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Annual Report - 2007-2008 - Cancer Care Cycle

Annual Report - Winter 2009

Momentum in Risk Assessment and Early Detection

Gaining Ground With Tools and Tests
Lung Cancer
Breast Cancer
Myelodysplastic Syndrome
Bladder Cancer

Gaining Ground With Tools and Tests

Epidemiologists, pathologists and oncologists at MD Anderson are making great strides in discovering the role of genetics, environment, exercise and diet in the various types and rates of cancer that occur in different groups around the world. They continue to increase the number of risk assessment tools and predictive tests for early detection.

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Lung – First-Ever Risk Model for African-Americans

Researchers created and validated a risk model on the predictability of lung cancer for the African-American population. “African-Americans have similar risk factors for lung cancer as Caucasians, but their risks tend to be higher, and there’s a stronger association with occupational exposures, such as wood dust and asbestos, than we have previously observed for whites,” says Carol Etzel, Ph.D., lead author and assistant professor in the Department of Epidemiology. “Additionally, we determined the risks associated with chronic obstructive pulmonary disease (COPD) are substantially higher than those noted in Caucasian subjects.” COPDs, such as emphysema, raise a person’s risk for lung cancer.

Published in the September 2008 edition of Cancer Prevention Research.

Lung – Mouth May Predict Lung Damage

For the first time, researchers have evidence that the easily accessible tissue in the mouth can be used to monitor molecular damage in the less accessible tissue of the lungs. “Our study opens the door to enhancing our ability to predict who has a higher probability of getting tobacco-related cancers. Not only lung cancer, but pancreatic, bladder and head and neck cancers, which also are associated with tobacco use,” says senior researcher Li Mao, M.D., professor in the Department of Thoracic/Head and Neck Medical Oncology.

Reported in April 2008 at the annual meeting of the American Association for Cancer Research.

Lung – Discovery Narrows Field of Genetic Variations From 317,498 to Two

Two commonly inherited genetic variations have been found to influence the risk for developing lung cancer. Called single-nucleotide polymorphisms (SNPs), they are places in the human genome that vary by a single DNA chemical building block, or nucleotide. People who have ever smoked and who have one or two copies of either of the SNPs with genetic variation have a greater risk — increased by 28% to 81% — of developing lung cancer.

“The major risk factor for developing lung cancer is cigarette smoking. But what we don’t understand is why some long-term smokers develop lung cancer and others don’t. There are so many different cancer-causing compounds in tobacco smoke that it’s hard to separate them, and we don’t fully understand the mechanisms that result in lung cancer,” says lead author Chris Amos, Ph.D., professor in the Department of Epidemiology.

The MD Anderson investigators identified variations in genes that made them respond abnormally to nicotine, suggesting that nicotine itself may play a direct role in lung cancer development. These findings put researchers one step closer to understanding lung cancer.

Published in the April 2, 2008, edition of Nature Genetics.

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Breast – Better Guidelines for Women Over 80

Routine mammography may significantly reduce the risk of women over the age of 80 being diagnosed with advanced stage breast cancer. Yet only about one-fifth of these women — who comprise approximately 17% of breast cancers diagnosed — have routine mammograms. “Finding breast cancer early in this age group lets us provide patients with less invasive treatment, sparing them from the more toxic therapies given to women diagnosed with advanced disease,” says senior author Gildy Babiera, M.D., associate professor in the Department of Surgical Oncology.

Published in the April 21, 2008, edition of the Journal of Clinical Oncology.

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Myelodysplastic Syndrome – Watching the Score

A new scoring system identifies patients with MDS, who may appear to have low risk for progression of disease but actually have poor prospects of survival when the disease does progress. “Identifying these low-risk, poor-prognosis patients could allow us to use more aggressive medication at an earlier stage when it may be more effective,” says Guillermo Garcia-Manero, M.D., lead author and associate professor in the Department of Leukemia.

Reported in the March 2008 edition of the journal Leukemia.

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Bladder – Telltale Gene

A simple, noninvasive way to detect bladder cancer may be to count copies of a specific gene, Aurora kinase A, in cells gathered from a urine sample. When the gene is overexpressed in urothelial cells, errors occur during cell division, creating either too few or too many chromosomes, instead of the normal pairs of 23.

“Abnormal chromosome counts are the most fundamental feature — the signature — of human cancers. As a biomarker, Aurora kinase A can enable early detection of bladder cancer in voided urine with high degrees of sensitivity and specificity,” says senior author Bogdan Czerniak, M.D., Ph.D., professor in the Department of Pathology.

Published in the Oct. 1, 2008, edition of the Journal of the National Cancer Institute.

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