health care information

Terramed Alliance News Nearly half of all breast cancer patients experienced chronic pain two to three years after treatment and more than half felt discomfort, according to a study by Danish researchers published Tuesday in the Journal of the American Medical Association, the New York Times reports. The study found that women younger than age 40, those who underwent radiation treatment and those who had surgery to remove lymph nodes in the armpit are most likely to experience lingering pain.

In an accompanying editorial, Loretta Loftus, a senior member of the breast cancer program at the Lee Moffitt Cancer Center, wrote, “This should alert clinicians who are caring for these patients to pay more attention to those who are in the high risk groups for pain” (Caryn Rabin, New York Times, 11/10).

Researchers examined a 2009 survey of 3,253 Danish women who had breast cancer surgery in 2005 and 2006, Reuters reports. Forty-seven percent of the patients reported pain. Within that group, 13% described the pain as severe, 39% described it as moderate and 48% said it was light. Twenty percent of the women surveyed said they had contacted a physician within the last three months regarding their pain (Brown, Reuters, 11/10). Women of all ages who had mastectomies were more likely to have severe pain than light pain. Pain most frequently occurred in the breast that was operated upon, in the chest area where tissue was removed, in the upper arm where lymph nodes were removed or along one side of the body, according to U.S. News & World Report’s “On Women.”

“This study isn’t saying to change treatment recommendations based on whether or not a certain treatment is likely to be associated with pain,” Loftus said, adding, “But it’s telling oncologists that they need to be more alert to the incidence of pain,” she said (Kotz, “On Women,” U.S. News & World Report, 11/10). The study’s author, Henrik Kehlet of the University of Copenhagen, said more research is needed to determine why some women experience lingering pain and others do not (Szabo, USA Today, 11/11).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

Terramed Alliance is a non-profit charity organization dedicated to research, education and advocacy of breast cancer. One of the vision of Terramed Alliance is to provide this community and Internet users with a charity based research and education entity. Advocacy of breast cancer through education is vital to the reduction of this disease.  For any requests and enquiries, please contact at us: cancer@terramedalliance.us www.terramedalliance.us

Terramed Alliance News Researchers at Rush University Medical Center and Argonne National Laboratory are collaborating on a study to determine if an imaging technique used by NASA to inspect the space shuttle can be used to predict tissue damage often experienced by breast cancer patients undergoing radiation therapy. The study is examining the utility of three-dimensional thermal tomography in radiation oncology.
Preliminary results from the study are being displayed during the American Society for Radiation Oncology (ASTRO) Annual Meeting in Chicago, being held from November 1 – 5, 2009.
Approximately 80 percent of breast cancer patients undergoing radiation treatment develop acute skin reactions that range in severity. The more severe reactions cause discomfort and distress to the patient, and sometimes result in treatment interruptions. The severity is quite variable among patients and difficult to predict.
“Because reactions usually occur from 10 to 14 days after the beginning of therapy, if we could predict skin reactions sooner we may be able to offer preventative treatment to maximize effectiveness and minimize interruption of radiation treatment,” said Dr. Katherine Griem, professor of radiation oncology at Rush. Terramed Alliance News : Researchers at Rush and Argonne are studying if three-dimensional thermal tomography (3DTT) can detect the earliest changes that may trigger a skin reaction. 3DTT is a relatively new thermal imaging process that is currently being used as a noninvasive away to detect defects in composite materials. The basic idea of thermal imaging is to apply heat or cold to a material and observing the resulting temperature change with an infrared camera to learn about its composition.
Unlike most thermal imaging studies which have quantitative limitations, 3DTT measures the thermal effusivity of skin tissue. Thermal effusivity is a measure of a material’s ability to exchange heat with its surroundings.
In this study, a flash of light is used to heat up the skin. An infrared camera captures a series of images over time that display the temperature of the skin, represented by colors. An algorithm developed by Argonne is used to calculate the temperature change and determine the thermal effusivity of different areas of the skin.
“How quickly the skin cools is related to the structure underneath. Damaged skin cells have different effusivity values compared to that of healthy skin, said James Chu, PhD, chairperson of the section of medical physics at Rush. “By identifying the earliest changes in damaged tissue, we may be able to predict acute skin toxicities.” Terramed Alliance News: Preliminary data from the study show that marked decreases in thermal effusivity of irradiated skin occur well in advance of the development of high grade skin reactions.
“Our initial data with radiation induced skin changes are quite encouraging,” said Dr. Alan Coon, chief resident of radiation oncology at Rush and primary author on the study. “In addition to finding decreases in effusivity of the treated areas many days before the development of skin reactions, we have also seen that the magnitude of these decreases varies with the grade of the reactions. This exciting result bodes well for the clinical utility of this technique in predicting the severity of a skin reaction before it occurs.”
In addition, researchers note that 3DTT techniques can be used to measure these tissue property changes noninvasively with no interruption of therapy and the technique allowed for rapid feedback.
“3DTT may also be used to detect other skin diseases such as skin cancer and measure skin damage caused by electricity or lightening. Such applications require the determinations of tissue conditions below the skin that is normally not visible but can be measured by 3DTT,” said J.G. Sun, a mechanical engineer at Argonne.
Researchers plan to perform additional studies to confirm the preliminary results and hope to soon begin studying 3DTT in breast cancer patients.
The investigators on the project include Dr. Katherine Griem, James Chu, PhD; Dr. Alan Coon; Damian Bernard, PhD; Riu Yao and Alistair Templeton, all from Rush University Medical Center and J.G. Sun from Argonne National Laboratory. Source: Kim Waterman Rush University Medical Center

