Cell phones and your brain - CNN video

From CNN:

Do cell phones cause brain cancer? It may be too early to say for sure. The latency period or time between exposure and recognition of a tumor is around 20 years, sometimes longer. And, cell phone use in the U.S. has been popular for only around 15 years. Back in 1996, there were 34 million cell phone users. Today there are 9-10 times as many.

Interphone is a multinational study designed to try to answer this question. The data showed people who used a cell phone 10 years or more doubled the risk of developing a glioma, a type of brain tumor.

References:
Cell phones, brain tumors and a wired earpiece. CNN.
Cell phones and your brain. CNN.

Mobile phones may increase cancer risk - list of DOs and DONT's of mobile phone use (scroll down the page). Daily Mail, 2011.

How much radiation does your phone emit? Comprehensive chart by CNN http://goo.gl/l0l5q

Aspirin 75 mg daily reduces incidence and mortality due to colorectal cancer

High-dose aspirin (≥500 mg daily) reduces long-term incidence of colorectal cancer, but adverse effects (bleeding) might limit its potential for long-term prevention. The long-term effectiveness of lower doses (75-300 mg daily) is unknown. This study in The Lancet assessed the effects of aspirin on incidence and mortality due to colorectal cancer over 20 years.

In the four trials of aspirin versus control (mean duration of treatment 6 years), 2·8% of 14,000 patients had colorectal cancer during a follow-up of 18 years.

Aspirin reduced the 20-year risk of colon cancer (incidence hazard ratio [HR] 0·76, but not rectal cancer (0·90).

Where subsite data were available, aspirin reduced risk of cancer of the proximal colon (0·45), but not the distal colon (1·10). Benefit increased with duration of treatment - aspirin taken for 5 years or longer reduced risk of proximal colon cancer by 70% and also reduced risk of rectal cancer (0·58).

There was no increase in benefit at doses of aspirin greater than 75 mg daily. However, risk of fatal colorectal cancer was higher on 30 mg versus 283 mg daily.

Aspirin taken for several years at doses of at least 75 mg daily reduced long-term incidence and mortality due to colorectal cancer. Benefit was greatest for cancers of the proximal colon, which are not otherwise prevented effectively by screening with sigmoidoscopy or colonoscopy.

References:
Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. The Lancet, Volume 376, Issue 9754, Pages 1741 - 1750, 20 November 2010.

Image source: Colon (anatomy), Wikipedia, public domain.

Oropharyngeal carcinoma increased by 22% in 6 years, related to rise in HPV

Head and neck cancer is the sixth most common cancer. Despite an overall marginal decline in the incidence of most head and neck cancers in recent years, the incidence of oropharyngeal squamous cell carcinoma has increased greatly, especially in the developed world.

In the United States, the incidence of oropharyngeal squamous cell carcinoma increased by 22% between 1999 and 2006.

The increase in incidence of oropharyngeal squamous cell carcinoma seems to be accounted for by a rise in human papillomavirus (HPV) related oropharyngeal carcinoma.

References:

Oropharyngeal carcinoma related to human papillomavirus. BMJ 2010; 340:c1439 doi: 10.1136/bmj.c1439 (Published 25 March 2010).

Image source: HPV types and associated diseases, Wikipedia, public domain.

Twitter comments:

@travispew (Travis Pew): So get your kids the HPV shot.

Diagnosis, treatment, and prognosis of glioma: 5 new things

5 new ideas that are changing the management of brain tumor patients:

1. Prognosis and glioma subtypes. The cell of origin of the glioblastoma has never been defined. In his pioneering work “Death Foretold,” Dr. Christakis says “prognosis gives diagnosis its affective component, striking fear in patients and physicians alike.” There has been a lot of therapeutic nihilism about the treatment of glioblastoma, but that is now changing. Image source: Sen. Ted Kennedy who died of glioma in 2009.

