UC San Diego Moores Cancer Center

Our mission is to save lives by transforming cancer prevention, detection and care.
Our researchers made a big discovery that could alter how certain cancers are treated in the future.
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Cancer Stem Cells Linked to Drug ResistanceDiscovery of previously undefined molecular pathway is step toward novel clinical trial
Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth. Researchers at the University of California, San Diego School of Medicine have discovered a molecule, or biomarker, called CD61 on the surface of drug-resistant tumors that appears responsible for inducing tumor metastasis by enhancing the stem cell-like properties of cancer cells.
The findings, published in the April 20, 2014 online issue of Nature Cell Biology, may point to new therapeutic opportunities for reversing drug resistance in a range of cancers, including those in the lung, pancreas and breast.
“There are a number of drugs that patients respond to during their initial cancer treatment, but relapse occurs when cancer cells become drug-resistant,” said David Cheresh, PhD, Distinguished Professor of Pathology and UC San Diego Moores Cancer Center associate director for Innovation and Industry Alliances. “We looked at the cells before and after they became resistant and asked, ‘What has changed in the cells?’”
Cheresh and colleagues investigated how tumor cells become resistant to drugs like erlotinib or lapatinib, known as receptor tyrosine kinase inhibitors and commonly used in standard cancer therapies. They found that as drug resistance occurs, tumor cells acquire stem cell-like properties that give them the capacity to survive throughout the body and essentially ignore the drugs.
Specifically, the scientists delineated the molecular pathway that facilitates both cancer stemness and drug resistance, and were able to identify existing drugs that exploit this pathway. These drugs not only reverse stem cell-like properties of tumors, but also appear to re-sensitize tumors to drugs that the cancer cells had developed resistance to. 
“The good news is that we’ve uncovered a previously undefined pathway that the tumor cells use to transform into cancer stem cells and that enable tumors to become resistant to commonly used cancer drugs,” said Cheresh.
Based on these findings, Hatim Husain, MD, an assistant professor who treats lung and brain cancer patients at Moores Cancer Center, has designed a clinical trial to attack this pathway in patients whose tumors are drug-resistant. The trial will be open to patients with lung cancer who have experienced cancer progression and drug resistance to erlotinib. It is expected to begin in the next year.
“Resistance builds to targeted therapies against cancer, and we have furthered our understanding of the mechanisms by which that happens,” said Husain. “Based on these research findings we now better understand how to exploit the ‘Achilles heel’ of these drug-resistant tumors.  Treatments will evolve into combinational therapies where one may keep the disease under control and delay resistance mechanisms from occurring for extended periods of time.”
Although the trial is expected to begin with patients who have already experienced drug resistance, Husain hopes to extend the study to reach patients in earlier stages to prevent initial resistance.
Pictured: When lung cancer cells become drug resistant, tumor cells return, as shown in brown in the photo on the left. Researchers identified an existing drug, bortezomib, that reverses stem cell-like properties of tumors, resensitizing them to drugs as shown in the photo on the right.

Our researchers made a big discovery that could alter how certain cancers are treated in the future.

ucsdhealthsciences:

Cancer Stem Cells Linked to Drug Resistance
Discovery of previously undefined molecular pathway is step toward novel clinical trial

Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth. Researchers at the University of California, San Diego School of Medicine have discovered a molecule, or biomarker, called CD61 on the surface of drug-resistant tumors that appears responsible for inducing tumor metastasis by enhancing the stem cell-like properties of cancer cells.

The findings, published in the April 20, 2014 online issue of Nature Cell Biology, may point to new therapeutic opportunities for reversing drug resistance in a range of cancers, including those in the lung, pancreas and breast.

“There are a number of drugs that patients respond to during their initial cancer treatment, but relapse occurs when cancer cells become drug-resistant,” said David Cheresh, PhD, Distinguished Professor of Pathology and UC San Diego Moores Cancer Center associate director for Innovation and Industry Alliances. “We looked at the cells before and after they became resistant and asked, ‘What has changed in the cells?’”

