Phase of illness plays large role in distress; Interventions should be targeted to spouses along with patients
ANN ARBOR, Mich. – A cancer diagnosis affects more than just the patient. A new study from researchers at the University of Michigan Comprehensive Cancer Center finds spouses report similar physical and emotional quality of life as the patient.
The study found that what really impacted emotional distress – among both patients and their spouses – was whether the patient was newly diagnosed, facing a recurrence or living with advanced disease.
Researchers looked at 263 men with prostate cancer and their spouses. Participants were recruited from three large cancer centers. Both the men and their wives completed questionnaires that assessed quality of life, including physical, social, family, emotional and functional issues. Patients and spouses each reported on their own quality of life.
The researchers found little difference in quality of life between patients and spouses, but found significant differences based on the phase of their illness. Couples coping with advanced disease had significantly poorer overall quality of life.
“The spouses of advanced cancer patients are really carrying the load. Cancer is a devastating illness, and a patient’s primary resource is the partner, who often doesn’t have the information she needs to deal with these complex problems. This isn’t just a common cold – this is the person you love and care about dealing with a life-threatening illness,” says lead study author Laurel Northouse, Ph.D., R.N., co-director of the Socio-Behavioral Program at the U-M Comprehensive Cancer Center and Mary Lou Willard French Professor of Nursing at the U-M School of Nursing.
Results of the study appear in the Sept. 20 issue of the Journal of Clinical Oncology.
Spouses reported lower confidence than patients in their ability to manage the illness, and more uncertainty about the illness. Patients also reported more social support than did spouses.
“Doctors, nurses and even family and friends often focus mainly on the patient who has cancer and don’t realize the illness has enormous ramifications on the family, especially the spouse,” Northouse says.
The researchers urge more health care interventions aimed at emotional distress for both patients and caregivers. At the same time, caregivers should recognize they too are emotionally affected by this illness and seek appropriate support. Patients also can play a role by encouraging their spouse to be actively involved in their care.
“Patients need to recognize this illness affects their partners as well as themselves. They need to find a way to be supportive of their partner; for example, including them in interactions with physicians so the partners get the information they desperately want. Work as a team together to deal with the illness. I think patients may underestimate the needs of their partners to get information. Those partners need first-hand information. If they’re able to go into the consultation, they’re able to get their questions answered,” Northouse says.
In addition to Northouse, study authors were James Montie, M.D., Valassis Professor of Urologic Oncology and chair of urology at U-M; Howard Sandler, M.D., U-M professor of radiation oncology; Maha Hussain, M.D., U-M professor of internal medicine and urology; Kenneth Pienta, M.D., U-M professor of internal medicine and urology; David Smith, M.D., U-M professor of internal medicine and urology; Darlene Mood, Ph.D., and Jeffrey Forman, M.D., both from Wayne State University and Karmanos Cancer Center; Martin Sanda, M.D., from Harvard Medical School; and Trace Kershaw, Ph.D., from Yale University.
Funding for the study was from the National Cancer Institute.
Reference: Journal of Clinical Oncology, Vol. 25, No. 27, Sept. 20, 2007
Contact: Nicole Fawcett
University of Michigan Health System
Sept. 13, 2007 ANN ARBOR, Mich.—Using atom-level imaging techniques, University of Michigan researchers have revealed important structural details of an enzyme system known as “Mother Nature’s blowtorch” for its role in helping the body efficiently break down many drugs and toxins.
The research has been detailed in a series of papers, the most recent published online this month in the journal BBA Biomembranes.
The system involves two proteins that work cooperatively. The first, cytochrome P450, does the actual work, but only when it gets a boost from the second protein, cytochrome b5. To complicate matters, the two proteins can interact only when both are bound to a cell membrane. That makes it difficult to use traditional techniques to discern the structural details that are crucial to the interaction, said Ayyalusamy Ramamoorthy, who leads the research group.
For instance, X-ray crystallography, often used to determine protein structures, requires separating the molecules from their membrane environment. Because part of cytochrome b5 sticks to the membrane, such separations involve breaking the molecule at the sticking point, which happens to be the part that controls its interaction with cytochrome P450. So while crystallography can offer some information on structure, it can’t provide insights into exactly what goes on between P450 and b5 during their cozy, membrane-bound encounters, Ramamoorthy said.
However, the technique his lab uses—solid state NMR spectroscopy—can produce detailed images of proteins in the membrane environment, not only revealing molecular structure but also showing how a particular protein nestles into the membrane. Cytochrome b5 presented a challenge even to that versatile method, though, because the molecule has three parts that all behave differently: the rigid, sticky portion that buries into the cell membrane, a highly mobile, water-soluble portion, and a less mobile “linker” that connects the other two parts.
But by tweaking their technique, the researchers were able to get high-resolution images of all three portions.
