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Monday, August 15, 2016

DNA Determine Cancer

What is genetic testing?

Genetic testing looks for specific inherited changes (mutations) in a person’s chromosomes, genes, or proteins. Genetic mutations can have harmful, beneficial, neutral (no effect), or uncertain effects on health. Mutations that are harmful may increase a person’s chance, or risk, of developing a disease such as cancer. Overall, inherited mutations are thought to play a role in about 5 to 10 percent of all cancers.
Cancer can sometimes appear to “run in families” even if it is not caused by an inherited mutation. For example, a shared environment or lifestyle, such as tobacco use, can cause similar cancers to develop among family members. However, certain patterns—such as the types of cancer that develop, other non-cancer conditions that are seen, and the ages at which cancer typically develops—may suggest the presence of a hereditary cancer syndrome.
The genetic mutations that cause many of the known hereditary cancer syndromes have been identified, and genetic testing can confirm whether a condition is, indeed, the result of an inherited syndrome. Genetic testing is also done to determine whether family members without obvious illness have inherited the same mutation as a family member who is known to carry a cancer-associated mutation.

Inherited genetic mutations can increase a person’s risk of developing cancer through a variety of mechanisms, depending on the function of the gene. Mutations in genes that control cell growth and the repair of damaged DNA are particularly likely to be associated with increased cancer risk.
Genetic testing of tumor samples can also be performed, but this Fact Sheet does not cover such testing.

Does someone who inherits a cancer-predisposing mutation always get cancer?

No. Even if a cancer-predisposing mutation is present in a family, it does not necessarily mean that everyone who inherits the mutation will develop cancer. Several factors influence the outcome in a given person with the mutation.
One factor is the pattern of inheritance of the cancer syndrome. To understand how hereditary cancer syndromes may be inherited, it is helpful to keep in mind that every person has two copies of most genes, with one copy inherited from each parent. Most mutations involved in hereditary cancer syndromes are inherited in one of two main patterns: autosomal dominant and autosomal recessive.
With autosomal dominant inheritance, a single altered copy of the gene is enough to increase a person’s chances of developing cancer. In this case, the parent from whom the mutation was inherited may also show the effects of the gene mutation. The parent may also be referred to as a carrier.
With autosomal recessive inheritance, a person has an increased risk of cancer only if he or she inherits a mutant (altered) copy of the gene from each parent. The parents, who each carry one copy of the altered gene along with a normal (unaltered) copy, do not usually have an increased risk of cancer themselves. However, because they can pass the altered gene to their children, they are called carriers.
A third form of inheritance of cancer-predisposing mutations is X-linked recessive inheritance. Males have a single X chromosome, which they inherit from their mothers, and females have two X chromosomes (one from each parent). A female with a recessive cancer-predisposing mutation on one of her X chromosomes and a normal copy of the gene on her other X chromosome is a carrier but will not have an increased risk of cancer. Her sons, however, will have only the altered copy of the gene and will therefore have an increased risk of cancer.
Even when people have one copy of a dominant cancer-predisposing mutation, two copies of a recessive mutation, or, for males, one copy of an X-linked recessive mutation, they may not develop cancer. Some mutations are “incompletely penetrant,” which means that only some people will show the effects of these mutations. Mutations can also “vary in their expressivity,” which means that the severity of the symptoms may vary from person to person.

Cat allergy

Cat allergy is often developed in childhood and implies an overreaction of the immune system to proteins secreted from the cat's urine, saliva, sebaceous gland and paw pads. Scientists are still not sure about why some people develop cat allergy and others don't, but most likely it has to do with a combination of environment and heredity. Some people may be allergic to cats for a long time without knowing it.

All cats release allergens, which are the irritating substances, so if you are allergic it is best to avoid contact with cats as far as it is possible. Avoiding cats all together might be hard and since the allergenic substances easily stick to clothes The allergen could travel and spread far beyond the home where the cat lives. If you are allergic to cats it will be good to know that there are medicines that can ease the symptoms on a short term basis, and also immunotherapy - vaccine treatment - which takes years.

Cat allergy symptoms

The cat allergens travel easily by air and will cause problems as they stick to the mucous membranes of your eyes, nose, skin or lungs. The symptoms of cat allergy are the same as that of dog allergy and other pet allergies:

Are there hypoallergenic cats?

