Overview:
The Women's Cancers Program Area addresses research, clinical and educational activities for malignancies in women. The program fosters interactive and collaborative activities between and among members in order to develop multidisciplinary research in the areas of breast and women's reproductive cancers. It takes a comprehensive approach to clinical cancer research with a focus on translational research.
Goals:
Establish genetic-based risk assessment and counseling by understanding high-risk/genetic predisposition
Evaluate and implement prevention and screening strategies by understanding high-risk/genetic predisposition
Investigate the molecular/genetic and environmental conditions that give rise to cancers in women for possible early intervention by understanding early cellular transformation events
Develop targeted therapeutics for women’s cancers by understanding the mechanisms of solid tumor progression/angiogenesis/invasion
Identify targets and develop new, rational, highly effective and minimally toxic therapeutic approaches by understanding established tumors/motility/metastasis
Meetings and Events:
Multiple weekly clinical meetings within each of the clinics
Monthly Ovarian Cancer Research Group meetings
Monthly joint Cedars Sinai-UCLA gynecologic oncology journal club for fellows and residents
Bi-annual meeting of Women’s Cancers Program Area members, with oral and poster presentations and an invited visiting research expert
Leadership:
Dr. John Glaspy serves as director of the Women's Cancers Program Area and is the inaugural recipient of the Estelle, Abe and Marjorie Sanders Endowed Chair in Cancer Research at UCLA in recognition of his distinguished contributions in the area of cancer research and his eminence as a faculty member in the David Geffen School of Medicine. A professor of medicine, Glaspy earned a medical degree at UCLA concurrently with a master's degree in public health from the UCLA School of Public Health. He has gained a national reputation in clinical medicine as an acute diagnostician and outstanding clinician. His research includes understanding the role of gene therapy in cancer and developing new and more efficient molecularly targeted therapies for melanoma and breast cancer. Glaspy played a major role in developing a community-based oncology research network designed to bring UCLA expertise and clinical research programs to regional oncology offices in California and several surrounding states.
Associate Director Dr. Robin Farias-Eisner, a professor of obstetrics and gynecology, serves as Chief of Gynecologic Oncology at UCLA. His research interests include developing better treatments for cervical and uterine cancer and better detection and treatment for ovarian cancer. Farias-Eisner and his colleagues are working on developing a test for the early detection of ovarian cancer that could join the mammogram, colonoscopy, and pap smear in the screening arsenal and save thousands of lives now lost every year to the cancer known as the "silent killer." The simple blood test can detect ovarian cancer when there are no physical signs of disease - when ovaries appear normal and CA 125, a biomarker for ovarian cancer, is normal. In a small study, Farias-Eisner and his team were able to diagnose early stage ovarian cancer with 100 percent accuracy using a panel of four biomarkers that create a specific protein signature. The work currently is being confirmed in a larger study.
Tuesday
National Institute of Health Cancer Statistics
http://seer.cancer.gov Welcome to the Surveillance, Epidemiology and End Results (SEER) Program, a premier source for cancer statistics in the United States. We collect information on incidence, prevalence and survival from specific geographic areas representing 28 percent of the US population and compile reports on all of these plus cancer mortality for the entire country. Our site is intended for anyone interested in US cancer statistics or cancer surveillance methods.
Overview of the SEER ProgramThe Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI) is an authoritative source of information on cancer incidence and survival in the United States. SEER currently collects and publishes cancer incidence and survival data from population-based cancer registries covering approximately 28 percent of the US population. For more information on this, please view the SEER Research Data. SEER coverage includes 26 percent of African Americans, 41 percent of Hispanics, 43 percent of American Indians and Alaska Natives, 54 percent of Asians, and 71 percent of Hawaiian/Pacific Islanders. (Details are provided in the table: Number of Persons by Race and Hispanic Ethnicity for SEER Participants.)
The SEER Program registries routinely collect data on patient demographics, primary tumor site, tumor morphology and stage at diagnosis, first course of treatment, and follow-up for vital status. The SEER Program is the only comprehensive source of population-based information in the United States that includes stage of cancer at the time of diagnosis and patient survival data. The mortality data reported by SEER are provided by the National Center for Health Statistics. The population data used in calculating cancer rates is obtained periodically from the Census Bureau. Updated annually and provided as a public service in print and electronic formats, SEER data are used by thousands of researchers, clinicians, public health officials, legislators, policymakers, community groups, and the public.
NCI staff work with the North American Association of Central Cancer Registries (NAACCR) to guide all state registries to achieve data content and compatibility acceptable for pooling data and improving national estimates. The SEER team is developing computer applications to unify cancer registration systems and to analyze and disseminate population-based data. Use of surveillance data for research is being improved through Web-based access to the data and analytic tools, and linking with other national data sources. For example, a Web-based tool for public health officials and policy makers, State Cancer Profiles, provides a user-friendly interface for finding cancer statistics for specific states and counties. This Web site is a joint project between NCI and CDC and is part of the Cancer Control PLANET Web site which provides links to comprehensive cancer control resources for public health professionals. SEER staff also work with a number of collaborating organizations that are involved in cancer surveillance and related disciplines.
