New Mexico School Board Member Draws Criticism Over Condom Comments

An Albuquerque, N.M., Public School board member's recent comments that condoms can increase users' risk of contracting sexually transmitted infections are drawing criticism from local physicians and advocates, the Albuquerque Journal reports. The issue arose during a school board discussion about changes to the district's policy on school-based health clinics (Uyttebrouck, Albuquerque Journal, 9/17).

The school district recently modified its policy on distributing contraceptives on school grounds, KOAT reports. Many APS schools have on-site health clinics run by physicians who are not employed by the district. APS Superintendent Winston Brooks said the revised policy "clarifies that APS employees cannot distribute condoms but that we're not going to interfere in the doctor-patient relationship." He added that although state law does not allow schools to interfere with the relationship under any circumstance, some parents were concerned (KOAT, 9/17).

Last week, while the board was discussing the policy change, APS Board Member David Robbins criticized the effectiveness of condoms to prevent transmission of HIV and other STIs. Robbins said he found references to studies on an abstinence website that suggest some pores in latex condoms are large enough to allow viruses to pass through, although he did not cite any specific studies. He said, "The public has been misled to believe by too many public health officials that condoms equal safe sex," adding, "They do not."

Bruce Trigg, medical director of the New Mexico Department of Health's STI program, said Robbins' comments are of "great concern," adding, "Every major medical and public health organization in the world supports condom use as the main protection against HIV" (Albuquerque Journal, 9/17). Barry Ramo, a physician and medical consultant to KOAT, said viruses cannot pass through condoms, adding that Robbins' remarks are "irresponsible and they are wrong" (KOAT, 9/17).

According to the Centers for Disease Control and Prevention's website, "studies have demonstrated that latex condoms provide an essentially impermeable barrier" to STIs, including HIV. CDC's website also says that condoms, "when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV" (Albuquerque Journal, 9/17).

Better Marker For Breast Cancer May Reduce Need For Second Surgeries

A new material could help surgeons more accurately locate breast cancers, reduce the need for second surgeries and minimize pre-surgical discomfort for patients. Microscopic gas-filled spheres of silica, a porous glass, can mark the location of early-stage tumors to show their position using ultrasound imaging in the operating room.

A team of chemists, radiologists and surgeons at the University of California, San Diego, created the new material, which they describe in a forthcoming issue of the journal MedChemComm.

The X-rays used to make mammograms reveal calcium deposits associated with breast cancer even in tumors too small to be felt. But surgeons can't use X-rays while operating. Instead, radiologists place guide wires into tumors hours or even the day before surgery. The wires don't mark depth well and can shift. Patients find them both uncomfortable and unsettling.

As an alternative, the researchers created spheres of silica and filled them with perfluoropentane, a gas that has been used before in short-lived contrast materials for medical imaging. The rigid silica shells help the new material last longer.

"These little gas-filled microbubbles stick to human breast tissue for days and can be seen with ultrasound," said William Trogler, professor chemistry. "If doctors placed them in early stage breast cancer, which is difficult to see during surgery, they could help surgeons remove all of it in the first operation."

In the past few years, radiologists have tried implanting radioactive "seeds" instead of wires to mark tumors, but the seeds last only a few hours and must be inserted with a large-bore needle, which is painful. In addition, only one abnormal region can be marked, but patients with a form of breast cancer called ductal in situ carcinoma often have several. The seeds also expose both patient and staff to radiation, can't been imaged in three dimensions and create radioactive medical waste.

At just two micrometers in diameter - half the width of a strand of spider silk - small silica microbubbles can be precisely injected into clusters of abnormal cells using a thin needle. Radiologists would be able to inject the durable material days before surgery. And ultrasound scans reveal the position of the bubble in three dimensions on the operating table.

"Instead of just using a Geiger-counterlike device to say you're getting closer to the radioactive seed, you could actually see where to carve," said Andrew Kummel, professor of chemistry. The increased precision should help surgeons avoid the need for second surgeries.

