Breast cancer research at Upstate: How do genes affect drugs that fight cancer?

Advances in the understanding, diagnosis and treatment of breast cancer begin in laboratories. Here’s a peek into one Upstate lab that received a grant this year from the Carol M. Baldwin Breast Cancer Research Fund:

005371How do genes affect drugs that fight cancer?

A gene called ECRG2 was recently identified as a tumor suppressor, and preliminary studies at Upstate reveal that it can “strongly inhibit” breast tumor cell growth, says professor of pharmacology, Ying Huang, MD, PhD.

She says ECRG2 also appears to play a role in the development of resistance to multiple anticancer drugs commonly used to treat breast cancer. Her project focuses on understanding how this happens.

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Pinpointing prostate cancers

Srinivas Vourganti presents the UroNav to Central New York media.

Srinivas Vourganti presents the UroNav fusion biopsy system to Central New York media earlier this year.

Upstate became the only provider in Central New York (and one of a few sites in the country) to offer breakthrough technology to help pinpoint hard-to-locate prostate cancers when it acquired the UroNav fusion biopsy system.

Traditional biopsies of the prostate gland rely on ultrasound to guide surgeons to areas where cancers tend to form, and random samples are taken.

The UroNav system uses technology similar to GPS navigation to guide a surgeon to where cancer may be hiding, such as an area within a man’s prostate where the blood supply is abnormal. This allows more accurate samples to be taken and reduces the need for multiple biopsies.

Here’s how it works.

The patient undergoes magnetic resonance imaging; those images are analyzed.

During the patient’s biopsy procedure, UroNav fuses the MRI images with real-time ultrasound images to guide the surgeon to the precise area within the prostate where the cancer might be growing. Tissue samples are removed for laboratory analysis.

Pathologists in the lab determine the extent and aggressiveness of the cancer, so that surgeons can tailor the appropriate treatment.

Hear an interview with Vourganti about UroNav and prostate cancer

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Breast cancer research at Upstate: Can we better protect bone from radiation therapy?

Advances in the understanding, diagnosis and treatment of breast cancer begin in laboratories. Here’s a peek into one lab at Upstate that received grants this year from the Carol M. Baldwin Breast Cancer Research Fund:

005371Can we better protect bone from radiation therapy?

Targeted radiation therapy can be effective in reducing the size of a tumor, but it can leave bones more susceptible to fractures in the years after cancer.

Studying stem cells for possible solutions are Megan Oest, PhD, assistant professor of orthopedic surgery, and Timothy Damron, MD, professor of orthopedic surgery, cell and developmental biology and neuroscience and physiology. Stem cells have the ability to develop into many different cell types, depending on the body’s needs.

Of the bone cells that are alive at the time of radiation, Oest and Damron have noticed that some die and are never replenished. They are experimenting with chemical or biological methods to prevent damage to these particular cells. Perhaps in the future, patients could receive an injection of a protective substance before undergoing radiotherapy.

It’s also possible, Oest theorizes, that patients could undergo something like a stem cell transplant after their therapy. Healthy cells could come from a donor, or from elsewhere in the patient’s body. She and Damron have learned that when radiation is applied to one leg, cells from the opposite leg remain undamaged. “In theory, if it worked, you could actually take cells from the healthy side of the patient and put them into the unhealthy side,” she says.

Listen to an interview with Oest about this project

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Most breast cancers occur in women with no family history

Illustration by Getty Images International.

Illustration by Getty Images International.

Women at increased risk for developing breast cancer have a growing number of options to help prevent the disease — but you may be surprised to learn who is at high risk.

Angelina Jolie garnered media attention in May 2013 when she underwent a preventive double mastectomy, revealing a family history of breast cancer and a faulty genetic mutation.

“It’s important to keep that in perspective,” says Jayne Charlamb, MD, who directs Upstate’s Breast Cancer High Risk Program. “The vast majority of women who get breast cancer have absolutely no family history.” She says only about 5 to 10 percent of breast cancers are thought to be hereditary, caused by abnormal genes passed from one generation to the next.

Women with a mutation in the same gene as Jolie’s, known as BRCA, are at increased risk — but so are many others.

As a woman ages, her risk increases. Not having children, or having children later in life puts a woman at higher risk than one who bears children when she is young. “Not breastfeeding puts you at a higher risk,” says Charlamb. Also, a woman with dense breast tissue has an increased risk of developing breast cancer.