Cheresh and colleagues investigated how tumor cells become resistant to drugs like erlotinib or lapatinib, known as receptor tyrosine kinase inhibitors and commonly used in standard cancer therapies. They found that as drug resistance occurs, tumor cells acquire stem cell-like properties that give them the capacity to survive throughout the body and essentially ignore the drugs.

Specifically, the scientists delineated the molecular pathway that facilitates both cancer stemness and drug resistance, and were able to identify existing drugs that exploit this pathway. These drugs not only reverse stem cell-like properties of tumors, but also appear to re-sensitize tumors to drugs that the cancer cells had developed resistance to. 

“The good news is that we’ve uncovered a previously undefined pathway that the tumor cells use to transform into cancer stem cells and that enable tumors to become resistant to commonly used cancer drugs,” said Cheresh.

Based on these findings, Hatim Husain, MD, an assistant professor who treats lung and brain cancer patients at Moores Cancer Center, has designed a clinical trial to attack this pathway in patients whose tumors are drug-resistant. The trial will be open to patients with lung cancer who have experienced cancer progression and drug resistance to erlotinib. It is expected to begin in the next year.

“Resistance builds to targeted therapies against cancer, and we have furthered our understanding of the mechanisms by which that happens,” said Husain. “Based on these research findings we now better understand how to exploit the ‘Achilles heel’ of these drug-resistant tumors.  Treatments will evolve into combinational therapies where one may keep the disease under control and delay resistance mechanisms from occurring for extended periods of time.”

Although the trial is expected to begin with patients who have already experienced drug resistance, Husain hopes to extend the study to reach patients in earlier stages to prevent initial resistance.

Pictured: When lung cancer cells become drug resistant, tumor cells return, as shown in brown in the photo on the left. Researchers identified an existing drug, bortezomib, that reverses stem cell-like properties of tumors, resensitizing them to drugs as shown in the photo on the right.

From our sister blog, questions with one of our experts on what’s known about e-cigarette safety. Although e-cigarettes do not have all the known carcinogens of traditional cigarettes, not enough is known to call them a “safer” alternative. Read more.
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To Vape or Not to Vape? We’ve got thee questions for our expert about the supposed safety of e-cigarettes
For the last 50 years cigarette smoking has been on the decline due in large part to aggressive advocacy by health professionals about the risks associated with smoking tobacco, and a once ubiquitous habit has become taboo. Quickly replacing tobacco cigarettes are electronic or e-cigarettes and “vaping” is the new inhaling. E-cigarette availability and popularity are at an all-time high, especially among teens and young adults, with claims of e-cigarette safety driving the trend.
But are e-cigarettes really safe? Recent reports of liquid nicotine poisoning beg to differ and much remains unknown about whether or not inhaling the vapor from e-cigarettes is safer than inhaling smoked tobacco.
We’ve asked John Pierce, PhD, Distinguished Professor of Family and Preventive Medicine, Moores Cancer Center director for population sciences and expert on tobacco cessation three questions about the relative safety of e-cigarettes.
Question: What, if anything, is known about the health effects of nicotine delivery from e-cigarettes versus traditional tobacco cigarettes? Are they, as advocates and tobacco companies suggest, safer?Answer: There is no question that a heavy smoker who stops using cigarettes and switches to e-cigs will have a reduced risk of lung cancer.  However, it is not at all clear that e-cigarettes will not introduce a new health risk to the person who has never smoked or whether it will be a safe alternative for the occasional smoker.
Q: Is there any evidence that it’s easier to quit smoking by shifting to e-cigarettes?
A: No, the evidence that is available suggests that e-cigarettes are not an effective smoking cessation device. The question is how difficult will it be for heavy smokers to substitute e-cigarettes for their regular cigarettes.
Q: How much nicotine from e-cigarettes is released as vapor, potentially to be inhaled by others? Does the vapor represent less of a health threat than secondhand smoke?
A: Plenty. Currently, there is very little standardization in e-cigarettes and lots of potentially harmful chemicals have been measured in it. The first study to report on this did so last December. There is no science that supports allowing e-cigarettes to be used where cigarettes are prohibited.
Image source: The Mercury News

