The prostate, part of the male reproductive system, is a gland located under the bladder and in front of the rectum. Prostate cancer usually begins in the gland cells and grows slowly, so many men have prostate cancer but are unaware of it. Sometimes, however, prostate cancer will grow and spread quickly. Prostate cancer is highly curable when detected and treated early.
Unfortunately, many men with prostate cancer become confused regarding the complex array of options that are available for prevention and treatment. The Prostate Cancer and Genitourinary Oncology Program at The James can help men and their families choose among the array of prostate cancer treatment options.
In addition, The James is a cutting-edge research facility where discovery is translated into more effective prevention and diagnostic strategies as well as more effective and safer treatments. Among recent research advances:
The James was one of many sites in a national study involving 18,000 men that demonstrated the ability of a hormonal agent, finasteride, to reduce the risk of prostate cancer by 25 percent. More than 250 men in Ohio and Kentucky participated through the Ohio State clinics directed by Steven K. Clinton, MD, PhD, and Robert Bahnson, MD. The study was the first in history to demonstrate that an intervention could protect men from developing prostate cancer.
The James is participating in the largest prostate cancer prevention trial to date, called SELECT (Selenium and Vitamin E Cancer Prevention Trial). The Ohio State effort, directed by J. Paul Monk, MD, and Drs. Clinton and Bahnson, will determine whether dietary supplements of vitamin E and selenium can prevent prostate cancer. The 12-year study is expected to involve more than 400 trial sites, with approximately 32,000 healthy men over the age of 55 (over 50 for African-Americans) participating.
Dr. Clinton and colleagues at the OSUCCC – James are seeking to prove whether consumption of tomato-based products and soy can reduce the risk of prostate cancer, as epidemiologic studies have suggested. These investigators are bringing dietary and nutritional studies into the clinic, where men with prostate cancer are able to participate in these important and exciting clinical trials.
Friday, April 10, 2009
Lung Cancer
Cancer of the lung, like all cancers, results from an abnormality in the body's basic unit of life, the cell. Normally, the body maintains a system of checks and balances on cell growth so that cells divide to produce new cells only when needed. Disruption of this system of checks and balances on cell growth results in an uncontrolled division and proliferation of cells that eventually forms a mass known as a tumor.
Tumors can be benign or malignant; when we speak of "cancer," we refer to those tumors that are considered malignant. Benign tumors can usually be removed and do not spread to other parts of the body. Malignant tumors, on the other hand, grow aggressively and invade other tissues of the body, allowing entry of tumor cells into the bloodstream or lymphatic system and then to other sites in the body. This process of spread is termed metastasis; the areas of tumor growth at these distant sites are called metastases. Since lung cancer tends to spread or metastasize very early in its course, it is a very life-threatening cancer and one of the most difficult cancers to treat. While lung cancer can spread to any organ in the body, certain organs -- particularly the adrenal glands, liver, brain, and bone -- are the most common sites for lung-cancer metastasis.
The lung is also a very common site for metastasis from tumors in other parts of the body. Tumor metastases are made up of the same type of cells as the original, or primary, tumor. For example, if prostate cancer spreads via the bloodstream to the lungs, it is metastatic prostate cancer in the lung and is not lung cancer.
The principal function of the lungs is the exchange of gases between the air we breathe and the blood. Through the lung, carbon dioxide is removed from the bloodstream and oxygen from inspired air enters the bloodstream. The right lung has three lobes, while the left lung is divided into two lobes and a small structure called the lingula that is the equivalent of the middle lobe. The major airways entering the lungs are the bronchi, which arise from the trachea. The bronchi branch into progressively smaller airways called bronchioles that end in tiny sacs known as alveoli where gas exchange occurs. The lungs and chest wall are covered with a thin layer of tissue called the pleura.
Lung cancers can arise in any part of the lung, but 90%-95% of cancers of the lung are thought to arise from the epithelial, or lining cells of the larger and smaller airways (bronchi and bronchioles); for this reason, lung cancers are sometimes called bronchogenic carcinomas or bronchogenic cancers. Cancers can also arise from the pleura (the thin layer of tissue that surrounds the lungs), called mesotheliomas, or rarely from supporting tissues within the lungs, for example, blood vessels.
