Drug cuts diabetics' pancreatic cancer risk: study

CHICAGO (Reuters) – Diabetics who took the drug metformin, which makes the body process insulin better, had a 62 percent lower risk of pancreatic cancer compared to those who had never received it, U.S. researchers said on Saturday.

But the risk of getting the cancer, one of the deadliest, was significantly higher among diabetics who took insulin or drugs that make the body produce more insulin, according to their study published in the journal Gastroenterology.

"We find that diabetics that had ever used metformin alone or in combination with other drugs had like a 60 percent reduced risk for pancreatic cancer, compared to diabetic patients who never used metformin," lead researcher Donghui Li from The University of Texas M.D. Anderson Cancer Center said.

Prior studies showed a lower cancer risk in diabetics who took metformin. The drug is used to treat type 2 diabetes, which is linked with poor diet and lack of exercise and accounts for about 90 percent of all worldwide cases.

"In addition, we see some increased risk of pancreatic cancer associated with the use of insulin and the use of insulin secretagogues." Those are drugs, such as sulfonylureas and glinides, which stimulate the pancreas to secrete more insulin or raise circulating levels of insulin.

Diabetics in the study who had taken insulin were nearly five times more likely to develop pancreatic cancer. And those who took insulin-stimulating drugs were 2.55 times more likely to develop pancreatic cancer.

Insulin is known to promote cell growth. "Insulin seems to have a growth promoting effect in cancer," Li said. That interaction could help explain the findings of four recent studies published in the journal Diabetologia, which suggested the popular Sanofi-Aventis insulin drug Lantus might raise the risk of cancer.

The European Medicines Agency said last week flaws in the studies made the findings inconclusive, and Sanofi-Aventis said it would do further research in the area. For her study, Li evaluated 1,800 people, including more than 900 who had pancreatic cancer and 350 with diabetes. The groups were matched by age, race and gender and completed detailed surveys of their health histories.

The study, however, was too small to find a benefit for people who had taken another popular type of insulin sensitizing drug in a class called thiazolidinediones, which include GlaxoSmithKline's rosiglitazone or Avandia and Takeda Pharmaceutical's pioglitazone or Actos.

Li said the study needs to be repeated in a bigger group of diabetics but added: "Our findings show metformin's potential as a chemopreventive agent."

There are dozens of diabetes drugs in different classes on the market. Metformin, available generically, is usually one of the first prescribed, with sulfonylureas such as glimepiride, sold by Sanofi-Aventis under the brand name Amaryl, added if patients cannot control blood sugar levels.

The American Diabetes Association already recommends metformin, which has been proven to lower the risk of heart disease.

Immune Systems of AIDS Patients More Prone to HPV Cancers

FRIDAY, July 31 (HealthDay News) -- As their immune system weakens, people with AIDS are at increased risk for human papillomavirus (HPV)-related cancers, a new study has found.

It was known that people with AIDS had a greater risk for HPV-associated cancers of the anus, cervix, penis, vagina, vulva and oropharynx. However, the extent to which AIDS-related weakening of the immune system played a role wasn't clear, the researchers pointed out.

For this study, researchers at the U.S. National Cancer Institute analyzed cancer registry data on almost 500,000 people diagnosed with AIDS between 1980 and 2004. They found that people with AIDS had a statistically significant higher risk for all HPV-related cancers.

"Given that individuals currently infected with HIV may obtain little benefit from available HPV vaccines…our results underscore the need for effective screening for cervical cancer and anal cancer among persons with HIV infections or AIDS," the researchers wrote.

The study was published online July 31 in the Journal of the National Cancer Institute. While it does offer new evidence of the link between HIV/AIDS and HPV-related cancer, the study doesn't actually prove a biological connection, Dr. Howard D. Strickler, of the Department of Epidemiology and Population Health at Albert Einstein College of Medicine, wrote in an accompanying editorial.

The disease that stalked Sir Bobby

What appeared to be a sinus problem was in fact malignant melanoma
Former England manager Sir Bobby Robson, who has died at the age of 76, was diagnosed with cancer five times. It is a scenario that most of us - even the one in three of us who develop the disease - are unlikely to face.

Sir Bobby is reported to have responded indignantly when he was first told in 1992 that a "little bit of cancer" in his bowel would take him away from PSV Eindhoven for three months.

It was taken out and the manager got back to business.

The fear for most would be a recurrence of the original cancer, or the news that it might have spread. But three years later, an entirely new form of the disease made an appearance - and a rare one at that.

