J. National Cancer Institute

Cell Phones and Brain Cancer: No Link

December 31st, 2009 | No Comments | Source: J. National Cancer Institute, MedPageToday

In the 15 years since cell phones first appeared on the scene, they have spread with astonishing speed and revolutionized communications on a global scale. But right around the time the Motorola Flip-phone was the rage, reports surfaced that cell phone use might be associated with brain cancer.

Since then, the majority of research on the subject has refuted this claim, as has the most recent publication on the matter by Isabelle Deltour of the Danish Cancer Society in Copenhagen, and her colleagues.

nofearDeltour’s group looked at registry data from 4 Scandinavian countries between 1974 an 2003, a period encompassing the birth and growth of the technology.

They found that the incidence of the 2 major forms of brain cancer either remained stable, decreased, or continued the same slow rise that had been observed in the pre-cell phone era.

These findings are “consistent with mobile phone use having no observable effect on brain tumor incidence in this period,” they wrote in the Dec. 16 issue of the Journal of the National Cancer Institute.

The registry contained 59,984 glioma and meningioma cases had been diagnosed in people between the ages of 20 and 79 during the study period.

The incidence of glioma increased in men by 0.5% annually and in women by 0.2% annually during the study.

The incidence of meningioma increased 0.8% per year in men, on average.  In women, the incidence of meningioma rose by 2.9% per year from 1974 to 1987 (when cell phones began hitting the market), then dropped by 2.1% per year between 1987 and 1991, and then began rising again at a rate of 3.8%.

Most of that recent increase in meningioma incidence occurred in women who were at least 60 years old when they were diagnosed–an age group not likely to have been heavy cell-phone users back then.

The scientists could not exclude the possibility that very heavy cell-phone use could pose risks, or that a positive association may be present for very rare brain tumors.

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Anemia Drugs Bump Risk of Blood Clots

December 11th, 2009 | No Comments | Source: BurrillReport, J. National Cancer Institute

Drugs used to reverse anemia in cancer and kidney failure patients are largely ineffective and markedly increase the risk of blood clots, according to a study by scientists at Columbia University Medical Center.

don'tusethatstuffTo reach this conclusion, Dawn Hershman and colleagues studied use of the so-called erythropoiesis stimulating agents (ESAs) in more than 50,000 patients that had been diagnosed with cancer.

In these patients, ESAs did not reduce blood transfusion requirements caused by chemotherapy, but they did jack up the risk of deep venous thrombosis and pulmonary embolism.

Hershman’s study population included patients that were at least 65 years of age and had been diagnosed with cancers of the breast, colon and lung. ESAs are used frequently in such patients as adjuncts to chemotherapy.

Survival was not impacted by the ESAs.

The number of patients receiving ESAs jumped 10-fold from 1991 through 2002. By that time, nearly half of all cancer patients were receiving them.

“This analysis confirms the association between ESAs and venous thromboembolism, which was observed in previous meta-analysis,” Hershman told BurillReport. “This data is from community practice – real-life clinical settings – where you see things that wouldn’t necessarily show-up in a short-term, 12-week study.”

Leading ESAs include Amgen’s Aranesp and Epogen, and Johnson & Johnson’s Procrit. Sales of these drugs topped $10 billion in 2006 in the US alone.

The meta-analysis mentioned above prompted the FDA to issue a black-box warning regarding the potential for tumor promotion, venous thromboembolism and decreased survival with ESAs. The warning suggested that ESAs should be used only for specific tumors and only when hemoglobin levels dropped below certain levels.

The write-up appears in the Journal of the National Cancer Institute.

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Cancer Survival: At What Price?

August 7th, 2009 | No Comments | Source: J. National Cancer Institute, Wall Street Journal

An editorial in the Journal of the National Cancer Institute has questioned the routine use of expensive cancer drugs that prolong lives by just weeks or months.

costofamonthoflifeNCI oncologist Tito Fojo and NIH ethicist Christine Grady called-out Erbitux as a particularly egregious example. An 18-week regimen of Bristol-Meyers Squibb’s cancer-fighter costs $80,000 and prolongs life by 1.2 months on average, they say.

“Many Americans would not regard a 1.2-month survival advantage as ‘significant’ progress,” the authors stated. “Would an individual patient disagree? The death of a mother of four at age 37 years would be no less painful were it to occur at age 37 years and 1 month, nor would the passing of a 67-year-old be any less difficult for the spouse were it to have occurred one month later.”

Complicating the debate is the fact that the drugs do work miracles in some patients, and it’s impossible to predict who will be so lucky.

“A drug like Erbitux is not very impressive when you look at the statistics, but for some it’s just remarkable,” Marti Nelson Cancer Foundation chief Robert Erwin told the Wall Street Journal. “How much does it cost for a person to have the opportunity to benefit?”

For their part, drug makers said the NCI article did not capture true costs of the cancer-fighters.  BMS spokesperson Brian Henry said the actual costs paid by patients for Erbitux is much less than $80,000.

“We can’t add on Mercedes-like drugs one after another and have every single patient cost the system phenomenal amounts of money,” said Eric Winer, chief scientific adviser to Susan G. Komen for the Cure, a breast-cancer advocacy group.

“But we have to be careful not to slow down the process of drug development. Ultimately, medical therapy will make a huge difference in people’s lives.”

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