Read Goals of the SEER Program for more information about SEER's activites
Overview of the SEER ProgramThe Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI) is an authoritative source of information on cancer incidence and survival in the United States. SEER currently collects and publishes cancer incidence and survival data from population-based cancer registries covering approximately 28 percent of the US population. For more information on this, please view the SEER Research Data. SEER coverage includes 26 percent of African Americans, 41 percent of Hispanics, 43 percent of American Indians and Alaska Natives, 54 percent of Asians, and 71 percent of Hawaiian/Pacific Islanders. (Details are provided in the table: Number of Persons by Race and Hispanic Ethnicity for SEER Participants.)
The SEER Program registries routinely collect data on patient demographics, primary tumor site, tumor morphology and stage at diagnosis, first course of treatment, and follow-up for vital status. The SEER Program is the only comprehensive source of population-based information in the United States that includes stage of cancer at the time of diagnosis and patient survival data. The mortality data reported by SEER are provided by the National Center for Health Statistics. The population data used in calculating cancer rates is obtained periodically from the Census Bureau. Updated annually and provided as a public service in print and electronic formats, SEER data are used by thousands of researchers, clinicians, public health officials, legislators, policymakers, community groups, and the public.
NCI staff work with the North American Association of Central Cancer Registries (NAACCR) to guide all state registries to achieve data content and compatibility acceptable for pooling data and improving national estimates. The SEER team is developing computer applications to unify cancer registration systems and to analyze and disseminate population-based data. Use of surveillance data for research is being improved through Web-based access to the data and analytic tools, and linking with other national data sources. For example, a Web-based tool for public health officials and policy makers, State Cancer Profiles, provides a user-friendly interface for finding cancer statistics for specific states and counties. This Web site is a joint project between NCI and CDC and is part of the Cancer Control PLANET Web site which provides links to comprehensive cancer control resources for public health professionals. SEER staff also work with a number of collaborating organizations that are involved in cancer surveillance and related disciplines.
Read Goals of the SEER Program for more information about SEER's activites
Thursday
Time Since Diagnosis as a Predictor of Symptoms, Depression, Cognition, Social Concerns, Perceived Benefits, and Overall Health in Cancer Survivors
Abstract
Purpose/Objectives: To assess whether health and other factors are different in short-term cancer survivors (less than five years since diagnosis), long-term survivors (5-10 years), and very long-term survivors (more than 10 years).
Design: A cross-sectional survey.
Setting: New Zealand.
Sample: 836 survivors of adult-onset cancers (6 months to 43 years since diagnosis).
Methods: Survivors were recruited using community-based methods and answered a mailed questionnaire.
Main Research Variables: Physical and emotional health, depression, symptoms, cognitive difficulty, social concerns, and perceived benefits of cancer.
Findings: Physical and emotional health, depression, physical symptoms, and perceived benefits of cancer were not associated with time since diagnosis, but longer time since diagnosis was associated with decreases in cognitive difficulties and social concerns. The survivors in this study reported a mean of 8.4 physical symptoms, regardless of time since diagnosis, with the most frequent being fatigue (76%), aches and pain (75%), and trouble sleeping (68%).
Conclusions: Most survivors enjoyed a moderately good level of health. However, some adverse effects, such as symptoms, were similar in short-, long-, and very long-term survivors, suggesting that interventions may be needed to prevent persistent issues as time progresses.
Implications for Nursing: The findings suggest a need to reconsider the common attitude that survivors who finish treatment should be able to return to normal life. Assessment of symptoms, particularly fatigue, pain, and sleep issues, is important even in very long-term survivors.
Jill A. Bennett, PhD, RN1, Linda D. Cameron, PhD2, Paul M. Brown, PhD2, Lisa C. Whitehead, PhD3, David Porter, MBChB, MD4, Tanja Ottaway-Parkes, MA2, Elizabeth Robinson, PhD2
1School of Nursing, University of Auckland, New Zealand
2School of Public Health, University of Auckland
3Centre for Postgraduate Nursing Studies, University of Otago in Christchurch, New Zealand
4Auckland District Health Board, Medical Oncology, Auckland Hospital
Purpose/Objectives: To assess whether health and other factors are different in short-term cancer survivors (less than five years since diagnosis), long-term survivors (5-10 years), and very long-term survivors (more than 10 years).
Design: A cross-sectional survey.
Setting: New Zealand.
Sample: 836 survivors of adult-onset cancers (6 months to 43 years since diagnosis).
