Barry Stein

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Homepage: http://www.colorectal-cancer.ca


Posts by Barry Stein

L’analyse de sang, piste d’avenir pour le soin

SOPHIE GUIRAUD

Cancer : l’analyse de sang, piste d’avenir pour le soin 
Marc Ychou et Alain Thierry, partenaires de la start-up DiaDx.

CHRISTOPHE FORTIN

Alain Thierry a mis au point une “biopsie liquide” présentée jeudi au congrès international d’oncologie digestive à Montpellier.

Il y a six mois, il a eu les honneurs de la revue scientifique Nature Medicine : pour la première fois, un chercheur montrait l’intérêt d’une “biopsie liquide”, qui consiste, depuis un échantillon sanguin, à rechercher des mutations génétiques dans l’ADN pour traiter les cancers colorectaux. Depuis, l’idée a fait du chemin. Ce jeudi, Alain Thierry, chercheur Inserm à l’institut de recherche en cancérologie de Montpellier (IRCM), a présenté ses travaux à la conférence internationale d’oncologie digestive organisée jusqu’à samedi au Corum. Le concept est aujourd’hui expérimenté dans une quinzaine de centres en France. Une start-up a été créée. Un développement est envisageable à l’horizon 2016.

Une prise de sang plutôt qu’une biopsie

Explications : “Toutes les cellules relarguent de l’ADN dans le sang, l’ADN circulant”, indique le chercheur. Que se passe-t-il chez un malade ? “Quand une personne a un cancer, l’ADN circulant est relargué en plus grande quantité. C’est un biomarqueur intéressant pour analyser la tumeur. Le test sanguin que nous avons mis au point évite de faire une biopsie pour accéder à des informations capitales dans les choix thérapeutiques à venir. On recherche des mutations génétiques qui, si elles sont présentes, rendent inefficaces un traitement par anticorps”, décrypte Alain Thierry.

Pionnier allemand

L’Allemand Klaus Pantel (CHU de Hambourg), pionnier et expert de l’étude des cellules tumorales circulantes, sera à Montpellier du 14 au 16 octobre 2014 pour une formation de la communauté scientifique et médicale. Il donnera un cours du master international “Cancer Biology” coordonné par le docteur Catherine Panabières, du CHU de Montpellier. Les deux établissements (CHU de Montpellier et de Hambourg) sont associés sur un projet européen de détection des cellules tumorales circulantes dans le cancer de la prostate.

18 000 décès du cancer colorectal par an en France

La méthode a plusieurs avantages : “On gagne du temps, avec un résultat obtenu en 48 h plutôt qu’en un mois. Le test est moins invasif, plus précis, moins coûteux.” L’histoire est loin d’être terminée : “On est dans un programme de recherche clinique”, précise le professeur Marc Ychou, de l’ICM (Institut régional du cancer de Montpellier), associé à Alain Thierry au sein de la start-up DiaDx. Le potentiel est conséquent. Le cancer colorectal touche 40 000 nouveaux patients par an en France, pour 18 000 décès. Enfin, précisent le chercheur et le médecin, “le test est adaptable aux cancers solides comme le sein et le poumon”.

Training Dogs to Sniff Out Cancer

 

Training Dogs to Sniff Out Cancer

By 

 September 11, 2014 2:50 pmoto

McBaine, a cancer detection dog.Credit Penn Vet Working Dog Center

PHILADELPHIA — McBaine, a bouncy black and white springer spaniel, perks up and begins his hunt at the Penn Vet Working Dog Center. His nose skims 12 tiny arms that protrude from the edges of a table-size wheel, each holding samples of blood plasma, only one of which is spiked with a drop of cancerous tissue.

The dog makes one focused revolution around the wheel before halting, steely-eyed and confident, in front of sample No. 11. A trainer tosses him his reward, a tennis ball, which he giddily chases around the room, sliding across the floor and bumping into walls like a clumsy puppy.