2. Diagnosis and imaging mimics. Acute stroke in the luxury perfusion stage is probably the most common mimic of a brain tumor. Diffusion MRI sequences and perfusion CT scan are helpful in differentiating stroke from tumor by showing hypoperfusion as would be expected, rather than hyperperfusion seen in tumors.

3. Treatment and pseudoprogression. Temozolomide is an oral drug, which is changed into MTIC (methyltriazeno-imidazole-carboxamide), a DNA-methylating drug. The concomitant use of radiation therapy and adjuvant temozolomide in glioblastoma patients showed a median survival of 14.6 months.

Increase in contrast enhancement and mass effect can mimic tumor progression. The term “pseudoprogression” describes the inflammatory reaction to effective treatment. Increasing steroid doses can control the edema.

4. Antiepileptic drugs. Prophylactic use of antiepileptic drugs (AEDs) is not recommended in patients with brain tumor due to lack of efficacy. The interactions between AEDs and chemotherapy can also be problematic.

5. Quality of life issues. The incidence of common symptoms reported was fatigue (90%–94%), sleep disturbance (32%–52%), headache (50%), and cognitive impairment (50%). Ritalin, modafinil, and Aricept have all been shown to have a positive effect on mood and cognition. Cause of death was presumed brain herniation 73% of the time.

References:

Diagnosis, treatment, and prognosis of glioma. Five new things. Lynne P. Taylor, MD. Neurology November 2, 2010 vol. 75 no. 18 Supplement 1 S28-S32.

Image source: Sen. Kennedy who died of glioma in 2009, Wikipedia, GNU Free Documentation license.

Participation in clean-up of oil spill associated with airway injury and chromosomal damage

In 2002, the oil tanker Prestige spilled more than 67 000 tons of bunker oil, heavily contaminating the coast of northwestern Spain. The study population included local fishermen who were highly exposed (n = 501) or not exposed (n = 177) to oil. They were evaluated 2 years after the spill.

Elevated markers of airway injury

Persons exposed to oil were at increased risk for lower respiratory tract symptoms (risk difference, 8.0). However, lung function did not significantly differ between the groups. Exposed participants also had higher levels of exhaled vascular endothelial growth factor (risk difference, 44.8) and basic fibroblast growth factor (risk difference, 16.0).

Human chromosomes (grey) capped by telomeres (white). Image source: Wikipedia, public domain.

Chromosomal damage

A higher proportion of exposed participants had structural chromosomal alterations (risk difference, 27.4), predominantly unbalanced alterations.

Participation in clean-up of a major oil spill was associated with persistent respiratory symptoms, elevated markers of airway injury in breath condensate, and chromosomal damage.

References:

Health Changes in Fishermen 2 Years After Clean-up of the Prestige Oil Spill. Ann Intern Med, October 19, 2010, vol. 153 no. 8 489-498.

Steve Jobs on medical leave - transplantation specialist discusses two likely clinical scenarios

From the WSJ:

William Chapman, transplantation chief at Washington University in St. Louis, hasn't examined Mr. Jobs personally, but said there are two likely scenarios in the CEO's case.

The first is that there was a transplant-related problem, though it would be unusual for that to happen a year and a half after the transplant.

A more likely possibility would be that the neuroendocrine tumor metastasized again. "It's really difficult to cure the disease with a liver transplant," said Mr. Chapman, adding that it's common to have some degree of recurrence. "Most people hope they reset the clock, gained some time and gained a quality of life even if you don't cure the disease."


Steve Jobs' speech at the 2005 Stanford graduation ceremony: “This is the closest I’ve ever gotten to a college graduation.”

He tells 3 stories from his life:

- Connecting the dots
- Love and loss
- About death

Mr. Jobs was diagnosed in 2004 with a rare type of pancreatic cancer called islet cell neuroendocrine tumor, which could be cured if surgery removed it promptly. He reportedly had surgery by the end of 2004 but began exhibiting weight loss in 2008. This type of cancer often metastasizes in another organ, usually the liver, during a patient's lifetime. A Tennessee hospital disclosed that Mr. Jobs had received a liver transplant there in 2009.

"Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose," Mr. Jobs said in the commence speech in June 2005, almost a year after he was diagnosed with pancreatic cancer.

I join everybody around the world in wishing Mr. Jobs a speedy recovery.

References:

Apple CEO Jobs to Take Medical Leave. WSJ.

Anticancer effect of "5 a day" fruit and vegetable servings is negligible

It is widely believed that cancer can be prevented by high intake of fruits and vegetables. However, inconsistent results from many studies have not been able to conclusively establish an inverse association between fruit and vegetable intake and overall cancer risk.

People who eat more fruit and vegetables than average may have a slightly reduced risk of getting cancer, a big study concludes, but the benefit is much smaller than previous studies suggested.

The European Prospective Investigation Into Cancer and Nutrition (EPIC) was a 9 year prospective study of nearly 500 000 Europeans. It concluded that the protective effect of eating fruit and vegetables is “very small” (J Natl Cancer Institute 2010).

Associations between reduced cancer risk and increased intake of total fruits and vegetables combined and total vegetables for the entire cohort were similar (200 g/d increased intake of fruits and vegetables combined, HR = 0.97); 100 g/d increased intake of total vegetables, HR = 0.98); intake of fruits showed a weaker inverse association (100 g/d increased intake of total fruits, HR = 0.99).

The reduced risk of cancer associated with high vegetable intake was restricted to women (HR = 0.98). Stratification by alcohol intake suggested a stronger reduction in risk in heavy drinkers and was confined to cancers caused by smoking and alcohol.

References:

Study finds that anticancer effect of “5 a day” is less than expected. BMJ, 2010.
Fruit and vegetable intake and overall cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 2010 Apr 21;102(8):529-37. Epub 2010 Apr 6.

Short telomeres lead to chromosomal instability and increased cancer risk and mortality

Telomeres are essential to preserve the integrity of the genome. Critically short telomeres lead to replicative cell senescence and chromosomal instability and may thereby increase cancer risk.

Leukocyte telomere length was measured by quantitative polymerase chain reaction in 787 participants free of cancer at baseline in 1995 from a prospective, population-based study in Italy. The follow-up period was 10 years.

Human chromosomes (grey) capped by telomeres (white). Image source: Wikipedia, public domain.

11.7% of participants developed cancer (incidence rate, 13.3 per 1000 person-years).

Short telomere length at baseline was associated with incident cancer independently of cancer risk factors (hazard ratio [HR] 1.60).

Compared with participants in the longest telomere length group, the HR for incident cancer was 2.15 in the middle length group and 3.11 in the shortest length group. Furthermore, short telomere length was associated with cancer mortality and individual cancer subtypes with a high fatality rate.

There is an inverse relationship between telomere length and both cancer incidence and mortality.

References:
Telomere Length and Risk of Incident Cancer and Cancer Mortality. Peter Willeit, MD; Johann Willeit, MD; Agnes Mayr, MD; Siegfried Weger, MD; Friedrich Oberhollenzer, MD; Anita Brandstätter, PhD; Florian Kronenberg, MD; Stefan Kiechl, MD. JAMA. 2010;304(1):69-75.

Michael Douglas on Having Throat Cancer - Late Show with David Letterman (video)

Oropharyngeal cancer is increasing at a "dramatic" rate, particularly in the male population http://goo.gl/JAko

Related:
Michael Douglas Has Stage IV Throat Cancer; Experts Weigh In. WebMD.
Catherine Zeta-Jones's fury at the doctors who missed her husband Michael Douglas's throat cancer. Daily Mail.

Update 01/11/2011:

Michael Douglas says his throat cancer tumor is in complete remission ("gone") after 7 weeks of radiation/chemotherapy, but salivary glands not working http://goo.gl/zfR9Z

Kylie Minogue on cancer - BBC video

Kylie Minogue on cancer - Friday Night with Jonathan Ross - BBC One.