“The challenge was something like having a room full of people and trying to get good photos of every one of them,” said Ramamoorthy, an associate professor of chemistry and Biophysics. “With one picture, you probably can’t do it. But if you say, ‘Everyone over age 50 stand up,’ and you take one picture, and then you ask for another age group and take another picture, and so on, you have a better chance.”
By spinning their samples (or aligning the molecules in the magnetic field), the researchers were able to differentiate parts of the molecule based not on age group, as in the photo analogy, but by mobility. “With the techniques we designed, we were able to observe the rigid portion separately from the highly mobile and less mobile portions,” Ramamoorthy said.
In the first part of the work, published in the Journal of the American Chemical Society in May, the researchers described the membrane-spanning segment of cytochrome b5, revealing for the first time its helical shape and the way it tilts in relation to the membrane. In the new work published in BBA Biomembranes, they determined that once both molecules are bound in the membrane, cytochrome b5 modulates the motion and the structure of cytochrome P450. More work is in progress to determine the detailed high-resolution structures of these two proteins.
Ramamoorthy’s team also is studying other membrane-associated proteins, a group that includes many biologically important molecules.
“These proteins are involved in all major diseases, everywhere in the body, and are therefore primary targets for pharmaceutical applications,” Ramamoorthy said. “In my opinion, solving the structures of membrane proteins should be the highest priority for structural biologists in the coming years.”
Ramamoorthy collaborated on the most recent work with Lucy Waskell, a professor of anesthesiology and a physician at the Department of Veterans Affairs Medical Center.
A leader in this area of research, Ramamoorthy has organized several major international symposia on the field at the University of Michigan, edited a special issue in the journal BBA-Biomembranes, published a number of papers in leading journals, and brought out a book on NMR Spectroscopy of Biological Solids. Ramamoorthy said that this area of research will grow considerably at U-M from implementing plans to set up a high magnetic field solid-state NMR spectrometer facility and an NIH-funded program.
More information on Ramamoorthy
Contact: Nancy Ross-Flanigan
Phone: (734) 647-1853
Related Categories: Science.
See also: News, Health, University of Michigan, Global News
ANN ARBOR, Mich.— A camper who chases a grizzly but won’t risk unprotected sex. A sky diver afraid to stand up to the boss. New research shows that not all risk is created equal and people show a mixture of both risky and non-risky behaviors.
The survey also shows that men are significantly riskier than women overall.
The University of Michigan research refutes the standard theories of risk that group people as either risk-seeking or risk-avoiding, and suggests that we can have a mix of both risky and non-risky behavior depending on the type.
The study appears in the journal Evolutionary Psychology. Daniel Kruger, a research scientist at the U-M School of Public Health, and colleagues X.T. Wang, University of South Dakota, and Andreas Wilke, UCLA, identified areas of risk taking (risk domains) based on the types of challenges that our ancestors faced during many thousands of years of human evolution.
“People are complex,” said Kruger. “Just because somebody seems to be a big risk taker in one area doesn’t mean they will take risks in all areas.”
The types of risks identified include competition with other individuals; competition with other groups; mating and allocating resources for mate attraction; environmental risks (chasing a bear or skydiving); and fertility risks. The study showed that our tendencies for risk taking follow these different types of challenges.
“It is remarkable not just that we were able to identify different areas of risk taking, but also that many of the challenges faced by our ancestors are similar to challenges we face in our modern world today,” Kruger said.
People surveyed for the study were least likely to take fertility risks, and most likely to take risks related to social status in one’s group — like standing up to one’s boss. In all domains, men were significantly more risk taking than women. During human evolution, men competed for social status and resources in order to attract mates. Thus, this pattern is not surprising, Kruger said.
The risks that threaten fertility function differently than the others, Kruger said. Other types of risk have a possible benefit in terms of survival and reproduction. But with fertility risks, there is just a threat to reproduction. They can only cause harm in the evolutionary sense since they would only hurt our ability to procreate.
“Those were types of risks that weren’t attractive to other people, those risks were the least likely to be taken, and people saw those risks as unattractive in a potential mate,” Kruger said.
Although in most parts of the world, threats from predators may be limited to those making wilderness expeditions, we still live in a world with complex challenges involving other individuals and material investments. The basic elements of our social environment have not changed; we just live on a much larger scale.
The study appears in the latest issue of Evolutionary Psychology.