Unfortunately there are no pets, which are completely free from allergens. On top of that, the allergen carried by cats is quite strong. For example, we run a 50% higher risk of developing a pet allergy from cats than from dogs. How strongly you react differs a lot between individuals and there are examples of allergic individuals who feel they tolerate some cats better than others.
Siberian cat, Ragdoll and Rex cat are some cat breeds that are sometimes said to be less allergenic than others. Although in general it is not possible to recommend a specific breed to someone suffering from allergy since the allergen levels may differ greatly also within the breed. If you are allergic but still insist on getting a cat, it is best to "test" individual cats. Some race cat societies offer contact with so called "testing homes" where allergic people can meet with different cats to see if they get an allergic reaction from them before going out to get one of their own. The general advice is to avoid getting a cat if you know you are allergic.   

Treating cat allergy

If you are allergic to cats you should avoid owning one. If you already have a cat at home you should discuss your options with a doctor. Should you choose to live with at cat in spite of your allergy there are some things you can do on your own in order to ease your problems:
  • Clean your house thoroughly and use a filtered air cleaner
  • Don't let the cat enter your bedroom or other rooms where you spend a lot of time
  • Clean your hands often and avoid touching your eyes
  • Try not to touch carpets, curtains or furniture textiles
  • Brush and bathe the cat on a regular basis
There are also medicines to cat allergies, which can prevent and alleviate symptoms but they do not cure the actual allergy.  Mild problems can be treated with over-the-counter antihistamine tablets and eye drops. If the allergy is causing nasal congestion, a nasal spray containing corticosteroid may be an option. Common cold sprays, however, do not work on allergies. They may, on the contrary, increase the symptoms. If you are not fully helped by over-the-counter medicines you should contact your doctor who can look over your treatment and also prescribe some medicines that are more effective than the ones you can get over-the-counter. It is important that you contact your doctor if you are not sure of what is causing your problems, or if your symptoms are similar to asthma. The doctor will then be able to do a full allergy examination and adjust your treatment.

Some people experience severe problems from their cat allergy despite taking their medicine and trying to prevent the problems. In such cases immunotherapy, or vaccine therapy, may be an option for treating the cat allergy. Such treatment implies regular visits to a specialised allergy clinic to receive shots containing small doses of the allergen. The dosage will gradually be increased as the body is getting used to the allergy provoking substance. The treatment may take up to five years to complete, which is something that's important to consider if you choose to start it.  

What is penile cancer?

Penile cancer develops in or on the penis. Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas in the body. To learn more about how cancers start and spread, see What Is Cancer?
To understand penile cancer, it helps to know about the normal structure and function of the penis.

About the penis

The penis is the external male sexual organ, as well as part of the urinary system. It has several types of body tissues, including skin, nerves, smooth muscle, and blood vessels.

The main part of the penis is known as the shaft, and the head of the penis is called the glans. At birth, the glans is covered by a piece of skin called the foreskin, or prepuce. The foreskin is often removed in infant boys in an operation called a circumcision.
Inside the penis are 3 chambers that contain a soft, spongy network of blood vessels. Two of these cylinder-shaped chambers, known as the corpora cavernosa, are on either side of the upper part of the penis. The third chamber is below them and is known as the corpus spongiosum. This chamber widens at its end to form the glans. The corpus spongiosum surrounds the urethra, a thin tube that starts at the bladder and runs through the penis. Urine and semen travel through the urethra and leave the body through an opening in the glans of the penis, called the meatus.
When a man gets an erection, nerves signal his body to store blood in the vessels inside the corpora cavernosa. As the blood fills the chambers, the spongy tissue expands, causing the penis to elongate and stiffen. During ejaculation, semen (which contains sperm cells and fluids) enters the urethra and passes out of the body through the meatus. After ejaculation, the blood flows back into the body, and the penis becomes soft again.

Benign conditions of the penis

Sometimes, growths can develop on the penis that are abnormal but are not cancers (they are benign). These lesions can look like warts or irritated patches of skin. Like penile cancer, they are most often found on the glans or on the foreskin, but they can also occur along the shaft of the penis.

Condylomas (genital warts)

These growths tend to look like tiny cauliflowers. Some are so small that they can only be seen with a magnifying lens. Others may be as large as an inch or more across. Condylomas are caused by infection with some types of human papilloma virus (HPV).

Bowenoid papulosis

This condition is also linked to infection with HPV and tends to occur in younger, sexually active men. It is seen as small, red or brown spots or patches on the shaft of the penis. These often look like genital warts, but when looked at under a microscope, dysplastic (abnormal) cells are seen in the surface layer of the penile skin.
Bowenoid papulosis can also be mistaken for an early-stage cancer called carcinoma in situ (CIS), also known as Bowen disease (described below). Usually bowenoid papulosis doesn’t cause any problems, and it can even go away on its own after a few months. But if it doesn’t go away and is not treated, rarely it can progress to Bowen disease.

