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The MDLinx Oncology App

  
  
  
  
  

MDLinx Oncology app

This app provides the latest oncology journal articles on your mobile device.

  • Journal articles reviewed and summarized by editors who are also oncologists
  • Search, sort, and filter articles to meet your personal specifications
  • Available for both Android® and iPhone®

This MDLinx Mobile resource is provided as an educational service. The content is selected and controlled exclusively by the MDLinx Editorial Team at M3.

MDLinx Oncology from M3

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Skin Cancer... Don't Let It Come Back To Haunt You!

  
  
  
  
  

Fact or Fiction: Educating skin cancer survivors on risks of tanning bed use could reduce recurrence of melanoma.

Well… it depends on the individual. For more than 20% of skin cancer survivors, the desire to maintain a killer tan overrides the known dangers of tanning bed use and overexposure to sunlight without sunscreen. According to an article published on MDLinx, “Some melanoma survivors still use tanning beds, skip sunscreen,it’s important to understand that melanoma, although the least common type of skin cancer, is the most dangerous, claiming over 9,000 American lives annually.  While the majority of melanoma survivors educate themselves and take precautionary measures to protect themselves from recurrence, reportedly over 20% do not.   

skin cancer Major risk factors for melanoma include:
  • Overexposure to ultraviolet (UV) light, commonly due to sunlight and tanning beds/lamps on unprotected skin
  • Moles
  • Fair skin and Freckles
  • Genetics
  • Immune suppression
  • Age
  • Gender

At the most recent annual meeting of the American Association for Cancer Research, a study found that 27% of melanoma survivors still do not use sunscreen, 15% rarely stayed in the shade when outdoors and 2% still use tanning beds.

Many medical professionals find it disturbing that after surviving skin cancer, patients continue their pre-cancer perilous behavior by not implementing the recommended skin protection practices and ignoring the risk of recurrence.  Tthere is clearly a need for more effective intervention and education on the part of healthcare providers to reduce the use of tanning beds/lamps and exposure to the sunlight, especially when educating patients who have already survived a bout with skin cancer. The question remains: Can better outcomes be achieved in time to save lives?

 

Find more articles about skin cancer at mdlinx.com/oncology:

skin cancer articles

Risk factors for second screen-detected breast cancers in women

  
  
  
  
  

Risk factors for second screen-detected or interval breast cancers in women with a personal history of breast cancer participating in mammography screening
Cancer Epidemiology, Biomarkers & Prevention, 03/25/2013  Clinical Article

Houssami N et al. – Our models identify risk factors for interval second BC in PHBC women.

Methods

  • Screening mammograms from women with history of early-stage BC at Breast Cancer Surveillance Consortium-affiliated facilities(1996-2008) were examined. Associations between woman-level, screen-level, and first-cancer variables and the probability of a second BC were modeled using multinomial logistic regression for three outcomes (screen-detected invasive BC, interval invasive BC, or DCIS) relative to no second BC.

Results


Read more: http://www.mdlinx.com/oncology/news-article.cfm/4527459/

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Prostatic Specific Antigen Testing for Prostate Cancer

  
  
  
  
  

Is it an effective method for screening for Prostate Cancer?

Prostate Cancer is the most frequently diagnosed cancer in men and one of the leading causes of cancer related deaths.   According to The American prostate cancer controversial updateCancer Society about 238,590 new cases of prostate cancer will be diagnosed and about 29,720 men will die of prostate cancer in 2013.  It’s primarily detected in men over the age of 40 and it is the second leading cause of cancer-related death in African American men.  Although prostate cancer is an extremely life-threatening disease, the survival rate is over 90%.  The most commonly used screenings for Prostate Cancer are: Digital rectal exam (DRE) and Prostatic Specific Antigen (PSA) testing.  A PSA test measures the blood level of PSA, which is a protein produces by the prostate gland.  Since the 1980’s doctors have been using this test to screen men between the ages of 40-75 for prostate cancer.

Recently many professional organizations are beginning to question the effectiveness of PSA testing.  They feel the benefits of the screening do not outweigh the risks.  When higher PSA levels are detected, it alerts doctors that cancer may be present.  “False positives” are common with PSA test and many times the tumors detected by PSA screening may not develop into life threatening tumors.  There are also situations when PSA test produce “false negatives” due to rapidly growing prostate cancers not producing sufficient PSA.  

Men who choose to be treated (better safe than sorry) and undergo one of many Prostate Cancer treatments are exposed to side-effects such as: Urinary dysfunction, Bowel dysfunction, erectile dysfunction, hormonal changes and infertility that can last up to 10 years after treatment. The severity of the side-effects depends significantly on the individual and his state of health. 

Although controversial for “over diagnosis” and “overtreatment”, “diagnosis and treatment of prostate cancer were radically improved after the discovery of the prostatic-specific antigen”, as noted in the MDLinx article on screening for Prostate Cancer.    Currently most insurance companies as well as Medicare will cover annual PSA screenings.  If a PSA screening detects elevates PSA levels, it’s important to get a biopsy done before starting treatment to accurately determine whether or not Prostate Cancer is evident. Researchers are currently trying to improve the PSA Test.  To learn more about the developments in PSA testing visit http://www.mdlinx.com/oncology/.

How much normal tissue should be excised around a liver metastasis from a colorectal cancer?

