Treatment- Different-3type Gastric Cancer

Treatment- Different-3type Gastric Cancer

Three Subtypes of Gastric Cancer Suggest Different Treatment Approaches

Aug. 27, 2013 — Stomach cancer, one of the leading causes of cancer death worldwide, actually falls into three broad subtypes that respond differently to currently available therapies, according to researchers at Duke-NUS Graduate Medical School Singapore.

The finding could greatly improve patient care with the development of a genetic test to classify tumors and match them to the therapies that offer the best outcomes."One of the features that makes gastric cancer so lethal is that it arises from many genetic alterations, creating differences in how the tumors respond to therapies," said Steve Rozen, Ph.D., director of the Centre for Computational Biology at Duke-NUS. Rozen is senior author of the study published in the September issue of the journal

Gastroenterology. "What our study has shown is that there are actually three distinct molecular classifications that appear to be biologically and therapeutically meaningful."

Worldwide, only lung cancer is more lethal than stomach cancer. Rates in all countries have been dropping for decades, and are much lower in the United States than in Asia, but the malignancy still afflicts more than 21,000 people in the U.S. a year, according to the National Cancer Institute.

Despite differences in the way their tumors respond to treatments, patients often receive a "one-size-fits-all" treatment approach, resulting in a five-year survival rate of about 27 percent in the United States.

"There has been an urgent need for improved classification of gastric cancer that provides insight into the biology of the tumors that might help predict treatment response," said co-senior author Patrick Tan, M.D., PhD., professor in the Cancer and Stem Cell Biology Program at Duke-NUS.

Using a technology called microarray-based gene expression profiling, Rozen and colleagues analyzed 248 gastric tumors, then further grouped them according to the genes that were expressed in the tumors.

The gene expression analysis broadly sorts the tumors into three subtypes: proliferative, metabolic and mesenchymal. These subtypes also differ in their genomic and epigenomic properties.

Tumors of the proliferative subtype have high levels of genomic instability and a mutation in the TP53 tumor suppressor gene that occurs in many types of cancers. Cancer cells of the metabolic subtype are more sensitive to the chemotherapy agent 5-FU. Cancer cells of the mesenchymal subtype have some features of cancer stem cells, and are particularly sensitive to a class of therapies called PI3K−AKT−mTOR inhibitors.

"In terms of clinical treatment, there are two promising findings from our research," Rozen said. "One is that 5-FU has been particularly effective against metabolic- subtype tumors, and the second is that drugs targeting the PI3K−AKT−mTOR pathway may be particularly effective against mesenchymal-subtype cancers."

"If confirmed in future studies, the classification of gastric cancers reported here could guide development of therapies tailored to the molecular subtypes," said lead author Zhengdeng Lei, PhD.

In addition to Rozen, Tan and Lei, study authors include Iain Beehuat Tan, Kakoli Das, Niantao Deng, Hermioni Zouridis, Sharon Pattison, Clarinda Chua, Zhu Feng, Yeoh Khay Guan, Chia Huey Ooi, Tatiana Ivanova, Shenli Zhang, Minghui Lee, Jeanie Wu, Anna Ngo, Sravanthy Manesh, Elisabeth Tan, Bin Tean Teh, Jimmy Bok Yan So, Liang Kee Goh, Alex Boussiouta, Tony Kiat Hon Lim and Horst Flotow.

The study was supported by the Duke-NUS Signature Research Programs, with funding from the Singapore Agency for Science, Technology, and Research and the Singapore Ministry of Health; the Singapore National Medical Research Council; the Singapore National Research Foundation and Ministry of Education; and the Singapore Biomedical Research Council.

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Drugs- Botox Not Just for Wrinkles

Drugs- Botox Not Just for Wrinkles

Botox Not Just for Wrinkles

Aug. 27, 2013 — Botox is best known as a cosmetic treatment for frown lines, but the drug also effectively treats the after effects of Bell's palsy and other serious facial nerve problems.

Bell's palsy results from damage to the facial nerve that controls muscles on one side of the face. Ear-nose-throat surgeon Dr. Matthew Kircher of Loyola University Medical Center is giving patients Botox injections to treat facial nerve disorders that sometimes occur after Bell's palsy, including unwanted facial movements known as synkinesis.

Botox injections work by weakening or paralyzing certain muscles or by temporarily blocking the nerve input into the muscles.Facial synkinesis is the involuntary movement of one set of muscles when the patient tries to move another set of muscles. For example, when the patient blinks, the

mouth smiles or grimaces.

Botox can improve the symmetry of the face and reduce muscle contractures and spasms. Botox also is effective for platysmal banding -- verticle lines that develop in the neck as a result of muscle contractions.

Kircher said he starts out conservatively, treating patients with dilute doses. After seeing how well the patient does, Kircher adjusts the dose if necessary.

Botox is not a cure. The drug wears off after three or four months, so patients need repeat injections.

