Fwd: Antibody-targeted RNase fusion proteins (immunoRNases) for cancer therapy.

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From: HubMed - mesothelioma cancer <rssfwd@rssfwd.com>
Date: Sat, Aug 9, 2008 at 12:44 AM
Subject: Antibody-targeted RNase fusion proteins (immunoRNases) for cancer therapy.
To: mesothelioma77@gmail.com


[1]Curr Pharm Biotechnol. 2008 Jun; 9(3): 231-4
Krauss J, Arndt MA, Dübel S, Rybak SM

Ribonucleases (RNases) of the superfamily A exhibit potent antineoplastic activity yet do not mediate appreciable immunogenicity or non-specific toxicity in both animal models and cancer patients. Ranpirnase (Onconase), the first ribonuclease being evaluated as a therapeutic in humans, has progressed to phase III clinical trials in patients with unresectable mesothelioma. Conjugation of RNases to internalizing tumor-targeting monoclonal antibodies was shown to enhance specific cell killing by several orders of magnitude both in vitro and in animal models. In this review we describe the development and current status of genetically engineered 2(nd) generation immunoRNases as promising novel anti-cancer therapeutics.



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Fwd: [Pemetrexed]

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From: HubMed - mesothelioma cancer <rssfwd@rssfwd.com>
Date: Sat, Aug 9, 2008 at 12:44 AM
Subject: [Pemetrexed]
To: mesothelioma77@gmail.com


[1]Gan To Kagaku Ryoho. 2008 Jun; 35(6): 1033-8
Sudoh J, Gemma A

Pemetrexed (ALIMTA, LY231514) is a novel, multi targeted antifolate chemotherapy agent that is active in various tumors including mesothelioma, NSCLC, breast, colon and bladder carcinoma. Pemetrexed inhibits several enzymes in the folate pathway including thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase. Pemetrexed is approved in the United States and a number of European Union countries for use in the treatment of mesothelioma, and the second-line treatment of advanced NSCLC. However, in Japan, pemetrexed was approved for use only in combination with cisplatin in the treatment of mesothelioma in January 2007. This approval was granted on the basis of a phase III trial of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. Treatment with pemetrexed plus cisplatin and vitamin supplementation, resulted in superior survival time, time to progression, and response rates compared with treatment with cisplatin alone. In addition, in a phase III trial of pemetrexed versus docetaxel in patients with NSCLC previously treated with chemotherapy, treatment with pemetrexed resulted in clinically equivalent efficacy outcomes, but with significantly fewer side effects including grade 3 or 4 neutropenia , neutropenic fever, and alopecia, compared with docetaxel. Therefore, pemetrexed should be considered a standard treatment option for second-line NSCLC in US and most of EU. Addition of folic acid and vitamin B12 significantly reduced the toxicity of pemetrexed, especially hematologic toxicity and gastrointestinal toxicity. Pemetrexed is the expected agent for use in high risk patients, especially elderly or poor performance status patients.



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Fwd: Amentoflavone Inhibits Experimental Tumor Metastasis Through a Regulatory Mechanism Involving MMP-2, MMP-9, Prolyl Hydroxylase, Lysyl Oxidase, VEGF, ERK-1, ERK-2, STAT-1, nm23 and Cytokines in Lung Tissues of C57BL/6 Mice.

---------- Forwarded message ----------
From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Sat, Aug 9, 2008 at 12:44 AM
Subject: Amentoflavone Inhibits Experimental Tumor Metastasis Through a Regulatory Mechanism Involving MMP-2, MMP-9, Prolyl Hydroxylase, Lysyl Oxidase, VEGF, ERK-1, ERK-2, STAT-1, nm23 and Cytokines in Lung Tissues of C57BL/6 Mice.
To: mesothelioma77@gmail.com


[1]Immunopharmacol Immunotoxicol. 2008 Aug 5; 1-17
Guruvayoorappan CS, Kuttan G

Amentoflavone has been shown to inhibit tumor metastasis in vivo, but its mechanism of action remains unclear. Here, C57BL/6 mice were injected once with B16F-10 melanoma cells via tail vein followed by amentoflavone treatment (50mg/kg BW) for 10 consecutive days. Twenty-one days after tumor injection, animals were euthanized, and tumor metastasis was found to confine in the lungs. As compared with the tumor controls, amentoflavone treatment significantly lowered the number of lung nodules (p

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Fwd: Acculturation and Familiarity With, Attitudes Towards and Beliefs about Genetic Testing for Cancer Risk Within Latinas in East Harlem, New York City.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Sat, Aug 9, 2008 at 12:44 AM
Subject: Acculturation and Familiarity With, Attitudes Towards and Beliefs about Genetic Testing for Cancer Risk Within Latinas in East Harlem, New York City.
To: mesothelioma77@gmail.com


[1]J Genet Couns. 2008 Aug 7;
Sussner KM, Thompson HS, Valdimarsdottir HB, Redd WH, Jandorf L

Recent research underscores the need for increasing use of genetic testing for cancer risk in Latinos. This study examined the influence of acculturation on attitudes, beliefs about and familiarity with genetic testing for cancer risk in a community-based sample of Latinas in East Harlem, New York City (N = 103). Multivariate linear regression models analyzed the relationship of acculturation to: (1) familiarity (2) perceived benefits (3) perceived barriers and (4) concerns about abuses of genetic testing for cancer risk. Controlling for sociodemographic factors, results revealed that with increasing acculturation Latinas were more familiar with genetic testing (beta = 1.62, SE = 0.72, p = 0.03), more likely to cite perceived benefits (beta = 1.67, SE = 0.79, p = 0.04), and less likely to report perceived barriers related to genetic testing (beta = -2.76, SE = 1.64, p = 0.10). Study results may help inform the development of culturally-appropriate health education outreach materials and programs targeted to increase awareness, knowledge and understanding about genetic testing for cancer risk within Latinas.



