Smokers Mistakenly Believe Vitamins Protect Them From Cancer

FRIDAY, Aug. 5 (HealthDay News) -- Smokers who take a multivitamin pill may think they can smoke more because the supplement protects them from the harmful affects of cigarettes, according to a new study.

Researchers found that some people who smoke mistakenly believe the vitamins will reduce their risk of cancer, allowing them to light up more often. The study noted that such trading of a virtuous behavior for a subsequent indulgence, known as the "licensing effect," could undermine smokers' urge to kick the addiction.

"Smokers who take dietary supplements can fool themselves into thinking they are protected against cancer and other diseases. Reminding health-conscious smokers that multivitamins don't prevent cancer may help them control their smoking or even encourage them to stop," said the study's lead author, Wen-Bin Chiou in a journal news release.

The study, published online Aug. 2 in the journal Addiction, involved two experiments. In the first experiment, a group of 74 daily smokers were given a placebo (dummy) pill, but half were told they were taking a vitamin C pill. After taking the pills, the smokers were allowed to smoke freely as they took an unrelated hour-long survey.

Researchers found the smokers who thought they had taken vitamins smoked nearly twice as many cigarettes than those who knew they took the placebo. They also reported having greater feelings of invincibility.

In the second study, 80 smokers were also given a placebo, with half being told they were taking a multivitamin. Afterwards, they were allowed to smoke while they took a survey, which contained questions about their attitudes towards multivitamins.

Not only did those who took multivitamins smoke more, but those who reported believing in the health benefits of vitamins had a greater surge in their feelings of invincibility and smoked still more than those who were less optimistic about the vitamins' effects.

The study's authors concluded health-conscious smokers who take vitamins may wrongly feel less vulnerable to the harmful effects of cigarettes. As a result, the researchers added, they may smoke more, increasing their overall health risks.

More information

The U.S. Centers for Disease Control and Prevention provides more information on how to quit smoking.

SOURCE: Wiley-Blackwell, news release, Aug. 2, 2011

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Cancer Patients May Be at Greater Risk for Sun Damage

TUESDAY, Aug. 2 (HealthDay News) -- During the summer, cancer patients are at greater risk for sun damage and need to be extra vigilant about sun safety, researchers say.

"Cancer patients may be more at risk for sun damage because of their treatment," said Dr. Elizabeth Kvale, director of outpatient supportive care and survivorship in the Department of Medicine at the University of Alabama at Birmingham, in a university news release.

"Skin that has been treated with radiation therapy may lose some of its natural protective capacity because of the changes that occur with treatment," she said. "Radiation-exposed skin should be completely protected from sun exposure."

In order to protect their skin from the sun's harmful rays, the UAB experts recommend that cancer patients follow some basic sun-protection guidelines during hot weather, including:

Apply sunscreenWear protective clothing Cover surgical scars (they may darken if exposed to the sun) Wear a hat (this is especially important for patients who have lost their hair)

Skin cancer patients should pay particular attention to the areas of skin being treated, advised the American Society of Clinical Oncologists. Dark, tightly woven fabrics are best for guarding against sun exposure, the group noted.

The UAB experts added that children who have been diagnosed with cancer are among those at greatest risk. "Pediatric cancer patients, survivors and their caregivers should be especially attentive to sun safety," said Kvale, who is also an associate scientist in the UAB Comprehensive Cancer Center.

Kvale explained that children who experience sunburn have a significantly elevated risk of developing serious skin cancer in the long-term.

The sun's harmful UV rays are not the only reason cancer patients have to exercise caution during the summer. Cancer patients are also more susceptible to heat exhaustion or dehydration since vomiting, diarrhea and nausea are side-effects of cancer treatment. As a result, UAB experts warn that cancer patients should also take the following steps:

Drink plenty of fluids throughout the dayChew on ice chips Avoid beverages with alcohol or caffeineEat fruits and vegetables with high fluid content

More information

The U.S. Centers for Disease Control and Prevention provides more tips on sun safety.

SOURCE: University of Alabama at Birmingham, news release, July 28, 2011.

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Scientists May Have Found Missing Link to Common Brain Cancer

THURSDAY, Aug. 4 (HealthDay News) -- A map of the genetic mutations associated with the second most common form of brain cancer appears to reveal the biological cause of the tumors, researchers report.

They created the map by sequencing protein-coding genes in seven samples of tissue from oligodendroglioma tumors, and concentrated on recurring mutations in two genes (CIC and FUBP1) not previously associated with those types of tumors.