"By outlining the tumor more completely in multiple directions, the particles could potentially help surgeons remove non-palpable tumors in a single operation," said Sarah Blair, a surgeon at Moores UCSD Cancer Center. "They will definitely make the operation more comfortable for patients."

The researchers think the ultrasound pressure waves burst the microbubbles. "They're thin, fragile balls of porous glass, like Christmas tree ornaments," Kummel said. "The shell is just one two-hundredth of the diameter of the ball. When it breaks, the gas squirts out. Doppler ultrasound detects that movement."

Nano-scale silica microbubbles, which the team reports in this paper as well, are too small to remain in place, but might drain from a cancerous site to help identify which lymph nodes are most likely to contain stray cells that could help the cancer spread.

The current study demonstrates the feasibility of the technology in tissue samples. Tests in animal models are underway, and toxicology studies must also be completed before clinical trials in humans could begin.

Chemists Bill Trogler, and Andy Kummel, of UCSD's Division of Physical Sciences, and radiologist Robert Mattrey and surgeon Sarah Blair of the Moores UCSD Cancer Center led the project. Additional co-authors include radiologist Yuko Kono, and Sergio Sandoval, Moores UCSD Cancer Center; Paul Martinez of the Department of Chemistry and Biochemistry; and Jessica Wang-Rodriguez of the Department of Pathology.

The National Cancer Institute provided financial support for this study.

New Study Shows Promise For Identifying, Reducing Reproductive Coercion

The latest research on reproductive coercion -- a type of intimate partner abuse in which the man threatens the woman to become pregnant -- shows that a simple intervention at a family planning clinic can empower women to protect themselves from future abuse, Time reports. Reproductive coercion, which usually coincides with other types of abuse within a relationship, is marked by physical or verbal threats against a woman for seeking birth control or an abortion. The male partner also might damage the woman's birth control pills or remove condoms during sex.

"It's another way a male partner tries to control a female partner," according to Elizabeth Miller, an associate professor of pediatrics at the University of California-Davis School of Medicine who has led much of the research in the field. She added, "Women say their partner tells them he wants to leave a legacy or have them in his life forever."

In one of Miller's studies, out of 1,300 family planning clinic patients ages 16 through 29, one-third who said they were in a violent relationship also said they experienced reproductive coercion. Another study found that as many as 75% of women ages 18 through 49 who had histories of abusive relationships reported experiencing reproductive coercion.

For Miller's most recent study, co-written by Jay Silverman of the Harvard School of Public Health, counselors and clinicians at two family planning clinics were trained to ask women questions about reproductive coercion, such as "Has your partner tried to force you to become pregnant when you didn't want to be?" and "Does your partner mess with your birth control?"

Women who responded "yes" to any question were given emergency contraception and offered advice on tamper-proof contraception methods, such as intrauterine devices and Depo-Provera shots. The researchers also monitored two other clinics where women were offered standard domestic violence and sexual assault screenings. The study found that subsequent reproductive coercion declined by 70% at the intervention clinics, but there was no change at the control clinics. In addition, women at the intervention clinics were 60% more likely to leave a relationship because they felt it was unsafe, Miller said. The study was published online in Contraception (Luscombe, Time, 8/31).

THT Launches Course To Teach Gay Men How To Get The Most Out Of Anal Sex, UK

This autumn, HIV and sexual health charity Terrence Higgins Trust (THT) will launch a new evening class to teach gay and bisexual men how they can enjoy the best - and safest - anal sex. 'Mind Your Backs, Guys' is a free, confidential, three-hour session at a central London location. The first session will run on Wednesday 22 September from 6.00pm - 9.00pm.

As well as looking at the biology of anal sex and how men can get pleasure from it, the session will also look at potential health risks, how men can stop HIV getting into the body, and how to achieve better orgasms.

Gordon Mundie, Groupwork Co-ordinator at THT, said: "As sex education in schools is still very much geared around procreation, with little attention paid to sex as recreation, we know many gay men leave the education system with big gaps in their knowledge. Our new course has been designed to increase guys' confidence about anal sex, which should help them make good, informed decisions about the type of sex they have."