Some women with a BRCA mutation are opting to have their breasts removed, like Jolie, to reduce their risk of developing breast cancer.

Others at high risk for the disease are choosing “chemoprevention,” a 5-year course of medications that reduces risk by about 50 percent during, and sometimes beyond, those five years, Charlamb says. The medications include selective estrogen receptor modifiers, which block the effects of estrogen on breast tissue, and aromatase inhibitors, which stop a key enzyme from changing other hormones into estrogen.

In addition, Charlamb and other breast cancer experts are studying the promise of vitamin D for breast cancer prevention, especially in women with dense breast tissue.

Prevention remains important, especially for women with an increased risk. Charlamb tells her patients to exercise regularly and to eat a diet rich with fruits and vegetables that includes a variety of foods and avoids processed foods and red meats. She also discusses alcohol intake.

“There is pretty clear evidence now that even very moderate alcohol intake — one drink a day — is enough to significantly increase a woman’s risk of developing breast cancer,” the doctor says.

Though it’s impossible to entirely eliminate breast cancer risk in any woman, a healthy lifestyle can bring down a woman’s risk of developing breast cancer, even if that woman is at very high risk due to a genetic mutation.

Women interested in the Breast Cancer High Risk Program can call 315-464-8224 to schedule an appointment.

Hear an interview with Charlamb about the Breast Cancer High Risk Program

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Breast cancer research at Upstate: What is the best way to restrict estrogen?

Advances in the understanding, diagnosis and treatment of breast cancer begin in laboratories. Here’s a peek into one Upstate lab that received grants this year from the Carol M. Baldwin Breast Cancer Research Fund:

005371 What is the best way to restrict estrogen?

Estrogen is crucial to human life for men and women, but once a woman enters menopause, excess estrogen can lead to breast cancer. Up to 80 percent of the breast cancers detected in women after menopause are triggered and proliferated by estrogen, explains Debashis Ghosh, PhD.

Ghosh, a professor of pharmacology, collaborates with Juntao Luo, PhD, assistant professor of pharmacology, about ways to deliver new inhibitors of aromatase, the molecule that makes estrogen, to the tumor sites in animal breast cancer models.  Having elucidated the molecular mechanism of how aromatase works, the Ghosh group has designed novel aromatase inhibitors, which are being tested in his lab.

“Some of our compounds have performed better, much better in breast cancer cells than the current drug, which is known as Aromasin or exemestane,” says Ghosh. The next step would be testing the compounds in laboratory animals.

Listen to an interview with Ghosh on HealthLink on Air

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Support group forms for those affected by head and neck cancers

A Head and Neck Cancer Support Group meets the third Wednesday of each month, bringing together patients, family and friends before, during and after treatment.

Participation is free, and so is parking. The meetings are led by Upstate speech language pathologist, Jenna Gardner, clinical trials coordinator Dena Martin, and nurses Ann Ray and Robin Salvaterra.

Meetings are held from 5:30 to 6:30 p.m. at the Oasis Learning Center Room, 6333 Route 298 in East Syracuse. Use 6333 Carrier Parkway for navigation systems.

Even though the group is affiliated with Upstate University Hospital, patients are welcome from anywhere. For details, call 315-464-5819.

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Sharing a cancer diagnosis in the workplace

Aliya Hafeez, MD, an assistant professor of psychiatry and behavioral sciences and a breast cancer survivor, answers the question: “How much information should I share about my cancer diagnosis with coworkers?”

Her response: “It really depends on what your motivation in doing so would be. If it is for emotional support, then realize that not everyone is capable or in tune with their own fears of illness and especially cancer to ‘really’ be there for you.

“If you have shared personal information with particular co-workers whom you trust and feel are a positive support, then do so. If you feel that your work will be affected, and you want to warn your co-workers or will need their help, please realize some will be more willing than others.

“Your cancer diagnosis is YOUR business, and you are not obligated to tell anyone but your boss. And even your boss does not need more details than you are comfortable in giving.”

Reach Hafeez through Upstate Connect at 315-464-8668.

Listen to an interview with her.

 

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6 reasons to say no to e-cigarettes

closeup of woman smoking electronic cigarette outdoorEnticed by the flavors and sleek designs of the new electronic cigarettes?

