Auckland scientist discovers breakthrough in cancer treatment

Study of the humble cooking ingredient baker's yeast by an Auckland scientist has lead to a breakthrough which can lead to new treatment for diseases from cancer to dementia and obesity research into yeast by Massey University scientist Dr Evelyn Sattlegger has paved the way to understanding how a exacting protein found in all living organisms affects memory, immunity and diseases.

Based in the Institute of Natural Sciences at Massey University's Albany campus, Sattlegger has work with colleagues in the United States and Brazil to split the protein code it is a complex story of biological chemistry - but in summary Sattlegger studied the protein Gcn2 which is occupied in a number of diseases.

She found another protein - given the scientific name eEF1A - plays an significant role in cells keeping Gcn2 in ensure she says it show there are finely-tuned chemical interactions within cells that eventually underpin our health.

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Could Coffee Lower Men's Risk for Prostate Cancer?

Men who drink at least six or more cups of coffee a day may be cutting their risk for advanced prostate cancer by 60 percent, new research suggests. This is the first large study looking specifically at the relationship between coffee and metastatic prostate cancer, lead researcher Kathryn Wilson said. "This is an exciting finding, because there aren't many modifiable risk factors for prostate cancer." A definite cause-and-effect link is still far from proven, experts say, and just how coffee might help thwart prostate malignancy isn't clear.

"There are a lot of compounds in coffee that have various biological effects. It's a major source of antioxidants and that might have anti-cancer effects," said Wilson, a research fellow in epidemiology at the Harvard School of Public Health, Boston. "Also, coffee seems to have effects on insulin and has been associated with a lower risk of type 2 diabetes. In addition, insulin is thought to play a role in many cancers, including prostate cancer." Compounds in coffee also have an impact on sex hormone levels, according to the study.

But right now, the findings point only to an association between a love of "java" and a healthier prostate. More study will be needed to confirm the findings and to see if a biological explanation for the phenomenon exists, Wilson said. The bottom line, she said: "It's probably too early to tell someone that should go out and start drinking coffee just because of this study." The report was published in the May 17 online edition of the Journal of the National Cancer Institute. Prostate cancer is the most common cancer diagnosed and the second leading cause of cancer death in men in the United States. In the U.S. it affects one in six men during their lifetime. More than 2 million Americans and 16 million men around the world are prostate cancer survivors, the researchers say.

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Gay Men More Likely to Have Had Cancer

A new study finds that homosexual men are twice as likely as other males to have been diagnosed with and then survive a cancer, shining a light on the unique medical risks that gay people may face. It's not the first time that researchers have noted differences in health risks linked to sexual orientation. Gay men, of course, are at higher risk of becoming infected with HIV, while lesbians may be more likely than heterosexual women to get breast cancer. Both gay men and lesbians have higher rates of tobacco use than the general population, and research has shown that lesbians drink more and are more prone to obesity than other women.

The new study adds to existing knowledge, but "there's a painful dearth of data about lesbian, gay, bisexual and transgender health in general," noted Liz Margolies, executive director of the National LGBT Cancer Network, who's familiar with the new research. In the new study, published online May 9 in Cancer, researchers examined surveys involving more than 122,000 California residents from 2001, 2003 and 2005. Among other things, the surveys asked about sexual orientation and whether the participants had ever been diagnosed with cancer. About 8 percent of the gay men in the group reported having had cancer almost double the rate among the heterosexual and bisexual men surveyed.

Lesbians didn't have a higher rate of cancer than other women, but lesbian cancer survivors were about twice as likely to report that they had fair or poor health compared to heterosexual women. The study can't say whether gays and lesbians are more likely to develop cancer in the first place, since it doesn't include people who have died from the disease or may be too ill to answer questions, stressed study author Ulrike Boehmer, an associate professor of community health sciences at Boston University School of Public Health. Experts already believe that gay men face a higher risk of anal, lung, testicular and immune-system cancers, she said. For their part, lesbians are thought to possibly be at higher risk of breast cancer, perhaps because many of them don't give birth.

