Breast cancer care guide

CHICAGO - AN ABNORMALITY in two genes can make a common class of chemotherapy drugs used to fight breast cancer less effective, US researchers said on Sunday in a finding that could help doctors better tailor treatments.

They said changes in two genes on a small region of chromosome 8q made tumours resist the effects of drugs called anthracyclines, but not other types of chemotherapy drugs.

'This is useful because it helps select who might be resistant to anthracyclines,' said Dr Andrea Richardson of the Dana-Farber Cancer Institute in Boston, whose study appears in the journal Nature Medicine.

'This can potentially be used to help guide therapy on a more personalised way based on a patient's own tumour. That's why it's exciting,' Dr Richardson said in a telephone interview. She said it may be possible to develop a genetic test to better tailor treatments to a patient's individual tumour.

Doctors already can test for certain genes to tell whether a woman's breast cancer is sensitive to estrogen, making her a candidate for hormone-blocking drugs such as tamoxifen.

Breast cancer patients whose tumours generate a protein called HER-2, which can fuel cancer growth, are often treated with Herceptin, or trastuzumab, a drug developed by Genentech, now a unit of Roche Holding AG. -- REUTERS

Vit D cuts colon cancer risk

Vitamin D, derived mainly from sunlight but also found in foods, plays a key role in bone strength by increasing levels of calcium in the blood.

PARIS - HIGH levels of vitamin D are linked with a lower risk of colon cancer, according to a comparison of more than half a million Europeans, published online on Friday by the British Medical Journal (BMJ).

Patients with the highest levels of vitamin D in their blood had a nearly 40 per cent lower risk of colorectal cancer compared to those with the lowest levels.

Vitamin D, derived mainly from sunlight but also found in foods, plays a key role in bone strength by increasing levels of calcium in the blood.

Whether it affects incidence of cancer has been hotly debated and the evidence is sketchy.

The paper draws on a very large study, the European Prospective Investigation into Cancer (EPIC) project, carried out in 10 Western European countries.

The authors sound a note of caution, saying it is unclear whether vitamin D supplements are any more effective than a balanced diet or getting regular exposure to sunlight. Further work is needed, they add, to show whether the statistical link in this investigation is born out - and whether there could be any side effects from taking supplements or eating food fortified with vitamin D. -- AFP

Call to ban diet drug

The European Medicines Agency advised doctors to stop prescribing medicines containing sibutramine, which are sold under the names Reductil, Reduxade and Zelium in Europe.

WASHINGTON - EUROPEAN authorities urged a halt on Thursday to sales of a diet pill made by Abbott Laboratories Inc after concluding heart-related risks were too great.

The European Medicines Agency advised doctors to stop prescribing medicines containing sibutramine, which are sold under the names Reductil, Reduxade and Zelium in Europe and Meridia in the United States, saying: 'The risks of these medicines are greater than their benefits.'

The European Commission will consider the recommendation for suspension of marketing approval.

In the United States, the Food and Drug Administration said it had concluded the drug increased the chances of a heart attack or stroke for people with cardiovascular disease.

The FDA said Abbott had agreed to add a stronger warning that explicitly states the drug should not be used in patients with a history of cardiovascular disease.

The agency said it would hold a public advisory committee meeting to gather outside input on whether more regulatory action was needed. The meeting will take place after the agency reviews a full report from a study called Scout, which tested Meridia compared with a placebo in about 10,000 patients. -- REUTERS

Start mammograms at age 40

CHICAGO - MAMMOGRAMS should begin at 40 for women with an average risk of breast cancer and by 30 for high-risk women, according to guidelines released on Monday by two groups that specialise in breast imaging, contradicting controversial guidelines from a US advisory panel last year.

The joint recommendations from the American College of Radiology and the Society of Breast Imaging take into account the success of annual mammography screening starting at 40, said Dr Carol Lee of Memorial Sloan-Kettering Cancer Center in New York, whose study appears in the Journal of the American College of Radiology.

'The significant decrease in breast cancer mortality, which amounts to nearly 30 per cent since 1990, is a major medical success and is due largely to earlier detection of breast cancer through mammography screening,' Dr Lee said in a statement.

The recommendations have been in the works for about two years, but they serve in part as a rebuttal to guidelines issued in November by the US Preventive Services Task Force, which recommended against routine breast mammograms for women in their 40s to spare them some of the worry and expense of extra tests to distinguish between cancer and harmless lumps.

Those recommendations contradicted years of messages about the need for routine breast cancer screening starting at age 40, sparking a rebellion from breast cancer specialists who argued the guidelines would confuse women and result in more deaths from breast cancer.

'Amidst all the furor, the ACR and the SBI stand firmly behind their recommendation that screening mammography should be performed annually beginning at age 40 for women at average risk for breast cancer,' Dr Lee and colleagues wrote. -- REUTERS

Tests for rare gene diseases

WASHINGTON - AT HIS first birthday, John Klor could not sit up on his own. A few months later, he was cruising like any healthy toddler - thanks to a special diet that is treating the boy's mysterious disease.

Doctors ordered a vegan diet - only fruits, vegetables and specially processed pastas - with no more than 6g of protein daily. John drinks a formula containing creatine and other missing nutrients.

What doctors initially called cerebral palsy instead was a rare metabolic disorder assaulting his brain and muscles, yet one that's treatable if caught in time. Urged by John's family, Duke University researchers are working on a way to test newborns for this disease, called GAMT deficiency.

It is part of a growing movement to add some of the rarest of rare illnesses - with such names as bubble-boy disease, Pompe disease, Krabbe disease - to the battery of screenings given to US babies hours after birth. But just how many illnesses can that tiny spot of blood pricked from a baby's heel really turn up? And not all are treatable, so when is population-wide testing appropriate?

'Families go through these odysseys of diagnosis' to learn what's wrong with a child, says Dr Alan Fleischman of the March of Dimes, who is part of a government advisory committee studying what to add to the national screening list. Often, 'they argue that they would have been better off knowing even if there were no treatments.'

Since 2004, specialists have urged that every US newborn be tested for 29 rare but devastating genetic diseases, using that single heel-prick of blood, to catch the fraction who need fast treatment to avoid retardation, severe illness, even death. -- AP