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Proton Therapy for Cancer: A New Technology Brief Of the estimated 1.47 million Americans who will be diagnosed with cancer in 2009, 60 to 75 percent will undergo radiation therapy for their disease. In select cities around the country, some of these patients who are hoping to improve their odds for a cure and minimize the long-term adverse effects of radiation therapy will be treated with a relatively new form of it called proton therapy. The cyclotrons that generate proton beams for treating patients are huge, expensive machines, requiring more than 90,000 feet of space and costing hundreds of millions of dollars. But several companies are working on smaller, lessexpensive models that may soon make proton therapy available for many more patients around the country and make it easier to recruit patients for randomized controlled trials that compare effectiveness. Public interest in proton therapy has grown substantially since the FDA approved it in 2001. However, there is concern among members of the medical and research communities that enthusiasm for this promising therapy may be getting ahead of the research. Proton therapy has wonderful potential as a treatment for some cancers, said Dr. Kevin Camphausen, chief of NCIs Radiation Oncology Branch, who has referred patients to be evaluated for the treatment when he felt it might work well for their tumor type. But I dont think its use should become widespread until we can validate where its needed, and where it has the greatest potential benefit for patients. The first proton accelerator dedicated to medicine opened at Loma Linda University in California in 1990. Today, a total of seven proton therapy centers in the United States are treating patients and numerous others are under construction or in the planning phase. The treatment is being used most often in children with many cancer types, as well as in adults who have small, well-defined tumors in organs such as the prostate, brain, head, neck, bladder, lungs, or the spine. Proton therapy centers are continuing to test its use for additional cancers. Experts Clash On Efficacy of New Brain Cancer Treatment (RobertsReview, RI, USA) Children with high-risk medulloblastoma have had only a 30-40 percent chance of surviving to five years. Now, however, a new experimental treatment that relies on a child's own stem cells dramatically improves the odds. "We can now cure about 70 percent of children with highrisk medulloblastoma and more than 80 percent of those with standard-risk disease with a much shorter chemotherapy approach," said lead researcher Dr. Amar Gajjar, from St Jude's Children's Research Hospital in Memphis, TN. In Sept. 7 online edition of medical journal The Lancet Oncology doctors described the new treatment in which radiation therapy is tailored to fit the severity of the brain cancer. It is then followed by a dramatically reduced course of chemo. To accomplish the reduction researchers took stem cells from patients before chemotherapy and implanted them after each round of chemo. Researchers report that this allows the chid's body to recover from the extensive damage caused by chemo. Use of (chemotherapy drug) cisplatin was reduced from eight doses to four doses, and the amount of vincristine from 32 doses to just eight! This alleviated much of the neurotoxicity associated with the normal chemo dosages. Gujjar says, "investigators should consider adopting a similar therapeutic strategy for high-risk patients. This approach should be feasible in most pediatric oncology units at academic medical centers, but meticulous staging and careful attention to detail during radiotherapy planning and treatment are essential to obtain similar results." But Dr. Anna J. Janss, co-director of the Neuro-Oncology Program at the Aflac Cancer Center of Children's Healthcare of Atlanta -- said the findings won't change her approach to treating childhood brain cancer. Dr Janss says the results don't make her say: "Oh, I want to treat all my patients this way." She said the new approach is only as good as what has been done before, but not good enough to make her harvest stem cells from every child she treats.

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T hese images show the difference in tissue exposure with standard radiation therapy (left) and proton therapy (right), using intensity-modulated treatment. Areas of red received higher doses, while those in blue and violet received low doses. The overall area exposed with standard radiation is much larger than that exposed with proton therapy.

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Leukocyte InFusion 100% Effective! Now Being Tried on Humans

(RobertsReview, RI, USA) -- Scientists are about to embark on a precedent-setting human trial to determine whether a new cancer treatment called Leukocyte InFusion Therapy (LIFT) will be as effective in humans as it has proven to be in mice. Researchers at Wake Forest University's Baptist Medical Center will transfuse specific white blood cells, called granulocytes, from select donors, into patients with advanced cancers. A treatment using the same type cells from cancer-resistant mice has cured 100 percent of lab mice with advanced malignancies, according to Zheng Cui, Ph.D., lead researcher and associate professor of pathology. "In mice, we've been able to eradicate even highly aggressive forms of malignancy with extremely large tumors," Cui said. "Hopefully, we will see the same results in humans. Our laboratory studies indicate that this cancer-fighting ability (of granulocytes) is even stronger in healthy humans!" FDA-approved human trails will use white blood cells from healthy young people whose immune systems produce cells with the highest levels of cancer-fighting activity. The anti-tumor response primarily involves granulocytes of the innate human immune system, a system known for its powerful ability to fight off infections. Granulocytes account for up to 60 percent of total white blood cells in healthy humans, researchers say, and people can donate granulocytes through a process called apheresis. It separates granulocytes and returns other blood components back to donors, whose systems quickly remanufacture replacement granulocytes. For the study, 500 potential local donors are being recruited who are 50 years old or younger and in good health. The 100 donors with the highest cancer-killing activity in their cells will be asked to donate white blood cells for the study. Twenty-two cancer patients with solid tumors that don't respond to conventional therapies will receive the donated cells.

New Treatment Destroys Cancer Cells & Tumors

(RobertsReview, RI, USA) -- Scientists at Katholieke Universiteit Leuven in Belgium, in collaboration with the Flemish biotech company, Thrombo-Genics, report the anti-cancer agent "antiPLGF" not only treats tumors for which other therapies fail, but also enhances effectiveness of existing forms of chemotherapy - all without side effects! The findings were published in the prestigious medical journal, CELL. How it works All living tissue is supplied with oxygen and nutrients via blood vessels. But tumors grow much more quickly than normal tissue and have a greater need for nutrients. This is why, at a certain stage, tumor cells produce growth factors that stimulate formation of additional blood vessels (called angiogenesis) to feed the tumor. When formation of blood vessels that feed tumor cells is blocked, the tumor starves to death due to the lack of oxygen and nutrients. Existing anti-angiogenesis drugs eliminate the most common angiogenesis growth factor but cause serious side effects. In addition the cancer compensates by producing other growth factors, so that the drugs lose their effect. For several years now, researchers have been experimenting with a new angiogenetic growth factor: the placental growth factor, or PLGF. PLGF only stimulates blood vessel formation in cancer and other diseases. Researcher Christian Fischer and his colleagues under the direction of Peter Carmeliet and in close collaboration with the biotech company ThromboGenics directed by Dsir Collen have been studying the therapeutic possibilities of anti-PLGF, which retards the action of PLGF. Anti-PLGF not only increases the effectiveness of chemotherapy and the current antiangiogenesis therapy, but also inhibits growth and metastasis of tumors resistant to existing drugs. In contrast to current therapies, anti-PLGF does not trigger a rescue operation in which other growth factors are produced as compensation.