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duminică, 5 august 2012

Self-Help For Men Supporting Their Spouses Through Breast Cancer

Male partners of breast cancer patients are likely to take a pass on spousal support groups in favour of exercise or an evening out with friends to cope with stresses associated with the disease, according to new research from the University of Alberta.

Faculty of Nursing professor Wendy Duggleby said spouses of women with breast cancer have unique needs when it comes to retaining a sense of hope at a time when they provide important physical and emotional support for their partners.

"There are many programs out there for women, but for men a lot of support mechanisms are support groups, and it was very clear from the participants in our study that's not what they wanted," said Duggleby, Endowed Nursing Research Chair in Aging and Quality of Life.

"What these spouses needed was help finding ways to do things for themselves to help reduce their stress."

The study, published in this month's Oncology Nursing Forum, is the first to look at the hope experience of male spouses of breast cancer patients, said Duggleby. Ensuring men have a sense of hope not only helps decrease their risk for depression, it helps their partners, too.

"If their husbands lose hope, the wives are really, really worried about them and they often lose hope themselves. For women with breast cancer, it actually helps with their own quality of life if we can do something to help the men. It's very interconnected."

In the study, men in Edmonton and Saskatoon were surveyed about hope and their ability to cope with their spouses' disease. Many reported that their partner's diagnosis was their darkest day, and that they struggled to find hope and balance after juggling career, added household duties and care.

Fighting back

Warren Tasker called upon a fighter's will when his partner Gwen Borowski was diagnosed with breast cancer on March 1, 2007. He made Borowski's needs a priority and together they put everything toward the fight, learning all they could about the disease and pressing physicians to explain treatment in detail.

"It was all I thought about, night and day," said Tasker, an Edmonton-based writer and editor, who wrote about the experience for the Canadian Breast Cancer Foundation - Prairies/NWT chapter.

After years of writing about boxing for the Edmonton Journal, he took up the sport to cope with stress, in addition to his regular running and cycling routine.

"I was getting hit and I was getting to hit back. It felt good - it felt really good," he said. "You need an outlet, you need to find something to release all the pent-up frustration, the fear, the apprehension, the anxiety."

In study interviews, filmed and posted online, spouses reported similar experiences, turning to exercise, music, hobbies and time away with friends to find balance. Many expressed a strong desire to be able to talk to or hear from other spouses who went through similar struggles - without taking time from work or family to attend support groups, Duggleby said.

Work schedules also presented challenges with attending medical appointments with their spouses to hear information first-hand, which was another strong need spouses expressed.

"If you're a working man, it becomes difficult to go to some appointments, although some of that is just perception. They're not being excluded but they feel like they're being excluded. It's part of breaking down some of those barriers in cancer care," said Duggleby.

Duggleby said the findings should help health-care providers and agencies provide the specific support and resources these men need. For many spouses, an easy solution would be a guide showing where to find online information about breast cancer without information overload.

"They really do want something that's specific for them, tailored for their needs. It doesn't have to be done through a research study. There is a lot that can be done just based on what these spouses said and the ideas they provided. It would make a huge, huge difference."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our men's health section for the latest news on this subject. The study was funded by the Canadian Breast Cancer Foundation - Prairies/NWT.
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joi, 15 decembrie 2011

Cancer Spread Can Be Predicted Through Molecular Markers

Main Category: Cancer / Oncology
Also Included In: Radiology / Nuclear Medicine; Lung Cancer
Article Date: 15 Dec 2011 - 0:00 PST

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Molecular markers found in cancer cells that have spread from a primary tumor to a limited number of distant sites can help physicians predict which patients with metastatic cancer will benefit from aggressive, targeted radiation therapy.

In a study published online in the journal PloS One, researchers from the University of Chicago show that if cells from metastatic tumors have high levels of a particular type of microRNA - a tool cells use to silence certain genes - not even aggressive treatment of those tumors would help. But if the cells have lower levels of that biological marker, then focused local treatment could be effective, even curative.