Malignant melanoma in Sir Bobby's face was found by a specialist after he had complained about blocked sinuses. A very rare and dangerous form of cancer, he was told he would be "dead by the end of the season" if something was not done straight away.

To remove it surgeons had to take out his teeth and tunnel through the roof of his mouth. When they were done, the hole they left had to be filled with a rubber plug.

It is unclear whether the cancers Sir Bobby subsequently faced were fresh ones or secondary tumours.

In 2006, cancer was found in his lungs and a year later a brain tumour left him with partial paralysis.

A scan then revealed inoperable nodules in his lungs. The doctor told him he may have as little as eight months to live, but Sir Bobby survived for over two years.

"It looks like Sir Bobby had at least two primary tumours - which in itself is very unusual," says Jean Slocombe, Cancer Research UK 's senior information nurse.

"Most people who get one cancer do not go on to develop a completely different one, and to have treatment for five bouts of cancer is very uncommon.

"This is a man who went through a huge amount and showed a great deal of spirit in the process."

Cancer campaigners all agree that Sir Bobby's legacy is multifaceted.

"To live with the disease so publicly has been immensely empowering to many people suffering - particularly given that he had a very complex cancer of the head and neck which required very unpleasant surgery," says Maureen Rutter, northeast regional director of Macmillan.

"He showed you could face cancer head-on, that you could get on with life. He had immense strength of character that was visible to all.

"But at the end of the day not everyone can or wants to cope in that way, and that is nothing to be ashamed of."

He also leaves the The Bobby Robson Cancer Foundation, which raised sufficient funds to open a trials research centre in Newcastle earlier this year.

It aims to offer patients access to early trials and potential new treatments, many of which have never been tried in humans.

Professor Ruth Plummer, the director of the unit, described him as "an extremely warm, generous and special man".

"It took great personal effort for him to set up the Sir Bobby Robson Foundation and it was typical of the Bobby we came to know that he thought of helping others even when fighting his own battle with cancer."

One man's 'breast cancer' fight

The youngest man in the world to be diagnosed with breast cancer says that treatment has contained the disease.

Nicky Avery, from Southend in Essex, was 24 when he was told that he had the illness, and three years on his doctors say that scans suggest his treatment has been successful.

"I'm over the moon," Nicky told Newsbeat: "The future is looking rosy. I'm going to take my onchologist to watch Arsenal."

Nicky still has to have bone fusion which he describes as "basically a medical polyfiller" to keep his illness at bay.

He is now planning to campaign to have the male form of breast cancer renamed 'chest cancer' to encourage more men to get themselves checked.

"If you say breast cancer to a man they take a step back, it is so taboo," he said.

"But if we could change the terminology, men would feel more comfortable about going to the doctors.

"Men haven't got breasts they have got chests."

A Department of Health spokesman said: "We understand that having a disease that largely affects women can cause embarrassment to male patients.

"However, the term breast cancer is anatomically correct and is the agreed terminology internationally."

Nicky said he was "shocked" at his initial diagnosis as he didn't believe that men could get breast cancer.

He said: "I saw my surgeon who said they sent my biopsy off to a lab without labelling it and the scientists thought I was a 64-year-old woman."

The cancer later spread to the bones of his head and his arm.

He has since undergone a mastectomy, intensive chemotherapy and radiotherapy.

Doctors say that he will have to continue to have a bone infusion every three weeks to keep him alive.

Nicky wants to raise awareness about the disease.

"There are a lot of men out there that don't know they can get breast cancer, you know what men are like, we sort of leave the problem and let it fester.

"I will keep fighting and campaigning until something is done. If I can save one or two lives then I will have done my job."

Green Tea: A New Weapon Against Prostate Cancer?

Many medical “discoveries” have occurred quite by happenstance. For instance, consider the story of Green Tea which began some 5,000 years ago when, as Chinese legend has it, leaves from a nearby Camellia sinensis tree fell into an emperor’s boiling pot of water. The leaves turned the water a light-brown color and gave off a delightful aroma. The emperor, upon taking a sip, found it also had an excellent taste and proclaimed it as “heaven sent.” Since then, the delectable brew has been considered a health-promoting beverage in China; used to treat everything from headaches to depression.

Today, a wealth of studies has provided hard evidence for its positive effects on health. Drinking green tea is reputed to promote heart health, lower high cholesterol levels, lessen free radical damage to cells, fight obesity, inhibit the abnormal formation of blood clots, and slow the progression of age-related cognitive impairment and Alzheimer’s disease. Researchers now say that certain compounds in green tea may actually slow the progression of prostate cancer, a disease that kills more men each year in the United States than any cancer other than lung cancer.