The Value of YouTube Videos for Cancer Patients - Mayo Clinic

Ruben Mesa, M.D., describes his experience using YouTube videos to provide in-depth information about blood cancers.

"Microscopic cancers are forming in human body all the time"

From TEDtalksDirector — May 17, 2010 - William Li presents a new way to think about cancer treatment: angiogenesis, targeting the blood vessels that feed a tumor. The crucial first (and best) step: Eating cancer-fighting foods that beat cancer at its own game.

"We're probably forming microscopic cancers all the time in our body. Autopsy studies from people who died in car accidents have shown that about 40 percent of women between the ages of 40 and 50 actually have microscopic cancers in their breasts. About 50 percent of men in their 50s and 60s have microscopic prostate cancers. And virtually 100 percent of us, by the time we reach our 70s, will have microscopic cancers growing in our thyroid. Yet, without a blood supply, most of these cancers will never become dangerous. Dr. Judah Folkman, who was my mentor, and who was the pioneer of the angiogenesis field, once called this "cancer without disease."

P.S.A. testing can’t detect prostate cancer, says its discoverer

Richard J. Ablin in the NYTimes:

"Approved by the Food and Drug Administration in 1994, the P.S.A. test’s popularity has led to a hugely expensive public health disaster. It’s an issue I am painfully familiar with — I discovered P.S.A. in 1970.

The annual bill for P.S.A. screening is at least $3 billion, with much of it paid for by Medicare and the Veterans Administration.

As I’ve been trying to make clear for many years now, P.S.A. testing can’t detect prostate cancer and, more important, it can’t distinguish between the two types of prostate cancer — the one that will kill you and the one that won’t."

References:
The Great Prostate Mistake. NYTimes.
Image source: Wikipedia, public domain.

TED Talks: A new strategy in the war on cancer

From TED Talks/TED Med: Traditionally, David Agus explains, cancer treatments have had a short-sighted focus on the offending individual cells. He suggests a new, cross-disciplinary approach, using atypical drugs and computer modeling.

Occupation may be a key factor in lung cancer

While cigarettes are by far the most important cause of lung cancer, chemicals and other on-the-job hazards "play a remarkable role" in lung cancer risk.

5% of lung cancers in men are job-related. Men in the known to be risky occupations were 74% more likely to have been diagnosed with lung cancer.

The strongest associations were seen for ceramic and pottery jobs and brick manufacturing, as well as for those working in manufacturing of non-iron metals.

A CXR shows a right upper lobe (RUL) mass due to lung cancer. Source: Finger Clubbing due to Lung Cancer. Clinical Cases and Images.

References:

Occupation a key factor in men's lung cancer risk. Reuters, 2010.
http://www.reuters.com/article/idUSTRE61E53920100215

Rock legend Ronnie James Dio is fighting stomach cancer

On 25 November 2009, Dio's wife and manager announced that he was diagnosed with stomach cancer:

"Ronnie has been diagnosed with the early stages of stomach cancer. We are starting treatment immediately at the Mayo Clinic. After he kills this dragon, Ronnie will be back on stage, where he belongs, doing what he loves best, performing for his fans. Long live rock and roll, long live Ronnie James Dio. Thanks to all the friends and fans from all over the world that have sent well wishes. This has really helped to keep his spirit up." -- "He has had a few hiccups between Christmas and New Year's," she said in a statement to fans. "He has had a blood clot, a trip to the emergency room, and a three-day stay at the hospital."


ArtisanNewsService — April 13, 2010 — "One of heavy metal's premiere vocalists Ronnie James Dio shares his thoughts on his battle with stomach cancer at the Revolver Golden Gods awards."

On 14 March 2010, Dio's wife and manager Wendy posted an online update on his condition:

"It has been Ronnie's 7th chemo, another cat scan and another endoscopy, and the results are good - the main tumour has shrunk considerably, and our visits to Houston (MD Anderson Cancer Center in Texas) are now every three weeks instead of every two weeks."