McBaine is one of four highly trained cancer detection dogs at the center, which trains purebreds to put their superior sense of smell to work in search of the early signs of ovarian cancer. Now, Penn Vet, part of the University of Pennsylvania’s School of Veterinary Medicine, is teaming with chemists and physicists to isolate cancer chemicals that only dogs can smell. They hope this will lead to the manufacture of nanotechnology sensors that are capable of detecting bits of cancerous tissue 1/100,000th the thickness of a sheet of paper.

“We don’t ever anticipate our dogs walking through a clinic,” said the veterinarian Dr. Cindy Otto, the founder and executive director of the Working Dog Center. “But we do hope that they will help refine chemical and nanosensing techniques for cancer detection.”

Since 2004, research has begun to accumulate suggesting that dogs may be able to smell the subtle chemical differences between healthy and cancerous tissue, including bladder cancer, melanomaand cancers of the lung, breast and prostate. But scientists debate whether the research will result in useful medical applications.

Photo

Trainers tend to notice early on that certain dogs have natural talents that make them better suited for specific kinds of work.Credit Penn Vet Working Dog Center.

Dogs have already been trained to respond to diabetic emergencies, or alert passers-by if an owner is about to have a seizure. And on the cancer front, nonprofit organizations like the In Situ Foundation, based in California, and the Medical Detection Dogs charity in Britain are among a growing number of independent groups sponsoring research into the area.

A study presented at the American Urological Association’s annual meeting in May reported that two German shepherds trained at the Italian Ministry of Defense’s Military Veterinary Center in Grosseto were able to detect prostate cancer in urine with about 98 percent accuracy, far better than the prostate-specific antigen (PSA) test. But in another recent study of prostate-cancer-sniffing dogs, British researchers reported that promising initial results did not hold up in rigorous double-blind follow-up trials.

Dr. Otto first conceived of a center to train and study working dogs when, as a member of the Federal Emergency Management Agency’s Urban Search and Rescue Team, she was deployed to ground zero in the hours after the Sept. 11 attacks.

“I remember walking past three firemen sitting on an I-beam, stone-faced, dejected,” she says. “But when a handler walked by with one of the rescue dogs, they lit up. There was hope.”

Today, the Working Dog Center trains dogs for police work, search and rescue and bomb detection. Their newest canine curriculum, started last summer after the center received a grant from the Kaleidoscope of Hope Foundation, focuses on sniffing out a different kind of threat: ovarian cancer.

“Ovarian cancer is a silent killer,” Dr. Otto said. “But if we can help detect it early, that would save lives like nothing else.”

Dr. Otto’s dogs are descended from illustrious lines of hunting hounds and police dogs, with noses and instincts that have been refined by generations of selective breeding. Labradors and German shepherds dominate the center, but the occasional golden retriever or springer spaniel — like McBaine — manages to make the cut.

The dogs, raised in the homes of volunteer foster families, start with basic obedience classes when they are eight weeks old. They then begin their training in earnest, with the goal of teaching them that sniffing everything — from ticking bombs to malignant tumors — is rewarding.

“Everything we do is about positive reinforcement,” Dr. Otto said. “Sniff the right odor, earn a toy or treat. It’s all one big game.”

Trainers from the center typically notice early on that certain dogs have natural talents that make them better suited for specific kinds of work. Search and rescue dogs must be tireless hunters, unperturbed by distracting environments and unwilling to give up on a scent – the equivalent of high-energy athletes. The best cancer-detection dogs, on the other hand, tend to be precise, methodical, quiet and even a bit aloof — more the introverted scientists.

“Some dogs declare early, but our late bloomers frequently switch majors,” Dr. Otto said.

Handlers begin training dogs selected for cancer detection by holding two vials of fluid in front of each dog, one cancerous and one benign. The dogs initially sniff both but are rewarded only when they sniff the one containing cancer tissue. In time, the dogs learn to recognize a unique “cancer smell” before moving on to more complex tests.

