Premenopausal women who receive a surgical oophorectomy and adjuvant therapy along with a mastectomy may fare better if they are operated on during the second half of their menstrual cycle rather than the first half of their menstrual cycle, concludes a study in the May 1 issue of the Journal of the National Cancer Institute.
Richard R. Love, M.D., of the University of Wisconsin School of Medicine, and his coworkers compared survival outcomes of premenopausal women who underwent mastectomy alone with those who underwent mastectomy plus adjuvant oophorectomy and tamoxifen. The authors used the date of the woman’s first and last menstrual period to estimate the phase of the menstrual cycle when the surgeries were performed.
The phase of the menstrual cycle did not appear to affect survival outcomes of women who underwent mastectomy alone. However, women who received mastectomy plus adjuvant oophorectomy and tamoxifen during the luteal phase, or the second half, of their menstrual cycle had better disease-free and overall survival than women who underwent surgery during the follicular phase, or the first half, of their menstrual cycle. In contrast, the timing of surgery in women who only had a mastectomy did not appear to be associated with survival.
Socioeconomic Status Does Not Explain Association Between Mononucleosis and Hodgkin’s Lymphoma
A new study suggests that socioeconomic status has no bearing on the association between Epstein-Barr virus (EBV)-related infectious mononucleosis and Hodgkin’s lymphoma. The findings appear in the May 1 issue of the Journal of the National Cancer Institute.
Both EBV-related infectious mononucleosis and Hodgkin’s lymphoma have been associated with high socioeconomic status. Researchers have speculated that factors related to socioeconomic status could explain or contribute to the association between these diseases. To indirectly determine if this is true, Henrik Hjalgrim, M.D., of the Danish Epidemiology Science Centre in Copenhagen, and his colleagues identified roughly 42,000 relatives of people with EBV-related mononucleosis and determined each family member’s risk of developing Hodgkin’s lymphoma.
The authors found that the relatives were not at an increased risk for Hodgkin’s lymphoma. They conclude that factors associated with socioeconomic status are an unlikely explanation for the association between EBV-related infections mononucleosis and Hodgkin’s lymphoma.
Common Mutations in p53 May be Associated with Lung Cancer Risk
Common mutations of the p53 tumor suppressor gene may be associated with increased lung cancer risk and may affect p53 function, conclude Xifeng Wu, M.D., Ph.D., of the University of Texas M. D. Anderson Cancer Center, and her coworkers in the May 1 issue of the Journal of the National Cancer Institute.
Mutations in the p53 tumor suppressor gene have been associated with inherited lung cancer risk. Because there is a difference in the risk of lung cancer among different ethnic groups, Wu and her colleagues looked at associations between three common mutations, or polymorphisms, of p53 and the risk of lung cancer in Caucasians, African-Americans, and Mexican-Americans. Of the participants, 635 had lung cancer and 635 were cancer-free.
The authors found an association between the frequency of each polymorphism and ethnicity, with variant copies of the gene present most often in African-Americans and least often in Mexican-Americans. Each polymorphism was associated with an increased risk of lung cancer among all ethnic groups and was associated with changes in p53 function.
Circadian Rhythms May Influence Speed of Tumor Growth
A new study shows that when the part of the brain that controls circadian rhythms is destroyed in mice, tumor growth is accelerated. The findings appear in the May 1 issue of the Journal of the National Cancer Institute.
A part of the hypothalamus in the central nervous system known as the suprachiasmatic nuclei (SCN) controls circadian rhythms. Changes in circadian rhythms have been associated with poor survival of patients with metastatic colorectal or breast cancer. To study the effects of destroyed SCN on tumor growth, Francis Lévi, M.D., Ph.D., and Elisabeth Filipski of the Paul Brousse Hospital in France, and their colleagues destroyed the SCN of 75 mice and inoculated the mice with two types of tumors.
Mice whose SCN had been destroyed showed faster tumor growth and decreased survival rates compared with mice that underwent sham operations and had functional SCN. The authors conclude that the host circadian clock may play an important role in endogenous control of tumor progression.
Oral Anticancer Drugs and Patient Adherence
New oral anticancer drugs offer convenience and are becoming increasingly available but raise the issue of patient adherence to prescribed regimens. Poor adherence may be the greatest barrier to the effective use of new oral medications, particularly if oncologists do not recognize the problem.
In a review published in the May 1 issue of the Journal of the National Cancer Institute, Eric P. Winer, M.D., and Ann H. Partridge, M.D., of the Dana Farber Cancer Institute and their colleagues analyzed data from published studies of adherence to oral medications in general as well as adherence to anticancer drugs in adults and children.
The reviewers found that patient adherence to oral chemotherapy regimens is variable and hard to predict. Adherence rates ranged from less than 20% to 100% and certain populations such as adolescents posed particular challenges. Winer and his colleagues recommend that future efforts focus on improving measurements and predictions of adherence and on developing interventions to improve adherence, both in clinical trials and in standard practice.
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Journal
JNCI Journal of the National Cancer Institute