adenoma Recurrnc

Epidemiology/Lifestyle Factors: Diet and Cancer 2

Does the level of adherence to a low-fat, high-fiber, high-fruit and -vegetable eating pattern affect adenoma recurrence?

Elaine Lanza, Kay Wanke, Grace Lee, Leah Sansbury, Paul S. Albert and Arthur Schatzkin
National Cancer Institute, Bethesda, MD; National Institue of Drug Abuse, Bethesda, MD

Abstract B174

Although differences in people’s dietary intake are thought to account for substantial variation in cancer incidence, there has been a consistent lack of effect of diet in cancer clinical trials.

These inconsistencies may reflect the multi-factorial and complex nature of cancer and the complex and diverse dietary components that may alter one or more phases of the cancer process. Another potential reason for the failure to find an effect in dietary intervention trials is the variation in adherence among participants.

In this analysis of the Polyp Prevention Trial (PPT), we examined the effect on adenoma recurrence of high adherence to a low fat, high fiber, high fruit and vegetable intervention. The most adherent participants were defined as “Super Compliers”. These Super Compliers consistently met or exceeded each of the three dietary goals at all four annual visits during the trial.

During the four years of the trial, these Super Compliers (n=210) reported consuming 17.2% of energy from fat, 22.9 g fiber/1000kc, and 5.32 servings of fruits & vegetables/1000kc. Dietary adherence was then modeled as a potential predictor of adenoma recurrence using logistic regressions.

Super Compliers had a lower adenoma recurrence rate; 31.0% compared to a 39.5% for the control group. In a logistic regression model comparing adenoma recurrence in these Super Compliers to the control group, after adjusting for all significant baseline covariates, the OR= 0.65, 95% CI=0.47-0.92.

Further adjustment for forty-two baseline variables known to be associated with adenoma recurrence or colorectal cancer including; NSAIDS use, number of adenomas, villous histology, did not alter the findings.

These Super Compliers, compared to the control group, had a significantly reduced OR for the recurrence of either an advancedadenoma or 3 or more adenomas (OR = 0.41; 95% CI, 0.021-0.81). The reduced recurrence rate among super-compliers does suggest that a low-fat, high-fiber, fruit- and vegetable-enhanced eating pattern reduces colorectal adenoma occurrence.

This was an ‘according to protocol’, as opposed to ‘intention to treat’ analysis, however, and it is possible that (unknown or unmeasured) factors associated with adherence, rather than diet per se, are responsible for the change in neoplastic recurrence.

Fifth AACR International Conference on Frontiers in Cancer Prevention Research, Nov 12-15, 2006

Lower Dose of Thalidomide As Effective: Multiple Myeloma

Lower Dose of Thalidomide May Be Just as Effective in Multiple Myeloma (6/7/06)

In May 2006 the U.S. Food and Drug Administration approved thalidomide for use in combination with another drug, dexamethasone, to treat newly diagnosed multiple myeloma.

The drug appears to affect the blood supply that fuels the growth of tumors and may fight cancer in other ways, as well. Thalidomide has also shown activity against multiple myeloma that has come back or is no longer responding to other therapies.

However, many patients discontinue treatment because of the drug’s side effects, which can include blood clots, constipation, tingling in the hands and feet, and drowsiness.

The study showed that cutting the daily dose of the drug thalidomide from 400 mg to 100 mg significantly reduced the drug’s potentially severe side effects in patients with multiple myeloma that had come back or stopped responding to treatment, and without a significant impact on survival, according to findings presented at the 2006 meeting of the American Society of Clinical Oncology.

Source National Cancer Institute (NCI)

low-fat diet may decrease the risk of ovarian cancer

A low-fat diet may decrease the risk of ovarian cancer in postmenopausal women, according to a study published online October 9 in the Journal of the National Cancer Institute.

Previous reports from the Women’s Health Initiative Dietary Modification Randomized Controlled Trial examined the effect of a low-fat diet on the risk of breast and colorectal cancer in postmenopausal women, but it was not yet known whether the same diet would alter ovarian cancer risk.