Pancreatic Cancer
The pancreas is an organ in the upper abdomen located beneath the stomach and adjacent to the first portion of the small intestine, called the duodenum. The pancreas is composed of glands that are responsible for a wide variety of tasks. The glandular functions of the pancreas can be divided into the following 2 categories:
Exocrine: The exocrine glands secrete enzymes into ducts that eventually empty into the duodenum. These enzymes then help in the digestion of food as it moves through the intestines.
Endocrine: The endocrine glands secrete hormones, including insulin, into the bloodstream. Insulin is carried by the blood throughout the rest of the body to assist in the process of using sugar as an energy source. Insulin also controls the levels of sugar in the blood.
The pancreas can be divided into the following 4 anatomical sections:
Head - The rightmost portion that lies adjacent to the duodenum
Uncinate process - An extension of the head of the pancreas
Body - The middle portion of the pancreas
Tail - The leftmost portion of the pancreas that lies adjacent to the spleen
Intraductal papillary mucinous neoplasia (IPMN) is a type of pancreatic cancer that is beginning to be recognized more frequently. This pancreatic cancer has a better prognosis than other types of pancreatic cancer. Intraductal papillary mucinous neoplasia is usually diagnosed endoscopically (see Exams and Tests).
The most common type of pancreatic cancer arises from the exocrine glands and is called adenocarcinoma of the pancreas. The endocrine glands of the pancreas can give rise to a completely different type of cancer, referred to as pancreatic neuroendocrine carcinoma or islet cell tumor. This article only discusses issues related to the more common type of pancreatic adenocarcinoma.Pancreatic adenocarcinoma is among the most aggressive of all cancers. By the time that pancreatic cancer is diagnosed, most people already have disease that has spread to distant sites in the body. Pancreatic cancer is also relatively resistant to medical treatment, and the only potentially curative treatment is surgery. In 2004, approximately 31,800 people in the United States were diagnosed with pancreatic cancer, and approximately 31,200 people died of this disease. These numbers reflect the challenge in treating pancreatic cancer and the relative lack of curative options.
Exocrine: The exocrine glands secrete enzymes into ducts that eventually empty into the duodenum. These enzymes then help in the digestion of food as it moves through the intestines.
Endocrine: The endocrine glands secrete hormones, including insulin, into the bloodstream. Insulin is carried by the blood throughout the rest of the body to assist in the process of using sugar as an energy source. Insulin also controls the levels of sugar in the blood.
The pancreas can be divided into the following 4 anatomical sections:
Head - The rightmost portion that lies adjacent to the duodenum
Uncinate process - An extension of the head of the pancreas
Body - The middle portion of the pancreas
Tail - The leftmost portion of the pancreas that lies adjacent to the spleen
Intraductal papillary mucinous neoplasia (IPMN) is a type of pancreatic cancer that is beginning to be recognized more frequently. This pancreatic cancer has a better prognosis than other types of pancreatic cancer. Intraductal papillary mucinous neoplasia is usually diagnosed endoscopically (see Exams and Tests).
The most common type of pancreatic cancer arises from the exocrine glands and is called adenocarcinoma of the pancreas. The endocrine glands of the pancreas can give rise to a completely different type of cancer, referred to as pancreatic neuroendocrine carcinoma or islet cell tumor. This article only discusses issues related to the more common type of pancreatic adenocarcinoma.Pancreatic adenocarcinoma is among the most aggressive of all cancers. By the time that pancreatic cancer is diagnosed, most people already have disease that has spread to distant sites in the body. Pancreatic cancer is also relatively resistant to medical treatment, and the only potentially curative treatment is surgery. In 2004, approximately 31,800 people in the United States were diagnosed with pancreatic cancer, and approximately 31,200 people died of this disease. These numbers reflect the challenge in treating pancreatic cancer and the relative lack of curative options.