Cancers of the penis

Each type of tissue in the penis contains several types of cells. Different types of penile cancer can develop from these cells. The differences are important because they determine the seriousness of the cancer and the type of treatment needed.
Almost all penile cancers start in skin cells of the penis.

Squamous cell carcinoma

About 95% of penile cancers develop from flat skin cells called squamous cells. Squamous cell carcinoma (also known as squamous cell cancer) can develop anywhere on the penis. Most of these cancers occur on the foreskin (in men who have not been circumcised) or on the glans. These tumors tend to grow slowly. If they are found at an early stage, they can usually be cured.
Verrucous carcinoma: This is an uncommon form of squamous cell cancer that can occur in the skin in many areas. A verrucous carcinoma growing on the penis is also known as Buschke-Lowenstein tumor. This cancer looks a lot like a large genital wart. Verrucous carcinomas tend to grow slowly but can sometimes get very large. They can grow deep into surrounding tissue, but they rarely spread to other parts of the body.
Carcinoma in situ (CIS): This is the earliest stage of squamous cell cancer of the penis. In this stage the cancer cells are found only in the top layers of skin. They have not yet grown into the deeper tissues of the penis. Depending on the location of a CIS of the penis, doctors may use other names for the disease. CIS of the glans is sometimes called erythroplasia of Queyrat. CIS on the shaft of the penis (or other parts of the genitals) is called Bowen disease.

Melanoma

Melanoma is a type of skin cancer that starts in melanocytes, the cells that make the brownish color in the skin that helps protect it from the sun. These cancers tend to grow and spread quickly and are more dangerous than the more common types of skin cancer. Melanomas are most often found in sun-exposed skin, but rarely they occur in other areas like the penis. Only a very small portion of penile cancers are melanomas. For more information about melanoma and its treatment, see Melanoma Skin Cancer.

Basal cell carcinoma

Basal cell carcinoma (also known as basal cell cancer) is another type of skin cancer that can develop on the penis. It makes up only a small portion of penile cancers. This type of cancer is slow-growing and rarely spreads to other parts of the body.

Adenocarcinoma (Paget disease of the penis)

This very rare type of penile cancer can develop from sweat glands in the skin of the penis. It can be very hard to tell apart from carcinoma in situ (CIS) of the penis.

Sarcoma

A small number of penile cancers are sarcomas. These cancers develop from blood vessels, smooth muscle, or other connective tissue cells of the penis. For more about this type of cancer, see Sarcoma - Adult Soft Tissue Cancer.

FDA expands indication for type 2 diabetes treatment

The U.S. Food and Drug Administration has approved an expanded indication for Synjardy® (empagliflozin and metformin hydrochloride) tablets to include treatment-naïve adults with type 2 diabetes (T2D). SYNJARDY, from Boehringer Ingelheim and Eli Lilly and Company (NYSE: LLY), is indicated as an adjunct to diet and exercise to improve glycemic control in adults with T2D when treatment with both empagliflozin and metformin is appropriate.

SYNJARDY is a combination of empagliflozin (Jardiance®) and metformin — two medicines with complementary mechanisms of action — to help control blood glucose in adults with T2D. Empagliflozin, a sodium glucose co-transporter-2 inhibitor, removes excess glucose through the urine by blocking glucose re-absorption in the kidney. Metformin, a commonly prescribed initial treatment for T2D, lowers glucose production by the liver and its absorption in the intestine.

"Type 2 diabetes is a complex condition, which often requires that people take more than one treatment to manage their blood sugar," said Paul Fonteyne, president and CEO, Boehringer Ingelheim Pharmaceuticals, Inc. "The expanded indication for SYNJARDY further validates the potential of this combination therapy to help adults with type 2 diabetes who are not at goal, including those already being treated and, now, those at the beginning of their treatment journey."
The SYNJARDY label was updated to include results from a phase III, double-blind, randomized, active-controlled study that evaluated the efficacy and safety of empagliflozin in combination with metformin as initial therapy compared with the individual components. In the study, at 24 weeks, the combination of empagliflozin 10 mg or 25 mg with metformin 1000 mg or 2000 mg resulted in significant reductions in A1C (a measure of average blood glucose over the past two to three months) compared with the corresponding dose of either component alone. 
SYNJARDY can cause serious side effects, including Lactic Acidosis (a buildup of lactic acid in the blood). Metformin, one of the medicines in SYNJARDY, can cause lactic acidosis, a rare, but serious condition that can cause death. Lactic acidosis is a medical emergency and must be treated in a hospital. SYNJARDY is not for the treatment of type 1 diabetes or diabetic ketoacidosis. 
About Diabetes Approximately 29 million Americans and an estimated 415 million people worldwide have diabetes, and nearly 28 percent of Americans with diabetes — totaling 8 million people — are undiagnosed. In the U.S., approximately 12 percent of those aged 20 and older have diabetes. T2D is the most common type, accounting for an estimated 90 to 95 percent of all diagnosed adult diabetes cases in the U.S. Diabetes is a chronic condition that occurs when the body either does not properly produce, or use, the hormone insulin.
What is SYNJARDY?SYNJARDY is a prescription medicine that contains 2 diabetes medicines, empagliflozin (JARDIANCE) and metformin.  SYNJARDY can be used along with diet and exercise to lower blood sugar in adults with type 2 diabetes.