From our sister blog, questions with one of our experts on what’s known about e-cigarette safety. Although e-cigarettes do not have all the known carcinogens of traditional cigarettes, not enough is known to call them a “safer” alternative. Read more.

ucsdhealthsciences:

To Vape or Not to Vape?
We’ve got thee questions for our expert about the supposed safety of e-cigarettes

For the last 50 years cigarette smoking has been on the decline due in large part to aggressive advocacy by health professionals about the risks associated with smoking tobacco, and a once ubiquitous habit has become taboo. Quickly replacing tobacco cigarettes are electronic or e-cigarettes and “vaping” is the new inhaling. E-cigarette availability and popularity are at an all-time high, especially among teens and young adults, with claims of e-cigarette safety driving the trend.

But are e-cigarettes really safe? Recent reports of liquid nicotine poisoning beg to differ and much remains unknown about whether or not inhaling the vapor from e-cigarettes is safer than inhaling smoked tobacco.

We’ve asked John Pierce, PhD, Distinguished Professor of Family and Preventive Medicine, Moores Cancer Center director for population sciences and expert on tobacco cessation three questions about the relative safety of e-cigarettes.

Question: What, if anything, is known about the health effects of nicotine delivery from e-cigarettes versus traditional tobacco cigarettes? Are they, as advocates and tobacco companies suggest, safer?

Answer: There is no question that a heavy smoker who stops using cigarettes and switches to e-cigs will have a reduced risk of lung cancer.  However, it is not at all clear that e-cigarettes will not introduce a new health risk to the person who has never smoked or whether it will be a safe alternative for the occasional smoker.

Q: Is there any evidence that it’s easier to quit smoking by shifting to e-cigarettes?

A: No, the evidence that is available suggests that e-cigarettes are not an effective smoking cessation device. The question is how difficult will it be for heavy smokers to substitute e-cigarettes for their regular cigarettes.

Q: How much nicotine from e-cigarettes is released as vapor, potentially to be inhaled by others? Does the vapor represent less of a health threat than secondhand smoke?

A: Plenty. Currently, there is very little standardization in e-cigarettes and lots of potentially harmful chemicals have been measured in it. The first study to report on this did so last December. There is no science that supports allowing e-cigarettes to be used where cigarettes are prohibited.

Image source: The Mercury News

Your on-hold message

You’re lucky; you have a big support group to rely on during your cancer treatment. The downside, your treatment leaves you exhausted and you may not have the energy to deliver your latest milestone or health update to your family and friends individually. Don’t feel bad; this is expected. Your support group will understand if you just explain to them that you may not be responding to calls, texts or video chats right now. But wait, isn’t communication the problem in the first place?

You need to craft a message that everyone can see or hear at the same time. This is when technology can really come in handy. You may have shied away from using social media applications or blogs but maybe now is the time. One important privacy point, you may not want to share your health information publicly so if you choose to use social media consider using a platform that allows you to create private groups or closed lists so that only the people you add to the list can see what you post. If you create a blog, make it private and share the link only with your supporters.

UC San Diego Moores Cancer Center patients can create a CarePages account that provides free, private websites that make it easy to stay connected.

If you’re new to social media ask for help creating a private group to ensure that your messages are not publicly displayed. Ask your family and friends to help you, surely there is a social media savvy person among them! Some social media tools allow you to create private groups in which all invited members can communicate with one another without outside eyes intruding on the conversation. You can post pictures or simply comments.

If you’re energy is so low that even typing short text messages leaves you exhausted then perhaps you’d prefer to use video to speak with your friends. Consider using one of the social media platforms that allow you to video chat. Some applications even let you speak with multiple people at the same time. Imagine, you’re too tired to leave your house or hospital or maybe your friends are in another city or state, you can still talk to them and best yet, all at once! If you have a smart phone, tablet computer or other computer, your device may already come with a video chat application.

