Does acupuncture help with breast cancer?

Acupuncture is as effective and longer lasting in managing the common debilitating side effects of hot flashes, night sweats, and excessive sweating (vasomotor symptoms) associated with breast cancer treatment and has no treatment side effects compared to conventional drug therapy, according to a study presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) Meeting in Boston.




The findings show there were additional benefits to acupuncture treatment for breast cancer patients, such as an increased sense of well being, more energy, and in some cases, a higher sex drive, that were not experienced in those patients who underwent drug treatment for their hot flashes.

The reduction in hot flashes lasted longer for those breast cancer patients after completing their acupuncture treatment, compared to patients after stopping their drug therapy plan.

Approximately eighty percent of women treated for breast cancer suffer from hot flashes after being treated with chemotherapy and/or anti-estrogen hormones, such as tamoxifen and Arimidex. Although HRT is typically used to relieve these symptoms, breast cancer patients cannot use this therapy because it may increase the risk of the cancer coming back.

Patients are often treated with steroids and/or antidepressant drugs instead. These drugs, however, have additional side effects, such as weight gain, nausea, constipation and fatigue. The antidepressant, venlafaxine (Effexor), a selective serotonin reuptake inhibitor, is one of the most common drugs used to treat hot flashes. However, many women decide against this treatment choice because of potential side effects, including decreased libido, insomnia, dizziness and nausea, or because they do not want to take any additional medications.

At ASTRO, the randomized clinical trial compared acupuncture treatment to venlafaxine for 12 weeks to find out if acupuncture reduced vasomotor symptoms in breast cancer patients receiving hormonal therapy and produced fewer side effects than venlafaxine. The study included 47 breast cancer patients who received either tamoxifen or Arimidex and had at least 14 hot flashes per week.

Overall, the results demonstrated that acupuncture reduces hot flashes as effectively as venlafaxine, with no side effects, and also provides additional health benefits to patients. This approach, although unusual, offers a safe and effective option for women with hormone-sensitive breast cancer.

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Can a vaccine help fight breast cancer?

A new vaccine in development targets breast cancers that proliferate aggressively in response to the growth factor HER-2. About 25-30% of women with breast cancer have HER-2 positive tumours. Herceptin (trastuzumab), a man-made antibody approved for the treatment of breast cancer, targets these cancers. However, tumour cells often become resistant to Herceptin over time. The experimental breast cancer vaccine makes mice reject tumours, even in cancers that are no longer sensitive to Herceptin.

The researchers published in the findings in Cancer Research and found that the vaccine elicits immune responses that kill HER-2 positive breast tumours in mice, irrespective of whether they become Herceptin resistant. If immune cells are properly primed by immunisation, then the cells can be destroyed.

The vaccine, developed at the Karmanos Cancer Center in Detroit, used DNA that carries the genetic code for a key piece of the HER-2 molecule. After injection of the DNA into the skin, a small electric pulse is administered to help cells take up the DNA and produce the protein that elicits immune responses.

Mice given the vaccine made anti-HER-2 antibodies. The vaccine also primed cellular immune responses that attacked breast cancer tumours. These cellular responses alone were enough to kill HER-2 positive cells in mice unable to make antibodies.

A version of the vaccine is now undergoing human safety tests.

A different HER-2 vaccine made headlines earlier this year when it halved the number of deaths in women with HER-2 positive breast cancer. The vaccine also slowed breast cancer recurrence. However, the researchers found that 26 months after vaccination, there was no significant difference in cancer recurrence between vaccinated and unvaccinated women.

In the long run, it is vitally important to test the animal research in humans to determine which approaches are valid and which are not. Early promising results do not always translate into survival advantages, but as we learn more about the science and biology of cancer, the technical approaches can only improve.

The concept behind using the bodies immune system to fight disease, including cancer, is a solid one but getting vaccines to work has proven elusive so far in solid tumours. More promising results have been seen in immune-related cancers such as NHL, but as the technology improves, we may one day see some advances in women with breast cancer.

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BRCA mutations in breast cancer

Genetic testing for BRCA1 and BRCA2 mutations can provide important information for women who are concerned about their breast and ovarian cancer risks and need to make relevant prevention and medical management decisions.

To date, lifetime risks of breast cancer in individual BRCA1/2 mutation carriers have been challenging to apply in clinical decision making. Published risk estimates vary significantly and are very dependent on the characteristics of the population under study. You can read more about in this article (free PDF download).