"Guys don't often get the chance to talk openly and frankly about the sex that they are having or would like to have. This group offers that opportunity, and a safe space to ask questions"

The session will be repeated on Wednesday 20th October, and again on Wednesday 16th February.

Alcohol Consumption After Breast Cancer Diagnosis May Increase Recurrence Risk

In the Life After Cancer Epidemiology (LACE) study, 1,897 participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited on average 2 years post-breast cancer diagnosis were evaluated for the association between alcohol intake and breast cancer recurrence and death. The women, who were generally light drinkers, were followed for an average of 7.4 years. The study reported an increase in risk of breast cancer recurrence and breast cancer death, but no effect on total mortality, to be associated with consumption of 3 to 4 or more drinks per week when compared with women not drinking following their cancer diagnosis.

Previous research has been mixed on this topic. Almost all large studies have shown no increase in all-cause mortality for women who drink moderately following a diagnosis of breast cancer (as does this study). As for recurrence of breast cancer, most have shown no increase in risk, although one previous study of women with estrogen-receptor

Immutep Announces Final Results In Phase I/II Chemoimmunotherapy Trial In Metastatic Breast Cancer

Immutep S.A. announced the publication of a clinical research paper showing that its lead product, IMP321, given with first-line paclitaxel achieved clinical benefit in 90 per cent of metastatic breast carcinoma (MBC) patients. Correlations were observed with both the patients' monocyte (i.e. the primary target cell for IMP321) count before treatment and the degree of activation of monocytes during treatment.

The study was an open-label fixed-dose-escalation trial carried out in three cancer centers in the Paris region. The lead center was the René Huguenin Cancer Centre in Saint Cloud. The other centers were Tenon Hospital and the Georges Pompidou European Hospital in Paris. The immuno-monitoring was done by Immutep at its laboratories near Paris.

MBC patients were administered one dose of IMP321 s.c. every two weeks for a total of 24 weeks (12 injections). The repeated single doses were administered the day after chemotherapy at day 2 and day 16 of the 28-day cycles of paclitaxel (6 cycles). Blood samples were taken 13 days after the sixth and the twelfth IMP321 injections to determine sustained APC, NK and memory CD8 T cell responses. Thirty patients received IMP321 in three cohorts (doses: 0.25, 1.25 and 6.25 mg).

IMP321 induced both a sustained increase in the number and activation of APC (monocytes and dendritic cells) and an increase in the percentage of NK and long-lived cytotoxic effector-memory CD8 T cells. Clinical benefit was observed for 90 per cent of patients with only 3 progressors at 6 months. Also, the objective tumor response rate of 50 per cent compared favorably to the 25 per cent rate reported in the historical control group.

IMP321 is a recombinant soluble LAG-3Ig fusion protein that binds to MHC class II with high avidity and mediates APC and then antigen-experienced memory CD8

Breast Cancer Signal May Be 'Turned Off' By Watercress

New scientific research from the University of Southampton has revealed that a plant compound in watercress may have the ability to suppress breast cancer cell development by 'turning off' a signal in the body and thereby starving the growing tumour of essential blood and oxygen.

The research, unveiled at a press conference, shows that the watercress compound is able to interfere with the function of a protein which plays a critical role in cancer development.

As tumours develop they rapidly outgrow their existing blood supply so they send out signals which make surrounding normal tissues grow new blood vessels into the tumour which feed them oxygen and nutrients.

The research, led by Professor Graham Packham of the University of Southampton, shows that the plant compound (called phenylethyl isothiocyanate) found in watercress can block this process, by interfering with and 'turning off' in the function of a protein called Hypoxia Inducible Factor (HIF).

Professor Packham, a molecular oncologist at the University of Southampton, comments: "The research takes an important step towards understanding the potential health benefits of this crop since it shows that eating watercress may interfere with a pathway that has already been tightly linked to cancer development.

"Knowing the risk factors for cancer is a key goal and studies on diet are an important part of this. However, relatively little work is being performed in the UK on the links between the foods we eat and cancer development."