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Race Seems to Play Role in Colorectal Cancer Screening

Elderly black and Hispanic Americans are less likely than whites to get colorectal cancer screening, even though Medicare has expanded coverage for screening tests such as colonoscopy and fecal occult blood test, a new study has found. Researchers examined U.S. National Cancer Institute data between 1996 and 2005 to determine rates of colorectal cancer screening among Medicare beneficiaries aged 70 to 89 with no history of any cancer. Blacks were less likely than whites to receive colorectal cancer screening before and after Medicare provided coverage of fecal occult blood test, and after coverage of colonoscopy, according to the University of Texas School of Public Health study.

The investigators also found that Hispanics were less likely than whites to receive colorectal cancer screening after Medicare provided coverage of colonoscopy. The study is published in the current issue of the journal Cancer Epidemiology, Biomarkers & Prevention. "Colorectal cancer screening increased as Medicare coverage expanded. However, screening rates were still low according to recommendations," study author Aricia White, an epidemic service officer at the U.S. Centers for Disease Control and Prevention, said in a news release from the American Association for Cancer Research.

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Genome Scans May Reveal Life-Saving Alternatives for Cancer Patients

A 39-year-old woman is referred to Washington University's Siteman Cancer Center in St. Louis with suspected acute myeloid leukemia (AML), a cancer that can be treated relatively simply with medication, or not so simply with a high-risk stem cell transplant, depending on the tumor subtype. But finding out which type of cancer she has proves trickier than expected. While the pathologist sees a type of leukemia known as M3AML, which generally has a good outcome and can be treated with the drug ATRA, the cytogeneticist sees something entirely different.

In his analysis, the woman has a type of leukemia with poor long-term survival that is usually treated with stem cell transplantation a risky therapy that sometimes leads to death. Fortunately, in this case study, documented in the April 20 issue of the Journal of the American Medical Association, the woman's oncologist is aware of a clinical trial and, deferring treatment for six weeks, refers her there so the researchers can do a full scan of her genome and come up with an answer.

Full-genome sequencing involves scanning all the thousand of genes on the human genome to try to find a mistake. It's different from the more common gene testing these days, which looks only for specific DNA that might or might not be responsible for a particular problem. In the St. Louis case, the more in-depth sequencing, done in only seven weeks, uncovered a new genetic "mistake" that showed the woman could be treated with ATRA and not the more-complicated, risky stem cell transplantation.

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Nervous System Imbalance May Cause Fatigue in Breast Cancer Survivors

The persistent fatigue and exhaustion plaguing some breast cancer survivors after successful treatment stems from a tug of war between the "fight-or-flight" and "resting" parts of the autonomic nervous system, with the former working overtime and the other unable to rein it in, a new study suggests. Researchers from Ohio State University split 109 women who had completed breast cancer treatment up to two years earlier into two groups those who did and didn't report long-term fatigue and tested their blood for a baseline level of norepinephrine, a stress hormone. Participants were then asked to give a five-minute speech and do a series of verbal math problems, both tasks aimed at increasing their stress levels.

As expected, further blood tests showed that levels of norepinephrine associated with the "fight-or-flight" sympathetic nervous system rose in both groups after the stressful experience, researchers said. However, breast cancer survivors who experienced persistent fatigue had higher levels than those who weren't chronically tired. The study, released online in advance of publication in an upcoming print issue of the journal Psychoneuroendocrinology, was partially funded by the U.S. National Institutes of Health and the American Cancer Society.

The findings are the most recent from a 30-year-long study about the effects of stress on the human body. The researchers used earlier data from a larger ongoing study looking at whether yoga can ward off continuing fatigue in breast cancer patients. "We're not sure if the fatigue is stress-induced. But certainly cancer is an extremely stressful life event," said study author Christopher Fagundes, a postdoctoral fellow at Ohio State University's Institute of Behavioral Medicine Research. "So those stressors might be contributing to those autonomic system changes."