Don’t forget about blogging. Writing can be a good outlet to help you release emotions and stress. Research shows that writing and sharing your cancer experience may help you make sense of complex emotions, diminish a sense of isolation that sometimes accompanies a cancer diagnosis, and gain insight and perspectives to help you cope more effectively. That’s why at Moores Cancer Center we offer a program called Writing Through Cancer for that very reason.

However you choose to communicate with your friends, just remember that they will understand if you’re not in your usual chit-cat shape. Again, please be careful with your privacy when using social media! Ask your friends and family for help if you’re new to this technology.

For Good and Ill, Immune Response to Cancer Cuts Both Ways

From our sister blog:

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The difference between an immune response that kills cancer cells and one that conversely stimulates tumor growth can be as narrow as a “double-edged sword,” report researchers at the University of California, San Diego School of Medicine in the April 7, 2014 online issue of the Proceedings of the National Academy of Sciences.

“We have found that the intensity difference between an immune response that stimulates cancer and one that kills it may not be very much,” said principal investigator Ajit Varki, MD, Distinguished Professor of Medicine and Cellular and Molecular Medicine. “This may come as a surprise to researchers exploring two areas typically considered distinct: the role of the immune system in preventing and killing cancers and the role of chronic inflammation in stimulating cancers. As always, it turns out that the immune system is a double-edged sword.”

The concept of naturally occurring “immunosurveillance” against malignancies is not new, and there is compelling evidence for it. But understanding this process is confounded by the fact that some types of immune reaction promote tumor development. Varki and colleagues looked specifically at a non-human sialic acid sugar molecule called Neu5Gc. Previous research has found that Neu5Gc accumulates in human tumors from dietary sources, despite an on-going antibody response against it.

The scientists deployed antibodies against Neu5Gc in a human-like mouse tumor model to determine whether and to what degree the antibodies altered tumor progression. They found that low antibody doses stimulated growth, but high doses inhibited it. The effect occurred over a “linear and remarkably narrow range,” said Varki, generating an immune response curve or “inverse hormesis.” Moreover, this curve could be shifted to the left or right simply by modifying the quality of the immune response.

Similar findings were made in experiments with two other mouse tumor models, and with a human tumor xenograft model using a monoclonal antibody currently in clinical use. The scientists concluded that the difference in intensity between an immune response stimulating tumors and one that kills them may be much less than previously imagined.

Varki said the results may have implications for all aspects of cancer science, from studying its causes to prevention and treatment. This is because the immune response can have multiple roles in the genesis of cancers, in altering the progress of established tumors and in anti-cancer therapies that use antibodies as drugs.

Diagnosed with Cancer? A Social Worker Can Help

In honor of Social Work Month, we would like to thank all social workers who dedicate themselves to improving the quality of life for people with cancer. In this post, Yuko Abbott, LCSW, shares with us the role a social worker plays through a cancer diagnosis.

Each one of us reacts to life-altering news in different ways. For some, being diagnosed with cancer sets the person on a journey of self-discovery where he or she learns his or her strengths. Or, reality might show that even the strongest of us needs support. The problem is that when a person is thrown into an unexpected situation, the individual may not know what help is needed or who to ask for assistance.

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I want to empower patients before a crisis occurs. Some patients are reluctant to reach out to a social worker on their own because of a stigma that may be attached. In 2013, the gynecological oncology team at UC San Diego Moores Cancer Center did a study looking at different ways to offer assistance. What we found was that if a social worker personally introduced psychosocial services like counseling and education groups, patients were more than 3 times more likely to seek out help.

Each person has unique needs. Some need emotional support and require referral to a pyschologist to talk through their feelings or maybe meet other patients who have been there. Some may need the help of medications and a psychiatrist. Other individuals have more practical needs, such as transportation or meal arrangements. For some patients, we simply need to make a suggestion or ask a question. Have you asked your child’s teacher to keep an eye out for behavioral changes in your child? Did you talk to human resources to discuss your rights and responsibilities as an employee?

