The survival rate for older men receiving colon cancer care and some types of lung cancer in VA was better than similar fee-for-service (FFS) Medicare beneficiaries, according to a study out of Harvard Medical School. 1
Prior to this research, few studies documented improved patient outcomes in the area of preventive chronic care and cancer care in VA. Researchers compared the survival rates of older patients with cancer and their FFS Medicare counterparts to determine whether differences in the stage of diagnosis and receipt of guideline-recommended therapies explained improved survival rates.
In partnership with VA, the researchers looked at data for men 65 and older that were diagnosed or received their first course of treatment for colorectal, lung, lymphoma or multiple myeloma in VA hospitals from 2001 to 2004.
VA patients with colon cancer and non-small-cell lung cancer had improved survival rates compared with FFS beneficiaries, while patients with other cancer types had similar survival rates. Much of the improvement in colon-cancer patients and non-small-cell lung cancer patients was due to VA patients being diagnosed at earlier stages of the diseases, researchers found.
They concluded that VA’s quality of care — especially its preventive care — could result in improved patient outcomes.
1: Landrum MB, Keating NL, Lamont EB, Bozeman SR, Krasnow SH, Shulman L, Brown JR, Earle CC, Rabin M, McNeil BJ. Survival of Older Patients With Cancer in the Veterans Health Administration Versus Fee-for-Service Medicare. J Clin Oncol. 2012 Mar 5. [Epub ahead of print] PubMed PMID: 22393093.
Protein Kinase May Help Counteract Chemotherapy Toxicity
Research has shown that the protein kinase can counteract the toxic side effects of some chemotherapy drugs. This could allow for anti-cancer agents to be administered for longer periods of time and generate better outcomes for patients. 1
Cisplatin is one of the commonly used anti-cancer drugs — a platinum-based inorganic compound that leads to inhibition of essential process like DNA replication and transcription. However, along with its impact on the ability of cancer cells to replicate, it has a wide range of side effects. Cisplatin treatment can lead to severe kidney damage, which has a high rate of mortality. The primary way Cisplatin injures the kidney is by killing off renal tubular cells, which undergo necrosis and apoptosis when exposed to too much of the drug.
According to researchers at the Georgia Health Sciences University and Charlie Norwood VA Medical Center in Augusta, GA, a protein kinase known as PKCδ may counteract this nephrotoxicity. PKCδ can function as an anti-apoptotic factor, thus conferring resistance to anti-cancer drugs. In this most recent study, PKCδ was seen to provide significant renal protection during Cisplatin treatment in in vitro cell cultures and in vivo murine models.
However, the protein kinase seems to be a pro-survival factor in several cancers.
Depending on the form of treatment and what type of cancer, PKCδ could play a contrasting role in cancer patients — helping patients withstand chemotherapy drugs while helping the cancer cells survive longer. The mechanisms of this dual role remain unclear, the researchers noted in their report. The exact role of PKCδ in normal cell function also is unknown.
While further studies are necessary, the researchers say they believe PKCδ could turn out to be an important target for anti-cancer therapy — reducing toxicity and at the same time increase the anti-cancer efficacy of Cisplatin.
1: Pabla N, Dong Z. Curtailing side effects in chemotherapy: a tale of PKCδ in cisplatin treatment. Oncotarget. 2012 Jan;3(1):107-11. Epub 2012 Jan 31. PubMed PMID: 22403741; PubMed Central PMCID: PMC3292897.
HIV Is Independent Risk Factor for Lung Cancer
According to research using VA data, HIV infection is an independent risk factor for lung cancer — increasing the likelihood of lung cancer by up to 70%.1
Researchers looked at 37,294 HIV-infected patients and 75,750 uninfected patients whose data was located in the VA Central Cancer Registry. The researchers calculated incidence rates of lung cancer, then adjusted for age, gender, race and ethnicity, smoking prevalence, previous bacterial pneumonia and chronic obstructive pulmonary disease.
The results showed that the rate of lung cancer for uninfected patients was 119 cases per 100,000 person-years. The rate for HIV-infected patients was 204 cases per 100,000 person-years. After adjusting for all the variables, the incidence rate ratio still was significant — 1.7.
Lung-cancer stage at presentation did not differ between the two groups. According to the researchers, this suggests that surveillance bias was an unlikely explanation for the finding and that HIV is a legitimate risk factor for lung cancer.
1: Sigel K, Wisnivesky J, Gordon K, Dubrow R, Justice A, Brown ST, Goulet J, Butt AA, Crystal S, Rimland D, Rodriguez-Barradas M, Gibert C, Park L, Crothers K. HIV as an independent risk factor for incident lung cancer. AIDS. 2012 Feb 29. [Epub ahead of print] PubMed PMID: 22382152.
NIH Study Finds Vitamin D Shrinks Fibroid Tumors In Rat Model
Vitamin D has been found to shrink fibroid tumors in rats, according to research funded by NIH.
Uterine fibroids are the most common noncancerous tumors in women of child-bearing age with 30% of women 25 to 44 years of age reporting fibroid-related symptoms. A recent analysis by NIH estimates the cost of fibroids to the United States at more than $34 billion in terms of healthcare and lost productivity. 1
According to the researchers, fibroids are three to four times more common in African-American women than in white women, and African-American women are approximately 10 times more likely to be deficient in vitamin D. In previous studies, researchers found that vitamin D inhibited the growth of human fibroid cells in laboratory cultures.
In this most recent study, small pumps were implanted under the skin of a group of rats, delivering a continuous dose of vitamin D for three weeks. Fibroids increased in size in the untreated rats, while tumors shrunk dramatically in those rats receiving vitamin D. 1
On average, the uterine fibroids were 75% smaller in the treated group.
The rats received the equivalent of more than twice the daily recommended dose of vitamin D for humans, although up to six times the daily recommended dose is still considered safe for adults.
1: Halder SK, Sharan C, Al-Hendy A. 1,25-Dihydroxyvitamin D3 Treatment Shrinks Uterine Leiomyoma Tumors in the Eker Rat Model. Biol Reprod. 2012 Feb 1. [Epub ahead of print] PubMed PMID: 22302692.
With pharmacists from across the DoD and VA clamoring for spots in the Clinical Pharmacy Course at Army Medical Department Center and School (AMEDDCS) in Fort Sam Houston, TX, organizers offered back-to-back programs this spring, with another scheduled for August.
A facility-specific survey found that 138 of 140 VA facilities reported shortages of medical officers, with psychiatry and primary care positions being the most frequently listed.