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Drop in Breast Cancer Among White Women May Have Stalled

Many American women abandoned hormone replacement therapy after a 2002 study found the treatment was tied to higher breast cancer risk. A sharp drop in breast cancer incidence among whites was observed soon after. However, a new study suggests that the 2002-2003 decline in breast cancer incidence among white women did not continue through 2007. The data suggests that the drop in breast cancers linked to women abandoning hormone replacement therapy (HRT) has now bottomed out.

Breast cancer rates among U.S. white women fell by about 7 percent between 2002 and 2003 after the release in 2002 of findings from the Women's Health Initiative study that linked HRT with an increased risk of breast cancer. To examine whether that trend has continued, American Cancer Society and U.S. National Cancer Institute (NCI) researchers reviewed breast cancer data collected from 2000 to 2007 by NCI Surveillance, Epidemiology and End Results (SEER) registries across the country.

The analysis revealed that the sharp decline in breast cancer rates among white women that occurred between 2002 and 2003 did not continue between 2003 and 2007. Instead, breast cancer rates among white women remained relatively stable from 2003 to 2007. "Postmenopausal hormone replacement therapy certainly had accounted for an increase in the incidence of developing a breast cancer. The use of postmenopausal HRT had sharply declined after multiple reports proved this relationship," noted one expert, Dr. Sharon M. Rosenbaum-Smith, a breast cancer specialist and surgeon at the Comprehensive Breast Center at St. Luke's-Roosevelt Medical Center in New York City.

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Smoking During Head & Neck Cancer Therapy Tied to Poor Outcome

Patients with head and neck cancer who continue to smoke while undergoing radiation treatments have a much lower long-term survival rate than those who kick the addiction, researchers have found. In the study of patients with squamous cell carcinoma of the head and neck, 23 percent of 101 patients who continued to smoke were still alive five years after treatment, compared with 55 percent of matched patients in a control group who quit smoking before they began radiation therapy.

In addition, 53 of the patients who continued to smoke suffered cancer recurrence, compared with 40 patients in the control group. The patients who kept smoking also had more treatment-related complications such as the development of scar tissue, hoarseness and difficulty eating. The poorer outcomes for persistent smokers were found both in patients who had radiation alone and in those who had surgery prior to radiation, the study authors noted in the report published in the February issue of the International Journal of Radiation Oncology/Biology/Physics.

"I've always told patients, 'You should really stop smoking,' but I had no tangible evidence to use to convince them that they would be worse off if they continued to smoke," lead author Dr. Allen Chen, residency training program director at the University of California, Davis, School of Medicine, said in a news release from the American Society for Radiation Oncology. "I wanted concrete data to see if smoking was detrimental in terms of curability, overall survival and tolerability of treatment. We showed continued smoking contributed to negative outcomes with regard to all of those," he added.

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Breast Cancer Treatment May Lead to Hip Fracture

Middle-aged breast cancer survivors face an increased risk for hip fractures, a condition normally uncommon in women younger than 70, a new study has found. Researchers at Northwestern University in Chicago say that this may be because early menopause caused by breast cancer treatment and the effects of breast cancer drugs could weaken the bones by the time women reach middle age. The finding came from a study of six women who had survived breast cancer and, in their early 50s, were being treated for hip fractures.

Most of the women did not have osteoporosis, but they did have lower-than-normal bone mineral density (osteopenia). This suggests that rapid changes in bone architecture caused by chemotherapy, early menopause and adjuvant breast cancer therapy may not be detected on a bone mineral density test, said Dr. Beatrice Edwards, an associate professor of medicine and orthopedic surgery and director of the bone health and osteoporosis program Northwestern University's Feinberg School of Medicine, who led the research.