Previous studies have shown that green tea may be linked to a reduced incidence of prostate cancer, and its polyphenols have been regarded as a potential cancer therapy. But last year, the FDA announced that the evidence for green tea benefits was inconclusive, because people consume relatively small quantities. So, Dr. James Cardelli, and his colleagues at Louisiana State University Health Sciences Center in Shreveport, carried out a clinical trial to determine the effects of short-term supplementation with increased amounts of the active compounds in green tea on the progression of prostate cancer.

The small study consisted of 26 men between 41 and 68 years of age who had been diagnosed with prostate cancer and were scheduled for radical prostatectomy. The men were put on a daily dose of four capsules containing a total of 1.3 grams of polyphenon E, equivalent to about 12 cups of normally brewed concentrated green tea, for 12 to 73 days (with an average time of 34.5 days), until the day before surgery. Blood tests showed a significant reduction in serum levels of three biomarkers associated with the growth and spread of prostate cancer: hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), and prostate specific antigen (PSA).

On an average, HGF decreased 18.9 percent, VEGF decreased by 9.9 percent and PSA dropped by 10.4 percent. Some patients demonstrated reductions of more than 30 percent. The researchers said that in vitro, EGCG (the main catechin in polyphenon E) swiftly blocked the production of HGF, and the block “seems to be at the level of transcription.” EGCG also blocked the production of VEGF, which plays a critical role in the angiogenic process in cancer-associated fibroblasts, they noted. Age, race, and time on the drug did not have a significant effect on the changes in serum biomarkers.

Previous studies have suggested that high levels of EGCG may have adverse effects on liver function, but in this study the liver function of the patients remained normal. “Our results show a significant reduction in serum levels of PSA, HGF, and VEGF in men with prostate cancer after brief treatment with EGCG (Polyphenon E), with no elevation of liver enzymes. These findings support a potential role for Polyphenon E in the treatment or prevention of prostate cancer,” the researchers concluded.

Dr. Cardelli admits that the study is still in an early stage and that the findings need to be verified by larger, placebo-controlled trials. “Green tea can keep cancer from growing very fast, but it may not be able to shrink tumors,” he said. “But it can be a good addition to traditional therapies, like chemotherapy or radiation.”

“We think that the use of tea polyphenols alone or in combination with other compounds currently used for cancer therapy should be explored as an approach to prevent cancer progression and recurrence," Dr. Cardelli said. “There is reasonably good evidence that many cancers are preventable, and our studies using plant-derived substances support the idea that plant compounds found in a healthy diet can play a role in preventing cancer development and progression.”

John Neate, chief executive of the Prostate Cancer Charity, says though there have been a number of studies into the potential benefits of green tea, there is no conclusive evidence. “The results of this study do suggest that there is merit in further research into the effects of extracts of green tea, both in relation to its impact on the prevention of prostate cancer and in controlling progression in men already diagnosed with the disease, as was investigated in this instance,” he said. “These initial positive findings could indicate that green tea could have a place in ‘active surveillance’, where a slow-growing, low risk tumor is monitored for changes and men want to take something which could help keep progression at bay.”

“Potentially, this could mean completely avoiding, in some cases, any of the more usual medical interventions and their associated side effects,” Neate said.

Prostate cancer is the second leading cause of cancer death among American men. According to the American Cancer Society, prostate cancer will be diagnosed in 192,280 men and will kill 27,360 in 2009. Men over 50 are urged to get tested for the disease annually, however very few do, putting them at risk of being diagnosed at a later stage rather than earlier in the cancer process.

The study is published in the journal Cancer Prevention Research.

“Trojan Horse” Used to Terminate Cancer Cells

Scientists have long been looking for a better way to fight the battle of cancer, rather than the traditional radiation and chemotherapy treatments, both of which damage healthy cells instead of just the cancerous ones. Now, they might have found the answer with a new treatment they call the “Trojan horse” therapy.

A team of researchers in Australia have developed the new “Trojan horse” therapy to help combat cancer by using a bacterially-derived nano cell to help penetrate and disarm the cell that is cancerous before a second nano cell kills it with the chemotherapy drugs. The “Trojan horse” therapy has the potential to target the cancer cells directly with chemotherapy, rather than the current treatment where drugs are injected into the cancer patient and end up attacking both the healthy and the cancer cells.

The scientists in Sydney, Dr. Jennifer MacDiarmid and Dr. Himanshu Barhmbhatt who formed EnGenelC Pty Ltd in 2001, stated that they have achieved a 100 percent rate of survival in mice with human cancer cells by using the “Trojan horse” therapy over the past two years. They plan to start the clinical trials on humans within the coming months. However, the human trials of the cell delivery system will begin next week at The Austin located at the University of Melbourne and the Peter MacCullum Cancer Center at the Royal Melbourne Hospital.