Thursday, April 2, 2009
Brain Awareness Week 2009
Earlier this week members of the Galway Neuroscience Group reported their experience of holding a public event as part of global 'Brain Awareness Week'. Supported financially by the Dana Foundation, BAW is a multi-national effort aimed at making as many people as possible interested in their own brains. Activities include visits to schools by neuroscientists, or information dissemination by various neurological organisations like Neurology Alliance Ireland, Dystonia Ireland, the Dublin Brain Bank and MS Ireland. Galway neuroscientists chose 'The beauty of neuroscience' as their theme, displaying beautiful prints of cells and tissue gnerated during the course of their own research activities. Poster stands and a microscope with sample tissue and cells for viewing, were set up at the Eyre Square Shopping centre on March 19th and 20th. A separate table dedicated to interactive questionairs and brain colouring booklets for children was also a feature. For more information about the activities of the Galway Neuroscience Group, go to http://www.ncbes.ie/research/NeuroscienceOverview.htm
Biomedical technology and Silicon Valley
On Thursday, Jan 31st, I attended a seminar on Biomedical Technology hosted by Silicon Valley Technical Institute. The instructor was Dr. Sudhi Gautam, an ex-ENT surgeon with a PhD in Engineering from the Indian Institute of Technology. For a layman in biomedical technology like me, it was an eye-opener. Overall, a most excellent introduction to biomedical technology.
To begin with, I did not know the difference between biotechnology and biomedical engineering (not to be confused with bioengineering). It turns out that biotechnology is best defined as the technology concerned with manipulation of living cells and is most related to biology. Biomedical engineering is at the convergence of technology, medicine and biology and is focused on developing medical devices and systems. Bioengineering is concerned with modification animal and plant cells by manipulating their genetic and cellular properties. So similar sounding names, with very different meanings. Furthermore, the regulatory approval process in the United States is dramatically different for biotechnology compared to biomedical devices.
Biomedical devices are classified based on their level of risk application and impact, and in the low risk devices can be approved anywhere from 90 days to 3 years. Biotechnology applications, especially where they have therapeutic applications go through the same cycle of approvals and clinical trial as pharmaceutical drugs and can generally take anywhere from 4 to 7 years or more to get approved. Some of the higher risk biomedical devices like pacemakers and robotic surgery machines like those from Intuitive Surgical can also take as long to be approved by the US regulatory bodies.
Where it gets very interesting is in that biomedical engineering, because of its intersection between engineering and medicine, has a great deal of relevance to Silicon Valley. Even with all the advances in medicine today, the gap between medicine and technology outside of medicine is huge. This makes the health care system very inefficient. This triggers the opportunity, which is so characteristic of others, which Silicon Valley exploits best, with its mix of capital, technology and entrepreneurship. California has close to 2600 biomedical companies, with over 700 in the Bay Area alone. Silicon Valley appears to be the biggest hub for biomedical technology, followed by Orange County, Minneapolis and the Northeastern US. Many of the Bay Area companies are spinoffs from Stanford, UC Berkeley and UCSF. The estimate is that 50% of the world’s biotech and biomedical companies are in the US and a very high percentage of them are in California. US biomedical devices are valued worldwide due to the rigorous approval process and quality requirements they are subjected to. These devices require a significant amount of engineering design and and in many cases have significant semiconductor content. Where the devices are endorsed by Medicare or the insurance companies for use by their patients, the volume can also be considerable at pretty good margins.
The latest biomedical device company in the news is Intuitive Surgical (mentioned earlier) of Sunnyvale, CA. They make the robotic surgery machines, called the da Vinci surgical system. These are approved only for three or four types of surgical procedures in the US (they are seeking approval for more types of procedures), but are still in hot demand in India and other countries. The latest rumor is that their machines have been approved for hysterectomies by the US regulatory bodies. This may account for the fact that their stock (ISRG) surged over 17% on Friday, February 2nd alone and is up close to 50% in less than a month.
