Sunday, February 03, 2008

Chemotherapy of no benefit for many younger breast cancer patients

Popular summary below followed by journal abstract:

A young woman is told she has breast cancer. She undergoes lumpectomy and possibly radiation treatment, and then must endure chemotherapy. Her hair falls out. She must be given antibiotics to prevent infections caused by damage to the immune system. Then the worst of insults --- She reads the newspaper and finds out chemotherapy was of no benefit. According to a recent study, chemotherapy for breast cancer patients under age 40 is of no value and should be abandoned. About two-thirds of breast cancers are hormone receptor-positive. Tumor cells have receptors or docking ports for estrogen on their surface.


Efficacy of adjuvant chemotherapy according to hormone receptor status in young patients with breast cancer: a pooled analysis

By Jos A van der Hage et al.

Introduction: Breast cancer at a young age is associated with an unfavorable prognosis. Very young patients with breast cancer therefore are advised to undergo adjuvant chemotherapy irrespective of tumor stage or grade. However, chemotherapy alone may not be adequate in young patients with hormone receptor-positive breast cancer. Therefore, we studied the effect of adjuvant chemotherapy in young patients with breast cancer in relation to hormone receptor status.

Methods: Paraffin-embedded tumor material was collected from 480 early-stage breast cancer patients younger than 41 years who participated in one of four European Organization for Research and Treatment of Cancer trials. Using immunohistochemistry on the whole series of tumors, we assessed estrogen receptor (ER) status and progesterone receptor (PgR) status in a standardized way. Endpoints in this study were overall survival (OS) and distant metastasis-free survival (DMFS). The median follow-up period was 7.3 years.

Results: Overall, patients with ER-positive tumors had better OS rates (hazard ratio [HR] 0.63; P = 0.02) compared with those with ER-negative tumors. However, in the subgroup of patients who received chemotherapy, no significant difference in OS (HR 0.87; P = 0.63) and DMFS (HR 1.36; P = 0.23) was found between patients with ER-positive tumors or those with ER-negative tumors. These differences were similar for PgR status.

Conclusion: Young patients with hormone receptor-positive tumors benefit less from adjuvant systemic chemotherapy than patients with hormone receptor-negative tumors. These results confirm that chemotherapy alone cannot be considered optimal adjuvant systemic treatment in breast cancer patients 40 years old or younger with hormone receptor-positive tumors.

Breast Cancer Research 2007, 9:R70

N.M. tax would target TVs, video games

The thought that people might be entitled to decide for themselves how much outdoor activity they want to do is obviously alien to these Greenie Fascists

Dave Gilligan remembers being pushed outside to play baseball and other sports, but feeling it just wasn't for him. So the 24-year-old business owner is skeptical about a proposal to nudge kids off the couch and out the door by taxing televisions and video games sold in New Mexico. The idea could backfire, he says. "If you take a kid that's just playing his X-Box or whatever and you take him outside and you make him play baseball, he's going to hate it," said Gilligan, co-owner of Gamers Anonymous, an Albuquerque video game store. "There's nothing wrong with sitting at home playing games. Everybody's doing it now."

But a coalition of groups, led by the Rio Grande chapter of the Sierra Club, is sold on the idea that outdoor education programs can inspire children in a way that video games and television cannot. The coalition wants state lawmakers to create a No Child Left Inside Fund with a 1 percent tax on TVs, video games and video game equipment. The fund would help pay for outdoor education throughout the state. Supporters of the tax - which would be the first of its kind in the nation - say outdoor programs have been shown to improve students' abilities in the classroom, boost their self-confidence and teach them stewardship and discipline. "We believe that an outdoor education program in New Mexico could be funded through a tax on the very activities that are divorcing kids from nature, promoting more sedentary lifestyles," said Michael Casaus, Sierra Club's New Mexico youth representative. "One of those culprits is TV and what we call screen time."

Blogs dedicated to the gaming world have been abuzz over the proposal, with critics complaining that they shouldn't have to foot the bill for parents who don't know how to raise their children. Some have seized the moment to talk about gaming's benefits. Gilligan, for example, says he learned to read at a young age thanks to video games. He also attributes his interest in art to gaming. "I'm not a very athletic person," he said. "I kept playing video games and eventually my parents accepted that, and now it's my career and I make good money so I'm happy."

Sean Bersell, a spokesman for the Entertainment Merchants Association, said the video game industry has fueled advances in computer technology, such as faster processors and better graphics and sound. Supporters of the tax are wrong to suggest that such complex problems as low test scores and childhood obesity can be solved by turning off the TV, said Bersell, whose group represents about 125 retailers in New Mexico. "Targeting a small category of entertainment as somehow a major contributor to these problem is just not justified and frankly it's not supported by a scientific consensus," he said. The tax would put New Mexico retailers at a disadvantage as they compete with online stores and retailers that offer downloadable games, Bersell warned.

Supporters argue that just as health programs are often supported by excise taxes on cigarettes or alcohol, an excise tax on games and TVs would provide a steady source of cash for outdoor education. Legislative analysts have said the tax would generate about $4 million a year. New Mexico State Parks already offers outdoor programs, but the funding is just a fraction of what the tax would bring in


Australia: Hope for cancer revolution

A QUEENSLAND scientist is developing a drug that could revolutionise cancer treatment for millions of people world-wide. Derek Richard, from the Queensland Institute of Medical Research in Brisbane, says he has found how to uniquely kill cancer cells without destroying healthy ones - a discovery that could see the end of aggressive chemotherapy and radiotherapy treatments.

Although more than two years of testing still have to be undertaken, researchers believe it could be the medical breakthrough scientists have been seeking for decades. Highly toxic chemotherapy is currently the only option for most cancer patients, but it also kills off healthy cells, which can lead to severe nausea, fatigue, hair loss and even death.

Dr Richard has identified a human gene - hSSB1 - which cancer cells need to survive, but normal cells can function without. He is now developing a drug that can target the hSSB1 gene, destroying cancer, without harming healthy cells and with much less risk to the patient. "It will be a universal drug that will be used for most cancers," he said.

He is working in partnership with Melbourne firm Cancer Therapeutics (CTx), which will fund $4 million for the drug's development. Clinical trials are expected to start in two years, with the drug being made universally available within six years



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

"What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!


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