Babies Born to Childhood Cancer Survivors Do Well

Cancer treatments can compromise fertility, but new research suggests that when survivors of childhood cancer are able to have children, their babies do not face an increased risk of birth defects.

Women who survived childhood cancer were more likely to have premature or low birth weight babies compared with women who had never had cancer, one study found. But the survivors’ newborns were no more likely to have malformations or die, nor were the mothers at greater risk for pregnancy complications over all.

A companion study of men who had survived childhood cancer found that their offspring were slightly more likely to be of low birth weight (less than five and a half pounds), but they were not at greater risk for birth defects or prematurity than children born to men who had not had cancer.

The two studies, done by researchers at the Fred Hutchinson Cancer Research Center in Seattle, were published in The Archives of Pediatrics and Adolescent Medicine.

The researchers used national cancer registry data from 1973 to 2000 in four regions — Seattle, Detroit, Salt Lake City and Atlanta — to identify boys and girls who had cancer before age 20. They then linked the data to birth records to identify the first children born to cancer survivors after their diagnosis.

They were able to compare the outcomes of babies born to 1,898 female cancer survivors with 14,278 controls, also identified from birth records, and to compare the outcomes of 470 babies of male survivors with 4,150 controls.

“The main take-home message is that most kids born to childhood cancer survivors did very well,” said Dr. Eric J. Chow, an author on both papers and a research associate at the cancer center.

The study was limited because it was only able to count birth defects that were obvious upon delivery, he said. Still, he added, “Most people can feel reassured.”

Prevent Periodontitis To Reduce The Risk Of Head And Neck Cancer

Chronic periodontitis, a form of gum disease, is an independent risk factor for head and neck squamous cell carcinoma. This suggests the need for increased efforts to prevent and treat periodontitis as a possible means to reduce the risk of this form of cancer.

"Prevent periodontitis; if you have it already, get treatment and maintain good oral hygiene," said Mine Tezal, D.D.S., Ph.D., assistant professor in the Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, and NYS Center of Excellence in Bioinformatics and Life Sciences at the University of Buffalo. She is also a research scientist in the Department of Dentistry and Maxillofacial Prosthetics at Roswell Park Cancer Institute, which is where the study was conducted.

Results of this study are published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Chronic periodontitis is characterized by progressive loss of the bone and soft tissue attachment that surround the teeth. The researchers assessed the role of chronic periodontitis on head and neck squamous cell carcinoma, as well as the individual roles on three subsites: oral cavity, oropharyngeal and laryngeal. They used radiographic measurement of bone loss to measure periodontitis among 463 patients; 207 of whom were controls.

Findings showed that chronic periodontitis might represent a clinical high-risk profile for head and neck squamous cell carcinoma. The strength of the association was greatest in the oral cavity, followed by the oropharynx and larynx, according to Tezal.

When they stratified the relationship by tobacco use, they found that the association persisted in those patients who never used tobacco. The researchers did not expect the periodontitis-head and neck squamous cell carcinoma association to be weaker in current smokers compared to former and never smokers, according to Tezal. However, this interaction, although statistically significant, was not very strong.

"Confirmatory studies with more comprehensive assessment of smoking, such as duration, quantity and patterns of use, as well as smokeless tobacco history are needed," she said.

"Our study also suggests that chronic periodontitis may be associated with poorly differentiated tumor status in the oral cavity. Continuous stimulation of cellular proliferation by chronic inflammation may be responsible for this histological type. However, grading is subjective and we only observed this association in the oral cavity. Therefore, this association may be due to chance and needs further exploration," Tezal added.

Andrew Olshan, Ph.D., said these results lend further support to the potential importance of poor oral health in this form of cancer. Olshan is professor and chair of the Department of Epidemiology at the Gillings School of Global Public Health, and professor in the Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill.

"The study of poor oral health including the possible carcinogenic role of microorganisms is part of a rapidly growing interest in how a community of microbes that live in the various environments of the human body can affect health," Olshan said. "Although the study is comparatively small, the researchers were able to also see an association between bone loss and the risk of head and neck cancer."

Immune system cancer found in young 9/11 officers

Researchers say a small number of young law enforcement officers who participated in the World Trade Center rescue and cleanup operation have developed an immune system cancer.

The numbers are tiny, and experts don't know whether there is any link between the illnesses and toxins released during the disaster.

But doctors who coordinated the study, published Monday in the Journal of Occupational and Environmental Medicine, said people who worked at the site should continue to have their health monitored.

"What we are trying to get out there is: Be alert," said Dr. Jacqueline M. Moline, director of the World Trade Center Medical Monitoring and Treatment Program at the Mount Sinai School of Medicine.