Ross Prentice, Ph.D., of Fred Hutchison Cancer Research Center in Seattle and colleagues analyzed data from the dietary modification trial to see if the changes in the women’s diets decreased the risk of ovarian and endometrial cancer and invasive cancers overall.

In the trial, nearly 20,000 women were randomly assigned to the diet modification group and almost 30,000 women ate their normal diet. The women participating in the diet were asked to reduce their fat intake to 20 percent of their overall diet, as well as eat at least five serving of fruits and vegetables a day and at least six servings of whole grains.

They were followed for an average of eight years.

The risk of ovarian cancer was similar in the two groups for the first four years of follow-up, but it was reduced in the dieting group during the following four years.

Women who had the highest fat intake before the trial saw the greatest reduction in risk. There was no difference in endometrial cancer risk between the two groups, but a trend toward a reduction in invasive cancers overall was suggested in the dieting group. It was not, however, statistically significant.

“Ongoing …follow-up of trial participants may provide additional valuable assessment of the effects of a low-fat dietary pattern on these and other cancer incidence rates,” the authors write.

Press Release, JNCI, October 2007

Ann’s NOTE: The value of nutrition when combined with exercise and a relaxation technique is worth studying. We suspect this would enhance survival.

Location of Contralaterl Bca After RtX

ABSTRACT: The Location of Contralateral Breast Cancers After Radiation
Therapy

Radiation therapy following conservative surgery results in scattered
radiation to the contralateral breast, with higher doses to the
medial breast and lower doses laterally.

The purpose of the current
study is to determine whether the location of contralateral breast
cancers developing following breast conserving surgery and radiation
is indicative of radiation-induced malignancies. The charts of
1,755 patients treated with conservative surgery and radiation
therapy between 1970 and 1998 were reviewed.

Fifty-nine patients
who developed a contralateral malignancy following conservative
surgery and radiation therapy and who had complete information
and documentation of the location of the second lesion served
as the primary focus of the current study.

The location of the
contralateral malignancy was compared with the location of the
primary tumors of the overall patient population.

The location
of breast cancers developing in the contralateral breast following
breast conserving therapy and radiation was not consistent with
radiation-induced malignancies.

Specifically, there was not a
preponderance of medially located tumors in patients developing
contralateral breast cancers following radiation. There was a
slight excess of central lesions that cannot be explained by
higher doses of radiation. The location of breast cancers in
the contralateral breast following conservative surgery and radiation
is not indicative of radiation-induced lesions.

These data should
be reassuring to women considering breast conserving surgery
and radiation.

[01/07/2002; The Breast Journal]

Local Hyperthermia & External RTx: Locoregional BCa

Local hyperthermia combined with external irradiation for regional recurrent breast carcinoma

ORIGINAL ARTICLE

Gong Li1, Michihide Mitsumor, Masakazu Ogura1, Naotoshi Horii2, Sachiko Kawamura1, Shin-ichiro Masunaga3, Yasushi Nagata1 and Masahiro Hiraoka1

(1) Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
(2) Department of Radiology, Kishiwada City Hospital, Kishiwada, Japan
(3) Radiation Oncology Research Laboratory, Research Reactor Institute, Kyoto University, Kyoto, Japan

Backgrounds
The purpose of this study was to evaluate the therapeutic effects of hyperthermia in combination with radiotherapy for locoregional recurrence of breast cancer, and to assess the factors related to subsequent local tumor control.

Methods
Between March 1981 and February 2001, 85 lesions in 73 patients were treated with local hyperthermia combined with external irradiation. Of 75 evaluable lesions, 41 were previously irradiated.

Mean radiation dose to the previously unirradiated area was 59.5 ± 6.8Gy (range, 40–70Gy), while a total dose of 43.0 ± 12.4Gy (range, 12–74.4Gy) was administered to previously irradiated tumors.