Ronnie James Dio passed away on May 16, 2010 at age 67. The music lives on: http://www.ronniejamesdio.com

References:
Ronnie James Dio. Wikipedia.
Black Sabbath, Dio singer Ronnie James Dio gives cancer update. NME.com.

Eddie Trunks Metal show with guests Ronnie James Dio & Geezer Butler, May 30, 2009.

Metal legend Ronnie James Dio dead at 67. USA Today, 2010.
Ronnie James Dio, Rock Singer, Dies at 67. NYTimes, 2010.
Ronnie James Dio died at age 67. YouTube.
Ronnie James Dio Remembered By Metallica's Lars Ulrich. MTV.
The Lighter Side of Ronnie James Dio. NYTimes.
Lars Ulrich's letter to Dio.

Dio, another day. Nigel Britto, TOI Crest, May 22, 2010.
Dio monument in Bulgaria - source one, two, three (in Bulgarian), 10/2010.

Updated: 10/24/2010

The College of American Pathologists unveils a new patient website MyBiopsy.org

The site is easy to navigate, well-organized and it looks helpful. Check the navigation menu in the left sidebar.

MyBiopsy.org redirects to:
http://www.cap.org/apps/docs/reference/myBiopsy/index2.html

RSS feed is also available: http://feeds2.feedburner.com/MybiopsyFeeds

This is the "fan page" on Facebook: http://www.facebook.com/MyBiopsy.org

(link via @Berci)

Martina Navratilova Fighting Breast Cancer - ABC Video

In February 2010, the tennis legend was diagnosed with an aggressive form of ductal carcinoma in situ (DCIS), considered the earliest form of breast cancer. Navratilova had a lumpectomy in February, during which her doctors determined that the cancer had not spread to her lymph nodes. She says there is only a "very small chance of it coming back."

Navratilova's cancer was diagnosed during a routine mammogram, after not having one for four years, and she hopes that speaking out will inspire other women to get mammograms.

"The reason I wanted to speak about this is to encourage these woman to have mammograms," she said. "I just want to encourage women to have that yearly check-up."

References:
Martina Navratilova Fighting Breast Cancer

The Colonoscopy Song - March is National Colorectal Cancer Awareness Month

Peter Yarrow of the musical group Peter, Paul and Mary appeared on the CBS Early Show to sing a song he composed about his own colonoscopy:



In the video below, Dr. Paul Limburg, a Mayo Clinic Gastroenterologist, provides background on colorectal cancer and the screening methods:

Related:

Dr. Oz Has Colon Cancer Scare During Taping of His Colonoscopy for the TV Show http://goo.gl/F4CX

Fear was the No. 1 reason people gave to explain why they hadn’t gone in for a colonoscopy to screen for colon cancer. NYTimes.

Get your colonoscopy in the morning - each hour brings a 4% reduction in the number of polyps the doctors spotted http://goo.gl/2FGQt

Dr. Oz: What I Learned from My Colon Cancer Scare http://goo.gl/q7rjD

Tobacco Smoke by Any Other Name Is Still as Deadly: Association of Pipe and Cigar Use With Cotinine Levels, Lung Function, and Airflow Obstruction

In a study of 3528 participants, 9% reported pipe smoking, 11% reported cigar smoking, and 52% reported cigarette smoking.

Self-reported current pipe and cigar smokers had elevated urine cotinine levels compared with never-smokers.

Participants who smoked pipes or cigars had increased odds of airflow obstruction.

Pipe and cigar smoking increased urine cotinine levels and was associated with decreased lung function and increased odds of airflow obstruction, even in participants who had never smoked cigarettes.

References:
http://www.annals.org/content/152/4/201.short
http://www.annals.org/content/152/4/259.short
Image source: Wikipedia, public domain.