The women had been diagnosed with early-stage breast cancer, and their treatments had included lumpectomy, radiation therapy and chemotherapy with cytoxan and adriamycin for one to four years before they broke a hip. All of the women were perimenopausal at the time of the fracture. In four of the women, their breast cancer had grown in response to estrogen, and their cancer therapy had included aromatase inhibitors to prevent their bodies from making estrogen. Recent research has linked aromatase inhibitors with possible bone loss in women.

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Breast Cancer Outcome: Your Doctor Matters

How doctors choose to treat their breast cancer patients and whether those treatment choices follow established recommendations may play a larger role in whether a cancer returns than experts have believed. In a new analysis looking at 994 women with ductal carcinoma in situ, the most common type of noninvasive breast cancer, researchers found treatment variations from surgeon to surgeon are significant, and may account for up to 30 percent of recurrences.

"Treatment variation is a troubling but well-known phenomenon in health care," said study author Andrew W. Dick, a researcher at RAND Corp. in Pittsburgh. The report is published online Jan. 3 and in the Jan. 19 print issue of the Journal of the National Cancer Institute. "The reason it is surprising in this case is that the variation is quite large, and related to factors that are very important in health outcomes," Dick said.

Those factors include having "negative margins" meaning that cancer cells are more than 2 millimeters away from the removed tissue's edge and getting radiation therapy after breast-conserving surgery. The variation by surgeon in treatments accounted for 15 percent to 35 percent of cancer occurring in the opposite breast in the next five years and 13 percent to 30 percent of recurrences over 10 years, the investigators found.

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Gene Activity May Affect Acute Myeloid Leukemia Outcome

For acute myeloid leukemia patients, overactive genes in their leukemic stem cells (LSC) can translate into a more difficult struggle to overcome their disease and achieve prolonged remission, new research reveals. "In many cancers, specific subpopulations of cells appear to be uniquely capable of initiating and maintaining tumors," the study authors explained in their report. The researchers identified 52 LSC genes that, when highly active, appear to prompt worse outcomes among acute myeloid leukemia (AML) patients.

Between 2005 and 2007, study author Andrew J. Gentles, of Stanford University in Palo Alto, Calif., and colleagues examined gene activity in a group of AML patients as well as healthy individuals. Separate data concerning AML tumors in four groups of patients (totaling more than 1,000) was also analyzed. In one of the patient groups, the investigators found that higher activity levels among 52 LSC genes meant a 78 percent risk of death within a three-year period. This compared with a 57 percent risk of death in the same time frame for AML patients with lower gene activity among these specific "signature" genes.

In another AML patient group, the research team observed that higher gene activity prompted an 81 percent risk for experiencing a disease set-back over three years, compared with just a 48 percent risk among patients with low gene activity. What's more, Gentles and his colleagues found that higher activity among these 52 LSC genes generally meant a poorer response to chemotherapy treatment and lower remission rates.

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Keeping Holiday Drinking in Check May Counter Cancer

Though holiday partying often includes alcohol consumption, cancer experts are urging partiers to partake moderately. "Research shows that drinking even a small amount of alcohol increases your chances of developing cancer, including oral cancer, breast cancer and liver cancer," Clare McKindley, clinical dietician in the Cancer Prevention Center at the University of Texas M.D. Anderson Cancer Center, said in a news release from the center.

"Researchers are still trying to learn more about how alcohol links to cancer," she added. "But convincing evidence does support the fact that heavy drinking damages cells and increases the risk for cancer development." To reduce risk, experts say, drinkers can do a number of things. First, stick to the recommended serving size. A drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor. Women should have no more than one drink a day and men should have no more than two drinks a day, according to the U.S. National Cancer Institute.