Hyperthermia was administered once or twice per week. The average number of hyperthermia sessions was 4.5 (2–9).
Results Complete responses (CRs) were achieved in 56% (23/41) of previously irradiated and 47% (16/34) of unirradiated tumors.

There was no significant difference in the CR rate between the two groups. Compared with the response of bulky/nodular tumors, diffuse/multiple small nodular tumors showed a higher CR rate at 4 weeks after treatment.

However, at 6 months after treatment, they showed a significantly lower local control rate.

Conclusions
The present findings suggested a significant benefit of local hyperthermia combined with radiotherapy in the treatment of locally recurrent breast cancer, especially for previously irradiated recurrence, by reducing the total irradiation dose.

Diffuse/multiple small nodular tumors respond earlier than bulky/large nodular tumors; however, they tend to recur within the treatment field.

International Journal of Clinical Oncology ISSN: 1341-9625 (Paper) 1437-7772 (Online) DOI: 10.1007/s10147-004-0395-3

Volume 9, Number 3Date: June 2004 Pages: 179 – 183

Loco-Regional Hyperthermia

Loco-Regional Hyperthermia

I. Introduction

The benefits of heat as a means of therapy have been recognized for a centuries. Even Hippocrates and the ancient Egyptians used heat therapy. Heat can cause considerable damage to living cells. Consequently, the body can survive a temperature in excess of 42°C (107°F) for only a short time.

However, the destructive force of heat can also be a blessing. When skillfully applied, heat can be very beneficial in the treatment of cancer. Malignant growths can be controlled or may even recede as a result of targeted hyperthermia.

Hyperthermia is a non-invasive and particularly gentle method of treatment. It is highly effective because, used alone or in combination with traditional medicine and naturopathic-biological forms of treatment, it is capable of bringing about a distinct improvement in
the course of tumor diseases.

This is why hyperthermia plays an important part in the complete, holistic treatment concept at St. George Hospital. For many years, St. George Hospital has worked extensively on researching and improving hyperthermia therapy techniques applied in the treatment of acute cancer, as well as in the after-care of cancer patients. St. George Hospital is among the worlds leading treatment centers in this
field.

II. How does loco-regional hyperthermia work?

In loco-regional hyperthermia, heat is focused directly on the organ or area affected by the tumor (as opposed to whole-body hyperthermia, in which the entire body is heated).

First, the affected area is positioned between two applicators. Radio waves directed by computer are concentrated on the tumor, and the temperature is raised to 42 to 44°C (107-111°F). This temperature is maintained in the tumor tissue for approximately 60 to 90 minutes. A temperature check is carried out either directly within the tumor, or externally by means of a radiometer which, unlike invasive temperature monitoring, carries no risk of infection or of spreading cancer cells.

Heating the tumor tissue to 44°C (111°F) also affects the adjacent healthy tissue. However, healthy tissue readily dissipates the heat through an increase of blood circulation – something of which the tumor tissue, with its more primitive blood supply, is incapable. The impaired blood supply to the tumor results in inadequate heat regulation and an increased internal temperature.

As a result of this increased heat, the cancer cells are starved of oxygen and nutrients. These
deficiencies result in the impairment of the vital metabolic processes of cell division and cancer cell maintenance, causing the failure of the repair systems of the cancer cells. Consequently, the heat-damaged cancer cell components (such as membranes and proteins) cannot be replaced, ultimately resulting in the destruction of the cancer cells.

Furthermore, current research shows that, unlike healthy tissue, when cancer cells are heated to approximately (107°F), they form peculiary characteristic protein structures on their surface. These protein structures (e. g. HSP 72), also known as heat-shock proteins, activate the natural killer cells of the body’s own defense mechanism to attack the cancer cells. Therefore, hyperthermia works not only by destruction of cancer cells, but also by
stimulating the immune system.

