Certain Cancer Drugs May Have Fatal Side Effects: Analysis

MONDAY, Feb. 6 (HealthDay News) -- Treatment with three relatively new cancer drugs may be linked to a slightly increased risk of death, a new analysis suggests.

While the risk is low, it should be taken into account by doctors and patients, according to Dana-Farber Cancer Institute scientists and colleagues.

The investigators analyzed the findings of 10 clinical trials that included nearly 4,700 patients treated with sorafenib (Nexavar) for kidney and liver cancer; sunitinib (Sutent) for kidney cancer and gastrointestinal stromal tumor; or pazopanib (Votrient) for kidney cancer.

These so-called "targeted" drugs are used to stop the growth or spread of cancer by blocking the vascular endothelial growth factor tyrosine kinase receptors in cancer cells, the researchers explained in a Dana-Farber news release.

The analysis of the clinical trials revealed that the incidence of fatal complications was 1.5 percent in patients who received any of the three drugs, compared with 0.7 percent in patients who received standard treatments or placebos.

Bleeding, heart attack and heart failure were the most common fatal side effects noted in the clinical trials. In addition, liver failure was also reported, according to the report published in the Feb. 6 edition of the Journal of Clinical Oncology.

"There is no doubt for the average patient, these drugs have benefits and are [U.S. Food and Drug Administration]-approved for these indications," study leader Dr. Toni Choueiri said in the news release. "While the absolute incidence of these fatal side effects is very small, the relative risks are higher and patients and practitioners need to be aware of it."

More information

The U.S. National Cancer Institute has more about targeted cancer therapies.

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Cancer survivors line up as opponents in Super Bowl

INDIANAPOLIS (Reuters) - There can only be one winner in Sunday's Super Bowl but for two opposing players, a bigger battle has already been won, victory over cancer.

New York Giants linebacker Mark Herzlich and New England Patriots offensive lineman Marcus Cannon have both had to deal with life-threatening illness and came through their treatment to achieve their sporting dream, a place in the biggest game in American sport.

After an outstanding season for Boston College, Herzlich was diagnosed, in May 2009, with Ewing's sarcoma, a rare form of cancer affecting bone and soft tissue.

He underwent a six month course of chemotherapy and radiation and also needed surgery and a titanium rod inserted into his leg, which remains in place to strengthen his bone.

The linebacker said his aim of making it in the National Football League (NFL) motivated him through the arduous treatment.

"Playing football again was the goal and that really pushed me. After six hours of chemotherapy you're sitting there and your body just feels drained," he said.

"You don't want to move but I said 'I am going to be playing football again in eight months, so I need to go and workout. I need to go ride a bike, get some cardio in."

Herzlich said he made a highlights video of his 2008 season to keep him motivated.

"I would put that on in the chemo room and watch it over and over again just to see myself succeeding," he said.

"The physical pain was intense. The pain that I would get in my leg and my lower back felt like knives being stabbed into my legs. The pain coming after the surgery where I had to get the scar tissue kind of kneaded out with massage and stuff.

"That was probably the worst pain I have ever been in because they had to actually tear the muscle off the bone and tear the scar tissue away. I was screaming on the massage table," said Herzlich.

Cannon's treatment for non-Hodgkins lymphoma was less painful but going through chemotherapy inevitably weakened him.

"I still had faith I was going to get into the NFL, I didn't know if I was going to get drafted or not but I still believed I would play in the league," he told Reuters.

"I was blessed not to get all the side effects that so many other people get."

Cannon entered the draft but his illness pushed him down the list. Nonetheless the Patriots took him in round five with the 138th pick.

After missing training camp and the early part of the season due to his treatment, Cannon was finally activated in week ten of the season and was part of the team which beat the Baltimore Ravens in the AFC Conference game two weeks ago to secure a Super Bowl spot.

"The confetti was coming down and I'm sat there thinking how am I supposed to feel? It's hard to take all of this in," he said.

Herzlich returned to college football in 2010 but went undrafted and his only contract offer came from the minor UFL league, a chance he turned down to keep alive his dream of reaching the NFL.

The Giants picked him up as an undrafted free agent in July and he featured in 11 games this season.

Herzlich says his doctors played a perfect game but knows he has won one of the toughest challenges anyone can face.

"I think it is a little bit of a miracle. It's a case of beating the odds," he said.

(Editing by Julian Linden)

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Soy Supplements May Not Shield Against Breast Cancer

FRIDAY, Feb. 3 (HealthDay News) -- Soy supplements do not protect women against breast cancer, a new study suggests.

The findings are consistent with the results of previous studies that examined the cancer prevention benefits of the dietary supplements, said lead researcher Dr. Seema Khan, a professor of surgery at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

The study included 98 women who were randomly assigned to receive a mixed soy isoflavones supplement or placebo. Isoflavones are components of soy foods thought to have anti-estrogen activity (estrogen is "fuel" for many breast cancers).

After six months, the researchers examined levels of Ki-67 -- a protein marker of cancer cell growth -- in certain breast cancer cells taken from the women. Overall, there were no differences in Ki-67 levels between women who took the soy supplement and those who took the placebo.

However, the level of Ki-67 increased from 1.71 to 2.18 in premenopausal women taking the soy supplement, which suggests the supplement might even have a negative effect, according to the study published in February issue of the journal Cancer Prevention Research.