A social worker is there to help, even if it’s just to help you think things through. Your mind may be focused on your health and not on other matters. Being proactive instead of reactive may give you a sense of control and will help your medical team focus on your medical needs. You can minimize turmoil and suffering alone. Emotional suffering is very exhausting not just for a patient, but for family members and caregivers as well.

So if you need help contact a social worker. If you don’t know how to reach someone ask your physician for a referral or check your facility’s website. At Moores Cancer Center, each healthcare team includes a social worker who is available to assist patients and their family with the emotional, social, psychological, spiritual and practical demands that may arise during cancer treatment. These services are planned with patients, with great respect for unique individual needs, strengths and culture.

Today, because I now try to reach out to patients during their first visit to the cancer center, most of the calls I receive are from patients who say, “I met you recently and I have questions.” Patients get the psychosocial help they need within an average of four days. Previously, calls were more crisis in nature and I was talking to patients an average of 80 days after their first visit. If we start a conversation at the beginning of a diagnosis together, we can plan ahead, making this journey more predictable for you and the people around you. Find us if you need us and when you’re ready.

Bariatric Surgery Decreases Risk of Uterine Cancer

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Researchers at the University of California, San Diego School of Medicine and Moores Cancer Center report that bariatric surgery resulting in dramatic weight loss in formerly severely obese women reduces the risk of endometrial (uterine) cancer by 71 percent and as much as 81 percent if normal weight is maintained after surgery.

Published in the April issue of Gynecologic Oncology, the official publication of the Society of Gynecologic Oncology, the findings indicate obesity may be a modifiable risk factor for endometrial cancer, and bariatric surgery a viable option for eligible patients. They are based on a retrospective cohort study of 7,431,858 patients in the University HealthSystem Consortium database, which contains information from contributing academic medical centers in the United States and affiliated hospitals. Of this total, 103,797 patients had a history of bariatric surgery and 44,345 had a diagnosis of uterine malignancy.

Obesity is a widespread public health problem in the United States, with an estimated two-thirds of the U.S. adult population considered to be overweight or obese. The condition is strongly linked to a host of health risks, among them heart disease, diabetes and cancer, in particular endometrial cancer.

“Estimating from various studies that looked at increasing BMI and endometrial cancer risk, a woman with a Body Mass Index (BMI) of 40 would have approximately eight times greater risk of endometrial cancer than someone with a BMI of 25,” said first author Kristy Ward, MD, the senior gynecologic oncology fellow in the Department of Reproductive Medicine at UC San Diego School of Medicine. “This risk likely continues to go up as BMI goes up.”

Bariatric surgery is often the last resort for obese patients after all other non-surgical weight loss efforts have failed. To qualify, patients must be an acceptable surgical risk and be defined as either severely obese with a BMI of 40 or greater or have a BMI of 35 or greater with at least one related condition: diabetes, obstructive sleep apnea, obesity-related cardiomyopathy or heart muscle disease or severe joint disease.

Typically, bariatric surgery involves reducing the size of the stomach using a constrictive gastric band, removing a portion of the stomach or resecting and re-routing the small intestines to a small stomach pouch. In all cases, the surgery must be followed by lifestyle changes to ensure long-term weight loss success.

A number of biological mechanisms link obesity to endometrial cancer. Excessive adipose or fat tissue, for example, raises circulating levels of estrogen, which is associated with tumor creation and metastasis. Obesity also causes chronic inflammation, boosting insulin resistance and increased estrogen levels.

“The majority of endometrial cancers are estrogen-driven,” said Ward. “In a normal menstruating woman, two hormones control the endometrium (inner lining of the uterus). Estrogen builds up the endometrium and progesterone stabilizes it. A woman with excess adipose tissue has an increased level of estrogen because the fat tissue converts steroid hormones into a form of estrogen.

“So there is too much estrogen, causing the endometrium to build up, but not enough progesterone to stabilize it. The endometrium continues to grow and can undergo changes into abnormal tissue, leading to cancer.”