III. What diseases are treated with loco-regional hyperthermia?

At St. George Hospital, loco-regional hyperthermia is offered in two different forms –

Loco-regional deep hyperthermia for:

– gynecological tumors such as cancer of the breast or uterus

– pulmonary and hepatic tumors and metastases

– cancer of the pancreas

– cancer of the stomach, bowel, or bladder

– ENT (ear, nose, throat) tumors

– brain tumors

– lymph node metastases and local lymphomas

Loco-regional surface hyperthermia for:

– surface tumors with a penetration depth of 1 – 3.5 cm

– various types of skin cancer and skin metastases of different primary tumors

Loco-Regional Hyperthermia Combined With Other Forms of Treatment:

Loco-regional hyperthermia combines well with chemotherapy. The overly acidic environment of the cancer cell that has been damaged by heat enables some cytostatic agents to achieve a more powerful cell-destroying effect.

The combined effect of both
treatments often means that significantly lower doses of the chemotherapy substances are needed than when these are used alone, minimizing their normal side effects, such as hair loss and nausea. Even a tumor that has been resistant to chemotherapy and radiation therapy will respond well to these therapies following hyperthermia treatment.

V. What other forms of hyperthermia are offered at St. George Hospital?

a) Systemic whole-body hyperthermia in the form of extreme hyperthermia at 41.5 – 42°C
(106 – 107°F), combined with hyperglycaemia, and possibly chemotherapy and radiation therapy.

b) Prostate hyperthermia as a special form of local hyperthermia.

In this case, a heat probe is inserted directly into the urethra and positioned in the prostate, so that the organ is heated to 45 – 70°C (113 – 126°F).

This hospital is in Germany. Reach them by contacting the US rep:

Contact Marla Manhart, U.S. Liaison St. George Hospital 941 921 3536 www.klinik-st-georg.de GERMANY

Article Q&A from
Dr. Douwes
Posted, 2005

Local Groups w/o websites

African-American Breast Cancer Groups:

African American Breast Cancer Alliance P.O. Box 8987 Minneapolis, Minnesota 55408 Contact: Linda Finney (612) 731-3792

Embracing Life Contact: National Black Leadership Initiative on Cancer University of Illinois at Chicago 2121 W. Taylor Street, Suite 512 Chicago, ILL 60612 Anita Hill (312) 996-8046 or (800) 799-2542

God Cares Support Group Church of the Great Commission 10137 Prince Place, #402 Largo, Maryland 20772 Contact: Carolyn P. Harvey (301) 350-3113 or (301) 735-7398

Sisters Breast Cancer Survivors Network
116 1/2 West 84th Place
Los Angeles, CA 90003
(323) 759-0200 phone (323) 753-7041 fax
e-mail: sbcsn@yahoo.com
website: survivorsofbreastcancer.org
Contact name: Jewel Williams

Rise Sister Rise 1765 N. Street Washington, D.C. 20036 Contact: Zora Kramer Brown (202) 463-8040

Women of Color Breast Cancer Survivors Support Project 8610 S. Sapulveda Suite 200 Los Angles, California 90045 Contact: Carol Tap

Edna B. & Joyce Fay Washington Breast Cancer Foundation P.O. Box 2904 New Orleans, LA 708189-0042 (504)246-1466 & fax washbcf@bellsouth.net

Sisters of Hope 2531 South J Street Tacoma, WA 98405
(25)572-2683 Betty J. Mewborn, Founder/Facilitator sistersofhope@hotmail.com

Local Groups

(Not in alphabetical order)

**The Gratitude Group for Breast Cancer
217 E. 71st St., #22
Chicago, IL 60619

Support group for women and their families. Meet once a week, every Saturday from 12:30pm until 2:00pm at Provident Hospital of Cook County located at 500 E. 51st St, Chicago 60615, first floor. Provide telephone support and educational packets to group participants.

Facilitators are survivors of breast cancer and trained in the psychosocial dynamics of providing support in a group setting. For additional Group information contact Public Affairs at the hospital 312-572-2000 or Founding Chairman Joyce Jones at 303-758-0317.

**New Hampshire Breast Cancer Coalition-72674.3724@Compuserve.com Offering Action/Education/Advocacy.
A non-profit state-wide advocacy effort.