So, following semiconductors, computers, the Internet, the iPod and iPhone, we have a lineup of alternative energy, biotech and biomedical products to supply the world. These are exciting times indeed for Silicon Valley.
To begin with, I did not know the difference between biotechnology and biomedical engineering (not to be confused with bioengineering). It turns out that biotechnology is best defined as the technology concerned with manipulation of living cells and is most related to biology. Biomedical engineering is at the convergence of technology, medicine and biology and is focused on developing medical devices and systems. Bioengineering is concerned with modification animal and plant cells by manipulating their genetic and cellular properties. So similar sounding names, with very different meanings. Furthermore, the regulatory approval process in the United States is dramatically different for biotechnology compared to biomedical devices.
Biomedical devices are classified based on their level of risk application and impact, and in the low risk devices can be approved anywhere from 90 days to 3 years. Biotechnology applications, especially where they have therapeutic applications go through the same cycle of approvals and clinical trial as pharmaceutical drugs and can generally take anywhere from 4 to 7 years or more to get approved. Some of the higher risk biomedical devices like pacemakers and robotic surgery machines like those from Intuitive Surgical can also take as long to be approved by the US regulatory bodies.
Where it gets very interesting is in that biomedical engineering, because of its intersection between engineering and medicine, has a great deal of relevance to Silicon Valley. Even with all the advances in medicine today, the gap between medicine and technology outside of medicine is huge. This makes the health care system very inefficient. This triggers the opportunity, which is so characteristic of others, which Silicon Valley exploits best, with its mix of capital, technology and entrepreneurship. California has close to 2600 biomedical companies, with over 700 in the Bay Area alone. Silicon Valley appears to be the biggest hub for biomedical technology, followed by Orange County, Minneapolis and the Northeastern US. Many of the Bay Area companies are spinoffs from Stanford, UC Berkeley and UCSF. The estimate is that 50% of the world’s biotech and biomedical companies are in the US and a very high percentage of them are in California. US biomedical devices are valued worldwide due to the rigorous approval process and quality requirements they are subjected to. These devices require a significant amount of engineering design and and in many cases have significant semiconductor content. Where the devices are endorsed by Medicare or the insurance companies for use by their patients, the volume can also be considerable at pretty good margins.
The latest biomedical device company in the news is Intuitive Surgical (mentioned earlier) of Sunnyvale, CA. They make the robotic surgery machines, called the da Vinci surgical system. These are approved only for three or four types of surgical procedures in the US (they are seeking approval for more types of procedures), but are still in hot demand in India and other countries. The latest rumor is that their machines have been approved for hysterectomies by the US regulatory bodies. This may account for the fact that their stock (ISRG) surged over 17% on Friday, February 2nd alone and is up close to 50% in less than a month.
So, following semiconductors, computers, the Internet, the iPod and iPhone, we have a lineup of alternative energy, biotech and biomedical products to supply the world. These are exciting times indeed for Silicon Valley.
Wednesday, April 1, 2009
Cancer symptoms n detection
Abnormal sensations or conditions that persons can notice that are a result of a cancer. It is important to see your doctor for regular checkups and not wait for problems to occur. But you should also know that the following symptoms may be associated with cancer: changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, thickening or lump in the breast or any other part of the body, indigestion or difficulty swallowing, obvious change in a wart or mole, or nagging cough or hoarseness. These symptoms are not always a sign of cancer. They can also be caused by less serious conditions. Only a doctor can make a diagnosis. It is important to see a doctor if you have any of these symptoms. Don't wait to feel pain. Early cancer often does not cause pain.
Cancer detection:
Methods used to find cancer in persons who may or may not have symptoms. Symptoms of cancer are abnormal sensations or conditions that persons can notice that are a result of the cancer. It is important to your doctor for regular checkups and not wait for problems to occur. But you should also know that the following symptoms may be associated with cancer: changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, thickening or lump in the breast or any other part of the body, indigestion or difficulty swallowing, obvious change in a wart or mole, or nagging cough or hoarseness. These symptoms are not always a sign of cancer. They can also be caused by less serious conditions. Only a doctor can make a diagnosis. It is important to see a doctor if you have any of these symptoms. Don't wait to feel pain. Early cancer often does not cause pain.