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Fwd: Developing a codebook to guide content analysis of expressive writing transcripts.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sat, Aug 9, 2008 at 12:44 AM
Subject: Developing a codebook to guide content analysis of expressive writing transcripts.
To: mesothelioma77@gmail.com


[1]Appl Nurs Res. 2008 Aug; 21(3): 165-8
Fonteyn ME, Vettese M, Lancaster DR, Bauer-Wu S

This article describes a team-based approach to the development of a comprehensive codebook for multiple researchers to use during content analysis of the transcripts of the expressive writings of women (in this study, N = 89) with metastatic breast cancer. The codebook structure was developed iteratively by reaching a consensus on the analysis of shared transcripts to create an all-encompassing set of codes, with definitions, inclusion and exclusion criteria, and exemplar text from the transcripts. The Qualitative Solutions and Research International NVivo software program was used to maintain an electronic database of the consensus analysis of transcripts, information about each code, and a detailed log about the process of developing the codebook. The team ultimately created a comprehensive codebook that contained 27 codes with definitions, inclusion and exclusion criteria, and example text. The codes were verified by each team member through reanalysis of a set of shared transcripts that had been previously coded using an earlier version of the codebook. The team met to discuss individual coding and reached a consensus on the final version of the codebook. No new code was identified during the reanalysis, and there was fairly uniform agreement on the coding. The final version of the codebook will be used to guide each team member's individual analysis of the remaining (74) transcripts, which will be divided among the team. Periodic meetings are planned to discuss the individual analysis and to resolve any issue associated with using the codebook. As new codes are identified and agreed upon by the team, they will be added to the codebook. A team-based approach can facilitate the development of a practical and accurate codebook to guide the analysis of a large amount of qualitative data.



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Fwd: New diagnostic techniques for breast cancer detection.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sat, Aug 9, 2008 at 12:44 AM
Subject: New diagnostic techniques for breast cancer detection.
To: mesothelioma77@gmail.com


[1]Future Oncol. 2008 Aug; 4(4): 501-13
Singh V, Saunders C, Wylie L, Bourke A

Breast imaging has made huge advances in the last decade, and along with newer techniques to diagnose primary breast cancer, many novel methods are being used and look promising in detecting distant metastasis, recurrent disease and assessing response to treatment. Full-field digital mammography optimizes the lesion-background contrast and gives better sensitivity, and it is possible to see through the dense tissues by altering computer windows; this may be particularly useful in younger women with dense breasts. The need for repeat imaging is reduced, with the added advantage of reduced radiation dose to patients. Computer-aided detection systems may help the radiologist in interpretation of both conventional and digital mammograms. MRI has a role in screening women at high risk for breast cancer. It also aids in cancer management by assessing response to treatment and can help in deciding appropriate surgery by providing accurate information on the extent of the tumor. Newer diagnostic techniques such as sestamibi scans, optical imaging and molecular diagnostic techniques look promising, but need more investigation into their use. Their roles will appear clearer in coming years, and they may prove to be of help in further investigating lesions that are indeterminate on standard imaging. Other upcoming techniques are contrast-enhanced mammography and tomosynthesis. These may give additional information in indeterminate lesions, and when used in screening they aid in reducing recall rates, as shown in recent studies. PET/computed tomography has a role in detecting local disease recurrence and distant metastasis in breast cancer patients.



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Fwd: Hereditary diffuse gastric cancer: surgery, surveillance and unanswered questions.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sat, Aug 9, 2008 at 12:44 AM
Subject: Hereditary diffuse gastric cancer: surgery, surveillance and unanswered questions.
To: mesothelioma77@gmail.com


[1]Future Oncol. 2008 Aug; 4(4): 553-9
Cisco RM, Norton JA

Hereditary diffuse gastric cancer (HDGC) is an inherited cancer-susceptibility syndrome characterized by autosomal dominance and high penetrance. In 30-50% of cases, a causative germline mutation in CDH1, the E-cadherin gene, may be identified. Female carriers of CDH1 mutations also have an increased (20-40%) risk of lobular breast cancer. Endoscopic surveillance of patients with CDH1 mutations is ineffective because early foci of HDGC are typically small and underlie normal mucosa. CDH1 mutation carriers are therefore offered the option of prophylactic gastrectomy, which commonly reveals early foci of invasive signet-ring cell cancer. We review recommendations for genetic testing, surveillance and prophylactic surgery in HDGC. Areas for future research are discussed, including development of new screening modalities, optimal timing of prophylactic gastrectomy, identification of additional causative mutations in HDGC, management of patients with CDH1 missense mutations and prevention/early detection of lobular breast cancer in CDH1 mutation carriers.



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Fwd: Phase II study of arsenic trioxide and ascorbic acid for relapsed or refractory lymphoid malignancies: a Wisconsin Oncology Network study.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Phase II study of arsenic trioxide and ascorbic acid for relapsed or refractory lymphoid malignancies: a Wisconsin Oncology Network study.
To: mesothelioma77@gmail.com


[1]Hematol Oncol. 2008 Jul 31;
Chang J, Voorhees P, Kolesar J, Ahuja H, Sanchez F, Rodriguez G, Kim K, Werndli J, Bailey H, Kahl B

Arsenic trioxide (As(2)O(3)) has established clinical activity in acute promyelocytic leukaemia and has pre-clinical data suggesting activity in lymphoid malignancies. Cell death from As(2)O(3) may be the result of oxidative stress. Agents which deplete intracellular glutathione, such as ascorbic acid (AA), may potentiate arsenic-mediated apoptosis. This multi-institution phase II study investigated a novel dosing schedule of As(2)O(3) and AA in patients with relapsed or refractory lymphoid malignancies. Patients received As(2)O(3) 0.25 mg/kg IV and AA 1000 mg IV for five consecutive days during the first week of each cycle followed by twice weekly infusions during weeks 2-6. Cycles were repeated every 8 weeks. The primary end point was objective response. In a subset of patients, sequential levels of intracellular glutathione and measures of Bcl-2 and Bax gene expression were evaluated in peripheral blood mononuclear cells during treatment. Seventeen patients were enrolled between March 2002 and February 2004. The median age was 71, and the majority of enrolled patients had non-Hodgkin's lymphoma (12/17). Sixteen patients were evaluable, and one patient with mantle cell lymphoma achieved an unconfirmed complete response after five cycles of therapy for an overall response rate of 6%. The trial, which had been designed as a two-stage study, was closed after the first stage analysis due to lack of activity. Haematologic toxicities were the most commonly reported events in this heavily pre-treated population, and comprised the majority of grade 3 and 4 toxicities. Intracellular depletion of glutathione was not consistently observed during treatment. As(2)O(3) and AA in this novel dosing strategy was generally well tolerated but had limited activity in patients with relapsed and refractory lymphoid malignancies. Copyright (c) 2008 John Wiley & Sons, Ltd.