Terramed Alliance is a non-profit charity organization dedicated to research, education and advocacy of breast cancer. One of the vision of Terramed Alliance is to provide this community and Internet users with a charity based research and education entity. Advocacy of breast cancer through education is vital to the reduction of this disease.  For any requests and enquiries, please contact at us: cancer@terramedalliance.us www.terramedalliance.us

Standard adjuvant treatment for HER2-positive breast cancer patients, following primary surgery for their cancer, is Trastuzumab (Herceptin)–typically used in combination with chemotherapy. However, a new study by researchers at Fox Chase Cancer Center reports that it may be safe to treat these patients with both Trastuzumab and adjuvant radiation therapy.

The study will be presented at the annual meeting of the American Society for Radiation Oncology (ASTRO).

“Our study evaluated the skin toxicity and early cardiac toxicity of concurrent Trastuzumab and radiation therapy treatment in the adjuvant setting,” says Penny Anderson, M.D., radiation oncologist at Fox Chase and lead author on the study. “We found that there was an extremely low rate of acute radiation dermatitis and cardiac toxicity in patients who received this type of treatment.”

The study followed 85 breast cancer patients who received adjuvant Trastuzumab while also receiving a course of adjuvant radiation therapy, as well as 85 breast cancer patients who only received adjuvant radiation therapy. Acute dermatitis was grade 2 in 15% and grade 3 in 2% of the patients receiving concurrent treatment, likewise grade 2 and grade 3 dermatitis was observed in 14% and 2 % of patients only receiving radiation therapy–there was only one patient who developed a grade > 2. There were no differences in cardiac toxicity between the two groups.

“The results of this study show that it is safe to use both Trastuzumab and radiation therapy in an adjuvant setting, when clinically indicated,” adds Anderson. “We would like to see longer follow-up to evaluate the potential differences in late cardiac toxicity.”  Adapted from materials provided by Fox Chase Cancer Center, via EurekAlert!, a service of AAAS.

Terramed Alliance is a non-profit charity organization dedicated to research, education and advocacy of breast cancer. One of the vision of Terramed Alliance is to provide this community and Internet users with a charity based research and education entity. Advocacy of breast cancer through education is vital to the reduction of this disease.  For any requests and enquiries, please contact at us: cancer@terramedalliance.us www.terramedalliance.us