"While we can never make the face perfect, we have found Botox to be extremely effective," Kircher said. "It can make a huge difference in patients' lives."

Kircher is an assistant professor in the Department of Otolaryngology of Loyola University Chicago Stritch School of Medicine.

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Reproductive health-MENSTRUAL CARE

Reproductive health-MENSTRUAL CARE

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You will find these tips helpful during your periods:

1. Have enough rest

2. Do mild exercises. Keep yourself active daily.

3. Take lots of fluids including fruit juce, soup, water.

4. Eat plenty of fresh fruits and vegetables.

5. Wear comfortable loose fitting, clean clothes.

6. Panties must be cotton made.

7. Always wash you hands before and after changing pads, tampons or cups. This is to prevent infections

Drug-in Blood Cancers- May Stop Spread of Breast Cancer Cells

Drug-in Blood Cancers- May Stop Spread of Breast Cancer Cells

Drug Used for Blood Cancers May Stop Spread of Breast Cancer Cells

Aug. 22, 2013 — A drug used to treat blood cancers may also stop the spread of invasive breast cancer, researchers at Mayo Clinic in Florida have discovered. Their study, published online in Breast Cancer Research, found that in the lab and in animals, the drug decitabine turns on a gene coding for protein kinase D1 (PRKD1) that halts the ability of cancer cells to separate from a tumor and spread to distant organs.

"Treatment with low doses of decitabine in an animal model of breast cancer restored PRKD1 expression, reduced tumor size, and blocked metastasis to the lung," says the study's senior investigator, Peter Storz, Ph.D., a biochemist and molecular biologist at Mayo Clinic in Florida.

"The outcome of patients with invasive breast cancer is less than optimal despite many attempts to improve treatment, including advanced chemotherapy and hormonal therapy," says Dr. Storz. "We hope this study offers a new avenue to prevent breast cancer from becoming aggressive and untreatable."

The research team, which includes first author Sahra Borges, Ph.D., a postdoctoral researcher in Dr. Storz's lab, found that the gene coding for PRKD1 was silenced in all but one subtype of invasive breast cancer, including aggressive triple negative breast cancer. That subtype is invasive lobular carcinoma.

Dr. Borges also developed an assay that can be used to measure the amount of PRKD1 that is silenced in patients' breast tumors."Because we found that PRKD1 is increasingly silenced as breast cancer becomes aggressive and spreads, the hope is that this test can be further developed and used to predict which patients are at risk for cancer metastasis, and thus may benefit from decitabine," Dr. Borges says.

Decitabine, approved by the U.S. Food and Drug Administration for use in some blood cancers, is a demethylating agent, meaning that it can switch on beneficial genes such as PRKD1 that cancer has silenced in order to grow.

Treating genes that are silenced is much easier than trying to restore function of a mutated gene, Dr. Storz says. The normal function of PRKD1, which is expressed in cells of the mammary gland, is to maintain normal function by preventing cells from morphing into a state where they can dislodge and spread, he says.

The researchers hope this study will help them to design a clinical trial in collaboration with Mayo Clinic physicians using decitabine to promote re-expression of PRKD1 and agents that activate PRKD1.

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New Technique -Help Brain Cancer Patients

New Technique -Help Brain Cancer Patients

New Technique to Help Brain Cancer Patients

Aug. 23, 2013 — A new scanning technique developed by Danish and US researchers reveals how susceptible patients with aggressive brain cancer are to the drugs they receive. The research behind the ground-breaking technique has just been published in Nature Medicine.

Each year sees 260 new cases of the most aggressive type of brain cancer in Denmark. Some patients survive only a few months, while others survive for 18 months. Only very few, 3.5%, are alive five years after their diagnosis. A new scanning technique can now reveal how the brain tumour responds to the drug administered:

"We have developed an MRI technique which reveals how a patient will respond to the treatment that inhibits the growth of new blood vessels to the tumour. The technique allows us to only select the patients who will actually benefit from the treatment and to quickly initiate or intensify other treatments for non-responding patients," says Kim Mouridsen, Associate Professor at Aarhus University and head of the research group Neuroimaging Methods at MINDLab, Aarhus University.

He has developed the new technique together with researchers from Harvard Medical School.

Brain architecture providing important knowledge

Aggressive brain cancer is usually treated with drugs that inhibit the growth of new blood vessels, as the most aggressive brain tumours are constantly trying to produce new blood vessels to get oxygen. The treatment alleviates the symptoms, but it also increases the efficacy of radiation therapy because it improves oxygenation.

According to Kim Mouridsen, the new technique -- Vessel Architectural Imaging -- is an important step towards better treatment:"Getting more knowledge about what the blood vessels in the tumour look like will also give us a better understanding of the mechanisms which are decisive for the

efficacy of the treatment. And understanding these mechanisms is precisely what we need to be able to develop and improve the treatment of brain tumours in general."

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