Methods: Survivors were recruited using community-based methods and answered a mailed questionnaire.
Main Research Variables: Physical and emotional health, depression, symptoms, cognitive difficulty, social concerns, and perceived benefits of cancer.
Findings: Physical and emotional health, depression, physical symptoms, and perceived benefits of cancer were not associated with time since diagnosis, but longer time since diagnosis was associated with decreases in cognitive difficulties and social concerns. The survivors in this study reported a mean of 8.4 physical symptoms, regardless of time since diagnosis, with the most frequent being fatigue (76%), aches and pain (75%), and trouble sleeping (68%).
Conclusions: Most survivors enjoyed a moderately good level of health. However, some adverse effects, such as symptoms, were similar in short-, long-, and very long-term survivors, suggesting that interventions may be needed to prevent persistent issues as time progresses.
Implications for Nursing: The findings suggest a need to reconsider the common attitude that survivors who finish treatment should be able to return to normal life. Assessment of symptoms, particularly fatigue, pain, and sleep issues, is important even in very long-term survivors.
Jill A. Bennett, PhD, RN1, Linda D. Cameron, PhD2, Paul M. Brown, PhD2, Lisa C. Whitehead, PhD3, David Porter, MBChB, MD4, Tanja Ottaway-Parkes, MA2, Elizabeth Robinson, PhD2
1School of Nursing, University of Auckland, New Zealand
2School of Public Health, University of Auckland
3Centre for Postgraduate Nursing Studies, University of Otago in Christchurch, New Zealand
4Auckland District Health Board, Medical Oncology, Auckland Hospital
Monday
Statins reduced incidence of prostate cancer recurrence after prostatectomy
In men with prostate cancer who underwent prostatectomy, the use of statins reduced the disease recurrence rate by 30%.
“Our findings require confirmation in other settings and in particular to determine whether statins are associated with a reduction in metastases and/or prostate cancer specific and overall mortality,” the researchers wrote.
These conclusions were drawn from data taken from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Data on 1,319 men treated with radical prostatectomy were taken from this database between 1988 and 2008. The researchers compared PSA recurrence between statin users and nonusers. Of the men examined, 18% were taking statins.
Significant differences between statin users and nonusers were identified at presentation. Those men taking statins were more likely to be older (P<.001), have a lower median PSA (P=.04), were more likely to be white (P<.001) and have a higher BMI (P=.05); however, they were also more likely to have a higher biopsy Gleason score (P=.002).
Median follow-up for statin users was 24 months; it was 38 months for nonusers. At that time, 23% of the men had a biochemical recurrence (16% for statin users vs. 25% in nonusers).
After adjusting for the pathological and clinical factors that differed between the two groups, the researchers found that men who used statins had a 30% decreased risk of PSA recurrence (95% CI, 0.50-0.97). This association was dose-dependent.
Hamilton RJ. Cancer. 2010;doi:10.1002/cncr.25308.
“Our findings require confirmation in other settings and in particular to determine whether statins are associated with a reduction in metastases and/or prostate cancer specific and overall mortality,” the researchers wrote.
These conclusions were drawn from data taken from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Data on 1,319 men treated with radical prostatectomy were taken from this database between 1988 and 2008. The researchers compared PSA recurrence between statin users and nonusers. Of the men examined, 18% were taking statins.
Significant differences between statin users and nonusers were identified at presentation. Those men taking statins were more likely to be older (P<.001), have a lower median PSA (P=.04), were more likely to be white (P<.001) and have a higher BMI (P=.05); however, they were also more likely to have a higher biopsy Gleason score (P=.002).
Median follow-up for statin users was 24 months; it was 38 months for nonusers. At that time, 23% of the men had a biochemical recurrence (16% for statin users vs. 25% in nonusers).
After adjusting for the pathological and clinical factors that differed between the two groups, the researchers found that men who used statins had a 30% decreased risk of PSA recurrence (95% CI, 0.50-0.97). This association was dose-dependent.
Hamilton RJ. Cancer. 2010;doi:10.1002/cncr.25308.
Human Chorionic Gonadotropin Weight Loss controversy
Where is the Human Chorionic Gonadotropin Weight Loss controversy come from.
A controversial usage of hCG is as an adjunct to the British endocrinologist A.T.W. Simeons' ultra-low-calorie weight-loss diet Simeons, while studying pregnant women in India on a calorie-deficient diet, and “fat boys” with pituitary problems treated with low-dose hCG, discovered that both lost fat rather than lean (muscle) tissue. He reasoned that hCG must be programming the hypothalamus to do this in the former cases in order to protect the developing fetus by promoting mobilization and consumption of abnormal, excessive adipose deposits. Simeons, practicing at Salvator Mundi International Hospital in Rome, Italy, recommended low-dose daily hCG injections (125 mg) in combination with a customized ultra-low-calorie (500 cal/day, high-protein, low-carbohydrate/fat) diet loss of adipose tissue without loss of lean tissue. After Simeons’ mysterious death, the diet started to spread to specialized centers and via popularization by such as the controversial author Kevin Trudeau.
