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Thursday, February 24, 2011

Danny Hillis: Understanding cancer through proteomics | Video on TED.com

Danny Hillis: Understanding cancer through proteomics | Video on TED.com

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Tuesday, February 1, 2011

A pilot phase II trial of magnesium supplements to reduce menopausal hot flashes in breast cancer patients

Via Supportive Care in Cancer:

Abstract


Background

We tested if magnesium would diminish bothersome hot flashes in breast cancer patients.

Methods

Breast cancer patients with at least 14 hot flashes a week received magnesium oxide 400 mg for 4 weeks, escalating to 800 mg if needed. Hot flash score (frequency × severity) at baseline was compared to the end of treatment.

Results

Of 29 who enrolled, 25 women completed treatment. The average age was 53.5 years; six African American, the rest Caucasian; eight were on tamoxifen, nine were on aromatase inhibitors, and 14 were on anti-depressants. Seventeen patients escalated the magnesium dose. Hot flash frequency/week was reduced from 52.2 (standard error (SE), 13.7) to 27.7 (SE, 5.7), a 41.4% reduction, p = 0.02, two-sided paired t test. Hot flash score was reduced from 109.8 (SE, 40.9) to 47.8 (SE, 13.8), a 50.4% reduction, p = 0.04. Of 25 patients, 14 (56%) had a >50% reduction in hot flash score, and 19 (76%) had a >25% reduction. Fatigue, sweating, and distress were all significantly reduced. Side effects were minor: two women stopped the drug including one each with headache and nausea, and two women had grade 1 diarrhea. Compliance was excellent, and many patients continued treatment after the trial.

Conclusions

Oral magnesium appears to have helped more than half of the patients and was well tolerated. Side effects and cost ($0.02/tablet) were minimal. A randomized placebo-controlled trial is planned.
 
***
From Livestrong.org:


Magnesium, a mineral found in tofu, grains, nuts, potatoes, leafy green vegetables, chocolate and cocoa powder, has been found to decrease during menopause, according to the University of Maryland Medical Center. Natural-Approaches-to-Menopause.com cites a study in which patients who increased their magnesium experienced decreased symptoms and eventual elimination of hot flashes, so supplementing magnesium levels may decrease the severity and frequency of your hot flashes.
***
From NaturalStandard.com (accessed Feb 1st/2011):

Brief Safety Summary:


Likely safe: When used orally, intravenously, or intramuscularly in people with normal renal function. Oral magnesium has been given in doses of 600-1,200mg daily for months without major adverse effects.
 
Interestingly:
"Hormonal effects: Oral magnesium has been reported to benefit mood changes associated with premenstrual syndrome (PMS) (6). Facchinetti et al. theorized that this effect may be due to raising intracellular magnesium levels."
 
Pharmacodynamics/Kinetics:


Magnesium is the second most abundant intracellular cation (positive ion) in the human body and is involved in more than 300 enzymatic reactions, including glucose use, the synthesis of fat, protein, and nucleic acids, the metabolism of adenosine triphosphate, muscle contraction, and some membrane transport systems (154). Magnesium is known to be essential for all ATPase activity, including its capability to facilitate movement of calcium across and within the cell membrane of cardiac and vascular tissues (155).

Absorption: Based on clinical review, 35-40% of ingested magnesium has been shown to be absorbed in the gastrointestinal tract (156). It has been found to reach steady-state after 2-3 hours and maximum concentrations at 4 hours (156). Magnesium is primarily absorbed in the small intestine (156).

Distribution: Normal serum magnesium levels are generally considered to be between 0.70 and 0.94mM/L; the average 70kg adult body contains approximately 24g of magnesium (60% is in the bone; 35% is in the muscles, particularly the heart and skeletal muscles; 1% is found in the extracellular fluid compartment). Approximately 35% of the body's magnesium is bound to albumin, with the rest primarily in ionized form (157).

Metabolism: Based on secondary sources, magnesium is not metabolized.

Excretion: Magnesium excretion is primarily via the kidneys and averages only 3-5% of the filtered load; excretion ranges from 10-5,000mg over a 24-hour period (156). Urinary magnesium and pH are known to modulate urinary calcium excretion; however, the underlying mechanism is unknown (158).