Working with Barbara Parry, Senior Research Dietician at the Winchester and Andover Breast Unit, Professor Packham performed a pilot study in which a small group of breast cancer survivors, underwent a period of fasting before eating 80g of watercress (a cereal bowl full) and then providing a series of blood samples over the next 24 hours.

The research team was able to detect significant levels of the plant compound PEITC in the blood of the participants following the watercress meal, and most importantly, could show that the function of the protein HIF was also measurably affected in the blood cells of the women.

The two studies, which have been published in the British Journal of Nutrition and Biochemical Pharmacology, provide new insight into the potential anti-cancer effects of watercress, although more work still needs to be done to determine the direct impact watercress has on decreasing cancer risk.

Watercress Alliance member Dr Steve Rothwell says: "We are very excited by the outcome of Professor Packham's work, which builds on the body of research which supports the idea that watercress may have an important role to play in limiting cancer development."

A summary of the research has been accepted for inclusion in the Breast Cancer Research Conference which is taking place in Nottingham from 15 to 17 September.

Breast cancer is the most common cancer in women in the western world and currently affects approximately 1 in 9 women during their lifetime.

Notes:
The study published in the British Journal of Nutrition was called 'In vivo modulation of 4E binding protein 1 (4E-BP1) phosphorylation by watercress: a pilot study.' Researchers were Syed Alwi SS, Cavell BE, Telang U, Morris ME, Parry BM, Packham G.
The second study, 'Inhibition of hypoxia inducible factor by phenethyl isothiocyanate' was published in Biochemical Pharmacology. Researchers were Wang X-h, Cavell BE, Alwi SSS, Packham G.

Urgent Steps Needed To Tackle Inadequate Support For Women With Secondary Breast Cancer

57% of breast care nurses who took part in a UK survey for the charity Breast Cancer Care feel that there is inadequate provision for women with secondary breast cancer, a progressive incurable disease that kills half a million women worldwide every year after the cancer spreads to other organs. Many said that they felt ill equipped to care for women with secondary breast cancer and that their time was dominated by meeting the needs of women with primary breast cancer. Only 14% said their organisation had a secondary breast cancer nurse specialist and only 13% of the nurses providing specialist care worked full-time.

The support provided for women with secondary breast cancer is inadequate and urgent steps are needed to provide better services for patients with this progressive incurable disease, which kills half a million women worldwide every year. Those are the key recommendations to emerge from a trio of papers in the September issue of the European Journal of Cancer Care.

Fifty-seven per cent of breast care nurses who took part in a UK survey for Breast Cancer Care told researchers that they felt there was inadequate provision for women whose cancer has spread to other organs, most commonly the bones, lungs, liver and brain. Many also said that they felt ill equipped to care for them.

Forty per cent of the 276 nurses who responded said that they saw caring for women with secondary breast cancer as part of their role, but the majority said that their time was dominated by meeting the needs of patients with primary breast cancer.

Fourteen per cent said that their organisation had a secondary breast care nurse specialist in post and 19 per cent said there was a nurse responsible for secondary breast cancer care. However, eight per cent said that their organisation had no nurses providing care for women with secondary breast cancer and less than 13 per cent of the nurses providing specialist care worked full-time.

A strong theme to emerge from the survey was the fact that breast care nurses felt that their time was dominated by meeting the needs of patients with primary breast cancer.

Many stated that they would like to offer a better support to women with secondary breast cancer, but felt they lacked knowledge and experience of the physical and emotional effects of this progressive disease and didn't have the staff numbers or time available to provide an effective service.

"It is clear that nursing support for UK women with secondary breast cancer is currently inadequate, although many health professionals are aware of the problem and are beginning to address it" says lead author Elizabeth Reed, a nurse and Research Officer for the charity.

"Breast Cancer Care wants to see well structured, co-ordinated services, dedicated resources and better training and support for those nurses who are already providing this specialist care and those looking to develop services for women with secondary breast cancer.