For more on Kruger visit: http://www.ns.umich.edu/htdocs/public/experts/ExpDisplay.php”ExpID=931
The University of Michigan School of Public Health has been working to promote health and prevent disease since 1941, and is consistently ranked among the top five schools in the country. Faculty and students in the school’s five academic departments and dozens of collaborative centers and institutes are forging new solutions to the complex health challenges of today, including chronic disease, health care quality and finance, emerging genetic technologies, climate change, socioeconomic inequalities and their impact on health, infectious disease, and the globalization of health. Whether making new discoveries in the lab or researching and educating in the field, our faculty, students, and alumni are deployed around the globe to promote and protect our health. For more on the School of Public Health, see: http://www.sph.umich.edu/
Contact: Laura Bailey
University of Michigan
ANN ARBOR, Mich.—More than 90 percent of Americans age 65 and older now have prescription drug coverage, compared to more than 75 percent who were covered in 2004, according to a University of Michigan analysis. And poor seniors are as likely to have coverage as the rich.
The analysis compares drug coverage among a nationally representative sample of 10,175 older Americans who were interviewed both in 2004 and in 2006, when the Medicare Part D prescription drug benefit started. The report is to be presented today in Washington, D.C.
The interviews are part of the on-going Health and Retirement Study, conducted by the U-M Institute for Social Research (ISR) and funded primarily by the National Institute on Aging,
“Despite widespread complaints that the Part D plan is complex and confusing, our findings suggest that older Americans have been able to make good choices,” said U-M economist David Weir, who directs the ISR Health and Retirement Study. Weir conducted the analysis with U-M economist Helen Levy.
They presented their findings today at the National Press Club, at a conference on “Challenges and Solutions for Retirement Security” sponsored by the Social Security Administration and the Retirement Research Consortium.
In 2004, nearly a quarter (23 percent) of Americans age 65 and older lacked prescription drug coverage, Levy and Weir found, compared with fewer than 10 percent in 2006.
The overall enrollment figures found in this study were quite similar to those reported by the U.S. Department of Health and Human Services, with roughly a quarter of Medicare beneficiaries enrolled in stand-alone Part D coverage in 2006.
But using data from the Health and Retirement Study, the researchers were able to go beyond the official statistics to show that rich and poor were equally likely to sign up for Part D and private coverage, and to lack coverage. Wealthy elders were much more likely to have employer-provided drug coverage, but poorer seniors were much more likely to get drug coverage through Medicaid.
Equally importantly, the researchers were able to show that the most common reason people chose not to obtain prescription drug coverage was that they used few or no drugs.
The study also asked people about the difficulty of the decision process, and whether they were confident that they had made a good choice. Only about one in six people reported that their decision about whether to sign up for Part D was very or somewhat difficult. The vast majority said the decision was not very difficult or not difficult at all. The majority of Part D plan enrollees (69 percent) reported feeling very or somewhat confident about having made the right decision, and 86 percent of them planned to sign up again the following year.
While Levy and Weir caution that their analysis is preliminary, the findings indicate that despite widespread criticisms, the Part D plan has succeeded in boosting drug coverage for U.S. seniors, especially for those who need it most. “Fewer than 10 percent of seniors lack drug coverage now,” Weir said. “And those with worse self-reported health and higher use of prescription drugs in 2004 were more likely than others to sign up.”
The Retirement Research Consortium consists of three multidisciplinary centers: the Michigan Retirement Research Center at ISR, the Center for Retirement Research at Boston College, and the NBER Retirement Research Center
Established in 1948, the University of Michigan Institute for Social Research (ISR) is among the world’s oldest academic survey research organizations, and a world leader in the development and application of social science methodology. ISR conducts some of the most widely-cited studies in the nation, including the Reuters/University of Michigan Surveys of Consumers, the American National Election Studies, the Monitoring the Future Study, the Panel Study of Income Dynamics, the Health and Retirement Study, and the National Survey of Black Americans. ISR researchers also collaborate with social scientists in more than 60 nations on the World Values Surveys and other projects, and the Institute has established formal ties with universities in Poland, China and South Africa. ISR is also home to the Inter-University Consortium for Political and Social Research (ICPSR), the world’s largest computerized social science data archive. Visit the ISR web site at http://www.isr.umich.edu for more information.
Contact: Diane Swanbrow
University of Michigan
Analysis of 43 US cities during 1918-1919 Spanish flu pandemic uncovers strong link between social restrictions and lower death rates
ANN ARBOR, Mich. — Although physicians have imposed quarantine orders since at least 1374, when the Port of Venice officially isolated foreigners and shippers for 40 days to keep out infectious scourges, there has been no definitive evidence that public health measures like quarantining the sick and isolating people after exposure to ill people would save lives during an influenza pandemic.
In a study published in the Aug. 8 Journal of the American Medical Association, a team of University of Michigan medical historians and epidemiologists from the federal Centers for Disease Control and Prevention say that social restrictions allowed 43 U.S. cities to save thousands of lives during the Spanish influenza pandemic of 1918-1919.
Although these urban communities had neither effective vaccines nor antiviral medicines, they were able to organize and execute a suite of classic public health measures – called non-pharmaceutical interventions or NPIs – before the pandemic gained full force.