Try to avoid high-calorie drinks. Many popular alcoholic drinks are loaded with calories, especially those mixed with soda, fruit juice or cream. A one-cup serving of eggnog, a holiday staple, has about 340 calories. Being overweight or obese is also associated with an increased risk for cancer. Researchers believe that it is the ethanol or alcohol in beer, wine and liquor that increases cancer risk. Check the ethanol percentage numbers on bottle labels and stay away from 100-proof liquor.

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Gene Research Brings Insight Into Deadly Childhood Brain Tumor

U.S. scientists have unraveled the genetic code for the most common type of brain cancer in children. Gene sequencing reveals that this tumor, medulloblastoma, or MB, possesses far fewer genetic abnormalities than comparable adult tumors. The discovery that MB has five to 10 times fewer mutations than solid adult tumors could further attempts to understand what triggers the cancer and which treatment is most effective.

"The good news here is that for the first time now we've identified the broken genetic pieces in a pediatric cancer, and found that with MD there are only a few broken parts," said lead author Dr. Victor E. Velculescu, associate professor with the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore. "And that means it's potentially easier to intervene and to stop it," he said, likening the cancer to a train that's speeding out of control.

Velculescu and his colleagues, who report their findings in the Dec. 16 online issue of Science, say this is the first time genetic decoding has been applied to a non-adult cancer. Each year this cancer strikes about 1 in every 200,000 children younger than 15 years old. Before migrating through the patient's central nervous system, MBs begin in the cerebellum portion of the brain that is responsible for controlling balance and complicated motor function.

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Daily Aspirin Linked to Steep Drop in Cancer Risk

Long-term use of a daily low-dose aspirin dramatically cuts the risk of dying from a wide array of cancers, a new investigation reveals. Specifically, a British research team unearthed evidence that a low-dose aspirin (75 milligrams) taken daily for at least five years brings about a 10 percent to 60 percent drop in fatalities depending on the type of cancer. The finding stems from a fresh analysis of eight studies involving more than 25,500 patients, which had originally been conducted to examine the protective potential of a low-dose aspirin regimen on cardiovascular disease.

The current observations follow prior research conducted by the same study team, which reported in October that a long-term regimen of low-dose aspirin appears to shave the risk of dying from colorectal cancer by a third. "These findings provide the first proof in man that aspirin reduces deaths due to several common cancers," the study team noted in a news release. But the study's lead author, Prof. Peter Rothwell from John Radcliffe Hospital and the University of Oxford, stressed that "these results do not mean that all adults should immediately start taking aspirin."

"They do demonstrate major new benefits that have not previously been factored into guideline recommendations," he added, noting that "previous guidelines have rightly cautioned that in healthy middle-aged people, the small risk of bleeding on aspirin partly offsets the benefit from prevention of strokes and heart attacks." "But the reductions in deaths due to several common cancers will now alter this balance for many people," Rothwell suggested. Rothwell and his colleagues published their findings Dec. 7 in the online edition of The Lancet.

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Blood Cancer Advances May Improve Survival

Advances in the treatment of blood cancers offer new hope for increased survival, according to two studies scheduled to be presented at the American Society of Hematology meeting Saturday in Orlando, Fla. Results from one study suggest that treating multiple myeloma patients with zoledronic acid can improve survival, while another group of researchers are scheduled to report on their progress in treating a particularly aggressive form of acute lymphoblastic leukemia (ALL).

Zoledronic acid, a type of bisphosphonate, is given to myeloma patients to bolster bone health and reduce the risk for fracture and bone pain that are a common feature of the disease.Although prior research has suggested that zoledronic acid may have a broader anti-cancer effect, the current study finds that a well-tolerated regimen of the drug can reduce the risk of death among myeloma patients.The study is published in the Dec. 4 online edition of The Lancet.

"These data add to growing clinical evidence supporting anti-cancer benefits with zoledronic acid in patients with newly diagnosed cancers," the study team, led by Gareth J. Morgan from the Institute of Cancer Research in London, said in a journal news release. The authors base their conclusions on work with 1,960 multiple myeloma patients, about half of whom were treated with zoledronic acid in combination with either intensive or non-intensive chemotherapy. The other half received clodronic acid and equivalent chemotherapy regimens.