Bariatric surgery has been shown to reduce the impact of these factors: hormone levels become normal; inflammation decreases; insulin resistance drops; weight loss allows for increased physical activity and improved overall health.

“The obesity epidemic is a complicated problem,” she said. “Further work is needed to define the role of bariatric surgery in cancer care and prevention, but we know that women with endometrial cancer are more likely to die of cardiovascular causes than they are of endometrial cancer.  It’s clear that patients who are overweight and obese should be counseled about weight loss, and referral to a bariatric program should be considered in patients who meet criteria.” 

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Is colorectal cancer getting its butt kicked?
Among those over 50, the number of people with colon or rectal cancer plummeted 30 percent from 2001 to 2010, due to screening and removal of precancerous polyps, according to data published this week.
For those 65 and older, the decline in new colon cancer incidents was even more dramatic, dropping 7 percent a year during the three-year period from 2008 to 2010. 
A national coalition of cancer groups, organized by the National Colorectal Cancer Roundtable, now hopes to eliminate colorectal cancer as a major public health problem through an “80 percent by 2018” campaign, launched this week. The goal is to screen 80 percent of people over 50 by 2018.
“It is realistic for us to achieve this goal at UC San Diego,” said Samir Gupta, MD, an associate professor of clinical medicine and gastroenterologist at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System. “We are in the midst of a coordinated effort between primary care physicians and gastroenterologists to optimize screening rates.
“To increase screening rates, we are reminding patients, who are not up to date, to get screened. This effort includes mailing patients invitations. Our main challenges are awareness and making sure patients are talking to their doctors about screening and when to get screened. The ‘ick factor’ is also probably significant.”
Colonoscopies are the primary means for detecting precancerous tumors early. For those who prefer non-invasive options, patients may request the fecal immunochemical test (FIT) or guaiac fecal occult blood test, both of which have the endorsement of the U.S. Preventive Services Task Force.
Virtual colonoscopy or CT colonoscopy has been endorsed by the American Cancer Society, but not all insurers cover the procedure and it still requires a bowel preparation.

Early detection can not only save lives, it can save you from unnecessary treatment if your disease is caught early.  Have you been tested?

ucsdhealthsciences:

Is colorectal cancer getting its butt kicked?

Among those over 50, the number of people with colon or rectal cancer plummeted 30 percent from 2001 to 2010, due to screening and removal of precancerous polyps, according to data published this week.

For those 65 and older, the decline in new colon cancer incidents was even more dramatic, dropping 7 percent a year during the three-year period from 2008 to 2010. 

A national coalition of cancer groups, organized by the National Colorectal Cancer Roundtable, now hopes to eliminate colorectal cancer as a major public health problem through an “80 percent by 2018” campaign, launched this week. The goal is to screen 80 percent of people over 50 by 2018.

“It is realistic for us to achieve this goal at UC San Diego,” said Samir Gupta, MD, an associate professor of clinical medicine and gastroenterologist at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System. “We are in the midst of a coordinated effort between primary care physicians and gastroenterologists to optimize screening rates.

“To increase screening rates, we are reminding patients, who are not up to date, to get screened. This effort includes mailing patients invitations. Our main challenges are awareness and making sure patients are talking to their doctors about screening and when to get screened. The ‘ick factor’ is also probably significant.”

Colonoscopies are the primary means for detecting precancerous tumors early. For those who prefer non-invasive options, patients may request the fecal immunochemical test (FIT) or guaiac fecal occult blood test, both of which have the endorsement of the U.S. Preventive Services Task Force.

Virtual colonoscopy or CT colonoscopy has been endorsed by the American Cancer Society, but not all insurers cover the procedure and it still requires a bowel preparation.

Early detection can not only save lives, it can save you from unnecessary treatment if your disease is caught early. Have you been tested?

Diagnosed with cancer, now what?