The genes appear to be the missing link in the "two-hit" theory of cancer development, the scientists said. That is, each cell in the body has two copies of 23 chromosomes, representing thousands of genes that produce protein. If one copy is missing, the other copy can make up for the lack of protein. But if the second copy fails, it can become cancerous.

For years, scientists have known that the "first hit" in oligodendrogliomas appears in the regions of chromosomes 1 and 19, which fuse together and cause the loss of many genes.

In this study, scientists found mutations in the CIC and FUBP1 genes on chromosomes 1 and 19, which suggests they are the "second hit" needed to cause cancer.

More mutations in the genes -- which regulate cell-signaling processes -- were found in an additional 27 tumor samples. Of all the tumor samples analyzed in the study, two-thirds had CIC and FUBP1 mutations, said the Johns Hopkins Kimmel Cancer Center scientists.

"Whenever we find genes mutated in a majority of tumors, it is likely that the pathway regulated by that gene is critical for the development and biology of the tumor," Nickolas Papadopoulos, an associate professor of oncology, said in a center news release.

The study appears Aug. 4 in the journal Science.

About 20 percent of brain cancers are oligodendrogliomas, which tend to affect people aged 30 to 45 and most often form on the frontal lobe in cells that coat neurons. Treatment involves surgery followed by chemotherapy and radiation. Median survival is 10 years.

More information

The National Brain Tumor Society has more about oligodendroglioma tumors.

SOURCE: Johns Hopkins Kimmel Cancer Center, news release, Aug. 4, 2011

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Breast Cancer Drug Raises Risk of Heart Problems in Older Women: Study

WEDNESDAY, Aug. 10 (HealthDay News) -- The breast cancer drug Herceptin increases the risk of heart problems in elderly patients, especially those with a history of heart disease and/or diabetes, a new study says.

Researchers analyzed the medical records of 45 women, ages 70 to 92, who were treated with Herceptin (trastuzumab) since 2005 and found that 12 (26.7 percent) of them developed heart problems caused by the drug.

That rate is slightly higher than what was noted in earlier clinical trials of younger, healthier women.

In this new study, 33 percent of the women with a history of heart disease developed either asymptomatic or symptomatic heart problems as a result of taking Herceptin, compared with 9.1 percent of women without a history of heart disease.

The researchers also found that about 33 percent of women with diabetes developed heart problems, compared with 6 percent of diabetes-free women.

When the women with heart problems stopped taking Herceptin, all but one recovered fully and five were able to re-start treatment with the drug.

The study appears in the journal Annals of Oncology.

"This is the first study specifically to assess trastuzumab-related cardiac toxicity and the cardiovascular factors that are associated with an increased risk in a selected population of elderly breast cancer patients," study author Dr. Cesar Serrano, who conducted the research while working as a clinical fellow at the Department of Medical Oncology Breast Cancer Centre at the Vall d'Hebron University Hospital in Barcelona, Spain, said in a journal news release.

"Trastuzumab is generally well-tolerated and, although there are some concerns about it causing heart problems, until now few risk factors have been identified among patients in clinical trials, most of whom are usually younger than 70 years and have good general health. Our study has demonstrated a significantly increased incidence of cardiac events among patients aged 70 and over with cardiovascular risk factors such as a history of cardiac disease and diabetes," said Serrano, who is now a postdoctoral research fellow at Brigham and Women's Hospital in Boston.

Serrano said the findings suggest that elderly women with one or more heart risk factors who are being treated with trastuzumab should be referred to a cardiologist. He also recommended closer monitoring of such patients for possible heart problems.

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

SOURCE: Annals of Oncology, news release, Aug. 9, 2011

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Counseling May Help Women at Risk for Breast Cancer Gene

FRIDAY, Aug. 5 (HealthDay News) -- Although women whose mothers had breast cancer may worry about developing cancer themselves, many do not fully understand when and why they should be screened or their options to reduce their risk for the disease, a new study suggests.

"Young, high-risk women have little knowledge about the probabilities and options for managing the cancers for which their risks are remarkably increased. Further, many report intense anxiety related to their potential cancer development," principal investigator Andrea Farkas Patenaude, of the Dana-Farber Cancer Institute, said in an institute news release.

The daughters of women with BRCA1 or BRCA2 genes have a 50 percent chance of having this mutation themselves, which will increase their risk of breast cancer by 85 percent and raise their risk of ovarian cancer by up to 60 percent. The researchers pointed out that these women will be unable to make informed health decisions until they know about these risks as well as the genetic testing, other types of screening and risk-reducing surgery available to them.

In conducting the study, the investigators questioned the 18- to 24-year-old daughters of mothers who are BRCA1 or BRCA2 mutation carriers, about their attitudes, health behaviors, life plans and how much they knew about hereditary breast or ovarian cancer genetics.