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Fwd: Cell cycle dysregulation influences survival in high risk breast cancer patients.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Cell cycle dysregulation influences survival in high risk breast cancer patients.
To: mesothelioma77@gmail.com


[1]Cancer Invest. 2008 Aug; 26(7): 734-40
Königsberg R, Röogelsperger O, Jäger W, Thalhammer T, Klimpfinger M, De Santis M, Hudec M, Dittrich C

BACKGROUND: Cell cycle progression is regulated by cyclin dependent kinases (cdk) and cdk inhibitors. Recent immunohistological studies suggested that dysregulation of cyclin A, cyclin D, cyclin E, p16(ink4), p21(waf1/cip1), and p27(kip1) are of prognostic value in patients with breast cancer. Our study represents the first comprehensive immunohistochemical cell cycle marker analysis for cdc25A, cyclin A, cyclin D, cyclin E, p16(ink4), p21(waf1/cip1), p27(kip1), and pRb in tumor tissue and adjacent benign breast tissue from 69 primarily untreated breast cancer patients. METHODS: Immunhistochemistry using primary monoclonal antibodies to detect cdc 25A, cyclin A, cyclin D, cyclin E, p16(ink4), p21(waf1/cip1), p27(kip1), and pRb has been performed. RESULTS: Sixty-nine patients with untreated, invasive breast cancer (n = 69) were divided into a low/ intermediate and a high risk group according to the St. Gallen 2005 consensus conference. High risk patients (n = 22) had a significantly (p = 0.003) shorter mean and median survival (282.85 weeks; 383.0 weeks, respectively) than low/intermediate risk patients (375.41 weeks; not reached yet, respectively). A subgroup of high risk breast cancer patients characterized in addition by overexpression of cdc25A, cyclin A, cyclin E, p16(ink4a), and p27(kip1) experienced a shortened mean survival of 222.03, 235.71, 257.25, 239.18, and 261.94 weeks, respectively. Regarding benign breast tissue adjacent to breast cancer tissue, 59.4% of the patients investigated overexpressed cdc25A, 23.2% overexpressed pRb, and 63.2% exerted dysregulation of p27(kip1) while they proved to be negative for immunohistochemical staining regarding all other markers tested. CONCLUSION: The immunohistological analyses of cdc25A, cyclin A, cyclin E, p16(ink4a), and p27(kip1) have the potential for further refining the risk assessment in patients with untreated breast cancer who belong to the high risk category defined according to the St. Gallen 2005 consensus conference. These cell cycle markers define a subgroup of high risk patients with even higher risk of metastazation and shortened survival. For confirmation a prospective study using standardized laboratory procedures in a larger population is needed.



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Fwd: Magnetic resonance imaging for monitoring the effects of thalidomide on experimental human breast cancers.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Magnetic resonance imaging for monitoring the effects of thalidomide on experimental human breast cancers.
To: mesothelioma77@gmail.com


[1]Eur Radiol. 2008 Jul 30;
Cyran CC, Sennino B, Chaopathomkul B, Fu Y, Rogut VS, Shames DM, Wendland MF, McDonald DM, Brasch RC

Thalidomide, which inhibits angiogenesis in certain tumor types, reduced extravasation of a macromolecular contrast medium (MMCM) in a human breast cancer model as assayed by MMCM-enhanced dynamic magnetic resonance imaging (MRI) and fluorescence microscopy in the same tumors. After a 1-week, three-dose course of thalidomide, the mean MRI-assayed endothelial transfer coefficient, K(PS), decreased significantly (p

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Fwd: Part II: Cancer in Indigenous Africans-causes and control.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Part II: Cancer in Indigenous Africans-causes and control.
To: mesothelioma77@gmail.com


[1]Lancet Oncol. 2008 Aug; 9(8): 786-95
Sitas F, Parkin DM, Chirenje M, Stein L, Abratt R, Wabinga H

Africa has contributed substantial knowledge to the understanding of certain risk factors for cancer, such as the role of several infectious agents (eg, viruses, bacteria, and parasites), aflatoxins, and certain lifestyle factors. Although the relative importance of many lifestyle factors is becoming better understood in developed countries, more work is needed to understand the importance of these factors in different African settings. In view of the substantial genetic diversity in Africa, it would be prudent not to generalise too widely from one place to the next. We argue that risks for several exposures related to certain cancers differ from the patterns seen in developed countries. In this paper, we review the current knowledge of causes of some of the leading cancers in Africa, namely cancers of the cervix, breast, liver, prostate, stomach, bladder, and oesophagus, Kaposi's sarcoma, non-Hodgkin lymphoma, and tobacco-related cancers. There are no comprehensive cancer-control programmes in Africa and provision of radiotherapy, chemotherapy, and palliation is inadequate. Certain cost-effective interventions, such as tobacco control, provision of antiretroviral therapy, and malarial and bilharzial control, can cause substantial decreases in the burden of some of these cancers. Vaccinations against hepatitis B and oncogenic human papilloma viruses can make the biggest difference, but very few countries in Africa can afford these vaccines without substantial subsidisation.