The new study finds that cities whose NPIs were sustained and layered with multiple tactics had the best outcomes. In addition to quarantine and isolation, the NPIs examined in this study were school closures and cancellation of public gatherings.
“Public health is everyone’s responsibility. In a world faced by the threat of newly emerging and re-emerging infectious diseases, it is critical to determine if costly and potentially socially harsh NPI measures can save lives and reduce the numbers of those infected,” says lead author Howard Markel, M.D., Ph.D., the George E. Wantz Distinguished Professor of the History of Medicine, professor of pediatrics and communicable diseases, and director of the U-M Center for the History of Medicine. “Now we know the answer is ‘yes.’ ”
Markel adds that in today’s world, implementing these measures in a layered, sustained fashion would also provide a cushion of time for the development and distribution of effective vaccines and antivirals, while reducing the crush on essential infrastructure.
“By better understanding what worked in the past, we can better prepare for the future,” says senior author Martin Cetron, M.D., director of the CDC’s Division of Global Migration and Quarantine. “Communities that were most successful during the 1918 pandemic quickly enacted a variety of measures. Those planning for the next pandemic need to carefully consider how to best use these strategies to protect people and decrease the potential impact of the next pandemic in their communities.”
The 43 cities in the study were scattered from coast to coast and represented a combined population of approximately 23 million. In an exhaustive review of 1,144 primary and secondary sources that included U.S. census data, municipal records, newspapers and handbills covering a 24-week period – Sept. 8, 1918 through Feb. 22, 1919 – the researchers identified which NPIs were used in each city and when officials turned them on and off.
Using both actual death rates from pneumonia and influenza, and baseline rates for what would have been normal without a pandemic, the researchers found there were 115,340 excess pneumonia and influenza deaths attributable to the pandemic in these cities during the period studied. In comparing the death rates to when NPIs were turned on and off, they found that NPIs did mitigate the death rate, with a statistically significant association between increased duration of NPIs and reduced mortality.
Further, they discovered that city-to-city variation in mortality was associated with the timing, duration and combination of NPIs. St. Louis, Missouri, for example, closed schools and cancelled public gatherings relatively early in the pandemic and sustained these measures for about 10 weeks. The analysis shows that St. Louis had one of the largest drops in mortality while the NPIs were in force.
As a whole, the study’s findings contrast markedly with the conventional wisdom that the Spanish Flu ravaged the United States and elsewhere, with little that could be done to stop its deadly toll.
Markel predicts that NPI measures will be socially painful in the next pandemic, but that the public’s acceptance of NPIs is essential.
“We need to have informed concern about what to do in a pandemic – and why,” concludes Markel.
Citation: JAMA, Nonpharmaceutical Interventions Implemented by US Cities During the 1918 -1919 Influenza Pandemic, Aug. 8, 2007, p. 644-654, Vol. 298, No. 6.
Other collaborators on the research were Alexandra Minna Stern, Ph.D., associate director, Center for the History of Medicine; J. Alexander Navarro, Ph.D., senior researcher, Center for the History of Medicine; Joseph R. Michalsen, research associate, Center for the History of Medicine; Alexandra Sloan, research associate, Center for the History of Medicine; and Harvey B. Lipman, Ph.D., (insert title), Centers for Disease Control and Prevention.
This work was funded by the Centers for Disease Control and Prevention and conducted by the University of Michigan Center for the History of Medicine and the CDC Division of Global Migration and Quarantine.
The complete bibliography of the 1,144 primary and secondary sources is available as an online supplement at http://www.cdc.gov/ncidod/dq/index.htm. The supplement provides access to data specific to each of the 43 cities.
The Center for the History of Medicine also has a Web-based source of materials that cover the 1918-919 influenza pandemic, which can be viewed at http://www.med.umich.edu/medschool/chm/influenza/.
More information about community strategies for pandemic influenza is available at http://www.pandemicflu.gov/plan/community/commitigation.html.
The 43 cities examined in this study were:
CA: Los Angeles, Oakland, San Francisco
CT: New Haven
LA: New Orleans
MA: Boston, Cambridge, Fall River, Lowell, Worcester
MI: Grand Rapids
MN: Minneapolis, St. Paul
MO: Kansas City, St. Louis
NY: Albany, Buffalo, New York, Rochester, Syracuse
OH: Cincinnati, Cleveland, Columbus, Dayton, Toledo
PA: Philadelphia, Pittsburgh
WA: Seattle, Spokane
Contact: Mary Beth Reilly
University of Michigan Health System
July 10, 2007
ANN ARBOR, Mich.—Organic farming can yield up to three times as much food as conventional farming on the same amount of land—according to new findings which refute the long-standing assumption that organic farming methods cannot produce enough food to feed the global population.