What exactly are the dogs sensing? George Preti, a chemist at the Monell Chemical Senses Center in Philadelphia, has spent much of his career trying to isolate the volatile chemicals behind cancer’s unique odor. “We have known for a long time that dogs are very sensitive detectors,” Dr. Preti says. “When the opportunity arose to collaborate with Dr. Otto at the Working Dog Center, I jumped on it.”

Dr. Preti is working to isolate unique chemical biomarkers responsible for ovarian cancer’s subtle smell using high-tech spectrometers and chromatographs. Once he identifies a promising compound, he tests whether the dogs respond to that chemical in the same way that they respond to actual ovarian cancer tissue.

“I’m not embarrassed to say that a dog is better than my instruments,” Dr. Preti says.

Photo

The dogs, raised in the homes of volunteer foster families, begin their training at 8 weeks of age, starting with basic obedience classes.Credit Penn Vet Working Dog Center.

The next step will be to build a mechanical, hand-held sensor that can detect that cancer chemical in the clinic. That’s where Charlie Johnson a professor at Penn who specializes in experimental nanophysics, the study of molecular interactions between microscopic materials, comes in.

He is developing what he calls Cyborg sensors, which include biological and mechanical components – a combination of carbon nanotubes and single-stranded DNA that preferentially bond with one specific chemical compound. These precise sensors, in theory, could be programmed to bind to, and detect, the isolated compounds that Dr. Otto’s dogs are singling out.

“We are effectively building an electronic nose,” said Dr. Johnson, who added that a prototype for his ovarian cancer sensor will probably be ready in the next five years.

Some experts remain skeptical.

“While I applaud any effort to detect ovarian cancer, I’m uncertain that this research will have any value,” said Dr. David Fishman, a gynecologic oncologist at Mount Sinai Hospital in New York City. One challenge, he notes, is that any cancer sensor would need to be able to detect volatile chemicals that are specific to one particular type of cancer.

“Nonspecificity is where a lot of these sort of tests fail,” Dr. Fishman said. “If there is an overlap in volatile chemicals — between colon, breast, pancreatic, ovarian cancer — we’ll have to ask, ‘What does this mean?’ ”

And even if sensors could be developed that detect ovarian cancer in the clinic, Dr. Fishman says, he doubts that they would be able to catch ovarian cancer in its earliest, potentially more treatable, stages.

“The lesions that we are discussing are only millimeters in size, and almost imperceptible on imaging studies,” Dr. Fishman says. “I don’t believe that the resolution of the canine ability will translate into value for these lesions.”

McBaine remains unaware of the debate. After correctly identifying yet another cancerous plasma sample, he pranced around the Working Dog Center with regal flair, showing off his tennis ball to anyone who would pay attention. In an industry saturated with hundreds of corporations and thousands of scientists all hunting for the earliest clues to cancer, working dogs are just another set of (slightly furrier) researchers.

Des selles fluo pour déceler un cancer

Des selles fluo pour déceler un cancer

Agence QMI 05/09/2014 15h08
Photo Fotolia

L’utilisation d’enzymes fluorescentes lors d’examens des selles d’individus pourrait permettre d’y déceler des traces de cancer colorectal, estiment deux chercheurs de l’Université McMaster, à Hamilton, en Ontario.

Les docteurs Yingfu Li, un biochimiste et Bruno Salena, un gastroentérologue, travaillent à ce projet en collaboration avec la Société canadienne du cancer qui leur a accordé une subvention de 200 000 $.

L’idée leur est venue lors d’une conversation au cours d’une partie de golf: le Dr Li a raconté qu’il étudiait les enzymes fluorescents tandis que le Dr Salena, lui, traitait des patients atteints du cancer colorectal.

«Nous nous sommes mis à échanger sur les possibilités de détection précoce du cancer à l’aide de ces enzymes, et j’ai trouvé ça très intéressant, a indiqué le Dr Salena. J’ai regardé les données du Dr Li et je me suis dit qu’on pourrait expérimenter quelque chose de nouveau.»

Les chercheurs tenteront d’identifier des enzymes qui émettront un rayonnement lorsqu’ils sont dans des échantillons de selle de patients ayant un diagnostic de cancer colorectal, mais qui demeureront neutres dans le cas d’échantillons sains.