"Any patient with secondary breast cancer should have the assurance that they can access a specialist nurse who is equipped to give them the support they need."

The paper, which is being published ahead of the UK's first ever secondary breast cancer awareness day, held by Breast Cancer Care on October 13, is accompanied by an international literature review and editorial.

Uncertainty, lack of control and poor emotional functioning are some of the main issues facing women with secondary breast cancer, according to the literature review, which was carried out by a Clinical Nurse Specialist in Secondary Breast Cancer. It indicates that living with secondary breast cancer is a complex experience that is influenced by a large number of factors. However many of these factors are under-researched, compared to those affecting women diagnosed with primary breast cancer, and women with secondary breast cancer need a great deal more support than they currently receive.

The editorial, by a Professor of Breast Cancer Medicine, states that the true impact of coping with an incurable condition and uncertain future is something that often goes unrecognised by healthcare professionals. It stresses that training specialist nurses for patients diagnosed with secondary breast cancer must be an urgent priority. This will enable these women to receive the same level of support as women with primary breast cancer and benefit from a longer and better quality of life.

Moores UCSD Cancer Center Designated An ACR Breast Imaging Center Of Excellence

Moores UCSD Cancer Center at the University of California, San Diego has been designated a Breast Imaging Center of Excellence by the American College of Radiology (ACR).

"We are committed to providing care above the standard and this prestigious certificate recognizes our extraordinary effort," said Haydee Ojeda-Fournier, MD, assistant professor of clinical radiology at Moores UCSD Cancer Center. "ACR leads the way toward the latest developments in science and patient care. To be a member of this elite group of Breast Imaging Centers of Excellence is quite an honor."

By awarding facilities the status of a Breast Imaging Center of Excellence, the ACR recognizes breast imaging centers that have earned accreditation in all of the College's voluntary breast-imaging accreditation programs and modules, in addition to the mandatory Mammography Accreditation Program.

UCSD breast imaging services are fully accredited in mammography, stereotactic breast biopsy, breast ultrasound and ultrasound-guided breast biopsy. Peer-review evaluations, conducted in each breast imaging modality by board-certified physicians and medical physicists who are experts in the field, determined that Moores UCSD Cancer Center has achieved high practice standards in image quality, personnel qualifications, facility equipment, quality control procedures, and quality assurance programs.

"Fewer than six percent of the imaging centers in California received this designation," said Anne Wallace, MD, professor of clinical surgery and director of the UCSD Breast Care Team. "Being recognized by ACR as a breast imaging center of excellence confirms what I experience every day as the surgeon leading the breast team at Moores UCSD Cancer Center. Our colleagues in breast imaging are not only kind, caring and efficient, but their amazing ability to catch and re-diagnose findings makes UCSD's breast imaging team world-class."

Stress Significantly Acclerates Breast Cancer Metastasis In Mice, UCLA Cancer Researchers Show For The First Time

Chronic stress acts as a sort of fertilizer that feeds breast cancer progression, significantly accelerating the spread of disease in animal models, researchers at UCLA's Jonsson Comprehensive Cancer Center have found.

Researchers discovered that stress is biologically reprogramming the immune cells that are trying to fight the cancer, transforming them instead from soldiers protecting the body against disease into aiders and abettors. The study found a 30-fold increase in cancer spread throughout the bodies of stressed mice compared to those that were not stressed.

It's long been thought that stress fuels cancer growth in humans. This study provides a model that not only demonstrates that stress can speed up cancer progression, but also details the pathway used to change the biology of immune cells that inadvertently promote the spread of cancer to distant organs, where it is much harder to treat.

The study appears in the Sept. 15, 2010 issue of the peer-reviewed journal Cancer Research.

"What we showed for the first time is that chronic stress causes cancer cells to escape from the primary tumor and colonize distant organs," said Erica Sloan, a Jonsson Cancer Center scientist, first author of the study and a researcher with the Cousins Center for Psychoneuroimmunology. "We not only showed that this happens, but we showed how stress talks to the tumor and helps it to spread."