Researchers from the University of Michigan found that in developed countries, yields were almost equal on organic and conventional farms. In developing countries, food production could double or triple using organic methods, said Ivette Perfecto, professor at U-M’s School of Natural Resources and Environment, and one the study’s principal investigators. Catherine Badgley, research scientist in the Museum of Paleontology, is a co-author of the paper along with several current and former graduate and undergraduate students from U-M.
“My hope is that we can finally put a nail in the coffin of the idea that you can’t produce enough food through organic agriculture,” Perfecto said.
In addition to equal or greater yields, the authors found that those yields could be accomplished using existing quantities of organic fertilizers, and without putting more farmland into production.
The idea to undertake an exhaustive review of existing data about yields and nitrogen availability was fueled in a roundabout way, when Perfecto and Badgley were teaching a class about the global food system and visiting farms in Southern Michigan.
“We were struck by how much food the organic farmers would produce,” Perfecto said. The researchers set about compiling data from published literature to investigate the two chief objections to organic farming: low yields and lack of organically acceptable nitrogen sources.
Their findings refute those key arguments, Perfecto said, and confirm that organic farming is less environmentally harmful yet can potentially produce more than enough food. This is especially good news for developing countries, where it’s sometimes impossible to deliver food from outside, so farmers must supply their own. Yields in developing countries could increase dramatically by switching to organic farming, Perfecto said.
While that seems counterintuitive, it makes sense because in developing countries, many farmers still do not have the access to the expensive fertilizers and pesticides that farmers use in developed countries to produce those high yields, she said.
After comparing yields of organic and convention farms, the researchers looked at nitrogen availability. To do so, they multiplied the current farm land area by the average amount of nitrogen available for production crops if so-called “green manures” were planted between growing seasons. Green manures are cover crops which are plowed into the soil to provide natural soil amendments instead of synthetic fertilizers. They found that planting green manures between growing seasons provided enough nitrogen to farm organically without synthetic fertilizers.
Organic farming is important because conventional agriculture—which involves high-yielding plants, mechanized tillage, synthetic fertilizers and biocides—is so detrimental to the environment, Perfecto said. For instance, fertilizer runoff from conventional agriculture is the chief culprit in creating dead zones—low oxygen areas where marine life cannot survive. Proponents of organic farming argue that conventional farming also causes soil erosion, greenhouse gas emission, increased pest resistance and loss of biodiversity.
For their analysis, researchers defined the term organic as: practices referred to as sustainable or ecological; that utilize non-synthetic nutrient cycling processes; that exclude or rarely use synthetic pesticides; and sustain or regenerate the soil quality.
Perfecto said the idea that people would go hungry if farming went organic is “ridiculous.”
“Corporate interest in agriculture and the way agriculture research has been conducted in land grant institutions, with a lot of influence by the chemical companies and pesticide companies as well as fertilizer companies—all have been playing an important role in convincing the public that you need to have these inputs to produce food,” she said.
Contact: Laura Bailey
Phone: (734) 647-1848
Dead on Target
There has been much recent interest in how nanotechnology will impact the field of medicine. Unfortunately, a number of promising nanostructured systems have turned out to be extremely toxic to humans, thus precluding their use in clinical applications and dashing hopes of an early success for the interdisciplinary field of nanobiotechnology. Now a group of researchers at the University of Michigan Nanotechnology Institute for Medicine and Biological Sciences have devised a multifunctional nanoparticle platform comprising nanoparticles synthesized within dendrimers equipped with targeting molecules and dyes. These dendrimer nanoparticle systems are able to seek out and specifically bind to cancer cells.
Xiangyang Shi, Suhe Wang, James R. Baker Jr., and their colleagues have designed dendrimer nanoparticle systems that are stable, water soluble, and biocompatible. The researchers start out by synthesizing gold nanoparticles within amine-terminated dendrimers. Next, dye molecules and a targeting molecule, folic acid, are attached to the ends of the dendrimers. Finally, the remaining amine groups are acetylated to ensure that the complex particles do not bear any surface charges. This last step is especially important to ensure the biocompatibility of these systems and to prevent the nonspecific adhesion of other materials. Molecular dynamics simulations indicate that the folic acid attachments project out into the solvent and are readily available for binding to cells, whereas the dye molecules stay far removed from the metal nanoparticles and thus retain their bright fluorescence.