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Fwd: Rational design of novel antiandrogens for neutralizing androgen receptor function in hormone refractory prostate cancer.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Rational design of novel antiandrogens for neutralizing androgen receptor function in hormone refractory prostate cancer.
To: mesothelioma77@gmail.com


[1]Prostate. 2008 Jul 30;
Singh P, Hallur G, Anchoori RK, Bakare O, Kageyama Y, Khan SR, Isaacs JT

BACKGROUND: The standard hormonal therapy with currently available antiandrogens and the leutinizing hormone releasing hormone (LHRH) analogs is not effective in the hormone-refractory stage of prostate cancer due to changes in androgen receptor (AR) signaling axis. In this refractory stage, AR continues to play a significant role in the growth of cancer cells even though the cancer cells are no longer dependent on the level of circulating androgens. METHODS: A series of 11beta-Delta(9)-19 nortestosterone compounds were designed through structure-based rationale and tested for their binding affinity against AR and glucocorticoid receptor (GR) using fluorescence polarization assays, their agonistic ability to induce AR dependent transcription using PSA-driven report gene assays, and their growth inhibitory affects against a series of AR positive (LAPC4, LNCap, and CWR22R) and negative human prostate cancer cell lines (PC3) using MTT cell proliferation assays. RESULTS: This study proposes the design of novel bifunctional antiandrogens based on the conjugation of 11beta and/or 7alpha-Delta(9)-19 nortestosterone class of steroidal compounds to the synthetic ligand for FK506-binding proteins. As a critical step towards the development of bifunctional antiandrogens, highly potent and AR-specific lead compounds were identified using in vitro data. The lead compounds identified in this study possessed low binding affinity for GR, indicating the absence of undesirable antiglucocorticoid activity. CONCLUSIONS: The results of this study validate our drug discovery rationale based on the structural biology of AR and pave the pay for future development of bifunctional compounds in order to block AR function in hormone refractory stage of prostate cancer. Prostate (c) 2008 Wiley-Liss, Inc.



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Fwd: Is pleomorphic lobular carcinoma really a distinct clinical entity?

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Is pleomorphic lobular carcinoma really a distinct clinical entity?
To: mesothelioma77@gmail.com


[1]J Surg Oncol. 2008 Jul 30;
Buchanan CL, Flynn LW, Murray MP, Darvishian F, Cranor ML, Fey JV, King TA, Tan LK, Sclafani LM

BACKGROUND: Attempts to define the clinical behavior of pleomorphic lobular carcinoma (PLC) have been limited to small series, and clinical management strategies have yet to be established. We describe our experience with PLC as compared to classic ILC and invasive ductal carcinoma (IDC). METHODS: From 9/1996 to 5/2003, clinical and histopathologic data for 5,635 patients undergoing primary surgical treatment and sentinel lymph node biopsy for breast cancer were collected. Four hundred eighty one (8.5%) patients were diagnosed with ILC; 3,978 (70.6%) with IDC. Of those with ILC, 356 (74%) patients had material available for pathologic re-review and comprise our study population: 52 were classified as PLC; 298 were classified as classic ILC; and 6 cases were reclassified as IDC. We compared clinical, pathologic, and treatment factors for patients with PLC, ILC, and IDC using the Wilcoxon rank sum and Fisher's exact tests. RESULTS: PLC were larger than ILC and IDC (20 vs. 15 vs. 13, P

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Fwd: [The attendance of the second screening period (2004-2005) of the Hungarian organized breast cancer screening program.]

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: [The attendance of the second screening period (2004-2005) of the Hungarian organized breast cancer screening program.]
To: mesothelioma77@gmail.com


[1]Orv Hetil. 2008 Aug 10; 149(32): 1491-8
Boncz I, Sebestyén A, Döbrossy L, Péntek Z, Kovács A, Budai A, Kövi R, Ember I

Aim: Organised, nationwide screening for breast cancer with mammography in the age group of 45-65 years with a 2-year screening interval started in Hungary in January 2002. The aim of this study is to analyze the attendance rate of breast screening programme, including the analysis of the ratio of screening and diagnostic mammography examinations. Data and methods: The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the 6-year period between 2000-2006. The ratio of women in the age group of 45-65 years was calculated having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 before and 2002-2003, 2004-2005 after the implementation of nationwide organised programme. Results: In the years 2000-2001 7.26% of the women aged 45-65 had an opportunistic screening mammography, while in 2002-2003 34% and in 2004-2005 29.5% of the target population had screening mammography within the organised programme. During the same periods 19.8% (2000-2001), 22.1% (2002-2003) and 23.2% (2004-2005) of women aged 45-65 had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.2% (2000-2001) to 53.5% (2002-2003) and 50.8% (2004-2005). Conclusions: The attendance of the Hungarian organised breast cancer screening programme slightly declined in 2004-2005, and to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.



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Fwd: [Epidemiological data on radiation-induced breast cancer.]

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: [Epidemiological data on radiation-induced breast cancer.]
To: mesothelioma77@gmail.com


[1]Rev Epidemiol Sante Publique. 2008 Jul 29;
Telle-Lamberton M

BACKGROUND: Female breast cancer is the most frequent cancer, both in incidence and mortality. It is well known that exposure to ionizing radiation increases the risk, but some questions remain concerning low dose and low-dose rate effects and cofactors. These potential effects have to be taken into account to carry out adequate risk assessment on medically exposed populations. A literature review is proposed on this issue. METHODS: A Medline research was undertaken. Keywords used were ionizing radiation, breast cancer and epidemiology. More studies were added through references included in the first list of articles. The focus was placed on studies including quantitative dose-effect relationship analyses. RESULTS: A latency of five to 10 to 13 years is observed in the appearance of risk. The risk diminishes with age at exposure. A diminution with age at risk is also suspected. The excess relative risk per gray varies between 0.3 and 1.5 for an age at first exposure of 25 years. The study of Hiroshima and Nagasaki survivors shows that risk is increased even if doses are restricted to below 0.5Gy. Above high doses (20Gy), the risk no longer increases. This can be interpreted as a cell-killing effect. The excess subsists if doses are fractionated, but a diminution of the effect is suspected. CONCLUSION: The effects of exposure to levels of doses used for medical diagnostic are very difficult to study in the general population by epidemiological methods. Only studies conducted on very young children could achieve enough power, because of their high radiosensitivity. Available information on the effects of doses above 0.5Gy allows extrapolation on maximal effects. Models deduced from existing cohorts can be used to assess risk, with their limits due to associated uncertainties. Preston et al. proposed an excess absolute-risk model, which makes estimates from the more comprehensive cohorts compatible. This model has been retained by the 2006 committee "Biological effects of ionizing radiation" (report VII).