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FDA Panel to Vote on Drugs Said to Prevent Prostate Cancer

A U.S. Food and Drug Administration advisory panel is expected to decide Wednesday whether to approve two drugs for the prevention of prostate cancer, the third highest cancer killer of men. Avodart and Proscar, manufactured by GlaxoSmithKline and Merck, respectively, are already approved to treat enlarged prostates. The drug makers say their research shows the drugs also lower the risk of prostate cancer by more than 20 percent. FDA regulators have several concerns, the Associated Press reported. For one thing, black men, who are at high risk for the disease, were underrepresented in the clinical trials.

"The applicability to African-American men is not known due to marked under-representation," the FDA's online review stated. Blacks made up just 4 percent of Merck's patients and only 2 percent of Glaxo's patients, according to the AP. The panel of outside experts assembled by the FDA is also likely to discuss the overall value of preventing low-grade tumors. According to the FDA, more than three-quarters of the tumors the drugs prevent are slow-growing, meaning they are non-aggressive and probably not life-threatening for anyone with a life expectancy of less than 20 years.

If the tumors aren't aggressive, Glaxo has said they often involve unnecessary treatment and biopsies, or surgical procedures, to diagnose cancer, that pose risks of their own. Also, slightly more aggressive tumors were seen in men taking Avodart and Proscar, compared with those taking placebo pills, according to the FDA. But the pharamaceutical companies say the drugs simply make those tumors easier to detect because they shrink the prostate. The U.S. National Cancer Institute estimates that 217,730 men will be diagnosed with prostate cancer this year and 32,050 men will die of it.

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Black Smokers May Face Higher Death Risk Than Whites: CDC

A study conducted in Missouri suggests that smoking may be even more lethal for blacks than it is for whites. In fact, researchers say the smoking related death rate for blacks is nearly one-fifth higher than it is for whites in that state. The study was conducted by researchers at the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. They analyzed data from 2003-2007 found that the average annual smoking-attributable death rate was 358 per 100,000 for blacks in Missouri and 286 per 100,000 for whites, a difference of 18 percent. That racial difference was larger among men than among women.

Blacks had a 26 percent higher smoking-related death rate for cancer and a 53 percent higher smoking-related death for circulatory diseases, but a 32 percent lower smoking-related death rate for respiratory diseases. Overall, smoking caused about a third of all cancer deaths, 15.3 percent of all circulatory disease deaths, and 46.5 percent of all respiratory disease deaths in Missouri between 2003 and 2007, according to the study. The findings appear in this week's issue of Morbidity and Mortality Weekly Report. Based on the data, the CDC says that "states should continue to implement population-wide tobacco control interventions that reach all racial groups."

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Diabetes Drugs Might Lower Risk of Lung Cancer

Researchers report that drugs used to treat diabetes may indeed both prevent and contain lung cancer. The findings, being presented Tuesday at the annual meeting of the American College of Chest Physicians in Vancouver, back up preliminary data that some diabetes medications might protect against tobacco-induced lung cancer. "Patients who did not develop lung cancer had a much higher chance of taking one of these medications than those who did develop lung cancer," said study author Dr. Peter Mazzone. "And those who did develop lung cancer were much less likely to have seen that cancer spread outside the chest and more likely to survive longer with one of these drugs."

Both metformin and the class of drugs known as thiazolidinediones (which includes Avandia and Actos) are used by tens of millions of Americans. A mouse study published in September found that metformin was associated with up to a 73 percent reduction in the number of tumors mice developed when they were given a common carcinogen found in tobacco. The mice had been genetically engineered to be susceptible to this kind of tumor. Epidemiological studies in humans have found similar effects. Metformin was originally marketed as Glucophage, but is now available as an inexpensive generic.