Si leur recherche, étalée sur deux ans, est un succès, les médecins pourraient à l’avenir faire passer ce test dans leur bureau. Utilisé sur des échantillons d’urine, ce test pourrait aussi servir à détecter les cancers du rein ou de la vessie.

Même s’il est traitable dans 90 % des cas, le cancer colorectal est le deuxième cancer le plus meurtrier au Canada.

 

Poop that glows: McMaster researchers developing colorectal cancer test

Researchers at McMaster University in Hamilton search for DNA enzymes to create early warning test

 Adam Carter CBC News

McMaster University researchers Dr. Yingfu Li, right, and Dr. Bruno Salena are conducting a research study to find enzymes that would cause glowing feces in colorectal cancer patients as an early warning system.

McMaster University researchers Dr. Yingfu Li, right, and Dr. Bruno Salena are conducting a research study to find enzymes that would cause glowing feces in colorectal cancer patients as an early warning system. Mike Lalich/Canadian Cancer Society. Researchers from McMaster University in Hamilton are working on what they call simple, non-invasive test for colorectal cancer: glowing poop.

Biochemist Dr. Yingfu Li and gastroenterologist Dr. Bruno Salena say the test they’re developing under a grant from the Canadian Cancer Society is an innovative way to get more people checked for cancer. “I find it very exciting as a clinician,” Salena said. “If we can produce a simple, cost-effective test here, the costs for a population are much less all around.”

‘If we could offer a simpler test, you’d get more people receptive to this type of screening.’- Dr. Yingfu Li, cancer researcher

To start the study, researchers are amassing a pool of as many as a quadrillion DNA sequences. With this massive pool, they plan to search for specific DNA enzymes that will glow in the feces of people with colorectal cancer. If they’re successful, the detection tool could one day be used in the doctor’s office as a simple, inexpensive test for cancer.

Colorectal cancer is the second leading cause of cancer deaths for men in Canada, behind lung cancer, and the third-leading cause of death among women, behind lung and breast cancer, according to Canadian Cancer Statistics 2014. But doctors say when colon cancer is caught early, it’s 90 per cent treatable. There are currently two at-home tests that can detect tiny amounts of blood in stool samples when cancer is present, but they can produce many false positives.

Getting more people screened

A colonoscopy is a more accurate test, but it’s invasive, expensive and not recommended for the general population until age 50, doctors say. The cancer society says anyone with risk factors for colon cancer, such as a “first-degree” relative with the disease, should work with their doctors to develop the plan that is right for them. Li says he has first-hand understanding of the need for less invasive screening procedures. He recently turned 50, and had a colonoscopy – something that “wasn’t easy.” “If we could offer a simpler test, you’d get more people receptive to this type of screening,” he said. Both men are confident they’ll be able to find the DNA enzymes necessary to make this work. Li is in the middle of proving a similar process is possible in another study on Clostridium difficile (C. difficile). “That’s given us the confidence to think this will work,” he said.

Supporting research

Dr Siân Bevan, director of research for the Canadian Cancer Society, says the “serendipitous” collaboration of Li and Salena — they met playing golf — has allowed them to tackle an old problem in a new way.“It’s a great example of the importance of supporting innovation in cancer research,” Bevan said. “In fact, in part because of the strength of the applications, this is the largest number of Innovation Grants we’ve funded since we launched the program.”The two doctors applied for the cancer society Innovation Grant in July. So far, 51 grants totalling almost $10 million have been issued under the program. “We’re very fortunate to receive this grant,” Li said.

Salena says researchers have already studied 30 colorectal cancer patients’ stool samples, and by next summer, they should have a panel of molecules that can be tested alongside them. If the test works, there’s no reason the same system couldn’t be implemented to test other types of cancer, Salena says, like using a glowing urine sample to find prostate cancer. “We’re really going to do our best to make this happen.”

