Archives for March 2013

Cancer Breathalyzer

Cancer Breathalyzer

Not only do cancer cells grow and spread differently than normal cells, many of them also digest chemicals differently. We’re learning that small amounts of these chemicals (such as benzene and formaldehyde) can be detected in the breath of cancer patients. And that just might give us a new, easier way to detect cancer in the first place.

 A report from the British Journal of Surgery describes early success with just such a specialized “breathalyzer”. In a small group of patients (some of whom had colon cancer) the breath test could identify the cancer patients 76% of the time. And earlier this year, an Israeli study of 74 patients tested whether a breath test could tell malignant lung tumors from benign ones (the breath test was correct 90% of the time).

These early results are promising, but there’s a lot more work to be done before any of this is ready for clinical use. To be really useful, a screening test must detect a cancer before it’s had a chance to spread. A test that can only identify cancer in the later, incurable stages isn’t going to do anyone much good. We’ll need a lot more patients to participate in good clinical trials if this is going to go anywhere.

But I’ll admit to being optimistic. I keep remembering all the stories patients have told me about dogs or cats closely sniffing a body part affected by cancer, as though their pets could smell something different. And one of my mentors used to say “if a shark can detect a drop of blood in several gallons of ocean water, we should be able to identify tumors by smell”. Maybe he was right all along.

Breath testing in lung cancer:

Breath testing in colon cancer:

Clinical trials:

Rivaroxaban approved for the treatment of DVT and PE

Rivaroxaban approved for the treatment of DVT and PE

In early November 2012, the FDA expanded the approved use of rivaroxaban (brand name Xarelto) to be used for the treatment of blood clots in deep veins (deep venous thrombosis, DVT) and in pulmonary arteries (pulmonary embolism, PE).  Rivaroxaban was originally approved for the treatment of patients with atrial fibrillation. DVT and PE are major health concerns in the United States with about 300,000 patients diagnosed annually.  It is estimated that DVT and PE are the cause of 100,000 deaths per year.

The standard treatment for these conditions in the US has consisted of starting patients on unfractionated heparin or low molecular weight heparin  followed by a Vitamin K antagonist (Coumadin or warfarin). This treatment requires frequent blood monitoring.

Analysis of the Einstein PE trial showed that rivaroxaban, which does not require regular monitoring, is not inferior to the standard treatment.

One word of caution regarding the results: only 5% of patients in the Einstein PE trial had malignancies and clearly more data are needed before rivaroxaban can be uniformly recommended for patients with cancer and DVT/PE. 

Does Sugar Cause Cancer Cells to Grow?

Does Sugar Cause Cancer Cells to Grow?

FACT:  Sugar does not make cancer cells grow faster! 

The truth is that all cells in our body use a form of simple sugar, called glucose, for energy.  We get sugar from foods that contain carbohydrates, protein and fat. Even though sugar does not “feed” cancer cells it is a good idea to limit the amount of simple sugars you eat. 

Too much sugar can lead to high insulin levels.  Insulin can tell “healthy cells” to grow which is good.  Our bodies need insulin to function, but it is unhealthy if we make too much insulin or if our body develops resistance to it.  It is in this way that cancer risk is increased in diabetics, not from sugar itself.

Does this mean we need to stop eating all sugar?  NO!  Remember, the normal cells in our body still need some sugar for energy.  If we eat less sugar, our bodies will compensate by making sugar from other sources. 

Like the other cells in our body, cancer cells need fuel.   Our bodies are carefully tuned to maintain blood sugar levels at a constant level.  In the complete absence of sugar, body cells use other fuels like ketones.  There is no evidence that cancer cells prefer one form of fuel over the other.  So, there is no way to “starve” a tumor by eating less sugar. 

It is important to eat a well-balanced diet including good carbohydrates, fats, proteins, and fiber, and yes, sugar.  This helps maintain your energy level and avoid other health issues while dealing with your cancer diagnosis. 


Another Advance in the Treatment of Prostate Cancer

Another Advance in the Treatment of Prostate Cancer

For many years, options for the treatment of advanced prostate cancers remained unchanged while advances were made in other areas of cancer treatment.  That has changed recently with multiple new treatments for prostate cancer.  Enzulatimide (Xtandi) is the latest development in advanced prostate cancer treatment.

We have known for a long time that blocking testosterone can be an effective way of treating prostate cancer; but often the cancer cells learn to grow despite this blockade.  One way cancer cells have become resistant is by using the androgen receptor (where testosterone acts) to drive cell growth and spread, even when testosterone is not present.  This new medicine, Enzulatimide, can enter the cell and destroy this receptor effectively halting the cancer in place. 

Enzulatimide appears to be well-tolerated and has been shown to increase survival of prostate cancer patients.

Please discuss any questions you may have with your physician.