In addition to documenting the effects of stress on cancer metastasis, the researchers were also able to block those effects by treating stressed animals with drugs that block the nervous system's reprogramming of the metastasis-promoting immune cells, called macrophages.

Beta blockers, used in this study to shut down the stress pathways in the mice, are currently being examined in several large breast cancer databases for their role in potential prevention of recurrence and cancer spread, said Dr. Patricia Ganz, director of cancer prevention and control research at UCLA's Jonsson Comprehensive Cancer Center. If preliminary findings indicate benefit, early phase clinical trials are being considered at the Jonsson Cancer Center testing beta blockers as a means of preventing breast cancer recurrence. Other healthy lifestyle behaviors may also influence the biological pathways described in the study, such as exercise and stress reduction techniques.

"We're going to be focusing on younger women, because they may have a multitude of things weighing on them when they're diagnosed with breast cancer. Younger women have more significant life demands and typically are under more stress," Ganz said.

Ganz said her proposed research will focus on "host factors," or things affecting the patient, that may be aiding the cancer progression and could help explain why a group of patients with the same type and stage of disease have varying rates of recurrence and cancer spread.

"This study provides evidence for a biological relationship between stress and cancer progression and identifies targets for intervention in the host environment," Ganz said. "Because of this study, we may be able to say to a patient in the future that if you follow this exercise regimen, meditative practice or take this pill every day it will help prevent recurrence of your cancer. We can now test these potential interventions in the animal model and move those that are effective into the clinic."

In Sloan's study, mice with breast cancer were divided into two groups. One group of mice was confined in a small area for a short period of time every day for two weeks, while the other group was not. The breast cancer cells were genetically engineered to include the luciferase gene, which is the molecule that makes a firefly glow. The growth and spread of the cancer in the mice was monitored using sensitive cameras that can pick up the luciferase signal and allowed Sloan and her team to observe both the development of primary tumors and the spread of metastases throughout the body, said Steven Cole, an associate professor of hematology/oncology, a Jonsson Cancer Center researcher and senior author of the study.

What was interesting, Cole said, was that the primary tumors did not seem to be affected by stress and grew similarly in both groups of mice. However, the stressed animals showed significantly more metastases throughout the body than did the control group. The cancer, in effect, acted differently in the stressed mice.

"This study is not saying that stress causes cancer, but it does show that stress can help support cancer once it has developed," Cole said. "Stress helps the cancer climb over the fence and get out into the big, wide world of the rest of the body."

Cole said Sloan detailed the biology of the stress-induced changes in the cancer cells along every step of the pathway, providing a road map by which stress promotes cancer metastasis. Additionally, she proved that using beta blockers in stressed mice prevented the same cancer progression seen in the stressed mice that did not receive medication.

When cancer occurs, the immune system sends out macrophages to try to repair the tissue damage caused by uncontrolled growth of cancer cells. The macrophages, in an attempt to help, turn on inflammation genes that are part of the normal immune response to injury. However, the cancer cells feed on the growth factors involved in a normal immune response. Blood vessels that are grown to aid healing instead feed the cancer the oxygen and nutrients it needs to grow and spread, and the extra cellular matrix, which provides structural support for normal cells, is attacked during the immune response, In Sloan's study, mice with breast cancer were divided into two groups. One group of mice was confined in a small area for a short period of time every day for two weeks, while the other group was not. helping the cancer cells escape from the primary tumor and spread to distant parts of the body.

"Many of the genes that promote cancer metastasis get turned on during the immune response by macrophages," Cole said. "This study shows that stress signaling from the sympathetic nervous system enhances the recruitment of macrophages into the primary tumor, and increases their expression of immune response genes that inadvertently facilitate the escape of cancer cells into other parts of the body."

Sloan showed that the beta blockers prevented the macrophages from hearing the signals sent by the sympathetic nervous system, and stopped them from infiltrating the tumor and encouraging cancer spread.

The study was funded by the National Institutes of Health, the Department of Defense and the Jonsson Cancer Center.