Cancer detection:
Methods used to find cancer in persons who may or may not have symptoms. Symptoms of cancer are abnormal sensations or conditions that persons can notice that are a result of the cancer. It is important to your doctor for regular checkups and not wait for problems to occur. But you should also know that the following symptoms may be associated with cancer: changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, thickening or lump in the breast or any other part of the body, indigestion or difficulty swallowing, obvious change in a wart or mole, or nagging cough or hoarseness. These symptoms are not always a sign of cancer. They can also be caused by less serious conditions. Only a doctor can make a diagnosis. It is important to see a doctor if you have any of these symptoms. Don't wait to feel pain. Early cancer often does not cause pain.
Cancer registry
A register designed to collect information about the occurrence (incidence) of cancer, the types of cancers that occur and their locations within the body, the extent of cancer at the time of diagnosis (disease stage), and the kinds of treatment that patients receive. In the US, these data are reported to a central statewide registry from various medical facilities, including hospitals, physicians' offices, therapeutic radiation facilities, freestanding surgical centers, and pathology laboratories.
Data collected by state cancer registries enable public health professionals to better understand and address the cancer burden. Registry data are critical for targeting programs focused on risk-related behaviors (eg, tobacco use and exposure to the sun) or on environmental risk factors (eg, radiation and chemical exposures). Such information is also essential for identifying when and where cancer screening efforts should be enhanced and for monitoring the treatment provided to cancer patients. In addition, reliable registry data are fundamental to a variety of research efforts, including those aimed at evaluating the effectiveness of cancer prevention, control, or treatment programs.
State cancer registries in the US and comparable cancer registries in all countries are designed to:
Monitor cancer trends over time.
Determine cancer patterns in various populations.
Guide planning and evaluation of cancer control programs (eg, determine whether prevention, screening, and treatment efforts are making a difference).
Help set priorities for allocating health resources.
Advance clinical, epidemiologic, and health services research.
Provide information for a national database of cancer incidence.
In the US, the Centers for Disease Control and Prevention (CDC) has administered the National Program of Cancer Registries (NPCR) since 1994. This program is currently helping states and U.S. territories to:
Improve their cancer registries.
Meet standards for data completeness, timeliness, and quality.
Use cancer data to support cancer prevention and control programs.
Train registry personnel.
Establish computerized reporting and data-processing systems.
Develop laws and regulations that strengthen registry operations.
Before the NPCR was established, 10 states in the US had no cancer registry and most states with registries lacked the resources and legislative support needed to gather complete data. With fiscal year 2002 funding of approximately $40 million, CDC's NPCR supported central registries and promoted the use of registry data in 45 states, the District of Columbia, and the territories of Puerto Rico, the Republic of Palau, and the Virgin Islands. CDC also developed special research projects such as studies to examine patterns of cancer care in specific populations. CDC's goal is for all states to maintain registries that provide high-quality data on cancer and cancer care.
NPCR complements NCI's Surveillance, Epidemiology, and End Results (SEER) registry program. Together, NPCR and the SEER program collect cancer data for the entire U.S. population. The SEER program gathers in-depth data on cancer cases diagnosed in Connecticut, Hawaii, Iowa, New Mexico, and Utah, as well as in six metropolitan areas and several rural/special population areas. The six metropolitan SEER registries and some of the rural/special population registries submit data to NPCR's state registries. In 2001, SEER began providing additional support to four NPCR-supported state registries (California, Kentucky, Louisiana, and New Jersey).
A cancer registry operated on the state level in the United States. Data collected by state cancer registries enable public health professionals to better understand and address the cancer burden. Registry data are critical for targeting programs focused on risk-related behaviors (eg, tobacco use and exposure to the sun) or on environmental risk factors (eg, radiation and chemical exposures). Such information is also essential for identifying when and where cancer screening efforts should be enhanced and for monitoring the treatment provided to cancer patients. In addition, reliable registry data are fundamental to a variety of research efforts, including those aimed at evaluating the effectiveness of cancer prevention, control, or treatment programs.