Many cancer cells, including those implicated in cancers of the ovary, kidney, uterus, testis, brain, colon, and lungs, tend to overexpress folic acid receptors. Owing to the folic acid attachments grafted onto the dendrimer nanoparticles, the dendrimer nanoparticles are seen to latch onto the cancer cells via these folic acid receptors. Since the dendrimer nanoparticles are also equipped with dye molecules, the high concentrations of nanoparticles accumulated in the cancer cells can be imaged by confocal microscopy, and indeed diseased cells can be easily told apart from healthy cells. Further verification comes from electron microscopy experiments. The high contrast provided by the gold nanoparticles allows the determination of the specific sites in the cell machinery where the nanoparticles are attached. Shi pointed out that it should be possible to design dendrimer nanoparticles with other biological ligands such as proteins and antibodies to image and target various biological systems.
“Beyond imaging, it may also be possible to specifically target and destroy cancer cells that internalize the nanoparticles by applying laser heat that intensifies in the presence of gold nanoparticles”, said Wang. “Another possibility is the attachment of drug molecules to these dendrimer nanoparticle systems”, added Baker, “since this will allow the direct delivery of drugs to the target cells”. The researchers are currently conducting further in vivo experiments to evaluate the suitability of this system for clinical applications.
Contact: Xiangyang Shi, University of Michigan, Ann Arbor (USA)
Contact: Nicole Fawcett
University of Michigan Health System
86 percent of patients treated with Bexxar survived after 8 years of follow-up
ANN ARBOR, Mich. — Eight years after being treated with a new drug for non-Hodgkin’s lymphoma, 86 percent of patients were still alive and half had not had a relapse of their disease, according to researchers from the University of Michigan Comprehensive Cancer Center.
The patients had follicular lymphoma, a type of cancer that is not considered to be curable using traditional treatments. Even if patients initially respond to treatment, the disease almost always comes back and becomes more difficult to treat.
The study followed 76 patients with follicular non-Hodgkin’s lymphoma, a cancer of the lymph system, who received the radioimmunotherapy drug Bexxar as their first treatment for the disease. Ninety-five percent of the patients saw their tumors shrink from the treatment and three-quarters of patients went into complete remission. Patients were followed for a median of eight years, and nearly two-thirds have remained in complete remission eight years after treatment.
“For years we have known radioimmunotherapy such as Bexxar is one of the most effective treatments for patients with relapsed follicular lymphoma. These data show Bexxar is particularly effective when used as a frontline treatment,” says Mark Kaminski, M.D., professor of internal medicine at the U-M Medical School. Kaminski will present these results June 4 at the American Society of Clinical Oncology annual meeting in Chicago.
“These results compare quite favorably with those achieved with state-of-the-art chemotherapy regimens that take months to deliver. But Bexxar is given as a single treatment, completed within one week, which makes it an extremely convenient regimen for patients,” Kaminski says.
Non-Hodgkin’s lymphoma, the nation’s sixth leading cause of cancer death, is a cancer of the lymph system, which is part of the immune system. Follicular lymphoma is the second most common type of non-Hodgkin’s lymphoma. Lymphoma spreads easily through the lymph system and the bloodstream and consequently tends to be widespread when it is diagnosed. Traditional treatment often involves intensive chemotherapy, or a combination of chemotherapy and the monoclonal antibody rituximab. These treatments are usually given every three weeks over a span of up to six months and can cause many unpleasant side effects, including nausea, hair loss and infections.
Bexxar, whose chemical name is tositumomab and iodine I 131 tositumomab, combines an antibody that seeks out cancer cells, and a radioactive form of the element iodine. When injected, it travels like a guided missile through the bloodstream to bind to a protein found on the surface of the cancerous cells. The radiation zaps these malignant cells with minimal exposure to normal tissues.
With the Bexxar therapeutic regimen, a patient receives an injected test dose of radioactive Bexxar, followed one to two weeks later with a custom-tailored therapeutic dose. After that, the therapy is considered complete. The most common side effect is a temporary lowering of blood counts several weeks after the treatment. There is no hair loss and nausea is rare.
Kaminski and his colleague Richard Wahl (formerly at U-M and now at Johns Hopkins University) developed the Bexxar regimen, which received approval from the U.S. Food and Drug Administration in June 2003 to treat follicular non-Hodgkin’s lymphoma after other treatments have failed. The current results involve Bexxar as a first-line treatment for this disease.
In addition to Kaminski and Wahl, U-M study authors were Judith Estes, R.N., a nurse practitioner; Missy Tuck, clinical research coordinator; and Charles Ross, M.D., associate professor of pathology.
Funding for the study was from the National Institutes of Health and GlaxoSmithKline. The University of Michigan holds patents for the Bexxar therapeutic regimen, which is marketed by GlaxoSmithKline under a licensing agreement. U-M receives royalties on sales of Bexxar, a portion of which goes to Kaminski and his co-inventors.
For information about non-Hodgkin’s lymphoma, visit http://www.mcancer.org or call the Cancer AnswerLine at 800-865-1125. For information about Bexxar from its manufacturer, call 877-4-BEXXAR or visit http://www.bexxar.com.