For this study, Mazzone and his colleagues reviewed and compared electronic medical records on 225 diabetics with lung cancer with a similar number of diabetic patients who did not have lung cancer, although both groups shared other risk factors such as age, smoking history and gender. "Forty-one percent of those with lung cancer had taken one of these medications at some point prior to developing the cancer, and 96 percent of all the controls had taken one of these medications in diabetic treatment," reported Mazzone, director of the lung cancer program at The Respiratory Institute at the Cleveland Clinic in Ohio.

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Doctors Ordering Transfusions to Get Patients into Drug Trials

Canadian researchers say they've noticed a disturbing trend: Cancer doctors ordering unnecessary blood transfusions so that seriously ill patients can qualify for drug trials. In a letter published recently in the New England Journal of Medicine, the researchers report on three cases during the last year in Toronto hospitals in which physicians ordered blood transfusions that could make the patients appear healthier for the sole purpose of getting them into clinical trials for chemotherapy drugs. The practice raises both medical and ethical concerns, the authors say.

"On the physician side, you want to do the best for your patients," said co-author Dr. Jeannie Callum, director of transfusion medicine and tissue banks at Sunnybrook Health Sciences Centre in Toronto. "If these patients have no other options left to them, you want to do everything you can to get them into a clinical trial," she said. "But the patient is put in a horrible position, which is, 'If you want in to the trial, you have to have the transfusion.' But the transfusion only carries risks to them," she added.

A particularly serious complication of blood transfusions is transfusion-related acute lung injury, which occurs in about one in 5,000 transfusions and usually requires the patient to go on life support, said Callum. But besides the potential for physical harm, enrolling very sick people in a clinical trial can also skew the study's results making the drug perform worse than it might in patients whose disease was not as far along. The unnecessary transfusions were discovered by the Toronto Transfusion Collaboration, a consortium of six city hospitals formed to carefully review all transfusions as a means of improving patient safety, Callum said.

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Many With Terminal Cancer Still Getting Routine Screens

Many patients with incurable cancer are still being screened for common cancers, although these tests are unlikely to provide any benefit, researchers from Memorial Sloan-Kettering Cancer Center in New York City have found. Specifically, many patients diagnosed with advanced lung, colorectal, pancreatic, gastroesophageal or breast cancer are still undergoing the ordeal of routine breast, prostate and colon cancer screening, said the researchers. Not only might these patients suffer from invasive procedures like colonoscopies near the end of life, the researchers said, but they face the unnecessary risk of additional tests, biopsies and psychological distress resulting from the detection of new malignancies.

"For patients living with advanced cancer, cancer screening should not be a routine procedure," said lead researcher Dr. Camelia S. Sima, an assistant attending biostatistician. "Patients living with advanced malignancies and their doctors should engage in a realistic conversation about the risks and benefits associated with cancer screening in face of a severely limited life expectancy," she added. The report is published in the Oct. 13 issue of the Journal of the American Medical Association. For the study, Sima's team collected data on 87,736 Medicare patients aged 65 years or older with advanced lung, colorectal, pancreatic, gastroesophageal or breast cancer, whose data was reported in the Surveillance, Epidemiology, and End Results (SEER) tumor registries.

These patients were followed from their diagnosis, between 1998 and 2005, until they died or to the end of 2007. To compare the findings to a control group, the researchers also collected data on 87,307 similar Medicare patients without cancer, who were matched with the other individuals for age, race, sex and SEER data. In both patient groups, Sima's team looked at the rates of mammograms for breast cancer, Pap tests for cervical cancer, prostate-specific antigen (PSA) tests for prostate cancer and endoscopy for colon cancer. The investigators found that among women with advanced cancer, 8.9 percent had a mammogram, compared with 22 percent of those without cancer; and 5.8 percent of the cancer patients had a Pap test, compared with 12.5 percent of those without cancer.

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