The researchers looked at 28,252 emergency responders who spent time amid ground zero dust and found eight cases of multiple myeloma.

Those findings were no surprise. Multiple myeloma is the second most common hematological cancer in the U.S. after non-Hodgkin's lymphoma. Normally, researchers would expect to find about seven cases in a group as large as the one examined in the study.

However, four of the people who fell ill were under age 45, and multiple myeloma is thought to be more rare among people of that age. Under normal circumstances, researchers would have expected to find only one case of the disease in that age group.

Those four young multiple myeloma patients included one officer who was caught in the dust cloud on 9/11 and then spent months working long hours at the site. Another spent 111 days at the Staten Island landfill where the rubble was sifted. Two others had less exposure, working 12 and 14 days each in the pit and rubble pile.

The study said it is possible the monitoring program was simply more effective at finding the illness among people who wouldn't ordinarily be subjected to intense medical tracking.

Nevertheless, Moline said, "You shouldn't be seeing so many cases of myeloma in younger folks." The median age of diagnosis for that cancer in the general public is 71.

Several groups are studying New Yorkers exposed to toxic dust when the skyscrapers collapsed.

To date, no study, including the one published Monday, has established a link between that dust and cancer, said Lorna Thorpe, a deputy commissioner and epidemiologist at New York City's health department.

The timing of the four cases examined by the team at Mount Sinai also raised questions about whether they are related to their work at ground zero, she said.

Most research on multiple myeloma indicates that it usually takes 10 to 20 years for someone to develop that cancer after an environmental exposure to a carcinogen.

In these cases, the cancers were diagnosed in as little as three to four years after the attacks, suggesting that something else caused the disease.

Meta-analysis: Can Helicobacter pylori Eradication Treatment Reduce the Risk for Gastric Cancer?

Background: Helicobacter pylori infection is associated with gastric cancer, but the effect of eradication treatment on gastric cancer risk is not well defined.

Purpose: To determine whether H. pylori eradication treatment can reduce the risk for gastric cancer.

Data Sources: PubMed, EMBASE, Cochrane Library, Google Scholar, and online clinical trial registers through 31 January 2009, without language restrictions.

Study Selection: Randomized trials that compared eradication treatment with no treatment in H. pylori–positive patients and that assessed gastric cancer or progression of preneoplastic lesions during follow-up.

Data Extraction: Two authors independently reviewed articles and extracted data.

Data Synthesis: Seven studies met inclusion criteria, 1 of which was excluded from pooled analysis because of clinical and methodological heterogeneity. All studies were performed in areas with high incidence of gastric cancer, mostly in Asia. Overall, 37 of 3388 (1.1%) treated patients developed gastric cancer compared with 56 of 3307 (1.7%) untreated (control) participants. In a pooled analysis of 6 studies with a total of 6695 participants followed from 4 to 10 years, the relative risk for gastric cancer was 0.65 (95% CI, 0.43 to 0.98).

Limitations: All studies but 1 were performed in Asia. Only 2 assessed gastric cancer incidence, and only 2 were double-blinded.

Conclusion: Helicobacter pylori eradication treatment seems to reduce gastric cancer risk.

New Molecular Pathway For Targeting Cancer, Disease Discovered

A UCLA study has identified a way to turn off a key signaling pathway involved in physiological processes that can also stimulate the development of cancer and other diseases. The findings may lead to new treatments and targeted drugs using this approach.

In the study, which is currently available in the online edition of the journal Molecular Endocrinology, scientists found that by activating a receptor in cells called the liver X receptor (LXR), they were able to inhibit the hedgehog (Hh) signaling pathway, which is involved in the maintenance of tissue integrity and stem cell generation. When stimulated in an unregulated manner, however, the Hh pathway can also cause cancers of the brain, lung, blood, prostate, skin and other tissues.

Blocking such unregulated stimulation of the Hh pathway had previously been shown in animal studies to prevent cancers, according to the researchers. How LXR was able to inhibit tumor cell growth by impeding the Hh pathway was previously unknown.

"Our finding shows that activation of LXR signaling is a novel strategy for inhibiting Hh pathway activity and for targeting various cell types, including cancer cells, which may provide important clues as to how we might be able to intervene with tumor formation," said Farhad Parhami, a professor of medicine at the David Geffen School of Medicine at UCLA and the study's principal investigator.

During the study, researchers performed various tests activating LXR receptors in cells and found that specific gene expression induced by the Hh pathway could be inhibited. This finding was also confirmed in mice.

"Since Hh signaling plays a major role in other physiological and pathological processes, we may be able to impact other diseases as well," Parhami said.