Reference: American Society of Clinical Oncology 43rd annual meeting, June 1-5, 2007, Chicago, Ill. Abstract No. 8033.
My good friend Jeanne Hambleton, a journalist and advicate from the UK, has asked me to contribute an article for her upcoming book, Pain 24/7 – To publish a self help FMS book 12/05/2007
Jeanne’s book is being written to raise severly needed research funds into Fibromyalgia, Chronic Fatigue Stndrome, M.E. and is a vital part of moving forward with research into these illnesses.
Please if you can, contribute to the book project by visiting this link: http://www.jeannehambleton.chipin.com/signup
as your donation no matter what size it is, will help bring this vitally important book into existance, hopefully on schedule.The need is urgent and the time to act is now.
Jeanne asked me write an article called three illnesses, one battle, but I did take the liberty with her permission to include “Chronic Multisympton Illnesses” in general, and how this is several illnesses being fought on many fronts.
Chronic Multisymptom illnesses (CMI) come in a number of forms, ranging from “Fibromyalgia”, “Chronic Fatigue Syndrome, M.E.”, and “Gulf War Syndrome.”, simply to name the more common and widely recognized ones.
Each of these illnesses faces one common challenge in the medical community. A severe lack of research funding. In spite of the lack of funding we have begun to learn a great deal about some of these illnesses, however the funding is scant at best when it comes to developing these discoveries into usable treatments.
One area we severly need improvement on is in Physician Education. Many Physicians, and these are good Doctors, simply have not taken the time to read the latest clinical research results. They were trained at a time when these illnesses were thought to be some form of somataform illness or psychiatric disorder and unfortunately so many of them are still under the beliefe that this is the case. To quote a favorite phrase used in psychotherapy, “denial is not a river.”
We severly need all Medical Professionals to be on the same page when it comes to understanding these illnesses. It is the simple way out to to deny these illnesses are legitimate in nature and dismiss them as such when the current medical facts are far from that common misconception. It creates a situation where many learned medical professionals appear as if they simply do not understand these mechanisms, nor do they want to, and it is creating a situation where many suffer needlessly as a result.
I strongly urge the medical community to look at the facts. If one is not part of the solution, one becomes part of the problem. One of the main area’s where a lack of Physician Education has taken it’s toll is in Canada. Most Canadian Physicians simply don’t know how to diagnose or treat these illnesses. As a result the Statistics Canada data on these illnnesses is severly flawed. This fatal flaw affects research funding in a very negative way.
I am calling for the Medical Community to come together and formulate a plan to make Physician Education into these illnesses a major priority.
I will do my part to help make this happen and work with as many Clinical Researchers as I can to help develop this vital information.
The time to create change is now so that we can move forward and find viable treatments that can restore the sufferer’s of these illnesses to some kind of reasonable quality of life. The refusal to do so or denial of these illnesses is neglegent, and neglegence is not in anyones best interest, it does not serve the best interest of the patient, neither does it serve the best interest of the Physician. The evidence is there and we must act upon it. The Physicians oath to “do no harm” is poorly served by dismissing these illnesses based on information that is decades outdated.
I plan to work with many of the top Clinical Reachers in these fields to improve Physician Understanding and Awareness in the coming months and cannot understate the importance of the work that lies ahead of us all.
Each of us has a responsability to learn as much as we can to bring these illnesses into a managable modality that will improve the quality of life for these patients.
Richard L. Usher
FMS Global News
Global Health Vision
- 25-hydroxyvitamin D
- Acetaminophen and Caffeine
- Acinetobacter calcoaceticus-baumannii complex
- acute lymphoblastic leukemia
- American Academy of Neurology
- American Association for Cancer Research
- American Chemical Society
- American College of Cardiology
- American Heart Association
- American Journal of Clinical Nutrition
- American Journal of Public Health
- American Legacy Foundation
- Ancestral Heritage
- Archives of Neurology
- Arthritis & Rheumatism
- Autism Spectrum Disorders
- Autoimmune Diseases
- B. Rappaport Faculty of Medicine at Technion in Haifa
- Biological Sciences
- Blackwell Publishing Ltd.