Aider l’ACCCC vous aider et lever des fonds importants. Il ne vous coûtera pas un sou. www.plaisirslaitiers.ca/consommezassez/app

Les Producteurs laitiers du Canada (PLC) ont mis au point une grande campagne de collecte de fonds pour aider l’Association canadienne du cancer colorectal, la Fondation des maladies du cœur et de l’AVC et Ostéoporose Canada. Ils ont développé une application pour promouvoir des modes de vie sains et des portions alimentaires recommandées par le Guide alimentaire canadien, tout en ayant une façon amusante de suivre ses propres habitudes alimentaires.Chaque jour que vous rentrez et sauvegardez vos portions alimentaires quotidiennes des quatre groupes alimentaires, les PLC feront un don de 1$ à l’organisme de choix. Alors s’il vous plaît, choisissez l’ACCC! Votre participation se fait en sélectionnant l’ACCC en tant que partenaire, ce qui pourrait nous permettre de gagner jusqu’à 50 000$ pour nous aider à la sensibilisation du cancer du côlon, l’éducation de la maladie et des programmes de soutien. Cette initiative est un excellent moyen de non seulement veiller à une alimentation équilibrée et saine, mais aussi pour nous aider à soutenir les milliers de Canadiens touchés par la deuxième cause de mortalité parmi les cancers dans le pays.

Alors s’il vous plaît, téléchargez l’application Consommez Assez pour les appareils Apple et Android dans la boutique d’applications et choisissez l’ACCC pour votre organisme de charité. Aidez-nous à vous aider, et ensemble, nous pouvons sauver des vies!

http://www.plaisirslaitiers.ca/consommezassez/app

HELP THE CCAC HELP YOU AND IT WONT COST YOU A PENNY! www.dairygoodness.ca/getenough/app

The Dairy Farmers of Canada (DFC) have come up with a great fundraising campaign to help the Colorectal Cancer Association of Canada, Heart & Stroke and Osteoporosis. They have developed an App to promote healthy lifestyles and healthy food portions in accordance with the Canada Food Guide, with a fun way to track your own eating habits. elEach day you input and save your daily food servings from the 4 food groups the DFC will donate $1 to the charity of choice. So please choose the CCAC! With your participation by selecting the CCAC as a partner we can earn up to $50,000 to assist us in Colon Cancer Awareness, Education and Support programs. It’s a great way not only to ensure you are eating healthy, but to help us help the thousands of Canadians touched by the second biggest cancer killer in the country.

 

So please down load the Get Enough Helper for Apple and Android apps in the App Store and choose the CCAC as your charity. Help us help you and together we can save lives!

 

http://www.dairygoodness.ca/getenough/app

Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption

Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption

Aug 04, 2014 04:23 AM EDT

Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption

Consuming Resistant Starch Reduces Risk of Colorectal Cancer From Red-Meat Consumption (Photo : Flickr)

 

A new study found that eating a type of resistant starch can help reduce the risk of colorectal cancer associated with red meat consumption.

 

Studies from around the world have suggested that high consumption of meat is linked to an increased risk of colon cancer. In all cases the worry is confined to red meat. A new study by researchers from Flinders University in Adelaide found that eating a type of resistant starch can help reduce the risk of colorectal cancer associated with red meat consumption.”Red meat and resistant starch have opposite effects on the colorectal cancer-promoting miRNAs, the miR-17-92 cluster,” said Karen J. Humphreys, a research associate at the Flinders Center for Innovation in Cancer at Flinders University, in a press release. “This finding supports consumption of resistant starch as a means of reducing the risk associated with a high red meat diet. Total meat consumption in the USA, European Union, and the developed world has continued to increase from the 1960s, and in some cases has nearly doubled.”

The study was conducted on 17 healthy males and six healthy females. All participants were aged between 50 and 75 years. They were put on a red meat or a red meat plus butyrate resistant starch diet for four weeks. After a four-week interval, the participants were made to switch diets. Researchers found that the participants that ate 300 g of lean meat daily for four weeks had a 30 percent increase in the levels of certain genetic molecules called miR-17-92 in their rectal tissue, and an associated increase in cell proliferation. However, those that ate 40 g of butyrate resistant starch per day along with red meat saw their miR-17-92 levels go down to baseline levels.