The controversy proceeds from warnings by the Journal of the American Medical Association[1] and the American Journal of Clinical Nutrition[2] that hCG is neither safe,[1] nor effective as a weight-loss aid.[3]
1. Fraser L. "Ten Pounds in Ten Days: A Sampler of Diet Fads and Abuse". Health resources special report. Caremark, L.L.C.. https://www.caremark.com/wps/portal/HEALTH_RESOURCES?topic=dietscams. Retrieved 2009-02-03.
2. Stein MR, Julis RE, Peck CC, Hinshaw W, Sawicki JE, Deller JJ (September 1976). "Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study". Am. J. Clin. Nutr. 29 (9): 940–8. PMID 786001. http://www.ajcn.org/cgi/reprint/29/9/940.pdf. Retrieved 2009-02-03
3. Barrett S. "HCG Worthless as Weight-Loss Aid". Diet Scam Watch. dietscam.org. http://www.dietscam.org/reports/hcg.shtml. Retrieved 2009-02-03.
A controversial usage of hCG is as an adjunct to the British endocrinologist A.T.W. Simeons' ultra-low-calorie weight-loss diet Simeons, while studying pregnant women in India on a calorie-deficient diet, and “fat boys” with pituitary problems treated with low-dose hCG, discovered that both lost fat rather than lean (muscle) tissue. He reasoned that hCG must be programming the hypothalamus to do this in the former cases in order to protect the developing fetus by promoting mobilization and consumption of abnormal, excessive adipose deposits. Simeons, practicing at Salvator Mundi International Hospital in Rome, Italy, recommended low-dose daily hCG injections (125 mg) in combination with a customized ultra-low-calorie (500 cal/day, high-protein, low-carbohydrate/fat) diet loss of adipose tissue without loss of lean tissue. After Simeons’ mysterious death, the diet started to spread to specialized centers and via popularization by such as the controversial author Kevin Trudeau.
The controversy proceeds from warnings by the Journal of the American Medical Association[1] and the American Journal of Clinical Nutrition[2] that hCG is neither safe,[1] nor effective as a weight-loss aid.[3]
1. Fraser L. "Ten Pounds in Ten Days: A Sampler of Diet Fads and Abuse". Health resources special report. Caremark, L.L.C.. https://www.caremark.com/wps/portal/HEALTH_RESOURCES?topic=dietscams. Retrieved 2009-02-03.
2. Stein MR, Julis RE, Peck CC, Hinshaw W, Sawicki JE, Deller JJ (September 1976). "Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study". Am. J. Clin. Nutr. 29 (9): 940–8. PMID 786001. http://www.ajcn.org/cgi/reprint/29/9/940.pdf. Retrieved 2009-02-03
3. Barrett S. "HCG Worthless as Weight-Loss Aid". Diet Scam Watch. dietscam.org. http://www.dietscam.org/reports/hcg.shtml. Retrieved 2009-02-03.
Thursday
Cancer Therapy Costs Influence Treatment: A National Survey Of Oncologists
A national survey of medical oncologists indicates that rising cancer treatment costs are influencing clinical practice, even as oncologists tend not to communicate with patients about costs. The survey shows that 84 percent of oncologists say that patients’ out-of-pocket spending influences treatment recommendations. Only 43 percent always or frequently discuss costs with patients.
Among those surveyed, 79 percent favor more comparative effectiveness research; 80 percent support more cost-effectiveness data, although only 42 percent feel well prepared to interpret it.
The results suggest that physicians support federally funded comparative effectiveness research but that they wish to retain a central role in making decisions about how and when to use expensive cancer treatments. The results also support educating physicians about cost-effectiveness and how to communicate with patients regarding cost.
Health Affairs, 29, no. 1 (2010): 196-202
Peter J. Neumann1,*, Jennifer A. Palmer2, Eric Nadler3, ChiHui Fang4 and Peter Ubel5
Among those surveyed, 79 percent favor more comparative effectiveness research; 80 percent support more cost-effectiveness data, although only 42 percent feel well prepared to interpret it.
The results suggest that physicians support federally funded comparative effectiveness research but that they wish to retain a central role in making decisions about how and when to use expensive cancer treatments. The results also support educating physicians about cost-effectiveness and how to communicate with patients regarding cost.
Health Affairs, 29, no. 1 (2010): 196-202
Peter J. Neumann1,*, Jennifer A. Palmer2, Eric Nadler3, ChiHui Fang4 and Peter Ubel5
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