- Bone Demineralisation
- Bone Diseases
- British Medical Journal
- Brooke Army Medical Center
- Buck Institute
- Calabria Regional Health Department
- Canadian Institutes of Health Research
- Cancer Biology
- Cancer Biology and Therapy
- Cancer Information In Spanish
- Cardiovascular Disease
- Catalan Institute of Oncology in Spain
- Childhood Lukemia
- Childhood Nutrition
- Children's Hospital of Philadelphia
- Children’s Cancer Institute Australia
- Children’s Hospital
- Children’s Hospital of Philadelphia
- Childrens Hospital Los Angeles
- Chromosome 17
- Chromosome 8
- Chronic Multisymptom Illnesses
- Chronic Stress
- Chronic Stress and Obesity
- CHS National Cancer Control Center and Technion
- CHS National Israeli Cancer Control Center
- Clinical Applications
- Clinical Trials
- College of Medicine in Houston
- Complex Chronic Conditions
- Cornell University
- Cytochrome b5
- Cytochrome P450
- Drug Abuse
- Duke University Medical Center
- Electronic Health Records
- Emergency Preparedness
- Emergency Room
- Emory Genetics Laboratory
- Emory University
- End Of Life Care
- European Cancer Conference
- European Journal of Cancer Care
- European League Against Rheumatism
- European Science Foundation
- FDA Warnings
- Fibromyalgia News
- FMS Global News
- Folic Acid
- Fort Sam Houston
- Fox Chase Cancer Center
- Fred Hutchinson Cancer Research Center
- Garvan Institute of Medical Research
- General Psychiatry
- Genetic Link
- Genetic Marker C allele of rs10505477
- Global Health Vision
- Global News
- Health Canada
- Health Information Technology
- Heart Disease
- Hebrew University of Jerusalem
- Hemorrhagic Stroke
- Historical Medicine
- Hospital Epidemiology
- Hospital Trauma
- Howard Hughes Medical Institute
- Human Genome
- Huntington's disease
- Imperial College London
- Interactive Autism Network
- Inuit children
- Irving Weinstein Foundation
- JAMA/Archives journals
- Japanese Society for the Promotion of Science
- Johns Hopkins University
- Joint Health Research Program
- journal BBA Biomembranes
- journal Cell
- journal Nature Genetics
- Journal of Clinical Investigation
- Journal of Experimental Social Psychology
- Journal of the American College of Surgeons
- Journal of Theoretical Biology
- Juvenile Diabetes
- Karolinska Institute in Stockholm
- Kennedy Krieger Institute
- Kyowakai Hospital
- Lamezia Terme
- London UK Feed
- Lung Cancer
- Massachusetts General Hospital
- Mayo Clinic
- McMaster University
- Medical History
- Medical Insurance
- Medical Journals
- Mitochondrial Diseases
- Molecular Biology
- Molecular Epidemiology
- Multiple Sclerosis
- Muscular Dystrophy
- Music Video Of The Day
- Music Video Pick Of The Day
- National Cancer Institute
- National Institute on Aging
- National Institutes of Health
- Nature Genetics
- Neurodegenerative Diseases
- Neuropeptide Y
- New England Journal of Medicine
- New York University
- News Australia
- News Canada
- News France
- News Germany
- News Israel
- News Italy
- News Jerusalem
- News Switzerland
- News UK
- News US
- News USA
- non-Hodgkin's lymphoma
- Northwestern University
- Nova Scotia
- Nutritional Anthropology
- Oak Ridge National Laboratory
- Occupational Health
- omega-3 fatty acids
- Orthopaedic Research Society
- Ottawa City Feed
- Oxford University
- Pain Management
- Palliative Care
- Parkinson Society of Canada
- Pediatric Palliative Care
- Peutz-Jeghers syndrome
- Pharmacology and Neuroscience
- Pick's Disease
- Pre/Post Natal Care
- Preventive Medicine
- Prince Edward Island
- Protein Growth Factor
- Public Health
- Research Australia
- Rheumatoid Arthritis
- RSS Feed
- Rush Alzheimer’s Disease Center
- Seattle Washington
- Spina Bifida
- Spinal Cord Injuries
- St. Elmos Fire
- St. Jude Children's Research Hospital
- Statin Drugs
- Stem Cells
- Sydney Children’s Hospital
- Systemic Lupus Erythematosus
- Temple University
- The American Academy of Neurology
- the Israel Institute of Technology
- Toronto City Feed
- trauma-associated and hospital-acquired infection
- Type 1 Diabetes
- Type 2 Diabetes
- Université Laval
- University College London
- University Hospital in Geneva
- University New South Wales
- University of Bern
- University of Calgary
- University of California
- University of Chicago
- University of Chicago Press Journals
- University of Florida
- University of Granada
- University of Manchester
- University of Michigan
- University of Missouri
- University of North Carolina
- University of North Texas
- University of Nottingham
- University of Oregon
- University of Pennsylvania School of Medicine
- University of Pittsburgh
- University of Rochester
- University of Toronto
- US Army soldiers in Iraq
- US Military Hospitals
- UT Southwestern Medical Center
- Vitamin D
- W. Garfield Weston Fellows
- Wake Forest University Baptist Medical Center
- Washington DC
- Washington DC City Feed
- Washington University
- Weather Anomolies
- Weill Medical College
- Wellcome Trust
- World Health Organisation
- World News
- Yale University