Resistant starch, unlike other starches, goes all the way through the small intestine without being digested at all. In this way, it is more like fiber, and in some cases is classified and labeled as fiber. Also, it is readily fermented by gut microbes to produce beneficial molecules called short-chain fatty acids, such as butyrate.

“Good examples of natural sources of resistant starch include bananas that are still slightly green, cooked and cooled potatoes [such as potato salad], whole grains, beans, chickpeas, and lentils. Scientists have also been working to modify grains such as maize so they contain higher levels of resistant starch,” said Humphreys.

Scientists have offered a number of explanations for the link between red meat and colon cancer. One theory blames heterocyclic amines (HCAs), chemicals produced when meat is cooked at high temperatures. HCAs may play a role, but since high levels can also be present in cooked chicken, this is unlikely to be the whole explanation. Preservatives have also been implicated in the case of processed meats; nitrates are a particular worry, since the body converts them to nitrosamines, which are carcinogenic.

Scientists from England have offered another explanation. Their investigation recruited healthy volunteers. The volunteers ate one of three test diets for a period of 15 to 21 days. The first diet contained about 14 ounces of red meat a day, always prepared to minimize HCA formation. The second diet was strictly vegetarian, and the third contained large amounts of both red meat and dietary fiber. Stool specimens from the 21 volunteers who consumed the high-meat diet contained high levels of N-nitroso compounds (NOCs), which are potentially cancer-causing chemicals. The 12 volunteers who ate vegetarian food excreted low levels of NOCs, and the 13 who ate meat and high-fiber diets produced intermediate amounts.

recent study also highlighted that consuming chilli peppers can reduce the risk of tumors associated with colorectal cancer. Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine. It is the third leading cause of cancer in males and fourth in females in the U.S. Risk factors for this disease include heredity, colon polyps, and long-standing ulcerative colitis. Most colorectal cancers develop from polyps.  Colon polyps and early cancer can have no symptoms. Therefore, regular screening is important.

The current study was published online in Cancer Prevention Research, a journal of the American Association for Cancer Research. The project was funded by the National Health and Medical Research Council of Australia, the Commonwealth Scientific and Industrial Research Organization (Preventative Health Flagship), and the Flinders Medical Center Foundation.

 

Gut Bacteria May Reveal Colon Cancer, Study Finds

Gut Bacteria May Reveal Colon Cancer, Study Finds

Test could be used in addition to current methods to better improve detection

By Robert Preidt

HealthDay Reporter

THURSDAY, Aug. 7, 2014 (HealthDay News) — Analyzing the composition of people’s collection of gut bacteria — also called the gut microbiome — can help improve identification of those who are at risk for, or already have, colon cancer, according to a new study.

Researchers collected stool samples from 30 healthy people, 30 people with precancerous intestinal polyps and 30 people with advanced colon or rectal cancerin order to assess the composition of their gut microbiomes.

 Each group had a different gut microbiome composition, according to the study published Aug. 7 in Cancer Prevention Research.

“If our results are confirmed in larger groups of people, adding gut microbiome analysis to other fecal tests may provide an improved, noninvasive way to screen for colorectal cancer,” study author Patrick Schloss, associate professor in the department of microbiology and immunology at the University of Michigan, said in a journal news release.

Adding analysis of gut microbiomes to assessment of age and race — known risk factors for precancerous polyps — led to a 4.5-fold improved prediction of precancerous polyps, the investigators found. Adding analysis of gut microbiomes to assessment of age, race and body mass index — known risk factors for invasive colorectal cancer — led to more than a fivefold improved prediction of the disease.

The researchers also found that analysis of gut microbiomes was better than fecal occult blood testing (a type of stool sample test) at distinguishing people with precancerous polyps from those with invasive cancer.