Another study interpreted validated functional data from the transactivation activity of BRCA1 in combination with analysis of protein modelling based on the structure of BRCA1 BRCT domains. With additional clinical and structural evidence, they were able to classify all missense variants in the BRCA1 COOH-terminal region. These results brought functional assays for BRCA1 closer to clinical applicability.

Cancer risks in a population-based study of BRCA1/2 mutation carriers have been recently estimated, but the numbers are still in their infancy and may be influenced by different risk factors. It is likely that there is broad variation in breast cancer risk among carriers of BRCA1 and BRCA2 mutations and ethnicity may also confer differences in risks associated with BRCA mutations.

FDA approves HER2 test for breast cancer

A genetic test to determine whether a breast cancer patient is likely to respond to treatment with the drug Herceptin (trastuzumab) has been approved by the U.S. Food and Drug Administration.

The SPOT-Light HER2 CISH kit helps calculate how many copies of the HER2 gene, which regulates the growth of cancer cells, are in tumour tissue. A healthy breast cell should have two copies of the HER2 gene, but patients with breast cancer may have many more. Since the gene signals cells when to grow, divide and make repairs, too many copies may cause cells to grow and divide too rapidly.

Herceptin targets HER2 protein, helping stop the growth of such cancer cells in breast cancer patients overproducing that particular protein. HER2 is overexpressed in about 30% of breast cancer cases.

This test can potential provide health care professionals with additional insight on treatment decisions for patients with breast cancer when used with other clinical information and laboratory tests.

The SPOT-Light test counts HER2 genes through a chemically stained sample of removed tumor observed under a standard microscope. Previous tests required more expensive and complex fluorescent microscopes. The SPOT-Light also allows labs to store the tissue for later reference, a feature not possible with previously available tests.

New gene shows promise in resistant breast cancer

Researchers have identified a new group of compounds that might one day be added to the armamentarium of therapies designed to fight estrogen-fueled breast cancer. The molecule, called TPBM, and related drugs may have a role in treating patients who have become resistant to other hormone-based therapies, such as tamoxifen.



There are a large number of people who have estrogen receptor-positive breast cancer who respond well to hormone therapy. Sometimes, after a number of years, the hormone therapy stops working. Then they are switched to something else. That works for a time before the cancer progresses.



Exactly what is happening in those cancer cells that they become resistant? Perhaps there is another mechanism that can be overcome and this could be one of them.

Some two-thirds of all breast cancers are estrogen receptor-positive and therefore respond to hormonal treatments such as tamoxifen or the newer aromatase inhibitors, letrozole and anastrozole. Tamoxifen works by blocking estrogen receptors on breast cancer cells, while aromatase inhibitors interfere with the body's ability to produce estrogen.

Many of the cancers in this category eventually become resistant to tamoxifen and, in some cases, tamoxifen may even turn the tables and start acting like estrogen, thereby fueling tumour growth and proliferation.

A new study was presented by researchers from the University of North Carolina, Chapel Hill, the University of Colorado Health Sciences Center, Denver, and the University of Illinois, Urbana-Champaign at the annual meeting of the Endocrine Society, in San Francisco.

Through extensive laboratory testing, they identified a group of compounds related to TPBM that interfered with estrogen's effect on breast cancer cells via a different pathway. The molecules work by affecting the way estrogen receptors interact with a woman's DNA.

TPBM has the advantage of being "highly specific" and therefore potentially much less likely to have any unwanted effects on other cells. It also works against tamoxifen when tamoxifen starts fueling tumour growth. The research is promising, but still preliminary at this stage.

Low levels of Vitamin D linked with poorer outcome in breast cancer

One of the most important abstracts at the forthcoming ASCO meeting suggests that vitamin D deficiency at the time of diagnosis is associated with a worse outcome in breast cancer. The results were reported in an analysis of 512 women treated in Toronto, Ontario.

Many of the women had low levels of vitamin D at the time they were diagnosed with breast cancer; some 37.5% had levels classified as "deficient," and only 24% had levels that were "sufficient". Is this a random or relevant finding?



After a median follow-up of 11.6 years, it was found that compared with women who had normal levels of vitamin D at diagnosis, the women with vitamin D deficiency were 94% more likely to experience metastasis and 73% more likely to die.

It is surprising to find vitamin D deficiency is so common in women diagnosed with breast cancer and that very low vitamin D levels adversely affect patient outcome. Although the data show an association, it is impossible say it is causal until the results are replicated.

Source:

ASCO 2008 Annual Meeting