Diabetes patients become less adherent to their diabetes medications following a diagnosis of cancer, concludes a new study published in Diabetologia (the journal of the European Association for the Study of Diabetes). The research is led by Marjolein Zanders, Netherlands Comprehensive Cancer Organisation, Eindhoven, the Netherlands, Jeffrey Johnson, School of Public Health, University of Alberta, Edmonton, Canada and colleagues.

Cancer patients with diabetes have a significantly higher overall mortality risk compared with patients without diabetes. Most research on diabetes and cancer has focussed on the influence of diabetes and glucose lowering drugs (GLDs) on outcomes after cancer diagnosis; yet cancer itself might affect outcomes associated with diabetes, in part by affecting adherence to their prescribed GLDs. Although one previous study has found that breast cancer patients were less likely to take their diabetes drugs as directed after being diagnosed with cancer, this study lacked a control group without cancer. In this new study, the authors aimed to evaluate changes in adherence to GLDs following a cancer diagnosis, taking into account changes in adherence to GLDs among similar diabetic patients without cancer.

All new users of GLDs (1998-2011) who lived in the Eindhoven Cancer Registry-PHARMO Database Network (which includes out-patient pharmacy data) catchment area were selected. From the 52,228 GLDs users selected, 3,281 cases with cancer and 12,891 controls without cancer during follow-up were included in the study, with a mean age of 68 years in each group. The Medication Possession Ratio (MPR) was used as an indicator for medication adherence. The MPR represents the amount of medication patients had in possession over a certain time period. Thus, a 10% decline in MPR translates to a difference of 3 days in a 30-day month that are not covered by the use of GLDs (that is, 3 days in that month where the patients did not take their diabetes medications). For every month the MPR for cases was compared with the MPR for matched controls, which represented the overall trend among individuals with diabetes but without cancer.

The data showed that before cancer diagnosis the MPR increased by 0.10% per month. Besides a significant drop in MPR at the time of cancer diagnosis of -6.3%, there was an ongoing, yet lower, monthly decline in MPR (-0.20%) after cancer diagnosis. The largest drops in MPR at the time of cancer diagnosis, in the range of 11-15%, were seen among patients with stage IV cancer disease and gastrointestinal or pulmonary cancers.

Patients who visit the doctor because of malignant skin cancer often go too late - the aggressive cancer has already formed numerous metastases in their bodies. 

This rapid, malignant metastatic formation of melanoma, was previously put down to the high mutation rate that is characteristic of melanoma, i.e. genetic changes that stimulate the growth of cancer cells. Various cancer drugs therefore target the signaling pathways activated in the process, some of which have recorded astonishingly positive results in the clinic and are able to prolong the lives of seriously sick patients. 

Unfortunately, however, in most cases a kind of resistance develops: Eventually, the cancer cells no longer respond to the drug and the tumor spreads again. Evidently, the cancer cells have found new ways to grow. A team of researchers headed by Professor Lukas Sommer from the University of Zurich's Institute of Anatomy has now found a possible explanation for this dynamic behavior in cancer cells: The scientists believe that, depending on the prevalent conditions, cancer cells are able to "read" different genes and use them to their own end.

First-in-human clinical trial using adenovirus to receive endorsement from both US Food and Drug Administration and Health Sciences Authority

The National Cancer Centre Singapore (NCCS) has launched a clinical trial of a new cancer vaccine administered to human patients for the first time in the world. Cancer immunotherapy (the harnessing of the body's defence system to fight the patient's cancer, has emerged as one of the most exciting medical breakthroughs in the past two years.

In fact, the prestigious Science journal voted Cancer Immunotherapy the Breakthrough of the Year for 2013. Cancer Immunotherapy includes cancer vaccines, a form of treatment aimed at stimulating the body's immune cells to attack a target protein on cancer cells. This particular cancer vaccine encodes one of the most common proteins, MUC-1 that is expressed on many cancers, including ovarian, breast, prostate, colon, pancreas and lung cancer, but not expressed on normal cells.