"This was a small finding," Khan stressed in a news release from the American Association for Cancer Research, "but one that should suggest caution."

"Simply put, supplements are not food. Although soy-based foods appear to have a protective effect, we are not seeing the same effect with supplementation using isolated components of soy, so the continued testing of soy supplements is likely not worthwhile," Kahn concluded.

But one expert said the study, while valuable, had limitations.

Dr. Patrick Borgen, director of Breast Cancer Care Services at the Maimonides Cancer Center in New York City, called the study "thought provoking and well-executed."

But he added that uncertainties remain. For example, the area of the breast from which the cells were taken and studied matters, because cancer develops in different ways across the geography of the breast. Furthermore, other potential risk factors, such as diet, exercise, alcohol intake and stress, could play a role in the women's breast cancer risk as well and "are extremely hard to control for in this kind of study," Borgen said.

Finally, Borgen said, it is still difficult to predict the "long-term consequences" of the cell changes captured by Ki-67 testing.

For all of those reasons, "the conclusions -- that further study may not be warranted or that use of these supplements in premenopausal women may be dangerous -- should therefore be taken in the context of the limitations of the study," Borgen said.

More information

The U.S. National Library of Medicine has more about soy.

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Breast Cancer Drug May Weaken Bones, Study Finds

TUESDAY, Feb. 7 (HealthDay News) -- A drug used to prevent breast cancer in women at high risk for the disease appears to cause bone loss in some postmenopausal women, a new study finds.

The drug, Aromasin (exemestane), has been shown to reduce the odds of breast cancer by 65 percent, but it also worsens bone density by about three times in older women who are taking it, Canadian researchers report.

"The drug did affect bone density at the hip and spine," said lead researcher Dr. Angela Cheung, a senior scientist at the University Health Network in Toronto. "It does not affect everyone; about 65 percent of women have some bone loss."

The fear of bone loss is not a reason not to take the drug, Cheung said. "You really need to pay attention to your bone health when you take this medication, especially for preventing breast cancer."

However, for women who are at high risk for fractures, other drugs should be considered, she added.

Women taking this drug should also be taking calcium and vitamin D supplements, and having their bone density monitored, Cheung said.

An older drug, tamoxifen, actually builds bone, but it is not as effective at preventing breast cancer, she said. "But, for someone with healthy bones it is worthwhile taking the medication."

Exemestane is an aromatase inhibitor and works by suppressing the female hormone estrogen. These drugs are standard treatment for postmenopausal women with early stage hormone-receptor-positive breast cancer.

It had been speculated that exemestane, a third-generation aromatase inhibitor, might result in less bone loss than other similar drugs and might even stimulate bone formation.

For the new study, Cheung's team looked at bone loss among the more than 4,500 women who took part in a trial that compared exemestane with a placebo.

Among women taking the drug, the risk of developing breast cancer was lowered 65 percent, compared with women taking a placebo.

Among the 351 women in whom bone loss was studied, the researchers found that after two years there was an 8 percent loss of cortical bone in women taking exemestane, compared with 1 percent in the placebo group.

Cortical bone is the outer shell of bone that provides most of the bone support, and its loss accounts for about 80 percent of fractures in older people, the researchers noted.

The findings were published in the Feb. 6 online edition of The Lancet Oncology.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, was somewhat cautious about the new research. She said that "the study needs longer follow-up to see if there is an increased risk of fracture."

"This study doesn't mean that we should stop using these drugs," she said. "We certainly rely on aromatase inhibitors more than tamoxifen in postmenopausal women, because the survival benefit has been proven."

The benefit of the drug outweighs that risk for most women, she said. However, if there is a family history of osteoporosis it may not be the best choice, Bernik said.

More information

For more on breast cancer, visit the American Cancer Society.

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Booze and Family History of Colon Cancer a Bad Mix: Study

FRIDAY, Feb. 3 (HealthDay News) -- People who consume a few alcoholic drinks a day and have a family history of colorectal cancer are at increased risk for developing colon cancer, new research suggests.

For the study, researchers in Boston examined data from more than 87,000 women in the Nurses' Health Study and 47,000 men in the Health Professionals Follow-up Study, and found that 1,801 cases of colon cancer were diagnosed among the participants from 1980 onward.

People with a family history of colorectal cancer who drank an average of 30 or more grams of alcohol per day (about 2.5 typical drinks in the United States) were at increased risk for colon cancer, according to lead author Eunyoung Cho, of the Channing Laboratory, department of medicine at Brigham and Women's Hospital and Harvard Medical School, and colleagues.

Those at greatest risk also ate the most red meat, smoked more and consumed the least folate, which suggests they ate fewer green vegetables and cereal. The findings indicate that other lifestyle factors, such as diet, play an important role in colon cancer risk, the researchers said.

Although the study uncovered an association between these factors and colon cancer risk, it did not prove a cause-and-effect relationship.

Among people who did not have a family history of colorectal cancer, no significant association was found between alcohol consumption and colon cancer. Greater alcohol intake was not associated with a consistent increase in cancer risk, the authors noted in a news release from Boston University Medical Center.

The study was published in the February issue of the American Journal of Clinical Nutrition.

More information

The American Cancer Society has more about colorectal cancer.

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