The diagnosis none of us want to hear has sent your mind spinning. You have cancer. After the shock has passed many questions may begin to form in your mind: What do I do first? What will my treatment consist of? How will this affect my work, school or other daily activities? How do I tell my family, friends or coworkers?

First, and most important, you should know that you have every right to go through a wide range of emotions. What you do with these feelings will help the outcome of your prognosis. So, take a deep breath and remember that you will want to treat the whole person during this event in your life not just the cancer. Find your support system. Whether it is with friends, family or other cancer patients and survivors, talk to them. And, ask for help!

Depending on the cancer—there are more 200 types—your oncologist will recommend a treatment plan. The plan may change as your medical team learns more about your cancer and your body’s reaction to the treatment. Write down all of the questions that have been running through your head, prioritize them and ask your physician these questions. No question is silly. And, if you don’t understand the answer ask for clarification or help. Not sure what to ask? We can suggest questions you may want to ask. Bringing a family member or close friend along may also be a good idea so they can remind you exactly what was said by your medical team.

Open communication with your doctor will only help improve the care you receive. Your medical team wants to help you make as much sense of this time in your life as they can.

Bring the following items with you to your first appointment:

  • X-rays, lab results or pathology reports related to your current condition
  • A list of medications you are taking, both prescribed and over the counter, including vitamins, supplements and herbal remedies
  • Name, phone numbers and address of your emergency contact
  • Name and contact information of your primary care physician and others involved in your care
  • Your health insurance card(s)
  • The list of questions you created for your doctor and something to write down the answers

Now is the time to look at your diet, your physical activity and evaluate your options. In addition to speaking with your medical team, consider participating in educational classes that offer tips about dealing with chemotherapy, radiation treatment and nutrition. Join a support group or participate in activities that help you express yourself or reduce stress like yoga. Check with your healthcare provider to see if they offer this like those at Moores Cancer Center

Lastly, take a deep breath and get some rest. Your body needs it.

Anti-psychotic Medications Offer New Hope in the Battle Against Glioblastoma

Clark Chen, MD, PhD, is now working with the UC San Diego Moores Cancer Center Neuro-Oncology team to translate findings of this study into a clinical trial for patients with glioblastoma.

ucsdhealthsciences:

Researchers at the University of California, San Diego School of Medicine have discovered that FDA-approved anti-psychotic drugs possess tumor-killing activity against the most aggressive form of primary brain cancer, glioblastoma. The finding was published in this week’s online edition of Oncotarget.

The team of scientists, led by principal investigator, Clark C. Chen, MD, PhD, vice-chairman, UC San Diego, School of Medicine, division of neurosurgery, used a technology platform called shRNA to test how each gene in the human genome contributed to glioblastoma growth.  The discovery that led to the shRNA technology won the Nobel Prize in Physiology/Medicine in 2006.

“ShRNAs are invaluable tools in the study of what genes do. They function like molecular erasers,” said Chen. “We can design these ‘erasers’ against every gene in the human genome. These shRNAs can then be packaged into viruses and introduced into cancer cells. If a gene is required for glioblastoma growth and the shRNA erases the function of that gene, then the cancer cell will either stop growing or die.”

Chen said that one surprising finding is that many genes required for glioblastoma growth are also required for dopamine receptor function. Dopamine is a small molecule that is released by nerve cells and binds to the dopamine receptor in surrounding nerve cells, enabling cell communication.

Abnormal dopamine regulation is associated with Parkinson’s disease, schizophrenia, and Attention Deficit Hyperactivity Disorder. Because of the importance of dopamine in these diseases, drugs have been developed to neutralize the effect of dopamine, called dopamine antagonists. 

Following clues unveiled by their shRNA study, Chen and his team tested the effects of dopamine antagonists against glioblastoma and found that these drugs exert significant anti-tumor effects both in cultured cells and mouse models. These effects are synergistic when combined with other anti-glioblastoma drugs in terms of halting tumor growth.

“The anti-glioblastoma effects of these drugs are completely unexpected and were only uncovered because we carried out an unbiased genetic screen,” said Chen.