Assessing body mass index (a measurement based on height and weight), fecal occult blood test results and gut microbiomes together was even more effective at distinguishing patients with precancerous polyps from those with invasive colon and rectal cancer, the study revealed.

“Our data show that gut microbiome analysis has the potential to be a new tool to noninvasively screen for colorectal cancer,” Schloss said. “We don’t think that this would ever replace other colorectal cancer screening approaches, rather we see it as complementary.”

The Future of cancer treatment will be by genetic and molecular type. Are we ready?

Cancer should be classified by genetic and molecular type, say scientists

Friday 8 August 2014 – 3am PST
A research network in the US proposes that cancer should be classified according to genetic and molecular features rather than by the type of tissue in which the tumor arises. While more work is needed to confirm and build on findings that look set to rewrite oncology textbooks, the scientists say such a system would be better for patients because it would help tailor treatment to their individual needs.
Cancer cells
Researchers found that different types of cancerous tumors were molecularly and genetically similar, prompting them to challenge the existing system of classifying cancers.

Writing about their findings in the journal Cell, researchers from The Cancer Genome Atlas (TCGA) describe how they analyzed more than 3,500 tumors on multiple genomic technology platforms.

There have already been studies that suggestcancer should be defined by features at the genetic and molecular level. For example, Medical News Today recently reported another TCGA study that found four distinct molecular subtypes of stomach cancer.

But in this latest study – the largest genomic study of cancer – the researchers found even across tissue types (for instance, breast, bladder and kidney), what we currently regard as different cancers have tumors that are more similar at the molecular and genetic level than at the tissue level.

‘Disruptive’ study challenges existing system of classifying cancers

In explaining the impact of the findings, co-corresponding author Chris Benz, a professor at the Buck Institute for Research on Aging in Novato, CA, points out most of our tissues comprise many different types of epithelial and non-epithelial cells (epithelial cells being those that line cavities in the body and cover flat surfaces, while non-epithelial cells form other tissue types such as connective, muscle and nervous tissue), and:

“This disruptive genomic study not only challenges our existing system of classifying cancers based on tissue type, but also provides a massive new data resource for further exploration as well as a comprehensive list of the molecular features distinguishing each of the newly described cancer classes.”

He cites the example of bladder cancer, which they propose should be reclassified into several different types, each with distinct and different outcomes, to explain why patients can expect quite different results when treated with the same systemic therapy.

For the study, the scientists compared the DNA, RNA and proteins of 3,527 specimens of 12 different tumortypes by analyzing them with six different “platform technologies.” The results showed tumors were more likely to be molecularly and genetically similar based on their cell type of origin as opposed to their tissue type of origin.

One subtype of bladder cancer virtually identical to lung adenocarcinoma

For example, the study suggests there are at least three different subtypes of bladder cancer, one of which is almost identical to lung adenocarcinoma, and another that is similar to squamous cell cancers found in the head-and-neck and lungs.

The study also confirms known differences in subtypes of breast cancer but reveals a surprising finding in that basal-like breast cancers – also known as triple-negative breast cancer – are actually a class of their own. These cancers are very aggressive and more common in African-American and younger women.

Even though these basal-like cancers may arise in the breast, the study shows that at the molecular level they are more like ovarian cancers and cancers of squamous cell origin than other breast cancer subtypes.

The team says the findings suggest at least 1 in 10 cancer patients would receive a different classification of their cancer type under the new system. However, Prof. Benz believes this proportion will grow after the next round of analysis, which will look at more samples and tumor types.

He anticipates this will show over 20 types of tumor, based on classification by molecular and genetic features at the cell level:

“We’re just appreciating the tip of the iceberg when considering the potential of this multi-platform type of genomic analysis. It could be that as many as 30 or 50% of cancers need to be reclassified.”

He believes this study and future repeats will improve design of clinical trials by helping to identify patients more likely to respond to new treatments based on the genomic reclassification of their tumors. He notes:

“Although follow-up studies are needed to validate and refine this newly proposed cancer classification system, it will ultimately provide the biologic foundation for that era of personalized cancer treatment that patients and clinicians eagerly await.”