**The Catherine Peachey Fund, Inc.
(219)268-9015 (Warsaw, IN) non-profit raising funds for Breast Cancer Research.

**Florida Breast Cancer Resource Network, (800)696-8349
Information clearinghouse/Advocacy/Legislative Action/Help for Newly Diagnosed. This group states they do NOT accept $$ from companies that manufacture of sell alcohol, chemicals, oil, pharmaceuticals, tobacco or insurance.

**ABCDInc. (414)278-1345 (Milwaukee, WI)provides information/support for newly diagnosed especially. This group works with local hospitals, clinics and other organizations, but is not affiliated with any medical providers.

**Breast Cancer Coalition of Rochester (&16)234-3337 (Rochester, NY) meets the 4th Tuesday of every month at 7PM at Valley Manor Apartments Education Ctr. 1570 East Avenue, Rochester,NY 14610. Works on promoting legislative issues, advocates for funding, seeks to improve access to screening, diagnosis, treatment and care. (Now with a website)

**Breast Cancer Coalition of Utah, PO Box 526174, Salt Lake City, UT 84152-6174 Newsletter, advocacy

**Women’s Cancer Advocacy Network
PO Box 19127
Reno, NV 89511
Toll-free: 877.984.WCAN (9226)
general e-mail: women@wcan.org

***Women’s Cancer Advocacy Network
WECAN
PO Box 5698
Charlottesville, VA 22905
(434) 984-6445
Fax (434) 295-7435 (women at risk or or diagnosed with breast or gyn cancers & health care professionals & organizations, researchers, govt agencies, lawmakers & industry.

**Wisconsin Breast Cancer Coalition
P.O. Box 170031
Milwaukee, WI 53127
(414)963-2103

**Chai Lifeline-Telephone support group for Orthodox (Jewish) women living with breast cancer, (212)699-6639 or
1(888)2-CHAI-LIFE (242-4543) (Funded by the UJA Federation of New York in conjunction with Beth Israel Medical Center Community Partnerships: Linking Breast Cancer Resources)

**Texas Breast Cancer Coalition
PO Box 13504
Austin, TX 78711

This group supports the legislative priorities of the National Breast Cancer Coalition. They hold meetings with state officials, write letters and call.

**The Breast Cancer Bridge
So Jersey Regional Cancer Ctr – Elmer
(856)363-1514 (856) 825-3344

Breast Cancer Action Group of the Monterey Peninsula
PO Box 221582
Carmel, CA 932922-1582
831 644-6365 Fax 831 620-1437

This group woks to address unmet needs of community members diagnosed with breast cancer. Advocacy, Education, Philanthropy.

(Especially for)African-American Breast Cancer Groups:

**ABC/African-American Community Health Group
Contact: Carmelita Austin-Schreher, ABC Director
Walnut Avenue Women’s Center
303 Walnut Avenue
Santa Cruz, CA 95060
(831) 426-3062
Fax (831) 426-3070
abcwawc@sbcglobal.net

**Embracing Life
Contact: National Black Leadership Initiative on Cancer
University of Illinois at Chicago
2121 W. Taylor Street, Suite 512
Chicago, ILL 60612
Anita Hill
(312) 996-8046 or (800) 799-2542

**God Cares Support Group
Church of the Great Commission
10137 Prince Place, #402
Largo, Maryland 20772
Contact: Carolyn P. Harvey
(301) 350-3113 or (301) 735-7398

**Sisters Breast Cancer Survivors Network
YWCA Greater Los Angeles
2501 W. Vernon Ave.
Los Angeles, CA 90008
Contact: Patsy Harris
(213) 293-9408

**Rise Sister Rise
1765 N. Street
Washington, D.C. 20036
Contact: Zora Kramer Brown
(202) 463-8040

**Sisters Network
National Headquarters
8787 Woodway Drive, Suite 4297
Houston, Texas 77063
Contact: Karen E. Jackson
(713) 781-0255 SEE WEBSITE

