Detecting ovarian cancer early
HRT doubles breast density, increases abnormal mammograms
Testis cancer survival shows ethnic differences
Identifying smokers at higher lung-cancer risk
Fighting complications of influenza infection in transplant patients
Declines in mental and physical skills after transplant are temporary
Roberts named new Basic Sciences Division director; Groudine increases center leadership role
Detecting ovarian cancer early
Testing for two blood proteins in combination holds promise for detection of early stage ovarian cancer
by Barbara Berg
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Drs. Martin McIntosh and Nathalie Scholler and colleagues have developed a better ovarian-cancer detection test. |
Dr. Martin McIntosh and colleagues examined the performance of the combined-marker test using serum samples from women who already had been diagnosed with symptomatic advanced-stage and localized ovarian cancer. In the next phase of the work, the scientists plan to determine whether the two proteins can be used to detect tumors much earlier, before symptoms develop and when the disease is more likely to be curable.
Scientists have been eager to develop a diagnostic tool to identify women who have a high risk of developing ovarian cancer. Previous studies have shown that a protein produced in abundance by the majority of advanced ovarian tumors, known as CA125, rises to high levels in only about half of women with early stage disease. That has prompted Fred Hutchinson investigators to search for additional markers which, when measured in conjunction with CA125, could constitute a test that detects the majority of early stage tumors.
“It’s unlikely that a single marker can be used to detect all cases of pre-symptomatic early stage ovarian cancer,” McIntosh said. “What’s encouraging about these new results is that we’ve found a second marker that increases the sensitivity of detection and does not increase the number of false-positives.”
The second marker is a protein called mesothelin, which is overproduced in the tissue of about 95 percent of ovarian cancers and is made at low levels in normal tissue. Fred Hutchinson’s Dr. Nathalie Scholler, whose work is supported by the Listwin Family Foundation, previously developed a test to detect a breakdown product of mesothelin in the blood. The new study found that this protein is at elevated levels in the blood of women with ovarian cancer.
“This is the first time we’ve seen that two markers combined can pick up significantly more cancers than a single marker,” McIntosh said. “We are searching for additional markers that are not redundant with CA125 and mesothelin, which could allow us to detect even more cancer cases.”
HRT doubles breast density, increases abnormal mammograms
Postmenopausal women who take combination estrogen-plus-progestin hormone-replacement therapy for one year experience a twofold increase in breast density — a known risk factor for breast cancer — and a quadrupled risk of having an abnormal mammogram, according to a new study led by Fred Hutchinson’s Dr. Anne McTiernan.
A woman’s risk of breast cancer and her chances of getting an accurate cancer diagnosis depend largely on the density of her breast tissue. Density is measured according to the ratio of connective and epithelial tissue, which appears on a mammogram as white, as compared to fatty tissue, which appears as black. Because cancer also appears as white on a mammogram, a high degree of breast density can make it difficult to spot tumors and other abnormalities.
While density is determined largely by age and genetics, the study underscores the fact that other factors can play a part as well. In addition to hormone-replacement therapy, weight and physical activity also have been found to have an impact on breast density.
Testis cancer survival shows ethnic differences
A man’s ethnicity may significantly affect his chances of surviving testis cancer, according to a recent Fred Hutchinson study.
In an analysis of data on more than 16,000 U.S. men with the disease, researchers found that compared to non-Hispanic whites, testis-cancer patients who were African-American, Native American, Filipino or Hawaiian were more than twice as likely to die of their cancer. Survival rates also were poorer for Hispanics. Consistent with these findings, many patients of ethnic minority backgrounds were more likely to have their disease diagnosed at late stages, when it is more difficult to cure.
The underlying reasons for these differences, which may stem from socioeconomic or biological factors or both, have not yet been analyzed for testis cancer. But the new data provide the groundwork for future research that could improve outcomes for all patients, said Mary Lou Biggs, who led the study along with Dr. Stephen Schwartz.
Identifying smokers at higher lung-cancer risk
A recent Fred Hutchinson study provides insight into one of the factors that may put some smokers at increased risk of lung cancer.
In a study of more than 17,000 men and women, the majority of whom were heavy smokers, Dr. Alyson Littman and colleagues found that those who had been diagnosed with chronic bronchitis or emphysema prior to their cancer diagnosis were about 30 percent more likely to develop lung cancer than those without such a diagnosis.
The findings — and other research of this kind — are important because they may help doctors identify smokers who are most likely to get lung cancer. Those individuals may benefit from prevention strategies or screening tests that could allow the disease to be diagnosed at an early stage, when it is more likely to be treatable.
Fighting complications of influenza infection in transplant patients
One of the populations at greatest risk for severe complications from flu infection is a group that cannot be successfully vaccinated against the influenza virus: cancer patients who recently have undergone bone-marrow or stem-cell transplantation. A new study now finds that administering antiviral drugs at the earliest signs of flu infection in transplant patients significantly reduces their likelihood of developing pneumonia, a potentially fatal complication.
Transplant patients have severely weakened immune systems for several months after the procedure, making it difficult for them to fight off viral, bacterial and fungal infections during the recovery period.
The Fred Hutchinson study identified the most effective flu-fighting drugs for this population, a class of antiviral drugs known as neuroaminidase inhibitors. The findings are expected to improve overall survival rates for transplant patients by minimizing the likelihood of influenza-related deaths, said Dr. Michael Boeckh, a co-author of the study.
Declines in mental and physical skills after transplant are temporary
Many patients who undergo bone-marrow or stem-cell transplantation experience a decline in mental skill and physical coordination after treatment. A new study led by Fred Hutchinson researchers shows that these effects are largely temporary and that most patients can expect a return to normal function within a year of their transplant.
“In all areas except coordination, function is back to normal within a year. Most people do recover well from their transplant treatment,” said Dr. Karen L. Syrjala.
Researchers know that the powerful chemotherapy drugs leukemia and lymphoma patients take to prepare for bone-marrow or stem-cell transplantation — or later to fight graft-vs.-host disease — can impair neurocognitive function. What hasn’t been known, until now, is whether impacts such as decreased memory or the ability to write with a pencil are long lasting.
The results of this study have major implications for advising health-care professionals, patients and their families about expectations after transplant. Overall, the authors concluded that providers can confidently advise patients that while short-term neurocognitive effects of chemotherapy can be severe, most patients return to their pretransplant levels of cognitive function by one year after transplant.
Roberts named new Basic Sciences Division director; Groudine increases center leadership role
Dr. Jim Roberts has been named the new director of Fred Hutchinson’s Basic Sciences Division, replacing Dr. Mark Groudine, who is devoting more time to his role as deputy director of the center. Groudine served as division director since 1995. He will focus on center-wide matters, including planning and faculty recruitment.
Roberts, a world-renowned expert on the cell cycle and cancer, has been a member of the division since 1988. Associate division directors Drs. Linda Buck and Jonathan Cooper will assist him in his new role.
