Published February 20, 2007 HIV/AIDS Cancer/AIDS News Staff Number of New Cancer Patients Expected to Double The number of new cancer patients is expected to more than double in the United States over the next half-century from 1.36 million recorded in 2000 to almost 3.0 million in 2050. This estimate is based largely on the growing and aging U.S. population. The number of cancer cases was projected from the latest information on types of cancer and survival rates from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program highlighted in a report which appeared in The Oncologist, the monthly international peer-reviewed journal for physicians devoted to cancer care. According to the paper, the likelihood of developing cancer in the U.S. during one's lifetime is approximately one in two for men and one in three for women. The SEER Program was created as a result of the 1971 National Cancer Act, which mandated the collection, analysis, and dissemination of cancer data for use in cancer prevention, diagnosis, and treatment. Other key statistics include: Blacks have the highest incidence and mortality rates for men and women for all types of cancers; five-year patient survival for all cancer stages combined range as low as only 16% for lung cancer patients to 100% for prostate cancer patients; and cancer survival varies by stage of disease and race, with lower survival in blacks compared with whites. More Work Needs to Be Done by States in Preventing Cervical Cancer A new state-to-state comparison report released by Women in Government, a non-profit, bi-partisan organization representing women state legislators, shows that while states have made significant progress in the fight against cervical cancer, real disparities still exist in cervical cancer incidence. The report, titled "Partnering for Progress 2007: The ‘State' of Cervical Cancer Prevention in America," looked at current data for each state on cervical cancer incidence and mortality rates; screening rates, including for low-income women; women's access to screening using the most up-to-date technology; uninsured women; and the legislative priority being put on this issue. Some key results were: For the first time, a state--Minnesota--received a grade of Excellent; a majority of states and the District of Columbia saw a decrease in both cervical cancer incidence and mortality; last year alone, more than 25 policy measures addressing cervical cancer prevention were introduced in legislatures around the country; just under half (49%) of the states experienced an increase in their rate of insured women; and in most states, incidence and mortality rates for black and Hispanic women were higher than for white women. Rising Weight Increases Risk of Prostate Cancer Death A prospective study published in the journal Cancer showed that extra pounds may increase the risk of dying from aggressive forms of prostate cancer in men who have already been diagnosed with the disease. However, the study did not find a correlation between obesity and developing the malignancy in the first place. According to Margaret Wright, PhD, and her colleagues at the National Cancer Institute, body mass index and adult weight gain each "were linked with higher prostate cancer progression leading to death." In fact, the study revealed that compared with normal-weight men, overly obese men had twice the risk of dying of prostate cancer. Men who had gained significant amounts of weight since the age of 18 also had an increased risk of a fatal outcome. In an unrelated study reported by Susan Harlap, MB, and her colleagues at Columbia University and Hebrew University in Jerusalem , fathers who have sons may possess some protection from developing prostate cancer. It appears that the risk of the disease declines with each additional son. What does all of this mean? It could mean that there is a genetic link with the possibility of prostate cancer genes lurking on the Y chromosome. The risk also appeared to increase with the size of boy-free families. For example, men who had only one child, a daughter, had a relative risk of 1.25; men with two girls had a relative risk of 1.41; and those with three daughters and no sons had a relative risk of 1.6. Reduced Levels of Fat May Decrease Risk of Breast Cancer Recurrence According to results from the Women's Intervention Nutrition Study (WINS), postmenopausal women who reduce their consumption of dietary fat and have been treated for early-stage breast cancer may reduce their chances for breast cancer recurrence or a second case of breast cancer. The study, which was sponsored by the National Cancer Institute (NCI) and recently published in the journal National Cancer Institute, revealed that an intervention aimed at reducing dietary fat consumption can reduce the risk of breast cancer recurrence. "It is also clear that some women benefit a lot more than others from a reduction in dietary intake of fat, possibly because a person's genetics may well be setting the tone for the benefits of dietary intervention," said John Milner, PhD, Chief of the Nutritional Science Research Group at NCI. He also cautioned that reduction of fat should be considered just one of many dietary modifications that may influence the development of cancer. Hormonal Contraception Does Not Appear to Increase HIV Risk A study published on the web site of the journal AIDS reports that using hormonal contraception does not appear to increase women's overall risk of infection with the AIDS virus. The study, the largest and most comprehensive of its kind to date, was commissioned by the National Institute of Child Health and Human Development of the National Institutes of Health (NIH). However, NIH project officer for the study, H. Trent MacKay, MD, MPH, Chief of the Contraception and Reproductive Health Branch, said the study findings do not provide a basis for changing current recommendations regarding contraceptive use. Dr. MacKay cautioned that hormonal contraception does not protect against HIV or other sexually transmitted infections. The authors concluded, "This large, multi-site study found no overall increased risk of HIV acquisition associated with contraceptive use. This provides reassurance for women in moderate and high HIV prevalence settings who need effective contraception that any increased overall risk associated with hormonal contraception is, at most, modest." Selenium May Slow HIV Progression A randomized, placebo-controlled, double-blind trial showed that daily doses of selenium supplements appeared to slow the progress of HIV. The results of the trial were reported by Dr. Barry Hurwitz, PhD, of the University of Miami in the Archives of Internal Medicine. He said the study was based on the observations that selenium appears to improve immune function and that the metal is often deficient in people with HIV. The researchers found that compared with patients taking a placebo, volunteers who got selenium had increased serum levels of the metal and decreased HIV viral load. Additionally, they saw their CD4 cell count increase as an indirect result of good viral control. Dr. Hurwitz and colleagues concluded that while the study did not determine how long the effect will last, the results support adding selenium to HIV therapies "as a simple, inexpensive and safe adjunct therapy." It is believed that selenium may repair damage done to immune cells or work directly on the HIV virion to suppress replication. Compliance an Issue Among Breast Cancer Patients According to a study by researchers at Dana-Farber Cancer Institute and funded in part by AstraZeneca Pharmaceuticals, one out of five women prescribed hormone therapy drugs may not take them regularly. Postmenopausal women with early stage, hormone-sensitive breast cancer have a lower risk of disease recurrence when their treatment includes a new class of drugs called aromatase inhibitors. Their mechanism of action is to reduce the production of the hormone estrogen by blocking aromatase, an enzyme that converts the hormone androgen into estrogen. Studies have shown that lowering estrogen levels in postmenopausal women with hormone receptor-positive breast cancer can reduce their risk of disease reoccurrence. "These data are very concerning because hormonal therapy for breast cancer is one of the most effective treatments in all of oncology," said Ann Partridge, MD, MPH, the study's lead author. "Women may be compromising their care, and ultimately their survival, if they do not take these medications as recommended." To comment on this article, contact editor@uspharmacist.com.