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Fwd: Perspectives on hormone replacement therapy: the Women's Health Initiative and new observational studies sampling the overall population.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Perspectives on hormone replacement therapy: the Women's Health Initiative and new observational studies sampling the overall population.
To: mesothelioma77@gmail.com


[1]Fertil Steril. 2008 Aug; 90(2): 258-64
Tannen RL, Weiner MG, Xie D, Barnhart K

This commentary integrates the most recent information on coronary heart disease from the Women's Health Initiative (WHI) trial and our new large observational studies, which complement and expand the WHI results to the overall population. Breast and colon cancer findings are also considered.



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Fwd: Breast cancer stem cells: implications for therapy of breast cancer.

---------- Forwarded message ----------
From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Breast cancer stem cells: implications for therapy of breast cancer.
To: mesothelioma77@gmail.com


[1]Breast Cancer Res. 2008 Jul 22; 10(4): 210
Morrison BJ, Schmidt CW, Lakhani SR, Reynolds BA, Lopez JA

ABSTRACT: The concept of cancer stem cells responsible for tumour origin, maintenance, and resistance to treatment has gained prominence in the field of breast cancer research. The therapeutic targeting of these cells has the potential to eliminate residual disease and may become an important component of a multimodality treatment. Recent improvements in immunotherapy targeting of tumour-associated antigens have advanced the prospect of targeting breast cancer stem cells, an approach that might lead to more meaningful clinical remissions. Here, we review the role of stem cells in the healthy breast, the role of breast cancer stem cells in disease, and the potential to target these cells.



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Fwd: Is there a qualitative interaction between adjuvant trastuzumab and size of the primary tumor in breast cancer?

---------- Forwarded message ----------
From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Is there a qualitative interaction between adjuvant trastuzumab and size of the primary tumor in breast cancer?
To: mesothelioma77@gmail.com


[1]Neoplasma. 2008; 55(5): 375-80
P V, B M

Benefit of adjuvant trastuzumab in breast cancer has been reported in four randomized trials of phase III, and these results are consistent in showing improvement in disease-free survival (DFS). Current evidence for homogeneity of this DFS benefit in subgroups of patients with the different size of the primary HER2-positive tumor treated according to the HERA trial is reviewed. It is evident that current published evidence is insufficient to rule out that there is a cohort of patients with HER2-positive disease who do not achieve a reduction in the risk of recurrence by adjuvant treatment with trastuzumab after completion of previous adjuvant chemo- and radiotherapy. An alternative interpretation of results of the HERA trial currently available in two primary reports (1-year, and 2-year median follow- up, respectively) is discussed. The risk factors of central nervous system (CNS) metastases in breast cancer and problem of CNS metastases in HER2-positive tumors are briefly reviewed. A hypothesis on the relations between brain metastases, their risk factors, the size of the primary tumor, and their impact on the DFS in patients with HER2-positive tumors treated with adjuvant trastuzumab is proposed based on the results of the HERA trial. Altogether, some direct evidence is presented here based on the published results of the HERA trial, and still more indirect evidence based on the information on related topics in literature, to show that current clinical practice of adjuvant trastuzumab in mono-therapy, which is based on assumption that there is a homogeneous benefit as for disease-free survival for all sizes of primary HER2-positive tumors above 1 cm, may not be based on such firm evidence as is commonly presented. Key words: breast cancer; trastuzumab; adjuvant; brain metastases.



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Fwd: Cytosine deaminase expressing human mesenchymal stem cells mediated tumour regression in melanoma bearing mice.

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Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Cytosine deaminase expressing human mesenchymal stem cells mediated tumour regression in melanoma bearing mice.
To: mesothelioma77@gmail.com


[1]J Gene Med. 2008 Aug 1;
Kucerova L, Matuskova M, Pastorakova A, Tyciakova S, Jakubikova J, Bohovic R, Altanerova V, Altaner C

BACKGROUND: Previously, we validated capability of human adipose tissue-derived mesenchymal stem cells (AT-MSC) to serve as cellular vehicles for gene-directed enzyme prodrug molecular chemotherapy. Yeast fusion cytosine deaminase : uracil phosphoribosyltransferase expressing AT-MSC (CD(y)-AT-MSC) combined with systemic 5-fluorocytosine (5FC) significantly inhibited growth of human colon cancer xenografts. We aimed to determine the cytotoxic efficiency to other tumour cells both in vitro and in vivo. METHODS: CD(y)-AT-MSC/5FC-mediated proliferation inhibition against a panel of human tumour cells lines was evaluated in direct and indirect cocultures in vitro. Antitumour effect was tested on immunodeficient mouse model in vivo. RESULTS: Although culture expansion of CD(y)-AT-MSC sensitized these cells to 5FC mediated suicide effect, expanded CD(y)-AT-MSC/5FC still exhibited strong bystander cytotoxic effect towards human melanoma, glioblastoma, colon, breast and bladder carcinoma in vitro. Most efficient inhibition (91%) was observed in melanoma A375 cell line when directly cocultured with 2% of therapeutic cells CDy-AT-MSC/5FC. The therapeutic paradigm of the CDy-AT-MSC/5FC system was further evaluated on melanoma A375 xenografts on nude mice in vivo. Complete regression in 89% of tumours was achieved when 20% CD(y)-AT-MSC/5FC were co-injected along with tumour cells. More importantly, systemic CD(y)-AT-MSC administration resulted in therapeutic cell homing into subcutaneous melanoma and mediated tumour growth inhibition. CONCLUSIONS: CD(y)-AT-MSC capability of targeting subcutaneous melanoma offers a possibility to selectively produce cytotoxic agent in situ. Our data further demonstrate beneficial biological properties of AT-MSC as a cellular vehicle for enzyme/prodrug therapy approach to molecular chemotherapy. Copyright (c) 2008 John Wiley & Sons, Ltd.



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Fwd: Localization of laminin alpha3B chain in vascular and epithelial basement membranes of normal human tissues and its down-regulation in skin cancers.