State cancer registries in the US and comparable cancer registries in all countries are designed to:
Monitor cancer trends over time.
Determine cancer patterns in various populations.
Guide planning and evaluation of cancer control programs (eg, determine whether prevention, screening, and treatment efforts are making a difference).
Help set priorities for allocating health resources.
Advance clinical, epidemiologic, and health services research.
Provide information for a national database of cancer incidence.
Data collected by state cancer registries enable public health professionals to better understand and address the cancer burden. Registry data are critical for targeting programs focused on risk-related behaviors (eg, tobacco use and exposure to the sun) or on environmental risk factors (eg, radiation and chemical exposures). Such information is also essential for identifying when and where cancer screening efforts should be enhanced and for monitoring the treatment provided to cancer patients. In addition, reliable registry data are fundamental to a variety of research efforts, including those aimed at evaluating the effectiveness of cancer prevention, control, or treatment programs.
State cancer registries in the US and comparable cancer registries in all countries are designed to:
Monitor cancer trends over time.
Determine cancer patterns in various populations.
Guide planning and evaluation of cancer control programs (eg, determine whether prevention, screening, and treatment efforts are making a difference).
Help set priorities for allocating health resources.
Advance clinical, epidemiologic, and health services research.
Provide information for a national database of cancer incidence.
In the US, the Centers for Disease Control and Prevention (CDC) has administered the National Program of Cancer Registries (NPCR) since 1994. This program is currently helping states and U.S. territories to:
Improve their cancer registries.
Meet standards for data completeness, timeliness, and quality.
Use cancer data to support cancer prevention and control programs.
Train registry personnel.
Establish computerized reporting and data-processing systems.
Develop laws and regulations that strengthen registry operations.
Before the NPCR was established, 10 states in the US had no cancer registry and most states with registries lacked the resources and legislative support needed to gather complete data. With fiscal year 2002 funding of approximately $40 million, CDC's NPCR supported central registries and promoted the use of registry data in 45 states, the District of Columbia, and the territories of Puerto Rico, the Republic of Palau, and the Virgin Islands. CDC also developed special research projects such as studies to examine patterns of cancer care in specific populations. CDC's goal is for all states to maintain registries that provide high-quality data on cancer and cancer care.
NPCR complements NCI's Surveillance, Epidemiology, and End Results (SEER) registry program. Together, NPCR and the SEER program collect cancer data for the entire U.S. population. The SEER program gathers in-depth data on cancer cases diagnosed in Connecticut, Hawaii, Iowa, New Mexico, and Utah, as well as in six metropolitan areas and several rural/special population areas. The six metropolitan SEER registries and some of the rural/special population registries submit data to NPCR's state registries. In 2001, SEER began providing additional support to four NPCR-supported state registries (California, Kentucky, Louisiana, and New Jersey).
A cancer registry operated on the state level in the United States. Data collected by state cancer registries enable public health professionals to better understand and address the cancer burden. Registry data are critical for targeting programs focused on risk-related behaviors (eg, tobacco use and exposure to the sun) or on environmental risk factors (eg, radiation and chemical exposures). Such information is also essential for identifying when and where cancer screening efforts should be enhanced and for monitoring the treatment provided to cancer patients. In addition, reliable registry data are fundamental to a variety of research efforts, including those aimed at evaluating the effectiveness of cancer prevention, control, or treatment programs.
State cancer registries in the US and comparable cancer registries in all countries are designed to:
Monitor cancer trends over time.
Determine cancer patterns in various populations.
Guide planning and evaluation of cancer control programs (eg, determine whether prevention, screening, and treatment efforts are making a difference).
Help set priorities for allocating health resources.
Advance clinical, epidemiologic, and health services research.
Provide information for a national database of cancer incidence.
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