The researchers found that the women surveyed worried a lot about hereditary breast or ovarian cancer. In fact, 40 percent of the daughters revealed they worried a great deal or to an extreme about hereditary cancer.

The study also revealed that the women were not well-informed about the genetics of breast or ovarian cancers, compared to those who had genetic counseling. The participants also did not fully understand their cancer screening and risk-reduction options, including when they should begin this screening process.

"These data support the need and can provide the foundation for the development of targeted educational materials to reduce that anxiety and ultimately improve participation in effective screening and risk-reducing interventions that can improve survival and quality of life for these young women," Farkas Patenaude said.

The findings were slated for presentation on Thursday in Orlando at the Era of Hope conference hosted by the Department of Defense Breast Cancer Research Program. Because this study was presented at a meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute provides more information on how to assess breast cancer risk.

SOURCE: Dana-Farber Cancer Institute, news release, Aug. 4, 2011

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Elderly Lung Cancer Patients Can Gain From Two-Drug Chemo: Study

MONDAY, Aug. 8 (HealthDay News) -- Countering conventional wisdom, researchers in France say that elderly lung cancer patients can gain significant benefit from an aggressive, double-barreled chemotherapy that's often used in younger patients.

The finding raises questions about standard public health recommendations, such as those issued the American Society of Clinical Oncology in 2004, which advised physicians not to expose elderly patients with non-small cell lung cancer (NSCLC) to the undesirable side effects of combination chemotherapy.

Instead, older patients have typically been offered less harsh -- but also less effective -- chemotherapies containing a single agent. That's because, until now, it's been assumed that the benefits to elderly patients of dual-chemo ("doublet") regimens simply weren't worth their onerous side effects and risks.

But, "our study demonstrates clearly that [the doublet] scheme is feasible in elderly patients," study author Dr. Elisabeth Quoix, from the department of chest diseases at Hopitaux Universitaires de Strasbourg at the University of Strasbourg. She noted that survival rates among elderly patients, even among those over the age of 80, appeared comparable to those of younger patients on the dual-drug regimen.

The findings are reported online Aug. 9 in The Lancet.

As life expectancy increases, so does the risk for lung cancer, the leading cancer killer worldwide. As a result, studies show that lung cancer rates have been ramping up among the elderly, with patients in the developed world now averaging between 63 and 70 years of age at diagnosis.

According to Quoix, that means that "elderly patients represent around 50 percent of all patients with lung cancer." She also believes that "there has been for quite a long time such a nihilism toward this disease, especially for elderly patients, that unfortunately most of these patients are under-treated."

In fact, prior research indicates that, in recent years, as little as one-quarter of NSCLC patients over the age of 66 have gotten the same first-line standard of care as younger patients.

To learn more, between 2006 and 2009 Quoix' team recruited just over 450 NSCLC patients between the ages of 70 and 89. All of these patients were undergoing treatment at one of 61 different medical centers across France.

Half were placed on a dual-chemotherapy regimen involving the agents carboplatin and paclitaxel, which together comprise what doctors call "platinum-based doublet chemotherapy." The other half were placed on a single drug ("monotherapy") regimen involving either vinorelbine or gemcitabine.

Dual-regimens were spread across four weeks, while the single regimens were spaced over three weeks.

The researchers found that toxic side effects were indeed more common among those exposed to two chemotherapy agents at once. Yet over the course of 2.5 years of follow-up (on average), the team also found that survival rates were much higher among the dual-chemo group.

For example, elderly patients who were placed on the two-drug therapy survived more than 10 months on average, compared with just over 6 months for those getting the single therapy group.

What's more, nearly 45 percent of doublet patients survived to the one-year mark post-treatment, compared with about 25 percent of those in the single-chemo group.

The authors concluded that -- harsher toxic side-effects notwithstanding -- double-chemo treatment appears to afford elderly lung cancer appreciable and worthwhile benefits. They therefore called for a reconsideration of current protocols for lung cancer treatment among the elderly.

However, in an editorial, Dr. Karen L Reckamp, from the City of Hope Comprehensive Cancer Center in Duarte, Calif., said that there have been too few clinical trials involving older men and women with lung cancer. That means that the "optimum chemotherapy regimen remains unknown" for elderly lung cancer patients, she wrote.

"Clinical trials that examine therapy for lung cancer usually include a minority of patients over 70, so that results do not provide guidance on the best treatment for this group," Reckamp explained.

But she agreed that the new French study "moves the field forward" by highlighting the apparent "dramatic improvement in survival" among elderly afforded dual-chemo treatment.