Other Locations:
Long Island, New York
Dallas, Texas
Los Angles, California
Lake Jackson, Texas

**Women of Color Breast Cancer Survivors Support Project
8610 S. Sapulveda
Suite 200
Los Angles, California 90045
Contact: Carol Tap

**Edna B. & Joyce Fay Washington Breast Cancer Foundation
P.O. Box 29042
New Orleans, LA 70189-0042
(504)246-1466 & fax
washbcf@bellsouth.net

**African-American Support Group, Inc.
Kings Art Complex
867 Mt. Vernon Avenue
Columbus, OH
(614) 470-0491

www.celebratinglife.org Breast cancer site geared toward African-American women

Lobular Ca & Breast Conserving Surgery

Oral Session

Examination of Breast Conserving Therapy in Lobular Carcinoma

Megumi Takehara–1, Motoshi Tamura–1, Hiroshi Kameda–2, and Masami Ogita–1

–1Department of Breast Surgery, National Sapporo Hospital, and –2Asabu Breast & Thyroid Clinic, Japan.

Background: Experience with conserving surgery for lobular carcinoma has grown as more breast conserving surgeries have been performed. We examined the results of breast conserving therapy in lobular carcinoma.

Patients and Methods: We examined the postoperative positive margin rate, presence or absence of additional surgery, presence or absence of local or systemic recurrence and role of breast helical CT in 25 cases of breast conserving surgery performed at this department from 1991 through June 2003.

Results: Among the 303 cases of all breast conserving surgeries, there were 63 case with positive margins (20.8%), but there were 15 of 25 positive margin cases (60.0%) among the lobular carcinoma cases.

In 8 of the 15 positive margin cases the technique was changed to mastectomy. One case of recurrence in the breast has been observed thus far.

Although the positive margin rate and positive margin rate in infiltrating carcinoma cases tended to decline after the introduction of breast helical CT, the rates remained high.

Conclusions: Since the positive margin rate was significantly high at the time of breast conserving surgery for lobular carcinoma, careful selection of technique based on imaging studies such as breast helical CT and MRI along with careful follow-up is considered necessary.

Reprint requests to Megumi Takehara, Department of Breast Surgery, National Sapporo Hospital, 4-2 Kikusui, Shiroishi-ku, Sapporo, Hokkaido 003-0804, Japan.
E-mail: takehara@sap-cc.go.jp

Breast Cancer 11:69-72, 2004.

Ann’s NOTE:

I was diagnosed with invasive lobular carcinoma of the left breast in January 1993. Treated with a lumpectomy by a surgeon who strongly believed in breast conserving surgery.

Tumors continued to recur from cancer that had not formed a lump at the original time of discovery. After three lumpectomies, and a mastectomy, tiny tumors grew on the chest wall too.

Judging by the fact that neither mammography, nor ultrasound was able to find cancer, although it was there, I consider a mastectomy the safest surgery. And I do not say that lightly, witness my three lumpectomies before I ‘gave up’ my left breast.

Eventually an MRI was able to ‘look’ at the chest wall area and correctly identify invasive cancer.

Lobular Bca -Usefulness of MRI

ABSTRACT: Lobular Breast Cancer: How useful is breast magnetic
resonance imaging?
[10/18/2001; Tumori (Italy)]

Rationale and objectives: To review magnetic resonance imaging
(MRI) findings in lobular breast carcinoma, the in situ or
infiltrating subtype, with special attention to the dynamic
curves with the aim to evaluate possible differences with ductal
carcinoma.

Conclusions: Due to its infiltrative growth associated to only
limited connective tissue reaction, lobular carcinoma often
encounters difficulties in mammographic diagnosis.

In contrast,
MRI can be very helpful in evaluating the true extension of the
disease, especially when breast conservation is considered. Due
to a more consistent fibrotic stroma, these lesions sometimes
show a delayed enhancement, which suggests that more than one
set of subtracted images should be evaluated during MRI analysis.