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Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Localization of laminin alpha3B chain in vascular and epithelial basement membranes of normal human tissues and its down-regulation in skin cancers.
To: mesothelioma77@gmail.com


[1]J Mol Histol. 2008 Aug 1;
Kariya Y, Mori T, Yasuda C, Watanabe N, Kaneko Y, Nakashima Y, Ogawa T, Miyazaki K

The basement membrane (BM) proteins laminins, which consist of alpha, beta and gamma chains, play critical roles in the maintenance of tissue structures. One of laminin alpha chains, alpha3 has two isoforms, the truncated form alpha3A and the full-sized form alpha3B. In contrast to alpha3A laminins, little is known about alpha3B laminins. To show the histological distribution of the laminin alpha3B chain, we prepared alpha3B-specific monoclonal antibodies. Immunohistochemical analysis showed that the alpha3B chain was colocalized with the alpha3A, beta3 and gamma2 chains in the epithelial BMs of the skin, esophagus, breast and lung, suggesting the presence of laminin-3B32 (laminin-5B) and laminin-3A32 (laminin-5A). In the lung alveoli, laminin-3B32 was dominant over laminin-3A32, but vice versa in other epithelial BMs. In contrast, the BMs of blood vessels including capillaries were strongly positive for alpha3B, but almost or completely negative for alpha3A, beta3 and gamma2. alpha3B was colocalized with beta1 and gamma1 in these BMs. The alpha3B chain was scarcely detected in the vessels of malignant skin cancers, though the gamma2 and beta3 chains were highly expressed in the cancer cells. These results strongly suggest that the laminin alpha3B chain is widely expressed in vascular BMs of normal tissues, probably as laminin-3B11/3B21 (laminin-6B/7B).



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Fwd: Venlafaxine versus clonidine for the treatment of hot flashes in breast cancer patients: a double-blind, randomized cross-over study.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Venlafaxine versus clonidine for the treatment of hot flashes in breast cancer patients: a double-blind, randomized cross-over study.
To: mesothelioma77@gmail.com


[1]Breast Cancer Res Treat. 2008 Aug 1;
Buijs C, Mom CH, Willemse PH, Marike Boezen H, Maurer JM, Wymenga AN, de Jong RS, Nieboer P, de Vries EG, Mourits MJ

Purpose Breast cancer patients with treatment-induced menopause experience frequent and severe hot flashes (HF). We compared venlafaxine and clonidine for the treatment of HF with regard to side effects, efficacy, quality of life and sexual functioning. Methods In a double-blind, cross-over study, 60 breast cancer patients experiencing HF were randomized to 8 weeks venlafaxine followed by 2 weeks wash-out, and 8 weeks clonidine or vice versa. HF frequency and severity, side effects, quality of life and sexuality were assessed. Results Thirty patients started with venlafaxine and 30 with clonidine. Premature discontinuation for toxicity occurred in 14/59 during venlafaxine and 5/53 during clonidine (P = .038). Venlafaxine induced more side effects. Median reduction in HF score was 49% for venlafaxine and 55% for clonidine (ns). Conclusion Venlafaxine and clonidine are equally, but moderately effective in HF reduction. Side effects are the main reason for drug discontinuation, occurring more often with venlafaxine.



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Fwd: Molecular targeted therapies for breast cancer treatment.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Molecular targeted therapies for breast cancer treatment.
To: mesothelioma77@gmail.com


[1]Breast Cancer Res. 2008 Jul 24; 10(4): 211
Schlotter CM, Vogt U, Allgayer H, Brandt B

ABSTRACT: Targeting the oestrogen receptor, HER2 (human epidermal growth factor receptor 2) and vascular endothelial growth factor has markedly improved breast cancer therapy. New targeted therapeutic approaches to induction of apoptosis or inhibition of anti-apoptosis, cell cycle progression, signal transduction and angiogenesis are described. The molecular pathways and their inhibitory or repair mechanisms are discussed in the preclinical and clinical settings.



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Fwd: Can we assume that research participants are utility maximisers?

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Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Can we assume that research participants are utility maximisers?
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[1]Eur J Health Econ. 2008 Jul 30;
Griffith GL, Morrison V, Williams JM, Edwards RT

The objective of this study was to experimentally examine by means of an information manipulation if respondents are adhering to the utility theory axiom of utility maximisation. A repeated measure experimental design was used. Assessments were conducted pre- and post-intervention with self-administered questionnaires. The study participants were 158 (142 after exclusions) first year undergraduate students, Bangor University (UK). The intervention-information manipulation-did not induce the hypothesised changes in the perceived pros and cons of, or desire for, genetic testing and counselling for breast cancer; correlation revealed a weak relationship between the pros and cons of and desire for testing and counselling. We conclude that there was no evidence of utility maximisation-the key tenet of utility theory-being used. Given the contradiction between the findings of this study and others, there is a need to conduct further research into utility maximisation.



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Fwd: Preparation, characterization, in-vitro drug release and cellular uptake of poly(caprolactone) grafted dextran copolymeric nanoparticles loaded with anticancer drug.

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Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Preparation, characterization, in-vitro drug release and cellular uptake of poly(caprolactone) grafted dextran copolymeric nanoparticles loaded with anticancer drug.
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[1]J Biomed Mater Res A. 2008 Jul 31;
Prabu P, Chaudhari AA, Dharmaraj N, Khil MS, Park SY, Kim HY

Biodegradable and biocompatible polymers that are engineered to nanostructures play a key role in providing solution for sustained chemotherapy. This study is focused on preparation, drug encapsulation efficiency, in-vitro drug release, in-vitro cellular uptake and cell viability of poly(caprolactone) grafted dextran (PGD) nanoparticles (NPs) formulation containing vinblastine as the anticancer drug. Drug-loaded PGD NPs were prepared by a modified oil/water emulsion method and characterized by laser light scattering, atomic force microscopy (AFM), and zeta potential. The drug encapsulation efficiency was determined spectrophotometrically and in-vitro drug release was estimated using dialysis bag. Breast cancer cell line (MCF-7) was used to image and measure the cellular uptake of fluorescent PGD NPs. Cancer cell viability was assessed by treating MCF-7 cells with vinblastine-loaded PGD NPs by crystal violet staining method. Result showed that the vinblastine-loaded PGD NPs were superior in properties such as drug encapsulation efficiency, the cellular uptake and the cancer cell mortality. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2008.