"This strongly supports doublet chemotherapy in carefully selected older individuals with NSCLC," Reckamp said. However, "the results must be balanced by a look at the increased toxicities and deaths in the combination arm. We are still in need of addition studies that evaluate older individuals with NSCLC and perform an assessment so that we might predict those who may have greater benefit or who might be at greater risk for toxicity."

More information

For more on non-small cell lung cancer, visit the American Cancer Society.

SOURCES: Elisabeth Quoix, M.D., department of chest diseases, Hopitaux Universitaires de Strasbourg, University of Strasbourg, France; Karen L Reckamp, M.D., City of Hope Comprehensive Cancer Center, Duarte, Calif; Aug. 9, 2011, Lancet, online

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Tamoxifen Wards Off Breast Cancer's Return for More Than a Decade

THURSDAY, July 28 (HealthDay News) -- Women who took the cancer-suppressing drug tamoxifen for five years after a breast cancer diagnosis were nearly 40 percent less likely to have the cancer return, and that protection lasted for more than a decade after they stopped taking the drug, a new study finds.

Researchers analyzed the results of about 20 randomized controlled trials on a five-year course of tamoxifen vs. not taking the drug. The trials involved 21,000 women from a dozen countries around the world, including the United States, Europe, China and Japan.

Some 15 years after their diagnosis -- and 10 years after they stopped taking the drug -- women who took tamoxifen still had one-third lower risk of dying than women who didn't take it.

"It's a remarkable drug," said study author Dr. Christina Davies, a lead investigator with the Early Breast Cancer Trialists Collaborative Group, which was established some 25 years ago to conduct periodic reviews of research on breast cancer from around the world. "It has probably saved more lives than any other oncological drug ever."

Of 10,645 women who took tamoxifen, about 26 percent had a relapse at the 10-year-mark, compared to 40 percent who didn't take the medication. By 15 years, 33 percent of women who took the drug had their cancer return, compared to 46 percent who didn't.

The statistics were similar when it came to death rates. After a decade, about 25 percent of women who didn't take the drug had died compared to 18 percent of those who did take it; at 15 years, 33 percent who didn't take the drug died compared to 24 percent of those who took tamoxifen.

"They not only gained the benefits while they were taking the drug, but for many years afterward," Davies said.

The study is published in the July 28 online issue of The Lancet.

Tamoxifen has been widely used for more than 30 years to treat the most common type of breast cancer, estrogen-receptor positive tumors.

The drug works by inhibiting the activity of estrogen, a female hormone that can drive the growth of breast cancer tumors. The drug is most often prescribed as a once-a-day pill for younger women with breast cancer.

Older, postmenopausal women are now often prescribed a newer class of drugs called aromatase inhibitors, which block estrogen released in body fat, experts said. Aromatase inhibitors are most easily used in women who no longer have ovaries that are producing estrogen, Davies said.

One reason for the switch to aromatase inhibitors: Prior research, as well as the current study, found that tamoxifen raises the risk of cancer of the lining of the uterus (endometrial cancer) and life-threatening blood clots in the lungs. The analysis found the added risk from tamoxifen to older women was small, and in younger women it was "almost non-existent," Davies said.

"The benefits greatly outweigh the risks," Davies said.

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said studies such as this that look at death rates over the long-term are valuable.

"The study shows that tamoxifen as an adjuvant [additional] therapy for breast cancer has had a very successful track record that has been sustained over 30 years of use in the clinic, even though it's used less now," he said.

The analysis found tamoxifen worked equally well in women who underwent chemotherapy and radiation in addition to surgery, Davies noted. Another benefit: tamoxifen is inexpensive. Davies estimated a five-year course of the drug costs about $150, of particular importance in developing nations where breast cancer rates have risen dramatically, she said.

Many of the women in the analysis, she noted, failed to take the full five-year course of the drug, so it's possible the protective effect from fully taking the medication as prescribed might be even greater. The findings raise the question of whether, say, a 10-year course of tamoxifen might be even more beneficial than five years.

About half of the women worldwide diagnosed with breast cancer are pre-menopausal, she said. "For those women, tamoxifen is the main treatment option," she said.

About two-thirds of breast cancers in the United States are estrogen-positive. The drug worked even on those whose tumors are "weakly positive," she noted.

More information

The U.S. National Cancer Institute has more on tamoxifen.

SOURCES: Christina Davies, M.D., senior research scientist, Clinical Trial Service Unit, University of Oxford, Oxford, England; Len Lichtenfeld, deputy chief medical officer, American Cancer Society, Atlanta; July 28, 2011, The Lancet, online

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