  
  
  
  
  

Interesting article addressing this question is now available as "Full Free Text" from Clin Cancer Res Published OnlineFirst April 29, 2011.

Original summary on MDLinx:

Holdhoff M et al. –Mutant tumor-specific DNA can be detected beyond the visible tumor margin, but never beyond 4 mm, even in patients whose tumors were larger prior to chemotherapy. These data provide a rational basis for determining the extent of surgical excision required in patients undergoing resection of liver metastases.

Methods

  • Evaluated 88 samples of tumor margins from 12 patients with metastatic colon cancer who each underwent partial hepatectomy of one to 6 liver metastases
  • Punch biopsies of surrounding liver tissue obtained at 4, 8, 12 and 16 mm from the tumor border
  • DNA from these biopsies analyzed by sensitive PCR-based technique, called BEAMing, for mutations of KRAS, PIK3CA, APC, or TP53 identified in corresponding tumor

Results

  • Mutations were identified in each patient's resected tumor and used to analyze the 88 samples circumscribing the tumor-normal border
  • Tumor-specific mutant DNA was detectable in surrounding liver tissue in five of these 88 samples, all within 4 mm of the tumor border
  • Biopsies 8, 12, and 16 mm from macroscopic visible margin were devoid of detectable mutant tumor DNA as well as of microscopically visible cancer cells
  • Tumors with significant radiologic response to chemotherapy were not associated with any increase in mutant tumor DNA in beyond 4 mm of main tumor
Read the full article here.

Tanning bed use during high school increases risk for BCC

  
  
  
  
  

As published in the Journal of Clinical Oncology, researchers at Harvard Medical School and the Harvard School of Public Health have reported that tanning bed exposure during the high school and college years is associated with an increased risk of basal cell carcinoma (BCC; HR=1.73) compared to tanning bed exposure between the ages of 25 and 35 years (HR=1.28). During a 20-year follow-up of 73,494 female nurses with tanning bed exposure during high school/college or between 25 and 35 years of age, 5,506, 403, and 349 developed BCC, squamous cell carcinoma (SCC), and melanoma, respectively. The HRs for BCC, SCC, and melanoma for tanning bed use (4x/y) were 1.15, 1.15, and 1.11, respectively.  Compared to nurses with tanning bed use (6x/y) between the ages of 25 and 35 years (HR=1.28), high school/college exposure was associated with increased risk (HR=1.73).  Tanning bed exposure increases the risk of BCC, especially when the exposure is at a younger age. 

Screening for ovarian cancer based on symptoms

  
  
  
  
  
In a study (Diagnosing Ovarian Cancer Early [DOvE]) funded by the Canadian Institutes of Health Research, women > 50 years of age with symptoms of ovarian cancer were offered CA-125 and transvaginal ultrasound screening.  Of 1455 women enrolled in the DOvE study, 11 invasive ovarian cancers were diagnosed, 9 of which were high-grade serous cancers (HGSCs). This corresponds to a prevalence of 1 in 132 women, which is 10-fold higher than reported rates.  The women in the DOvE study were generally younger, better educated, and English-speaking, compared to clinic patients.  Further, the women in the DOvE study had decreased tumor burden and were more likely to have complete resections than clinic patients (73% vs. 44%).   Because 78% of the HGSCs originated outside the ovaries, the CA-125 levels were not as highly elevated as clinic patients diagnosed with ovarian cancer, and the ovaries had an essentially normal appearance on sonography, the authors recommend focusing on low-volume disease rather than early-stage disease.    

MRI + mammography improves breast cancer detection in high-risk women

  
  
  
  
  
In a study headed by the American College of Radiology Imaging Network (Philadelphia) and published in JAMA involving 2809 women at 21 clinical centers, the addition of MRI to mammography and ultrasonography increased the detection of breast cancer.  The study subjects had an increased risk of breast cancer and dense breasts, and underwent annual mammography plus ultrasonography for 3 years.  One hundred ten of 2662 women had detectable breast cancer as follows:  33, mammography; 32, ultrasonography; 26, mammography plus ultrasonography; 9, MRI after mammography plus ultrasonography; and 11, missed detection.  The sensitivities for detecting breast cancer of mammography plus ultrasonography, mammography alone, and MRI after mammography plus ultrasonography were 0.76, 0.52, and 1.0, respectively.  The number screened for detection was 127, 234, and 68 for mammography, mammography plus ultrasonography, and MRI after negative mammography plus ultrasonography, respectively.

ASA reduces risk of cancer

  
  
  
  
  
A meta-analysis published in The Lancet Oncology has confirmed that long-term aspirin use reduces the risk of cancer.  Specifically, the risk of colorectal (OR=0.62), esophageal, gastric, biliary, and breast cancer was reduced in patients who used ASA long-term.  Moreover, the risk of distant metastases (OR=0.69), but not regiona spread, was reduced. 
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PCPA detects early-stage pancreatic cancer

  
  
  
  
  
Pro-carboxypeptidase A (PCPA) levels were determined in 10 and 16 patients with early and late adenocarcinoma of the head of the pancreas, respectively. The upper limit of normal of 2.35 u/L for PCPA was exceeded in 90% and 56% of patients with early- and late-stage pancreatic cancer, respectively.  PCPA was shown to have a sensitivity of 94% in the detection of early-stage pancreatic cancer. 
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