Archive for July, 2010

Cancer Risk After Kidney Transplant Unaffected by Type of Drug Treatment

Sunday, July 25th, 2010

The type of drug treatment used to prevent organ rejection in kidney transplant patients doesn’t affect cancer risk, a new study finds.

Kidney transplant patients are at increased risk for cancer, likely because of patients’ long-term use of immunosuppressive drugs to prevent organ rejection. In this study, Australian researchers examined the incidence of cancer in 481 kidney transplant patients.

The patients had received one of three treatment regimens: azathioprine and prednisolone; cyclosporine monotherapy; or cyclesoporine monotherapy followed by a switch to azathioprine and prednisolone after three months.

In the 20 years after transplant, 226 patients developed at least one cancer, including 48 percent who developed skin cancer and 27 percent who developed non-skin cancer. None of the anti-rejection treatments had a greater effect than another on cancer timing or incidence.

The findings indicate that “any differences in cancer risk from these different treatments are unlikely to be clinically significant,” said study author Martin Gallagher, of the George Institute for International Health in Australia.

He and his colleagues also found that kidney transplant recipients’ increased risk of cancer is significantly influenced by certain characteristics at the time of transplant. For example, non-skin cancer is associated with increasing age and previous smoking history, while skin cancer is associated with increasing age, non-brown eye color, fairer skin, and a functioning transplant.

High-risk patients need to be monitored more closely and use preventive measures to protect against cancer, the researchers said.

The study appears in the issue of the Journal of the American Society of Nephrology.

Exercise, Weight Control May Keep Fibromyalgia at Bay

Sunday, July 18th, 2010

Women who are overweight or obese appear to have an increased risk of developing the chronic pain syndrome known as fibromyalgia, a new study suggests.

If they are also sedentary, the risk is even greater, said lead researcher Paul Mork, of Norwegian University of Science and Technology in Trondheim, Norway.

The study is published in the May issue of Arthritis Care & Research.

Fibromyalgia is marked by widespread pain lasting more than three months. The pain strikes so-called “tender points” in the neck, shoulders, back, hips, arms and legs.

The condition is also marked by fatigue without apparent cause, mood disturbances, sleep problems and headaches. More women than men have it, and experts don’t thoroughly understand its cause.

The condition may be due to dysfunction in the nervous system and other problems, and it is thought to be affected by genetic susceptibility.

In the new study, Mork and his colleagues turned to a data base of nearly 16,000 women in Norway who had responded to health surveys. Among the participants were 380 who developed fibromyalgia during the 11-year follow-up.

Mork’s team compared the data from patients with the healthy respondents, including body-mass index (BMI) and exercise habits.

Exercise and a healthy body weight were found to be protective.

“According to previous findings reported in the literature, we expected that regular leisure-time physical exercise would have a protective effect on future development of fibromyalgia [FM],” Mork said. “However, we only found a weak association between development of FM and exercise. However, it should be noted that we were not able to differ between different types of exercise, and it might be possible that some exercise types are more beneficial than others in protecting against future development of FM,” he added.

“Women who reported exercising four times per week [or more] had a 29 percent lower risk of fibromyalgia compared with inactive women,” Mork said in a news release about the study.

Those who exercised two to three times a week were about 11 percent less likely to get fibromyalgia.

Being overweight — with a BMI of 25 or higher — was a strong independent risk factor, with the heavier women having a 60 percent to 70 percent higher risk of developing the condition compared to the healthy weight women.

The overweight women who exercised an hour or more a week, however, were less likely to get the condition than were overweight women who were inactive.

Mork’s advice: Regular exercise, which can help maintain weight, may serve as a “buffer” against the symptoms that eventually lead to fibromyalgia.

The results are entirely plausible, said Dr. Patrick Wood, senior medical adviser for the National Fibromyalgia Association, who cares for many fibromyalgia patients.

But with the condition, there are often the chicken-egg questions, he added, such as whether the pain leads to the inactivity or weight gain or vice versa. “It’s difficult with any level of assurance to know what’s driving what,” Wood said. There could be underlying factors driving both excess weight and pain sensitivity, he noted.

The inflammation that is associated with obesity may heighten pain sensitivity, Wood added.

More study is needed, Wood said. Until more is known, however, he would advise people who want to avoid the condition to maintain a healthy weight and exercise regularly. That’s especially wise for those with a family history of fibromyalgia, he stressed, because he has found that it does tend to run in families.

For those already diagnosed with the condition, Wood said, “some data show if you exercise and keep your weight down you may have less pain.”

SOURCES: Patrick Wood, M.D., senior medical advisor, National Fibromyalgia Association, and family medicine physician, Renton, Wash.; Paul Mork, D.Phil., Norwegian University of Science and Technology, Trondheim, Norway;

FDA Approves a Cellular Immunotherapy for Men with Advanced Prostate Cancer

Sunday, July 11th, 2010

The U.S. Food and Drug Administration today approved Provenge (sipuleucel-T), a new therapy for certain men with advanced prostate cancer that uses their own immune system to fight the disease.

Provenge is indicated for the treatment of asymptomatic or minimally symptomatic prostate cancer that has spread to other parts of the body and is resistant to standard hormone treatment.

Prostate cancer is the second most common type of cancer among men in the United States, behind skin cancer, and usually occurs in older men. In 2009, an estimated 192,000 new cases of prostate cancer were diagnosed and about 27,000 men died from the disease, according to the National Cancer Institute.

“The availability of Provenge provides a new treatment option for men with advanced prostate cancer, who currently have limited effective therapies available,” said Karen Midthun, M.D., acting director of the FDA’s Center for Biologics Evaluation and Research.

Provenge is an autologous cellular immunotherapy, designed to stimulate a patient’s own immune system to respond against the cancer. Each dose of Provenge is manufactured by obtaining a patient’s immune cells from the blood, using a machine in a process known as leukapheresis. To enhance their response against the cancer, the immune cells are then exposed to a protein that is found in most prostate cancers, linked to an immune stimulating substance. After this process, the patient’s own cells are returned to the patient to treat the prostate cancer. Provenge is administered intravenously in a three-dose schedule given at about two-week intervals.

The effectiveness of Provenge was studied in 512 patients with metastatic hormone treatment refractory prostate cancer in a randomized, double-blind, placebo-controlled, multicenter trial, which showed an increase in overall survival of 4.1 months. The median survival for patients receiving Provenge treatments was 25.8 months, as compared to 21.7 months for those who did not receive the treatment.

Almost all of the patients who received Provenge had some type of adverse reaction. Common adverse reactions reported included chills, fatigue, fever, back pain, nausea, joint ache and headache. The majority of adverse reactions were mild or moderate in severity. Serious adverse reactions, reported in approximately one quarter of the patients receiving Provenge, included some acute infusion reactions and stroke. Cerebrovascular events, including hemorrhagic and ischemic strokes, were observed in 3.5 percent of patients in the Provenge group compared with 2.6 percent of patients in the control group.

Provenge is manufactured by Seattle-based Dendreon Corp.