Dr. William Matsui of Johns Hopkins Medical Institute, an expert on Hh signaling in cancer development, noted the importance of the UCLA study and its significance for the next stages of research — finding a pharmaceutical drug or substance molecule to act as an agonist, which would stimulate LXR activity to inhibit aberrant Hh signaling.

"The hedgehog Hh signaling pathway is an important regulator of tumor formation, and these findings suggest that LXR agonists may be novel treatments for a wide variety of human cancers," Matsui said.

According to researchers, utilizing this new treatment pathway could have broad applications in the cancer field.

"This discovery identifies an entirely new and unexpected mechanism of hedgehog pathway modulation," said study author Dr. James A. Waschek, an expert on Hh signaling in brain tumor development and a professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA. "This has great potential in offering other options, because current hedgehog pathway inhibitors have severe side effects which preclude their use in many cancer patients, especially children."

Waschek also noted that this discovery may reveal new details on how Hh signals within the cell, which is currently poorly understood.

The next stage of the research will focus on activating the LXR pathway using various pharmacological molecules to inhibit tumor formation. Matsui will be a collaborator in this follow-up research.

In addition, the team has started a medicinal chemistry program to design and test small molecules that activate the LXR pathway while avoiding the adverse effects that may be caused when LXR is activated in tissues such as the liver.

The study was funded by the National Institutes of Health and the American Heart Association.

Other authors include Woo-Kyun Kim and Vicente Meliton from the UCLA Department of Medicine; Peter Tontonoz from the UCLA Department of Pathology and Laboratory Medicine and the Howard Hughes Medical Institute; Kye Won Park from the department of food science and biotechnology at Korea's Sungkyunkwan University; Cynthia Hong from the Howard Hughes Medical Institute and the David Geffen School of Medicine at UCLA; Pawel Niewiadomski from the UCLA Department of Psychiatry; and Sotirios Tetradis from the UCLA School of Dentistry.

WHO approves cervical cancer vaccine Cervarix

The World Health Organization has approved a second cervical cancer vaccine, this one made by GlaxoSmithKline, meaning U.N. agencies and partners can now officially buy millions of doses of the vaccine for poor countries worldwide.

GlaxoSmithKline PLC said in a statement Thursday the approval would help speed access to Cervarix globally.

WHO had previously approved Gardasil, a competing cervical cancer vaccine made by Merck & Co. With two cervical cancer vaccines now ready to be bought by donor agencies, officials estimate that tens of thousands of lives might be saved.

More than 80 percent of the estimated 280,000 cervical cancer deaths a year occur in developing countries. In the West, early diagnosis and treatment has slashed the disease's incidence.

Last year, the global health association GAVI, formerly known as the Global Alliance for Vaccines and Immunization, prioritized the purchase of cervical cancer vaccines for the world's 73 poorest countries. GAVI includes U.N. agencies, the World Bank and the Bill & Melinda Gates foundation and is a major buyer of vaccines for the developing world.

"We're very eager to offer women in developing countries these vaccines because without early screening, they are arguably more vulnerable to cervical cancer," said Dan Thomas, a GAVI spokesman. Thomas said the vaccine's price was essential to making it available to poor countries.

In the West, the vaccines typically cost about $360 for a three-shot dose — which is far too expensive for poor countries, Thomas said.

Thomas said GAVI is in talks with drugmakers, but that it is still not clear whether either Merck & Co or GSK might sell their vaccines to donor agencies at a cheaper price.

Cervarix has not been approved for use in the U.S. or Japan, but is available in 97 other countries. In the U.S., the cervical cancer vaccine market has been cornered by Gardasil since it was approved in 2006.

The FDA is expected to decide within the next few months whether to approve Cervarix. Gardasil racked up $426 million in global sales in the most recent quarter, versus $69 million for Cervarix, which has won more contracts from government health programs beyond the United States.

Melanoma No. 2 cancer in young women

Melanoma is now the second-most common cancer in U.S. women ages 20 - 29, a dermatologist says.

Dr. Adelaide Hebert of the University of Texas Medical School at Houston also states the American Academy of Dermatology Association considers ultraviolet radiation the single largest environmental contributor to skin cancer and the rates of skin cancer are increasing significantly. More than 1 million new cases are diagnosed each year.

Hebert points out limiting sun exposure reduces not only skin cancer risks but painful sunburns and heat rash.

"Minimize your exposure in the sun during the hottest hours of the day, which are usually between 10 a.m. and 2 p.m.," the dermatologist said in a statement.

The doctor's recommendations for those who are going to be in the sun include:

-- Wearing sun screen with an SPF of 30 or higher and reapplying every two hours if sweating or if exposed to water, wind, or high altitudes.

-- Wearing protective tightly woven clothing and hats and to protect eyes, wraparound sunglasses.

-- Not forgetting to protect lips, ears and the tops of feet.