Category: Cancer

Fast Relief for Breakthrough Cancer Pain

Fast Relief

“Breakthrough” pain, a transitory exacerbation of pain that has been generally stable, can be unpredictable and can escalate rapidly in patients with cancer. Oral opioid agents are not always the answer because they may act too slowly.

A nasal morphine-chitosan solution might be a fast, reliable, convenient way to tame breakthrough pain, say British researchers who conducted a pilot study of the drug combination. The nose offers advantages to enhance drug absorption, because it is a large, highly vascularized surface area and the venous blood drains from the nose directly into the systemic circulation, thus avoiding hepatic first-pass metabolism.

Chitosan, a bioadhesive material that binds to mucous membranes, provides other benefits. Morphine, a hydrophilic drug, is poorly absorbed nasally. Chito-san delays clearance and gives the drug more time to work. Adding chito-san to morphine boosts its nasal bioavailability from 10% to 54%, with a time to maximum concentration of 15 minutes. In contrast, even “immediate-release” morphine can take 20 to 30 minutes to begin relieving pain, with peak analgesia reached after one hour or more.
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In the study of 14 patients, the researchers observed 20 episodes of breakthrough pain. The patients were given 5 to 80 mg of nasal morphine-chitosan in addition to their regularly prescribed analgesics. Nearly all of the patients rated the treatment as “good” to “excellent”; two found it only “fair.” Morphine-chitosan acted rapidly, with pain relieved or reduced after only five minutes and with maximal improvement reached after 45 minutes.

Side effects were slight and transient. Four patients reported “severe” taste disturbance, which was apparently dose-related. The most common adverse effect was sedation, reported during 16 episodes.

The researchers suggest that the formulation allows morphine to be given more conveniently, which might benefit patients at home and those who are vomiting or unable to swallow.

Low-dose Aspirin Lowers Risk of Colon Polyps

A baby aspirin taken daily reduces the risk of recurring polyps in patients with advanced adenomas or colorectal cancer, researchers reported at the annual meeting of the American Association for Cancer Research. Their study of 1,121 patients had an unexpected finding: the lower dose (80 mg) had a greater preventive effect, reducing the risk of advanced adenoma by 40%. The 325-mg dose reduced the overall risk of adenoma recurrence by only 4% and the risk of recurrence of advanced adenomas and colorectal cancers by 19%. buy sumatriptan

It is premature to recommend a daily 80-mg aspirin regimen for all adults over 50 years of age, because this group is at an only mildly elevated risk. Study results are going to be analyzed to determine possible reasons for the different effects that resulted from different doses.

Cervical Cancer Vaccine: Ineffective During Ovulation

A vaccine that protects against human papillomavirus 16 (HPV16), the virus that causes cervical cancer, produces antibodies against HPV16 at the site where cervical cancer develops—a promising indication of the vaccine’s effectiveness. Because antibody levels appear to decrease around the time of ovulation, however, the vaccine might be less effective during that time. A vaccine is considered promising if it produces an immune response (as determined by antibody levels) at disease-specific sites (e.g., the cervix). Although previous studies showed that an HPV16 vaccine can trigger an immune response and can protect against HPV16 infection, most of these studies involved women …

Breast Cancer Risk and HRT

Estrogen-progestin combination therapy (Prempro™, Wyeth), which was recommended for many years to treat the symptoms of menopause, also appears to make mammograms less reliable or more difficult to read and may delay the diagnosis of breast cancer.

Findings from the Women’s Health Initiative (WHI) in 2003 prompted millions of American women to discontinue hormone replacement therapy (HRT), which had once been viewed as a panacea for menopausal complaints.

Because of the apparent health risks, the estrogen-progestin part of the WHI study was stopped early in 2002. The new data found a 24% increase in breast cancer risk (an increase in the lifetime risk from one in eight to about one in seven). levothyroxine 50 mcg

Although earlier studies indicated that hormone users tended to have curable, slow-growing breast tumors, the WHI found that these tumors were likely to be as aggressive as those in nonusers. Hormone users also had a higher number of abnormal mammograms, with larger and more advanced tumors at diagnosis. This might be because HRT increases breast density, making mammograms less reliable, or because the hormones stimulate cancerous growth, or both.

A Novel Therapy: Bortezomib for Multiple Myeloma

Multiple Myeloma

Millennium Pharmaceuticals has announced the FDA’s approval of bortezomib (VelcadeTM) for patients with multiple myeloma who have received at least two prior courses of therapy and have demonstrated disease progression. Myeloma is the second most common cancer of the blood, responsible for approximately 1% of all cancers and 2% of all cancer deaths.

A proteasome inhibitor, bortezomib represents the only new and approved treatment option for multiple myeloma in more than a decade. It is a dipeptide boronic acid that has been found to enhance the sensitivity of cancer cells to chemotherapy agents and seems to overcome drug resistance. Proteasome inhibitors cause cancer cells to stop dividing and to eventually die. Researchers hope that disrupting the cancer cell protea-some can delay the disease and even bring about remissions.
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Side effects of treatment were generally predictable and manageable.

Drug Aids Survival in Early Breast Cancer

A chemotherapy cocktail that contains docetaxel (Taxotere®, Aventis) has shown promise in improving survival rates for women with early-stage breast cancer while reducing the likelihood of recurrence.

Researchers presented their findings at the San Antonio Breast Cancer Symposium, held from December 2-6, 2003. In a study of almost 1,500 women, 87% of those who were taking the drug were alive 55 months later, compared with 81% of women taking 5-fluorouracil, a commonly used therapy. In addition, 75% remained disease-free, compared with 68% receiving the standard treatment. prevacid online

The researchers suggested that if all patients with newly diagnosed disease received the new regimen, almost 18,000 women would still be living five years after their diagnosis.

Taxotere® was approved in 1996 for women with advanced breast cancer.

Letrozole after Tamoxifen Reduces Breast Cancer Recurrence

Letrozole ( Drug Femara ®, Novartis) has been shown to lower the risk of return of hormone-dependent breast cancer by 43% in older women who have already taken tamoxifen, a weak synthetic version of estrogen. This international study, coordinated by the National Cancer Institute of Canada Clinical Trials Group in Kingston, Ontario, was stopped early (halfway through) so all the patients could consider switching from placebo to letrozole. Researchers in Toronto and across the U.S. and Canada tested letrozole, an aro-matase inhibitor that suppresses estrogen production, in women who had already completed the standard treatment recommended in many cases of breast cancer—five …