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Fwd: Addressing the needs of young breast cancer survivors at the 5 year milestone: can a short-term, low intensity intervention produce change?

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Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Addressing the needs of young breast cancer survivors at the 5 year milestone: can a short-term, low intensity intervention produce change?
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[1]J Cancer Surviv. 2008 Aug 1;
Bloom JR, Stewart SL, D'Onofrio CN, Luce J, Banks PJ

BACKGROUND: Today, the 5-year relative survival rate for cancer is 65% and there are 10.5 million survivors. The largest group of survivors are those of breast cancer. Reductions in mortality are occurring at a greater rate for women under age 50 at diagnosis than among older women. AIMS: Our goal was to design a socio-educational intervention for 5-year survivors aged 50 or younger at diagnosis and test the hypotheses that women in the intervention group would show greater improvement than controls with respect to (1) knowledge of breast cancer, its treatment, and long-term health concerns; (2) lifestyle habits (i.e., exercise and diet); and (3) communication with family and physicians. METHODS: Using a randomized controlled trial with a pre-post design, 404 women who were 5 years from diagnosis and cancer-free (response rate 54%) were randomly assigned to an intervention or delayed intervention (control) group and were assessed at pre-test (baseline) and 6 months later (96% retention). The intervention consisted of three 6-h workshops over a 3 month period. Four series of workshops were held at different geographical areas in the greater San Francisco Bay Area. The workshops included activities and information to promote physical, social, emotional, and spiritual well-being. The intervention design was based on findings from focus groups and a survey of 185 cancer-free 5-year survivors that assessed changes since the early months after diagnosis in physical, social, emotional, and spiritual concerns (response rate 73%). RESULTS: Consistent with our first hypothesis, at post-test, women in the intervention group, on average, had greater knowledge regarding breast cancer, its treatment, and their own future health than did those in the control group (p = 0.015). Hypothesis 2 was partially supported as women in the intervention group were more likely than the control group to report an increased amount of physical activity (p = 0.036), but not significant dietary changes. Social support was related to increased self report of physical activity. With the exception of the last series of workshops, the intervention group did not report improved communications with family, friends, and physicians (hypothesis 3). CONCLUSIONS: A short-term intervention can affect knowledge levels and physical activity but not diet or communication in the family. IMPLICATIONS FOR CANCER SURVIVORS: The intervention was related to greater knowledge related to breast cancer, and increased report of physical activity. The program was not related to changes in reported diet or family communication.



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Fwd: Management of women who have a genetic predisposition for breast cancer.

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Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Management of women who have a genetic predisposition for breast cancer.
To: mesothelioma77@gmail.com


[1]Surg Clin North Am. 2008 Aug; 88(4): 845-61
Jatoi I, Anderson WF

The management of women who have a genetic predisposition for breast cancer requires careful planning. Women who have BRCA 1 and BRCA 2 mutations are at increased risk for breast cancer and for other cancers as well, particularly ovarian cancer. Screening, prophlyactic surgery, and chemoprevention are commonly utilized strategies in the management of these patients, and women may choose more than one of these strategies. No randomized prospective trials have assessed the impact of these strategies specifically in mutaiton carriers. All patients should be informed that screening, prophylactic surgery, and chemoprevention have the potential for harm as well as benefit.



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Fwd: Phantom Breast and Other Syndromes After Mastectomy: Eight Breast Cancer Patients Describe Their Experiences Over Time: A 2-Year Follow-up Study.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Phantom Breast and Other Syndromes After Mastectomy: Eight Breast Cancer Patients Describe Their Experiences Over Time: A 2-Year Follow-up Study.
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[1]J Pain. 2008 Jul 29;
Björkman B, Arnér S, Hydén LC

Patients often experience hard-to-treat neuropathic pain and other sensations after surgery; consequently, they could develop chronic pain conditions. The phantom limb phenomenon is a well-documented postoperative pain condition. However, phantom phenomena after mastectomies are less documented. The reviews report several views on the prevalence of breast phantoms and coexisting distress. Researchers observed that new methodological approaches might facilitate further research of these issues. This prospective, qualitative study used semistructured interviews to acquire knowledge of if and how phantom breast phenomena appear within the range of other postmastectomy symptoms and sensations. The study revealed that a phantom breast could be difficult to describe and position spatially. The phantom breast phenomenon varied from classic phantom extremity phenomenon and did not seem to cause much distress. However, it proved to be a phenomenon so unknown and different that there is urgent need for more knowledge. This study highlights the importance of further investigation regarding how information and communication related to a phantom breast might be developed. PERSPECTIVE: The phantom breast is only one piece of a complicated puzzle. Because it was relatively unknown for the women in the study, it is important that analyses of this phenomenon, as a part of a postmastectomy syndrome, be conducted in a dialogue with the patients, by scientifically using qualitative methods.



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Fwd: The guardians' perspective on paediatric cancer treatment in Malawi and factors affecting adherence.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: The guardians' perspective on paediatric cancer treatment in Malawi and factors affecting adherence.
To: mesothelioma77@gmail.com


[1]Pediatr Blood Cancer. 2008 Jul 30;
Israëls T, Chirambo C, Caron H, de Kraker J, Molyneux E, Reis R

BACKGROUND: Abandonment of paediatric cancer treatment is a common problem in developing countries. Little is known about the guardians' perspective on cancer treatment in these countries, especially the factors that affect adherence. METHODS: Following a pilot study enquiring into the possible causes of abandonment, a problem analysis diagram was drawn which helped to develop the questionnaires. Semi-structured interviews (n = 83) and focus group discussions (n = 8) were held with the guardians of 25 Burkitt lymphoma patients and 7 Wilms tumour patients at different phases of therapy in Malawi. RESULTS: Parents in Malawi are very motivated to continue treatment if they think that it will cure their child. Financial costs are important concerns. Not all tasks at home are assumed by other household members. The diagnosis of cancer was unknown before being told about it in hospital and caused fear of recurrence and death. Guardians are reluctant to ask the health personnel questions. They worry that taking frequent blood samples will weaken their child. The side effects of the chemotherapy are seen as a proof of efficacy. CONCLUSION: It is important to appreciate the guardians' concerns when offering treatment that requires their sustained commitment. It is necessary to provide not only medical treatment, but also travel allowances and adequate nutritional support during long hospital stays to impoverished families. Information should be given proactively. Pediatr Blood Cancer (c) 2008 Wiley-Liss, Inc.



