ONS Connect - June 2008 - (Page 8)

JUSTIN [By Deborah McBride, RN, MSN, CPON ®, Contributing Editor] Intensive Chemotherapy May Improve Survival in Young Patients 10-year study has shown that more intensive chemotherapy can improve survival rates in young patients with high-risk neuroblastoma. The study, which took place in 19 centers in six countries from 1990–1999, looked at the effects on 262 children of administering chemotherapy every 10 rather than 21 days at 1.8 times the conventional dose. Researchers treated children older than age one who had high-risk types of the disease neuroblastoma. They found that the five-year event-free survival rates increased 12% in the group with the rapid 10-day technique. The time taken to move on to the next stage of treatment also was reduced by 55 days. Survival in the rapid treatment group was 30.2%, compared with 18.2% in the standard treatment group. Pearson, A.D., Pinkerton, C.R., Lewis, I.J., Imeson, J., Ellershaw, C., Machin, D., et al. (2008). Randomized trial of high dose rapid schedule induction chemotherapy with conventional schedule for stage 4 neuroblastoma over the age of one year. Lancet Oncology, 9(3), 247–256. Mechanism Associated With Cancer Treatment Resistance Identified he diagnosis and treatment of some cancers are improving rapidly; however, over time, many tumors become resistant to treatment. Scientists have discovered a new genetic mechanism that helps cancer cells survive by changing the way the cells respond to treatment. The researchers studied tumor cells containing a faulty version of the breast cancer gene BRCA2. The faulty gene renders cells unable to repair damaged DNA, which can lead to them becoming cancerous. Drugs, such as poly(ADP-ribose) polymerase inhibitors and the platinumbased chemotherapy drug carboplatin, have been shown to be effective against BRCA2 tumors in early laboratory trials. The drugs work by causing more DNA damage, killing the cancer cells. In the recent study, scientists took tumor cells that contained faulty BRCA2 genes and made them resistant to both of these treatments. They also studied tumor cells from women with a faulty A T BRCA2 gene whose cancers had become resistant to carboplatin. In both cases, they discovered a previously unknown genetic mechanism that altered the faulty BRCA2 gene in the cancer cells, restoring its normal functions and making the cancer resistant to treatment. Scientists believe that many other types of cancer become resistant to treatment through the same mechanism. They hope that by understanding this process they can alter patient treatment to counter the problem of resistance. Edwards, S.L., Brough, R., Lord, C.J., Natrajan, R., Vatcheva, R., Levine, D.A., et al. (2008). Resistance to therapy caused by intragenic deletion in BRCA2. Nature, 451(7182), 1111–1115. Overlooked Lesions Tied to Colon Cancer n easily overlooked flat lesion in the colon that was thought to be rare in Americans is actually relatively common and is much more likely to turn cancerous than the polyps that doctors normally screen for, according to a new study. The lesions, known as nonpolypoid or flat lesions, are harder to detect during a colonoscopy than the abnormal polyps that protrude from the lining. In the new study, 1,819 veterans, mostly male, underwent routine colonoscopies. The physicians were specially trained to detect flat lesions and found them in 9.35% of the men. The lesions were five times as likely as polyps to contain cancerous or precancerous tissue. The new study underscores the need for careful examinations, because the flat lesions are more dangerous than previously thought. According to the researchers, the message to patients is that when preparing for a colonoscopy, A 8 ONS CONNECT June 2008

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ONS Connect - June 2008 Contents Editor's Note Just In They Have a Dream A Year in the Life—Month Six Web Connect Capitol Connection Notice Nursing Now Caregiver Care Manage Skin Toxicities Associated With EGFR Inhibitors Blood Test for Ovarian Cancer May Be 99 Percent Accurate Calendar of Events Working For You Staying On Top

ONS Connect - June 2008

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