"We previously demonstrated that we could provide lasting disease-free survival to a percentage of patients with metastatic disease," said study author Ralph Weichselbaum, MD, professor and chair of radiation and cellular oncology and Director of the Ludwig Center for Metastasis Research at the University of Chicago. "This finding means we can have a pretty good sense in advance of which patients we can help. Patients unlikely to benefit from focused, local therapy can move on to systemic treatment."

When patients die from cancer, it is usually caused by distant metastases, numerous cancer sites established by malignant cells that split off from the primary cancer and began growing in new settings. In 1994, Weichselbaum and colleague Samuel Hellman proposed that there was a potentially curable intermediate state between cancer that had not spread at all and cancer that had spread extensively. They named this phenomenon "oligometastasis," meaning cancer that had spread to a few distant sites.

In 2004, they began a small clinical trial to test that theory. Patients with stage IV cancer with one to five distant metastases and no tumors bigger than 10 centimeters in diameter were enrolled. The results, published in 2008, showed that precisely targeted radiation therapy could eradicate all evidence of disease in about 20 percent of those patients.

"We were pleased to get such encouraging results in patients with stage IV cancers that had spread to distant sites," Weichselbaum said. "This was proof of principle in patients who had already failed standard therapies."

A follow-up study, published in October 2011, found that 18 percent of the patients in that initial trial had seen no progression of their cancers for the duration of the study and 27 percent developed no new tumor sites.

The next step was to determine in advance which patients were most likely to benefit from such targeted therapy and which ones should move on to whole-body treatments, such as chemotherapy. So they compared cells from secondary tumors from patients who did well in the original studies with those whose cancers went on to establish multiple metastatic sites.

They found that tumors that were highly proliferative, producing many metastases, had patterns of microRNA expression that differed from those that produced only a few. The tumors most likely to spread had high levels of a small nucleic acid known as microRNA-200c.

This came as a surprise. MicroRNA-200c was thought to suppress metastasis. But when the researchers boosted microRNA-200c levels in a mouse model of cancer, it significantly increased metastasis. The researchers subsequently showed that microRNA-200c reduced the activity of other genes that acted to prevent the spread of cancer.

Further tests in mouse models showed that boosting microRNA-200c levels significantly increased the metastatic potential of tumors that were not as prone to spread.

"Our findings are an initial step in discriminating between patients with a few treatable sites where the tumor has spread and those who will develop widespread metastasis, which is not curable with focused radiation therapy," Weichselbaum said. "It is encouraging to find a common molecular basis for this treatable state across a broad variety of metastases from solid tumors."

Oligometastases are "more common than generally recognized," the authors note. "Potentially, 50 percent of patients with metastatic non-small cell lung cancer, the leading cause of cancer death in men and women, may be oligometastatic."

When combined with other factors - the number and size of metastasis, the interval from treatment of a primary tumor to the appearance of metastasis, the microscopic structure and appearance of tumor tissue - the presence of microRNA-220c could become a key element of patient selection for targeted radiation therapy, Weichselbaum said, distinguishing between patients who have treatable tumors and those who have widespread metastasis, including many tumors too small to detect.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cancer / oncology section for the latest news on this subject. The National Institutes of Health, the Ludwig Center for Metastasis Research, the University of Chicago Center for Radiation Therapy, the Chicago Tumor Institute, Dr. Lloyd Old, Mr. And Mrs. Vincent Foglia and the Foglia Family Foundation, the Lung Cancer Research Foundation, the University of Chicago Cancer Research Foundation, the University of Chicago Comprehensive Cancer Center and the Center for the Multiscale Analysis of Genomic and Cellular Networks supported this study. Additional authors include Yves Lussier of the University of Illinois at Chicago; Rosie Xing, Nikolai Khodarevi, Yong Huang, Qingbei Zhang, Sajid Khan, Xinan Yang, Michael Hasselle, Thomas Darga, Renuka Malik, Hanli Fan, Samantha Perakis, Matthew Filippo, Kimberly Corbin, Younghee Lee, Mitchell C. Posner, Steven J. Chmura, and Samuel Hellman of the University of Chicago Medical Center, and Joseph Salama of Duke University Medical Center.
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