The Singapore Clinical Research Institute (SCRI), a wholly-owned subsidiary of MOH Holdings, sponsored this clinical trial providing support that included project oversight, study drug importation, quality assurance and providing the medical expertise required in conducting a cancer trial.

Dr Toh Han Chong, NCCS Principal Investigator of the phase I clinical trial, who is also a Senior Consultant in the Division of Medical Oncology, said, "What makes this vaccine unique is that MUC-1 is attached to a protein that is intentionally designed to further enhance and boost the efficiency and power of the body's immune system." This protein is called CD40-ligand (CD40L), to form a construct called MUC-1+CD40L.

This construct fits into the backbone of a hardy virus called adenovirus, which further improves the body's immune system specifically against MUC-1 expressed on the surface of the cancer, as demonstrated in convincingly superior animal study results. This vaccine has been developed by a United States biotech company, MicroVAX, and is injected under the patient's skin. The Singapore Clinical Research Institute (SCRI) is the sponsor for this clinical study.

Among nearly 375,000 U.S. women diagnosed with invasive breast cancer, the likelihood of diagnosis at an early stage, and survival after stage I diagnosis, varied by race and ethnicity, with much of the difference accounted for by biological differences, according to a study in JAMA.

In the United States, incidence rates of breast cancer among women vary substantially by racial/ethnic group. Race/ethnicity and sociodemographic factors may influence a woman's adherence to recommendations for clinical breast examination, breast self-examination, or screening mammogram and the likelihood of her seeking appropriate care in the event that a breast mass is noticed. A growing body of evidence suggests that biological factors may also be important in determining stage at diagnosis (i.e., the growth rate and metastatic potential of small-sized breast cancer tumors may vary between women due to inherent differences in grade and other or unknown pathological features), according to background information in the article.

Javaid Iqbal, M.D., of Women's College Hospital, Toronto, and colleagues examined the proportion of breast cancers that were identified at an early stage (stage I) in different racial/ethnic groups in the United States and whether ethnic differences may be better explained by early detection or by intrinsic biological differences in tumor aggressiveness. The study included women diagnosed with invasive breast cancer from 2004 to 2011 who were identified in the Surveillance, Epidemiology, and End Results (SEER) 18 registries database (n = 452,215). For each of 8 racial/ethnic groups, biological aggressiveness (triple-negative cancers [negative for estrogen receptor, progesterone receptor, and ERBB2 (formerly HER2 or HER2/neu)], lymph node metastases, and distant metastases) of small-sized tumors of 2.0 cm or less was estimated. In addition, the odds were determined for being diagnosed at stage I compared with a later stage, as was the risk of death from stage I breast cancer by racial/ethnic group.

Even decades after being cured, many cancer survivors face physical and mental challenges resulting from their disease and its treatment. That's the conclusion of a new study published early online in CANCER, a peer-reviewed journal of the American Cancer Society. The findings could help clinicians and other experts develop interventions that are tailored to the specific types of problems and concerns that cancer survivors may experience.

Increasingly, cancer patients are living many years after cancer treatment, with the number of US survivors expected to top 19 million by 2024. While many survivors do well after treatment, some experience continuing problems that can significantly impair their quality of life well beyond the magical 5-year survival milestone. These problems and challenges can vary by the type of cancer patients had and the treatments they received.

To assess the unmet needs of cancer survivors, Mary Ann Burg, PhD, LCSW, of the University of Central Florida in Orlando, and her colleagues looked at the responses from an American Cancer Society survey, wherein 1514 cancer survivors responded to the open-ended question, 'Please tell us about any needs you have now as a cancer survivor that ARE NOT being met to your satisfaction.' "This study was unique in that it gave a very large sample of cancer survivors a real voice to express their needs and concerns," said Dr. Burg.