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Fwd: Effectiveness of service screening: a case-control study to assess breast cancer mortality reduction.

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Date: Fri, Aug 1, 2008 at 4:32 PM
Subject: Effectiveness of service screening: a case-control study to assess breast cancer mortality reduction.
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[1]Br J Cancer. 2008 Aug 5; 99(3): 423-7
Puliti D, Miccinesi G, Collina N, De Lisi V, Federico M, Ferretti S, Finarelli AC, Foca F, Mangone L, Naldoni C, Petrella M, Ponti A, Segnan N, Sigona A, Zarcone M, Zorzi M, Zappa M, Paci E

The aim of this study was the evaluation of the impact of service screening programmes on breast cancer mortality in five regions of Italy. We conducted a matched case-control study with four controls for each case. Cases were defined as breast cancer deaths occurred not later than 31 December 2002. Controls were sampled from the local municipality list and matched by date of birth. Screening histories were assessed by the local, computerised, screening database and subjects were classified as either invited or not-yet-invited and as either screened or unscreened. There were a total of 1750 breast cancer deaths within the 50 to 74-year-old breast cancer cases and a total of 7000 controls. The logistic conditional estimate of the cumulative odds ratios comparing invited with not-yet-invited women was 0.75 (95% CI: 0.62-0.92). Restricting the analyses to invited women, the odds ratio of screened to never-respondent women corrected for self-selection bias was 0.55 (95% CI: 0.36-0.85). The introduction of breast cancer screening programmes in Italy is associated with a reduction in breast cancer mortality attributable to the additional impact of service screening over and above the background access to mammography.British Journal of Cancer (2008) 99, 423-427. doi:10.1038/sj.bjc.6604532 www.bjcancer.com.



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Fwd: Return to Work After Early-stage Breast Cancer: A Cohort Study into the Effects of Treatment and Cancer-related Symptoms.

---------- Forwarded message ----------
From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: Return to Work After Early-stage Breast Cancer: A Cohort Study into the Effects of Treatment and Cancer-related Symptoms.
To: mesothelioma77@gmail.com


[1]J Occup Rehabil. 2008 Aug 1;
Balak F, Roelen CA, Koopmans PC, Ten Berge EE, Groothoff JW

Introduction Earlier diagnosis and better treatment have increased the survival rates of cancer patients. This warrants research on return to work of cancer survivors. What is the return to work rate following early-stage breast cancer? What is the effect of the type of treatment and cancer-related symptoms on return to work? Methods Our occupational health department registers sickness absence of about 50,000 employees. In the period 2001-2005 we counted 154 cases of newly diagnosed breast cancer of which 72 were eligible for analysis. In these women, return to work was followed for 24 months after diagnosis and linked to the type of treatment and cancer-related symptoms. Results The mean duration of absence with early-stage breast cancer was 11.4 +/- 5.5 months; 35% of patients were absent longer than one year and 4 patients did not return to work within two years after diagnosis. The duration of absence depended on the type of treatment and was significantly longer in patients who underwent chemotherapy (hazard rate [HR] = 0.31; 95% confidence interval [CI] = 0.12-0.81) or multimodal treatment (HR = 0.24; 95% CI = 0.10-0.54). Women started working about 4 months after the end of therapy irrespective of the type of treatment. At that moment, reaching above shoulder level was impaired in 11 patients (15%) which significantly delayed partial return to work (HR = 0.48; 95% CI = 0.23-0.98) but not full return to work (HR = 0.63; 95% CI = 0.31-1.26). Fatigue was reported by 9 patients (13%) and neither postponed partial return to work nor full return to work. Conclusions The time taken to return to work after early-stage breast cancer was principally determined by the type of treatment.



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Fwd: A Method to Quantify Residents' Jargon Use During Counseling of Standardized Patients About Cancer Screening.

---------- Forwarded message ----------
From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sun, Aug 3, 2008 at 8:08 AM
Subject: A Method to Quantify Residents' Jargon Use During Counseling of Standardized Patients About Cancer Screening.
To: mesothelioma77@gmail.com


[1]J Gen Intern Med. 2008 Aug 1;
Deuster L, Christopher S, Donovan J, Farrell M

BACKGROUND: Jargon is a barrier to effective patient-physician communication, especially when health literacy is low or the topic is complicated. Jargon is addressed by medical schools and residency programs, but reducing jargon usage by the many physicians already in practice may require the population-scale methods used in Quality Improvement. OBJECTIVE: To assess the amount of jargon used and explained during discussions about prostate or breast cancer screening. Effective communication is recommended before screening for prostate or breast cancer because of the large number of false-positive results and the possible complications from evaluation or treatment. PARTICIPANTS: Primary care internal medicine residents. MEASUREMENTS: Transcripts of 86 conversations between residents and standardized patients were abstracted using an explicit-criteria data dictionary. Time lag from jargon words to explanations was measured using "statements," each of which contains one subject and one predicate. RESULTS: Duplicate abstraction revealed reliability kappa = 0.92. The average number of unique jargon words per transcript was 19.6 (SD = 6.1); the total jargon count was 53.6 (SD = 27.2). There was an average of 4.5 jargon-explanations per transcript (SD = 2.3). The ratio of explained to total jargon was 0.15. When jargon was explained, the average time lag from the first usage to the explanation was 8.4 statements (SD = 13.4). CONCLUSIONS: The large number of jargon words and low number of explanations suggest that many patients may not understand counseling about cancer screening tests. Educational programs and faculty development courses should continue to discourage jargon usage. The methods presented here may be useful for feedback and quality improvement efforts.



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