The therapy, which was published in the latest Nature Biotechnology journal, sees the mini-cells that are called EDVs (EnGenelc Delivery Vehicle) attach and then enter the cancer cell. The first wave of these mini-cells release ribonucleic acid molecules, which are called siRNA, that are used to switch off the production of proteins that make the cancer cell resistant to the chemotherapy treatment. Then, a second wave of the EDV cells are accepted by the cancer cells and release the chemotherapy drugs, in turn, killing the cancer cell.

MacDiarmid stated, “The beauty is that our EDVs operate like ‘Trojan horses’. They arrive at the gates of the affected cells and are always allowed in. We are playing the rogue cells at their own game. They switch-on the gene to produce the protein to resist drugs, an we are switching-off the gene which, in turn, enables the drugs to enter.”

RNA interference, also known as RNAi, is designed to help silence the genes that are responsible for producing disease-causing proteins and is considered one of the hottest areas of biotechnology research. The subject of RNA was the basis of the 2006 Nobel Prize in medicine. Dozen of biotechnology companies are already looking for way that they can manipulate RNA to help block the genes that produce disease-causing proteins that are involved in blindness, cancer or AIDS.

Brahmbhatt said that after the treatment with the conventional drug therapy, a high number of the cancer cells are terminated, however, a small percentage of the cells can produce the proteins that make cancer cells resistant to the chemotherapeutic medications. “Consequently, follow-up drug treatments can fail. The tumors thus become untreatable and continue to flourish, ultimately killing the patient. We want to be part of moving toward a time when cancers can be managed as a chronic disease rather than being regarded as a death sentence,” he stated.

The Nature report said that the mini-cells were well tolerated by the animals that were actively treated with no adverse side effects or deaths, despite the repeated dosing. MacDiarmid said, “Significantly, our methodology does not damage the normal cells and is applicable to a wide spectrum of solid cancer types. The hope is that the benign nature of this EDV technology should enable cancer sufferers to get on with their lives and operate normally using outpatient therapy.”

Novel H1N1 Flu

Novel H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

Why is novel H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a "quadruple reassortant" virus.

Are there human infections with novel H1N1 virus in the U.S.?
Yes. Cases of human infection with novel H1N1 influenza virus were first confirmed in the U.S. in Southern California and near Guadalupe County, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus. An updated case count of confirmed novel H1N1 flu infections in the United States is kept at http://www.cdc.gov/h1n1flu/update.htm. CDC and local and state health agencies are working together to investigate this situation.

Is novel H1N1 virus contagious?
CDC has determined that novel H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of this virus in people?
The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with novel H1N1 flu virus?
It’s not known at this time how severe novel H1N1 flu virus will be in the general population. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with certain chronic medical conditions. Early indications are that pregnancy and other previously recognized medical conditions that increase the risk of influenza-related complications, like asthma and diabetes, also appear to be associated with increased risk of complications from novel H1N1 virus infection as well.

One thing that appears to be different from seasonal influenza is that adults older than 64 years do not yet appear to be at increased risk of novel H1N1-related complications thus far in the outbreak. CDC is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age. Early reports indicate that no children and few adults younger than 60 years old have existing antibody to novel H1N1 flu virus; however, about one-third of adults older than 60 may have antibodies against this virus. It is unknown how much, if any, protection may be afforded against novel H1N1 flu by any existing antibody.

How does novel H1N1 flu compare to seasonal flu in terms of its severity and infection rates?
CDC is still learning about the severity of novel H1N1 flu virus. At this time, there is not enough information to predict how severe novel H1N1 flu outbreak will be in terms of illness and death or how it will compare with seasonal influenza.

With seasonal flu, we know that seasons vary in terms of timing, duration and severity. Seasonal influenza can cause mild to severe illness, and at times can lead to death. Each year, in the United States, on average 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years old. Over 90% of deaths and about 60 percent of hospitalization occur in people older than 65.

So far, with novel H1N1 flu, the largest number of novel H1N1 flu confirmed and probable cases have occurred in people between the ages of 5 and 24-years-old. At this time, there are few cases and no deaths reported in people older than 64 years old, which is unusual when compared with seasonal flu. However, pregnancy and other previously recognized high risk medical conditions from seasonal influenza appear to be associated with increased risk of complications from this novel H1N1.

How does novel H1N1 virus spread?
Spread of novel H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.