SYNJARDY is not for people with type 1 diabetes, or for people with diabetic ketoacidosis (increased ketones in the blood or urine).

Sunday, August 14, 2016

Cancer breakthrough could boost diagnosis

Kiwi researchers have found a new way to reveal tiny traces of cancer in the body, in a million-dollar study that could allow clinicians to find and treat tumours while still barely detectable.

Doctors hunting for evidence of cancer in samples often face a needle-in-a-haystack scenario, with cancer cells hidden among a sea of normal cells.

For the past few years, leading New Zealand cancer researcher Professor Parry Guilford has been investigating how these faint traces can be picked out of the mix - and has now discovered a promising solution.

Guilford, director of Otago University's Centre for Translational Cancer Research, said earlier detection of cancer was critical, as it could mean the difference in patients surviving the disease, which accounts for nearly a third of all deaths in New Zealand.

"If you can detect very small cancers and treat them at this very early stage, the cure rate can be higher than 95 per cent - but this can fall away to 10 percent five-year survival rates for advanced cancers," he said.


"So what we are doing is pushing into those very small tumours."

Guilford used a million-dollar, three-year Health Research Council grant to identify cancer cells in a range of body fluid samples.

"In the case of bladder cancer, you'll find a lot of cells will fall off the wall of the normal bladder and you'll also get cells that fall off the tumour, and you'll get both of these cell types ending up in your urine sample.

"This means that if your tumour is small, the background noise from the normal cells can hide the signal from those tumour cells."

The approach he has developed centred not on studying all of the cells from a sample at once, but feeding cells individually through the wells of a high throughput polymerase chain reaction (PCR) plate and then analysing each separately.

"By doing that we've been able to get proof of principle, that in fact, we can actually use this to see a rare cancer cell in a sea of normal cells," Guilford said.

"So we think it's got the potential to be used to improve test sensitivity."

Another benefit of the method was that it had the potential to distinguish benign cells that confusingly appeared like cancer cells, such as those involved in wound healing, thereby improving test specificity.

While the study had been carried out in the context of bladder cancer, Guilford said it could be applied to many cancers, including prostate cancer and endometrial cancer, and key killers lung cancer and colon cancer.

The test could be performed using standard biological samples, including urine and stool samples, or vaginal swabs.

Guilford, who is now is writing up the study results, said the next step was to refine how the approach could be quickly and easily used in clinical settings.

"It won't be a lot faster than current methods, but should still have a reasonable turn-around time," he said.

"Most importantly, it opens up the game to look at a lot more markers that could be used to diagnose the disease and all its subtypes."

Cancer Society NZ chief executive Claire Austin said it was great to see Kiwi researchers leading the way with ground-breaking research.

"Research that increases early detection is another great step in the right direction and the Cancer Society of New Zealand are encouraged by research that can translate into assisting better clinical diagnosis," Austin said.

"It may sound obvious, but the earlier you can diagnose and start to treat different cancers, the better the outcomes will often be.

"This is particularly relevant for those that are currently difficult to pick up early such as lung cancer."

Cancer breakthroughs "a blessing" - Sir Peter Leitch
It wasn't a groundbreaking diagnostic test that probably saved the life of Sir Peter Leitch, but a good doctor and a good specialist.

"If they hadn't got it, who knows, I could have been done for," said the Mad Butcher, now in remission after beating back a rare and aggressive form of bladder cancer that his brother had died from.

But the diehard Warriors fan said anything that could combat cancer was a blessing.

"It's a very scary word, cancer, when you're told you've got it. And I'm certainly not a doctor, but the one thing I know is the sooner they find it, the better chance you are of getting it treated."

Bladder cancer accounts for around three percent of cancer diagnosed in New Zealand each year, typically affects people over 60 years of age, and is more common in men than women.

Still, the 72-year-old thought he'd never have to be confronted with it.