“On the clinical front, the finding is important for two reasons,” said Bob Carter, MD, PhD, chairman of UC San Diego, School of Medicine, division of neurosurgery. “First, these drugs are already FDA-cleared for human use in the treatment of other diseases, so it is possible these drugs may be re-purposed for glioblastoma treatment, thereby bypassing years of pre-clinical testing. Second, these drugs have been shown to cross the blood-brain barrier, a barrier that prevents more than 90 percent of drugs from entry into the brain.”

Chen is now working with the UC San Diego Moores Cancer Center Neuro-Oncology team to translate his findings into a clinical trial.

ucsdhealthsciences:

Vitamin D crystals, image courtesy of the NIH Office of Dietary Supplements
Vitamin D Increases Breast Cancer Patient SurvivalBreast cancer patients with high levels of vitamin D in their blood are twice as likely to survive the disease as women with low levels of this nutrient, report University of California, San Diego School of Medicine researchers in the March issue of Anticancer Research.
In previous studies, Cedric F. Garland, DrPH, professor in the Department of Family and Preventive Medicine, showed that low vitamin D levels were linked to a high risk of premenopausal breast cancer. That finding, he said, prompted him to question the relationship between 25-hydroxyvitamin D — a metabolite produced by the body from the ingestion of vitamin D — and breast cancer survival rates.
Garland and colleagues performed a statistical analysis of five studies of 25-hydroxyvitamin D obtained at the time of patient diagnosis and their follow-up for an average of nine years. Combined, the studies included 4,443 breast cancer patients.
“Vitamin D metabolites increase communication between cells by switching on a protein that blocks aggressive cell division,” said Garland. “As long as vitamin D receptors are present tumor growth is prevented and kept from expanding its blood supply. Vitamin D receptors are not lost until a tumor is very advanced. This is the reason for better survival in patients whose vitamin D blood levels are high.”
Women in the high serum group had an average level of 30 nanograms per milliliter (ng/ml) of 25-hydroxyvitamin D in their blood. The low group averaged 17 ng/ml. The average level in patients with breast cancer in the United States is 17 ng/ml.
“The study has implications for including vitamin D as an adjuvant to conventional breast cancer therapy,” said co-author Heather Hofflich, DO, UC San Diego associate professor in the Department of Medicine.
More here

ucsdhealthsciences:

Vitamin D crystals, image courtesy of the NIH Office of Dietary Supplements

Vitamin D Increases Breast Cancer Patient Survival

Breast cancer patients with high levels of vitamin D in their blood are twice as likely to survive the disease as women with low levels of this nutrient, report University of California, San Diego School of Medicine researchers in the March issue of Anticancer Research.

In previous studies, Cedric F. Garland, DrPH, professor in the Department of Family and Preventive Medicine, showed that low vitamin D levels were linked to a high risk of premenopausal breast cancer. That finding, he said, prompted him to question the relationship between 25-hydroxyvitamin D — a metabolite produced by the body from the ingestion of vitamin D — and breast cancer survival rates.

Garland and colleagues performed a statistical analysis of five studies of 25-hydroxyvitamin D obtained at the time of patient diagnosis and their follow-up for an average of nine years. Combined, the studies included 4,443 breast cancer patients.

“Vitamin D metabolites increase communication between cells by switching on a protein that blocks aggressive cell division,” said Garland. “As long as vitamin D receptors are present tumor growth is prevented and kept from expanding its blood supply. Vitamin D receptors are not lost until a tumor is very advanced. This is the reason for better survival in patients whose vitamin D blood levels are high.”

Women in the high serum group had an average level of 30 nanograms per milliliter (ng/ml) of 25-hydroxyvitamin D in their blood. The low group averaged 17 ng/ml. The average level in patients with breast cancer in the United States is 17 ng/ml.

“The study has implications for including vitamin D as an adjuvant to conventional breast cancer therapy,” said co-author Heather Hofflich, DO, UC San Diego associate professor in the Department of Medicine.

More here

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