Don’t be.

That’s the advice of Upstate Cancer Center Medical Director Leslie Kohman, MD, a thoracic surgeon who oversees the Lung Cancer Screening Program. She elaborates:

* 1. E-cigarettes contain nicotine, the same tobacco product that makes traditional cigarettes so addictive. Kohman says half of the e-cigarettes studied by the FDA also contained cancer-causing chemicals.

* 2. Glycol, a flavoring, nicotine and “who knows what else” are contained in the devices, which are manufactured without regulation, Kohman says. “They are manufactured in various locations around the world with no manufacturing controls, no safety controls whatsoever.”

* 3. If the flavor cartridges spill or are left where a child has access, their alluring sweet smell could lead to a toxic exposure or even a lethal ingestion of nicotine for a child. The Upstate New York Poison Center fielded 24 calls about accidental ingestions of e-cigarette chemicals in 2013 and 53 calls in the first three quarters of this year.

* 4. The synthetic liquid in most electronic cigarettes, propylene glycol has been recognized as safe for eating by the Food and Drug Administration. “But inhaling it is very different,” she says, “because the lungs absorb things in a very different way from the intestinal tract.”

* 5. Though some theories suggest the e-cigarette could serve as an aid to smoking cessation, “there is no evidence that this is more effective in helping people to quit cigarettes.”

* 6. In communities where smoking restrictions have become the norm, vaping is emerging as a worrisome trend. Big cities (including New York, Boston, Chicago, Los Angeles) are starting to ban e-cigarettes, but Kohman says, “we really fear for the public health danger and the social consequences of making it look normal to be walking around with something that looks like a cigarette.”

Public health experts worry that e-cigarettes will be a lure for former smokers or a gateway for teens to experiment with traditional cigarettes or other drugs. They also point out that more research on the dangers of e-cigarettes is needed.

E-cigarettes are proving more dangerous than some researchers initially believed, Stanton Glantz told Science News earlier this year. He is the director of the Center for Tobacco Control Research and Education at the University of California, San Diego.

In a paper in the journal, Circulation he and his team explained that e-cigarettes deliver high levels of nanoparticles, which have been linked to asthma, stroke, heart disease and diabetes – in case you need a seventh reason to say no to e-cigarettes.

Listen to an interview with Kohman about e-cigarettes

 

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Should you be tested for hepatitis C?

Hepatitis C, the most common blood-borne infection in the United States, is one of the viruses that can cause cancer — and the majority of people who are infected don’t know it.

The virus causes a chronic liver infection that can exist for decades without symptoms and that can lead to cirrhosis. Up to 7 percent of people with cirrhosis develop liver cancer each year, says Ajay Jain, MD, the associate director of hepatobiliary and pancreas surgery at Upstate. He spoke at the 10th annual Upstate Cancer Symposium in September.

No vaccine exists, but treatments can eliminate the virus or prevent its progression. A blood test can reveal hepatitis C antibodies.

The Centers for Disease Control and Prevention recommends testing for all Baby Boomers – anyone born from 1945 to 1965. Jain adds that healthcare workers and anyone who believes he or she may have been exposed should also be tested.

Hepatitis C has become a leading cause of liver cancer. Jain says the disease is treated most successfully with a liver transplant, but surgery or radiofrequency ablation are sometimes recommended. Chemotherapy does not work.

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Seeking ideas for the 50th anniversary time capsule

Upstate employee Jennifer Congel holds a time capsule which will buried at Upstate University Hospital.

Upstate employee Jennifer Congel holds a time capsule that will buried at Upstate University Hospital on October 15.

There’s still time to contribute ideas for objects to go in the Upstate time capsules, to be installed on Wednesday, October 15 in honor of the 50th anniversary of the opening of Upstate University Hospital’s downtown and community campuses. (10 a.m.-downtown; 1 p.m.-community campus.)

The time capsules are to include items that represent healthcare today, especially at Upstate University Hospital. Ideas already submitted include a Tigger pediatric hospital gown, Healing Muse literary journal, patient handbook, a list of current immunization guidelines for children and a program from the Cancer Center opening.

To share your time capsule ideas, contact Susan Keeter, 315-464-4834, keeters@upstate.edu.

Interested in knowing what’s in the 1964 time capsule that’s in the cornerstone of the hospital’s downtown building? Click here.

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