"I never expected to get bloody cancer. Not in a million years.

"Mate, I only checked it because I felt funny down below, and through the doctor being thorough, he sent me to a urologist and we picked it up very promptly."

The journey had changed his life.

"I think I'm more grateful to be alive now. You tend to take being alive for granted."

It had also opened his eyes to the leading clinicians and researchers fighting it.

"We do have some wonderful people in the country that we have to be very thankful for."

Protein could stop breast cancer spread
Meanwhile, a team of Kiwi scientists have begun investigating a protein that could be the key to stopping the spread of breast cancer to other parts of the body.

The Massey University and international researchers are focusing on Heterochromatin Protein 1a, or HP1a, which is involved in suppressing cellular invasion, the first step in metastasis of cancer.

"The protein is often lost in metastatic tumours, therefore understanding the role this loss plays in allowing a cell to become invasive will identify potential targets for the next generation of anti-cancer therapies," said Massey's Dr Tracy Hale, who is leading the just-funded study.

"When these cancer cells invade, their nucleus must become more malleable to allow them to squeeze through their surrounding environment and we believe the presence or absence of the protein controls this process and ultimately dictates whether the cancer spreads or not."

Hale said the research could apply to a number of cancers, but its importance for breast cancer patients was immense as it has been found that they were at a greater risk of metastasis than other sufferers.

The two-year study received a $200,000 grant from the joint Breast Cancer Research in New Zealand initiative, including the New Zealand Breast Cancer Foundation and Health Research Council of New Zealand (HRC).

"The latest scientific developments indicate that the most effective treatments for breast cancer in the future will focus on targeted treatments and immune therapies that are tailored specifically for individual types of breast cancer," said HRC chief executive, Professor Kath McPherson.

"This initiative is focused on these areas of research because we believe they offer the best chance to significantly improve breast cancer treatment and survival rates."

Friday, August 12, 2016

A deep look inside living cells reveals a key cancer process

Telomerase, a powerful enzyme that acts at the ends of human chromosomes, can keep us healthy, but it can also promote cancer growth. Now, researchers at the University of Colorado Boulder have used a process called single-molecule imaging to visualize the process that this enzyme uses to attach itself to the ends of chromosomes.

The new understanding could help researchers develop new approaches for treating cancer and other diseases.

The findings, which were recently published in the journal Cell, show that telomerase has a small window of opportunity, lasting only minutes, to do its job at the ends of chromosomes. The team was surprised to find that telomerase may probe each telomere thousands of times, rarely forming a stable connection, in order to be successful at connecting to the chromosome end. Researchers believe that inhibiting telomerase from attaching to telomeres in cancer cells is a strategy for treatment of the disease.

Telomerase is the enzyme that keeps cells young. From stem cells to germ cells, telomerase helps cells continue to live and multiply. Too little telomerase produces diseases of bone marrow, lungs and skin. Too much telomerase results in cells that over-proliferate and may become “immortal.” As these immortal cells continue to divide and replenish, they build cancerous tumors. Scientists estimate that telomerase activation is a contributor in up to 90 percent of human cancers.

Telomeres have been studied since the 1970’s for their role in cancer. They are constructed of repetitive DNA sequences that sit at the ends of our chromosomes like the ribbon tails on a bow. This extra material protects the ends of the chromosomes from deteriorating or from fusing with neighboring chromosome ends.

Telomeres are consumed during cell division and, over time, will become shorter and provide less cover for the chromosomes they are protecting. The enzyme, telomerase, replenishes telomeres throughout their lifecycles.

“This discovery changes the way we look at how telomerase recruitment works,” said CU Boulder Distinguished Professor and Nobel laureate Thomas Cech, who is director of CU’s BioFrontiers Institute and the lead author on the study. “It’s exciting to see this in living cells as it happens. Single-molecule imaging isolates the process, allowing us to study its dynamics.”

The research team included co-authors Jens Schmidt, a Damon Runyon Cancer Research Foundation postdoctoral fellow, and Staff Scientist Arthur Zaug. They used CRISPR genome editing and single-molecule imaging to track telomerase’s movements in the nuclei of living human cancer cells. CRISPR, or Clustered Regularly Interspaced Short Palindromic Repeats, allowed the team to attach fluorescent protein tags to telomerase and telomeres in human cancer cells so that the search process was visible under a powerful microscope.

“At the end of the day, the goal is to target telomerase as an approach to treat cancer,” said Schmidt. “You can inhibit telomerase across the board, but the challenge is isolating the telomerase in cancer cells from the telomerase participating in the normal processes of healthy cells. This research brings us closer to understanding these processes.”