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Dog Sniffing Out Cancer May Lead to Early Detection Test


Via Medscape:

January 31, 2011 — The latest study demonstrating that dogs can sniff out cancer has confirmed the notion that a specific cancer smell does exist, and has added fuel to the idea of developing a test based on odor.

Previous studies have reported on dogs that can detect lung and breast cancer from breath samples, and there has been anecdotal evidence suggesting that dogs can detect melanoma, bladder, and ovarian cancers.

In this latest study, published online January 31 in Gut, a Labrador retriever was trained over several months to sniff out colorectal cancer in breath and watery stool samples.

The dog correctly identified cancer in 33 of 36 breath tests and in 37 of 38 stool tests. This equates to 95% accuracy overall for the breath test and 98% accuracy overall for the stool test, the researchers report.

The highest detection rates were among samples taken from patients with early-stage cancer, they add. Samples taken from smokers and from people with other gastrointestinal diseases, which might be expected to mask or interfere with cancer odors, did not appear to confuse the dog.

"This study shows that a specific cancer scent does indeed exist," the researchers conclude.

They are not suggesting using dogs in clinical practice, however. They point out that training the dog was expensive and time-consuming, and that ability and concentration vary between individual dogs and even the same dog on different days. The dog's concentration tends to decrease during the hot summer season; hence, they conducted their test between November and early June.

What they do propose is that this research could be used to develop cancer detection tests based on "odor materials."
This would involve identifying the cancer-specific volatile organic compounds (VOC) that are being detected by dogs using chemical analysis, and then developing an early cancer detection sensor that would substitute for the dog, they explain.

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Timing of Commencing HRT Influences Breast Cancer Risk

Via Medscape:

January 31, 2011 — Breast cancer risk associated with combination hormone replacement therapy (HRT) is greater if the therapy is started soon after menopause, according to the results of the observational Million Women Study conducted in the United Kingdom...

...Among current users of estrogen–progestin formulations, the relative risks for breast cancer were greater if use began less than 5 years after menopause (relative risk [RR], 2.04; 95% confidence interval [CI], 1.95 to 2.14) than if it began 5 years or more after menopause (RR, 1.53; 95% CI, 1.38 to 1.70)...

...Overall, for women who used combination HRT, compared with control subjects, there was a 39% increase in the relative risk of developing breast cancer in the Million Women Study and a 26% increase in the WHI trial, which the editorialists call "consistent" findings...

"The question of the effect of estrogen-only formulation use on breast cancer risk in postmenopausal women, even with longer-term hormone use, still stands unanswered," write the editorialists.

J Natl Cancer Inst. Published online January 28, 2011. Full text, Editorial
The other question that remains unanswered is what are the impact of other formulations of estrogen and progesteron supplementation for HRT.

For instance:
- Estrace & Prometrium
- "bioidentical" hormones (compounded)

Interestingly, here is an article that was published Feb '10 (epublished about 6 months ago) in the Gynecological Endocrinology Journal. This article looks at women who were administered natural estrogen plus progesterone with or without DHEA or testosterone. It is obviously not a long-term study looking at breast cancer incidence outcomes, but leaves one thinking "what if" and what would be the outcome should this be readily explored. Ethics may come into the equation, however, given the other mainstream evidence that has been published.


Link: http://bit.ly/bKbwGc

"Mental symptoms experienced upon presentation improved in 90% of the patients. Sixty percent of the patients, who had gained weight during menopause, lost an average of 14.8 lbs [SD 11.98 lbs]. Complications described with traditional HRT did not develop in this group of patients."

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Welcome and thanks for visiting Onco-P.R.N. - The oncology website with a focus on all things oncology pharmacy/pain/palliative care-related. It is intended to be an information resource for those pharmacist and relevant health care professionals involved in whatever fashion with cancer and palliative care. Stay tuned for the latest and greatest links and information with respect to: oncology medications, continuing education, pharmaceutical care initiatives, pain and symptom control, supportive care topics, and whatever else that might fit into the theme.

*Note: This website is not affiliated with Alberta Health Services (AHS) or CAPhO and the opinions expressed herewithin are that of the author(s).

Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia: http://en.wikipedia.org/wiki/Pharmacy#History_of_pharmacy

Journal of Palliative Medicine - Table of Contents

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