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African-Americans get their first colonoscopy at age 45, while the rest of the population remains with the 50-year benchmark

New age limit set for first colonscopy for African-Americans: Linda Rhodes

Dr. Linda Rhodes | Special to PennLiveBy Dr. Linda Rhodes | Special to PennLive 
on July 30, 2014 at 11:15 AM, updated July 30, 2014 at 11:18 AM

Q: I heard on the radio something about men and women needing to get their first colonoscopy when they turn 45 years of age rather than fifty. What’s that all about?

A: You likely didn’t catch the whole story. It’s now recommended that African-Americans get their first colonoscopy at age 45, while the rest of the population remains with the 50-year benchmark. Once both groups have graduated from their first screening, they’re to come back every ten years.

It turns out that African-Americans are being hit with colorectal cancer at a higher rate than all other races. Worse yet, they survive it less than their counterparts. According to the American Cancer Society, more than 50,000 people are expected to die this year from colorectal cancer and they are twice as likely to be African-American. Screenings could save more than half of those lives. Researchers believe that lack of access to care and preventive screenings with a subsequent delay in seeking care are partially to blame for the disparity.

Colorectal cancer is the second-ranked killer cancer in the United States among men and women (first is lung cancer). The number of new cases this past year was 136,830. It is the one cancer that can be prevented by screening, in fact, according to the American College of Gastroenterology, you can expect a 90 percent reduction in cancer risk following a colonoscopy and removal of polyps in the colon discovered during the procedure. Most colorectal cancers develop from polyps that are abnormal growths in the colon that make for a cancer-friendly environment for cancer cells to grow. If left undetected, that’s exactly what can happen.

The likelihood of developing colorectal cancer is 1 in 20 and the lifetime risk is roughly equal in men and women. Those are odds most of us can avoid by screening; yet, one in three of us (23 million) turn down the opportunity to dodge the colorectal cancer bullet.

Ever since “Today Show” newscaster Katie Couric underwent a colonoscopy on national television in March 2000, the aversion to getting the procedure has been chipped away. Most will tell you (me included) that the procedure, itself, isn’t all that bad. It’s the stuff you drink the day before to cleanse your colon – so the tiny camera can scope out polyps with a clear view – that’s the hard part. But given what’s at stake, my best advice is what my mom told me: “Quit your whining.”

For an excellent video on colonoscopy as to what to expect be sure to click here.

Most insurance plans cover preventive colonoscopies at the recommended ages and every ten years following. One other screening test that the American College of Gastroenterologist recommends to detect blood in the stool is a Fecal Immunochemical Test (FIT) that can be prescribed by a physician (there are also at-home tests you can purchase). An annual exam using FIT between colonoscopies can uncover hidden blood in the stool warranting further testing.

Early stages of colon cancer rarely produce symptoms. A dear friend of mine found this out by dutifully getting her first colonoscopy at age fifty feeling just fine. She was shocked when she was told that, indeed, she had colorectal cancer at Stage 2. Five years out, she’s doing just fine and that screening saved her life.

If you have symptoms of abdominal pain, blood in or on the stool, a change in the texture, color or shape of your stool (e.g diarrhea or black tarry stool) or a change in your typical bowel movements (e.g. constipation) be sure to see your primary care physician. It doesn’t necessarily mean it’s colorectal cancer but it does deserve a doctor’s attention.

A family history of colon cancer, inherited forms of colorectal polyps and predisposing chronic digestive diseases like Crohns or ulcerative colitis place you at higher risk for this stealthy cancer.

Since your colon does the heavy lifting digesting your food, be kind to it by eating vegetables, fruits and grains. Reduce a cancer-friendly environment in your colon by cutting down your consumption of red and processed meats. Belly fat and being over weight has been linked to a higher incidence of colorectal cancer – so exercise is definitely part of any cancer prevention plan.

Dr. Linda Rhodes is a former Secretary of Aging and author of “The Essential Guide to Caring for Aging Parents,” and can be reached at rhodescaregiving@gmail.com.